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Staff experiences, perceptions of care, and communication in the intensive care unit during the COVID-19 pandemic in Australia
journal contribution
posted on 2023-02-19, 23:50 authored by Robin DigbyRobin Digby, Elizabeth ManiasElizabeth Manias, KJ Haines, J Orosz, J Ihle, Tracey BucknallTracey BucknallBackground: In 2020, during the first wave of the COVID-19 pandemic in Australia, hospital intensive care units (ICUs) revised patient care practices, curtailed visiting, and augmented the use of personal protective equipment to protect patients, staff, and the community from viral transmission. Aim: The aim was to explore ICU staff experiences and perceptions of care and communication with patients during the COVID-19 pandemic to understand how alternative ways of working have influenced work processes, relationships, and staff morale. Methods: This was a qualitative exploratory design study using audio-recorded and transcribed interviews with 20 ICU staff members. Data were analysed using thematic analysis. Findings: Four major themes were derived from the data: (i) Communication and connection, (ii) Psychological casualties, (iii) Caring for our patients, and (iv) Overcoming challenges. Patient care was affected by diminished numbers of critical care qualified staff, limited staff entry to isolation rooms, and needing to use alternative techniques for some practices. The importance of effective communication from the organisation and between clinicians, families, and staff members was emphasised. personal protective equipment hindered communication between patients and staff and inhibited nonverbal and verbal cues conveying empathy in therapeutic interactions. Communication with families by phone or videoconference was less satisfying than in-person encounters. Some staff members suffered psychological distress, especially those working with COVID-19 patients requiring extracorporeal membrane oxygenation. Moral injury occurred when staff members were required to deny family access to patients. Workload intensified with increased patient admissions, additional infection control requirements, and the need to communicate with families using alternative methods. Conclusion: The results of this study reflect the difficulties in communication during the early stages of the COVID-19 pandemic. Communication between staff members and families may be improved using a more structured approach. Staff reported experiencing psychological stress when separating families and patients or working in isolation rooms for prolonged periods. A flexible, compassionate response to family presence in the ICU is essential to maintain patient- and family-centred care.
History
Journal
Australian Critical CareVolume
36Pagination
66-76Location
AustraliaPublisher DOI
ISSN
1036-7314eISSN
1036-7314Language
enPublication classification
C1 Refereed article in a scholarly journalIssue
1Publisher
Elsevier BVUsage metrics
Keywords
COVID-19CommunicationIntensive carePatient carePsychological stressStaff perceptionsHumansPandemicsIntensive Care UnitsQualitative ResearchAustraliaClinical Research8 Health and social care services research8.1 Organisation and delivery of services3 Good Health and Well BeingNursing not elsewhere classifiedClinical Sciences not elsewhere classified
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