Themes, codes, example of submission narrative quotes and recommended strategy
| Themes | Codes | Examples of submission narrative quotes | Recommended strategy |
| 1. Hopeful and resilient |
| This photo symbolizes the first time I truly allowed myself to hope for a future without COVID—S2. After wave upon wave of Covid-19, the vaccines bring hope to what feels like a never-ending pandemic—S11. Being resilient in a long career in Medicine is always encouraged. More than ever, I felt my resilience was tested and strengthened since the pandemic began—S15. | In hospital vaccination accessibility for patients. |
| 2. Pandemic fatigue-negative mental and physical states |
| During the pandemic, many have had feelings of isolation during these tough times—S25. I do not think any of us knew what was to be done, and you could not really move under the pressure of it all…it was all consuming and paralyzing—S4. As nurse colleagues started to fall ill from Covid-19 we all felt fearful, anxious, and scared—S23. Many healthcare providers have survived Covid-19 months ago but… It is still hard to breath, head hurts, difficult to concentrate, feeling anxious and worried. We are injured—S10. Behind the Mask, Stethoscope and Pager, I hide my own uncertainty and doubt about the pandemic from others—S16. | Mental health supports offered via digital platforms, hospital-based councillor and accessible through the human resources department. Staff self-reflection (eg, ‘Pause and Reflect’—a peer-to-peer debriefing support activity or self-reflection questioning) on ethical issues arising from the pandemic, such as caring for unvaccinated patients, highly emotional and traumatising events. |
| 3. PPE is our armour but masks who we are |
| PPE ensured our patients received the caring professional hands of our dedicated nursing teams—S8. I wonder what people think when they see me smile, laugh, frown from behind the mask—S12. | Staff safety as a top priority, that is, PPE supplies accessible and PPE coaches present on the units to provide assistance. Wearable buttons to show HCW faces. |
| 4. Human connection |
| Previously an area where staff, patients, and families visited in large groups, Previously an area that was noisy and often full of laughs from hard working teams on their much-deserved breaks. Previously an area of gathering—S1. We can overcome it when we surround ourselves with the right support system. And when we acknowledge it, we can allow ourselves to feel, heal and continue growing—S15. The strength of the team is each individual member; the strength of each member is the team—S8. | Collaborate with existing programmes following local infection prevention guidance to reintroduce safe staff interaction/activities (ie, pet and music therapy, and hospital-based artistic programmes) Hospital-based HCW peer support group. |
| 5. Responsibility, preparation and obligation |
| We have spent countless hours on surge Covid-19 planning to prepare our teams for the pandemic—S8. I had the moral duty to listen to my patient’s fears, to try to answer their questions and to understand their doubts—S21. | Proactively address HCW fatigue through ongoing recruitment into regular, casual, temporary and new graduate positions in addition to redeployment strategies. |
| 6. Technology surge |
| For me, the pandemic marked a widespread adoption of digital medical interpretation across the province—S7. (…)during COVID it became more and more difficult to keep on top of the latest information due to the flood of emails that felt like they would never end—S18. | Technology accessible and training provided (ie, digital medical interpretation, virtual appointments, etc). Centralise and reduce COVID-19 communications, preventing information overload (ie, weekly and daily summary of key messages). |
PPE, personal protective equipment.