Changes in nurses' work: A comparative study during the waves of COVID-19 pandemic

AimThe aim of this study is to describe and evaluate how nurses caring for COVID and non-COVID patients assess changes in their work and in nursing activities during the two waves of the COVID-19 pandemic.MethodsTwo cross-sectional surveys were conducted for Estonian nurses working during the first and second waves of the COVID-19 pandemic, using The impact of COVID-19 emergency on nursing care questionnaire. Based on convenience sampling, the data were collected among the members of professional organizations, unions and associations. Responses from the first (n = 162) and second wave (n = 284) were analysed using descriptive statistics, Fisher's exact test and McNemar's test.ResultsThe COVID-19 pandemic changed the working context during both waves for nurses caring for COVID and non-COVID patients. Changes were considered to a greater extent during the second wave, when Estonia was severely affected, and by nurses caring for COVID patients. During the second wave, the number and complexity of patients increased, and nurses caring for COVID patients performed fundamental care, nursing techniques and symptom control significantly more frequently compared to nurses caring for non-COVID patients.ConclusionTaking care of COVID patients is demanding, requiring nurses to perform more direct patient care. However, the pandemic also increased the frequency of activities not related with direct patient care. What is already known about this topic? The COVID-19 pandemic has influenced the context of care and all dimensions of nurses' work. Despite increasing research on the impact of the COVID-19 pandemic on nursing care, little attention has been given to differences between caring for COVID and non-COVID patients during the different waves of the COVID-19 pandemic.What this paper adds? Nursing care for COVID patients requires from nurses more direct patient care through fundamental care activities, nursing techniques and symptom control compared to non-COVID patients. The impact of the COVID-19 pandemic on nurses' work reflects the severity and progress of different waves of the pandemic, which needs to be considered in preparing for future pandemics. Nursing care during a pandemic may also lead to an extensive workload due to tasks not related to direct patient care as nurses contribute to the management of the pandemic on all levels of health care.The implications of this paper: The COVID-19 pandemic has had a significant impact on nursing, where the mitigation of long-term effects of the pandemic is still ongoing, and thus, knowledge about the details of the resulting changes is required. Study findings enable us to mitigate the impact of the pandemic on nurses and to highlight aspects that need to be taken into account when preparing for future pandemics.