‘THE TERROR AND THE PRIDE’: A THEORETICALLYINFORMED, MIXED METHOD STUDY OF THEIMPACT ON REDEPLOYED NURSES OF WORKINGIN ICU DURING THE PANDEMIC

Background: Multiple surges in critical care admissions during the pandemic necessitated the rapid redeployment of nurses from other clinical areas. The majority of redeployed nurses (RDNs) had little or no experience of critical care and received variable training and/or support1. Little is known about their experiences.
Aim: To explore the impact on, and experiences of, nurses redeployed into critical care during the pandemic.
Method: Mixed methods exploration, using the Job Demand-Resources (JDR) model of occupational stress2. Data were collected from RDNs and critical care nurses (CCNs) between May 2021–22 (waves 2 and 3 of the pandemic). The quantitative component comprised well-validated surveys that captured the model's key constructs, including job demands (e.g., mental load), job resources (e.g., staffing), health impairment (e.g., burnout) and organisational outcomes (e.g., quality and safety of patient care).Surveys were completed by 200 RDNs and regression analyses identified predictors of health impairment and organisational outcomes. Qualitative exploration comprised individual semi-structured online or telephone interviews with 16 redeployed nurses. The interview schedule was iteratively developed around the JDR model and data were analysed deductively.
Results: In survey data, 75% of RDNs reached the threshold for psychological distress.50% reported burnout and/or emotional exhaustion and ~33% reported clinically concerning PTSD symptoms equivalent with CCNs. However, RDNs reported greater job satisfaction, and higher patient safety and quality of care than CCNs. Interviews revealed divergent experiences, from the ‘terror… of not knowing what you do not know’, to deep personal and professional satisfaction. Training and support from both pre-redeployment and critical care managers was important, as was camaraderie, and a sense of belonging within the critical care team.
Implications for practice: Working in critical care during the pandemic presented unique challenges for redeployed nurses, with a significant (and likely enduring) impact on their psychological well-being. They too will require support to recover.