WORK-RELATED STRESS: THE IMPACT OF COVID-19 ON CRITICAL CARE AND REDEPLOYED NURSES.

COVID-19 placed great pressure on critical care units. Critical Care Nurses (CCNs) were working under very difficult conditions and experienced significant challenges. For example, they had to deliver care whilst using very cumbersome personal protective equipment, many of their patients died from COVID-19 and, because relatives were not allowed access to critical care units, staff were the only people available to be with patients at the end of their lives, staff also had to communicate and support worried and bereaved relatives at a distance, and their work posed well-publicised potential risks to their own and their family's health. In addition, the pressure on critical care units meant nurses from other areas were redeployed to critical care. These nurses experienced the same stressors as CCNs but with the additional challenges posed by having to work in a very different and new environment and without specialist critical care skills and training. It is possible that the physical and psychological wellbeing of nurses working critical care during the pandemic has been affected and their intention to continue in critical care nursing reduced. It is important, therefore, to understand how nurses working in critical care have experienced and been affected by the pandemic. In this study we will use a model of occupational stress called the Job Demand Resources model (JD-R model) to better understand stress in nurses working in critical care during the pandemic. The JD-R model states that stress occurs when the demands of a situation outweigh the resources available to meet those demands. Two types of resources are described, the personal resources of the individual nurse and the resources provided by the job and workplace. For example, a nurse might be highly resilient and their job might give them lots of control over how they work; both of which are resources available to help the nurse meet the demands of the job. However, when demands outweigh resources negative outcomes occur; e.g., the individual nurse might experience physical and mental health strain that presents as 'burnout', which affects their ability to care for their patients, and they may decide to leave critical care. We will ask all CCNs in the 20 adult critical care units in Scotland and 3 units in England and all nurses deployed to those units on at least 2 occasions to complete a questionnaire designed to measure the JD-R model. To examine how the current pandemic has impacted staff we will compare the results to a similar study completed just before the onset of COVID-19. This questionnaire survey will identify sources of stress before and during the pandemic and the factors that reduce or increase the impact of that stress on the physical and mental health of staff and their intention to stay in post. In addition, we will interview staff in depth to understand better their experiences of working in critical care during the pandemic. We will also ask staff about the support services they were offered, the services they used and those they found helpful. We will combine the results of the survey and interviews to develop a full understanding of the sources of stress in critical care and how the impact of that stress can be mitigated by the personal, job and support resources available to staff. In this way we will be better prepared to support staff if a second or third wave of the pandemic occurs and will be better placed to retain staff within critical care.