Nursing during COVID-19: Communicating with professionalism, grace, and a touch of human connection: Presenter(s): Valerie Smith, California State University, East Bay, United States

BACKGROUND: Healthcare provision during COVID-19 has called for shifting standards of care because of limited time, personal-protective equipment, and staff to care for surges in patient populations that challenged emergency department, ICU, and COVID-19 floor capacities, as well as non-COVID hospital care and outpatient clinics. Crisis standards of care have provided some help for healthcare providers to make ethically informed decisions towards quality patient care, yet disease containment has been the priority. Nurses have borne the brunt of this quandary as they have sought to communicate with some semblance of human connection and relationship with patients and their family members, amidst limited visitation policies, cancellation of "elective" surgeries, and when other typical standards of care could not always be met. This study investigated frontline nurses’ accounts of communication strategies and interventions to provide this relationally based care in these challenging COVID-19 environments. METHODS: This qualitative research study employed in-depth, semi-structured interviews with 17 nurses working in healthcare during coronavirus surges. A code book was created by the author and three research assistants were trained to code transcripts using Atlas.ti software. Once initially trained, coders independently coded a transcript and results were compared to ensure accuracy. The remaining transcripts were coded, and themes were identified related to relationship-centered care and to ethical challenges. RESULTS: Findings consisted of nurses employing strategies for self-care, including gaining support from colleagues who understood their challenges; developing or implementing creative PPE and disease containment protocols to foster patient support; and communication practices with patients and family members that demonstrate professionalism, grace, and a touch of human connection in the midst of extraordinary circumstances. CONCLUSION: While not ideal situations, nurses are capable of resilience and excellence in crises with models of care that can be adapted in other limited-resource and emergency settings.