No Backstage: The Relentless Emotional Management of Acute Nursing Through the COVID-19 Pandemic

Aim(s)To explore the impact of the COVID-19 pandemic on nurse's well-being, experiences of delivering healthcare within acute settings and their emotional management.DesignSequential mixed methods.MethodsFebruary to July 2021 an online well-being survey was disseminated to nurses working in acute settings within one Scottish health board. In-depth interviews with a purposive sample of respondents were conducted. Survey data were analysed descriptively, and interview data using Framework analysis and emotional management as the theoretical framework.ResultsWell-being was poor overall. Infection control measures impeded interactions, with loss of connection between patients, families and nurses. Emotional work was extended in caring for patients and families when visits were forbidden or restricted. Disconnect between colleagues was intensely felt. On COVID and non-COVID wards, nurses were caring for patients with a significantly reduced workforce and often outside their clinical speciality. Nurses masked their own anxieties, fears, moral distress and exhaustion on the ward. Communal 'backstage' spaces, were reduced to enable more infection-control space but reduced opportunity for collegial support. Formal psychological intervention required access after shift, and/or nurses feared they could not contain their emotions afterwards.ConclusionWorking during the pandemic was emotionally and physically demanding for those in COVID a.nd non-COVID wards. Unintended consequences of infection control measures significantly extended nurses' emotional management, by caring for isolated patients and families but impeding opportunities to care for each other, compounding their emotions.Implications for the ProfessionThere is a need to value emotional work in nursing to better support mental well-being.ImpactWe advance the nursing emotional management literature by addressing the gap of exploration in challenging conditions. The importance of emotional management on nurses' mental well-being has been overlooked but focusing on this in the next crisis could improve nurse's well-being.Patient or Public ContributionNo patient or public contribution.Reporting MethodGRAMMS.