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

Marleen D W Dohmen,Christina L E Thielman,Johanna M Huijg,Tineke A Abma,Charlotte Van Den Eijnde,Jolanda Lindenberg

doi:10.3390/ijerph19042106

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.

Highlights

Like many care homes around the world, Dutch care homes for older people have been severely affected by the coronavirus disease 2019 (COVID-19) pandemic
We aim to contribute to existing knowledge by answering the following research question: Which experiences did Dutch care home staff describe in their narratives during their work shifts in the COVID-19 pandemic? We draw upon original data from 424 brief personal narratives, written by care home staff members during the first and second waves of the COVID-19 pandemic in the Netherlands
In the study presented here, we have shown that residents’ wellbeing has been Dutch care home staff’s central focus during the COVID-19 pandemic

Summary

Introduction

Like many care homes around the world, Dutch care homes for older people have been severely affected by the coronavirus disease 2019 (COVID-19) pandemic. Since there were shortages of personal protective equipment (PPE), care staff felt pressured to work without protection This added to the fear of both contracting and spreading the novel coronavirus [5], a fear that became reality, as many residents were infected with and died from COVID-19. It was the disease itself, and the related mitigation measures that were challenging for care staff. They were required to enforce room isolation for residents suspected of having a COVID-19 infection, as well as a temporary

Objectives

Methods

Results

Discussion

Conclusion