CARING FOR COVID-19 POSITIVE PATIENTS:

THE CASE OF THREE NURSES IN SOUTH COTABATO

PSYCHOLOGY AND EDUCATION: A MULTIDISCIPLINARY JOURNAL

2022
Volume: 6
Pages: 1297-1309
Document ID: 2022PEMJ427
DOI: 10.5281/zenodo.7447063
Manuscript Accepted: 2022-13-12
Psych Educ, 2022, 6: 1297-1309, Document ID: PEMJ427, doi: 10.5281/zenodo.7447063, ISSN 2822-4353
Research Article

Caring for COVID-19 Positive Patients: The Case of Three Nurses in South Cotabato

Christian Jay O. Lumactod*, Charles Dominic F. Ortigosa, Rica Mae B. Rabino, Jun Y. Badie
For affiliations and correspondence, see the last page.

Abstract
The study explored and described the experiences of nurses on caring for COVID-19 positive
patients. The study gained insights from the three nurses in South Cotabato who are employed in a
private hospital, government hospital, and isolation facility. This research featured a qualitative
method. The purpose of the qualitative method is to reveal the multiple realities of the phenomenon
via the participants retelling of their experiences. The design of the research was holistic multiple-
case study as it aimed to provide an in-depth understanding of the phenomenon within the case
boundaries, which is an intensive, transferrable understanding of the phenomenon. This method was
appropriate for the study since the researchers sought to describe the experiences of nurses in South
Cotabato in caring for COVID-19 positive patients. The researchers conducted an online interview in
collecting the data. The results showed that in the case of the three nurses, care was manifested in
two ways: the physical and non-physical ways. The nurses experienced both negative and positive
challenges. The nurses defined caring as holistic and in caring for patients they felt bounded and
ambivalent.

Keywords: experiences, nurses, COVID-19 patients, holistic multiple-case study, Philippines

Introduction Nurses are the ones who have the most interaction
with COVID-19 patients. During the COVID-19 era,
The Coronavirus Disease 2019 (COVID-19) pandemic nurses performed the most important tasks in rescuing
has disrupted people's daily lives and slowed the critically ill patients and curing infected patients.
global economy. Thousands of people have been While this is true, healthcare organizations have
infected by the pandemic, with many being ill or dying indicated that as the pandemic spreads, they will need
as a result of the disease's spread. Treatment is more healthcare professionals.
currently unavailable for this new viral outbreak,
which is affecting humans for the first time. As an Caring is at the heart of the healthcare profession,
effect, people are advised on taking high precautions especially the nurses, and it is critical to their ability to
such as extensive hygiene protocol (e.g., regularly form effective relationships with the people they assist.
washing hands, avoiding face-to-face interaction, etc.), The nature of care itself and new ways of working are
social distancing, and mask wearing, and plenty of potentially highly stressful for nurses. The nurses are
other things (Haleem & Javaid, 2020). It is a great not only experiencing an increase in the volume and
challenge for every individual to adapt to these new intensity of their work, but are having to accommodate
challenges since direct contact and face-to-face new protocols and a very “new normal” (Bridges,
interaction are strictly prohibited. 2020). Every nurse is expected to serve their utmost
service towards their patients. Having close contact to
Healthcare segments across nations are struggling to COVID-19 positive patients is a great threat to nurses'
cope with the massive imbalance in supply and social and mental aspects. Evidence from studies on
demand of medical supplies as well as the manpower COVID‐19 and other infectious respiratory disease
in health care services. Indeed, COVID-19 pandemic outbreaks by Bridges (2020) reflected high concern
surfaced unexpectedly and indeed surprised the whole among nurses for personal or family health in the face
world. With this, all aspects of the society are affected of direct contact with a potentially deadly virus and the
including the public and private sector, the education stress of balancing this concern with the ethical
system, the economy, and the health sector which is obligations of continuing to provide care.
the most contaminated part in the society.
Many healthcare professionals are vulnerable both to
Every aspect of the medical field has been heavily high risk of infection and mental health problems and
affected by the Coronavirus disease 2019 this evidence was learned from the 2003 SARS
(COVID-19). According to Arasli (2020), health care outbreak. The 2014 MERS-CoV outbreak in Jeddah,
professionals especially nurses play an important role Saudi Arabia had also caused emotional distress
in disease prevention and limit the spread of the among the health care workers (Khalid et.al., 2016).
outbreak as a trusted health professional community. Since Covid-19 pandemic is a new and a global-scale
phenomenon (Sampaio, 2020), the researchers saw the

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Research Article

of questions. The researchers found in-depth interview

as a suitable and conducive instrument in collecting
the data in the said research because in-depth interview
relevance to pay attention to the healthcare workers focuses on a small population of participants wherein
specifically the nurses who are in the frontline in it provides unlimited responses from the participants
combating the disease Covid-19. This study would be through intensive individual interview. In analysis of
a great help in the field of Psychology since the the data, the researchers used thematic analysis. The
researchers sought to explore the experiences of nurses study focused on the experiences of nurses in South
which would greatly provide information about the Cotabato in caring for COVID-19 positive patients.
physical, cognitive, and emotional experiences of the The researchers utilized inclusion criteria in choosing
nurses in South Cotabato during COVID-19 pandemic. the participants. The inclusion criteria are as follows:

Research Questions 1. The participant must be a registered nurse.

