Core stories of physicians on a Swiss internal medicine ward during the first COVID-19 wave: a qualitative exploration.

Abstract

The first COVID-19 wave (2020), W1, will remain extraordinary due to its novelty and the uncertainty on how to handle the pandemic. To understand what physicians went through, we collected narratives of frontline physicians working in a Swiss university hospital during W1. Physicians in the Division of Internal Medicine of Lausanne University Hospital (CHUV) were invited to send anonymous narratives to an online platform, between 28 April and 30 June 2020. The analysed material consisted of 13 written texts and one audio record. They were examined by means of a narrative analysis based on a holistic content approach, attempting to identify narrative highlights, referred to asfoci, in the texts. Five main foci were identified: danger and threats, acquisition of knowledge and practices, adaptation to a changing context, commitment to the profession, and sense of belonging to the medical staff. In physicians' narratives,dangerdesignated a variety of rather negative feelings and emotions, whereasthreatswere experienced as being dangerous for others, but also for oneself. Theacquisition of knowledge and practicesfocus referred to the different types of acquisition that took place during W1. The narratives that focused onadaptationreflected how physicians coped with W1 and private or professional upheavals. COVID-19 W1 contributed to revealing a naturalcommitment(or not) of physicians towards the profession and patients, accompanied by the concern of offering the best possible care to all. Lastly,sense of belongingreferred to the team and its reconfiguration during W1. Our study deepens the understanding of how physicians experienced the pandemic both in their professional and personal settings. It offers insights into how they prepared and reacted to a pandemic. The foci reflect topics that are inherent to a physician's profession, whatever the context. During a pandemic, these foundational elements are particularly challenged. Strikingly, these topics are not studied in medical school, thus raising the general question of how students are prepared for the medical profession.