Title

In Their Own Words: Experiences of Emergency Health Care Workers During the COVID-19 Pandemic

Authors

Janice Blanchard, Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Yixuan Li, Department of Health Policy, George Washington University, Milken Institute of Public Health, 950 New Hampshire Ave, NW, Washington, DC, USA.
Suzanne K. Bentley, Departments of Emergency Medicine & Medical Education, Icahn SOM at Mount Sinai, New York City Health + Hospitals/Elmhurst, 1468 Madison Ave, New York, NY, USA.
Michelle D. Lall, Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Anne M. Messman, Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, 4201 St. Antoine, University Health Center - 6G, Detroit, MI, USA.
Yiju Teresa Liu, Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Harbor-UCLA Medical Center, 1000, West, CA, USA.
Deborah B. Diercks, Department of Emergency Medicine, University of Texas, Southwestern, 5323 Harry Hines Boulevard E4.300, Dallas, TX, USA.
Rory Merritt-Recchia, Department of Emergency Medicine, Alpert Medical School of Brown University, 55 Claverick Street, Providence, RI, USA.
Randy Sorge, Department of Emergency Medicine, Louisiana State University Spirit of Charity Emergency Medicine Residency Program, 2000 Canal Street New Orleans, LA, USA.
Jordan M. Warchol, Department of Emergency Medicine, University of Nebraska Medical Center, 981150 Nebraska Medical Center, Omaha, NE, USA.
Christopher Greene, Department of Emergency Medicine, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL, USA.
James Griffith, Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Rita A. Manfredi, Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Melissa McCarthy, Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Document Type

Journal Article

Publication Date

3-24-2022

Journal

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine

DOI

10.1111/acem.14490

Abstract

BACKGROUND: During the COVID-19 pandemic, a substantial number of emergency HCWs have screened positive for anxiety, depression, risk of post-traumatic stress disorder and burnout. The purpose of this qualitative study is to describe the impact of COVID-19 on emergency care providers' health and well-being using personal perspectives. We conducted in-depth interviews with emergency medicine (EM) physicians, EM nurses and emergency medical service providers at ten collaborating sites across the United States between September 21, 2020, and October 26, 2020. METHODS: We developed a conceptual framework that described the relationship between the work environment and employee health. We used qualitative content analysis to evaluate our interview transcripts classified the domains, themes and subthemes that emerged from the transcribed interviews. RESULTS: We interviewed 32 emergency HCWs. They described difficult working conditions, such as constrained physical space, inadequate personnel protective equipment and care protocols that kept changing. Organizational leadership was largely viewed as unprepared, distant, and unsupportive of employees. Providers expressed high moral distress caused by ethically challenging situations, such as the perception of not being able to provide the normal standard of care and emotional support to patients and their families at all times, being responsible for too many sick patients, relying on inexperienced staff to treat infected patients, and caring for patients that put their own health and the health of their families at risk. Moral distress was commonly experienced by emergency HCWs, exacerbated by an unsupportive organizational environment. CONCLUSION: Future preparedness efforts should include mechanisms to support frontline health care workers when faced with ethical challenges in addition to an adverse working environment caused by a pandemic such as COVID-19.

Department

Emergency Medicine

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