‘Now I can train myself to be with death’: a phenomenological study with young doctors in care homes supported by a palliative care unit during the second wave of the pandemic in Italy

Abstract

ObjectiveDuring the second wave of the COVID-19 pandemic, one of the organisational strategies established by the Italian National Health System was the special units for continuity of care (SUCCs). In the province of Ravenna, those units enrolled novice doctors to care for elderly patients with COVID-19 in care homes (CHs). The local palliative care (PC) unit decided to offer consultations and support to them. This study aimed to comprehend the experience of young doctors who asked for consultations when facing, during their first early years of practice, complex situations.DesignWe conducted a qualitative study employing a phenomenological approach and in-depth interviews.ParticipantsWe involved 10 young doctors who worked in Italian SUCC during the pandemic and used a PC consultation support service.ResultsWhat describes our participants’ experience is related to four main themes: (1) reducing distances, (2) perceiving medical futility and improvising, (3) being supported to learn how to be with death and (4) narrowed timing to humanise care. The pandemic was, for our participants, a moment of reflection and critique on the skills acquired during the university course. It was a strong experience of human and professional growth that helped them reshape and deepen their role and skills, incorporating the approach of PC into their professional identity.ConclusionsIntegration between specialists and young doctors with an early entry into the workforce during the pandemic in CHs set out a ‘shift’ to a proactive and creative approach through a new awareness of professional and personal roles in doctor–patient relations. The continuity of care models should be rethought by integrating CHs and PC. Adequate PC training for young doctors (at pregraduate and postgraduate levels) can change doctors’ vision and daily practice in assisting patients at the end of life.