Nancy Kentish-Barnes1, Lucas Morin2, Zoé Cohen-Solal1, Alain Cariou3, Alexandre Demoule4, Elie Azoulay1. 1. AP-HP, Saint Louis University Hospital, Medical Intensive Care, Famiréa Research Group, Paris, France. 2. Inserm CIC 1431, CHU Besançon, 25000 Besançon, France. 3. AP-HP, Cochin University Hospital AP-HP Centre, Medical Intensive Care and Université de Paris, Paris, France. 4. AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service de Pneumologie, Médecine Intensive et Réanimation (Département R3S) and Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France.
Abstract
OBJECTIVES: During the coronavirus disease 2019 pandemic, frontline healthcare professionals were asked to reorganize the provision of critical care in unprecedented ways. Our aim was to gain insight into the lived experience of clinicians who worked in ICUs during the surge. DESIGN: Qualitative study using semistructured, in-depth interviews. SETTING: Clinicians who worked in three ICUs in Paris (France) during the peak of the pandemic (April and May 2020). PARTICIPANTS: Twenty-seven ICU clinicians (12 physicians, 11 nurses, three nursing assistants, and one respiratory therapist). MEASUREMENTS AND MAIN RESULTS: Interviews were audio recorded and analyzed using thematic analysis. Six themes emerged: coping with initial disorganization and creating new routines, the intensification of professional relationships and the development of unexpected collaborations, losing one's reference points and recreating meaningful interactions with patients, working under new constraints and developing novel interactions with family members, compensating for the absence of family members and rituals at the end of life, and the full engagement of ICU clinicians during the coronavirus disease 2019 crisis. CONCLUSIONS: Among ICU clinicians, there was a sense of total professional engagement during the surge. Caring for critically ill coronavirus disease 2019 patients was fraught with challenges and generated a strong feeling of responsibility, as clinicians felt they had to compensate for the absence of family members. Rethinking policies about family visits and safeguarding positive relationships among colleagues are two important priorities for future healthcare crises.
OBJECTIVES: During the coronavirus disease 2019 pandemic, frontline healthcare professionals were asked to reorganize the provision of critical care in unprecedented ways. Our aim was to gain insight into the lived experience of clinicians who worked in ICUs during the surge. DESIGN: Qualitative study using semistructured, in-depth interviews. SETTING: Clinicians who worked in three ICUs in Paris (France) during the peak of the pandemic (April and May 2020). PARTICIPANTS: Twenty-seven ICU clinicians (12 physicians, 11 nurses, three nursing assistants, and one respiratory therapist). MEASUREMENTS AND MAIN RESULTS: Interviews were audio recorded and analyzed using thematic analysis. Six themes emerged: coping with initial disorganization and creating new routines, the intensification of professional relationships and the development of unexpected collaborations, losing one's reference points and recreating meaningful interactions with patients, working under new constraints and developing novel interactions with family members, compensating for the absence of family members and rituals at the end of life, and the full engagement of ICU clinicians during the coronavirus disease 2019 crisis. CONCLUSIONS: Among ICU clinicians, there was a sense of total professional engagement during the surge. Caring for critically ill coronavirus disease 2019patients was fraught with challenges and generated a strong feeling of responsibility, as clinicians felt they had to compensate for the absence of family members. Rethinking policies about family visits and safeguarding positive relationships among colleagues are two important priorities for future healthcare crises.
Authors: Kelly C Vranas; Sara E Golden; Shannon Nugent; Thomas S Valley; Amanda Schutz; Abhijit Duggal; Kevin P Seitz; Steven Y Chang; Christopher G Slatore; Donald R Sullivan; Catherine L Hough; Kusum S Mathews Journal: Chest Date: 2022-05-11 Impact factor: 10.262