Operating room nurses’ experiences with redeployment and task shifting during the COVID-19 pandemic

Objective: The objective was to explore operating room nurses' experiences of how their professional expertise was utilised during redeployment in the first two waves of the COVID 19 pandemic.Method: We recruited a strategic sample of operating room nurses who had been redeployed during the early waves of the COVID 19 pandemic.Semi-structured individual interviews were held with the help of an interview guide.Digital audio recordings of the interviews were transcribed verbatim.The data were analysed using the NVivo 12 data analysis software, based on Braun and Clarke' s reflexive thematic analysis. Results:The study shows that operating room nurses' professional competence was underutilised during the first two waves of the COVID 19 pandemic.Crisis management differed across health authorities because they were not well prepared for a crisis and faced challenges relating to information flow and resource management.Operating room nurses experienced an increased psychological and ethical burden.The pandemic was managed in solidarity with society and in accordance with professional standards.The operating room nurses felt frustrated during the pandemic because they found that patient safety was compromised to some extent, particularly when the task shifting involved entirely new patient-facing duties in relation to critically ill patients. Conclusion:In the next major crisis situation, hospitals should have more detailed plans for how to utilise the specific competence of operating room nurses.Transparent and appropriate information and resource management will also be crucial success factors.The allocation of tasks in hospitals needs to be more aligned with employees' work-life balance in order to prevent burnout and significant shortages of essential nursing competence, and to reduce the risk of compromising patient safety. Method Study designWe designed a qualitative study and developed a semi-structured interview guide.A combined deductive-inductive approach was planned, with reporting according to the Consolidated Criteria for Reporting Qualitative Research COREQ checklist (Appendix 1) 13 . Study context and participantsThe study was conducted in May and June 2021, shortly after the second wave of COVID 19 patients were hospitalised in Norway.The study participants were operating room nurses at four hospitals in South-Eastern Norway Regional Health Authority.The COVID 19 patient flow was similar in these hospitals during the first two waves in Norway starting in March 2020.We used a strategic sampling method to include operating room nurses with clinical experience of redeployment. Data collectionWe conducted the interviews based on Kvale and Brinkmann' s 14 and Braun and Clarke' s methodologies 15, 16 , where the operating room nurses' experiences were explored deductively and inductively.The individual interviews were carried out by the two authors and a colleague, all of whom have extensive backgrounds in specialised nursing.Managers at the hospital departments invited to participate approved and facilitated the recruitment of participants.A semi-structured interview guide (Appendix 2 -only in Norwegian) was used in the interviews, and this was based on available literature and our preconception of the field and the context. Data analysisThe audio recordings of the interviews were transcribed verbatim and the transcription was analysed using NVivo version 12. Immediately after the interviews, we took field notes of thoughts and ideas related to what was said in the interview to support the ongoing preliminary analysis and assess the richness of information in the interviews.We analysed the data using reflexive thematic analysis as described by Braun and Clarke 15, 17 .This was supported by notes taken throughout the data collection and analysis processes.Reflexive thematic analysis is performed in six phases: familiarisation with the empirical data, coding, generating themes, revising themes, defining and formulating themes and finally reporting and writing up the analysis 16 .