Covid-19 in nursing homes as experienced by employees

Sara Erlandsson Petra Ulmanen Sara Wittzell

Employees highlight great challenges in nursing homes during the pandemic. Their experiences offer important lessons for the future, according to Sara Erlandsson, Petra Ulmanen and Sara Wittzell in a new SNS report.

Covid-19 in nursing homes as experienced by employees. English summary 64.9 KB PDF

In addition to the risk of getting infected with Covid-19, employees and residents in nursing homes were also exposed to other risks during the pandemic. For employees, this involved health risks in the form of high workloads and emotional stress, while the residents risked a reduction in their quality of life as well as poorer care. This is emphasized by the authors of the SNS report Covid-19 in nursing homes as experienced by employees.

The new requirements with regard to preventing the virus from spreading were hampered by shortcomings ranging from information and hygiene procedures to language and professional skills. Furthermore, low staffing with a high proportion of employees working on an hourly basis or with fixed-term contracts also made these operations more vulnerable.

“We interviewed employees at four nursing homes in Stockholm concerning their work situation during two years of the pandemic. They told us about how their work was hampered by deficiencies related to language skills and educational background among new employees,” says Sara Erlandsson, associate professor of social work.

According to the interviewees, the skills exhibited by assistant nurses also varied.

“There are several assistant nurse training programs. Employees we have talked to believe that many of these programs do not exhibit sufficient quality,” says Petra Ulmanen, senior lecturer of social work.

The interviewees also described how the autonomy of the elderly was curtailed when a visitation ban was introduced and they found themselves isolated in their apartments. According to the report, residents may also have been exposed to medical risks as a result of Region Stockholm deciding not to prioritize elderly individuals with regard to hospital care, especially as the physicians linked to the nursing homes were only available by phone at the beginning of the pandemic. The interview responses suggest that measures aimed at stopping the virus from spreading reduced the quality of care. In addition to having a negative impact on the elderly, this also caused emotional stress for the employees.

“Nursing homes are where the elderly live – their homes – not infectious disease wards. The employees were forced to strike a difficult balance between individual autonomy and preventing the virus from spreading. Much more support and guidance are needed in such situations,” says Sara Erlandsson.

The authors call on politicians and other decision-makers to learn from the experiences of the employees. The aim is not only to get better at addressing future infections from spreading but also to improve care in general. According to Erlandsson, Ulman and Wittzell, the pandemic sheds light on what is always required to offer good care in nursing homes.

about the report

The report examines the experiences of different employee groups in terms of managing the pandemic in nursing homes in Stockholm. In the spring of 2022, the researchers carried out a case study at four nursing homes where they interviewed unit managers, nurses, assistant nurses and care assistants. They have also collected data on the size and staffing of the nursing homes and the layout of the premises.

About the authors

Sara Erlandsson is an associate professor of social work at Stockholm University.

Petra Ulmanen is an associate professor of social work at Stockholm University.

Sara Wittzell is a PhD student in social work at Stockholm University and has served as a research assistant in the study.