COVID-19 confessions: a qualitative exploration of healthcare workers experiences of working with COVID-19

Bennett, Paul; Noble, Simon; Johnston, Stephen; Jones, David; Hunter, Rachael

doi:10.1136/bmjopen-2020-043949

Cited by 141 publications

(222 citation statements)

References 7 publications

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“…That collective achievement should not blind us to the anguish that many participants endured and its lasting damage: several staff expressed a deep reluctance to return to critical care to tackle a second wave, something highlighted in other qualitative studies of frontline staff experience. 30 Nor should we assume that the communities of fate that coalesced in response to the first wave will survive as the pandemic becomes increasingly protracted and challenges recur. As Baehr notes "Where all hope is gone, resources spent, and action deemed hopeless, communities of fate are impossible."…”

Section: Discussionmentioning

confidence: 99%

Critical care work during COVID-19: a qualitative study of staff experiences in the UK

et al. 2021

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ObjectiveTo understand National Health Service (NHS) staff experiences of working in critical care during the first wave of the COVID-19 pandemic in the UK.DesignQualitative study using semistructured telephone interviews and rapid analysis, interpreted using Baehr’s sociological lens of ‘communities of fate’.ParticipantsForty NHS staff working in critical care, including 21 nurses, 10 doctors and advanced critical care practitioners, 4 allied health professionals, 3 operating department practitioners and 2 ward clerks. Participants were interviewed between August and October 2020; we purposefully sought the experiences of trained and experienced critical care staff and those who were redeployed.SettingFour hospitals in the UK.ResultsCOVID-19 presented staff with a situation of extreme stress, duress and social emergency, leading to a shared set of experiences which we have characterised as a community of fate. This involved not only fear and dread of working in critical care, but also a collective sense of duty and vocation. Caring for patients and families involved changes to usual ways of working, revolving around: reorganisation of space and personnel, personal protective equipment, lack of evidence for treating COVID-19, inability for families to be physically present, and the trauma of witnessing extreme patient acuity and death on a large scale. The stress and isolation of working in critical care during COVID-19 was mitigated by strong teamwork, camaraderie, pride and fulfilment.ConclusionCOVID-19 has changed working practices in critical care and profoundly affected staff physically, mentally and emotionally. Attention needs to be paid to the social and organisational conditions in which individuals work, addressing both practical resourcing and the interpersonal dynamics of critical care provision.

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Section: Discussionmentioning

confidence: 99%

Critical care work during COVID-19: a qualitative study of staff experiences in the UK

et al. 2021

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“…[23][24][25][26][27][28] However, there are limited qualitative data describing the drivers of distress. [29][30][31][32][33][34][35][36][37] The aim of this study was to describe the drivers of distress and motivation with the goals of informing local and national strategies to reduce avoidable distress in interdisciplinary clinicians on the frontline of COVID-19.…”

Section: Open Accessmentioning

confidence: 99%

Frontline interdisciplinary clinician perspectives on caring for patients with COVID-19: a qualitative study

et al. 2021

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ObjectiveTo describe the drivers of distress and motivations faced by interdisciplinary clinicians who were on the frontline caring for patients with COVID-19.Design50 semistructured interviews. Transcripts were analysed using qualitative thematic analysis.SettingA safety-net hospital in Denver, Colorado.ParticipantsInterdisciplinary frontline clinicians including physicians, advance practice providers, nurses, respiratory therapists and paramedics providing inpatient hospital care to patients hospitalised for COVID-19.ResultsFifty clinicians (32 women and 18 men) participated. Five themes with respective subthemes (in parentheses) were identified: depersonalisation and barriers to care (impeding rapport and compassion, focusing on infection risk at the expense of high-quality care, grief from witnessing patients suffer in isolation), powerless in uncertainty (inescapable awareness of personal risk, therapeutic doubt in a void of evidence, confronting ethical dilemmas, struggling with dynamic and unfamiliar challenges), overwhelmed and exhausted (burden of personal protective equipment (PPE), information overload and confusion, overstretched by additional responsibilities at work, compounded by personal life stressors, feeling vulnerable and dispensable, compassion fatigue, distress from the disproportionate impact on socially oppressed communities), bolstering morale and confidence (motivated by community and family support, equipped with data), and driven by moral duty (responsibility to patient care and community, collegial solidarity and collaboration, contributing to the greater good).ConclusionFrontline clinicians reported distress due to the challenges of PPE, uncertainty and powerlessness, new responsibilities at work and home, losing control of their schedules, grief from witnessing patients suffer in isolation and witnessing healthcare disparities exacerbated by this pandemic. Clinicians feel supported by their colleagues, families, and community and were driven by a sense of moral duty. Healthcare system should adopt strategies to minimise distress faced by interdisciplinary clinicians on the frontline of COVID-19.

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“…Secondly, doctors and nurses felt a lack of knowledge and skills. Bennett et al found that frontline National Health Service workers were not ready while caring for patients with COVID-19 (16). They were fully prepared and had all volunteered to work on the COVID ward, but still found it difficult to manage because of their lack of experience in this area.…”

Section: Discussionmentioning

confidence: 99%

The Difficulties and Mental Health Intervention Need of Doctors and Nurses in Biological Emergencies: A Qualitative Study

Liang

Chen

et al. 2021

Front. Psychiatry

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When a biological public health event breaks out, due to the characteristics of their work, doctors and nurses must face risks directly when the situation is unknown. Their difficulties and psychological pressure are unimaginable. However, few studies have investigated the difficulties encountered by those doctors and nurses and their requirements for psychological interventions. This study aimed to explore the difficulties and psychological intervention needs of doctors and nurses during the new biological public health events in China in 2019. We carried out a qualitative study using a phenomenological approach. We used convenience sampling to identify participants who provided direct care and treatment for patients with biological events such as coronavirus disease 2019 (COVID-19). They participated in semi-structured, in-depth face-to-face interviews. The interviews were transcribed and analyzed using Colaizzi's seven-step method. Analysis of this study was divided into the difficulties encountered by doctors and nurses and their mental health need. The difficulties encountered by doctors and nurses included four themes: being worried about the impact on others, lack of knowledge and skills, difficult patients, being socially isolated, and the feeling of uncertainty. The mental health need was summarized into two parts, needs expressed by doctors and nurses and needs observed by researchers. Doctors and nurses mostly did not feel that they needed any psychological support, but the researchers noticed several signs of stress or potential mental health problems among interviewees. Doctors and nurses faced significant complex and multidimensional difficulties. Many denied needing psychological support, even though the researchers noted signs that it might be helpful. Interventions and support strategies that involve mental health promotion activities should consider individual needs related to doctors and nurses' situation.

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COVID-19 confessions: a qualitative exploration of healthcare workers experiences of working with COVID-19

Cited by 141 publications

References 7 publications

Critical care work during COVID-19: a qualitative study of staff experiences in the UK

Critical care work during COVID-19: a qualitative study of staff experiences in the UK

Frontline interdisciplinary clinician perspectives on caring for patients with COVID-19: a qualitative study

The Difficulties and Mental Health Intervention Need of Doctors and Nurses in Biological Emergencies: A Qualitative Study

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