Introduction
Background
Methods
Aim
Study design
Sampling and recruitment
Data collection
Data analysis
Rigor and reflexivity
Results
Healthcare workers a | Gender | Age | Marital Status | Professional Title | Work experience, years | Department | Recruitment Avenue |
---|---|---|---|---|---|---|---|
N1 | Female | 33–35 | Married | Nurse-in-Charge | 12–14 | General Surgery | Center 1 |
N2 | Female | 32–34 | Single-Married | Primary nurse- Nurse-in-Charge | 8–10 | ICU | Center 2 |
N3 | Female | 39–41 | Married | Nurse-in-Charge | 17–19 | Traditional Chinese Medicine | Center 3 |
N4 | Female | 35–37 | Married | Nurse-in-Charge | 12–14 | Respiratory Department | Center 1 |
N5 | Female | 35–37 | Married | Nurse-in-Charge | 15–17 | Respiratory Department | Center 1 |
N6 | Female | 28–30 | Single | Primary nurse- Nurse-in-Charge | 6–8 | Traditional Chinese Medicine | Center 2 |
N7 | Female | 29–31 | Single-Married | Primary nurse - Nurse-in-Charge | 7–9 | Emergency Department | Center 3 |
N8 | Female | 40–42 | Married | Associate chief nurse | 18–20 | Neurosurgery Department | Center 3 |
N9 | Female | 38–40 | Married | Associate chief nurse | 18–20 | General Surgery | Center 2 |
N10 | Female | 30–32 | Married | Nurse-in-Charge | 7–9 | Neurosurgery Department | Center 3 |
D1 | Male | 41–43 | Married | Associate chief physician | 17–19 | Emergency Department | Center 1 |
D2 | Male | 40–42 | Married | Associate chief physician | 17–19 | Respiratory Department | Center 2 |
D3 | Male | 38–40 | Married | Attending physician | 14–16 | ICU | Center 3 |
D4 | Female | 32–34 | Married | Attending physician | 6–8 | Respiratory Department | Center 2 |
Themes | Sub-themes |
---|---|
Changes in emotions | Negative emotions; Positive emotions |
Changes in organization and management of care | Self-protection; Acute goals with care; Teamwork; Human resource challenges |
Changes in knowledge and capabilities | COVID-19 knowledge levels; Critical care management capabilities; Communication ability; Grief counseling ability |
Change in outlook on life and career | Close relationships with family members; Sense of professional mission |
Changes in emotions
Negative emotions
“It was an annoying and depressing time for me because they (patients) were always vomiting and we were afraid of being infected.“ (N1, T1).
“Just leave that scene, that fear slowly faded away.” (D1, T2).
“(Collecting nucleic acid) was risky because you didn’t know who was carrying the virus… But we’ve all gone through the strict protection training, so it was OK.” (N7, T3).
“I haven’t worried about it, because I think my experience is quite adequate. I didn’t worry too much about that. I think as long as you follow the standards process, you won’t get an infection.“ (N3, T4).
“I was devastated, (I) thought, I’ve been here for over fifty days, (why) won’t you let me go back?” (N7, T1).
“(I)felt like I couldn’t breathe well and had a headache, but it wasn’t really a headache. As soon as I mentioned (Wuhan) it slowly started to get stuffy and my head started to hurt and (I) felt sad.“ (N4, T2).
“We had to take the caregiver’s temperature every day, check their escort card every day, check their nucleic acid report, we have added a lot of trivial work.” (N1, T3).
“I missed Wuhan a little bit, which was a valuable experience.“(N2, T3).
“Although I made some small mistakes in life, but it was infinitely magnified… Such words were very hurtful.” (N4, T2).
“As a local medical team, it must be very sad to see all COVID-19 patients were local people. (N7, T4)
Positive emotions
“Some people were very congratulatory and some were jealous… people were cynical… They speculated every day that we got a million dollars in prize money, but we didn’t.” (N8, T2).
“Because after all, others have not experienced it, and when you talked to them, they might think you are showing off.” (D3, T4).
“My high school classmates cared about me and supported me when they heard I was going to Wuhan, which made me feel touched.” (N10, T1).
“The policy of our country was really quite good, in fact (I) haven’t been working for long, (but) to get such a high honor and such good treatment, I thought omg it was really worth it!” (N8, T2).
“I was thankful to my family, especially my husband, for always being behind me and he took good care of the kids.” (N5, T3).
“Thanks to our national leadership has been adhering to the dynamic zeroing policy… Some of my family members are old with a lot of underlying diseases, and they cannot withstand the infection.” (N2, T4).
