Occupational challenges of health care workers during the COVID-19 pandemic. A qualitative study

Background: The COVID-19 pandemic has placed a significant burden on health care systems worldwide with health care workers (HCWs) delivering care under unprecedented conditions. This study deals with HCWs9 physical, mental, emotional and professional challenges of working during the COVID-19 pandemic and seeks to understand structural determinants of those challenges. Methods: We carried out an exploratory qualitative study in public and private hospitals in Vienna, Austria. HCWs such as medical doctors, qualified nursing staff, nurse assistants, technical and cleaning staff in direct and indirect contact with COVID-19 patients were included. Collected data was analyzed using content analysis. Findings: We conducted 30 semi-structured interviews in person and per phone from June 2020 to January 2021. Three overall themes resulted as relevant: challenges due to lack of preparedness, structural conditions, and physical and mental health of HCWs. Lack of preparedness included missing or delayed infection prevention and control (IPC) guidelines, shortages of personal protective equipment (PPE) combined with structural conditions such as staff shortages and overworked personnel. Physical and mental strains resulted from being overworked and working permanently on alert. Further, working in PPE, facing medical uncertainties and the critical conditions of patients were challenging factors. HCWs lacked recognition on multiple levels and dealt with social stigma and avoidance behavior of colleagues, especially in the beginning of the pandemic. Interpretation: To mitigate HCWs9 occupational health risks and staff turnover, we propose the following context-specific recommendations: Required medical personnel in care of COVID-19 patients, especially nursing staff, should be carefully planned and increased to avert chronic work overload. Intensive training and education in palliative care, as well as in IPC for all HCWs is important. Providing supportive supervision is as essential as appropriate recognition by higher level management and the public. Funding: This article has received funding from The Vienna Science and Technology Fund (WWTF) COVID-19 Rapid Response Funding 2020. The funders did not play a role in the decision to publish the article.