Longitudinal Research: Differences in Nurse Work Environment Between the COVID-19 Outbreak and Mitigation Periods.

Abstract

Aim: The coronavirus disease 2019 (COVID-19) outbreak led to a massive influx of patients into hospitals, thus prompting the implementation of various response mechanisms to manage the surge in number of patients. During the mitigation period, hospital response mechanisms ceased and ensued a return to normal settings. However, changing hospital settings can affect nurses' work environments. Therefore, the primary objectives of this study were to investigate the impact of changes during disease outbreaks and the mitigation period on nurses' work environments, and to analyse the relationship between nurses' background variables and work environments.

Study design: A longitudinal research design is employed herein.

Methods: Two surveys were conducted in a hospital: the first during the COVID-19 outbreak period, when the hospital implemented response mechanisms, and the second during the COVID-19 mitigation period, when the hospital returned to normalcy. The questionnaire covered the nurses' background variables and work environment.

Results: When the COVID-19 outbreak transitioned to the mitigation period, satisfaction with managerial (p < 0.05) and unit support (p < 0.05) in the workplace decreased. Regarding the relationship between nurses' backgrounds and work environment satisfaction, we found that nurses working in COVID-19 dedicated units reported higher satisfaction with manager support (p < 0.001), peer support (p < 0.001), unit support (p < 0.05) and intent to stay (p < 0.05) than those in non-COVID-19 dedicated units. Additionally, factors such as age, nursing experience, sex, education, clinical teaching/mentoring roles, perceived COVID-19 infection risk, work shifts, housing problems during the outbreak and experience of discrimination influenced work environment satisfaction.

Patient or public contribution: Hospitals need to adjust the transformational steps of their COVID-19 or emerging infectious disease response mechanisms, or provide sufficient support to these nurses to mitigate the impact on their work environment.