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The impact of COVID-19 on nurses (ICON) survey: Nurses' accounts of what would have helped to improve their working lives

Ball, Jane; Anstee, Sydney; Couper, Keith; Maben, Jill; Blake, Holly; Anderson, Janet E.; Kelly, Daniel; Harris, Ruth; Conolly, Anna; the full ICON Study Team

The impact of COVID-19 on nurses (ICON) survey: Nurses' accounts of what would have helped to improve their working lives Thumbnail


Jane Ball

Sydney Anstee

Keith Couper

Jill Maben

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Professor of Behavioural Medicine

Janet E. Anderson

Daniel Kelly

Ruth Harris

Anna Conolly

the full ICON Study Team


Aims: To use nurses' descriptions of what would have improved their working lives during the first peak of the COVID-19 pandemic in the UK. Design: Analysis of free-text responses from a cross-sectional survey of the UK nursing and midwifery workforce. Methods: Between 2 and 14 April 2020, 3299 nurses and midwives completed an online survey, as part of the ‘Impact of COVID-19 on Nurses’ (ICON) study. 2205 (67%) gave answers to a question asking for the top three things that the government or their employer could do to improve their working lives. Each participants' response was coded using thematic and content analysis. Multiple response analysis quantified the frequency of different issues and themes and examined variation by employer. Results: Most (77%) were employed by the National Health Service (77%) and worked at staff or senior staff nurse levels (55%). 5938 codable responses were generated. Personal protective equipment/staff safety (60.0%), support to workforce (28.6%) and better communication (21.9%) were the most cited themes. Within ‘personal protective equipment’, responses focussed most on available supply. Only 2.8% stated that nothing further could be done. Patterns were similar in both NHS and non-NHS settings. Conclusions: The analysis provided valuable insight into key changes required to improve the work lives of nurses during a pandemic. Urgent improvements in provision and quality of personal protective equipment were needed for the safety of both workforce and patients. Impact: Failure to meet nurses needs to be safe at work appears to have damaged morale in this vital workforce. We identified key strategies that, if implemented by the Government and employers, could have improved the working lives of the nursing and midwifery workforce during the early stages of the COVID-19 pandemic and could prevent the pandemic from having a longer-term negative impact on the retention of this vital workforce. Patient or Public Contribution: No Patient or Public Contribution, due to the COVID-19 Pandemic, urgency of the work and the target population being health and social care staff.


Ball, J., Anstee, S., Couper, K., Maben, J., Blake, H., Anderson, J. E., …the full ICON Study Team. (2022). The impact of COVID-19 on nurses (ICON) survey: Nurses' accounts of what would have helped to improve their working lives. Journal of Advanced Nursing, 79(1), 343-357.

Journal Article Type Article
Acceptance Date Aug 31, 2022
Online Publication Date Sep 29, 2022
Publication Date Sep 29, 2022
Deposit Date Nov 17, 2022
Publicly Available Date Nov 17, 2022
Journal Journal of Advanced Nursing
Print ISSN 0309-2402
Electronic ISSN 1365-2648
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 79
Issue 1
Pages 343-357
Keywords General Nursing
Public URL
Publisher URL
Additional Information © 2022 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.


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