The lived experiences of emergency care personnel in the Western Cape, South Africa during the COVID-19 pandemic: A longitudinal hermeneutic phenomenological study

Theron, Elzarie; Erasmus, H.; Wylie, Craig; Khan, W; Geduld, Heike; Stassen, Willem

doi:10.1016/j.afjem.2022.08.004

Cited by 2 publications

(2 citation statements)

References 46 publications

(51 reference statements)

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“… 28 This lack of ‘breathing space’ may lead to HCWs’ struggling with breaking bad news, compounding the psychological impact of working on the COVID-19 frontline and result in HCWs’ emotionally disengaging and/or feeling overwhelmed by feelings of guilt, sadness and anger. 7 , 29 It is also possible that the reduced ability to connect with the external world contributed to how favourably teamwork and team support was experienced by the participants.…”

Section: Discussionmentioning

confidence: 99%

‘I am afraid the news is not good’ – Breaking bad news in the time of COVID: Experiences from a field hospital

Cunningham,

Mayers,

Giddy

et al. 2024

African Journal of Primary Health Care & Family Medicine

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Background: The COVID-19 Pandemic had profound effects on healthcare systems around the world. In South Africa, field hospitals, such as the Mitchell’s Plain Field Hospital, managed many COVID patients and deaths, largely without family presence. Communicating with families, preparing them for death and breaking bad news was a challenge for all staff.Aim: This study explores the experiences of healthcare professionals working in a COVID-19 field hospital, specifically around having to break the news of death remotely.Setting: A150-bed Mitchells Plain Field Hospital (MPFH) in Cape Town.Methods: A qualitative exploratory design was utilised using a semi-structured interview guide.Results: Four themes were identified: teamwork, breaking the news of death, communication and lessons learnt. The thread linking the themes was the importance of teamwork, the unpredictability of disease progression in breaking bad news and barriers to effective communication. Key lessons learnt included effective management and leadership. Many families had no access to digital technology and linguo-cultural barriers existed.Conclusion: We found that in the Mitchell’s Plain Field Hospital, communication challenges were exacerbated by the unpredictability of the illness and the impact of restrictions on families visiting in preparing them for bad news. We identified a need for training using different modalities, the importance of a multidisciplinary team approach and for palliative care guidelines to inform practice.Contribution: Breaking the news of death to the family is never easy for healthcare workers. This article unpacks some of the experiences in dealing with an extraordinary number of deaths by a newly formed team in the COVID era.

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Section: Discussionmentioning

confidence: 99%

‘I am afraid the news is not good’ – Breaking bad news in the time of COVID: Experiences from a field hospital

Cunningham,

Mayers,

Giddy

et al. 2024

African Journal of Primary Health Care & Family Medicine

View full text Add to dashboard Cite

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“…The study used two different qualitative datasets. Dataset I included data from the end of the first wave of COVID-19 in August to October 2020 and explored emergency medical personnel’s lived experiences with the pandemic 28. Dataset II was collected during the second and third waves, from February 2021 to January 2022, and included semistructured interviews of physicians’ perceptions on how COVID-19 affected emergency care.…”

Section: Methodsmentioning

confidence: 99%

Companion restrictions in the emergency department during COVID-19: physician perceptions from the Western Cape, South Africa

2023

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ObjectivesTo determine emergency department (ED) physicians’ perceptions regarding hospital companions being prohibited from accompanying the patient during COVID-19.DesignTwo qualitative datasets were combined. Data collected included voice recordings, narrative interviewing and semistructured interviews. A reflexive thematic analysis was conducted and guided by the Normalisation Process Theory.SettingSix hospital EDs in the Western Cape, South Africa.ParticipantsConvenience sampling was used to recruit a total of eight physicians working full time in the ED during COVID-19.ResultsThe lack of physical companions provided an opportunity for physicians to assess and reflect on a companion’s role in efficient patient care. Physicians perceived that the COVID-19 restrictions illuminated that patient companions engaged in the ED as providers contributing to patient care by providing collateral information and patient support, while simultaneously engaging as consumers detracting physicians from their priorities and patient care. These restrictions prompted the physicians to consider how they understand their patients largely through the companions. When companions became virtual, the physicians were forced to shift how they perceive their patient, which included increased empathy.ConclusionThe reflections of providers can feed into discussions about values within the healthcare system and can help explore the balance between medical and social safety, especially with companion restrictions still being practised in some hospitals. These perceptions illuminate various tradeoffs physicians had to consider throughout the pandemic and may be used to improve companion policies when planning for the continuation of the COVID-19 pandemic and future disease outbreaks.

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The lived experiences of emergency care personnel in the Western Cape, South Africa during the COVID-19 pandemic: A longitudinal hermeneutic phenomenological study

Cited by 2 publications

References 46 publications

‘I am afraid the news is not good’ – Breaking bad news in the time of COVID: Experiences from a field hospital

‘I am afraid the news is not good’ – Breaking bad news in the time of COVID: Experiences from a field hospital

Companion restrictions in the emergency department during COVID-19: physician perceptions from the Western Cape, South Africa

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