Exploration of Factors Influencing Nurses' Preparedness and Response to the COVID-19 Outbreak.

Introduction and Objective: Nurses as the core of the health care workforce affect an organization's preparedness and response. This study explores the factors and unique determinants influencing nurses' preparedness and response to the coronavirus disease 2019 (COVID-19) outbreak in Singapore. Methods: This qualitative phenomenological study utilized purposive sampling and in-depth interviews with 10 registered nurses and two enrolled nurses who had worked or were still working in an infectious disease (ID) hospital during the COVID-19 outbreak at the point of recruitment. The data were collected from September 2020 to December 2020. Results: (1) Before the outbreak: Factors such as knowledge, skills, and experiences that enhanced nurses' adaptability and response through training and exposure prior to the outbreak influenced preparedness. In addition, the importance of nurses' knowing their purpose and the role of their institute during the outbreak also influenced preparedness. (2) The COVID-19 phase: Factors such as the novelty of the disease, communication, load and demand, and coping mechanisms affected participants' working response to the outbreak. (3) Learning and looking forth: Lessons learnt to enhance preparedness and response to future outbreaks, and positive sentiments as part of the nation's effort to combat the disease. Conclusion: Ground nurses should be actively involved in outbreak planning to gain a better view of their responsibilities and unpredictable events that may occur. A transparent and bidirectional communication among management and nurses is crucial amidst rapid changes in an outbreak to strike a balance between the needs of nurses and leadership and to enhance nurses' resilience throughout this challenging journey.