Frontline nurses’ sensemaking during the initial phase of the COVID-19 pandemic in 2020 Aotearoa New Zealand

Abstract

The aim of this study was to identify the COVID-19 pandemic impacts on nurses’ sensemaking and explore resilience and mitigation strategies nurses adopted to sustain their wellbeing. Frontline clinical nurses are an essential population within the health workforce. Although they are educated to deal with the many challenges working in health presents, this pandemic has created new stressors and vulnerabilities, placing strain on their wellbeing. This article reports on the qualitative data from a national mixed methodology study undertaken between October and December 2020. Twenty-nine interviews were conducted remotely using Zoom and telephone with nurses in a wide range of clinical front-line roles. Data were analysed thematically drawing from the theoretical lens of sensemaking, and related concept of liminality. Findings identified that early in the pandemic, participants who were frontline nurses prioritised patient care while negotiating shifting uncertainties, fear, under-resourcing, and variable leadership. They watched the unfolding international crisis and anticipated that we, in Aotearoa New Zealand, faced a similar disaster. Amidst significant stressors, they endured separation from their families while acting as substitute family for patients and residents isolated from whānau. Six themes were identified: liminality; teamwork and leadership; relational dynamics; health and safety precarity; care ethics; and heroes and pariahs. The study highlights that organisational culture, communication, and clinical leadership either fractured or strengthened nurses’ professional commitment.