Front-line nurses' responses to organisational changes during the COVID-19 in Spain: A qualitative rapid appraisal

Aims: To identify the organisational changes faced by front-line nurses working with COVID-19 patients during the first wave and describe how they responded to these changes. Background: The COVID-19 pandemic has altered the provision of care and the management of health care around the world. Evolving information about SARS-CoV-2 meant that health care facilities had to be reorganised continually, causing stress and anxiety for nurses. Methods: Qualitative study based on Rapid Research Evaluation and Appraisal (RREAL). The research took place in hospital and community health settings of the Spanish national health system with a purposive sampling of 23 front-line nurses. Semi-structured interviews were conducted between May and June 2020. The duration was 30-45 min per interview. We used the Dedoose (R) data analysis software to perform a thematic analysis. Results: Nurses responded to organisational changes using the following strategies: improvisation, adaptation and learning. Conclusion: Our rapid approach allowed us to record how nurses responded to changing organisation, information that is easily lost in a disaster such as the COVID-19. Implications for nursing management: Knowing about their strategies can help planning for future health disasters, including subsequent waves of the COVID-19.