“WE SURVIVED!

’: POST- PANDEMIC LIVED EXPERIENCES OF NURSES

IN SUERO GENERAL HOSPITAL.

A Research Proposal

Presented to the Faculty and Staff of

Senior High School Department

San Juan National High School

Immayos Sur, San Juan, Ilocos Sur

In Partial Fulfillment of

the requirements on the subject

Practical Research 1

by:

CARL LLOYD P. BRIONES

ROVEL U. HILARIO

KEVEN D. LUSTADO

PRINCESS MAE F. NOLASCO

BRIENE AKISHA T. SEATRIZ

JHASTINE D. VERACION

2023
 Chapter I

The problem

Introduction

The COVID-19 pandemic outbreak is caused by severe acute respiratory

syndrome coronavirus 2 (SARS-CoV-2). It started on Wuhan, China and was first

reported to World Health Organization (WHO) on December 31, 2019, the WHO

declared its outbreak a global health emergency on January 30, 2020. Meanwhile,

according to World Health Organization (2022), the SARS-CoV-2 and any other

viruses can change over time and will continue to make changes the more they

circulate, and variants of the virus may produce, that contains only one new change

to the original virus. In addition, Delta and Omicron are the variants of the

coronavirus and are spreading more easily between people.

Furthermore, the COVID-19 affects many individuals with their businesses,

lifestyle and may more. However, the one who are affected the most are the medical

workers especially nurses. They were assigned to fight the pandemic even though it

made them be away from their loved ones that gave them issues with their selves

such as anxiety, depression, fear, insomnia, and traumas. Some research shows how

nurses cope with their issues during the outbreak. Codorin et al. (2023) said that

nurses have strategies that they used to counteract the suffering that the COVID-19

cause them, such as tiredness, tensions, heavy works, and burden. Some of the nurses

prefer chatting and videocalling more because it was more safety; did gardening
while being isolated; some are engaged in cooking, reading, walking, or running to

reduce tension; most of them take precautionary measures like putting mask even at

home and making distance with their friends to avoid exposure; and others did small

rest for like sitting up for 10 minutes to reduce pressure with their job.

As days go by, with the help of many vaccines the situation is getting back to

normal and with these changes, some researchers have stopped investigating the

lived experiences of nurses with the reason that the pandemic is already gone. The

Suero General Hospital, where nurses are one who also faced the outbreak during its

first to last phase, and now carrying unpleasant feelings that during outbreak caused

them now to not have an ease in adjusting the post- pandemic.

Some researchers found reasons why nurses are having a hard time in

adapting these changes. Nurses is suffering from secondary burden. The pandemic

took its toll on many patients who could not obtain timely and proper care. Not only

looking after patients with COVID-19 that nurses work more difficultly, but also

experiencing hurdles for other patients, increased the stress on nurses. With the

reason that nurses provided care for families who had recently lost a loved one

unexpectedly.

Many families may endure protracted grief disorder because they were unable

to be with the dying patient. While there may be grief and suffering associated with

every death, families dealing with a significant illness or death during the COVID-19

outbreak may have gone through additional distress and worry. While being simple
to comprehend, Nurses now must concentrate on the “secondary burden” that

families experience by having gone through a period of extreme anxiety and stress.

This is due to the possibility that patients after intensive care treatment and

prolonged ventilation may be traumatized and need to regain trust in their abilities to

return to their daily living. Time is necessary for both the sick individual and the

family to find a path back to life, to strength, and to trust in the future. (Konradsen et

al., 2023)

Nurses has Post-Traumatic Stress Disorder (PTSD). In the study of Weirich

and Ramirez (2022) they said "As frontline workers, nurses bear astonishing pressure

due to physical exhaustion, increased workload, inadequate personal protective

equipment, intrahospital transmission, and moral distress. As a result, nurses are

susceptible to depression, anxiety, emotional distress, fear, insomnia, burnout, and

post-traumatic stress disorder (PTSD). Given the high likelihood that sarbecoviruses

will arise again, it is imperative that nurse leaders learn from this pandemic and

implement strategies that support our current at-risk workforce while maintaining

force readiness for the future."

This research study needs to be addressed and studied as a continuation of

what has been investigated in these past 2 years and how is this will be renewed as

COVID-19 was already gone. Due to gently changes in our new-normal, this study

will try to seek for knowledge on the experiences of nurses right now, post-

pandemic.
 This study will be conducted to determine the lived experiences of nurses in

Suero General Hospital, and to find how do they adapt to those negative thoughts and

unpleasant feelings that the COVID-19 gave them.

