The Role of Nurses in Handling Covid-19 Situation

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Supervised by:
Dr Rab Nawaz Lodhi

Submitted by:
AROOJ KHAN MBA-FALL-19-132
MUHAMMAD SAAD MBA-FALL-19-125
UMER ALAM MBA-FALL-19-113

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Institute of Business & Management

University of Engineering and Technology, Lahore

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Declaration

We (Arooj Khan 2019-mba(1.5)-132, Muhammad Saad 2019-mba(1.5)-125, Umer Alam 2019-

mba(1.5)-113) hereby declare that we have produced the work presented in this thesis, during
the scheduled period of study. We also declare that we have not taken any material from any
source except referred to wherever due that amount of plagiarism is within acceptable range

Date: 25-08-2020

_________________________________________

Institute of Business & Management

University of Engineering and Technology, Lahore

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 DEDICATION
This report is dedicated to:

TO HOLY PROPHET (PBUH) “The greatest Reformer”

To our loving Parents for nursing us with their affection and love without
whom none of our success was possible
To our Respected Teacher who is always in our heart and are nearest,
dearest and deepest to us

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ACKNOWLEDGEMENT

First of all, thanks to Almighty Allah (the most beneficial, the most
merciful) for giving us an intellectual sight or ideas and for us establishing
us to complete this report. We would like to thank Dr. RABNWAZ KHAN
LODHI our supervisor, who introduced us the most important concept of
information technology and provided us persistence guidance. He has
shown attitude and the substance of a genius and continually conveyed
excitement in regard to supervision. Without his supervision and constant
help this report would not have been possible.

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Contents
Abstract ......................................................................................................................................................... 6
Introduction .................................................................................................................................................. 7
Research Objectives ...................................................................................................................................... 9
1. To explore the strategies of the Nurses to treat the Critical patients of Covid-19....................... 9
2. To explore the strategies of the Nurses to treat the Non-Critical patients of Covid-19............... 9
3. To explore the strategies of the Nurses to treat the recovered warriors of Covid-19 ................. 9
Conceptual Model ......................................................................................................................................... 9
Research Method ........................................................................................................................................ 10
Data Collection ............................................................................................................................................ 10
Descriptive Statistics ................................................................................................................................... 10
Table. Characteristics of participants ........................................................................................................ 10
Findings of study ......................................................................................................................................... 11
Conclusion and Discussions ....................................................................................................................... 12
Appendix ..................................................................................................................................................... 13
Future Limitations ....................................................................................................................................... 15
Questionnaire ............................................................................................................................................. 15

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Abstract
The aim of the study was to investigate the role of nurses in handling COVID-19 situation

factors affecting the mental health of patients in which we highlight three types of patients that

are affected badly critical patients, non-critical patients and recovered warriors during the

corona virus disease (COVID-19) pandemic in Pakistan. The study also measured the factor

influencing the mental health of nurses during the corona virus disease (COVID-19) pandemic.

Semi-structured, in-depth telephone interviews were done at a time convenient for participants

between August, 3 to August, 16, 2020. With participant permission, all interviews were audio-

recorded. Participants' age, marital status, years of work experience, original department, the

date they started working on the COVID-19 ward, and number of days they worked on the

COVID-19 ward before the interview was obtained at the start of the interview. Non-probability

sampling method was used. In non-probability convenience sampling technique was used.

NVivo 12 software has been used for in-depth qualitative analysis. Many techniques have been

used to authenticate the themes of study like coding, word tree, word tag clouds and tree maps

etc. Hierarchy chart is being used to abstract the findings.

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Introduction
COVID-19 was first recognized in December 2019 and was firstly detected in China. After words

it spread all around the world. The Corona virus disease (COVID19) was declared a global

pandemic by the World Health Organization on March 11, 2020 (World Health Organization,

2020c). One infected patient can infect many others through touch and direct contact. Germs

of COVID-19 can spread through sneezing and coughing etc. These germs can live on a surface

for some hours. This pandemic in not only a health crisis but has affected whole economies and

societies. To overcome these situations different techniques were used by every government

varying from country to country. Some practiced curfew and complete lock downs and some

followed smart lock downs. Due to corona virus pandemic all activities have been

interrupted.COVID-19 Corona virus is increasing rapidly spreading worldwide. As of 15

August,2020 there have been confirmed cases in all over the world with 765Kdeaths. The

rapidly evolving epidemic has stressed the entire nursing system in ULTH. When fever clinics

and respiratory and infectious disease units in ULTH were overwhelmed by the increasing

number of suspected and confirmed cases in the early stage of the outbreak, general wards

were quickly modified into isolation wards, and Nurses who did not have infectious disease

expertise stepped up to provide care for patient with COVID-19. As the epidemic progressed in

ULTH, more Nurses joined the epidemic control efforts.

Nurses are vital resources for every country. Their health and safety are crucial not only for

continuous and safe patient care, but also for the control of any outbreak. However, Nurses

area taking care of patients during the severe acute respiratory syndrome (SARS) outbreaks

were under extraordinary stress related to high risk of infection, stigmatization, understaffing

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and uncertainty and comprehensive support was a high priority during the outbreaks and

afterwards. Quantitative studies have shown that frontline Nurses treating patients with

COVID-19 have greater risks of mental health problems, such as anxiety, depression, insomnia

and stress. Frontline nurses who had no infectious disease expertise had additional challenges

when adjusted to an entirely new working environment in this stressful situation. To our

knowledge, no qualitative research studies of the experiences of Nurses have been published.

