Workload of frontline nurses and health professionals during COVID-19 pandemic

Abstract

Background: In March 2020 coronavirus infection was reported in Mongolia, the infection outbreak started in November and as of 6 April 2022, there had been 919.625 confirmed cases.The research “Impact of nursing workload on quality of patient care” showed that 85% of nurses experience a higher workload than ever before there was not sufÏcient time for performing nursing care duties due to the high number of patients per nurse. Moreover, caring for critically ill patients adversely affects nursing care quality.1 A Nationwide Survey in Korea showed that in the ward for COVID-19 patients, nurses did duties other than their general duties: medical equipment management (80.0%), cleaning and disinfection of hospital rooms and beds (66.7%), transfer of patient specimens (33.3%), and meal delivery and feeding assistance of patients (26.7%).6 During the Covid -19 pandemic, doctors and nurses worked in Covid-19 wards with an average duration of 10-14 days with a high workload and a shortage of human resources worldwide. Thus, we aimed to explore the workload of nursing staff and other health workers caring for patients with Covid-19. Aim: To investigate and evaluate the workload of nurses worked in inpatient wards during the Covid-19 pandemic at the General hospital of Govi-Altai province Materials and Methods: We involved 87 nurses and midwives who worked in Covid -19 departments of the General hospital of Govi-Altai province in the study. An analytical cross-sectional study design was utilized. The data analysis was done using SPSS version 21. The Kolmogorov–Smirnov test was used to determine data distribution and the statistical dependence was calculated by Spearman’s correlation coefÏcient. Results: As regards the gender and professions of the study participants, 93.1% were females, 6.9% were males, the majority were nurses (87.4%) and 12.6% were midwives. 57% of study participants were infected once, 13%-twice and 24% didn’t get an infection while working in Covid-19 wards. In terms of the frequency of working in Covid 19 wards was 1-5 times. When the study participants were asked what was the reason for working in Covid-19 wards they responded that because of arranged shifts (34%), the organization’s decision (48%), and their desires(18%). The study revealed that while the average number of patients in usual wards was more than 25 daily, the intensive care units had over 20 patients. In terms of nursing care procedures: administering medications was (71%) for 17-24 patients in the intensive care unit and usual wards’ was (63%)for more than 25 patients. Inserting urinary catheter was performed for 1-5 patients (92%) and intravenous cannulation and its care in usual wards-55% and 59.3% in the intensive care unit respectively. Regarding the nursing procedures, the subcutaneous shot was 58.3% in usual wards and 59.3% in the intensive care unit, and intramuscular injection -was 45% in usual wards while it was 54.9% in ICU. Infusion procedure was 35% in usual wards and 44.4% in the ICU. The physical and mental impacts nurses faced while working in Covid 19 wards were the following: fatigue-92%, headache-63%, fear-81.5%, worrying about family59.3%, working long hours with personal protective equipment-74%, and handling difÏcult patients89% respectively. Conclusion: 1. Nurses and other health workers in Covid-19 wards worked with high frequency of shifts wearing personal protective equipment for longer hours. 2. Nurses of Intensive Care and usual Covid-19 wards spent most of their working hours for giving injections ,performing nursing care and for filling in treatment and nursing report sheet. 3. Our study findings showed that most of the nurses who were working in Covid-19 wards experienced health crisis including headache, fatigue, worrying family members, hypertension, and handling with difÏcult patients which indicated strong positive correlations.Moreover,they faced many challenges including excessive workload, lack of protective equipment, psychological problems, fear, isolation in personal and family life, and lack of support in the workplace.