Voices from the COVID‐19 frontline: Nurses’ trauma and coping

• Published in: Journal of advanced nursing Vol. 77; no. 9; pp. 3853 - 3866
• Main Authors: Foli, Karen J., Forster, Anna, Cheng, Chang, Zhang, Lingsong, Chiu, Yu‐Chin
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.09.2021; John Wiley and Sons Inc
• Subjects: Adaptation, Psychological; Alcohol use; Behavior problems; Betrayal; Content analysis; Coping; COVID-19; Crises; Critical care; Disasters; Drug use; Humans; Medical screening; Mental health; Mental health services; Natural disasters; Nurse led services; Nurses; nursing; Original Research: Empirical Research ‐ Qualitative; Pandemics; Post-traumatic growth; Psychiatric nurses; Psychological distress; Psychological trauma; Research Papers; Resilience; SARS-CoV-2; Social development; Substance abuse; Support networks; Tests; Trauma; Well being; COVID-19; nursing; psychological trauma; content analysis; mental health
• ISSN: 0309-2402; 1365-2648; 1365-2648
• DOI: 10.1111/jan.14988

Aim To describe the experiences of frontline nurses who are working in critical care areas during the COVID‐19 pandemic with a focus on trauma and the use of substances as a coping mechanism. Design A qualitative study based on content analysis. Methods Data were collected from mid‐June 2020 to early September 2020 via an online survey. Nurses were recruited through the research webpage of the American Association of Critical Care Nurses as well as an alumni list from a large, public Midwest university. Responses to two open‐ended items were analysed: (1) personal or professional trauma the nurse had experienced; and (2) substance or alcohol use, or other mental health issues the nurse had experienced or witnessed in other nurses. Results For the item related to psychological trauma five themes were identified from 70 nurses’ comments: (1) Psychological distress in multiple forms; (2) Tsunami of death; (3) Torn between two masters; (4) Betrayal; and (5) Resiliency/posttraumatic growth through self and others. Sixty‐five nurses responded to the second item related to substance use and other mental health issues. Data supported three themes: (1) Mental health crisis NOW!!: ‘more stressed than ever and stretched thinner than ever’; (2) Nurses are turning to a variety of substances to cope; and (3) Weakened supports for coping and increased maladaptive coping due to ongoing pandemic. Conclusions This study brings novel findings to understand the experiences of nurses who care for patients with COVID‐19, including trauma experienced during disasters, the use of substances to cope and the weakening of existing support systems. Findings also reveal nurses in crisis who are in need of mental health services. Impact Support for nurses’ well‐being and mental health should include current and ongoing services offered by the organization and include screening for substance use issues.