Lived experiences of home care nurses during the COVID-19 pandemic in Switzerland: A descriptive phenomenological study

Objective This study explores the lived experiences of home care nurses in Switzerland during the COVID-19 pandemic. It aims to understand how nurses navigated a period marked by uncertainty, emotional strain, changing professional demands, and close proximity to vulnerable patients. Particular attention was paid to how this context shaped their engagement with end-of-life (EOL) discussions and related practices in daily care. Methods A qualitative design with a descriptive phenomenological approach was used. Twelve home care nurses from the Geneva public home care service participated in semi-structured interviews conducted between November 2021 and February 2022. Interviews were analysed following Giorgi's method, and methodological rigour was ensured through triangulation and team discussion. Results The analysis identified six interrelated themes. The first axis described the emotional and professional experiences of nurses during the pandemic. Nurses faced continuous uncertainty and emotional strain but demonstrated adaptive capacities through individual and collective coping strategies. Institutional responses provided both stability and new constraints, while care practices were restructured and professional identities redefined between empowerment and exhaustion. The second axis described engagement with advance care planning (ACP)-related practices in the pandemic context. When conditions allowed, the training fostered confidence and humanity in communication with patients, though its implementation remained limited by organisational, relational, and emotional barriers. In some cases, the reflection initiated professionally extended to the personal sphere. Conclusions The study highlights the complexity and evolving nature of home care nursing during the pandemic. Beyond documenting adaptation under pressure, it underscores the need for sustained institutional support, recognition of nurses' expertise, and clear frameworks for their role in EOL discussions.