Title: Nurses' Experiences Caring for Patients from Communities of Low Income and Low Resources in Hospital-based Ambulatory Care Clinics during the COVID-19 Pandemic
Description: This qualitative descriptive research study was conducted to understand nurses’ experiences caring for patients from communities of low income and low resources in hospital-based ambulatory clinics during the COVID-19 pandemic. Examination of the literature revealed research on the importance of ambulatory care nurses, their bond with the communities they serve, and the need for ambulatory settings for underserved communities. The review also explored the fierce strike of the COVID-19 pandemic on these communities and the social justice implications of serving low-income and low-resource patients. No literature was found on this specific dissertation topic: ambulatory nurses’ experiences working in underprivileged communities during the COVID-19 pandemic. The sample used for this study consisted of 25 registered nurses who worked in ambulatory settings during the inception of the COVID-19 pandemic. In particular, the time period spanned February 2020 through the end of June 2020. The communities consisted of poorly resourced neighborhoods.

The narrative description and accounts of nurses interviewed for this study will facilitate an understanding of nurses’ experiences caring for patients from communities of low income and low resources in hospital-based ambulatory clinics during the COVID-19 pandemic. The researcher used a qualitative methodology, qualitative descriptive, to frame the stories. Qualitative content analysis methods, specifically thematic analysis, were used to understand the nurses’ reflections and experiences. Roy’s Adaptation Model (RAM) was the theoretical framework to guide the open-ended interview questions. The researcher developed questions based on the four modes of RAM: the physiologic mode, the self-concept mode, the role function mode, and the interdependence mode. Thematic analysis was used to identify themes from the interview transcripts. A thematic analysis strategy is an approach used to identify and analyze patterns of meaning from interview data (Braun & Clarke, 2006). A thorough overview was made of all the data, including initial notes.

The notes were obtained by reading and rereading the transcripts and highlighting interesting phrases or statements called meaningful units. These units were then compiled into sub-themes, and ultimately themes were comprised after highlighting parts of the transcripts that generated similar content. Themes were developed by identifying patterns among meaningful units and data relevant to each theme. Themes were then reviewed to ensure they accurately represented the data after highlighting, constant review, and compounding them in meaningful units that identified and generated the final set of themes. The researcher developed and kept reflexive journal notes, which were reviewed constantly throughout the study to maintain best-practice qualitative methodology (Ortlipp, 2008). The thematic analysis revealed multiple themes. The themes discovered were crying, protector vs. moral distress, resilience vs. compassion fatigue, family vs. bereavement, and self-concept vs. self-care. An overarching theme of struggle was also manifested within this research.