Emergency Nursing and Staff Experiences With Visitation Restrictions During the Coronavirus Disease 2019 Pandemic: A Qualitative Descriptive Study.

Abstract

Introduction: At the onset of the coronavirus disease 2019 pandemic, visitors were prohibited in the emergency department, leaving patients bereft of their companionship and advocacy. However, little was known about the conflicts and distress of emergency department staff related to this policy. This study aimed to qualitatively explore emergency nursing and staff experiences regarding the no-visitor policy.

Methods: A qualitative descriptive approach explored short answers to 1 open-ended question. Emergency nurses and assistive personnel (patient care technicians and emergency medical technicians/paramedics) were recruited from 11 participating emergency departments, using convenience sampling and a web-based survey. We followed the 6-step process of reflexive thematic analysis to identify patterns in the data and develop themes that describe the results.

Results: Of 180 respondents, 69 (38%) answered our qualitative question. Participants were typically female (78.3%), White (82.6%), and mostly registered nurses (79.7%), with an average age of 39 years and an average of 10 years' ED experience. Participants offered complex, heartfelt responses, resulting in 3 themes: (1) exposure and risk, (2) experiencing patient and family reactions; and (3) policy enforcement challenges.

Discussion: Although many respondents concluded that the policy was protective against pandemic risk, some saw it as ineffective. They believed exceptions must be made for imminent death. Participants felt that patients/visitors understood, but did not always like, restrictions. Adherence to policy left respondents conflicted, leading to inconsistent enforcement. Visitation policies for patients with infectious diseases must consider patient/visitor needs, moral distress of ED staff, and pragmatic enforcement strategies.