What challenges did junior doctors face while working during the COVID-19 pandemic? A qualitative study

Abstract

ObjectivesThis paper reports findings exploring junior doctors’ experiences of working during the COVID-19 pandemic in the UK.DesignQualitative study using in-depth interviews with 15 junior doctors. Interviews were audio-recorded, transcribed, anonymised and imported into NVivo V.12 to facilitate data management. Data were analysed using reflexive thematic analysis.SettingNational Health Service (NHS) England.ParticipantsA purposive sample of 12 female and 3 male junior doctors who indicated severe depression and/or anxiety on the DASS-21 questionnaire or high suicidality on Paykel’s measure were recruited. These doctors self-identified as having lived experience of distress due to their working conditions.ResultsWe report three major themes. First, the challenges of working during the COVID-19 pandemic, which were both personal and organisational. Personal challenges were characterised by helplessness and included the trauma of seeing many patients dying, fears about safety and being powerless to switch off. Work-related challenges revolved around change and uncertainty and included increasing workloads, decreasing staff numbers and negative impacts on relationships with colleagues and patients. The second theme was strategies for coping with the impact of COVID-19 on work, which were also both personal and organisational. Personal coping strategies, which appeared limited in their usefulness, were problem and emotion focused. Several participants appeared to have moved from coping towards learnt helplessness. Some organisations reacted to COVID-19 collaboratively and flexibly. Third, participants reported a positive impact of the COVID-19 pandemic on working practices, which included simplified new ways of working—such as consistent teams and longer rotations—as well as increased camaraderie and support.ConclusionsThe trauma that junior doctors experienced while working during COVID-19 led to powerlessness and a reduction in the benefit of individual coping strategies. This may have resulted in feelings of resignation. We recommend that, postpandemic, junior doctors are assigned to consistent teams and offered ongoing support.

A qualitative analysis of psychosocial stressors and health impacts of the COVID-19 pandemic on frontline healthcare personnel in the United States

“…In the past year alone, a multitude of studies have been conducted globally across China (Z.-Q. Dong et al, 2020 ), Iran ( Galehdar, Aziz, Toulabi, & Heydari, 2020 ), Turkey ( Elbay et al, 2020 ), Pakistan ( Arshad et al, 2020 ), Egypt ( Aly, Nemr, Kishk, & Elsaid, 2021 ), Netherlands ( Pan et al, 2020 ), Portugal ( Duarte et al, 2020 ), Italy ( Trumello et al, 2020 ), India ( Dubey et al, 2020 ; Khasne, Dhakulkar, Mahajan, & Kulkarni, 2020 ), the United Kingdom ( Spiers et al, 2021 ) and the United States ( Ripp, Peccoralo, & Charney, 2020 ) examining both the drivers and psychological manifestations of stress in frontline HCP during the COVID-19 pandemic ( Vizheh et al, 2020 ; Xiong et al, 2020 ). However, only a few studies have been qualitative or have utilized participants' own words regarding the stressors engendered by the pandemic in the workplace.…”

Relationship between working conditions and psychological distress experienced by junior doctors in the UK during the COVID-19 pandemic: a cross-sectional survey study

“…Finally, the cross-sectional study design means causality cannot be presumed, and the single time point measure also does not capture the full effects of the pandemic, with other studies showing a general deterioration of healthcare workers’ mental health over the course of the pandemic. 26 52 53 As we did not factor in date of completion, we were not able to determine the proportion of respondents who completed the survey during one of the peak periods. Nonetheless, the findings from this study provide a valuable understanding of the relationship between working conditions and mental health for junior doctors.…”

Recommendations to support the mental wellbeing of nurses and midwives in the United Kingdom: A Delphi study

“…The upheaval and adjustment to working conditions and patient care during the pandemic has in some instances seen the implementation of some of our recommendations for healthcare workers more generally. For example, the enhanced provision of food and rest facilities provided by some hospitals has been well‐received (Spiers et al, 2021). Similarly, there has also been a greater recognition of the need for healthcare staff to access support for mental health, in line with evidence of deteriorating wellbeing and the need to reduce recognized risk factors such as reducing bureaucracy and improving peer support and supervision (Baker et al, 2021; Mhawish & Rasheed, 2021).…”