Nurses crisis management during COVID-19 at individual and organizational levels in a qualitative single centre study in Poland

A key lesson from COVID-19 is the distinctive role of nurses during pandemic crises and the insights derived from their experiences. The aim of the study is to show the unique functioning of nurses in a strong and multifaceted crisis from their own point of view and to outline suggestions at the level of employees/ organizations. The primary research method was the individual in-depth interview (IDI), conducted with a purposively selected group of participants. The sample of 80 respondents was randomly selected from 1221 hospital employees who participated in a quantitative and serological study at the beginning of 2020. Nurses and midwives were included in the sampling, as an earlier study found that this occupational group had a higher risk of SARS-CoV-2 infection. A total of 26 nurses participated in structured, in-depth interviews. The study provided a comprehensive account of nurses' organizational behavior in crisis situations, as well as an overview of how the medical center functioned during such times. It also offered recommendations to improve the resilience of healthcare facilities in the face of future crises. Both the analysis of the crisis and the proposed guidelines addressed the individual level (i.e., individual staff members) and the team or organizational level. The study also identified key similarities and differences in nurses' responses and included recommendations for strengthening healthcare system resilience during the COVID-19 pandemic. The identified patterns-such as the absence of denial and acceptance accompanied by increasing conflict-may extend beyond the context of the COVID-19 pandemic and could be indicative of responses to future large-scale infectious outbreaks without clearly defined treatments. Recommendations for enhancing the resilience of medical centres in future crises were developed based on observed dynamics in nurses' responses. These include fostering a "positive internal PR" around the infection control team, recognizing and reinforcing positive behaviours demonstrated during the COVID-19 crisis, and incorporating constructive crisis-time practices into standard nursing protocols.