2. The registered nurse must be deployed in any of the
This study aimed to describe the experiences of nurses following: Isolation facility, Private hospital,
in South Cotabato in caring for COVID-19 positive and Government hospital
patients. Specifically, it answered the following 3. The registered nurse must be handling COVID-19
questions: positive patients.

1. How may the experiences of nurses on caring for Participants of the Study
COVID-19 positive patients be described in terms of
the following: The participants of the study were composed of three
1.1 Manifestation of care, nurses who were employed in a government hospital,
1.2 Challenges in caring; and private hospital and isolation facility and have
1.3 Coping mechanism to these challenges? experience in taking care of COVID-19 positive
2. How do nurses understand care? patients.
3. How do nurses feel about caring for COVID-19
positive patients? Adrian is a nurse employed in a government hospital
in Surallah, South Cotabato, specifically at
SOCSKSARGEN General Hospital. Adrian is a
Methodology committed medical practitioner for almost four years.
He is a dedicated nurse driven by purpose and passion
Research Design to help COVID-19 positive patients despite the risk
and deprived benefits. He made many sacrifices to be
This research featured a qualitative method. The of service to his fellowmen in the Philippines. Adrian
purpose of the qualitative method is to reveal the has prior experience in a government hospital which
multiple realities of the phenomenon via the was at South Cotabato Provincial Hospital. Adrian is a
participants retelling of their experiences. The design registered nurse and a licensed professional teacher as
of the research was holistic multiple-case study as it well. He has been invited to seminars to be a resource
aimed to provide an in-depth understanding of the speaker where he takes it as a great opportunity to be
phenomenon within the case boundaries, which is an able to impart his acquired knowledge and experiences
intensive, transferrable understanding of the as a nurse to others.
phenomenon. This method was appropriate for the
study since the researchers sought to describe the Angelo is a private hospital nurse particularly
experiences of nurses in South Cotabato in caring for deployed at Doctor Arturo P. Pingoy Medical Center.
COVID-19 positive patients. The study was conducted He is a registered nurse and has a degree in Masters of
in South Cotabato, specifically in a government Arts in Nursing. Also, he has been affiliated in the
hospital, private hospital and isolation facility. The same institution for more than six (6) years. Angelo
participants were nurses who have been serving in a experienced being assigned in various areas in the
COVID-19 facility. The researchers conducted an in- institution such as at ICU and Pediatric ward, but is
depth interview with the participants using a now currently assigned as an emergency nurse. Caring
researcher-made interview guide that contains a series for COVID-19 positive patients has honed him to be
more effective in rendering quality care to his patients.
Even though there is a lot of pressure inside the
hospital due to the outrage of the said virus, he

