Hierarchies of need: a systematic review of resilience, challenge, and change in the global nursing workforce during the first two years of the COVID-19 pandemic

McKenna Lawson, Stephen, Whybrow, Dean ORCID: https://orcid.org/0000-0001-9066-6196, Thomas, Hywel, Beech, Ian and Nute, Alex 2025. Hierarchies of need: a systematic review of resilience, challenge, and change in the global nursing workforce during the first two years of the COVID-19 pandemic. Creative Nursing: A Journal of Values, Issues, Experience, and Collaboration 10.1177/10784535251390034

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Abstract

Background: Nursing was critical to global health care delivery during the COVID-19 pandemic. Nurses everywhere experienced an extreme tension between public appreciation and personal distress. These experiences are ubiquitous in nursing research conducted across the world between 2020 and 2022. Despite holding profound value for future clinicians, policymakers, and wider society, these stories already appear absent in the collective memory. Review Question: To synthesize available qualitative and quantitative research about nurses’ experiences of resilience, challenge, and change during the first two years of the COVID-19 pandemic. Type of Review: Mixed-methods systematic review. Methods: The review followed a convergent integrated approach with multiple reviewers involved at each stage. Results: A total of 59 studies were eligible for analysis. Coding of results revealed a similarity to Maslow's expanded hierarchy of needs, which was used as a framing device for findings. The greater portion of recorded experiences expressed needs for safety, belonging, and esteem. Conclusions: The findings contained common and conflicting stories. Taken as a whole, the nursing experience during early COVID represents a powerful, compassionate counter-narrative to contemporary political dystopianism. Implications: Nurses need to leverage their critical importance to health-care delivery for improved work security, sociocultural recognition, and political influence.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Healthcare Sciences
Publisher:	SAGE Publications
ISSN:	1078-4535
Date of First Compliant Deposit:	4 November 2025
Date of Acceptance:	8 October 2025
Last Modified:	04 Nov 2025 11:31
URI:	https://orca.cardiff.ac.uk/id/eprint/182080

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