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| Subthemes | Categories | Quotations |
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| Theme 1: abrupt transition from normality to the COVID-19 pandemic |
| (1.1) Participants felt overwhelmed, overworked, physically and mentally exhausted, and faced high mortality rates | Rapid changes in working structure, COVID-19 policies, and more responsibilities | Participant 7: “We felt that management was failing us, changing protocols many times but not coming to us to hear our problems” |
| Participants were overworked due to a shortage of staff | Participant 2: “We were not prepared; we did not know the signs and symptoms of it and how it spread from one person to another. We were all scared, and we were overworked” |
| Participants faced moral distress and moral injury | Participant 8: “…shortage of staff affected us negatively. Patients were left with us; no visitors were allowed. Most of the staff members were infected. Nursing three patients and sometimes you find us that you are the only one who is ICU trained. Most of the staff never nurse a ventilated patient” Participant 1 shared his sadness: “We worked ten days or more straight shift to cover the ward” |
| Participants witnessed an increased death rate | Participant 4: “We are still not recovered emotionally from seeing lots of people dying. We have lost so many patients” |
| The extra burden of patient care led to self-neglect, and nurses sacrificed their own holistic needs | Participant 2: “We were in the ward for 6 hrs. In that six hour we couldn’t eat, or drink anything. We were sweating to the point that we were thirsty. We kept on working because our patients were very sick” |
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| Theme 2: experienced isolation from family, community, and nursing management |
| (2.1) Participants experienced stigma from the community and isolation from family | Participants sacrificed seeing their families and friends and suffered loneliness | Participant 3: “You arrived at home after a hectic day, you are tired physically and emotionally, you can’t share with your family because you are scared that you might infect them, you isolate yourself” |
| Participants experienced stigma from the community | Participant 5: “…when I am off, I will stay in my flat because people in our building were assuming that if you are a nurse, you got Covid. You can see the way they were looking at me and suddenly avoiding me” |
| (2.2) Participants mentioned a lack of support from nursing management | Participants shared that nursing management did not physically or emotionally support them during extremely challenging times | Participant 4: “Nursing management was not even coming inside just to say thank you. Only people from outside on TVs and radios that were acknowledging our hard working. it is very sad” |
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| Theme 3: feelings of satisfaction and gratitude for teamwork and learning |
| (3.1) Participants expressed that COVID-19 gave them learning opportunities and empowered them to mature professionally | Participants experienced very positive team support | Participant 7: “Jaa, we were good team there were some instances when we talk about the incidents that happened and how to improve ourselves. Yes, and after talking we were feeling better. We were praying every morning before starting the routine and it was helping” Participant 1: “I have learned a lot. After so much that I have learned, I want to do a degree in Nursing. Nursing COVID-19 patients has encouraged me to study more. I have realized that I need more knowledge” |
| (3.2) Participants expressed feelings of satisfaction | Participants shared their joy when patients recovered | Participant 4: “It was hectic, but we were grateful if we extubate a patient and see them recovering well, it was very pleasing. Discharging patient home was a bonus, we will be so excited. Patients will phone us and update them about their progress, we were also doing the follow up, they were concerned about us. They were so grateful” |
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