Abstract
BACKGROUND: Nurses are exposed to high levels of stress in the workplace. During the coronavirus disease 2019 (COVID-19) pandemic, levels of stress were exacerbated, impacting on nurses' mental health. AIM: The aim of the study was to investigate psychological distress and resilience, and how nurses with different levels of education responded to stress. SETTING: The study was conducted in three hospitals (a psychiatric hospital, a general district hospital and a dedicated COVID-19 hospital) in the Western Cape province, South Africa. METHODS: A survey was conducted with frontline nurses (N = 167 [71.8%]) in three hospitals in the Western Cape using six validated self-administered scales. RESULTS: Respondents reported high levels of moral distress related to time (3.42/6, ± 1.6) and protection during COVID-19 (1.3/3, ± 0.7). Mild-to-moderate levels of fear of COVID-19 (19.4/35, ± 8.2) and a moderate perception of vulnerability to disease (60.7/105, ± 19.9) contributed to nurses' stress. High levels of psychological distress, especially during COVID-19 compared to current levels (27.2 vs 18.8; W = 8.9, p = < 0.001), with high levels of resilience (73.2/88, ± 17.9) were reported. Enrolled nurses reported significantly higher levels of stress during the pandemic. CONCLUSION: Post COVID-19, there was reduction in the respondents who reported severe levels of psychological distress, highlighting the impact of the pandemic on nurses' mental health and the need to build resilience. CONTRIBUTION: This study enhances understanding of the factors that result in psychological distress in nurses and how nurses with different levels of education respond to stress.