Exploring the Long-Term Impact of Emotional Exhaustion on Frontline Nurse Managers Post-COVID-19: A Qualitative Study

Abstract

Aim: To explore emotional exhaustion in frontline nurse managers after 3 years of COVID-19, considering their essential role in healthcare systems and the prolonged impact of the pandemic on staff well-being and organizational effectiveness.

Design: A qualitative phenomenological study was used. This approach attempts to uncover the essence of the experiences that nurse managers may have had.

Method: Semi-structured interviews were conducted with 12 frontline nurse managers at a tertiary-level university hospital in Spain during May 2023. The data were analyzed using thematic analysis. A thematic framework was developed, and coding was guided by a well-established methodological approach.

Results: Five categories were established after the analysis: general difficulties related to fear and uncertainty, and continuous changes in protocols, availability of human resources, accessibility to material resources, management carried out with relatives of patients, and emotional management.

Results: Following the analysis, five key categories were identified that reflect the main challenges faced by nurse managers: (1) general difficulties related to fear and uncertainty, aggravated by frequent changes in protocols and the work environment; (2) availability of human resources, marked by high absenteeism and work overload; (3) accessibility to material resources, where the shortage of protective equipment and medical supplies generated ethical dilemmas and operational tensions; (4) management with patients’ relatives, a significant emotional component that required balancing empathy and safety measures in high-conflict contexts; and (5) emotional management of managers, which evidenced a significant emotional impact, highlighting the need for clear strategies to prevent burnout and foster resilience in these critical roles.

Conclusions: Nursing managers experienced emotional exhaustion during the pandemic, not only due to the health consequences of the virus but also due to the complex management of material, human, and family resources. They faced difficult situations with families justifiably separated from their vulnerable loved ones. This highlights the need for specific interventions, such as psychological support, leadership training, and better allocation of resources, to reduce the risk of burnout and strengthen a more resilient healthcare system.