Qualitative study exploring the well-being experiences of paediatric critical care consultants working in the UK during the COVID-19 pandemic

Abstract

ObjectivesThe aim of this study was to examine the well-being experiences of consultants working in paediatric critical care (PCC) settings in the UK during the COVID-19 pandemic.DesignQualitative design using individual interviews and thematic analysis.SettingPCC.ParticipantsEleven medical consultants working in PCC in a range of PCC settings/transport teams in the UK from nine units participated. Participants ranged in years of experience as a consultant from four to 23 years.MethodsA set of open semistructured questions were used to elicit information about participants’ experiences of workplace well-being. Interviews were audiorecorded and transcribed.FindingsThematic analysis identified six themes and data saturation was reached. These were as follows: (1) positive and negative impact of working during COVID-19, (2) job satisfaction and public scrutiny in the unique environment of PCC, (3) supporting the workforce through modified shift work, (4) perceptions of support and recognition offered from the hospital management, (5) successful coping strategies are personal and adaptive, and (6) importance of civility and good teamworkConclusionFindings show that consultants’ well-being is challenged in a number of ways and that the solutions to the problem of burn-out are multifaceted. Action is required from individual consultants, clinical teams, hospital management and national regulatory bodies. Our work corroborates the recent General Medical Council report highlighting doctors’ core needs for well-being: autonomy, belonging, competence. Burn-out is a long-term problem, requiring sustainable solutions. Future research needs to develop and evaluate the effectiveness of evidence-based interventions to improve consultants’ well-being. Trials of effectiveness need to present evidence that will persuade hospital management to invest in their consultants’ well-being within the economic context of reduced budgets and limited PCC workforce.

Challenges to well‐being in critical care

“…54 These are described as basic psychological needs for psychological growth and well-being. 44 Previous research with PCC staff corroborated this theory 30,55 and these concepts were identified in a recent British Medical Association (BMA) report to represent the A-B-C of well-being in medical practice 29 : autonomy/control, belonging and competence.…”

“…This study took place in one UK hospital PCC unit. Results may not transfer to other sites or countries but it clearly resonates internationally 30,55,56 . Further research in other countries would help confirm this transferability.…”

“…38,42,43 The model (see Figure 2) has universal support at the base of the pyramid, indicating staff require foundational support, that psychologically safe space, a team culture which nurtures its staff, a sense of belonging, and honest, open communication, especially when things are challenging or mistakes are made. 30,44 This could include regular reflective sessions, but also social support activities.…”

“…9 We know very little about the nature of typical challenges to everyday workplace well-being and to date, interventions to address well-being have been perceived as inaccessible or insufficient. 30…”