To support them effectively, it is necessary to gain insights into their lived experience. While

being quarantined at home and not able to provide frontline care at the height of the corona

virus outbreak, we wanted to make sure the experience of these front line Nurses who had no

infectious disease expertise were not lose. Therefore, we aimed to describe the experience of

this Nurses Caring for COVID-19 in the early stage of the outbreak.

According to a Nurse, after the breakdown of corona virus in Pakistan, Initially ULTH develop

PCR level 2 laboratory in private sector for the tests of COVID-19. They provide discount to

public from which 4000 patients came to COVID-19 positive.

ULTH is based on 460 beds, and they develop a ward of 60 beds including ICU (intensive care

unit), HDU (High dependency Unit) and Isolation Ward for the Corona positive patients. They

have been provided separate Assessment unit, separate area and lift for Corona positive

patients. They also provide healthy food to the patients. High quality PPs for medical staff were

also imported from China. Doctors with high expertise in caring for patients. Teams consisting

of Physician Cardiologists and Anesthesia were injections e.g Actemra, Remidsvior and

Dexamethasone in a timely and uninterrupted manner. Thus, about 180 patients were treated

in the hospital out of which formed who are engaged in the treatment of patients 24/7.

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Patients of COVID-19 were provided with life-saving medicines including 225 patients were

given intensive care. The recovery rate was much better.

Thus, the infection rate among health workers was less than 10% due to standard

arrangements for staff safety, which is commendable. All the patients were treated as per the

directions of Punjab Healthcare Commission at very low and reasonable fees. The hospital

played a key role in treating the global epidemic by providing the best facilities for the public.

Research Objectives
1. To explore the strategies of the Nurses to treat the Critical patients of Covid-19.

2. To explore the strategies of the Nurses to treat the Non-Critical patients of Covid-19.

3. To explore the strategies of the Nurses to treat the recovered warriors of Covid-19

Conceptual Model

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Research Method
We did a qualitative research by using an empirical phenomenological approach. Nurses were

recruited from COVID-19 designated University of Lahore Teaching Hospital. Interviews were

transcribed by Nurses.

Data Collection
Data are collected from the period of July to August. Data collection occurred concurrently with

data analysis. The audio recordings were reviewed by the interviewers for accuracy. The

interviews, original transcriptions, and data analysis were in Urdu. During the data analysis, all

authors agreed with the results and chose the highlighted quotations. All quotations were

translated into English to ensure that meaning was retained. Respondents are physically

involved in hospital to cure the COVID-19.

Descriptive Statistics
Our sample consisted of 8 nurses including Nursing Superintendent and male Nurse from

COVID-19-designated hospital (University of Lahore, Teaching Hospital) in Lahore in August,

2020. Many nurses declined to participate in the study due to their high level of fatigue. All

participants took care of patients with COVID-19 in the hospital. They joined COVID-19 wards at

different times, from mid-March to early May. Interviews lasted about 5–10 minutes.

Table. Characteristics of participants

Sr. Age Gender Marital Status Work Original Since working in

No Experience Year Department COVID-19 WARD

1 56 Female Married 23 Head of 15 March

Department

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2 26 Female Married 3 MICU 21 March

3 27 Female Unmarried 5 MICU 21 March

4 27 Female Unmarried 4 SICU 16 March

5 24 Female Married 2 MICU 15 March

6 32 Male Married 8 SICU 25 March

7 28 Male Unmarried 5 SICU 2 May

8 33 Male Married 7 MICU 6 May

Findings of study
Combined Hierarchy Chart of all three Factors: Significance of each theme of the study is
shown by hierarchy chart. The below hierarchy chart shows the themes of three factors
affecting the mental health of nurses during COVID-19 pandemics.

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Conclusion and Discussions
This study has aimed to dig out the effect of critical patients, non-critical patients and
recovered warriors on mental health of nurses during COVID-19 pandemics. Non- probability
sampling was done. In non-probability convenience sampling technique was used to dig out the
things after doing in depth research. The data was collected from July, 2020 to August, 2020. In
depth audio interviews of the on-duty nursing staff working in Lahore University Teaching
Hospital. Several Semi structured questions were asked from the respondents. Several
techniques have been used for qualitative data analysis with the help of NVivo 12. The effect of
the patients (critical, non-critical, recovered warriors) has been identified. Analysis techniques
like coding. Thematic analysis, word clouds, tree maps and hierarchy charts were used to find
the results of the study which showed that in this situation proper safety precautions are used
to cure from this treatment and proper training given to the staff of hospital to take care of the
patients from this disease. Secondly proper motivations are required for critical patients to
properly cure from this virus and for the mental health of nurses who were involved in this
treatment and this disease has direct impact on nurses finally.

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Appendix
Tag Cloud

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Word Tree

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Future Limitations
This research has been done in the University of Lahore Teaching Hospital, in future any
researcher can research on another hospital’s Nurses and Nurses of whole Lahore or Pakistan.

Questionnaire
“Please tell me about your experiences of taking care of patients with COVID-19.” Open-ended

follow-up questions were used to obtain detailed descriptions, and examples were:

1. what is the difference between providing care due to the epidemic and working in your

original department”?

2. How was your first day in Corona ward and how are you feeling now after 3-4 months of

working in Corona Ward?

3. How you deal with critical covid-19 patients?

4. How you deal with non-critical covid-19 patients?

5. How you deal with recovered warriors of covid-19?

6. What challenges did you encounter?

7. Probing questions, such as “Please tell me more about that”, were used to enhance the

depth of discussion.

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