STATEMENT OF THE PROBLEM

This is study generally aims to evaluate the post-pandemic lived experiences

of nurses in Suero General Hospital.

Specifically, it seeks to answer the following question:

1. What are the views of nurses in the post-pandemic?

2. What are the challenges of nurses in facing the post- pandemic?

3. Why are the other nurses having a hard time on adapting the post-pandemic?

4. What are the coping mechanisms of the nurses right now, post-pandemic?

SIGNIFICANCE OF THE STUDY

Significance of the study the researchers hope that this study would be beneficial to

the following:

Nurses. The result of the study would be helpful in aiding the traumas and

difficulties of nurses during the post pandemic. Furthermore, this will serve as a

resolution to nurse's mental health with negative impacts of COVID-19.

Patients. The patients will also be benefited with this study. This will further deepen

the bond between the nurses and the patients through giving each other moral support

despite the challenges.

Doctors. To the doctors, the result of the study will offer them knowledge about the

challenges of nurses during the post pandemic. Furthermore, it will give insights to

assure a safe environment despite daily panic attacks and anxiety about COVID-19

Futures researchers. This study will serve as a reference for any similar studies to be

conducted.

Future Researchers. this study will serve as a reference to any further related

studies that will be conducted.

Scope and Delimitation

This study will focus with the lived experiences of nurses now, post-

pandemic. The participants of the study are the nurses of Suero General Hospital for

the year 2023. The participants will be limited to 10 nurses, the selection of it was

done through a purposive sampling. Interview and some questionnaires will be use in

the collection of data and information.

OPERATIONAL DEFINITION OF TERMS

Nurses. They are the participants of this study and patient’s caregiver by taking care

of their physical requirements, avoiding disease, and treating medical issues.

Patients. To tell the accountable nurses of any changes to their general health status,

symptoms, or allergies. If a patient is unsure of the course of therapy or their role in

the plan, they are accountable for reporting. Doctors and nurses. Keeping

appointments is the patient’s responsibility.

Doctors. To tell about the patient’s condition, diagnosis, and therapy, the doctor

educates patients, families, and assistants. The doctor will provide patients with

information and research-based resources so they may decide on their treatment plan

in an accurate way.

Post-Pandemic. Decreasing cases of covid and the outbreak slowly getting done.

Frontline workers. They are ensuring the health, safety and security of the people.

Moral distress. When you are restrained from taking the morally right action despite

knowing what to do like feelings of anger, frustration, hopelessness, isolation, and

suicidality.

Inadequate personal protective equipment. This are the things of Health and

safety protocols involved.

 Conceptual framework

This study was guided by the conceptual framework below:

CHALLENGES ADAPTATION

VIEWS COPING
“WE SURVIVED!’: POST- PANDEMIC
MECHANISM
LIVED EXPERIENCES OF NURSES IN

SUERO GENERAL HOSPITAL.

Figure 1: Research Paradigm

Figure 1 illustrate the conceptual framework of the research. As shown in the

picture, the study will focus on lived experiences of nurses. The researchers will

investigate the challenges encountered by nurses now post-pandemic and their

coping mechanisms and as well as the views of nurses on post-pandemic.

 Chapter II

Review of Related Literature

This part deals with the relevant literature that have a significant connection

on this study.

Nurses During the Outbreak

Nurses are one of the health workers that has a huge risk during the COVID-

19 pandemic outbreak, all of them gave their most sacrifices dealing with those

affected patients even though death is the possible supersede of their hard work.

According to the study of Bleich and Bowles (2021), nurses are some of the frontline

healthcare workers especially when caring for COVID-19 patients. Also, they took

an active part in hospital leadership and management tasks, such allocating hospital

resources during the pandemic. Since they frequently have heavy workloads, they are

dealing with several ethical issues and concerns. With moral ambiguities, a high rate

of patient deaths, and lengthy workdays, nurses have had to deal with unpleasant and

challenging ethical dilemmas in the real world.

Due to the continuous growth of COVID-19 cases, nurses felt pressured

within their jobs and been burnout day by day. Also, according to Havaei et al.

(2021), since COVID-19 was declared a global pandemic, nurses have faced

previously unheard-of workplace stressors like limited access to personal protective

equipment, a lack of effective pandemic management plans, worries about

contracting the virus and spreading it, and the sudden death of patients and

colleagues because of COVID-19. In many nations, nursing professionals have a

mortality risk that is between 15 and 125 times higher than that of doctors, making
them one of the healthcare workers with the highest risk of contracting the virus.

Thus, stress connected to COVID-19 makes nurses more likely to experience

negative mental health consequences.

