COVID-19 pandemic or chaos time management: first-line worker shortage – a qualitative study in three Canadian Provinces

Abstract

Background Over the successive waves of the COVID-19 pandemic, front-line care workers (FLCWs) —in this case, at long-term care facilities (LTCFs)— have been the backbone of the fight. The COVID-19 pandemic has disproportionately affected LTCFs in terms of the number of cases, deaths, and other morbidities, requiring managers to make rapid and profound shifts. The purpose of this study is to describe the effects of the pandemic on LTCF services offered and LTCFs staff dedicated to linguistic minorities in three Canadian provinces. Methods This qualitative descriptive study involved eleven managers and fourteen FLCWs, from six LTCFs of three Canadian provinces (New-Brunswick, Manitoba and Quebec). A qualitative content analysis was performed to identify key themes describing the effects of the COVID-19 pandemic on the services offered and the management of LTCFs staff. Results Based on participants’ experiences, we identified three main categories of themes. These macro-themes are as follows: (i) organization and management of staff, (ii) communication and decision-making method, and (iii) staff support. Conclusion The study highlighted the tremendous impact of COVID-19 on direct care staff in terms of the high risks associated with caring for LTCFs residents, which are exacerbated by absences and resignations (sometimes up to 50% of staff), resulting in higher resident to FLCWs ratios. Team members had to support each other, they also received accolades and appreciation from the residents.. Finally, the pandemic led to the rethinking of management procedures centred on a coordinated, inclusive and more hands-on management approach.

“We’re sinking”: a qualitative interview-based study on stakeholder perceptions of structural and process limitations to the Canadian healthcare system

“…Hospital re-admissions, lack of preventative care, administrative overhead [ 46 , 47 ], as well as inefficiencies and inconsistencies in service offerings and coverage across provinces [ 10 , 12 , 22 ], have been reported as primary inefficiencies within the Canadian healthcare system, with public opinion polls highlighting that Canadians are feeling the burden of these problems regularly [ 30 ]. Our study aligns with earlier findings suggesting that staffing shortages are a significant structural shortcoming [ 3 , 11 , 48 ] that have been intensified by the COVID-19 pandemic [ 4 – 6 ] and impact patients, healthcare professionals, and allied staff [ 4 , 5 ]. Canadians in our sample also commented frequently on the lack of a pan-Canadian electronic medical record database that would make patient data more accessible and organized, helping the healthcare system to operate more efficiently and save more lives.…”

“…Health experts have long anticipated a Canadian healthcare “crisis,” [ 1 – 3 ] citing concerns that include widespread staff shortages [ 4 – 6 ], long wait-times for emergency rooms [ 7 , 8 ] and surgical procedures [ 9 ], as well as inconsistent and inaccessible rural care [ 10 , 11 ]. Inefficiencies in healthcare systems globally have been exacerbated during the COVID-19 pandemic [ 7 , 8 , 12 , 13 ].…”

Were the unfinished nursing care occurrence, reasons, and consequences different between COVID-19 and non-COVID-19 patients? A systematic review

“…However, the quality of the included studies, as evaluated with the Joanna Briggs Institute [ 25 ] checklist, was appropriate in all items, except for those regarding the confounding factors that have been less precisely described. The work environments and the nursing care processes were chaotic (e.g., [ 36 ]); thus, taking into account all confounding factors was a challenge. Moreover, while the exposed group (COVID-19 patients) was substantially homogeneous, the comparison group (e.g., medical surgical, critical care patients) may have been affected by different health issues requiring different elements of care.…”

Under pressure – The working situation of Swedish healthcare managers during the first wave of COVID-19

“…Other studies have expressed the importance of the team regarding support in decision making. Involving the staff in the decision making helped create a feeling of solidarity between the workers and the managers and increased their sense of belonging during the health crisis ( Beogo et al, 2022 ). The third theme illustrates the significance of organizational and social support from the immediate manager, managerial colleagues and support functions such as HR specialists, experts in infection medicine and care hygiene, and the communication department.…”