Abstract
Background: The coronavirus (COVID-19) pandemic has presented unprecedented challenges
to healthcare systems worldwide, with intensive care unit (ICU) nurses at the forefront of patient care.
Kuwait, like many other countries, experienced a surge in COVID-19 cases that strained its healthcare
resources and exposed ICU nurses to physical, emotional, and ethical challenges. The aim of this study
was to construct a theory of the good nurse in ICUs in Kuwait during a pandemic.
Methods: Semi-structured interviews were conducted with 25 nurses working in three ICUs
during the COVID-19 pandemic. Charmaz’s grounded theory methodology was employed to analyse
the data, using comparative analysis and theoretical coding to construct the theory.
Results: The analysis revealed a core theme of 'sense of duty' as the central concept that
defined the nurses' perception of being a good nurse. The nurses' sense of duty was grounded in their
professional values and moral principles, and also shaped by societal expectations. Their sense of duty
motivated them to provide compassionate and dedicated care to their patients despite the
overwhelming stressors and ethical challenges of the pandemic. In particular, they relied upon mental
strength, self-care, and the provision of support to one another to cope with these challenges.
Ultimately, though, the nurses were also driven to increasing levels of unsustainable self-sacrifice by
their sense of duty, resulting in moral distress and impaired well-being.
Conclusion: This study reveals what it meant to be a good nurse in ICUs during the COVID-19
pandemic in Kuwait. The findings show that nurses were motivated by their sense of duty to keep
working during the pandemic, but this commitment left them at risk of burnout and moral distress. To
reduce the risk of resignations and compromised patient care, healthcare organisations and
policymakers should prioritise the well-being of their nurses and provide them with adequate support,
resources, and training to ensure sustainable and resilient nursing practice.