Ethical Responsibilities

While nurses deal with hazard on a regular basis during COVID-19,

occupational safety is extremely important to their employment. The primary

responsibility of nurse leadership will be to see that the necessary security and

preventative measures are adopted to lessen workplace risks. As Fawaz et al. (2022)

said that, even though nurses frequently encounter danger during COVID-19, their

jobs depend greatly on occupational safety. The main duty of nurse leadership will be

to oversee the implementation of the essential security and preventative measures to

reduce workplace dangers.

According to the study of Peter et al. (2022), by maintaining their affiliation

with the social and cultural context, nurses help patients maintain their sense of

identity. Despite the routinization of bureaucratic labor and the depersonalization of

disease, the cultural world of nurses. The moral obligation to care for others is not

just necessary for people who are nearby; it is also required. Through health policy

for future and unidentified individuals. When patients are imminent, however, the

proximity to strong normative intuitions are sparked in nurses by pain, suffering, and

vulnerability to care for and attend to their needs.

According to the study of Noviana et al. (2022), despite the position they are

in, nurses are required to provide care even though they are on scenarios that will put
themselves in danger. While operating under severe time restrictions, they must

make difficult judgments.

Mid-Pandemic Challenges

The pandemic affects nurses during the pandemic, this caused them not to

do their duties properly. At the same time, those issues made gap between the nurses

and patients because of unstable working emotions of medical workers. Furthermore,

those challenges changed them physically, emotionally, and mentally.

According to the study of Noviana et al. (2022), when providing care to

those patients with COVID-19, nurses are having poor personal protective equipment

(PPE), inconsistent working moods, and exhausting shift work. Extremely

challenging situations confront nurses worldwide. When the COVID-19 virus first

started to propagate. Even the nurses and their families experienced stigmatization

and it was difficult to them to speak up.

According to the study of Delgado et al. (2021), nurses experienced

significant psychological distress, including anxiety and fear, which were

compounded by concerns about contracting the virus and infecting family members.

Nurses also reported high levels of fatigue and burnout due to increased workload

and long working hours.

Post-Pandemic Challenges

The COVID-19 gave nurses issues during mid-pandemic such as anxiety,

depression, insomnia, being burnout, and tiredness. In addition, now that the world is

in post-pandemic state, there are some problems of nurses and all healthcare workers

that has been left by the COVID-19 pandemic outbreak. one of the challenges of
nurses right now is the posttraumatic stress disorder (PTSD), a typical, severe, and

complex mental illness that develops after being exposed to traumatic circumstances.

It is characterized by intrusion and reliving the trauma through dissociative reactions

that resemble flashbacks, attempts to avoid trauma-related ideas, emotions, locations,

or people, persistently negative cognition and mood, and hyperarousal, including

anxiety, trouble sleeping, and irritability. (Yuan et al., 2021)

Also according again to Yuan et al. (2021), nurses took this disorder by an

unsatisfactory workplace conditions utilizing personal protection equipment over an

extended period of time working conditions that are demanding and frequently

overburdened due to the extreme pandemic conditions, a dearth of understanding of

the condition and its specific medications, and the death inevitably results in

psychological shock are all factors that contribute to the high occurrence of PTSD

among frontline healthcare professionals and frontline nurses. A different specialty

of healthcare professionals is worth. Those who worked on the front lines received

special attention. Those who contracted the illness and ended up as sufferers.

Frontline Healthcare professionals are very likely to be exposed to infection and are

at very high risk of contracting an infection.

Coping Mechanisms

Despite of all the challenges that the COVID-19 pandemic outbreak caused

them such as insomnia, trauma, fear, being away from their family or friends, being

burnout, drained, and tired because of the heavy duties that were assigned to them.

Nurses still find ways to cope those issues that the virus gave them, coping

mechanisms help them to forget those hurdles and rise again with a new look and
new set of confidence in their everyday work. And according to Huang et al. (2020),

Compared to nursing students, nurses exhibit stronger emotional reactions and are

more open to using problem-focused coping strategies. Not necessarily among

nursing students, but among nurses, there may be a loop of "more coping-more

panic."

According to the study of Sim et al. (2022), several frontline employees

looked for ways to manage the stressors brought on by the pandemic. Their own

methods of self-care, such as taking breaks and seeking interests, as well as

contacting mental health professionals or other emotional support systems.

Also, according to Havaei et al. (2021), The nurses talked about their

individual coping mechanisms for dealing with the suffering that COVID-19 caused

them. Some nurses preferred video calls and shopping, while others spent time

gardening, cooking, renting, going for walks, or running. Some nurses also took

protective measures for their families. In order to ease the anxiety, especially from

being away from family, the nurses recounted everything.

