Abstract
This study aimed to gain an uncensored insight into the most difficult aspects of working as a frontline doctor across successive COVID-19 pandemic waves. Data collected by the parent study (CERA) was analysed using conventional content analysis. Participants comprised frontline doctors who worked in emergency, anaesthetic, and intensive care medicine in the UK and Ireland during the COVID-19 pandemic (n = 1379). All seniority levels were represented, 42.8% of the sample were male, and 69.2% were white. Four themes were identified with nine respective categories (in parentheses): (1) I’m not a COVID hero, I’m COVID cannon fodder (exposed and unprotected, “a kick in the teeth”); (2) the relentlessness and pervasiveness of COVID (“no respite”, “shifting sands”); (3) the ugly truths of the frontline (“inhumane” care, complex team dynamics); (4) an overwhelmed system exacerbated by COVID (overstretched and under-resourced, constant changes and uncertainty, the added hinderance of infection control measures). Findings reflect the multifaceted challenges faced after successive pandemic waves; basic wellbeing needs continue to be neglected and the emotional impact is further pronounced. Steps are necessary to mitigate the repeated trauma exposure of frontline doctors as COVID-19 becomes endemic and health services attempt to recover with inevitable long-term sequelae.
Highlights
The present study reports on qualitative data gathered during the second wave of the pandemic as part of the fourth COVID-19 Emergency Response Assessment (CERA) survey distributed to participants
Of the 1719 participants who responded to the fourth CERA survey [8], 1384 provided consent for their data to be shared with this study (80.5%)
The incidence of betrayal-based moral injury found in the present study indicates that this phenomenon warrants further consideration when designing post-pandemic recovery strategies; the finding that betrayal experienced may vary by seniority level, such as the impact junior doctors felt the pandemic had on their training, suggests this may need to be tailored by professional grade
Summary
The critical role of frontline doctors and healthcare workers (HCW) more broadly during the pandemic cannot be understated. This has not come without cost; it has been predicted that at least 115,000 of the recorded deaths due to COVID-19 have been in HCW [2]. In addition to infection risks [3,4], substantial evidence has illustrated the psychological impact of working on the COVID-19 frontline, with high rates of psychological distress and traumatic stress being found in HCW globally [5,6,7,8,9,10]
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