Nurse's experience in giving nursing care to Covid-19 patients

Siregar, Hotma Royani; Simamora, Febrina Angraini; Daulay, Nanda Masraini; Ritonga, Sukhri Herianto; Simamora, Asnil Adli; Harahap, Mei Adelina; Sagala, Nanda Suryani; Napitupulu, Natar Fitri; Antoni, Adi; Alwi, Fahrizal; Napitupulu, Mastiur
doi:10.1016/j.enfcli.2022.03.017
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Starting from the phase when the Global Pandemic COVID-19 outbreak entered Indonesia&#44; Nurse is a profession that must carry out its professional obligations to be at the front line of tackling this virus in nursing care&#46; When most workers do work at home&#44; one of the health workers who still have to work and continue to serve is a nurse&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The nursing profession during the COVID-19 pandemic was challenged to provide professional nursing care with the risk of contracting and even becoming victims of COVID-19&#46; The duty of a nurse in the COVID-19 pandemic is to meet the basic needs of patients and provide education so that patients can take preventive measures in the event of a similar case&#46; Although the chain of transmission has not been broken&#44; nurses must continue to carry out their duties by providing nursing care for infected patients&#46; During a pandemic&#44; nurses together with their peers need to decide how much care they can give to others in addition to caring for themselves&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Nurses at hospitals who treat COVID-19 patients are faced with two choices&#44; namely continuing to work by upholding professionalism or prioritizing personal and family safety&#46; Nurses have a very important role in providing promotive&#44; preventive&#44; and nursing care services in the COVID-19 pandemic&#46; Nurses who are currently involved in the care of COVID-19 patients in all hospitals around the world have sacrificed personal and family interests&#46; Nurses have sacrificed safety and face the threat of contracting a virus that could end in death&#46; The purpose of this study is to describe Nurse&#39;s experience in giving nursing care to covid-19 patients&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">This research uses a qualitative study with a phenomenology design&#46; This design was chosen so that participants&#8217; experiences could be explored more clearly so that the description of the nurses experience during giving nursing care to Covid-19 patients could be clearly illustrated&#46; This method is very appropriate to be used to explore the phenomenon of nurse&#39;s experience because each nurses has his own experience in giving nursing care&#46; The study was conducted in the regional hospital in Padangsidimpuan city&#46; Because the hospital became referral hospital for Covid-19 patients from several surrounding places of South Tapanuli Area&#46; The study began in June September 2020&#44; data collection was conducted in July to August 2020&#46; The number of participants in this study was 6 participants&#46; Participants were taken using purposive sampling with inclusion criteria&#58; willing to be a participant&#44; become covid-19 nurse and giving nursing care to Covid-19 patients&#46; Participants in this study have agreed to provide information and have been kept confidential by the researcher by not including the participant&#39;s name</p><p id="par0025" class="elsevierStylePara elsevierViewall">Data collection used in-depth interviews conducted by researchers with a duration of 50&#8211;60<span class="elsevierStyleHsp" style=""></span>min by telephone to record interviews&#46; The interview was carried out several times to obtain data saturation&#46; Data collection tools in this study were demographic data questionnaires&#44; interview guidelines&#44; and mobile phones&#46; The interview guide consisted of 5 open-ended questions such as motivation to become a Covid-19 nurse&#44; nurse emotional response&#44; problems faced by nurses when providing nursing care&#44; benefits of being a nurse during the Covid-19 pandemic&#44; and nurse expectation&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Qualitative data analysis using the Colaizzi model with 7 stages ranging from reading all the contents of the interview&#44; identifying significant statements&#44; formulating meaning&#44; clustering themes&#59; developing an exhaustive description&#44; producing the fundamental structure&#44; and seeking verification of the fundamental structure&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> Ethical approval was approved by the Universitas Prima Indonesia Health Research Ethics Commission &#40;064&#47;KEPK&#47;UNPRI&#47;III&#47;2021&#41;&#46; The limitation in this research is that triangulation of sources&#44; methods and theories is not done&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">The characteristics of participants</span><p id="par0035" class="elsevierStylePara elsevierViewall">The number of respondents in this study were 6 nurses&#46; 4 female nurses&#44; and 2 male nurses&#46; Age between 33 and 38 years old 4 nurses&#44; and age between 25 and 32 years old 2 nurses&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">There were 5 themes emerged from this