Community healthcare workers' experiences during and after COVID-19 lockdown: A qualitative study from Aotearoa New Zealand

Shortly after the COVID-19 pandemic reached Aotearoa New Zealand, stringent lockdown measures lasting 7 weeks were introduced to manage community spread of the virus. This paper reports the findings of a qualitative study examining how lockdown measures impacted upon the lives of nurses, midwives and personal care assistants caring for community-based patients during this time. The study involved nationwide surveys and in-depth interviews with 15 registered nurses employed in community settings, two community midwives and five personal care assistants. During the lockdown, nurses, midwives and personal care assistants working in the community showed considerable courage in answering their 'call to duty' by taking on heightened care responsibilities and going 'the extra mile' to help others. They faced significant risks to personal and professional relationships when they were required to take on additional and complex responsibilities for community-based patients. Despite the hypervigilant monitoring of their personal protective equipment (PPE), the need to safeguard family and community members generated considerable stress and anxiety. Many also faced personal isolation and loneliness as a result of lockdown restrictions. Moreover, the negative impacts of experiences during lockdown often continued to be felt once restrictions had been lifted, inflecting life during periods in which community transmission of COVID-19 was not occurring. This article makes five core service delivery and policy recommendations for supporting community-based nurses, midwives and personal care assistants in respiratory disease pandemics: acknowledging the crucial role played by community-based carers and the associated stress and anxiety they endured by championing respect and compassion; demystifying the 'heroism' or 'self-sacrifice' projected onto care workers; the timely provision of adequate protective equipment; improving remuneration, with adequate provision for time off; and regular counselling, peer support groups and education on work-life balance delivered by support workers in recognition of stressors arising from these complex and isolated working conditions.