Lessons for Leadership Planning Employee Support in a Long-Term Crisis: The COVID-19 Healthcare Worker Experience.

Background: Numerous programs were promoted during the COVID-19 pandemic to mitigate stress and provide support. Healthcare workers (HCWs) response to these support measures has not been evaluated. Objective/Aim: The objective of this study was to identify and describe the HCWs well-being and support needs over the course of the pandemic and to inform disaster planning preparations. Methods: In this qualitative descriptive study, five semistructured focus groups with 24 multidisciplinary HCWs were conducted between March and June 2022. Using thematic analysis, team members read each transcript to identify patterns in the phrases and apply codes. Phrases were then compressed, and themes identified. Results: Three phases were identified, each with unique themes. Phase 1) "The Beginning": themes included "hard to know what's right", "looked like a warzone", "we're all in it together", "seeing patients suffer", and "it was kind of nonstop". Phase 2) "Tide Turned": themes included "trying to be strong", "angry when they had to come back", and "wanted it both ways". Phase 3) "Starting to Process": themes included "I couldn't cry then", "started therapy, had to keep living", and "considered leaving". Conclusions: HCWs need support during and after prolonged crises to manage ongoing fears and anxieties. Leader presence during the crisis is valuable. Disaster planning through interdisciplinary shared governance is warranted to identify and develop appropriate and meaningful interventions. Resources and plans for psychological support need to be vetted by staff. Support is required in preparation for the crisis, as well as during and after the crisis.