Nurses' perceptions and demands regarding COVID-19 care delivery in critical care units and hospital emergency services

Abstract

Background: The COVID-19 pandemic is a public health challenge that puts health systems in a highly vulnerable situation. Nurses in critical care units (CCUs) and hospital emergency services (HESs) have provided care to patients with COVID-19 under pressure and uncertainty.

Objective: To identify needs related to safety, organisation, decision-making, communication and psycho-socio-emotional needs perceived by critical care and emergency nurses in the region of Madrid, Spain, during the acute phase of the epidemic crisis.

Methods: This is a cross-sectional study (the first phase of a mixed methods study) with critical care and emergency nurses from 26 public hospitals in Madrid using an online questionnaire.

Results: The response rate was 557, with 37.5% reporting working with the fear of becoming infected and its consequences, 28.2% reported elevated workloads, high patient-nurse ratios and shifts that did not allow them to disconnect or rest, while taking on more responsibilities when managing patients with COVID-19 (23.9%). They also reported deficiencies in communication with middle management (21.2%), inability to provide psycho-social care to patients and families and being emotionally exhausted (53.5%), with difficulty in venting emotions (44.9%).

Conclusions: Critical care and emegency nurses may be categorised as a vulnerable population. It is thus necessary to delve deeper into further aspects of their experiences of the pandemic.

Keywords: COVID-19 [supplementary concept]; Emergency service; Health planning guidelines; Health services research; Hospital; Intensive care units; Needs assessment; Nursing services.

Fig. 1

Description of the data collection period (COVID-19 cases reported, deaths, and patients recovered in Spain) and questionnaires completed. Source of epidemiological data: Spanish Ministry of Health, Consumer Affairs, and Social Welfare.