What challenges did junior doctors face while working during the COVID-19 pandemic? A qualitative study

• Published in: BMJ open 2021-12, Vol.11 (12), p.e056122-e056122
• Main Authors: Spiers, Johanna, Buszewicz, Marta, Chew-Graham, Carolyn, Dunning, Alice, Taylor, Anna Kathryn, Gopfert, Anya, Van Hove, Maria, Teoh, Kevin Rui-Han, Appleby, Louis, Martin, James, Riley, Ruth
• Format: Article
• Language: English
• Subjects: Anxiety; Burnout; Coronaviruses; COVID-19; Data collection; depression & mood disorders; Disease transmission; Female; Humans; Interviews; Male; Medical research; Medical Staff, Hospital; Mental depression; Mental disorders; Mental Health; Mental health care; Pandemics; Patients; Psychologists; Qualitative research; SARS-CoV-2; State Medicine; Stress; Suicides & suicide attempts; Workers; Working conditions; Workloads
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2021-056122

ObjectivesThis paper reports findings exploring junior doctors’ experiences of working during the COVID-19 pandemic in the UK.DesignQualitative study using in-depth interviews with 15 junior doctors. Interviews were audio-recorded, transcribed, anonymised and imported into NVivo V.12 to facilitate data management. Data were analysed using reflexive thematic analysis.SettingNational Health Service (NHS) England.ParticipantsA purposive sample of 12 female and 3 male junior doctors who indicated severe depression and/or anxiety on the DASS-21 questionnaire or high suicidality on Paykel’s measure were recruited. These doctors self-identified as having lived experience of distress due to their working conditions.ResultsWe report three major themes. First, the challenges of working during the COVID-19 pandemic, which were both personal and organisational. Personal challenges were characterised by helplessness and included the trauma of seeing many patients dying, fears about safety and being powerless to switch off. Work-related challenges revolved around change and uncertainty and included increasing workloads, decreasing staff numbers and negative impacts on relationships with colleagues and patients. The second theme was strategies for coping with the impact of COVID-19 on work, which were also both personal and organisational. Personal coping strategies, which appeared limited in their usefulness, were problem and emotion focused. Several participants appeared to have moved from coping towards learnt helplessness. Some organisations reacted to COVID-19 collaboratively and flexibly. Third, participants reported a positive impact of the COVID-19 pandemic on working practices, which included simplified new ways of working—such as consistent teams and longer rotations—as well as increased camaraderie and support.ConclusionsThe trauma that junior doctors experienced while working during COVID-19 led to powerlessness and a reduction in the benefit of individual coping strategies. This may have resulted in feelings of resignation. We recommend that, postpandemic, junior doctors are assigned to consistent teams and offered ongoing support.