Table 2 Revealed problems and lessons for improvements from COVID-19
Theoretical constructs | Problematic Codes | Key concepts | Improvement Codes |
|---|---|---|---|
Independent practice | Passive and dependent tendencies | Autonomy | Nurse-led improvement efforts |
Role Ambiguity and Role Conflict | Working boundaries and delegation for nurses to focus on the nursing work | ||
| Â | Accountability | Nurse accountability | |
Collaborative practice | Conflict with other health professionals. | Collaboration | Improving the nurse-other healthcare workers, nurse-patient relationship |
Difficulties in nursing due to not cooperative patient | |||
Inefficient communication system | Communication | ||
Leadership | Oppressive leader | Leadership | Decision guide/ control tower/leader |
Environment | Resource shortage | Physical setting | Sufficient resource supply |
Inefficient resource allocation | Efficient resource allocation | ||
Inefficient environmental workflow | |||
Inappropriate hospital room assignment | |||
Lack of skilled medical staff and resources | The need for strategic standards for the workforce | ||
Inadequate incident reaction due to working alone | |||
Discomfort due to poor environment | |||
Difficulty in assessing patient condition | The need for patient monitoring devices | ||
Unfamiliar work environment | Task complexity & workload | Understanding of work environment | |
Difficulties associated with wearing PPE | Enhanced infection control | ||
Discomfort related to unmet basic physical needs | Application of efficient nursing care delivery system | ||
Misplacement by a manager with no medical experience | Â | ||
The unpredictability of workload | Â | ||
Weighted workload | Â | ||
Requirement of increased time for the work | Â | ||
A culture of not sharing detailed information | Sociocultural environment | Improving public awareness of infection prevention | |
Lack of general awareness of the severity | |||
Social isolation | |||
Sensitive situation | Respectful work environment | Â | |
Complaints (blame) of patient/ patient family | Â | ||
Advancement & recognition | Misconceptions about nursing professionals | Awareness of nursing professionalism | Improving recognition of nurse professionalism |
The scarlet letters of the confirmed COVID-19 medical staffs | |||
Inappropriate response in emergencies | Critical thinking & technical expertise | Enhanced education and training | |
Ineffective coping due to inexperienced staffs | |||
Lack of work-related training opportunities due to situational difficulties | |||
Anxiety/ Fear and powerlessness/ fears of being a transmitter | Support system | Peer support | |
The ambivalence between professional duty and individual needs | Encouragement | ||
Ethical dilemma | The importance of professional supports | ||
Strain and Psychological conflict concerning not being protected | Â | ||
Conflict due to inappropriate pay system | Â | ||
Fatigue | Â | ||
| Â | Lack of support from the Nursing Association | Â | |
Research/ Innovation | Ambiguity and vagueness in clinical practice guidelines | Guideline & protocol/Innovation | The need to utilize advanced technology such as artificial intelligence (AI), supporting robots |