Practical strategies and the need for psychological support: recommendations from nurses working in hospitals during the COVID-19 pandemic

Purpose Nurses working during the coronavirus disease 2019 (COVID-19) pandemic have reported elevated levels of anxiety, burnout and sleep disruption. Hospital administrators are in a unique position to mitigate or exacerbate stressful working conditions. The goal of this study was to capture the recommendations of nurses providing frontline care during the pandemic. Design/methodology/approach Semi-structured interviews were conducted during the first wave of the COVID-19 pandemic, with 36 nurses living in Canada and working in Canada or the United States. Findings The following recommendations were identified from reflexive thematic analysis of interview transcripts: (1) The nurses emphasized the need for a leadership style that embodied visibility, availability and careful planning. (2) Information overload contributed to stress, and participants appealed for clear, consistent and transparent communication. (3) A more resilient healthcare supply chain was required to safeguard the distribution of equipment, supplies and medications. (4) Clear communication of policies related to sick leave, pay equity and workload was necessary. (5) Equity should be considered, particularly with regard to redeployment. (6) Nurses wanted psychological support offered by trusted providers, managers and peers. Practical implications Over-reliance on employee assistance programmes and other individualized approaches to virtual care were not well-received. An integrative systems-based approach is needed to address the multifaceted mental health outcomes and reduce the deleterious impact of the COVID-19 pandemic on the nursing workforce. Originality/value Results of this study capture the recommendations made by nurses during in-depth interviews conducted early in the COVID-19 pandemic.