Strain and lessons learned among healthcare professionals working in intensive care units during COVID-19: a qualitative study

Background COVID-19 represented challenges for healthcare professionals working in intensive care units. There was a need for knowledge about the experiences of healthcare professionals working in such demanding conditions. The specific aim of this study was to explore ICU healthcare professionals’ challenges and experiences of the COVID ICU daily working conditions during the initial phase of the pandemic. Methods This paper reports on five focus group interviews conducted in five hospitals in Norway in the autumn of 2020. The study sample comprised 18 nurses and one physician who provided direct clinical care to patients with COVID-19 in an ICU setting. The interviews were analysed by inductive reflexive thematic analysis following Braun and Clarke's method. Results The analysis resulted in four themes: 1) Navigating uncertainty: contamination risk and information gaps, 2) Making it work: professional attitude and cohorts optimised patient care and working conditions, 3) In the absence of direction: unclear expectations and strained teamwork, and 4) Resilience under pressure: professionally, psychologically, and physically stretched. Conclusions During the initial phase of the COVID-19 pandemic, the daily working conditions of healthcare professionals-predominantly nurses-in the intensive care unit were significantly affected by fear and uncertainty. These conditions were both physically and psychologically demanding and further complicated by collaborative challenges. Despite the considerable strain, the nursing staff reported substantial professional growth. The construction of ICU cohorts contributed to improvements in working conditions. Trial registration Clinicaltrial.gov: NCT04372056.