Exploring the psychological impact of the COVID-19 pandemic on PICU consultants, advanced nurse practitioners and trainee doctors
Paediatric intensive care unit (PICU) staff members are at risk of burnout, stress, and fatigue. The COVID-19 pandemic has affected how we live and work; we postulate this increases the risk of stress-related disorders.
To explore the impact of the COVID-19 pandemic on the wellbeing of PICU clinicians.
An anonymised, single-centre survey was sent to clinicians, comprising four sections: burnout, work-related stress, work-related fatigue, and work-life balance. Two free-text questions explored perceptions of work-life balance and measures to improve wellbeing.
55.6% of respondents returned scores suggesting high burnout risk. 55.6% had answers suggesting work-related stress. 82.4% reported work-related fatigue. 55.5% felt that work-life balance had not improved during the pandemic.
The proportion of staff at risk of burnout in this study is higher than that reported in pre-pandemic studies. Perceived work-life balance has been negatively impacted, and high levels of work-related stress and fatigue were identified.
The paediatric intensive care unit (PICU) is a challenging work environment with the demands of managing complex and critically unwell patients, physical demands of long shift/out-of-hours duties as well as the emotional demands of providing paediatric end of life care. There is a constant requirement for high performance (in both technical and non-technical skills) in a high-intensity atmosphere.
Recent studies have shown that PICU staff are at high risk of moral distress, burnout, stress, and fatigue, which can affect the ability to make critical decisions while under pressure (Colville et al, 2015; 2018; Looseley et al, 2019; McClelland et al, 2019; Jones et al, 2020). This has been shown to be a significant contributing factor in many critical incidents, not only in health care, but also in other large corporations such as NASA (Farquhar, 2017). In a health-care setting, the presence of burnout may lead to a reduction in patient safety (Gandi et al, 2011; Salyers et al, 2017; Garcia et al, 2019). Stress, burnout, and fatigue also have an impact on the physical and emotional wellbeing of staff members. Burnout has been demonstrated to be a predictor of poor physical health outcomes (such as type 2 diabetes and coronary heart disease) and mental health outcomes (including insomnia, depression, and hospitalisation for mental disorders) (Salvagioni et al, 2017).
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