“(I) hope the epidemic ends quickly, otherwise the country’s human and financial resources are too costly.” (D1, T1).
“I hope the epidemic can end quickly. I haven’t traveled with my family for a long time.” (N1, T3).
Changes in organization and management of care
Self-protection
“After a period of time, I think the protection is even a little bit too much, but protection is the way to go.” (N9, T1).
“You had to wear a mask when you went out, and also at work, which was the most basic measure (to protect yourself).” (D2, T2).
“(I) stored some masks and disinfectant from time to time, and I also stored more supplies at home, unlike before, used up and bought again.“” (N2, T3).
“Before entering the warehouse everyone must be assessed in putting on and taking off protective clothing, and only those who got a pass could go in… It was already a proven process, just follow the requirements (to complete).” (N9, T4).
Acute goals with care
“I see nothing wrong with protecting ourselves while making sure our normal nursing work have been done.” (N6, T1).
“I will care for them a little bit more. I will go to comfort them and talk to them if they are in a bad mood.” (N1, T4).
Teamwork
“We were all new colleagues and we needed to have a bonding process. Because we were not familiar with each other, we couldn’t have the same level of tacit understanding as did in the past.” (N7, T1).
“At first it was a bit hard to get used to the pace of their (colleagues’) work when I first came back …… Soon (I) got used to it.” (N1, T2).
“(We) were a little bit prepared and we knew each other, which made us feel safe.” (N3, T4).
“My captain was a little more communicative and coordinated the issues I found a little better.” (N5, T1).
“I tried to be fair when I was in charge of scheduling, and I sometimes chose to sacrifice my time off to keep the ward in order.” (N9, T3).
Human resource challenges
“There were other medical teams coming to support us and to manage the patients together, so we felt less pressure.” (N6, T1).
“It was true that some people resigned, but there were also a lot of people that came in, it was the same as before.” (N8, T2).
“We have to arrange nurses to go to the sports park to vaccinate the residents, this is the hospital, this is required by the health commission.” (N9, T3).
“The biggest problem was the lack of staff. Instead of having four-hour shifts, we actually had six-hour shifts.” (N5, T4).
Changes in knowledge and capabilities
COVID-19 knowledge levels
“We referred to the books for some knowledge and experience of people who have participated in SARS.” (D1, T1).
“I was certainly not afraid, we have encountered these things, just like the normal process to work.” (N6, T4).
“The virus was COVID-19 in Wuhan, but now it is delta, and it seems to be several times more spreadable than the original one in Wuhan.” (N6, T3).
Critical care management capabilities
“I was worried about what would happen if I needed to use these instruments but I didn’t know how to use. It was with this in mind that I had concerns.” (N6, T1).
“(We) also came across (patients) who needed to be rescued, and (we) needed to give them CPR, ventilator or other things, we did our best to save them.” (D3, T3).
“The last patients left were just really sick, some on ECMO, then on a ventilator, and on CRRT, and the patients were particularly sick.” (N4, T4).
Communication ability
“This experience has given me comradeship and made me more willing to communicate with others, and (I) thought communication was a beautiful thing too.” (N7, T1).
“After returning to Jiangsu, I think the changes I made were that I was more serious in my work and communicated better with my leaders and colleagues.” (N10, T2).
“Some patients and families did not understand and quarreled with us, although I understood their feelings, but that was my job.” (N2,T3).
Grief counseling ability
“I would go to comfort her. The distance was very close, I would be a little nervous, and I would try to maintain some distance.” (N3, T1).
“Some patients were so unstable that we had to comfort them.” (N5, T4).
Change in outlook on life and career
Close relationships with family members
“(My mother and I) usually communicated for about half an hour (every day). (I wanted to) see her, see my mom. (I) missed her and wanted to see how she was doing, how she was doing at home.” (N2, T1).
“The child was closer to me, and he might also be afraid that his mom would be away for a long time again.” (N10, T2).
“I was very busy at work and couldn’t take care of either the elderly or the children.” (N5, T3).
“I want to spend more time with my children, more time with my husband, and hopefully travel if I have the chance.” (N10, T4).
Sense of professional mission
“They (patients) were grateful to us…… Most doctors or healthcare workers were like that, and it was their mission to bring patients back from the brink of death.” (D2, T1).
“Although I did not verbally say that I regretted going to support Wuhan, but I thought in my heart: why should I protect you? … (I was) just sad inside.” (N4, T2).
“You can’t control people’s ideas. All you can do is do yourself, work hard and treat patients well. It’s just your responsibility.” (N4, T3).
“I was always prepared and willing to go if the need arose.” (N8, T4).