Table 2.

Lived experiences and perspectives of HCWs in a single ICU during the COVID-19 pandemic

Theme	Quotation
Communications and informational needs	The hospital itself sent a lot of and continues to send a lot of communication as to the large-scale hospital policies with regards to visitors and screening upon entrance and that sort of thing. And for my department specifically, our manager has been amazing about just keeping us up to date on everything. (RT, P-15) From an [allied staff] perspective, we weren't really spoken to about anything, I guess maybe because we're not medical professionals. There was nothing. (AS, P-19) To put the burden on us to remember everything, plus remember 10 additional things that are brand new, I think that’s the stress. And even though each one of the things is easy to remember, when you’re putting 10 things together and trying to remember all of them, plus worrying about other things, I think it gets overwhelming at times. (RT, P-12)
Adjusting to restricted visitation	Not being able to go into the room or at least avoiding going into the room means that you're not communicating enough. There was this kind of distance between the team and the patient that we normally don't have. (MD, P-17) It was a weird feeling because it challenged how we communicate with patients and families because the families wouldn't be present. We always made it a priority, like make sure we call every patient's family every day to give them an update because they all felt like they were really isolated from their family member who was in the ICU. (MD, P-01) I was exposed to communicating decisions around withdrawal of ECMO, which is one of the therapies, the last therapy that we have as a choice. Withdrawing that means that the patient dies probably sometimes in a matter of minutes. This was really difficult because this was done via Zoom, and the family saw the patient die through an iPad. (MD, P-17)
Staffing and workplace support	Because we don't belong to nursing stations, we are not able to go into the nursing station lounge because they look at us like weird, what are you doing here? We feel like we're being rejected. But we have been working from day one, and we haven't got that type of emotional support or hospitality. We don't feel supported. That's the bottom line. (AS, P-10) I think that our management, they are not available, because whatever issues we have right now are not important. At least that's the feeling. We try to get feedback. They're never available, there are other things at hand. (AS, P-10) We really worked as a unit. Because we knew that if one of us got sick, that there's a potential that a lot of us would have probably gotten sick. (RT, P- 12)
	We were trying to get other people and they had no interest because they didn’t want to expose themselves to put their families at risk. Come on, we’re not asking you to do something we’re not willing to do. (MD, P-01) I saw people who didn't want to cover my clinical area because one, they were afraid or they were fearful, or they didn't have the knowledge and they didn't want to get the knowledge. (AS, P-14) We had good resources available. They increased staffing. So, we always had extra staff to help. (RN, P-20) For a few months during the peak of it, we up‐staffed our department a bit, and so that also allowed us to feel a bit of extra support, especially when things did get busier and when we were a bit more strained, to kind of be able to see all the patients and give enough time to each one. (RT, P-16) I felt it was really important having early available psychiatry or psychological therapy, which our nursing staff did to provide support for anyone at any time. So, it was an open invitation. You didn't have to use it, but at least it was available, so if you would reach out. We had lots of discussions about wellness and things like that. (MD, P-05)
Permeability of professional and personal lives	I was changing in the hospital…and I didn't talk when I [went] back home, I didn't talk to anyone, I first showered, put my clothes in the laundry…hand sanitizers and all that. (RN, P-20) That was very stressful also for my family because they were worried. I mean, they support me in my desire to serve society as a physician, but they're not really willing to put me on the line to do that, they don't like that. (MD, P-06) When school shut down, day care shut down, and my husband had to look after our child full time. That is not what he's meant to do. That created a lot of tension. (MD-T, P-04) Friends, depending on what's going on in their life personally, sometimes reached out. Kind of like what happened with SARS, they were like, oh, you work in a COVID unit, we're staying away from you. (RN, P-21) People outside of medicine were like, oh, we're so proud and you're such a hero and all this. And honestly, I didn't think I was doing anything different, so it made me feel uncomfortable, I found those statements were unfounded. (MD, P-01) I mean, we are not heroes like all the propaganda say. I don't like that. I don’t think we’re heroes. (MD-T, P-03)
Dynamic COVID-19 landscape	At the beginning, the stress was the unknown because a lot of the people were getting infected, and we didn't know whether it's airborne or droplets and the information was changing every single day. (RN, P-22)
	Using public transit and seeing people who weren't wearing masks and people not following the rules, I thought about, do I still want to work in a hospital after this? (AS, P-19) Once we started having patients in the ICU, I think anxiety reduced quite a lot because I could understand how we would implement all of this, how the day would look, how we would care for these patients. But I think then the concern turned to, how could we actually do what we would usually do for these patients, with all these additional challenges surrounding patient care, wearing PPE, and how best to wear it, when to wear it. (MD-T, P-17) Definitely it was very stressful to work. When we didn't have too much information, it was extremely stressful, but right now I think we are more relaxed, we just calm down a little bit with the new signs. (RN, P-23) I just wore a simple face mask yesterday, but now I'm being told to wear an N95. Does that mean I was at risk yesterday, or is that just a policy, or is it a supply issue? (MD-T, P-02) You never got a chance to be comfortable with anything and you were constantly questioning if you were doing the right process. (AS, P-14)

AS = allied staff; ECMO = extracorporeal membrane oxygenation; HCW = healthcare worker; ICU = intensive care unit; MD = medical doctor; MD-T = medical doctor – trainee; RN = registered nurse; RT = respiratory therapist