Critical Care Work During COVID-19: A Sociological Analysis of Staff Experiences

Abstract

Background: The COVID-19 pandemic and ensuing healthcare crisis presented staff working in critical care with unprecedented demands. We sought to understand frontline staff’s experiences of working in critical care in the UK during the first wave of the outbreak.Methods: Between August and October 2020, we conducted qualitative, semi-structured telephone interviews with forty NHS staff who worked in critical care during the first wave of the pandemic in the UK. Staff were recruited from four hospitals and included doctors, nurses, allied health professionals and ward clerks. We purposefully sought the experiences of trained and experienced critical care staff and those who were redeployed. We analysed the data using Rapid Analysis and subsequently interpreted the findings using Baehr’s sociological lens of ‘communities of fate’.Findings: COVID-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 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.Interpretation: COVID-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.Funding: Medical Research Scotland, Wellcome TrustDeclaration of Interests: CM reports a grant from Medical Research Scotland during the conduct of the study; SH reports a grant from Florence Nightingale Foundation, outside the submitted work; SS reports grants from Wellcome Trust, during the conduct of the study; CMC, AD and NP declare no competing interests.Ethics Approval Statement: Ethical approval was granted by the University of Edinburgh School of Social and Political Science Research Ethics Committee; HRA approval (20/HRA/3270) was also obtained.