TY - JOUR
T1 - The Long Tail of COVID-19
T2 - Implications for the Future of Emergency Nursing
AU - Holtz, Heidi K.
AU - Weissinger, Guy M.
AU - Swavely, Deborah
AU - Lynn, Lisa
AU - Yoder, Angela
AU - Cotton, Bridgette
AU - Adil, Thomas
AU - Alderfer, Mary
AU - Romig, Barb
AU - Neils, Kristen
AU - Rushton, Cynda Hylton
N1 - Publisher Copyright:
© 2022 Emergency Nurses Association
PY - 2023/3
Y1 - 2023/3
N2 - 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.
AB - 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.
KW - COVID-19
KW - Emergency department
KW - Moral resilience
KW - Nurses
KW - Trauma
UR - http://www.scopus.com/inward/record.url?scp=85145269282&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85145269282&partnerID=8YFLogxK
U2 - 10.1016/j.jen.2022.10.006
DO - 10.1016/j.jen.2022.10.006
M3 - Article
C2 - 36503829
AN - SCOPUS:85145269282
SN - 0099-1767
VL - 49
SP - 198
EP - 209
JO - Journal of Emergency Nursing
JF - Journal of Emergency Nursing
IS - 2
ER -