Experiências de enfermeiros no cuidado de pacientes com covid-19 no contexto hospitalar durante a pandemia: revisão de escopo

Abstract

INTRODUCTION: The COVID-19 pandemic, caused by the SARS-CoV-2 virus, began in China in December 2019 and quickly spread globally. Healthcare systems faced enormous challenges, especially in protecting healthcare professionals who played a crucial role in controlling the pandemic. Nurses, in particular, had direct and constant contact with patients, performing vital functions and leading multidisciplinary teams. However, they faced a high workload, insufficient information, and a shortage of personal protective equipment (PPE), resulting in a higher prevalence of anxiety, depression, and post-traumatic stress disorder. The lack of specific studies on nurses and their experiences during the pandemic highlights the need for qualitative investigations to better understand the challenges these professionals faced. This study aims to fill that gap by mapping nurses' experiences globally to support strategies for improving working conditions and management in future health crises. OBJECTIVE: This study aims to map the scientific literature on the experiences of nurses caring for COVID-19 patients in hospitals. METHODOLOGY: A scoping review was conducted following the guidelines of the Joanna Briggs Institute (JBI) and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The search covered the databases MEDLINE, Web of Science, CINAHL, EMBASE, and LILACS, using controlled descriptors and synonymous terms. RESULTS: A total of 134 articles were included in the review, most of them published in 2022. The results were categorized into: 1) "Hero Nurse" vs. "COVID Nurse"; 2) Emotional Challenges and Resilience Strategies; and 3) Complex Challenges in Nursing Practice. DISCUSSION:The pandemic imposed significant challenges on nurses, affecting the organizational, emotional, and social aspects of the profession. Nurses' mental health was severely impacted by the fear of infection, uncertainty due to inadequate training, and poor working conditions. The high workload resulted in feelings of anger, frustration, guilt, and devaluation, leading to psychological problems such as anxiety, depression, and post-traumatic stress disorder. To cope with stress, nurses sought spiritual support, leisure activities, but also turned to alcohol and medications. Although praised as heroes, they faced stigma and discrimination, intensifying their emotional suffering. At work, the lack of adequate PPE and institutional support increased health risks and affected the quality of patient care. Additionally, they encountered ethical dilemmas, cultural difficulties, and language barriers. These challenges harmed their family and social relationships, but many were motivated by their love for the profession and social recognition. The pandemic also provided opportunities for professional growth, highlighting the importance of a holistic approach and new technologies. For future crises, it is essential to invest in continuous training, robust support policies, standardized protocols, and professional recognition. CONCLUSION: The crisis highlighted the need to strengthen healthcare systems, provide continuous training, institutional support, and value the nursing profession. It is crucial to implement strategies to prepare nurses for future crises, ensuring their safety and well-being, and promoting quality patient care.