Date of Completion

2021

Document Type

Thesis

Degree Name

Bachelor of Science in Nursing

Keywords

COVID-19, Nurses

Abstract

Purpose Statement The purpose of the study was to describe the experiences of nurses who handled moderate to severe cases of COVID-19 patients who were admitted to the hospitals regardless of the number of days the patients stayed in the hospital. Further, the study aimed at capturing the nurses’ subjective experiences of being at the frontline of caring for the aforementioned COVID19 patients and the personal meaning the nurses discovered in caring for them. The general question asked to the participants was: What are your experiences in handling COVID-19 patients as a nurse frontliner? (Ano-ano ang iyong mga karanasan bilang isang nurse na nag-aalaga ng mga pasyenteng may COVID19)?

Scope and Limitations of the Study The researchers selected participants who were registered nurses regardless of their age and gender from different hospitals. Participants were registered nurses who were working in the hospital and experienced in giving bedside care, nursing intervention, and management to patients regardless of the number of days they cared for the patients, and their working experience with COVID-19 patients. The patients were confirmed positive with COVID-19 and were categorized as moderate to severe. Primarily, the researchers were supposed to target participants from different parts of the Philippines, but due to lack of connections, participants were only limited to CALABARZON (Cavite, Laguna, Batangas, Rizal, and Quezon), specifically from Southern Tagalog. The number of participants depended on data saturation, which means that as information kept increasing and repetitively occurring, thick enough to form themes, a point when no new ideas or information are shared by the participants anymore is reached (Fernandez, 2020). The study focused on the experiences of the nurses during the outbreak of COVID-19 in the year 2020, regardless of when they started handling COVID-19 patients. In qualitative research, the data are usually collected from a few persons as participants; a small number assures depth of exploration of experiences and manageable dearth, not the quantity of information that is also analyzed in-depth (Polit & Beck, 2017). Quality, not quantity of information is what is vital in qualitative investigations. In this study, the verbalization of the experiences of nurses in handling COVID-19 patients provided deep insights, not generalizable to a larger population. In terms of the limitations of the study, the researchers foresaw technological disturbances during online interviews since the data gathering would be done virtually. The researchers, therefore, let the participants know beforehand that there might be a possibility of interviewers to not clearly understand what the participants would say, and vice versa, or that there might be sudden ruffling of sounds. The researchers informed them of possible rescheduling of the interview. The researchers assured them, however, that all possible efforts would be exerted to achieve efficiency of internet connections during the interview. In the actual data gathering, the researchers have encountered minimal difficulty in terms of internet connectivity which was also resolved. Another limitation the researchers foresaw was the possible refusal of the participants to be interviewed through video call, which could have facilitated the observation of non-verbal cues. The pandemic has somehow discouraged people to come out to the open, for fear that they might be suspected as infected since they had been in constant contact with positive COVID-19 patients and be ostracized. Some health workers already experienced being discriminated upon. This time around in this study, the researchers somehow anticipated a certain degree of hesitancy on the part of the nurse participants to be fully identified, no matter how much the researchers assured anonymity. Only one from among the participants agreed to be seen virtually through video call and the rest preferred to answer through audio call, not showing their faces. To maximize the understanding of non-verbal information, the researchers listened intently to changes in the tone, the volume, and inflection of the voice of the participants while narrating their stories. Follow-up open-ended questions also helped in capturing the underlying meanings of what the participants shared.

Methodology The study employed a descriptive qualitative research design. The information gathered from this study consisted in subjective accounts of experiences from the nurses obtained through online interviews using an appropriate virtual platform preferred by the participants as convenient to them. During the interviews, the researchers used an audio recorder after securing the consent of the participants. The interview provided an answer to the question, ‘What are your experiences on handling COVID-19 patients?’ (Anoano ang iyong mga karanasan bilang isang nurse na nag-aalaga ng mga pasyenteng may COVID-19).

