# “Without Filters” Nurse and Healthcare Worker Personal Protective Equipment Injuries and the COVID-19 Experience: An International Social Media Ethnographic Study

## TL;DR

This study explores how healthcare workers shared PPE-related injuries on social media during the pandemic, revealing emotional and physical tolls and highlighting the need for psychosocial support.

## Contribution

The study introduces a novel ethnographic approach using social media to analyze the psychosocial impact of PPE injuries on healthcare workers during the pandemic.

## Key findings

- Healthcare workers shared PPE injuries on social media, reflecting grueling shifts and emotional scars.
- Themes like PPE shortages and pervasive fear emerged from the analysis of Instagram posts.
- The study emphasizes the need for psychosocial support and improved emergency preparedness for future pandemics.

## Abstract

Selfies of nurses and healthcare workers (HCWs) with painful personal protective equipment (PPE) injuries posted to social media provided early warning of the global PPE shortage impact during the COVID-19 pandemic. We aim to describe contextual factors associated with these injuries and describe factors that influenced posting on social media. A social media ethnographic study used purposeful sampling of Instagram posts (selfies/text) from March–October 2020 (170 posts; 26 countries). Posts were coded using focused content analysis to identify contextual factors. Data were reduced to understand and interpret the “essence” of the posts and discern themes. Themes included the following: (1) grueling shifts filled with unimaginable loss; (2) faces forever marked by the physical and emotional scars of COVID-19; (3) the COVID-19 battlefront; (4) dire and unprecedented PPE shortages; (5) pervasive fear (for self, colleagues, and family); (6) extreme emotional and physical consequences; (7) creating a collective voice. Examining injuries within the context of the nurses’/HCWs’ experiences provided new insights into the emotional scars, pervasive fears, and extreme emotional and physical consequences. An urgent need exists to address these harms and facilitate recovery. Before addressing emergency preparedness for the next pandemic event, psychosocial support is needed to address the harms incurred during the COVID-19 pandemic. Moreover, it is critical to understand past experiences to truly prepare for future pandemics.