study&#44; namely&#58;</p><p id="par0045" class="elsevierStylePara elsevierViewall">&#40;1&#41; Motivation of nurses to Provide Nursing care in the COVID-19 pandemic&#44; &#40;2&#41; nurse emotional response&#44; &#40;3&#41; patient emotional response&#44; &#40;4&#41; Problems faced by nurses&#44; &#40;5&#41; The expectations of the nurse&#46;</p><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Theme 1&#46; Motivation of nurses to Provide Nursing care in the COVID-19 pandemic</span><p id="par0055" class="elsevierStylePara elsevierViewall">Nurses explained that their motivation to provide nursing care in the COVID-19 pandemic was because it was an obligation for nurses to provide nursing care to patients regardless of their condition&#46; And also nurses can get experience how to care the patient with Covid-19&#46;<span class="elsevierStyleDisplayedQuote" id="dsq0005"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">&#8220;yes&#44; nurses still have to provide nursing care&#44; it is our duty to provide nursing care&#44; and we also know about COVID-19&#44; and also we can have experience giving nursing care to the COVID-19 patients&#8221; &#40;P2&#41;</span></p></span></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Theme 2&#46; Nurse Emotional Response</span><p id="par0065" class="elsevierStylePara elsevierViewall">Providing nursing care in the COVID-19 pandemic was still carried out by nurses&#46; There was a feeling of pleasure and it became a challenge to be able to provide nursing care to patients&#46; However&#44; there were nurses who also felt afraid of being infected with COVID-19 and felt uncomfortable with the stigma from the community towards nurses who provide services during the COVID-19 pandemic&#46;<span class="elsevierStyleDisplayedQuote" id="dsq0010"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">&#8220;i am happy giving care to patients&#44; even though there is a fear of contracting them from patients&#8221; &#40;P5&#41;</span></p></span><span class="elsevierStyleDisplayedQuote" id="dsq0015"><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">&#8220;afraid of being infected with covid-19 from patients&#44; anxious and stressed also taking care of covid-19 patients&#8221; &#40;P4&#41;</span></p></span><span class="elsevierStyleDisplayedQuote" id="dsq0020"><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">&#8220;people are afraid to see uss&#44; they think the nurses will transmit COVID-19 to others&#8221; &#40;P3&#41;</span></p></span></p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Theme 3&#46; Patient Emotional Response</span><p id="par0075" class="elsevierStylePara elsevierViewall">The majority of COVID-19 patients felt anxious and sad such as the patient crying&#44; being anxious and feeling sad&#46; But some patients felt happy because they were cared for by the nurse&#44; considered by their family and got support and motivation from nurses&#46;<span class="elsevierStyleDisplayedQuote" id="dsq0025"><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">&#8220;Patients sometimes cry because they feel sad about their illness&#44; so they feel stressed when they are treated &#8220;&#40;P4&#41;</span></p></span><span class="elsevierStyleDisplayedQuote" id="dsq0030"><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">&#8220;There are also those who refuse to be treated&#44; but over time they also want to be treated&#8221; &#40;P5&#41;</span></p></span><span class="elsevierStyleDisplayedQuote" id="dsq0035"><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">&#8220;Some of them feel happy because they are not alone in the isolation room&#44; they treated us like their family&#8221; &#40;P3&#41;</span></p></span><span class="elsevierStyleDisplayedQuote" id="dsq0040"><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">&#8220;We give them attention and motivation so they feel like we are their family and also they feel like they are in their home&#8221; &#40;P5&#41;</span></p></span></p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Theme 4&#46; Problems faced by nurses</span><p id="par0085" class="elsevierStylePara elsevierViewall">There are many problems that should be handled by nurses while caring for the patient&#44; such as personal protective equipment&#44; difficulty meeting basic needs and the impact of wearing hazmat suits&#46;<span class="elsevierStyleDisplayedQuote" id="dsq0045"><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">&#8220;when you wear hazmat clothes&#44; sometimes it&#39;s hard to breathe&#44; sweat is pouring out and your clothes get wet&#8221; &#40;P4&#41;</span></p></span><span class="elsevierStyleDisplayedQuote" id="dsq0050"><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">&#8220;Wearing hazmat clothes&#44; you can&#8217;t eat and drink&#44; sometimes you want to pee&#44; you have to hold it until you finish the task&#44; the clothes are only disposable&#46;&#8221; &#40;P6&#41;</span></p></span></p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Theme 5&#46; The expectations of nurses</span><p id="par0095" class="elsevierStylePara elsevierViewall">Nurses hope that the community does not stigmatize patients and nurses who work in health services and also the community must comply with the health protocols set by