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Research Article

passionately commits his service to help his patients and Ethics review board.
recover completely.
Ethical Considerations
Kristine is a community nurse that was assigned to an
isolation facility in Zone IV, Koronadal City, South The researchers aimed to be effective and ethical in
Cotabato. A registered nurse and has been a conducting the said study. To prevent future
community nurse for almost five (5) years and was misunderstanding and misjudgements, the researchers
assigned and was actively imparting his service to an considered the following: (1) The researchers provided
isolation facility due to the lack of manpower during letters of approval and requests to formally select the
the pandemic. Due to the outrage of the pandemic, qualified participants in the study; (2) The consent
Kristine becomes unstoppable rendering her service to forms were aimed to protect the identity of the
her fellowmen despite the fatigue and inconvenience. participants. The letter had the content to ensure and
safeguard the rights, dignity, and well-being of the
Research Instrument research participants; (3) The researchers aimed to
provide knowledge, truth and avoidance of error.
The researchers used a researcher-made interview Hence, the researchers had honestly and truthfully
guide in order to explore the experiences and interpreted the responses of the participants; (4) In
perceptions of the participants in the said study. The order to promote trust and rapport, the researchers had
guide questions were composed by the researchers approached politely and respectfully the participants of
with supervision and was checked by their adviser. the said study; (5) The researchers had ensured that all
The Interview guide was formulated based on the data and information that were collected from the
statement of the problem and it can be found on participants have been treated with full confidentiality;
Appendix A on page 118. Question number 1 is about and (6) The researchers made sure to produce a
the nurses’ understanding of care, Question number 2 conducive output that aims to help other people and
is about how nurses view their patients which were have definitely been aware of negative interpretations
positive of COVID-19. Question number 3 is about and statements that would be degrading to the readers.
nurses’ experiences on caring for COVID-19 positive
patients. Question number 4 is about nurses’ feelings
in caring COVID-19 positive patients. Question Results and Discussion
number 5 is about how the community reacts about
nurses handling COVID-19 positive patients. Question
number 6 is about how nurses deal with the treatment This section presents the results of the study on caring
shown by the community. Question number 7 is about for COVID-19 positive patients: the case of three
how nurses manifest their care towards COVID-19 nurses in South Cotabato. It answers the question how
positive patients. Question number 8 is about how may the experiences of nurses on caring for
nurses facilitate or handle patients with COVID-19. COVID-19 positive patients be described? How do
Question number 9 is about how nurses attend or nurses understand care? How do nurses feel about
address the needs of the patients with COVID-19. caring for COVID-19 positive patients? The
Lastly, Question number 10 is about how nurses succeeding sections are organized in view of the
communicate or connect with the family of the patients identified cases of the study.
with COVID-19. With this, the researchers had gained
a rich amount of information about the experiences of CASE 1: ADRIAN
the three nurses in South Cotabato. The researchers
conducted the study through an online platform Adrian is a nurse employed in a government facility in
specifically, Zoom Meeting and Google Meet. Surallah, South Cotabato, specifically, at
SOCSKSARGEN General Hospital. Adrian is a
Data Gathering Procedure committed medical practitioner for almost four (4)
years. The interview was conducted last September 21,
In this section, data collection procedures are 2021 at 8:30 in the evening. He is very enthusiastic
presented which includes the instruments, preliminary and willing to share the significant experiences that he
preparations, fieldwork and quality control. The encountered as a government facility nurse. Adrian
researchers used an interview guide questionnaire explicitly explained those challenges and experiences
formulated by the researchers to answer the statements that he went through in doing what he loves, which is
of the problem. The questionnaire was evaluated and to care, despite being infected also with the COVID-19
authorized by the research adviser, panel members, virus.

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SOP 1: How may the experiences of nurses on treatment to the staff and overwork. The experience
caring for COVID-19 positive patients be described was also stressful and it was because of financial and
in terms of the following: discrimination stress, hardship brought by the
pandemic, incompetency of the government, lack of
Manifestation of care knowledge of the society about COVID-19, stress in
the leadership of hospital management and physical
Adrian talked about how the nurses in a government stress in work. COVID-19 pandemic was already
facility manifested care towards the COVID-19 being identified as a major healthcare issue, evidenced
positive patients and the themes that emerged in the by the growing incidence of stress, burnout,
manifestation of care are Physical assistance, Verbal depression, drug and alcohol dependence and suicide
guidance and information dissemination, Financial-aid across all groups of health professionals in many
and Assistive care. Under physical assistance, Adrian countries (Billings et al., 2021). The experience was
stated that nurses attend to the needs of the patients by also described to be traumatic due to the shortage of
giving medicines and food for the patients and essential medical supplies such as alcohol, personal
physical monitoring. Adrian stated that: “Naka attach protective equipment (PPE) and oxygen. Working
yung mga patients sa mga machines sa mechanical environment was unsafe because of the shortages
ventilators inaayos yun, nag sa suction kung may mga which became traumatic for the nurses in the
secretions.” government hospital. As Adrian
stated: ”nagkakaubusan ng PPE, nagkakaubusan ng
Patients, depending on the disease severity, needed alcohol, uhm now nagkakaubusan ng Oxygen. so, yun
special attention and support from the health care ang naging traumatic effect naming mga healthcare
team. To meet these needs, there are requirements for workers the sad thing pa is because of that incident of
equipment such as intubation devices, thermometers, hindi naging safe yung working place environment”
medications, etc., as well as health care procedures
such as suctioning secretions, catheterization, and Nurses experienced discomfort in caring for
other physical care (Galehdar, et al. 2020). The second COVID-19 positive patients due to wearing personal
manifestation of care is through Verbal guidance and protective equipment for long hours, working more
information dissemination which talks about the act in than their regular duty, compromising personal
which nurses explain and spread correct information to necessities, and being reprimanded to make an
the patients regarding the implications and the nature explanation letter of why Adrian became infected with
of COVID-19 . The third manifestation is the COVID-19. The experience was fearsome for Adrian
financial-aid wherein the nurses extended monetary because of the fear of being infected of the virus,
help to the patients to uplift and give them which eventually happened, and fear of infecting
encouragement. Adrian stated that: “supportive nalang others after becoming positive for COVID-19. Adrian
kung ano yung kaya mo mabigay, yun na lang.. May also feared to be scolded when wanting to take proper
mga times na walang-wala na yung pasyente kaming care of the COVID-19 positive patients because there
mga nurse nag aambag-ambag para lang at least were a lot of restrictions. “So dun ako troubled na part
makabigay sa kanila…” in the performance of what is due for me I mean, in the
performance of my profession, of my task as a nurse,
The last form of manifestation is the Assistive care and hindi ko siya nagagawa because of, yun. Takot din ako
its scope consisting of bed bathing for the patients and na mapagalitan and na mahawaan ko yung kasama
giving of food. Adrian stated: “you do the bed bathing, ko”
kayo nagpapaligo sa mga pasyente, kayo nag
papakain kasi walang mga watcher.” Lacking support from the government was also noticed
in the experience of Adrian since he said that there was
Challenges in caring a delay in the distribution of salary. Nurses were
deprived of benefits and were given no freedom to
As a government facility nurse, Adrian encountered a
speak for what is right. “yung mga kasamahan ko sa
lot of challenges described to be filled with anxiety,
province delayed yung sahod nila for three months.
stressful, traumatic, discomforting, fearsome and
lacking support. The experience was full of anxiety Imagine, how will you deliver a quality care kung
because of having insufficient knowledge of the virus, mismo ikaw hindi napapangalagaan yung.. yung needs
hearing news about the deadly virus and the rising mo diba? nai-imagine niyo kung saan humuhugot ang
death count, unclear hospital protocols, unfair isang nurse na.. na deprived of salary, deprived of

