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‘Going against the grain of all we do’: hospice staff experiences of moral distress during COVID-19
BMJ Supportive & Palliative Care ; 11(Suppl 2):A1, 2021.
Article in English | ProQuest Central | ID: covidwho-1495560
ABSTRACT
BackgroundCOVID-19 has placed huge stress on healthcare systems and services, often impacting the well-being of staff across all settings (Mehta, Machado, Kwizera, et al., 2021). Little is known about the pandemic’s impact on hospice staff.AimsIdentify how responding to COVID-19 has impacted hospice staff, whether and why this resulted in experiences of moral distress, and how hospices have responded in supporting staff well-being.MethodsQualitative multiple case study (Yin, 2017) (n= five cases), as part of the CovPall study which explored the multinational response of specialist palliative services to the pandemic. Cases were hospices in England providing specialist palliative care services in any setting. Data collection involved individual interviews with hospice professionals and analysed using framework analysis (Ritchie, Lewis, Nicholls, et al., 2013).Results24 participants sampled by role, experience, and setting. Themes demonstrated how infection control constraints (i.e., visiting restrictions) prohibited and diluted staff’s capacity to provide care that reflected their professional values. This caused moral distress. Despite organisational, team, and individual support strategies to address moral distress, continually managing these constraints led to a ‘crescendo effect’ with cumulative effects of moral distress (e.g., sadness, guilt, frustration, and fatigue) sometimes leading to burnout. Solidarity with colleagues and the feeling of making a valued contribution provided ‘moral comfort’ for some.ConclusionsDespite their experience of dealing with death and dying, the well-being of hospice staff has been, and continues to be, affected by experiences of moral distress during the pandemic.How innovative or of interest is the abstractWe provide an in-depth insight into why and how hospice staff experienced moral distress during the pandemic, alongside how voluntary organisations responded. Given that prolonged experiences of moral distress has detrimental effects on staff and the quality of patient care, (Burston & Tuckett, 2013) national and organisational changes need to be implemented to alleviate and manage the short and long-term impact of moral distress (Jameton, 2017).Funding statementThe CovPall study is jointly funded by UKRI and NIHR [COV0011;MR/V012908/1]. Additional support was from the National Institute for Health Research (NIHR) Applied Research Collaboration, South London, hosted at King’s College Hospital NHS Foundation Trust, and Cicely Saunders International (Registered Charity No. 1087195).

Full text: Available Collection: Databases of international organizations Database: ProQuest Central Type of study: Qualitative research Language: English Journal: BMJ Supportive & Palliative Care Year: 2021 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: ProQuest Central Type of study: Qualitative research Language: English Journal: BMJ Supportive & Palliative Care Year: 2021 Document Type: Article