the government&#46; Hospitals and the government should give rewards to nurses who treat COVID-19 patients&#46;<span class="elsevierStyleDisplayedQuote" id="dsq0055"><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">&#8220;I hope that society does not stigmatize patients and nurses who work in nursing care&#8221; &#40;P2&#41;</span></p></span><span class="elsevierStyleDisplayedQuote" id="dsq0060"><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">&#8220;It is my hope that the public will comply with the health protocol recommended by the government&#44; so that they can prevent the transmission of COVID-19&#8221; &#40;P1&#41;</span></p></span></p></span></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0100" class="elsevierStylePara elsevierViewall">The study found that the obligation of nurses to provide nursing care to patients was a motivation to treat Covid-19 patients&#46; Nurses did not regret choosing nursing as a profession&#46; They had the motivation to treat COVID-19 patients and were obliged to help people who need care&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> Nurses also gained experience in providing nursing care to Covid-19 patients&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Negative emotions such as the feeling of fear of contracting COVID-19 from patients are experienced by nurses when providing nursing care during the COVID-19 pandemic&#46; Health workers experience fear&#44; especially at the increased risk of exposure&#44; infection and the possibility of infecting their loved ones also becomes a burden&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> Many health workers have had to isolate themselves from their family and closest people even though they don&#8217;t have COVID-19&#46; The study found that nurses who worked in providing nursing care to patients during the COVID-19 pandemic were stigmatized by society&#46; People were afraid of getting infected from nurses who treat patients infected with COVID-19&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">The study found that nurses were happy to be able to provide nursing care to COVID-19 patients&#46; Nurses have positive emotions such as happiness&#44; which simultaneously or gradually appear with negative emotions during an outbreak&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> Support from hospitals and patients makes nurses enthusiastic and responsible for treating COVID-19 patients&#46; Mutual respect&#44; teamwork&#44; family and team support bring happiness&#46; The hospital had a reward and welfare system to support and motivate nurses&#46; Coworkers&#8217; encouragement also brings happiness to nurses and other forms of social support are important for nurses&#8217; feelings of appreciation&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">The study found that patients were happy while receiving treatment in the isolation room&#46; Nurses provide support and motivation to patients so they are not stressed during treatment and treat patients like family&#46; With the motivation and support of nurses will have a positive impact on the patient so that the patient is not sad about his situation&#46; The feeling of pleasure will create a good relationship between nurses and patients&#44; so that patients will be cooperative when receiving nursing care&#46; Before patients go home&#44; COVID-19 nurses also always provide health education related to preventing COVID-19 transmission&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Negative responses are also felt by patients&#44; sometimes cry and always look sad and do not accept the disease they are suffering from&#46; In fact&#44; sometimes patients refuse to be given nursing care by nurses even though nurses always provide support to patients so that patients are willing to accept the reality of their illness&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">The stress experienced by patients is caused by various things&#44; such as patients thinking that COVID-19 is a deadly disease so that patients always feel sad&#44; especially when patients are treated in isolation rooms without any accompanying family&#46; The existence of stigma has also exacerbated the stress level of Covid-19 patients and this is also experienced by patients who have been treated in the COVID-19 isolation room&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Nurses who wear Personal Protective Equipment &#40;PPE&#41; such as wearing hazmat suits when providing nursing care feel uncomfortable&#44; such as difficulty breathing&#44; experiencing excessive sweating and always feeling thirsty&#46; When the nurse is wearing the hazmat suit the nurse cannot open the PPE before completing her task&#46; So that the basic needs of nurses sometimes cannot be met while wearing hazmat suits&#46; As stated by one of the nurses who worked at the hospital&#44; wearing hazmat suits felt hot and sweaty and had difficulty breathing caused by the long use of hazmat&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">The problem faced by nurses in providing nursing care was that patients and families do not comply with health protocols&#46; This finding is in line with other studies which state that the public does not comply with the government&#39;s