The COVID-19 pandemic has strained healthcare systems and resulted in widespread critical care staffing shortages, negatively impacting quality of care delivered.
How have hospitals’ emergency responses to the pandemic influenced the well-being of frontline intensivists, and are there any potential strategies to improve their well-being and help preserve the critical care workforce?
We performed semi-structured interviews of intensivists at clusters of tertiary and community hospitals located in six regions across the U.S. between August-November 2020, using the “Four S framework” of acute surge planning (i.e., Space, Staff, Stuff, and System) to organize the interview guide. We then employed inductive thematic analysis to identify themes describing the influence of hospitals’ emergency responses on intensivists’ well-being.
33 intensivists from 7 tertiary and 6 community hospitals participated. Intensivists reported experiencing substantial moral distress, particularly due to restricted visitor policies and their perceived negative impacts on patients, families, and staff. Intensivists also frequently reported burnout symptoms due to their experiences with patient death, exhaustion over the pandemic’s duration, and perceived lack of support from colleagues and hospitals. We identified several potentially modifiable factors perceived to improve morale, including the proactive provision of mental health resources, establishment of formal back-up schedules for physicians, and clear actions demonstrating that clinicians are valued by their institutions.
Restrictive visitation policies contributed to moral distress as reported by intensivists, highlighting the need to reconsider the risks and benefits of these policies. We also identified several interventions as perceived by intensivists that may help mitigate moral distress and improve burnout as part of efforts to preserve the critical care workforce.

Copyright © 2022. Published by Elsevier Inc.