Healthcare Workers From Diverse Ethnicities and Their Perceptions of Risk and Experiences of Risk Management During the COVID-19 Pandemic: Qualitative Insights From the United Kingdom-REACH Study

Abstract

IntroductionHealthcare workers (HCWs) are at higher risk of being infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Previous studies have examined factors relating to infection amongst HCWs, including those from ethnic minority groups, but there is limited data regarding the lived experiences of HCWs in relation to self-protection and how they deal with SARS-CoV-2 infection prevention. In this study, we presented data from an ethnically diverse sample of HCWs in the United Kingdom (UK) to understand their perceptions of risks and experiences with risk management whilst working throughout the COVID-19 pandemic.MethodsWe undertook a qualitative study as part of the United Kingdom Research study into Ethnicity and COVID-19 outcomes among Healthcare workers (United Kingdom-REACH) conducting semi-structured interviews and focus groups which were recorded with participants’ permission. Recordings were transcribed and thematically analyzed.FindingsA total of 84 participants were included in the analysis. Five broad themes emerged. First, ethnic minority HCWs spoke about specific risks and vulnerabilities they faced in relation to their ethnicity. Second, participants’ experience of risk assessments at work varied; some expressed satisfaction while many critiqued it as a “tick-box” exercise. Third, most participants shared about risks related to shortages, ambiguity in guidance, and inequitable distribution of Personal Protective Equipment (PPE), particularly during the start of the pandemic. Fourth, participants reported risks resulting from understaffing and inappropriate redeployment. Finally, HCWs shared the risk mitigation strategies which they had personally employed to protect themselves, their families, and the public.ConclusionHealthcare workers identified several areas where they felt at risk and/or had negative experiences of risk management during the pandemic. Our findings indicate that organizational shortcomings may have exposed some HCWs to greater risks of infection compared with others, thereby increasing their emotional and mental burden. Ethnic minority HCWs in particular experienced risks stemming from what they perceived to be institutional and structural racism, thus leading to a loss of trust in employers. These findings have significance in understanding staff safety, wellbeing, and workforce retention in multiethnic staff groups and also highlight the need for more robust, inclusive, and equitable approaches to protect HCWs going forward.

Prevalence of burnout and mental health problems among medical staff during the COVID-19 pandemic: a systematic review and meta-analysis

“…A multinational, multicentre study found that there may be a bidirectional link between physical and psychological symptoms among healthcare workers 18. In addition, medical staff also faced some unique challenges in this period, including staff shortage, long work shifts, long wearing of personal protective equipment (PPE), an insufficient supply of protective materials, guidelines changing rapidly, the risk of infection spreading to friends or family, lack of sufficient training and psychosocial support 19–21. These challenges trigger multiple mental health problems and contribute to burnout 22.…”

Redeployment Experiences of Healthcare Workers in the UK during COVID-19: data from the nationwide UK-REACH study

“…These findings raise serious concerns as HCWs from ethnic minority backgrounds already faced several compounding risk factors. They were at a higher risk of contracting COVID-19, and despite this increased risk, had limited access to risk assessments compared to HCWs from a White background, as revealed by the UK-REACH qualitative study [26,30]. It is crucial to note that our quantitative findings suggest that HCWs from an ethnic minority background were offered risk assessments but experienced no changes in their working practices [31].…”

Caring for Those Who Take Care of Others: Developing Systemic and Sustainable Mental Health Support for the Diverse Healthcare Workforce in the United Kingdom

“…We have shown that employing organisations have lacked operational capacity to deliver usual levels of care, which has meant existing staff having to take up extra work and responsibilities coupled with extra patients, adding to their mental distress [ 22 ]. This concept of flexible redeployment is particularly concerning for ethnic minority staff who reported disproportionate redeployment to COVID-19 ‘hot wards’ [ 23 ] at times without adequate training [ 24 ].…”