Uncertainties and coping strategies among nurses during the first wave of Covid-19 in Germany : nursing students’ use of diary entries to document their experiences during the first wave of infections in the Covid-19 pandemic

Abstract

Background: In March 2020, German hospitals were preparing for the first major wave of Covid-19 infections, implementing crisis management procedures without precedent or prior testing. At this time, we asked stu-dent nurses in their eighth semester of study to complete a nursing diary for a period of four weeks. The aim of this research was to ascertain students’ perceptions of the constantly evolving crisis and retrace their re-flections on the situation on the basis of the knowledge they had at the time. Methods: Eleven students completed a nursing diary, which entailed writing entries on the care they provided on the wards to which they were assigned. They added images such as pictures, screenshots and drawings to their diary entries. We analysed the data using ethnographic methods as follows: a) categorisation of the entries in accordance with general thematic similarities; b) comparison of the entries with published nursing literature from this time period, with the aim of identifying possible gaps in the content of our data. Results: The student nurses worked on different wards; some volunteered to staff the newly established Covid-19 wards. Nursing students felt the unfolding crisis to be defined by a sense of uncertainty and potential threat, associated with various fears. The students described their own actions and behaviour in specific sit¬uations and outlined observations of others. We categorised our findings in four sub-topics: a) crisis manage¬ment; b) the invisible crisis; c) a sense of crisis; and d) coping with the crisis. Discussion: In giving insights into the day-to-day work of nurses under extreme conditions, the diaries col-lected and analysed for this study highlight experiences of ambivalence and uncertainty during the first wave of Covid-19 infections. Specifically, the students’ reflections on professional responsibility point to this princi¬ple’s importance within the system of values espoused by members of the nursing profession.