'Doing the best we can': Registered Nurses' experiences and perceptions of patient safety in intensive care during COVID-19.
Louise Caroline Stayt, Clair Merriman, Suzanne Bench and 6 others
PMID 35986583WHAT IT FOUND
Intensive care nurses reported that pandemic surges forced fragmented, task-focused care.
They described missed turns, delayed extubations, and rationed oxygen as safety compromises. Nurses felt professionally unsafe delivering 'bare minimum' care while supporting redeployed staff.
Key findings
01Care was fragmented into short task lists and tag teams, which nurses felt stripped away holistic patient-centred care.
02Nurses reported specific missed care incidents including delayed patient turns, omitted delirium bundles, and extended mechanical ventilation due to staffing shortages.
03Formal incident reporting decreased because nurses accepted unsafe practices as routine during the surge, masking the true scale of patient harm.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study relies on nurses' perceptions and self-reported experiences; actual adverse event rates were not measured. Participants were recruited only from England, limiting transferability to other UK nations or health systems. Most participants were senior nurses with over 20 years of experience, which may not reflect the views of less experienced staff. Data collection ended in July 2021, so findings may not reflect the evolving pandemic situation or the impact of vaccination programs.
Declared interests
The study was funded by the Burdett Trust for Nurses. No other conflicts of interest were declared.
The easy way to misread this
Do not interpret the reduced number of formal incident reports as evidence of improved safety. The nurses stated that reporting thresholds rose and unsafe care was accepted as routine during the crisis, meaning actual adverse events likely went unrecorded.