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Research Article

benefits, deprived of liberty to speak out for what is

right, diba?”

Coping mechanisms to the challenges

The nurses would not be able to survive these

challenges without coping strategies. In the case of
maintain the resources needed to provide safe and
Adrian, those strategies were in the form of voicing
high-quality nursing care (Gebreheat & Teame, 2021).
out humor, boosting one's own morale and courage,
and being patient. He voiced out the concerns about SOP 3: How do nurses feel about caring for
the protocols and mistreatment of the management and
COVID-19 positive patients?
used humor to avoid discrimination from colleauges
since Adrian became positive for COVID-19. Adrian The researchers asked Adrian about how nurses feel
experienced being avoided by his colleagues but he about caring for COVID-19 positive patients and the
used humor to cope with the discrimination from the
two themes gathered are the feeling of fulfillment and
workplace. As Adrian said: “kaya minsan dinadaan ko
restriction. Basically, fulfillment is felt if something
nalang sa biro ano ka ba? Naka hindi ano na ko wala
good happens to the patient especially when the patient
na akong gusto mo hug kita ha ganon? Niloloko ko pa
is recovering. The good treatment from the patients
lalo”
also contribute to the feeling of fulfillment just as
Uplifting own morale and courage instead of resigning Adrian stated: “Siguro guys what drived us to still
also became a coping mechanism for Adrian, and perform our task is.. yung simpleng thank you ng mga
being patient with everything since he understood the patients namin if ...yung makita mo yung patient mo
role of a nurse and how caring is important in his nabubuti yung kalagayan because of the services you
profession. rendered yun.. it’s more than a monetary value.”
”feeling ko gani gina-treat nakami nila as their family
SOP 2: How do nurses understand Care? eh kasi alam mo yung sasabihin... Te, kamusta ka?
Nagkaon kana? mga amo gud na. Oh diba maka-touch
Adrian was asked about his understanding of care and siya as a nurse”
stated that care is the essence of a nurse, and caring is
challenging. What entails with caring being the Aside from fulfillment, Adrian felt restricted in taking
essen ce of a n ur se is that you have to be care of COVID-19 positive patients. One of the main
compassionate, patient, and must be a health issues pointed out by Adrian was the unclear protocols
advocate. “to care and to compass.. to be from the hospital wherein they were restricted so much
compassionate, I must be a health advocate I must be because of the lack of manpower. The management
there.. their protector of their health. I should help tried to restrict the nurses in delivering quality care
them to attain the ultimate level of functioning na because another problem might arise regarding the
tinatawag.” “caring is the essence of a nurse. You lack of manpower if the nurses would be infected
cannot be a nurse if you don’t have a caring heart. would the virus. As adrian stated: “yung feeling na
You cannot be a nurse if you don’t have a gusto mong alagaan, gusto mong magbigay ng care sa
compa ssio nate heart” pasyente mo pero papagalitan ka ng senior mo”

