RN Reflections: Lessons Learned, Recommendations, and Pearls of Wisdom in Caring for the COVID-19 Population.

In the early months of the COVID-19 pandemic, frontline nurses faced unprecedented challenges and were often excluded from decision-making, creating a critical research gap as their valuable insights were not captured, hindering the development of effective public health strategies.This study aimed to explore lessons learned, recommendations, and pearls of wisdom from frontline nurses who cared for COVID-19-positive patients in the United States during the early phases of the pandemic.The study employed a descriptive qualitative approach. Data were collected via virtual semi-structured interviews with 30 frontline nurses between July 2020 and November 2020. Analysis utilized reflexive thematic analysis by a 3-member coding team. Rigor was maintained through frequent team debriefing, reflexive discussions, the inclusion of multiple quotation exemplars, a national recruitment strategy, and an audit trail. Reporting followed the Consolidated Criteria for Reporting Qualitative Research checklist for qualitative research.Codes relating to nurses' lessons learned included leadership actions and visibility, innovations in patient care, teamwork and flexibility, and preparedness. Nurse recommendations encompassed soliciting nurses' voices, leadership competencies and enhancing emergency response preparedness, mental health support, and ensuring sufficient resources. Pearls of wisdom for future generations emphasized self-care, mindfulness, effective communication, and engagement with colleagues and family.Effective pandemic preparedness must be managed as a systematic approach. Neglecting these actions risks repeating catastrophic mistakes in future health crises, compromising care quality and patient health outcomes. Improvements need to occur in nursing education, leadership training, and health care support for nurses.

Duke Scholars

Author Melissa Harris School of Nursing