Lived experiences of hemodialysis healthcare workers during the COVID-19 pandemic: A qualitative study from the Quebec Renal Network

Background: The COVID-19 pandemic has disrupted health systems and created numerous challenges in hospitals worldwide for patients and healthcare workers (HCWs). Hemodialysis centers are at risk of COVID-19 outbreaks given the difficulty of maintaining social distancing and the fact that hemodialysis patients are at higher risk of being infected with COVID-19. During the COVID-19 pandemic, HCWs have had to face many challenges and stressors. Our study was designed to gain HCWs' perspectives on their experiences of the impacts of the COVID-19 pandemic in hemodialysis units. Methods: Semi-structured interviews were conducted with 22 HCWs (nurses, nephrologists, pharmacists, social workers, patient attendants, security agents) working in five hemodialysis centers in Montreal, between November 2020 and May 2021. The content of the interviews was analyzed using thematic analysis. Results: Four themes were identified during the interviews. The first was the impact of COVID-19 on work organization, regarding which participants reported an increased workload, a need for a consistent information strategy, and positive innovations such as telemedicine. The second theme was challenges associated with communicating and caring for dialysis patients during the pandemic. The third theme was psychological distress experienced by hemodialysis staff and the psychosocial impact of COVID-19 on their personal lives. The fourth theme was recommendations made by participants for future public health emergencies, such as maintaining public health measures, ensuring an adequate supply of protective equipment and developing a consistent communication strategy. Conclusions: During the first and second waves of the COVID-19 pandemic, HCWs working in hemodialysis units faced multiple challenges that impacted their wellbeing and their work. In order to minimize challenges for HCWs in hemodialysis during a future pandemic, the healthcare system should provide an adequate supply of protective equipment, develop effective communication strategies and take into account the psychological distress related to HCWs' professional and personal lives.