Following Dutch healthcare professionals’ experiences during COVID-19: Tensions in everyday practices and policies amid shifting uncertainties

Abstract

While the limits of rational-calculative approaches for healthcare decision-making, alongside institutional forms of ritual, routines and hope employed to deal with these limits, were already described in the 1950s, healthcare professionals’ syncretism of rational and non-rational approaches in their everyday work remains a neglected topic in Northern Europe. Using COVID-19 as an urgent problem for healthcare policy and practice, and a natural ‘breaching experiment’ which disrupts everyday work in ways which help professionals to critically reflect, this article explores how a small, purposive sample of young healthcare professionals in the Netherlands dealt with the uncertainties and risks posed by continued healthcare work amid the pandemic. Analysing qualitative data, collected via longitudinal online interviews among healthcare professionals, the analysis pays particular attention to: concerns, anxieties and risks faced by professionals; understandings and ways of working with(out) protocols; different logics for handling uncertainty in different situations; how different logics (rational, non-rational and ‘in between’ rationalities) are combined in different aspects of their work. A key feature of the analysis is the tensions which emerged within these combined strategies and how these relate to broader tensions in terms of the limits of rationality, economic scarcity, work-life experiences, and evidence versus emotions.