Frontline clinicians have become society’s line of defence against a raging pandemic. Their stories reflect the uncertainty faced on a daily basis and are witness to their courageous acts first-hand. While research to understand the virus and curtail the disease is readily available, there is sparse information on the emotional hardship medical practitioners have to face.
Prof. Victor Grech and I have thus conducted a small study to provide a better understanding of the experiences of doctors practising medicine during the pandemic, with the focus on Malta and on Maltese doctors currently working abroad.
Messages were solicited from those who wished to share their experiences, and were posted, after the authors’ permission, on a COVID-19 website. On analysis, four major themes emerged: initial reaction, hospital’s response to the COVID-19 pandemic, the new normal, and personal adjustments.
The outbreak created a unique and unprecedented scenario for most healthcare workers and their families. Pervasive throughout their descriptions of their lived experiences of battling COVID-19 was a sense of responsibility to alleviate patients’ suffering and a need to make concerted efforts to safeguard the work environment. Joseph Degiovanni, a consultant paediatric cardiologist in the UK, wrote:
“We are coping with lockdown but the hospital closure for ‘routine’ admissions is causing big issues with waiting lists and delayed treatment. I am sure they can ease on this by utilising the Nightingale Hospitals to a higher capacity to open up other beds.”
The COVID-19 pandemic also brought to the fore the need for hospitals to efficiently and effectively respond to protect the nation. Response to a pandemic required a multidisciplinary team effort in order to ensure effective implementation of preparatory measures, followed by continuous diligent efforts to ensure modifications in plans as needed while addressing new demands as they arise. This brought with it a ‘new normal’ and a need to frequently adjust to meet rapidly-evolving requirements, communication and adoption, and coordinating the needs of multiple stakeholders while maintaining high-quality medical care became common ground.
Dr Mireille Formosa explained how her week consists of daily telephone or video clinics with parents/carers with limited face-to-face contact. There are also frequent virtual meetings with colleagues from hospital, community, the Children’s Learning Disability Team and Children and Adolescent Mental Health Service (CAMHS).
Indeed, this pandemic had a major toll on the personal front of medical practitioners. They had to primarily adjust to psychological and emotional matters overnight. While doctors are notoriously resilient, this pandemic exposed their vulnerable side. Fuelling hope thus became an important requisite, while a better future is yearned for, as Dr Susan Mulvaney said: “I know we will get through this and we will be better equipped for the next one. I hope to be able to visit my sunny home soon. Until then, be kind to yourself and one another.”
The themes identified in this study have important implications for pandemic planning. The conditions faced by healthcare workers during the current COVID-19 pandemic can be likened to battlefield conditions faced by military personnel.
We believe that an intervention based on the Battle Buddy system of the US army to describe a rapidly deployable psychological resilience combined with elements of the anticipate − plan − deter model can be easily introduced in hospitals. The intervention would provide peer support, unit level support through appointing a mental health consultant and individual support for at-risk individuals.
While there are limitations to such a small-scale study, this research accurately portrayed the resilience of these medical practitioners as they came to terms with a rapidly changing healthcare system and the adjustments they made to fall into a new normal. Indeed, their monumental efforts need to be lauded and their outstanding contributions recognised.
Mariella Scerri is reading for a PhD in Medical Humanities at the University of Leicester.