Welcome to CANDID: Critical Care and re-Deployed Nurses: the impact of COVID-19 on work-related stress. CANDID is a research study funded by the NIHR (National Institute for Health Research) the nation’s largest funder of health and social care research as part of its funding initiative to examine the long-term impact of Covid-19.

Background to CANDID

Covid-19 has placed considerable pressure on critical care units. Critical Care Nurses (CCNs) are working under very difficult conditions and are experiencing significant challenges. For example, CCNs are delivering care whilst using very cumbersome personal protective equipment, many of their patients have died and are dying from Covid-19 and, because relatives are not allowed access to critical care units, staff are the only people available to be with patients at the end of their lives. Staff also have to communicate and support worried and bereaved relatives at a distance, and their work poses well-publicised potential risks to their own and their family’s health.

In addition, the pressure on critical care units means nurses from other areas have been redeployed to work in critical care. These nurses experience the same stressors as CCNs but with the additional challenges posed by having to work in a very different and new environment, without the same level of specialist critical care skills and training. It is possible that the physical and psychological wellbeing of nurses working in critical care during the pandemic has been affected, and their intention to continue in critical care nursing reduced. It is important, therefore, to understand how nurses working in critical care have experienced and been affected by the pandemic. In this study, we will use a model of occupational stress called the Job Demand Resources model (JD-R model) to better understand stress in nurses working in critical care during the pandemic.

What are the aims of CANDID?

CANDID aims to:

  1. establish the impact of Covid-19 on Critical Care Nurses, and those deployed to critical care units
  2. establish the prevalence of work-related stress and the subsequent impact on intention to remain and quality of care
  3. explore the experiences of Critical Care Nurses and those deployed to critical care units, during the COVID-19 pandemic
  4. understand which support service initiatives were accessed by nurses and how useful they found those services

How will CANDID achieve these aims?

CANDID is a 2-phase study:

Phase 1

Phase 1 is a survey of nurses who have worked in Intensive Care during the pandemic.  Staff in all 20 intensive care units across Scotland and in three of the largest units in England will be invited to complete the survey.  The survey uses a theoretical model of occupational stress (the Job Demand Resource Model) to measure the level of stress experienced by nurses and to identify the sources of that stress.  The survey also invites staff to express, in their own words, what working during the pandemic has been like for them.

Phase 2

Phase 2 is an in-depth interview study.  Nurses who take part in the survey will also be invited to take part in an interview study.  The interviews will be designed to explore their experience of working in critical care in greater depth.  Staff will also be asked about the support services offered to them during the pandemic; what services were offered, and which services were useful or not.