Abstract
Pandemics are unique forms of disasters characterised by adverse psychological symptoms and behaviours. Literature confirms that a globally increased workload during pandemics caused emotional exhaustion and poor concentration among healthcare workers. The rapid global spread of the COVID-19 virus resulted in an influx of high-acuity patients in hospitals, resulting in an increased workload for the nurses and adding more pressure on the already existing staff shortage. Like other countries, South Africa was unprepared for the COVID-19 pandemic, as evidenced by overcrowded hospitals and high mortality rates with inadequate resources and guidelines. The experiences of Intensive Care Unit professional nurses during the COVID-19 pandemic profoundly impacted their well-being — mentally, physically, socially and spiritually — resulting in holistic self-care neglect.
The purpose of the study was to develop and evaluate a model to facilitate professional nurses’ holistic care while caring for COVID-19 patients in private hospitals in Gauteng, South Africa. Ethical considerations, as well as COVID-19 protocols, were maintained throughout the study. Trustworthiness criteria were adhered to, including credibility, dependability, confirmability and transferability.
This study was done in two phases and five steps. Phase one: A qualitative, phenomenological, exploratory, descriptive, and contextual research design was used to explore and describe the experiences of Intensive Care Unit (ICU) professional nurses in caring for COVID-19 patients in private hospitals in Gauteng, South Africa. Purposeful sampling was implemented. Semi-structured, in-depth, individual interviews were conducted and audio recorded, as well as multiple enquiries such as observation and field notes; from April 2022 to December 2022. The central open-ended question was as follows: “How was it for you to care for COVID-19 patients during the pandemic?” Data reached saturation with the fifteenth participant. The interviews were transcribed verbatim and analysed using Giorgi’s approach.
Three themes emerged: (a) abrupt transition from normality to the COVID-19 pandemic, (b) professional nurses experienced isolation from family, community, and nursing management, and (c) feelings of satisfaction and gratitude for teamwork and learning.
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The unexpected, chaotic disruption in the care of patients and the overflowing of patients in the hospitals resulted in rapid changes in the working structure and more responsibilities. This situation left the professional nurses physically, mentally, emotionally, socially and spiritually exhausted. In this phase, step 1.1 (concept analysis), the central concepts were identified.
The researcher and the supervisor published the article: “Lived Experiences of Intensive Care Professional Nurses Caring for COVID-19 Patients in Private Hospitals in Gauteng, South Africa: A Phenomenological Study.” This article concurred with the need for the researcher to develop a model as a framework to facilitate professional nurses’ holistic care in caring for COVID-19 patients in private hospitals in Gauteng, South Africa, which is phase two of the study.
Phase two: the researcher used a theory-generating approach in this phase, and the research question was: “What can be done to facilitate professional nurses’ holistic care caring for COVID-19 patients in private hospitals in Gauteng, South Africa?” The model was developed by defining and classifying concepts derived from phase one (Step 1.2). Step two: relationship statements were constructed to provide a structure to the theory. Step three was the development and description of the model, and step four was a description of guidelines for model operationalisation. Step five was the evaluation of the model.
This study revealed that physical, mental, emotional, social and spiritual care are paramount to professional nurses’ ability to deliver holistic self-care to themselves and their patients. The researcher hopes this study’s findings will help healthcare organisations develop new strategies and policies to support and prepare nurses for future pandemics and outbreaks. Unfortunately, South Africa does not have clinical resource organisations that support nurses’ holistic self-care, such as the American Holistic Nurses Association (AHNA), which supports the well-being of nurses. The authors hope the nurses’ voices will be heard and awareness of the need to promote their mental health will be created. A model in this study could be used as a framework of references for ICU professional nurses in private hospitals in practising holistic self-care and thus will promote health and wellness, quality of life and job satisfaction of professional nurses.