Three years of pandemic stress and staffing challenges: a retrospective qualitative study of COVID-19 impacts on frontline healthcare workers’ mental health and wellbeing

TL;DR

This study explores how the stress and challenges of the pandemic affected the mental health of healthcare workers over three years.

Contribution

The study provides new insights into the evolving stressors and support needs of healthcare workers during the pandemic.

Findings

Healthcare workers experienced anxiety and stress from pandemic-related work demands.

Staffing shortages and exhaustion impacted workplace culture and patient care.

Relational supports helped healthcare workers manage stress during the pandemic.

Abstract

Healthcare systems have faced unprecedented demand over the course of the COVID-19 pandemic, placing significant burdens on frontline doctors, nurses, and support staff. Many studies have thus observed significant impacts on frontline healthcare workers’ mental health and wellbeing, however, few studies have explored the evolving nature of healthcare roles and its impacts on healthcare workers. This study retrospectively explored the changing nature of frontline healthcare roles over the last three years of the pandemic, and its impact on stressors and supports related to frontline healthcare workers’ mental health and wellbeing.

A total of 11 Victorian (Australia) frontline healthcare workers from frontline wards participated in retrospective semi-structured interviews between March 2023 to April 2023. Data was analysed using thematic analysis, using a reflective approach to identify patterns across participant narratives and experiences.

Three superordinate and nine subordinate themes were identified. Themes revolved around (1) COVID-19 anxiety and work related stressors in the initial and later stages of the pandemic, (2) The great resignation of healthcare workers that led to workforce issues, fatigue and exhaustion, which subsequently impacted team dynamics, workplace culture, engagement at work, and patient care, and (3) Strained social connections and work to family spillover effects during the COVID-19 era, as well as the key relational supports that helped healthcare workers manage stressors.

The COVID-19 pandemic appears to have amplified existing challenges in healthcare provision and highlighted the psychological burden of healthcare roles on staff. Workplace demands have shifted from crisis management of acute risk of COVID-19 infections to now managing staffing shortages, presenting new challenges that require innovative solutions to ensure frontline HCWs’ mental health are protected. There is thus a need to adapt staff supports to manage the excessive demand on staff now, and the findings here offer recommendations for governments, health organisations, and healthcare leaders to design policies and supports that meets the needs of frontline HCW’s mental health and wellbeing.

The online version contains supplementary material available at 10.1186/s12888-025-07348-4.