Caring for COVID-19 positive patients was also The WHO and government guidelines were changing
challenging because of restrictions, as stated by continuously given the disease was new and previous
knowledge was little. Consequently, doctors remained
Adrian: “Caring in the midst of a pandemic is very
uncertain about the line of treatment. These
challenging.” “there are so many restrictions in the
uncertainties created additional mental stress for
delivery of quality care during this pandemic”
medical professionals (Arif et al., 2021).
The lack of full protection for nurses across the health
industry raises ethical questions about the extent of
their duty, lack of personal protective equipment, and
risk of failure of personal protective equipment.The
significant number of nurses also experienced moral
distress because they were under prolonged pressure to

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Figure 1. Schematic diagram of care of Adrian professional. As of six years of being in the field
rendering quality healthcare in the said hospital,
Angelo has seen through his own lens the different
dimensions of care. Caring for other people is not just
the call of Angelo’s duty but it is his undertakings that
turned out as his natural pursuit. However, it was
challenged by the hit of the unfamiliar and
unpredictable health crisis which was the surge of the
COVID-19 pandemic– the unseen enemy Angelo did
not see that it would be coming.

SOP 1: How may the experiences of nurses on

caring for COVID-19 positive patients be
described? In terms of the following:

Manifestation of care

His dedication to his profession was evidently

manifested inside the hospital. Indeed, Angelo made a
lot of sacrifices in taking care of COVID-19 positive
patients. He manifested his care holistically. He
addressed the physical needs of his patients with
COVID-19 by means of monitoring their health status,
considering the health protocols and providing life
support equipment for the COVID-19 positive
patients. Emotionally, by means of saying encouraging
The schematic diagram above shows the overall words that uplift the hope of the patients. Verbally, by
experience of Adrian on caring for COVID-19 positive means of giving proper instructions and providing
patients. Under the manifestation of care, there are information to the patients with regard to their
four (4) themes which are medications. Spiritually, by means of prayer and
interceding for fast recovery of their patients. Lastly,
Physical assistance, Verbal guidance and information
out of the three participants, Angelo manifested
dissemination, Financial aid, and Assistive care. Also,
intensive care towards COVID-19 positive patients by
there are six (6) themes that emerged from the
means of reviving them in their most critical hours, he
challenges of Adrian as a government facility nurse
testified: “May ara kami gaabot dira mga cs 3 so
namely, anxiety, stressful, traumatic, discomforting,
Glasgow coma scale of 3 over 15 so ibig sabihin tulog
fearsome and lack of support. There were five (5)
na siya. Wala gahambal, way gahulag,typically patay.
coping mechanisms used by Adrian to cope with the
challenges and these are being patient, boosting one's So sa amon, ipilit na namon siya irevive. Piliton gid na
morale, voicing out, being courageous, and humor. namon siya irevive hanggat may pulso pa. piliton gid
When asked about Adrian’s understanding of care, na namon siya irevive so amo na mga wor mga worst
there were two (2) themes that emerged: challenging case scenarios” “...bal’an mo na ang pasyente gabato,
and the essence of a nurse. Under the essence of a may will, amo na makita mo na na siya eh. Actually,
nurse, one must be compassionate, patient, and an para saakon bal-an mo gid nga ang pasyente gabato,
advocate of health. Lastly, on the feelings of caring for may will, e hatag mo tanan”
COVID-19 positive patients, Adrian said that he was
fulfilled and restricted at the same time. Challenges in caring

CASE 2: ANGELO Giving utmost care for the patients has transpired to be
more constrained and challenging for Angelo. The
Angelo is a private nurse in Doctor Arturo P. Pingoy pandemic brought a great deal of challenges and
Medical Center located in Koronadal City. He was afflictions in his caring profession, wherein he stated
interviewed by the researchers at exactly 8:30 am on
that: “Tiresome, stressful, lack of support usually para
September 24, 2021. Out of the three nurses, Angelo
sa government” “syempre anxious, may fears sa part
has the most number of years working as a healthcare
namon as nurses, health care providers kay syempre

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magpuli kami ang family” centered on their healing process.

