“It never ends…”-A qualitative study of nurses’ experience of caring for hospitalised unvaccinated patients with COVID-19 in Sweden

Introduction: COVID-19 was considered a pandemic as of mid-March 2020 until May 2023. The first vaccine against COVID-19 gained approval at the end of 2020. Overall willingness to be vaccinated is high in Sweden, some people have refused the vaccine. The pandemic caused trauma to nurses around the world due to heavy workloads, deaths in the profession, and employers’ failure to prioritise nurses’ physical and mental well-being. This, together with hesitation to get vaccinated, might have affected nurses’ work. Therefore, it is important to investigate how nurses were affected during the COVID-19 pandemic and their work with unvaccinated patients. The aim was to explore nurses’ experience of caring for hospitalised unvaccinated patients with COVID-19.Methods: A qualitative approach was used to describe nurses’ perceptions and experiences. Nine semi-structured interviews were conducted in the spring of 2022. The study was set in two departments of infectious care at tertiary care emergency hospitals in Stockholm, Sweden. Results: The findings are presented with four themes: A difficult work situation; The strength of colleagues; Dealing with different opinions; and Lessons learned from the pandemic. Each theme has two subthemes.Conclusions: The nurses were often working under stress during the pandemic, and they showed signs of compassion fatigue, which affected the nurses and, by extension, their unvaccinated patients. For pandemics, epidemics and challenges to come, our findings show that there is a need for mandatory reflection and scenario-based training to increase resilience and competence and to prevent compassion fatigue.