Background
Methods
Data collection, materials, and participants
Surveys
Staff function | Case 1 | Case 2 | Case 3 | Case 4 | Total | ||||
---|---|---|---|---|---|---|---|---|---|
Survey* | Interview | Survey | Interview | Survey | Interview | Survey | Interview | ||
Manager | 9 | 1 | 2 | 0 | 3 | 4 | 1 | 0 | 20 |
Medical specialist | 6 | 2 | 4 | 1 | 6 | 2 | 0 | 0 | 21 |
Physician resident | 2 | 3 | 1 | 2 | 3 | 0 | 0 | 0 | 11 |
Nurse | 24 | 3 | 22 | 0 | 39 | 9 | 21 | 3 | 121 |
Support staff | 42 | 0 | 26 | 0 | 43 | 7 | 19 | 0 | 137 |
Total | 84 | 9 | 55 | 3 | 94 | 22 | 41 | 3 | 311* |
In-depth interviews
Data analysis
Results
Survey | n (%) | ||
---|---|---|---|
Yes | No | Total | |
One (December, 2020) | 77 (8.4%) | 838 (91.6%) | 915 (100%) |
Two (March, 2021) | 49 (5.1%) | 903 (94.9%) | 952 (100%) |
Three (June, 2021) | 27 (4.4%) | 585 (95.6%) | 612 (100%) |
Four (September, 2021) | 18 (3.6%) | 489 (96.4%) | 507 (100%) |
Reasons for non-use psychosocial support
Theme | Subtheme | Quote (Q = quote number, staff function, C = case number, data source) |
---|---|---|
Unnecessary | Not needed | “No, I didn't use that supported at all. I, I, I know what it was there, but I just didn't need them. For me fortunately, I can leave my work at work.”—Q1, Medical specialist, C3, interview |
“I deemed my complaints to be normal considering the hectic at work in combinations with the situation at home.”—Q2, Support staff, C2, survey | ||
Other support | “At some point it was often pointed out like: “yeah the psychosocial support team is here, the palliative team is here, if you ever want to talk to someone, or social work.” But every time we had those talks we thought: actually it’s much better if we just uhm, evaluate in our own team and discuss whether there are certain things people want to talk about.”—Q3, Nurse, C3, interview | |
“I thought this was something I had to learn to deal with myself.” – Q4, Nurse, C1, survey | ||
“There were other institutions that I could approach for my care needs.”—Q5, Management, C2, survey | ||
Unsuitable | Not helpful | “I believe it won’t have much effect.”—Q6, Nurse, C4, survey |
“At the time I didn’t see the added value in it and with some members of the BOT team I don’t have a click.”—Q7, Support staff, C1, survey | ||
Type of support | “When it was needed, it was only possible to do it online instead of face-to-face.”—Q8, Support staff, C3, survey | |
“[I] work a lot during the night and weekends, then there is no support available.”—Q9, Nurse, C2, survey | ||
Lack of time | “I didn’t make time for it.”—Q10, Nurse, C2, survey | |
“I wasn’t being given the time or space to think about making an appointment or giving a call.”—Q11, Nurse, C2, survey | ||
Unaware | Not sufficiently actively promoted | “I wasn’t aware of the existence of this team. For me personally I found out to late!!”—Q12, Manager, C1, survey |
“During the first wave they sometimes visited and asked how you were doing. In the second wave, when I had corona myself, I actually didn’t really know where I could go to and what I then could say or ask.”—Q13, Physician resident, C1, survey | ||
“I need this [psychosocial support]. Last week I went looking for the phone number, because during the beginning of the corona period it was communicated that everyone could call. The only thing I was now able to find was the working conditions service, and then the threshold is too high. So now I need help but cannot get it.”—Q14, Support staff, C1, survey | ||
Unaware | More than COVID-19 | “It would be nice to have such support also for non-COVID related stuff… Clearing your mind without having to go through an entire trajectory.”—Q15, Support staff, C2, survey |
“Yes I came across it, that there was a living room where you could go to. Well, I really interpreted that as that being there for the people in the frontline. And I was not onsite so I, I never felt like that was addressed to me. And yes looking back I may have had the need to have a little extra talk or to be taken care of.”—Q15, Support staff, C3, interview | ||
“Of course, people working from home also had quite some fears about COVID and stuff…. some really, really struggled just having to be home all the time and not talking to people, not seeing people, having difficulties concentrating at home. […] And from accounts I heard, they didn't feel supported.”—Q16, Support staff, C3, interview | ||
Undeserving | Others need it more | “There were- there were phone numbers and on internet. You know, a lot of explanations going on… The blogs and- and that you could call if- if you wanted to talk. But it was, I think, not for me but for the nurses because they were- they were at the bedside where patients died. So, I guess, although I felt depressed the first few weeks, I- I didn't want to call that number because I felt it was nothing compared to what the nurses have to go through.”—Q21, Support staff, C3, interview |
“For me there is also a barrier because I think colleagues on the specific corona department should get priority.”—Q18, Support staff, C3, survey | ||
“There is no one in the team of which I think: that person won’t take it anymore. […] But I think that that is for example different for the IC. […] and I think for the wards sometimes as well. […] During the first wave you had of course a lot [of patients] at the ward who were really sick but didn’t go to the IC. If you then have shift and four people die, yes that is of course not, not a nice shift.”—Q19, Physician resident, C2, interview | ||
“Yes actually, yes it was.. I wouldn’t be right if I said it was a piece of cake. […] [But] we’re a surgical ward, we are used to hectic situations and fluctuations in busyness. It’s either very busy or very quiet,, we’re used to that.” [But] the new colleagues from the paediatrics ward [who helped out on the COVID ward], for them I think it is really challenging.—Q20, Nurse, C1, interview |
“During the moment itself it doesn’t seem to be necessary. But looking back, that’s a different story.”—Medical specialist, Case 2, Survey.
