Background
Methods
Study design
Study participants
Data collection
Quantitative
Data analysis
Quantitative
Results
Survey responses
Demographics | Frequency (%) |
---|---|
Gender | |
Female | 218 (86.9%) |
Age | |
25-34 years | 31 (12.3%) |
35-44 years | 64 (25.5%) |
45-54 years | 93 (37.1%) |
55-64 years | 61 (24.3%) |
65+years | 2 (0.8%) |
Profession | |
Dietician | 6 (2.4%) |
Medical Practitioner | 11 (4.4.%) |
Nurse | 218 (86.9%) |
Pharmacist | 2 (0.8%) |
Other | 14 (5.5%) |
Marital status | |
Single | 42 (16.7%) |
Married/Co-habiting | 185 (73.7%) |
Widow | 4 (1.6%) |
Divorced/separated | 20 (8.0%) |
Caring responsibilities | |
Children <18 years | 94 (37.5%) |
Other relative | 6 (2.4%) |
None | 102 (40.6%) |
Other | 13 (5.2%) |
Parent | 27 (10.8%) |
Relative with medical condition | 9 (3.5%) |
Experience | |
Years since qualification | 21.5 +/-11.1 (mean/SD) |
Years in the renal speciality | 16.3 +/- 9.3 (mean/SD) |
Survey item | Frequency (%) |
---|---|
Ever been tested for COVID-19? | |
Tested but negative | 98 (39.0%) |
No | 138 (55.0%) |
Not formally but suspected | 10 (4.0%) |
Yes, and recovering | 5 (2.0%) |
How many times tested? (Mean (range)) | 1 (1-10) |
Worked at a facility with COVID-19 patients? | |
No | 44 (17.5%) |
Yes | 194 (77.3%) |
Unsure | 13 (5.2%) |
Provided direct care to COVID-19 patients? | |
No | 104 (41.4%) |
Yes | 140 (55.8%) |
Unsure | 7 (2.8%) |
Had to isolate due to COVID-19? | |
Yes | 79 (31.5%) |
No | 172 (68.5%) |
Had to isolate away from home? | |
Yes | 28 (35.4%) |
No | 51 (64.6%) |
Cared for patients who have died of COVID-19? | |
Yes | 56 (22.3%) |
No | 179 (71.3%) |
Unsure | 16 (6.4%) |
Personally bereaved by COVID-19? | |
Yes | 16 (6.4%) |
No | 235 (93.6%) |
Do you understand the guidelines that have been set by your employer regarding COVID-19? | |
No, I have questions | 11 (4.4%) |
Somewhat | 7 (2.8%) |
Yes, confidently understanding | 151 (60.1%) |
Yes, I think so | 82 (32.7%) |
How prepared do you feel to provide care for a patient with a known or suspected COVID-19? | |
Somewhat prepared | 123 (49.0%) |
Somewhat unprepared | 9 (3.6%) |
Unsure | 16 (6.4%) |
Very prepared | 96 (38.2%) |
Very unprepared | 7 (2.8%) |
Have you had sufficient PPE during the COVID-19 pandemic? | |
No | 56 (22.3%) |
Unsure | 26 (10.4%) |
Yes | 169 (67.3%) |
Do you feel you received adequate training to work during the COVID-19 pandemic? | |
No | 62 (24.7%) |
Unsure | 30 (12.0%) |
Yes | 159 (63.3%) |
Does your facility have a plan in place to care for those with known or suspected COVID-19? | |
No | 5 (2.0%) |
Unsure | 9 (3.6%) |
Yes | 237 (94.4%) |
Is there a place in your facility to screen and treat patients who come into the facility to make sure that patients with possible COVID-19 are isolated? | |
No | 21 (8.4%) |
Unsure | 11 (4.4%) |
Yes | 219 (87.2%) |
Have you ever felt afraid to come to work due to COVID-19 pandemic? | |
Yes | 101 (40.3%) |
No | 150 (59.7%) |
Would mental health and well-being support be helpful to you whilst working as a renal Health Care Practitioner during the COVID-19 outbreak? | |
Yes | 193 (76.9%) |
No | 58 (23.1%) |
Levels of burnout and mental-health distress
Domains | ||||
---|---|---|---|---|
Emotional exhaustion >27 | Depersonalisation >10 | Lack of personal accomplishment <33 | ||
Renal HCPs | Mean (SD) | 21.5 (11.9) | 5.3 (4.7) | 38.8 (6.4) |
Cases % | 35.9% | 16.7% | 21.1% |
GHQ-12 mean total score (CI 95%) (using Likert method) | 14.0 (13.2 – 14.8) |
Proportion with significant level of mental distress (using bi-modal method) | 49.8% |
Qualitative findings
Managing COVID-19 within a renal setting
"… [heads of dept] didn’t consider that we are a specialised [unit] and that our patients could get COVID-19 as well…just kind of find out along the way” and “Whilst the hospital has effective screening and isolating of COVID suspected patients, satellite dialysis patients are not as well catered for. The unit is old and crowded with only 1 single room. It is very difficult to truly isolate a patient…"
"When everything begins, we received a lot of recommendations from government and from our quality department. And of course, the recommendation was very wide internally. And we looked what is really appropriate for us and really [what would] fit…"
“Wearing PPE to greet all patients, [it is] a barrier to normalcy and hot to wear. The PPE is exhausting and the emotional impact of caring for people who are fed up from shielding mixed with the fear of working with positive cases and contracting COVID-19 is exhausting. There just seems to be no let-up”.
“…Our patients had no option to stay away. Even if sick they had to come. In the first week of lockdown, we had inadequate PPE, and the rules changed hour by hour which was incredibly stressful. I went home wondering if I had done things wrong…”.
"…you are asking the same people time and time again to keep going...so you are asking the same people to continually do one surge, do a big catch up, do a second surge and do an even bigger catch up. So that is difficult…"
Holistic impact of COVID-19 on staff
“I work with a great bunch of people the hardest thing would be if one of our patients or staff passed away from this bloody disease”.
“For me, the hardest part is being unable to return to my family, because if I do I will not be able…to return to work”.
“But partly it was challenging the whole concept of nurses as saints and saying well no, actually…it worries me this whole putting a halo on the healthcare workers at the moment, because there might be this expectation that you’ll continue to be saints, and we can all just get [by with unacceptable working conditions]”.
Safeguarding HCPs working in nephrology
“A lot of virtual clinics for us are not terribly helpful because people have to always get their bloods and their urine and their observations and things done, so they have to come and have that done anyway. So when they are here, you might as well see them if they are going to be here anyway. But whenever there was big issues with capacity, then there was the ability to see some people [virtually]…”.
“…working on plans to try and clear some of that backlog, but again, staff???… it’s not money or machines or things that are a barrier to that, it’s having enough skilled staff to provide it”.
"…I think really that senior people within your department are the people who are providing [support] for their own staff, really. And I suppose that then [it] is a burden on them as well as what they are going through personally…"