Table 2.

Coding tree.

Shift in commitment first to second wave
	First order codes	Second order codes	Third order codes
First wave	Common enemy Noses in the same direction Clear focal point and goal	Shared responsibility	High level of commitment (COVID-19 care)
	Once in a lifetime event Excitement of unknown Proud to help Emotional connection to the crisis effort	Emotional investment
	Staff commitment Desire and willingness to help Staff volunteering	Dedication
Second wave	COVID-19 should be only in certain specialties Everyone is tired of COVID-19 Staff want to focus on their own patients and care Difficulty redeploying staff	Lack of responsibility	Waning commitment (COVID-19 care)
	Staff will provide care if needed Professional responsibility to patients Everyone is tired of COVID-19 COVID-19 care is everyone's responsibility	Sense of obligation
Contributing factors to shift in commitment
First order codes		Second order codes	Third order codes
Exhaustion staff Physical illness Absenteeism due to illness Need for physical recovery		Physical strain	Energy depletion
Heavy emotional burden Uncertainty is high Unresolved trauma from first wave Hard to mentally detach No end in sight Absenteeism due to burnout symptoms		Mental strain
Lack of recovery Hard to detach Strain of long working hours		Lack of recovery
Doing COVID-19 work on top of regular work Scaling up regular care difficult Patients transfer from other areas in second wave		Balancing regular and COVID-19 care	Competing demands
No common goal Commitment to own patients Intergroup tensions Protection of staff in own department		Own priorities
No more gifts or applause Public not following regulations Aggression/frustration of patients and families Patients and visitors more demanding		Waning public support	Support and appreciation
Staff doesn't feel valued by board Importance of leadership visibility Lack of additional signs of appreciation Staff not thanked for their work in other departments Staff appreciate recognition by the board		Lack of support and recognition by organization
Zorgbonus (care bonus) Financial reward would motivate Compensation for additional hours		Financial support