“I don’t want to appear weak.”—Support staff, Case 2, survey
“Have attention for the deaths on non-COVID departments. More people are dying here now as well compared to the normal situation, I notice that especially nurses are struggling with this.”—Physician resident, Case 2, survey
“There were phone numbers and on [the] internet, you know, a lot of explanations going on. [Stating] that you could call if you wanted to talk. But it was, I think, not for me but for the nurses because they were at the bedside where patients died. So, I guess, although I felt depressed the first few weeks, I didn't want to call that number because I felt [that] it was nothing compared to what the nurses have to go through.”—Support staff, Case 3, interview.
Important elements regarding the offering of psychosocial support
Theme | Quote (Q = quote number, staff function, C = case number, data source) |
---|---|
After the crisis | “There should be structural attention for this!”—Q21, Medical specialist, C2, survey |
“What they did well already during the first peak, is the taking care of professionals. Then they really created teams for psychosocial support […] And then afterwards we also had a digital meeting to see how we could keep doing that structurally. But I didn’t hear anything from that ever since.”—Q22, Nurse, C3, interview | |
“I think this team has since been disbanded, so in that case it would be nice if there was an alternative place where you can go for psychosocial care. If there is, there is too little known about it.”—Q23, Nurse, C3, survey | |
Accounting for diverse needs | “On the one hand lower the threshold more than currently is happening and on the other hand make it more anonymous. Support together with peers is nice, but on the other hand it is sometimes nice to be able to talk with a stranger.”—Q24, Support staff, C3, survey |
“I miss an independent person who you can go to.”—Q25, Nurse, C4, survey | |
“Especially ask the employee what he/she thinks he/she needs, really listen to that and where possible also actually accommodate that.”—Q26, Support staff, C1, survey | |
Accessibility and awareness | “Create more awareness as to where people can go to and make this especially easily accessible. If I don't feel well and run into problems, scouring the intranet for the appropriate contact details is not what I will do. However, if I can walk-in somewhere for a first talk, I will probably schedule an appointment.”—Q27, Support staff, C3, survey |
“Make it more easily findable on Intranet.”—Q28, Medical specialist, C3, survey | |
“Psychosocial support is at this moment voluntarily, while I think it would be could to have a more ‘mandatory’ reflection on difficult cases or situation and what it did to you more often.”—Q29, Management, C2, survey | |
“Nurses think they can solve everything for themselves and often go beyond their limits. [They] feel the work pressure at the department and the requests regarding scheduling work, want to go home after a long shift which makes that they ask for support too late. Provide unsolicited psychosocial support and approach employees personally with regard to feeling safe.”—Q30 Nurse, C2, survey | |
Active supervision | “Perhaps do it via supervisors so that there is time during work to pay attention to this. Now there often is ‘no time’ or colleagues or the supervisors see it as weird/abnormal if you go there.”—Q31, Physician resident, C1, survey |
“It is well organized, but the one who needs support normally doesn’t search and asks for it themselves. Supervisors have an important role, they hear [and] feel what and whether something is going on with an employee.”—Q32, Support staff, C3, survey | |
“Provide support to supervisors so that they can better help their employees. They are often the first point of contact in case of problems.”—Q33, Support staff, C3, survey |
“In my experience, the consequences of the COVID pandemic are only now really starting to become clear. […] Exhaustion, [feeling] emotionally overloaded, [these] are things that I recognize in myself and in colleagues, even though everyone has had a holiday. [Psychosocial support teams should] now go to departments to be able to do something for the employees here.”—Support staff, Case 2, survey.
“Create an open consultation hour where employees can go for a quick question regarding coaching/counselling in these times.”—Management, Case 3, survey.
“The threshold for contacting the [psychosocial support] team is way too high. It has already been stated several times to the team that they must approach all employees personally. Nurses often have the tendency to put themselves in the background and will therefore experience a barrier to seek help. If you contact people personally this can lower the threshold.”—Nurse, Case 4, survey.
“[A good team leader is] always there for us. And always asking us: how are we doing and what are we struggling with? What can be changed? What can we do differently? Um yeah that, that’s really, really so important to… To survive.”—Nurse, Case 1, interview.