Frontline Nurses’ Coping Practices and Career Impacts in Highly Infectious Environments: A Roy Adaptation Model Perspective

Introduction: Frontline nurses, particularly those working in highly infectious environments, experienced unprecedented challenges during the COVID-19 pandemic and faced significant physical, emotional, and psychological demands with uncertainty and risk. Understanding their experiences, coping practices, and the broader impacts on their career trajectories from a Roy adaptation model perspective is critical to informing future workforce support and resilience strategies. Objective: To identify stressors experienced by the interviewed nurses, working in highly infectious environments during the initial peak of the COVID-19 outbreak, explore their coping practices, and investigate the impacts of pandemic stress on their career paths. Design: A qualitative analysis of an interview study. Sixteen nurses participated in online interviews using semistructured and open-ended questions. Conversations were recorded and transcribed. Analysis of transcripts from sixteen nurses was conducted using Graneheim & Lundman's content analysis method. Results: The study drew three themes distilled from the coded narratives of the transcripts: (1) lived experiences of stress including eight stressors: fear of infection, emotional frustration, lack of personal protective equipment, information overload, workplace uncertainty, increased workload, organizational disarray, and professional stigma; (2) adaptive coping practices employed by the nurses in response to the stressors including doing exercises, meditating, watching movies, listening to music, sleeping longer hours, engaging in gardening, studying, reading, and connecting with friends through social media; and (3) impacts of pandemic-induced stress on career goals and pursuits. The interviewed nurses exhibited positive attitudes toward managing stress and expressed determination to continue pursuing their nursing career paths. Conclusion: The study revealed that stressors experienced by interviewed nurses working in highly infectious environments did not merely have negative impacts on their career paths. Successful coping strategies were observed to involve an intricate interplay between innate and acquired coping dimensions, manifested by adaptive stress coping practices.