Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar;49(2):198-209.
doi: 10.1016/j.jen.2022.10.006. Epub 2022 Oct 21.

The Long Tail of COVID-19: Implications for the Future of Emergency Nursing

Heidi K Holtz, Guy M Weissinger, Deborah Swavely, Lisa Lynn, Angela Yoder, Bridgette Cotton, Thomas Adil, Mary Alderfer, Barb Romig, Kristen Neils, Cynda Hylton Rushton

The Long Tail of COVID-19: Implications for the Future of Emergency Nursing

Heidi K Holtz et al. J Emerg Nurs. 2023 Mar.

Abstract

Introduction: COVID-19 has led to exacerbated levels of traumatic stress and moral distress experienced by emergency nurses. This study contributes to understanding the perspectives of emergency nurses' perception of psychological trauma during COVID-19 and protective mechanisms used to build resilience.

Method: The primary method was qualitative analysis of semistructured interviews, with survey data on general resilience, moral resilience, and traumatic stress used to triangulate and understand qualitative findings. Analyses and theme development were guided by social identity theory and informed by the middle range theory of nurses' psychological trauma.

Results: A total of 14 emergency nurses were interviewed, 11 from one site and 3 from the other. Almost all nurses described working in an emergency department throughout the pandemic as extraordinarily stressful, morally injurious, and exhausting at multiple levels. Although the source of stressors changed throughout the pandemic, the culmination of continued stress, moral injury, and emotional and physical exhaustion almost always exceeded their ability to adapt to the ever-changing landscape in health care created by the pandemic. Two primary themes were identified: losing identity as a nurse and hopelessness and self-preservation.

Discussion: The consequences of the pandemic on nurses are likely to be long lasting. Nurses need to mend and rebuild their identity as a nurse. The solutions are not quick fixes but rather will require fundamental changes in the profession, health care organizations, and the society. These changes will require a strategic vision, sustained commitment, and leadership to accomplish.

Keywords: COVID-19; Emergency department; Moral resilience; Nurses; Trauma.

PubMed Disclaimer

Comment in

References

    1. Hooper C., Craig J., Janvrin D.R., Wetsel M.A., Reimels E. Compassion satisfaction, burnout, and compassion fatigue among emergency nurses compared with nurses in other selected inpatient specialties. J Emerg Nurs. 2010;36(5):420–427. doi: 10.1016/j.jen.2009.11.027. - DOI - PubMed
    1. Hunsaker S., Chen H.C., Maughan D., Heaston S. Factors that influence the development of compassion fatigue, burnout, and compassion satisfaction in emergency department nurses. J Nurs Scholarsh. 2015;47(2):186–194. doi: 10.1111/jnu.12122. - DOI - PubMed
    1. Meadors P., Lamson A., Swanson M., White M., Sira N. Secondary traumatization in pediatric healthcare providers: compassion fatigue, burnout, and secondary traumatic stress. Omega (Westport) 2009;60(2):103–128. doi: 10.2190/om.60.2.a. - DOI - PubMed
    1. Pich J., Hazelton M., Sundin D., Kable A. Patient-related violence against emergency department nurses. Nurs Health Sci. 2010;12(2):268–274. doi: 10.1111/j.1442-2018.2010.00525.x. - DOI - PubMed
    1. Speroni K.G., Fitch T., Dawson E., Dugan L., Atherton M. Incidence and cost of nurse workplace violence perpetrated by hospital patients or patient visitors. J Emerg Nurs. 2014;40(3):218–295. doi: 10.1016/j.jen.2013.05.014. - DOI - PubMed