appeal about the dangers of COVID-19 and the public considers that COVID-19 was just an ordinary virus&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> Lack of awareness from the community itself regarding the importance of using personal protective equipment for the prevention of COVID-19&#46; The government&#39;s Covid-19 task force unit is increasingly aggressive in breaking the chain of transmission of COVID-19&#44; so that people are aware of following health protocols&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The study found that being a COVID-19 nurse&#44; all nurses felt like family&#44; because while providing nursing care&#44; nurses had to stay in the hospital&#44; thus making fellow COVID-19 nurses closer and feeling like they had a new family&#46; In addition&#44; nurses also feel very excited to provide nursing care to patients and a sense of empathy for patients is increasing&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">After giving nursing care to COVID-19 patients&#44; nurses hope that the public will comply with the health protocols set by the government so that the incidence of COVID-19 does not increase&#46; In addition&#44; the nurse also hopes that society will eliminate the stigma against patients and nurses&#44; so that patients and nurses can live their lives as usual without discrimination from the community&#46; Because with the COVID-19 pandemic&#44; nurses&#8217; anxiety and depression levels have increased&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> The nurses hope that there will be incentives provided by hospitals and local governments for their duties to provide nursing care during the COVID-19 pandemic</p><p id="par0150" class="elsevierStylePara elsevierViewall">The conclusions in this study provide evidence of how nurses experience while providing nursing care to patients infected with COVID-19&#46; Nurses experience significant personal risk and emotional burden and nurses present a strong dedication to continuing to care for sick patients and do not regret working as nurses&#46; However&#44; nurses need support from various parties so that they can have strong motivation while providing nursing care to help break the chain of transmission of COVID-19&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflict of interest</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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              "titulo" => "The characteristics of participants"
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                  "identificador" => "sec0035"
                  "titulo" => "Theme 1&#46; Motivation of nurses to Provide Nursing care in the COVID-19 pandemic"
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                1 => array:2 [
                  "identificador" => "sec0040"
                  "titulo" => "Theme 2&#46; Nurse Emotional Response"
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                  "identificador" => "sec0045"
                  "titulo" => "Theme 3&#46; Patient Emotional Response"
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                3 => array:2 [
                  "identificador" => "sec0050"
                  "titulo" => "Theme 4&#46; Problems faced by nurses"
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                4 => array:2 [
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                  "titulo" => "Theme 5&#46; The expectations of nurses"
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          "titulo" => "Discussion"
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            1 => "Nursing care"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The objective was to describe Nurse&#39;s experience in giving nursing care to covid-19 patients&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Phenomenology design was used in this study&#46; Participants in this study were nurses who provided nursing care for COVID-19 patients&#46; Participant data were obtained from the nursing office and contacted via cell phone to become participants&#46; After data saturation the researcher found six nurses as participants&#46; In-depth interviews were conducted from July to August 2020 to explore the experiences of nurses giving nursing care to Covid-19 patients&#46; Data was analyzed using the Colaizzi method&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Result</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We found five themes of nurses giving nursing care to Covid-19 patients&#46; The themes include the Motivation of nurses to provide nursing care during the COVID-19 pandemic&#44; the nurse emotional response&#44; the patient emotional response&#44; the problems faced by COVID-19 nurses&#44; and the expectations of the nurses&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Nurses need support while giving nursing care to Covid-19 patients to break Covid-19 transmission&#46;</p></span>"
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        "texto" => "<p id="par0160" class="elsevierStylePara elsevierViewall">The authors would like to thank the University of Aufa Royhan Padangsidimpuan for helping researchers to fund this research&#46;</p>"
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