Year 2021
October 2021


Abstract Title
The Hand-Head-Heart Connection: ICU Nurses’ Experience of Managing Patient Safety During COVID-19.



Tan Tock Seng Hospital1, National Centre for Infectious Diseases2

Background & Hypothesis

Increased critical care service utilisation during COVID-19 may impact ICU nurses’ ability to maintain patient safety. However, evidence surrounding nurses’ experience in managing patient safety remains sparse. Hence, this study seeks to explore ICU nurses’ narratives in managing patient safety during COVID-19.


A purposive sample of 18 registered nurses who practiced in the outbreak intensive care units during the COVID-19 pandemic were recruited between June to August 2020. Individual semi-structured interviewed were conducted, transcribed verbatim and narratively analysed.


Findings revealed an overarching anatomy-specific storyline of a “Hand-Head-Heart” connection that describes ICU nurses’ experience with managing patient safety during COVID-19. Firstly, stories on “the hands of clinical practice” revealed how critical care nursing is practiced and adapted by ICU nurses. In particular, ICU nurses banded together to safeguard patient safety by practicing critical care nursing with mastery. Secondly, stories on “the head of psychosocial wellness” highlights the tumultuous impact of COVID-19 on ICU nurses’ psychosocial wellbeing, and how nurses demonstrated resilience to continually uphold patient safety. Lastly, stories on “the heart of nursing” drew upon ICU nurses’ intrinsic professional nursing identity to safeguard patient safety. Specific patient tales further bolstered the nurses’ commitment to uphold patient safety during the pandemic.

Discussion & Conclusion

Through their stories, ICU nurses narrated how they seek to uphold patient safety through clinical competence, resilience and heightened nursing identity. Nurse leaders will need to provide sustainable clinical resources and visible psychosocial support channels, to better support ICU nurses in navigating through a brave new world of critical care nursing.