Dancing with Death in the Dust of Coronavirus: The Lived Experience of Iranian Nurses

Abstract

The novel coronavirus disease (COVID-19) pandemic as a public health emergency poses dramatic challenges for healthcare systems. The experiences of health-care workers are important in planning for future outbreaks of infectious diseases. This study explored the lived experiences of 14 nurses in Tehran, Iran caring for coronavirus patients using an interpretative phenomenological approach as described by Van Manen. In-depth interviews were audio-recorded between March 10 and May 5, 2020. The essence of the nurses ‘experiences caring for patients with COVID-19 was categorized as three themes and eight subthemes: (a) Strong pressure because of coronavirus: initial fear, loneliness, communication challenges, exhaustion. (b) Turn threats into opportunities: improvement of nursing image, professional development. (c) Nurses ‘expectations: expectations of people, expectations of government. The findings of this study showed that identifying the challenges and needs of health-care providers is necessary to create a safe health-care system and to prepare nurses and expand their knowledge and attitudes to care for patients in new crises in the future.

Keywords

coronavirus disease outbreak nurses phenomenology

Get full access to this article

View all access options for this article.

References

Abolfotouh

M. A.

, AlQarni

A. A.

, Al-Ghamdi

S. M.

, Salam

, Al-Assiri

M. H.

, & Balkhy

H. H.

(2017). An assessment of the level of concern among hospital-based health-care workers regarding MERS outbreaks in Saudi Arabia. BMC Infectious Diseases, 17(1), 4.

Beck

C. T.

(2020). Introduction to phenomenology: Focus on methodology. Sage.

Duan

, & Zhu

(2020). Psychological interventions for people affected by the COVID-19 epidemic. The Lancet Psychiatry, 7(4), 300–302.

Guba

E. G.

, & Lincoln

Y. S.

(1989). Fourth generation evaluation. Sage.

Iranian Ministry of Health and Medical Education. (2020). http://behdasht.gov.ir/.

Kang

, Ma

, Chen

, Yang

, Wang

, Li

, … Yao

(2020, July). Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study. Brain, Behavior, and Immunity, 87, 11–17. doi:10.1016/j.bbi.2020.03.028.

Khalid

, Khalid

T. J.

, Qabajah

M. R.

, Barnard

A. G.

, & Qushmaq

I. A.

(2016). Healthcare workers emotions, perceived stressors and coping strategies during a MERS-CoV outbreak. Clinical Medicine & Research, 14(1), 7–14.

Kim

(2017). Nurses' experience of Middle East respiratory syndrome patients care. Journal of the Korea Academia-Industrial Cooperation Society, 18(10), 185–196.

Kim

J. S.

, & Choi

J. S.

(2016). Factors influencing emergency nurses' burnout during an outbreak of Middle East respiratory syndrome coronavirus in Korea. Asian Nursing Research, 10(4), 295–299.

10.

Kim

(2018). Nurses' experiences of care for patients with Middle East respiratory syndrome-coronavirus in South Korea. American Journal of Infection Control, 46(7), 781–787.

11.

Lam

K. K.

, & Hung

S. Y. M.

(2013). Perceptions of emergency nurses during the human swine influenza outbreak: A qualitative study. International Emergency Nursing, 21(4), 240–246.

12.

Lancee

W. J.

, Maunder

R. G.

, & Goldbloom

D. S.

(2008). Prevalence of psychiatric disorders among Toronto hospital workers one to two years after the SARS outbreak. Psychiatric Services, 59(1), 91–95.

13.

Lee

R. L.

, Loke

A. Y.

, Wu

C. S.

, & Ho

A. P.

(2010). The lifestyle behaviours and psychosocial well-being of primary school students in Hong Kong. Journal of Clinical Nursing, 19(9–10), 1462–1472.

14.

Lin

, Zhang

, He

, Huang

, Ye

, Ju

, Chu

, Zhong

, & Li

(2020). Psychological burden in health care professionals in Chinese cities during the coronavirus disease 2019 (COVID-19) Outbreak. Available at SSRN 3576782.

15.

Maunder

R. G.

, Lancee

W. J.

, Balderson

K. E.

, Bennett

J. P.

, Borgundvaag

, Evans

, … Goldbloom

D. S.

(2006). Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerging Infectious Diseases, 12(12), 1924.

16.

Novel

C. P. E. R. E.

(2020). The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Zhonghua liu xing bing xue za zhi=Zhonghua liuxingbingxue zazhi, 41(2), 145.

17.

Smith

M. W.

, Smith

P. W.

, Kratochvil

C. J.

, & Schwedhelm

(2017). The psychosocial challenges of caring for patients with Ebola virus disease. Health Security, 15(1), 104–109.

18.

Tam

C. W.

, Pang

E. P.

, Lam

L. C.

, & Chiu

H. F.

(2004). Severe acute respiratory syndrome (SARS) in Hong Kong in 2003: Stress and psychological impact among frontline healthcare workers. Psychological Medicine, 34(7), 1197–1204.

19.

Tiwari

, Chan

, Wong

, Tai

, Cheng

, Chan

, … Tsang

(2003). Severe acute respiratory syndrome (SARS) in Hong Kong: Patients' experiences. Nursing Outlook, 51(5), 212–219. doi:10.1016/j.outlook.2003.07.002.

20.

Treston

(2020). 2020: Year of the nurse and midwife. Journal of the Association of Nurses in AIDS Care, 31(2), 261.

21.

Van Manen

(2016). Writing in the dark: Phenomenological studies in interpretive inquiry. Routledge.

22.

Van Manen

, Higgins

, & van der Riet

(2016). A conversation with Max van Manen on phenomenology in its original sense. Nursing & Health Sciences, 18(1), 4–7.

23.

World Health Organization. (2020). http://behdasht.gov.ir/health-topics/coronavirus.

24.

, Chen

, Cai

, Zhou

, Xu

, Huang

, … Zhang

(2020). Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Internal Medicine, 180(7), 934. Published online March 13, 2020. doi:10.1001/jamainternmed.2020.0994.

25.

Yin

, & Zeng

(2020). A study on the psychological needs of nurses caring for patients with coronavirus disease 2019 from the perspective of the existence, relatedness, and growth theory. International Journal of Nursing Sciences, 7(2), 157–160. doi:10.1016/j.ijnss.2020.04.002.