Frustrations, fatigue, stress, unfair treatments and SOP 3: How do nurses feel about caring for
pressures inside the hospital are some of the major COVID-19 positive patients?
challenges Angelo faced in caring for COVID-19
positive patients. For Angelo, it was fulfilling knowing that he was able
to cater not just the physical needs but also the
Coping mechanisms to the challenges emotional and mental needs of his patients.
Unfortunately, the worst part of being a nurse who is
Angelo became more flexible and resilient in his really passionate in rendering care to COVID-19
endeavors in rendering quality care amidst the positive patients is that not all of them would be able
pandemic. Thus, as he faced all these difficulties and to su rv iv e th eir b attl e. As wh at An g elo
with the challenging healthcare system in the country, shared: “...kami nga mga nurses, gatalikod nalng kami
he managed to develop coping strategies to battle the
sina tapos mastorya na kami kalooy siya no? amo
said challenges, once he quoted: “Stop kagid kuha ka
nang at least, at least, ginaham kami pirmi naga naga
breather or gwa ka istorya ka sa someone na open ka
ano kami ga group naga group meeting kami at least
gusto mo, ‘istoryaha ko bi’, gusto mo na ma vent ang
nahimo namon ang part namon.”
emotions mo.”
It was an enduring moment for Angelo and his
Angelo made sure that he was taking care of his own
colleagues every time their patients did not survive
health, and among the participants he was the only one
their fight against COVID-19. With this, It was clearly
who had not been tested positive of the said virus up to
seen in the case of Angelo that the essence of caring is
the day of the conducted interview and he was the only
beyond their profession, it has something to do with
participant that shared that his coping strategy was
knowing the right condition of the person in all aspects
talking to someone whom he trust to vent out all the
and care beyond the profession– perceiving care not
intense emotions caused by frustrations, stress,
just a call of a nurse but naturally, a call of every
pressures, toxic patients, and fatigue in taking care of
individual.
COVID-19 positive patients. Hereof, in this time of
pandemic, the world failed to see that the foremost
Figure 2. Schematic diagram of care of Angelo
provider of care stands in need of care also. Perhaps,
the best way possible is for primary needs to be taken
care of, not to compromise and must be prioritized
especially the physical, emotional, mental and spiritual
needs of the nurses.

SOP 2: How do nurses understand care?

“Treat the person not merely the patient.” It was a

statement found in the study of Leininger (1990).
Hereof, Angelo believed that caring must be
holistically rendered and this claim was supported by
his statement: “Care... holistic siya. For me ang care,
hindi lang siya physical na factor ang ma involve,
dapat isali mo man ang emotional factors sang
patient…”

According to the study of Panchal et al. (2021), the

physical condition of the COVID-19 positive patients
have worsened because of isolation, fear, anxiety, loss
of income and bereavement. So, it is not enough to just
treat the patient of their physical condition but all the
possible factors that would delay the recovery process.
In the case of Angelo, he always had a small talk with
his patients, comforting and uplifting them saying that
everything will be alright and their main focus must be

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The schematic diagram above shows the overall consume sang amon na time ng online, nang ara na
experience of Angelo on caring for COVID-19 tanan sa cellphone ang tanan bala haw amo na ang
positive patients. Under the manifestation of care, iban ma misinterpret nila ay si ma’am/sir sige lang ka
there are five (5) themes which are intensive care, cellphone pero di lang nila bal-an ga refer gali kami
spiritual help,information dissemination, constant
snag mga patient sa doctor or nang may ara gali
communication, and monitoring patient’s health. Also,
nagpa check-up nga gahulat sang call or update nang
there are five (5) themes that emerged from the
challenges of Angelo as a private facility nurse and amo na bala haw so amo na siya”
these are anxiety, lack of support, tiresome,
discrimination, and frustrations. There are four (4) Through physical assistance, Kristine manifested care
coping mechanisms used by Angelo to cope with the not only by giving medicines and simply referring the
challenges and those are being patient, performing patient to the respective hospitals. As Kristine
professionalism, taking a breather and talking to a revealed, when she referred a patient she assisted with
trusted friend. When asked about Angelo’s proper care and she accompanied the patient to the
understanding of care, there are three (3) themes that hospital. As Kristine stated: “hindi man pwede nga
emerged: caring is holistic, caring is the essence of a mag refer ka sang patient na hindi mo pag updan so
nurse and caring is challenging. Lastly, on the feelings alas tres sang kaagahun naabtan kami alas kwatro
of caring for COVID-19 positive patients, Angelo sang kaagahun ara lang dyapon kami sa provincial...”
stated that he was frustrated and empathic at the same
time. Through positive verbal communication and emotional
assistance, Kristine shared that when caring with the
The Case of Kristine patient she did not only show care physically but she
also showed care by giving positive affirmations. As
Kristine, who was an isolation nurse and now a Kristine articulated: “hindi lang sila patient na
community nurse in Brgy. Zone IV in the city of
kailangan e attend ang physical concerns nila most of
Koronadal had experienced a lot of things in terms of
the patient nga gina uyatan namon, same siya sa
caring for COVID-19 positive patients. It was exactly
condition namon mentally pud. Kay damo na mga
8:30 pm on September 24, 2021 when the researchers
patient nga nag positive na hindi maka pati nga nagka
interviewed Kristine. At some point of the interview
Kristine was not able to control her emotions, she cried COVID nila”
when she was sharing the experiences and challenges
she encountered during her duties with the COVID-19 “by listening anay sa ila nga scenario saila nga shoes
positive patients. The interview was conducted online kung ano ang ila nga gina isip, ano ila ginabatyag,
with the use of Zoom. The duration of the interview anong nahitabo kay uhm pag covid-19 abi ang gina
lasted for two hours. istoryahan, as nurses hindi ka pwede mag react nga
hala kailangan, pamatian mo ano ma’am, anong
SOP 1: How may the experiences of nurses on nahitabo , nag symptoms ka, pila na ka adlaw, nag
caring for COVID-19 positive patients be isolate ka, may mga test ka, kailangan mamati ka saila
described? In terms of the following: kay in that way, mabal’an mo kung diin ka makabulig
saila”
Manifestation of care
For spiritual help, Krisitine revealed that she always
On the manifestation of care, Kristine showed care in
included the fast recovery of her patients in her
six different ways: Through the use of technology,
prayers. As Kristine said: “Gina release ko gid ang
through physical assisitance, through positive verbal
communication, through emotional assistance, through healing dira sa ila nga lawas everytime nga naga ga
spiritual help and through giving proper instructions. uyat ko saila nga kamot, kung mag BP ko saila, mag
With the use of technology, Krisitine was able to kamusta ko saila, ang prayers ko hindi gid na siya
instantly send the current situation of the patients to madula”
the doctor, since it was not possible to have easy
contact with the patients. Technology gives a big Lastly, Krisitine said that in giving care they not only
advantage in providing and showing care to the give the patient the medicine during the scheduled
patient. However, these actions sometimes led to time but, they also instruct the patient on how to take
misinterpretation from the patients and patient the medicine properly. As Kristine stated: “so ang
watchers. As Krisitne stated: “isa pud sa naga strategy namon when it comes to medication, once the

