Document Type : Letter to the Editor (Policy Brief)
Authors
1 sabzevar
2 Prof, Health in Emergency and Disaster Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran 5. Department of Clinical Science and Education, Karolinska Institute, 17177 Stockholm,
3 Department of Nursing, Faculty of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
4 Prof., Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
Abstract
Background and Objective: The COVID-19 pandemic, as an unprecedented crisis, placed immense pressure on healthcare systems, particularly ICUs. Frontline nurses faced unprecedented challenges. This study aimed to explore the nursing care process for COVID-19 patients in ICUs and provide practical strategies for effective management of similar future crises.
Methods: This qualitative study used a Grounded Theory approach. Data were collected through semi-structured interviews with 24 nurses in ICUs of selected Iranian hospitals. Purposive sampling with maximum variation was employed. Data were analyzed using Strauss and Corbin's coding method (open, axial, and selective). Lincoln and Guba's criteria ensured trustworthiness. In the second phase, findings were validated via Delphi technique with 15 experts, and final strategies were developed.
Results: Nurses' primary concern was "providing beneficial and safe care," shaped by four contextual factors: pervasive fear, resource shortages, disease uncertainty, and insufficient support. Nurses employed three main strategies: compassionate comprehensive care, tolerating difficult complex care, and striving for adaptation. Consequences included compassion fatigue (psychological and physical burnout) and professional empowerment (enhanced clinical skills and growth). Based on findings, four strategic domains were developed: health system preparedness, human capital empowerment, organizational support, and resource management.
Conclusion: Investing in nurses and strengthening supportive and managerial structures is a strategic necessity for health system resilience in future crises. Developing and implementing a national action plan based on this study's lessons is recommended.
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