Exploring Front-line nurses’ loyalty in Covid-19 Emergency wards: a Grounded Theory study Exploring Front-line nurses’ loyalty in Covid-19 Emergency wards: a Grounded Theory study

Lara Pierboni; Domenica Gazineo; Riccardo Triani; Pamela Bagli; Lea Godino

doi:10.54103/dn/28708

Authors

Lara Pierboni Direzione Infermieristica e Tecnica, AUSL Romagna, Rimini, Italy
Domenica Gazineo Governo Clinico e Qualità, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy https://orcid.org/0000-0003-1866-3358
Riccardo Triani Direzione Generale, Risk manager, AUSL Romagna, Cesena, Italy https://orcid.org/0009-0007-0499-7695
Pamela Bagli U.O. Oncologia, AUSL Romagna, Rimini, Italy https://orcid.org/0009-0003-2709-4553
Lea Godino Medical Genetics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna https://orcid.org/0000-0002-3763-9372

DOI:

https://doi.org/10.54103/dn/28708

Keywords:

Grounded Theory, Nurses, Loyalty, Covid-19, Psychosocial adaptation, Job Satisfaction

Abstract

Background. Front-line Covid-19 nurses developed a sense of belonging and professional loyalty to the newly established Covid-19 wards, often resisting a return to their original wards after the first wave.

Objective. This study explores the psychosocial processes shaping their loyalty, with a focus on the evolution of their personal and professional identity.

Methods. A qualitative study based on Strauss and Corbin’s Grounded Theory was performed. Data were analysed using coding techniques, constant comparison and memo-writing. Interviews were conducted until data saturation was reached.

Results. Analysis of 25 semi-structured interviews identified a theoretical model describing the process through which frontline nurses developed professional loyalty in Covid-19 wards. This model comprises four interconnected themes: “Awareness of the importance of their role”, “Confidence acquired”, “Satisfaction with the work accomplished” and ‘Relationships established’, which emerged as the core category. Findings indicate that professional relationships, characterized by mutual support, trust, and shared experiences, were central to fostering loyalty, reinforcing nurses’ identification with their team and workplace, and shaping their long-term professional commitment.

Conclusions. These findings highlight the crucial role of a supportive work environment in strengthening team cohesion and long-term commitment. From a practical perspective, fostering strong peer relationships, structured support programs, and clear career progression pathways may enhance nurse retention and mitigate post-crisis attrition. Beyond immediate applications, this study contributes to the broader discussion on workforce resilience in healthcare, emphasizing the need for further research on the long-term impact of crisis deployments on career trajectories and healthcare systems worldwide.

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