Author’s Note
The COVID-19 pandemic has created unprecedented challenges for our healthcare heroes. As the on-going pandemic continues, many of our healthcare heroes are continually risking their lives to help fight the battle. I personally wanted to celebrate our healthcare heroes by highlighting research that describes the experiences of healthcare professionals. Thus, I hope this sidebar article allows you to connect these experiences to our own healthcare heroes who continually fight on the frontlines.
The paper we’ll be demystifying can be found here, if you’d like to follow along!
TL/DR;
Researchers in this study describe the experiences of healthcare heroes in Wuhan, China, at the beginning of the COVID-19 pandemic.
Introduction
In the early stages of the COVID-19 outbreak, the number of cases was very detrimental to the healthcare system in Wuhan, China. Due to this, many healthcare heroes with no infectious disease knowledge had to help fight the battle. Many of these healthcare heroes reported that they experienced extreme stress as they were worried about the potential risk of infection, the uncertainty of the pandemic and more. Towards this, researchers in the present study analyzed and described the experiences of healthcare heroes in Wuhan, during the early stages of the COVID-19 pandemic.
Methods
The goal of qualitative research is to understand how the world works, such as understanding why people have different experiences. Additionally, qualitative research seeks to answer “how” and “why” questions. Most of the time, the data collected in qualitative research are images or words.
Researchers in the study conducted a qualitative study, using phone interviews. Nurses and physicians that had no infectious disease knowledge prior to the pandemic were recruited. More specifically, four physicians and nine nurses were recruited to participate in the study. In-depth phone interviews were held from February 10th to February 15th, 2020.
The researchers began interviews by asking the healthcare heroes: “Please tell me about your experiences of taking care of patients with COVID-19.” Following this, open-ended follow-up questions were asked to gather details.
Data from the interviews were analyzed to understand the messages that the healthcare heroes wanted to communicate and to establish the most meaningful phrases made. After analyzing the interviews, the researchers used the most meaningful phrases to develop three specific themes that emerged from the conversations. Within each theme were sub-categories, called theme clusters.
Results
The three themes are as follows: 1) being fully responsible for patient’s wellbeing – this is my duty 2) challenges of working on COVID-19 wards 3) resilience amid challenges.
Theme 1: Being Fully Responsible for Patient’s Wellbeing – This is My Duty
Within the first theme, is the first theme cluster – “A call to duty: joining the fight”. Around mid-January to early February, these healthcare heroes saw their frontline colleagues struggling as the virus continued to progress rapidly. Thus, these healthcare workers felt a personal duty to join the frontlines and save lives.
Following the first theme cluster is the second theme cluster – “treating and caring for patients—managing both mundane and extraordinarily difficult situations”. The healthcare heroes had to care for patients under a variety of conditions. For instance, the nurses often helped patients who struggled to do daily activities independently, such as helping patients with oral hygiene. This was challenging as they were in close contact with these patients and were worried about becoming infected with the virus. Despite the stressful conditions, these healthcare heroes wanted to give their patients the best possible care.
The third theme cluster was identified as “supporting patients emotionally—‘treating the patient, not just the disease’”. The healthcare heroes were worried that their patients were struggling emotionally and psychologically, in addition to physically. One physician expressed that “[they] are not treating the disease, [they] are treating the patient. Many patients have severe anxiety and [they] need to deal with this”. Therefore, these healthcare heroes always tried to give emotional support when caring for their patients.
Theme 2: Challenges of Working on COVID-19 Wards
Within the second theme are five theme clusters that relate to the various challenges of working with COVID-19 patients, alongside adapting to new working conditions.
One of the most major challenges that the healthcare heroes expressed was treating patients while experiencing their own emotional stresses. Prior to the pandemic, these healthcare heroes had no infectious disease experience and found that the working conditions were stressful as they were constantly reminded that they were treating an infectious virus. They were also anxious about treating patients suffering from a new virus. One nurse expressed that “[they] felt very depressed on the first day in the infectious disease hospital because there was only one entrance and passage for medical staff, and it is a real isolation unit with negative pressure. [They] felt it was difficult to breathe… This new environment brought a sense of oppression.” These healthcare heroes also had to work with the constant fear that they may become infected with the virus or that they would infect their colleagues and family members.
The healthcare heroes also felt that working long hours with PPE was a major physical challenge as their movements were clumsy in PPE and their eye protection googles were often blurry. For instance, one of the nurses expressed that “wearing the whole set of PPEs [was] very uncomfortable. I have difficulty breathing and feel very hot and my heart rate speeds up. We keep on sweating and the clothes are soaked.”
“When I talk with patients who are recovering, I am more relaxed because treatments are effective. But when patients have a persistent fever without obvious improvement, or their condition deteriorates, I am very depressed when I enter their room.” – Physician 1
Among this, the healthcare heroes felt that their emotions fluctuated depending on their patients’ conditions. They felt a sense of relief if their patients were improving. On the other side, they felt depressed when their patients were becoming sicker. In the cases where their patients did pass away, the healthcare heroes felt that they failed to help their patients. Due to this, they would often feel extreme grief and emotional distress.
Theme 3: Resilience amid Challenges.
Within the third theme are two theme clusters – “many sources of social support to cope with the situation” and “transcendence”.
Thankfully, the healthcare heroes stated that they had many support systems, such as colleagues, family members, significant others, and friends. In addition to their support systems, these healthcare heroes tried to implement self-care strategies to maintain mental wellness. They also took care of their physical health by ensuring adequate nutrition and rest.
Limitation
The researchers conducted phone interviews to collect participant data. This contributed to a limitation of the study as it was harder to build rapport with the healthcare heroes. Moreover, the researchers were unable to collect non-verbal communication signs.
The sample size was also relatively small. Thus, the results of the study may be limited as larger sample sizes are important to represent the study population. Among this, the sample had an uneven number of physicians and nurses. Although it is unsure whether this may affect the results of the study, research with an even number of nurses and physicians must be completed.
The study only analyzed nurses and physicians in Wuhan, China. This limits the results of the study as the themes identified may not be applicable to nurses and physicians in other areas. Further research on the experiences of nurses and physicians in other areas, must be completed.
Conclusion
The present study describes the experiences of healthcare heroes that worked on the frontlines, during the early stages of the COVID-19 pandemic in Wuhan, China. Four physicians and nine nurses were recruited as participants. Phone interviews were conducted and after studying the interviews, the researchers developed three specific themes that emerged from the conversations.
Overall, all the healthcare heroes felt a sense of responsibility to fight on the frontlines as they wanted to help alleviate suffering within the country. Thus, despite the unprecedented challenges associated with fighting on the frontlines, all these healthcare workers showed incredible strength.
