Table 3.

Leading return to work obstacles

Obstacle (anticipated or experienced)	n	Example quotes
Individual level (physical or psychological factors)
Fatigue	29	‘Need for huge amount of rest...never had an illness I could not push through before.’
Social distancing	23	‘Not able to social distance at work with patients’
Poor concentration	20	“Each two days of work could cause me three days of brain fog and short-term memory loss’
Relapsing nature of symptoms	13	‘Rollercoaster nature of symptom severity making it impossible to plan work’
Safety (personal or patient safety)	12	‘Cognitive symptoms made nursing unsafe.’
Expectations/professional identity	10	‘Feeling worried about not being able to perform as well as I used to’
Job (factors in the immediate work environment)
Symptom interaction with physical job demands of a given job	29	‘Absolutely could not safely care for patients nor handle the physicality of nursing’
Control over job pressures	28	‘High pressure in my own caseload, which has increased since the original lockdown’
Working patterns	17	My days are 7.30 to 6.40 pm at the earliest-there is no way I would manage these “
Symptom interaction with cognitive job demands of a given job	12	‘Working IT systems is difficult with brain fog and concentration is hard too’
Work support (managerial support factors)
Human resources/Occupational health support (−) (the quantity and quality of human resources services and/or occupational health services support undermines workability)	14	“They paid me for the time, I was positive with COVID but now I have long-COVID don’t know what pay I will get if any
Line management (−)	12	‘Not believing you and saying you are over exaggerating, telling you to push yourself, saying you risk losing your job if phone in sick.’
Peer/colleague behaviour (–)	11	“Peers and colleagues are already burnt out and exhausted from the pandemic, will face resentment from being out for so long“
Organizational support (wider organisational factors)
Sickness absence policies	26	‘Organization is generally supportive... but the HR policies are quite rigid e.g. limited company sick pay in first few years, refusal to use furlough.’
Organizational culture (awareness of COVID and collective and attitudes about health and work)	27	‘It would be great if people understood fatigue is not the same as tiredness’
Job Security	15	‘Once you are back, you are back fully or not at all’    ‘Not sure if they will keep my job open until I’m able to return...and that will be very phased.’
External factors (societal factors that affect ability to work)
Access to suitable health care	33	‘I struggled to get GP appointment. Waiting for appointment at long-COVID clinic for 3 months’
Transport issues	26	‘I would need to be given special permit to allow me to park at work’