Ana Cristina Castro-ÁvilaJaviera Aguilera2026-03-222026-03-22202510.1101/2025.09.28.25336848https://doi.org/10.1101/2025.09.28.25336848https://andeanlibrary.org/handle/123456789/84557Abstract Aim To explore how intensive care unit healthcare workers experienced their hospital response prior to and during the COVID-19 pandemic in seven centres in Chile. Methods We conducted semi-structured telephone interviews with ICU consultants, nurses, physiotherapists and healthcare assistants in seven hospitals in Chile. Healthcare professionals enrolled through QR codes displayed on posters in their staff rooms. The interviews were recorded, transcribed verbatim and analysed following the principles of framework analysis. Findings We interviewed 38 healthcare professionals between November 2020 and March 2022, of which 15(39%) were physiotherapists, 9(24%) were nurses, 7(18%) were healthcare assistants, of whom 21(56%) had worked in ICU for three to 10 years. We identified seven themes: 1) Units opened and converted to ICU “as the pandemic unfolded”; 2) “change of usual roles” where more experienced professionals took on provisional managerial roles alongside their clinical duties; 3) “social isolation, exhaustion, and lack of psychological support”; 4) “Fear of becoming a vector for infection”; 5) “Keep calm and carry on” mentality where professionals kept working regardless of their own wellbeing; 6) “Depersonalisation”; and 7) “Uncertainty” of the best course of treatment. Conclusions Our interviewees perceived the institutional preparation as insufficient, which led to a more-than-expected workload increase, exhaustion, and personal sacrifices to maintain standards of care. Institutional measures to support the workforce were perceived as late, inadequate, or insufficient. Implications for Clinical Practice ICU workers are a scarce and valuable resource during public health emergencies, planning should be in place to rapidly increase ICU staff in the event of a new prolonged emergency without burning out existing human resources. Appropriate psychological and emotional support should be provided in a timely fashion.enPandemicHealth careWorkloadNursingWorkforceQualitative researchHealth professionalsMedicineIntensive care unitUnit (ring theory)preprint