'Thank you for helping me remember a nightmare I wanted to forget': qualitative interviews exploring experiences of death and dying during COVID-19 in the UK for nurses redeployed to ICU
'Thank you for helping me remember a nightmare I wanted to forget': qualitative interviews exploring experiences of death and dying during COVID-19 in the UK for nurses redeployed to ICU
复制标题
“谢谢你帮助我记住一场我想忘记的噩梦”：对调到 ICU 的护士进行定性访谈，探讨英国 COVID-19 期间的死亡和临终经历
DOI：
10.1080/13576275.2022.2144356
复制
发表时间：
2022
期刊：
影响因子：
0.8
通讯作者：
Pilbeam C
中科院分区：
文献类型：
--
作者：
Pilbeam C
重症监护室（ICU）在英国新冠肺炎大流行期间成为关键的临终空间。许多护士从其他专业重新部署到ICU，导航不断变化的角色，优先事项和风险。有限的资源，包括时间，设备和人员配备扩大了护士的责任;病毒的传染性限制了家人的探视，即使在生命的最后。新兴文献探讨了新冠肺炎期间ICU的死亡，但很少关注护士的经历，尤其是那些重新部署的护士。在这里，我们探讨如何重新部署护士谈判这些相互竞争的需求，他们的情感和身体资源，并进行意义的决策，通过整合的框架“意义”与理论的应对。从两个基于英国的纵向定性研究，我们详细的深刻的变化，独特的挑战护士的身份，责任感和目的六名护士的采访。这包括采用未经测试的护理协议，降低“非必要”护理的优先级，并与患者/家属建立沟通仪式。了解护士如何谈判，并履行自己的角色时，护理范式显着不稳定，是至关重要的支持劳动力从倦怠，道德伤害和道德困扰的恢复。这项研究还为未来的应急响应管理提供了重要的学习，并扩展了生活经验如何映射到理论知识的知识。
Intensive Care Units (ICUs) became key end-of-life spaces during the Covid-19 pandemic in the UK. Many nurses were redeployed to ICU from other specialities, navigating changing roles, priorities, and risks. Limited resources including time, equipment, and staffing widened nurses’ responsibilities; the virus’ infectious nature restricted family visits, even at end of life. Emerging literature explores ICU deaths during Covid-19, but little focuses on nurses’ experiences, especially those redeployed. Here, we explore how redeployed nurses negotiated these competing demands on their emotional and physical resources, and undertook meaning-making, by integrating a framework of ‘sensemaking’ with theories of coping. Drawing on interviews with six nurses from two UK-based longitudinal qualitative studies we detail profound shifts that uniquely challenged nurses’ sense of identity, duty, and purpose. This included adopting untested caring protocols, de-prioritising ‘non-essential’ care, and establishing communication rituals with patients/families. Understanding how nurses negotiated and performed their roles when paradigms of care were dramatically destabilised is vital to supporting workforce recovery from burnout, moral injury, and moral distress. This research also provides important learning for the management of future emergency responses and extends knowledge of how lived experience maps onto theoretical knowledge.