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patient is capable sa pag take kag nang maka intindi ko iroll ko gid ang tangke pasulod sa room tapos
naman siya ginahatagan lang na siya namon sang patindogon mo butangan mo sang tung pang sang
instructions how to take it like, ang right timing sa pag sang oxygen”
inom sang bulong
Coping mechanisms to the challenges
Challenges in caring
With all the given challenges Kristine experienced, she
At some point Kristine experienced challenges in cope by praying and asking for the guidance of God,
taking care of COVID-19 positive patients. She was following health protocols and doing her job correctly,
able to encounter maltreatment from patients and as she stated that: “pero saamon abi as long as wala
patients watchers, wherein she stated that: “ikaw pa lang kami sang lagnat okay lang man kay ang
bala ang masisihan nga imbes ara ka lang dira experience kay more on battle siya sa isip gid siya na
magbulig ka lang tani pero at the end of the day pag the more isipun nga gibutang kagid ni Lord diri nang
gina explain mo man saila, ng maanhan man sila, amo na saakun spiritually kay ang spiritual life ko is a
maumpawan man sila pero the pain, the words nga na big factor kung ngaa ga stand lang dyapon ko asta
release na nila saimo, naghatag na to siya sang subong”
emotional ano mo, stress saimo. Like dugay ka gid
maumpawan pero ako personally, wala ko gid siya “Ang permi ko lang ginahambal is nang Lord e renew
gina absorb ng daw gina anhan ko ng emotional lang ang akon na strength adlaw adlaw wala nako naga
to si sir, ng ano lang, sige lang” hambal nga Lord kailangan makaya ko ni in 1 year,
isa nalang ka tuig ang COVID, wala nako ga amo na,
She also developed stress due to patients who were not subong na adlaw, subong lang gid nga adlaw Lord
following proper health protocols mandated by the hatagan mo lang ko sang kakusog nga mag serve sa
authority. She explained how her efforts cannot be iban nga tao”
paid off when the people did not seriously follow
proper health protocols. Kristine showed her She was also able to cope by being courageous and by
sentiments by saying: “nang very toxic patient, nang being aware of the problems she encountered, as she
mga demanding lang gid or nang mga pasaway said that: “atubang mo gid siya with courage na
usually mga pasaway like naghambal ka nga mag- kailangan maging strong ka para sa family mo” “as a
isolate tapos may mabatian ka halin sa kapitbahay frontliner kabalo ka gid mag filter sang stressors nga
nga waay ga isolate nang mga amo na” dawaton mo abi”

