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The causative factors of psychological distress and mental ill-health among ICU nurses during the pandemic

23 November 2023
Volume 32 · Issue 21


The coronavirus disease (COVID-19) pandemic had a global impact on health systems and health professionals. Nurses, particularly those working in intensive care units (ICUs), held a central critical role in the care of COVID-19 patients, facing numerous challenges in the delivery of care, leading to significant psychological and mental health issues. This article reports on findings from a qualitative narrative review of the literature related to psychological ill-being and mental health of ICU nurses' during the pandemic. Four key themes emerged: (1) isolation (2) workload (3) clinical preparedness and lack of protocols and (4) fear.

Throughout the COVID-19 pandemic, nurses – particularly those working intensive care units (ICUs) – played a pivotal role in the care of patients, (Labrague and Santos, 2021). The health emergency that followed the emergence of a novel and highly contagious strain of severe acute respiratory syndrome (SARS) coronavirus (SARS-Cov-2), led to significant and rapid change to global healthcare systems, resulting in unprecedented workload and uncertainty for healthcare workers. This included nurses who were placed under extreme stress when dealing with the rapid influx of COVID-19 patients to ICU and facing exposure to the virus (Fernández-Castillo et al, 2021).

A global pandemic was announced in March 2020 (Bolina et al, 2020). In June 2020, the International Council of Nurses (ICN) reported that more than 600 nurses had died worldwide as a result of COVID-19, the largest group of health professionals infected with the disease (ICN, 2020). The high incidence of infection in the workplace at the height of the pandemic inevitably led to psychological and mental health issues such as compassion fatigue, depression, anxiety, stress, burnout and post- and peri-traumatic stress disorder among ICU nurses (Lai et al, 2020; Hacimusalar et al, 2020; Schwerdtle et al, 2020; Gordon et al, 2021; Labrague and Santos, 2021). Indeed, it is arguable that ICU nurses experienced greater despair and anxiety than any other clinician (Mo et al, 2020; Heesakkers et al, 2021).

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