Impact of COVID-19 in quebec hemodialysis units: Health care providers' experiences

Background: Chronic kidney disease is a risk factor for the severe form of COVID-19 and the hemodialysis unit represents a high-risk setting for virus transmission. Healthcare providers (HCPs) have the duty to keep patients safe and healthy, and also to protect themselves from the virus. The objective of this study was to gather health care providers' experiences working in dialysis units. Methods: We conducted semi-directed interviews by phone or video with 21 HCPs working in 6 hemodialysis units -nurses, nephrologists, pharmacists, social workers, security agent and housekeeping attendant -between November 2020 and May 2021. The content of the interviews was analyzed using thematic content analysis. Results: Participants identified positive and negative impact of Covid-19 pandemic. In their professional life, HCPs declared developing more collaboration, creativity and mutual support. However, due to the pandemic restrictive measures and lack of resources, HCPs felt a lot of distress not being able to provide adequate care for patients' needs. Participants also reported disruption in communication between HCPs and patients because of physical distancing and wearing a mask. They also described problems associated with patient transportation leading to delays or even absence of patients to their treatment. In their personal life, some HCPs declared being concerned by these new challenges at work and reported difficulties balancing work and family life. Also, most of them feared to contaminate their family and adopted certain routine cleaning to alleviate this fear. Conclusions: HCPs working in hemodialysis unit faced multiple challenges during the Covid-19 pandemic that impacted their wellbeing. However, they have shown high level of resilience and dedication to ensure health care delivery and to support hemodialysis patients.