'I became the nurse I dreamed to be': Posttraumatic growth of hospital nurses during COVID-19

Abstract Background The unexpected COVID-19 pandemic outbreak has shaken the personal and professional lives of people worldwide. Nurses, as the largest healthcare workforce and in the closest proximity to patients, are at high risk of being infected, facing life-threatening situations while being exposed to secondary traumatic stress from direct care of others who are also experiencing traumatic events. Aim To explore the lived experiences of frontline hospital nurses as direct caregivers of COVID-19 patients, during four waves of the pandemic. Methods The grounded theory approach was employed to generate a theory of nurses’ lived experiences during four waves of the pandemic using the constant comparative method of analysis. Semi-structured interviews were conducted with 23 nurses from nine tertiary hospitals in Israel, between August and September 2021. Interviews were video recorded and transcribed verbatim. Criteria for establishing trustworthiness were applied. Results Nurses experienced the COVID-19 pandemic as (1) A direct and secondary threatening event; unexpected, uncertain with poor conditions and resources; (2) Paradoxical negative and positive changes were experienced such as threats to life vs. valuing life; social distancing vs. improved relations; and professional challenges vs. growth; (3) Nurses gained meaningful professional growth such as awareness of their professional strengths and limitations; choosing the optimal career path, and restructuring their nursing identity and image. Conclusions This study shed some light on nurses’ positive experiences during their struggle during the COVID-19 pandemic without neglecting the impact of adverse experiences on nurses. The phenomenon of secondary traumatization in nursing is still undervalued and needs to be explored and addressed. The pandemic provided nurses with a rare opportunity to redefine the meaning of being a nurse and experience professional growth. Key messages • Nursing leadership should consider nurses’ emotional needs and include affective-cognitive processing of traumatic events as part of the professional curricula in nursing education and at workplace. • Public recognition of the added value of nurses strengthened nurses’ professional identity and image. This process of developing the future state of the nursing image must be continued internationally.