Table 3 Participants’ declarations in the qualitative approach. Rio de Janeiro, 2021

Working Conditions

Covid-19 Protocol

Creation of protocols

[…] we took the Brazilian Association of Surgical Centre, Anaesthesia Recovery and Material and Sterilisation Centre Nurses (Associação Brasileira de Enfermeiros de Centro Cirúrgico, Recuperação Anestésica e Centro de Material e Esterilização, SOBECC) as our basis because that was where, as far as I know, the society placed the various recommendations that came out of the Ministry of Health, right, on health surveillance, but like who really guided the OR was our society. So, based on that, we developed a protocol, […]. (ENF-12)

First of all the SOP were developed, which the teams got together and created… That is what was to be followed. (ENF-03)

Safety Climate

Patient safety

Commitment to patient safety

I believe so, yes. From the nurses, medical staff, anaesthesia… Everyone takes responsibility for safety. Always checks the tests, the patient history, tries to locate the correct side for the surgery so as to leave no doubts. So I believe so, yes. (CIR-19)

It was not my perception that safety was reinforced and increased during the pandemic. Although I perceived that to be the intention, but here in our sector I did not have the impression that safety increased. (ANEST-09)

Perception of Stress

Feelings

Feelings

I think that everyone was really lost before, but as I already said, I think that was the general feeling and, until things were settled, everyone was more or less lost, but later they learned from the errors as they went along. (ENF-03)

I worked with more fear. (ANEST-23)

I think people were more concerned with themselves, with their families, but I can understand that. (ENF-12)

Perception of Job Performance

Workload

Fatigue

I felt very tired because of the staff reduction in the area. Whoever was left had to work flat out. (ENF-06)

It’s that wear and tear during the shift, because you, in that period, we do a lot of reworking, of redoing things, as regards the protocol, as regards taking over from the team, yes,… multidisciplinary team and having to chase them up, chase them up, go after them to get them to do what’s written, yes… So then, that reworking, that wears you down. (ENF-24)

I even felt more tired when I got out of here, because the shifts were heavier going, more difficult. (ANEST-09)

Perception of Management

Management Attitude

Lack of information

Nobody can inform you. You don’t have a figure and we weren’t told: this many patients admitted, this many deaths, this many recovered… I think that’s important. This many staff. […] Information is everything. (CIR-11)

No, that access to feedback was more difficult. Coming up and giving a suggestion or asking why, why it changed, why it happened, that’s more… It doesn’t happen like that, that’s more… That’s not what comes across. All that comes are orders and we obey. There’s nothing like the reason for the changes. (CIR-21)

But I had the impression that maybe the unit leaders should have come to more of the resident people and given more information. (CIR-23)

Communication in the Surgical Environment

Communication

Meetings as a strategy for horizontal communication

I think it might be better to have… I don’t know… at some point, Ah, every Friday there will be one session and there we’ll talk about that, talk about how each one is feeling, how the protocol is being done, […] So I think there could be at least some session, at some point in the day. “Ah I’ll set a fixed day and that way there will be one single information”. So there is a certain deficiency in that regard, in receiving communication. (ENF-08)

I think that what is lacking is meetings to like… once a month to say “oh, this happened, we need to improve this”. Otherwise, it seems like everyone is going a different direction and we are left rather not knowing which way to go. (CIR-11)