The Impact of COVID-19 on Canadian Acute Care Nursing Professionals: An Integrative Review

Background: The COVID-19 pandemic has put widespread pressures on the Canadian healthcare system. As infections soared and the healthcare system attempted to grapple with increased patient loads and acuity, nurses were impacted and, among other issues, began leaving the profession. Shortfalls of acute care staff have caused bed closures, service disruptions, and decreased access to timely patient care. In order to stem the tide of nurses exiting the profession, the system needs to change. Understanding the complexity of pandemic impacts on nurses is integral to making changes that will be most impactful as COVID-19 continues and as new pandemics occur. Purpose: To integrate the current evidence of COVID-19 impacts on Canadian acute care nurses. Method: This is an integrative review using Whittemore and Knafl’s framework. The databases searched were CINAHL, MEDLINE, Web of Science, and NIH. The search terms used were Canada/Canadian/Canadians, the name of each province, nurse/nurses/nursing, and COVID 19/SARS-CoV-2/coronavirus/cov-19. Search criteria were supported by a health sciences librarian. Twenty articles were found to meet inclusion criteria and contribute to an understanding of the impacts of the COVID-19 pandemic on acute care nurses specifically. Results: The current evidence has been synthesized into a conceptual framework which indicates the COVID-19 pandemic impacted acute care nurses in Canada through four main mechanisms: a) changes which sometimes occurred rapidly and frequently; b) access to needed resources; c) connections between nurses as well as others; and d) aspects of the infectious agent itself. The outcomes of the pandemic on nurses included positive effects, physical effects, emotional responses, leaving/attrition, and mental health disorders. As well, four significant mediating factors were identified as coping, making connections, learning and experience, and finding meaning. Application to Nursing: Nurses have been impacted by the COVID-19 pandemic in ways that are far-reaching and possibly long-term. Understanding how these impacts occur, can help in the formation of policies and procedures that can mitigate the effects and support nurses even during pandemic events