‘Thank you for helping me remember a nightmare I wanted to forget’: qualitative interviews exploring experiences of death and dying during COVID-19 in the UK for nurses redeployed to ICU

Abstract

ABSTRACT Intensive Care Units (ICUs) became key end-of-life spaces during the Covid-19 pandemic in the UK. Many nurses were redeployed to ICU from other specialities, navigating changing roles, priorities, and risks. Limited resources including time, equipment, and staffing widened nurses’ responsibilities; the virus’ infectious nature restricted family visits, even at end of life. Emerging literature explores ICU deaths during Covid-19, but little focuses on nurses’ experiences, especially those redeployed. Here, we explore how redeployed nurses negotiated these competing demands on their emotional and physical resources, and undertook meaning-making, by integrating a framework of ‘sensemaking’ with theories of coping. Drawing on interviews with six nurses from two UK-based longitudinal qualitative studies we detail profound shifts that uniquely challenged nurses’ sense of identity, duty, and purpose. This included adopting untested caring protocols, de-prioritising ‘non-essential’ care, and establishing communication rituals with patients/families. Understanding how nurses negotiated and performed their roles when paradigms of care were dramatically destabilised is vital to supporting workforce recovery from burnout, moral injury, and moral distress. This research also provides important learning for the management of future emergency responses and extends knowledge of how lived experience maps onto theoretical knowledge.