Nurses' perceptions and demands regarding COVID-19 care delivery in critical care units and hospital emergency services

Background: The COVID-19 pandemic is a public health challenge that puts health systems in a highly vulnerable situation. Nurses in critical care units (CCUs) and hospital emergency services (HESs) have provided care to patients with COVID-19 under pressure and uncertainty. Objective: To identify needs related to safety, organisation, decision-making, communication and psychosocio-emotional needs perceived by critical care and emergency nurses in the region of Madrid, Spain, during the acute phase of the epidemic crisis. Methods: This is a cross-sectional study (the first phase of a mixed methods study) with critical care and emergency nurses from 26 public hospitals in Madrid using an online questionnaire. Results: The response rate was 557, with 37.5% reporting working with the fear of becoming infected and its consequences, 28.2% reported elevated workloads, high patient-nurse ratios and shifts that did not allow them to disconnect or rest, while taking on more responsibilities when managing patients with COVID-19 (23.9%). They also reported deficiencies in communication with middle management (21.2%), inability to provide psycho-social care to patients and families and being emotionally exhausted (53.5%), with difficulty in venting emotions (44.9%). Conclusions: Critical care and emegency nurses may be categorised as a vulnerable population. It is thus necessary to delve deeper into further aspects of their experiences of the pandemic. (C) 2020 Elsevier Ltd. All rights reserved.

Automated summary

The study identified needs related to safety, organization, decision-making, communication, and psychosocio-emotional needs perceived by critical care and emergency nurses in Madrid, Spain, during the acute phase of the COVID-19 epidemic crisis. Nurses reported fear of infection, high workloads, communication deficiencies, and emotional exhaustion, highlighting the vulnerability of this population and the need for further exploration of their experiences during the pandemic.