Maria Andersson

Aim To elucidate the meaning of being a close relative of a critically ill person cared for in intensive care during the initial phase of the COVID‐19 pandemic. Design A narrative inquiry design following the COREQ guidelines. Methods Individual interviews with fifteen close relatives of patients critically ill with COVID‐19 were analysed using phenomenological hermeneutics. Results The surreal existence of not being allowed to be near was emotionally difficult. While distancing due to restrictions was challenging, physicians' phone calls served as a connection to their relatives and brought a sense of security. Keeping notes helped them remember what happened and brought order to a chaotic situation. Conclusion Close relatives feel secure when they receive regular information about their critically ill relative, not just when their condition worsens. They wish to be physically near to their critically ill person; when this is impossible, digital technology can provide support, but further accessibility developments are needed.

Aim. To describe intensive care managers’ experiences of premises and resources of care in intensive care units during the COVID-19 pandemic. Background. Intensive care units (ICUs) were enormously pressured during the COVID-19 pandemic from many ill patients, requiring advanced care. Hospital and community volunteers increased staff strength. Obligatorily, recruitments were also conducted using transfer of staff from different hospital departments. However, there is little knowledge about intensive care managers’ (ICMs) experiences of leadership during the COVID-19 pandemic. Methods. A qualitative descriptive study was conducted from March to April 2022. Semistructured interviews were held with 12 ICMs who were purposively sampled from the ICU in ten Swedish hospitals. Data were analysed using qualitative content analysis. Results. Two themes emerged: a dramatic change of the intensive care landscape and we could handle more than we thought, but at a steep price. Participants described that the ICUs had to perform extraordinary changes at a very fast pace, which initially created a sense of cohesion. Training and introduction to war-like conditions associated with uncertainty meant that ICMs had to support ICU staff in prioritising interventions. Participants described how ICUs stood strong against a pandemic, but stress, worries, and anxiety took a heavy toll on ICU staff and ICMs. The pandemic eroded the resilience in ICUs. Participants described a deterioration in health and said that sick leaves and resignations occurred. Conclusion. Our findings show ICMs’ experiences as a field of tension between resources and demands, whereby the changes created a heavy burden that left intensive care weakened. Implications for Nursing Management. Findings emphasised the importance of creating working conditions using human resources and materials in order to rebuild resilience in intensive care with the ability to conduct safe patient care.