Staff Experiences Working During COVID-19 Outbreaks in Long-Term Care in Northern Settings: A Qualitative Study

Working during an outbreak poses additional challenges for staff working in long-term care facilities (LTCFs). The existing literature explores the experiences of LTCF staff during the COVID-19 pandemic, but there is a paucity of research focusing on the specific challenges of working during COVID-19 outbreaks in rural and northern communities. Secondary analysis was conducted on interview transcripts from sixteen participants with experience working during COVID-19 outbreaks in northern LTCFs. Participants engaged in in-depth semi-structured interviews and shared their experiences working during COVID-19 outbreaks in the COVID-19 pandemic. Seven themes emerged through thematic analysis, including: (1) personal fear and moral distress, (2) coping with resident death due to COVID-19, (3) relationship dynamics, (4) changing workload expectations during staffing shortages, (5) resource constraints and organizational support gaps, (6) resources and support, and (7) impact of vaccinations. Findings emphasize the increased complexity of working during a COVID-19 outbreak in rural and northern communities and describe factors that shaped both the positives and negatives of the experience for staff. These findings show that rural and northern LTCFs faced additional challenges during COVID-19 outbreaks due to pre-existing resource and staffing shortages. However, we also highlight the unique strength of these communities in how they coped and supported each other through COVID-19 outbreaks. This study provides practical insights to inform improved outbreak management, including the need for region-specific guidance and support, clear communication from management, reliable access to personal protective equipment, consistent staffing, and support for grief and burnout, all while highlighting the voices of those who worked through these outbreaks.