 CHAPTER III

METHODOLOGY

This section presents the research design, study participants, data gathering

instrument and procedure, ethical considerations, and data analysis in this study.

Research Design. The purpose of this study was to investigate the lived

experiences of nurses in Suero General Hospital. It employed qualitative research in

a phenomenological approach. Wherein, phenomenology as a research method is

used in psychology, education, and in health care. (Connelly, 2010), Which makes it

suited to this study.

Participants. The researchers covered the nurses of Suero General Hospital

as participants of this study. The selection method is Purposive Sampling since it is

known as the widely used for qualitative research studies for it provides useful data

from selected respondents or sample that one of interest. The participants were

recruited based on the following inclusion criteria: (1) nurses of Suero General

Hospital, (2) nurses since COVID-19 outbreak, (3) male or female, (4) a participant

that is willing to be a respondent of the study.

Data Gathering. This qualitative phenomenological research study use of an

Interview Guide in gathering the data to address the research question or problems.

The data that gathered were described and analyzed to determine the impact of post-

pandemic in the lived experiences of nurses in Suero General Hospital.

 Data Analysis. The researchers of this study employed Colaizzi Method in

data analysis which consist of seven steps:

Familiarization. Each transcript will be read many times to understand the

full content. The researchers will do bracketing to explore the data by the

participant/s considering the feelings, thoughts, and ideas.

Identifying Significant statements. Significant statements and phrases will

be identified. Each statement will be written and will be translated in a separate sheet

coded accordingly with transcripts, pages, and lines.

Formulating meanings. The formulation of the meaning of the significant

statements will be done. Codes will be provided for each underlying meaning in one

category from the detailed description. Formulated meanings will be checked with

the original meanings and finalized after corrections from an expert researcher who

agreed that the process is correct, and the meanings are consistent.

Clustering Themes. After finalizing the meanings done by the researcher,

groupings of all those formulated meanings will be processed into categories.

Reflecting unique structures of clusters of themes will be made. Each topic cluster

will be coded, including all stated meanings associated with the group meanings.

After, which group of clusters of themes reflecting a particular point will be done.

Developing an Exhaustive Description. At this stage, all emergent themes

from a thorough description will be defined. Based on the themes, the whole

structure of the phenomenon will be emerged.

Producing the Fundamental Structure. In this step, the findings with

repetitions, wrong usage, and uncalled-for descriptions will be eliminated from the
whole structure. Hence, the emphasis on the fundamental structure will be well-

defined. Corrections specified the real meaning of the relationship between the

clusters of themes from the extracted themes. All unnecessary structures that affect

the full description will be removed.

Seeking Verification of the Fundamental Structure. This step will validate

the findings using the “member checking” strategy by returning to the participant’s

and discussing the results.

Ethical Considerations

The following ethical principles were followed during the investigation.

Conflict of Interest. There was no conflict of interest in the study’s conduct because

the researcher was only interested in the participants’ lived experiences for research

purposes.

Privacy and Confidentiality. By assigning codes/pseudonyms to the

responses, the researcher ensured the anonymity and confidentiality of the

participants. All documents about the participants were kept in a lockable file

cabinet. The materials will be shredded after the research is completed, and the

recorded interview will be removed.

Informed Consent. The researcher provided the participants with proper

orientation on the purpose of the study. The benefits that they get from the research

were explained to them. Their willingness to participate by answering the questions

during the interview was tantamount to implied consent.

Recruitment. Voluntary participation was solicited from the respondents.

They were told that they might opt out of the study at any moment.
 Risk. During the research, the researcher ensured that the participants’

dignity, autonomy, and involuntariness were not jeopardized,

Benefits. The participants benefited from the study because the result will be

used to develop suitable support programs for them.

Compensation. There was no compensation given to the respondents for

participating in the interview.

 References

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and workplace resilience: A cross‐sectional survey. International journal of mental

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021-01036-x
 Appendices

Appendix “A”

Communication Letter/s
 Interview Guide Questions

Impact:

1. What is your perception to the changes in now post-pandemic?

2. How does the COVID-19 affect your life now that the outbreak is getting done?

3. What are the issues that you encountered during mid-pandemic that stays until now?

4. What are the challenges that hinder your own adaptation in now post-pandemic?

5. What are your coping mechanisms this post-pandemic?

6. Do you have any thoughts that the pandemic will be back again?

7. How can you differentiate yourself during and after pandemic?

7.1 How about the relationship with your family and friends?

8. What did you felt when some of your patients died during the pandemic?

8.1 with their family that they left?