Critical care nurses role and scope of practice during a global crisis: a qualitative study.

Abstract

Background: Critical care nurses (CCNs) role and scope of practice include advanced nursing care for acute and critically ill patients and patients significant others. Before the pandemic, it was well-known that there was a shortage of nurses globally and a need to invest in greater self-sufficiency of nurses. The borders closed at the start of the pandemic in Norway and intensive care units were challenged with increased numbers of seriously ill patients and a shortage of CCNs. This study aimed to explore how CCNs experienced their role and scope of practice during the COVID-19 crisis in Norway.

Methods: The study had a descriptive explorative design. Individual semi-structured interviews were conducted with fourteen CCNs working in five intensive care units from four hospitals during the pandemic in Norway. The interviews were analysed using Braun and Clarkes six-phase approach to thematic analysis.

Results: The CCNs described their role and scope of clinical practice with promoting safe critical care nursing, competence in critical care nursing and their moral responsibility during the COVID-19 crisis in Norway. Promoting safe critical care nursing was challenged with. Competence in critical care nursing was useful in caring for patients with COVID-19 and in collaboration with less experienced and allocated healthcare professionals. The moral responsibility of a CCN is to contribute during a national crisis and to promote a patient and family-centred environment.

Conclusions: This study aimed to explore critical care nurses` experience of their role and scope of practice when caring for patients with COVID-19 during the pandemic in Norway. The findings revealed a need to acknowledge the unique broad competence and moral responsibility of CCNs in caring for ICU patients when an unknown virus led to the lockdown of a country such as Norway. Moreover, the CCNs` role and scope of a wide variety of responsibilities needs to be addressed, and their strong sense of duty needs attention and support. A sustainable qualified critical care workforce should be established and supported to prepare for future global crises.