Findings After the data were analyzed, five themes and 16 sub-themes were identified. The first theme, “The Unforeseen Onset,” showed mixed emotions and feelings that the participants endured during such a vulnerable situation as a pandemic. This theme reveals how difficult it was to adapt to a sudden change. The nurses sacrificed several things, such as quality time with their families. This also affected their mental and physical health. Data revealed that the participants did not see beforehand that the COVID-19 surge would be significant. With the sudden change, they were not able to prepare. Protocols and approaches to patients were changed, workloads increased since hundreds of thousands of people were infected by the said virus. The majority of the participants narrated that they felt stressed, scared, depressed, and burned out. Most of them were anxious about being infected by the virus because they were in close contact with the COVID-19 patients as the handson care providers. The disease frightened them more, upon knowing that there was no sure direction towards treatment outcomes. Curative approaches were still being explored. The second theme is “Spiraling Negative Thoughts.” This theme speaks of the emotions the participants conveyed related to a situation without certainty of ending. The pandemic became the number one stressor to healthcare workers. Facing the pandemic became the most challenging phase in the nurses’ working years. The participants were worried for themselves since they lacked PPEs (Personal Protective Equipment). They were worried also for their families who were vulnerable to contamination because they, the nurses, were potential carriers to their homes. Amidst this battle against the pandemic, the participants, the nurses, felt alone and neglected. At times they almost lost hope. Seeing their patients suffer from the disease made them feel sad, on top of overwhelming workloads they faced day by day. The physical and emotional struggle the nurses faced spiraled at every turn of a bleak journey on a road which has never been travelled before the pandemic. The third theme, “Dilemma in Professional Responsibilities,” shows how scared the participants were of the virus to the extent that that their mental health was challenged. Their dilemma revolved around a conflicting desire to be of service on one hand, and of running away from the situation on the other. They faced mounting problems in their tour of duty in the clinical areas. They had to hurdle scarcity of equipment, inadequate number of beds for patients, and lack of medical staff. Consequently, their peace of mind was shattered. With increasing number of COVID-19 cases, the nurse frontliners' responsibilities also increased. It was not impossible to feel pressured. They had no more time to care for themselves; hence, they got physically and mentally drained. In short, they were burned out but could not simply run away. They had to stay at the battlefront against the pandemic. The fourth theme, “Health and Self-care at Risk,” shows how the participants lacked time to care for themselves. It delineates the difficulties and worries they faced since the onset of the COVID-19 outbreak, and how the surge in cases affected their health. Several confirmed COVID-19 cases were confined in the hospitals, so the nurses missed their desired resting time. Their 12-hour shift covering an increased workload would sometimes extend to a few hours more. The patients’ lives had to be prioritized, so the nurses’ health was sacrificed somehow. Extended worktime and increased workload put them at risk of weakening their immune system. Self-care was set aside, uncertain when to pay attention to it again. Lastly, the fifth theme, “Growth Under Pressure,” shows how the participants’ experiences during the pandemic made them stronger than in earlier situations in their career. During the pandemic, they gained more knowledge and skills in caring for patients. The participants also shared that they became more confident in facing the responsibilities related to their job as nurses. Moreover, they were able to focus on the tasks at hand and to work well, even under pressure. Most important of all, they claimed having adapted to the difficult situation without losing their compassion in the midst of work which had the potential to make warm-blooded humans to turn cold. The participants saw the pandemic as an opportunity to reflect on their profession as a calling.

Conclusion The findings of this study led to the conclusion that the nurses who work as frontliners in the healthcare institutions consider handling COVID-19 patients as one of the most memorable events of their lives. The 12 participants mentioned that several consequences surfaced from handling COVID-19 patients, which affected their mental health. Such consequences ranged from the difficulty of adapting to changes and the inadequacy of experiences related to COVID-19 cases, to the various challenges that they endured due to the changes in the protocols observed in the hospitals. However, despite all the challenges that they have experienced, they still managed to smile in front of their patients, providing them maximum healthcare even if during their tour of duty these nurses were already physically, emotionally, and mentally exhausted. Most importantly, they managed to see the bright side of the pandemic, looking at it as an opportunity for significant experiences with unforgettable life lessons that would guide them personally and professionally. Their experiences in handling COVID-19 patients transformed them into individuals who would look after one another’s welfare. The pandemic accordingly also showed them what they were capable of as they developed in knowledge and skills at the frontline as days went by. Compared to the first few months of being exposed to care for COVID-19 patients, their confidence in themselves was better as their exposure progressed in the next months that followed. Based on their narratives, it can also be concluded that a trying situation such as that of being at the frontline to handle COVID-19 patients could put one’s faith to the test: faith in people and faith in God. With a sense of triumph, the participants concluded that their faith has not been shattered.

First Advisor

Joselita M. Bongcaron, RN, MHPEd, PhD

Download

Share

COinS