Table 2.

Quotes—new disease and high workload

1	‘No, you have this feeling that you’re less in control of the situation.(…) And I think no one had that feeling that they knew what was coming in the case of COVID.(…) In the terminal phase too, I felt it was like hey, suddenly it all changed… and they were dead, or hey, suddenly they were stable, or hey, everything suddenly fell apart. Normally you would be dropping in on them regularly and you’d see things happening, you know, and you adjust accordingly. But for me this wasn’t like that… it was more difficult’ (4: Nurse, hospice).
2	‘But when you saw him, he really wasn’t comfortable. Laboured breathing, high respiratory rate, increasing heart rate. You could see the panic in his eyes but there came a point when we couldn’t communicate with him anymore. He was kind of asleep, as it were, but you could see that he was still physically really hard at work. If he’d been a non-COVID patient I would have said he’s not comfortable so we need to do something with the medication. And so that’s what we did. Only it didn’t work well enough for this man. And that remained the case up to the end. I found that difficult’ (10: Nurse, hospital COVID ward).
3	‘In that respect, I didn’t think there was much privacy, so… of course, there were really strict visiting rules so I felt patients got a bit abandoned. And with the IC cohort, that was completely (…), right, that was basically 18 people lying in a single room, all on their stomachs, all kind of like interchangeable. So when we had our shift, we’d start by turning the first one back over, and then go through the whole lot one by one, as it were. It was almost like a production line. With no curtains in between, they’d all been removed, so I found it incredibly degrading’ (9: Nurse, hospital COVID ward).
4	‘We provided the necessary care. In the end, we were never really satisfied with what we did and how we did it. We were never really satisfied, because we simply couldn’t give assistance in social and emotional aspects and I find that very important. So it was just a case of giving people the essential care, trying to keep them stable’ (9: Nurse, hospital COVID ward).
5	‘What you also realize afterwards is that, because it wasn’t just IC nurses but other people too, they didn’t have all the necessary knowledge. So now I’m increasingly hearing that people have ended up with eye problems because they didn’t get the drops every so often, and the eyes became dehydrated. Then I think to myself: oh, there are some things we made a right mess of’ (9: Nurse, hospital COVID ward).
6	‘Normally, we’re used to providing as much continuity as possible. So if you switch from a morning shift to an evening shift, you try to have the same patient who you had in your morning shift in the evening shift too. Now I might not be on my own ward, as it were, for three weeks because I’d be working all over the place, then I’d come back and oh, that patient’s been there a long time. Well, you don’t know what that means because you didn’t get any of the news about the patient’ (3: Nurse, ICU).
7	‘We also had more patients to care for than we would normally, so we had less time available to spend on the family. In the normal situation, if we know a patient is going to die, we always try to make sure there’s one nurse who can focus entirely on that and give the family their full assistance and go through that whole process properly. But that wasn’t possible during the COVID period. That did make it rather unsatisfying for everyone, yes’ (3: Nurse, ICU).
8	‘Yes, then we would just phone the family at home and that was often for medical reasons. A conversation with the family and, yes, the tricky thing… we would agree with them who else needs to come. How do we want the final goodbye… what’s the procedure? But at the same time we didn’t want it to take days because you needed the beds. So it was really 24 hours max. And then it was indeed a question of stopping, removing the ventilation and then it was often less than quarter of an hour and the patient was dead. So that often happened very quickly. And then the patient would be removed, room cleaned, new patient put in. Yes, that was really weird’ (9: Nurse, hospital COVID ward).