Not only she experienced maltreatment from the SOP 2: How do nurses understand care?
patient but also she experienced indirect mistreatment
in work from the management that she worked with. Kristine defined caring as holistic as it attends all
She said that during her work she experienced fatigue aspects of the patients wherein, she stated that: “Para
due to working more than her work loads which saakon, caring is holistically gid siya. Holistic care
resulted to less sleep and rest. As she said: “pagka 12 gid siya like hindi pwede nga physical lang..hatagan
midnight gid nga sirado nagtawag siya tapos may mo lang siya bulong okay na na, kailangan
feeling nagid ko that time manug tulog nagid ko sa kamustahon mo man siya emotionally, mentally.
higdaan ko may feeling lang gid ko na daw may Holistic care gid siya like kailangan, for me abi, hindi
kailngan gid siya saakun kay tuod man gid abi kung ako tung nurse nga amo na lang hatag lang sang
waay kagid man labot pwede mo man gid siya hindi bulong. Kung may time gid ko, kung hindi gid ko busy
pagsabaton or basi kung may ano. So, tung pag check gahatag gid ko sang time sa patient nga magkamusta
ko tapos nag ano siya, nagtext siya sa phone ko nga pero, may mga times pud na busy pud..Ang caring amo
“ma’am nabudlayan nagid ko maginhawa” teh waay gid na siya, holistic care gid siya like tanan nga aspect
na nakatulog” sang area sang patient mo kailngan gid e-attend…”

Kristine was also able to do works that were not She also added that during this pandemic caring
related to her job description. She revealed that during becomes more challenging as there protocols that need
her work she experienced carrying and rolling oxygen to be followed in order to provide care for the patients
tanks for her patients. As Kristine stated: “naka try gid but, despite of the challenges she still view caring as

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Research Article

fulfilling part of her job, as Krisitne stated that: “kapoy The schematic diagram above shows the themes that
siya pero amo bi ning calling namon, amo man ni ang emerged in the thematic analysis on the case of
bal-an ko na best ko na maubra sa iban nga tao, So, Krisitne. Under the manifestation of care, there are six
(6) themes which are physical assistance, use of
kapoy siya pero fulfilling siya na trabaho.”
technology, positive verbal communication, emotional
assistance, spiritual help, and giving of proper
SOP 3: How do nurses feel about caring for
instructions. Also, there are four (4) themes that
COVID-19 positive patients?
emerged from the challenges of Krisitne as an isolation
nurse and these are maltreatment from patient and
Kristine felt frightened in caring for COVID-19
watchers, overworking, less sleep, and less rest. There
positive patients and she also felt helpless but was still are five (5) coping mechanisms used by Kristine to
able to continue her work, as Krisitne stated that: “so cope with the challenges and these are praying to the
during that time ang battle mo abi is ang isip mo... Lord, following health protocols, doing job correctly,
every time may naga hambal na may gaka positive being courageous, and being aware of problems. When
amo na gani nga na pull out kami so ang fear bala asked about Krisitne’s understanding of care, there are
hindi gid siya madula.” “daw ka give up-on nako kay four (4) themes that emerged: these are holistic, the
grabe na ang pulaw kay ako abi, ano gid ko very heart of a nurse, profession, and challenging . Lastly,
on the feelings of caring for COVID-19 positive
important gid saakon ang sleep so pag na deprive gid
patients two (2) themes emerged: frightened and
ko sang sleep hindi gid ko ka function sina sang sakto
helpless.
like maka function ko pero hindi in a, in a full energy
and full focus bala haw” Figure 4. Conceptual Framework on Care of the Three
Nurses (Adrian, Angelo, and Kristine)
With the given statements shared by Kristine, it was
seen that caring is not an easy job, that caring is not a
simple task. Caring is something that needs to be given
enough time to perform.

Figure 3. Schematic Diagram of Care of Kristine

The figure above shows the conceptual framework on

care of the three nurses. Hereof, shows the grand
themes based on the significant statements of the three
nurses wherein, there are two (2) themes emerged in
the manifestation of care namely physical and non-

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Research Article

physical care; four (4) in the challenges experienced, against the COVID-19 Pandemic: An Integrative Review.
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38/?tool=pmcentrez&report=abstr act
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Bachelor of Science in Nursing and see the importance and burnout levels of healthcare professionals caring for COVID-19
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spiritually, and emotionally. Knowledge alone will not Coates S. J., Andersen, L. K., & Boos, M. D. (2020). Balancing
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of dermatology climate change committee. International Journal of
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awareness on what is happening inside the working have children when caring for COVID-19 patients. International
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field. spersonal-caring/

García‐Martín, M., Roman, P., Rodriguez‐Arrastia, M., Diaz‐

Cortes, M. d. M., Soriano‐Martin, P. J., & Ropero‐Padilla, C.
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