Table 4 Codes, subcategories, and categories extracted from data analysis

Experiences and challenges

Lack of protective equipment

Lack of protective equipment such as gloves, high quality masks, face shields, disinfectant solution, and isolation clothes

High work pressure

Increasing work shifts, increasing number of patients, more visits to patients due to too many drugs and giving different serums, doing patients’ work due to not having a companion

Marginalized physical health

Fatigue, headache, muscle fatigue, weakness, lethargy, sleeplessness, low quality of sleep, digestive problems, disrupted eating hours and eating habits, menstruation problems of female nurses

Problems related to the use of protective equipment

Shortness of breath, facial ulcers, heat, sweating, body burns, itching, and leg wounds

Being excluded

Relatives run away from dealing with nurses, inappropriate behavior and avoidance of neighbors, inappropriate behavior of others outside the workplace, and inappropriate behavior of family members

Lack of supportive work environment

Not having a suitable place to rest, crowded break rooms, lack of motivational stimuli such as material rewards, worries about dismissal, lack of psychological counseling to cope with the stress related to COVID-19, and lack of adequate training in how to deal with COVID-19 patients

Problems related to patients

Getting abused and bullied by patients, patients’ boredom, patient’ homesickness, seeing patients in bad condition

Psychological problems

Depression, self-morbidities, and grief over losing a colleague due to COVID-19

Fear

Fear of being infected, fear of carrying and transmitting the virus to their families, the disease’s persistence, and ignorance of the COVID-19 virus

Marginalized personal and family life

Disconnection with family, homesickness for family, reduction of the role of mother or father in the family, being distant from the family during Nowruz, not attending their child’s birthday party, disruption in life plans such as marriage, cancellation of family travel plans

The challenge of communication with patients’ families

Difficulty in informing families about positive test results, difficulty in informing families about their patient’s death, difficulty in informing families about their patient’s exacerbated condition, accusing the nurses of being shirkers by the patient’s family, too much contact by the patient’s family

Adaptation strategies for work conditions

Performing religious-spiritual activities

Praying, saying daily prayers, listening to the Qur’an, saying blessings to Prophet Muhammad [Salawaat], asking for help from the Imams

Creating an empathetic atmosphere in the workplace

Creating emotional relationships with patients, strengthening relationships with other colleagues, forgiveness and devotion, helping colleagues, giving positive feedback to colleagues, talking more with colleagues, and providing an atmosphere for jokes and laughter

Spiritualizing their work

Considering their work as jihad in the way of God, equating death due to COVID-19 with martyrdom, and receiving rewards in the hereafter

Trying to convince the family and gaining their support

Explaining the necessity of being in the hospital, explaining the importance of nurses’ work, observing health principles and comforting the family, showing working conditions to family members, and making phone and video calls to the family

Enhancing their sense of self-worth and responsibility

Feeling satisfied with strengthening their social image and status among people, satisfaction with people’s gratitude, increasing their efforts to save people, increasing interest in their work and profession, taking responsibility for people’s health