Abstract

There is extensive research on nurse outcomes1-6 and nurse-reported patient outcomes7-11 before, during, and after the COVID-19 outbreak . However, there is a notable absence of studies that examine such outcomes in emergency units across South Africa. It is evident that emergency nurses often experience the most adverse nurse outcomes, and the COVID-19 pandemic has exacerbated these negative impacts on emergency nurse outcomes12-15. Not only is there a scarcity of studies examining the effects of the COVID-19 pandemic on nurse outcomes and nurse-reported patient outcomes in general in South Africa, but minimal research has been conducted on nurse and patient outcomes specifically within emergency units in developing countries16.

A cross-sectional correlational design was used, with data collected from two different groups in the public and private sectors after the second and third COVID-19 waves using a questionnaire. Purposive sampling of 116 private sector and 27 public sector emergency units (total n=143) and total population sampling of nurses (n=332) were used.

South African emergency nurses experienced high levels of emotional exhaustion (M=28.03; SD=1.08) and exhibited moderate levels of job satisfaction (M=2.81; SD=0.07). They were, however, dissatisfied with their salary and appreciation, recognition and rewards (M=2.15-2.81; SD=0.07-0.08). Over a quarter (n=84; 25.30%) intended to leave their jobs. While patient safety was rated favourably (M=2.32; SD=0.09), monthly complaints from patients/families were reported (M=3.08; SD=0.09). Quality of care also received a good rating (M=2.06; SD=0.07). Nurses responding after the third wave reported higher rates of compassion fatigue, dissatisfaction with their professional status, and dissatisfaction with independence at work (OR=3.2, 2.23, 2.21; 95% CI=1.01-10.1, 1.13-4.40, 1.24-3.94; p=0.047, p=0.02, p=0.01). There were practically visible correlations between job satisfaction and recommending one’s place of work to family and friends, emotional exhaustion and confidence in post-discharge care, and job satisfaction and quality of care (r=-0.44, 0.40, -0.39; p<0.001).

The study showed that COVID-19 had a significant impact on nurse and patient outcomes in South African emergency units, raising concerns regarding emotional exhaustion, compassion fatigue, job dissatisfaction and turnover intent. Addressing these concerns is critical to achieving better outcomes and planning for future health emergencies.

Description

Emergency nurses often have the worst nurse outcomes, and these deteriorated significantly during the COVID-19 pandemic, which negatively affects organisational and patient outcomes. This study not only contributes evidence of the impact of COVID-19 on nurse and patient outcomes in emergency units in South Africa during the pandemic, but also at two specific points after the second and third waves of the pandemic, illuminating the progressive impact of a health crisis on emergency nurses.

Author Details

Annette L. Pienaar, MNSc, RN; Siedine Knobloch Coetzee, PhD; Alwiena Johanna Blignaut, PhD; Marcel Fladimar Mather, MNSc; Erika Fourie, PhD

Sigma Membership

Non-member

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Cross-Sectional

Research Approach

Quantitative Research

Keywords:

Sustainable Development Goals, History, Workforce, COVID-19, Emergency Departments, South Africa

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the slide deck.

Additional Files

References.pdf (100 kB)

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Impact of COVID-19 on Selected Nurse and Patient Outcomes in Emergency Units Across South Africa

Seattle, Washington, USA

There is extensive research on nurse outcomes1-6 and nurse-reported patient outcomes7-11 before, during, and after the COVID-19 outbreak . However, there is a notable absence of studies that examine such outcomes in emergency units across South Africa. It is evident that emergency nurses often experience the most adverse nurse outcomes, and the COVID-19 pandemic has exacerbated these negative impacts on emergency nurse outcomes12-15. Not only is there a scarcity of studies examining the effects of the COVID-19 pandemic on nurse outcomes and nurse-reported patient outcomes in general in South Africa, but minimal research has been conducted on nurse and patient outcomes specifically within emergency units in developing countries16.

A cross-sectional correlational design was used, with data collected from two different groups in the public and private sectors after the second and third COVID-19 waves using a questionnaire. Purposive sampling of 116 private sector and 27 public sector emergency units (total n=143) and total population sampling of nurses (n=332) were used.

South African emergency nurses experienced high levels of emotional exhaustion (M=28.03; SD=1.08) and exhibited moderate levels of job satisfaction (M=2.81; SD=0.07). They were, however, dissatisfied with their salary and appreciation, recognition and rewards (M=2.15-2.81; SD=0.07-0.08). Over a quarter (n=84; 25.30%) intended to leave their jobs. While patient safety was rated favourably (M=2.32; SD=0.09), monthly complaints from patients/families were reported (M=3.08; SD=0.09). Quality of care also received a good rating (M=2.06; SD=0.07). Nurses responding after the third wave reported higher rates of compassion fatigue, dissatisfaction with their professional status, and dissatisfaction with independence at work (OR=3.2, 2.23, 2.21; 95% CI=1.01-10.1, 1.13-4.40, 1.24-3.94; p=0.047, p=0.02, p=0.01). There were practically visible correlations between job satisfaction and recommending one’s place of work to family and friends, emotional exhaustion and confidence in post-discharge care, and job satisfaction and quality of care (r=-0.44, 0.40, -0.39; p<0.001).

The study showed that COVID-19 had a significant impact on nurse and patient outcomes in South African emergency units, raising concerns regarding emotional exhaustion, compassion fatigue, job dissatisfaction and turnover intent. Addressing these concerns is critical to achieving better outcomes and planning for future health emergencies.