Risks versus Responsibilities: Critical Care Nurses Experiences’ during Their Work with Suspected or Diagnosed COVID – 19 Patients

Background: Critical care nurses are exposed to serious risk and even death while
administering care for patients with COVID-19 as they are exposed to aerosol
generating procedures and longer periods of patient contact. According to the
American Nursing Association (ANA), “Risk exceeding the limits of duty is not
ethically obligatory; it is a moral option and nurses should carefully balance
between their professional job responsibilities and risks.” Despite the fact that
nurses have a professional obligation to care for critically ill patients with
diagnosed or suspected COVID - 19, many nurses experience conflicts and
stressors such as fear and anxiety about the risk of being infected and transmitting
the infection to their family members and other contacts. Exploring the experiences
that nurses’ face during their battle with the crisis will support them and help in
developing protocols and plans to improve their preparedness (ANA, 2015a &b; Al
Thobaity et al., 2020). Therefore, this study aimed to explore the critical care
nurses’ experiences during their work with diagnosed or suspected COVID – 19
patients. Methods: a descriptive –a cross-sectional design was used to conduct the
current study. Sample: a convenient sample of 80 critical care nurses who worked
in the critical care units at the Main University Hospital and agreed to participate in
the study were recruited. The tool was developed by the researcher based on
reviewing of both quantitative and qualitative studies published during 2019 and
2020 to bring the critical care nurses’ experiences together. Nurses’ experiences
were identified, analyzed, tabulated, and categorized into six main themes. Results:
analysis of the lived experiences faced the critical care nurses during their working
with suspected or COVID – 19 patients revealed that for the first theme, the
statements "I am afraid of becoming infected and infecting others)" and “There is a
shortage of staff” were reported as agree and strongly agree by about all of the
nurses. Regarding the second theme, a sense of obligation toward their profession
and saving the patients’ lives were agreed by the majority of the nurses. Moreover,
near of the three – a quarter of the nurses claimed the continuous availability of an
adequate amount of personal protective equipment” however, the majority of the
nurses had confidence in the government. They agreed that "the government has
strong prevention and control measures and that epidemic will be controlled very
soon” (theme 3). As regard theme (4), the majority of nurses was appreciated the
physical and psychological support received from the colleagues, families, and
donations provided by the companies, however, they claimed the hospital, Original Article
Egyptian Journal of Health Care, 2020 EJHC Vol.11 No.4
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syndicate, and the media due to the inadequate support and motivation. Concerning
coping strategies to alleviate moral distress (Theme 5), the result revealed that the
majority of the nurses were used positive coping strategies such as attending
webinars to enhance their knowledge about COVID – 19 & followed the safety
guidelines. Finally, all nurses perceived that the crisis makes them stronger and
nothing will beat them (Theme 6). Conclusions: risks versus responsibilities were
highlighted in this study. The nurses were experienced risks that potentiated a
feeling of a conflict. A conflict was raised between the nurses’ obligation to protect
their family members (especially their children) from transmission infection and
their obligations towards the job responsibilities (saving of the patients’ lives).
Shortage in the nursing staff, medical supplies, especially the personnel protective
equipment, inadequate support provided by administrative nursing bodies, and
sometimes, the media were also claimed by the majority of nurses. However, they
appreciated the support provided by their colleagues and families and they were
having confidence regarding the infection control strategies used by the infection
control units and the ability of the government to control the crisis very soon.