Intensive care unit nurses' redeployment experiences during the COVID-19 pandemic: A qualitative study

The pandemic response required the large-scale redeployment of nurses to support the care of patients with COVID-19. Surveys of staff and analysis of staff feedback indicated that the frequent redeployment of intensive care unit (ICU) registered nurses (RNs) led to dissatisfaction and contributed to voluntary reductions in hours and increased intentions to resign. Whilst much is understood about the redeployment of non-ICU RNs into ICUs to support patient care during periods of high demand, less is known about ICU RNs' experiences of being redeployed to general wards. ICU RNs are often required to work in other areas to cover staff shortages within the organisation when ICU beds are available.

The aim of this study was to explore ICU RNs' experiences of redeployment to hospital wards during 2021 and 2022.

A descriptive qualitative study using semi-structured interviews with 26 ICU RNs was conducted at three hospitals within a major health service in Melbourne, Australia. Participants were interviewed in July 2023. Transcribed audio recordings of interviews were analysed using reflexive thematic analysis.

Six major themes and 12 subthemes were constructed from the data: (i) risk (subthemes: absenteeism, bad for patients-ICU and ward); (ii) choice (subthemes: no choice, security of the ICU); (iii) lost (subthemes: lack of orientation, unfamiliar everything); (iv) distress (subthemes: clinical and emotional stress); (v) a number (subthemes: undervalued, unfair); and (vi) positive perspectives (subthemes: good experience, has to happen, helping out).

ICU RNs' experiences of redeployment out of the ICU were predominantly negative. However, positive aspects were noted regarding the support of colleagues during staff shortages and the opportunity to provide care to patients. The findings highlight the risks associated with redeployment and its impact on both the ICU and the broader health service. Suggested strategies include implementing through orientation practices, adopting a sustainable team nursing approach, and prioritising staff wellbeing.