Front-line nurses' responses to organisational changes during the COVID-19 in Spain: A qualitative rapid appraisal

To identify the organisational changes faced by front-line nurses working with COVID-19 patients during the first wave and describe how they responded to these changes.

The COVID-19 pandemic has altered the provision of care and the management of health care around the world. Evolving information about SARS-CoV-2 meant that health care facilities had to be reorganised continually, causing stress and anxiety for nurses.

Qualitative study based on Rapid Research Evaluation and Appraisal (RREAL). The research took place in hospital and community health settings of the Spanish national health system with a purposive sampling of 23 front-line nurses. Semi-structured interviews were conducted between May and June 2020. The duration was 30-45 min per interview. We used the Dedoose® data analysis software to perform a thematic analysis.

Nurses responded to organisational changes using the following strategies: improvisation, adaptation and learning.

Our rapid approach allowed us to record how nurses responded to changing organisation, information that is easily lost in a disaster such as the COVID-19.

Knowing about their strategies can help planning for future health disasters, including subsequent waves of the COVID-19.