• Bertrand Lavoie, Claude Julie Bourque, Anne-Josée Côté, Manasi Rajagopal, Paul Clerc, Valérie Bourdeau, Samina Ali, Evelyne Doyon-Trottier, Véronique Castonguay, Érika Fontaine-Pagé, Brett Burstein, Pierre Desaulniers, Ran D Goldman, Graham Thompson, Simon Berthelot, Maryse Lagacé, Nathalie Gaucher, and Pediatric Emergency Research Canada (PERC).
• Faculty of Law, Université Sherbrooke, CHU Sainte-Justine Research Centre, Montreal, QC, Canada.
• CJEM. 2022 Aug 1; 24 (5): 482-492.

BackgroundThis study's objective was to examine emergency department (ED) workers' perspectives during the Canadian COVID-19 first wave.MethodsThis qualitative study included workers from nine Canadian EDs who participated in 3 monthly video focus groups between April and July 2020 to explore (1) personal/professional experiences, (2) patient care and ED work, (3) relationships with teams, institutions and governing bodies. Framework analysis informed data collection and analysis.ResultsThirty-six focus groups and 15 interviews were conducted with 53 participants (including 24 physicians, 16 nurses). Median age was 37.5 years, 51% were female, 79% had more than 5 years' experience. Three main themes emerged. (1) Early in this pandemic, participants felt a responsibility to provide care to patients and solidarity toward their ED colleagues and team, while balancing many risks with their personal protection. (2) ED teams wanted to be engaged in decision-making, based on the best available scientific knowledge. Institutional decisions and clinical guidelines needed to be adapted to the specificity of each ED environment. (3) Working during the pandemic created new sources of moral distress and fatigue, including difficult clinical practices, distance with patients and families, frequent changes in information and added sources of fatigue. Although participants quickly adapted to a "new normal", they were concerned about long-term burnout. Participants who experienced high numbers of patient deaths felt especially unprepared.InterpretationED workers believe they have a responsibility to provide care through a pandemic. Trust in leadership is supported by managers who are present and responsive, transparent in their communication, and involve ED staff in the development and practice of policies and procedures. Such practices will help protect from burnout and ensure the workforce's long-term sustainability.© 2022. The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU).

16 keywords...

hide…