The unseen frontlines: Perceptions and challenges of ancillary staff in the emergency department during COVID-19 pandemic

ABSTRACT

Background and objectives: The COVID-19 pandemic has shed some light on healthcare workers (HCW), their safety, and their well-being. Although medical and nursing teams are traditionally perceived as the faces of healthcare, ancillary staff are also integral to the effective operations of the frontline of the pandemic and can be exposed to occupational hazards in their line of duty. Despite this, few studies have focused on their experience during the pandemic. This study explores the perceptions and challenges faced by ancillary staff working in an emergency department (ED) in Singapore during the first year of the pandemic. Methods: Fourteen participants were recruited via stratified random sampling from administration, portering, housekeeping, and security personnel from the ED. Data were collected from July 2020 to December 2020 through in-depth, semi-structured interviews until data saturation. Interviews were audio-recorded and transcribed verbatim. Codes were identified independently then iteratively by three research members and analyzed using thematic analysis. Results: The results centered on a total of seven main themes. Three themes were identified as challenges "adapting to changes," "exhaustion and insufficient rest," and "increased manpower demands." Four themes were related to perceptions "fear and uncertainty," "safety and preparedness at work," "team communication and support," and "motivation for work." Foreign staff (71.4% of the respondents) faced additional stress from travel restrictions and being away from family;35.7% of the respondents do not feel recognized as a healthcare hero. Conclusion: This study highlighted the different challenges faced by ancillary staff and their perceptions of working during a pandemic. It is important to provide open and clear communication channels between management, the staff, and the public and to provide rationales for change. Regular training sessions, disease outbreak simulations, and knowledge of the disease boosted the confidence of staff in their safety. Practical implications include reviewing the work contract obligations to provide adequate rest for ancillary staff.