A nurse changes out gloves while New Jersey National Guard Airmen direct traffic at a COVID-19 Community-Based Testing Site at the PNC Bank Arts Center in Holmdel, N.J., on March 23, 2020. File Photo by Master Sgt. Matt Hecht/U.S. Air National Guard/UPI | License Photo
Frontline nurses were plagued by "moral distress" in the early days of the pandemic because they lacked the support to provide high-quality care, a new report reveals.
Between May and September 2020, researchers interviewed 100 nurses across the United States who cared for COVID-19 patients.
The nurses reported moral distress caused by knowing how to treat patients and protect themselves, but not having the necessary staff, equipment or information. This led to feelings of fear, frustration, powerlessness and guilt.
"We go into nursing with the intention of saving lives and helping people to be healthy," said study co-author Shannon Simonovich, an assistant professor of nursing at DePaul University School of Nursing, in Chicago. "Ultimately, nurses want to feel good about the work they do for individuals, families and communities."
The study participants expressed many types of frustration, including disappointment with healthcare officials being out of touch with frontline staff.
Nurses felt powerless to protect themselves and others from infection, and said they faced difficult patient care experiences that triggered guilt about letting down patients and their families, as well as others on the healthcare team.
The report was published online recently in the journal SAGE Open Nursing.
The study authors noted that frontline nurses have faced exceptional physical and mental health demands during the COVID-19 pandemic, and their opinions could help guide efforts to reduce nurse burnout and keep them on the job.
"People need to listen to nurses more, and nurses need to feel empowered to share their experiences at every level of leadership," Simonovich said in a university news release.
What's needed? Clear, safe standards for nurses that will be legally binding and hold hospitals and healthcare agencies accountable, according to the researchers.
They noted that 65% of the nurses in the study identified as a member of a racial, ethnic or gender minority group, providing a realistic representation of U.S. nursing.
As media coverage of "nurse heroes" in the pandemic fades, the experiences described by the nurses in this study should be a call to action, said Kim Amer, an associate professor at DePaul with 40 years of nursing experience.
"Nurses need to come together as a profession and make our standards and our demands clear," Amer said. "We are a largely female profession, and we don't complain enough when things are tough. As a faculty member, we teach students that it's OK to refuse an assignment if it's not safe. We need to stand by that."
More than 3,300 U.S. nurses, doctors, social workers and physical therapists died of COVID-19 between February 2020 and February 2021, according to DePaul researchers.
For more on nurses and the COVID-19 pandemic, go to Duke University's Margolis Center for Health Policy.
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