Navigating redeployment during COVID- 19 : the experiences of nurses without critical care background in the ICU

Abstract

Background: The COVID-19 pandemic posed multiple challenges in healthcare systems including staff shortages and a significant increase in critical care admissions. For this reason, a lot of nurses had to be redeployed to the ICU without prior intensive care background, facing various challenges both professionally and emotionally. Understanding the lived experiences of these nurses is important for improving future crisis situations. Objectives: This study aimed to identify the challenges that redeployed nurses faced in the ICU during the pandemic including skill gaps, emotional and psychological challenges and logistical difficulties. It also aimed to examine the coping mechanisms employed by the nurses and evaluate the adequacy of training and support available from pre-redeployment and throughout. Additionally, the study explored the professional and personal impact including nurses’ perceptions of the process as well as its influence on their growth and career trajectories. It aimed to provide recommendations to enhance aspects such as training, support and preparedness for future similar situations. Design: A qualitative study employing an interpretative phenomenological analysis (IPA) design was used to study the research question. Setting: The study was conducted in Mater Dei Hospital (MDH) in wards that participated in the redeployment of their nurses to the ICU. Participants: A purposive sample of six nurses, four females and two males redeployed to the ICU during the 1st and 2nd waves of the pandemic participated in the study. Method: Semi- structured interviews were conducted with the participants face- to face. The interviews lasted between 20- 60 minutes each and were done using an interview guide. Data from the interviews was transcribed verbatim and analyzed using the IPA analysis framework in order to interpret how participants made sense of their redeployment experience and to draw the appropriate conclusions from their accounts. Findings: Five group experiential themes with 17 sub- elements emerged from the analysis of the data collected. These themes were mainly: i) Navigating redeployment- experiences and challenges ii) Psychological and emotional impact of redeployment iii) Coping strategies and support systems iv) Professional growth and learning through redeployment v) Lessons learned and future considerations. These findings reveal a complex connection between vulnerability, resilience and adaptation. While participants experienced fear and other psychological challenges they also reported the development of a renewed sense of purpose and professional development. Conclusion: This research reveals the effects of rapid redeployment during emergencies on the nurses and emphasizes the need for systemic, evidence- based approaches and the development of a structured redeployment process that includes training and support for future crisis situations. The findings also provide insights for leaders and policymakers aiming to enhance crisis preparedness.