Implications for COVID-19 : a systematic review of nurses' experiences of working in acute care hospital settings during a respiratory pandemic

Background: Pandemics and epidemics are public health emergencies that can result in substantial deaths and socio-economic disruption. Nurses play a key role in the public health response to such crises, delivering direct patient care and reducing the risk of exposure to the infectious disease. The experience of providing nursing care in this context has the potential to have significant short and long term consequences for individual nurses, society and the nursing profession. Objectives: To synthesize and present the best available evidence on the experiences of nurses working in acute hospital settings during a pandemic. Design: This review was conducted using the Joanna Briggs Institute methodology for systematic reviews. Data sources: A structured search using CINAHL, MEDLINE, EMBASE, PubMed, Google Scholar, Cochrane Library, MedNar, ProQuest and Index to Theses was conducted. Review methods: All studies describing nurses’ experiences were included regardless of methodology. Themes and narrative statements were extracted from included papers using the SUMARI data extraction tool from Joanna Briggs Institute. Results: Thirteen qualitative studies were included in the review. The experiences of 348 nurses generated a total of 116 findings, which formed seven categories based on similarity of meaning. Three synthesized findings were generated from the categories: (i) Supportive nursing teams providing quality care; (ii) Acknowledging the physical and emotional impact; and (iii) Responsiveness of systematised organizational reaction. Conclusions: Nurses are pivotal to the health care response to infectious disease pandemics and epidemics. This systematic review emphasises that nurses’ require Governments, policy makers and nursing groups to actively engage in supporting nurses, both during and following a pandemic or epidemic. Without this, nurses are likely to experience substantial psychological issues that can lead to burnout and loss from the nursing workforce