Stress and Coping among Nursing Home Staff during the COVID Pandemic

Objectives: The purpose of this study is to explore the stressors and coping mechanisms of staff working in a nursing home environment during the COVID-19 pandemic.
Nursing homes house our most aged and vulnerable populations, contributing to the high levels of Coronavirus illness and death. Healthcare staff who are often emotionally engaged and working in such close proximity, pose an increased risk to these highly susceptible populations in nursing homes. Since there is still much to learn related to COVID-19 we turned our attention to investigating the emotional toll and impact of healthcare staff working with those residing in nursing homes.

Methods: Institutional Review Board (IRB) approval was received to conduct a qualitative study using a semi-structured survey for administering individual interviews. A series of the same 12 open ended questions were posed to each staff member. Participants were nursing home staff currently employed or were employed by one of two New York State long term care facilities during the COVID-19 pandemic. Interview data were transcribed verbatim and then analyzed using Braun and Clarke’s Reflexive Thematic analysis. Thematic analysis results in explaining people’s experiences, perceptions, views, or representations of a given topic.

Results: Results focus on twelve nursing home staff participating in the study. These included 2 nurse practitioners, 7 registered nurses, 1 executive director, 1 social worker and 1 physical therapist. Of the participants 11 were female and 1 male. Collectively, their experience working within a long-term care facility ranged from 7 months to 25 years.
Based upon the data, four main stressors were identified and five helpful coping strategies were shared by study participants.

Conclusions: Staff of both nursing homes describe their experiences as exhausting, frustrating, and constantly uncertain, as demands change daily. Several describe that counseling services, leadership, colleague support and family support enabled them to address and manage the constant stress they experience. Of particular concern is the coverage and shortage of staff available to address patient needs resulting from the COVID-19 pandemic. Furthermore, staff articulated worry about a second wave. From these findings, the researchers believe they help to understand the impact COVID-19 has on staff located in nursing homes. Healthcare staff working in direct patient care require ongoing support to address stress and prevent staff turnover. Further research needs to identify stress reduction interventions to assist nursing home staff.