Good Care during COVID-19: A Narrative Approach to Care Home Staff’s Experiences of the Pandemic

Abstract

Due to its major impact on Dutch care homes for older people, the COVID-19 pandemic has presented care staff with unprecedented challenges. Studies investigating the experiences of care staff during the COVID-19 pandemic have shown its negative impact on their wellbeing. We aimed to supplement this knowledge by taking a narrative approach. We drew upon 424 personal narratives written by care staff during their work in a Dutch care home during the COVID-19 pandemic. Firstly, our results show that care staff have a relational-moral approach to good care. Residents’ wellbeing is their main focus, which they try to achieve through personal relationships within the triad of care staff–resident–significant others (SOs). Secondly, our results indicate that caregivers experience the COVID-19 mitigation measures as obstructions to relational-moral good care, as they limit residents’ wellbeing, damage the triadic care staff–residents–SOs relationship and leave no room for dialogue about good care. Thirdly, the results show that care staff experiences internal conflict when enforcing the mitigation measures, as the measures contrast with their relational-moral approach to care. We conclude that decisions about mitigation measures should be the result of a dialogic process on multiple levels so that a desired balance between practical good care and relational-moral good care can be determined.

Experiences of Healthcare Workers in Long-Term Care during COVID-19: A Scoping Review

“…Carrying the load refers to the cognitive, socio-emotional, and psychological burden carried by HCWs throughout the pandemic and the impact on their health and wellbeing. This burden, or “emotional load” (Dohmen et al, 2022), was directly linked to work-related demands and tremendous responsibilities placed on HCWs in the LTC sector. Twenty-five of the 40 studies reported negative emotions and internal struggles that diverse groups of LTC workers (i.e., care aides, nurses, physicians) experienced in caring for infected and dying residents.…”

“…The effects of carrying this emotional burden and feelings of guilt often led to “internal conflict” and “moral distress” for HCWs (Dohmen et al, 2022). Most HCWs conveyed a deep-seated grief, anxiety, and concern for the quality of life of residents as many deteriorated.…”

“…Despite the enormous burden of distress and potentially traumatic events experienced by HCWs in LTC homes, some studies (Blanco-Donoso et al, 2021; Dohmen et al, 2022) highlighted the positive feelings experienced by HCWs including a sense of duty and commitment to care and gratification and fulfillment working during the crisis and how their work contributed to the greater good of society. For instance, participants reported feelings of pride, satisfaction in helping others (Hung et al, 2022) and professional fulfillment in providing care to residents during the pandemic.…”

Long-Term Care Workers’ Experiences and Their Views About Support During the COVID-19 Pandemic: A Scoping Review

“…Carrying the load refers to the cognitive, socio-emotional, and psychological burden carried by HCWs throughout the pandemic and impact on their health and wellbeing. This burden, or "emotional load" (Dohmen et al, 2022), was directly linked to work-related demands and tremendous responsibilities placed on HCWs in the LTC sector. Twenty-five of the 40 studies reported negative emotions and internal struggles that LTC workers experienced in caring for infected and dying residents.…”

“…The effects of carrying this emotional burden and feelings of guilt often led to "internal conflict" and "moral distress" for HCWs (Dohmen et al, 2022;Scerri et al, 2022). One participant expressed that "[h]er emotional turmoil was associated with moral distress of not being able 'to be a nurse' in the current circumstances" (Scerri et al, 2022, p.6) as a result of COVID-19 mitigation measures.…”