GPs' experiences of the COVID-19 pandemic - a focus group study. / Fastlegers møte med covid-19-pandemien ­ en fokusgruppestudie.

BACKGROUND: The working day of Norwegian GPs was turned on its head during the COVID-19 pandemic due to the extreme, ongoing pressure the GP service was under. We conducted a qualitative study of the GPs' perceptions of the challenges they faced and of how they coped during the pandemic. MATERIAL AND METHOD: Focus group interviews were conducted with 19 GPs from four medical practices in the county of Innlandet. The interviews were analysed using the systematic text condensation method. RESULTS: The GPs described how they have coped with the extremely challenging demands on them. They expressed an expectation of rapid adaptability, and considered this a fundamental characteristic of the role of the GP. They felt an enormous responsibility for their own patients and that in a time of crisis this responsibility was extended to include the entire population. They saw themselves as an important part of the local authority's public health preparedness, even though they had not reflected on this to any great extent prior to the pandemic. INTERPRETATION: The GP service's adaptability during times of crisis depends on the GPs' strong individual and collective sense of responsibility and their ability to cope. The latter is the GP service's great strength, but it also represents a vulnerability due to the camouflaging of the overburdening of the service. This can lead to local authorities failing to take responsibility for their statutory duties.

Restructuring in a GP practice during the COVID-19 pandemic - a focus-group study. / Driftsomlegging ved et fastlegekontor under covid-19-pandemien ­ en fokusgruppestudie.

BACKGROUND: Outside the cities, the medical services in the municipality are often centred around one GP practice. The local medical service is key to the municipality's healthcare preparedness. We wished to investigate how the healthcare personnel perceived the restructuring at their GP practice during the COVID-19 outbreak in March 2020, and the factors that facilitated and impeded the process. MATERIAL AND METHOD: The article is based on a focus group interview that was conducted with eight nurses and medical secretaries at Otta GP practice in June 2020. The interview was transcribed and analysed using systematic text condensation. RESULTS: The informants described a chaotic and demanding situation, in which they had to deal with their own as well as the patients' fears. They found crisis management to be difficult in a situation where the leadership in the municipality were unaware of the challenges of the GP practice. Lack of guidelines from the authorities at the start of the outbreak gave rise to considerable uncertainty. Through collaboration and flexibility, the practice arrived at new ways of working in order to safeguard its running. This gave a strong feeling of coping and fellowship, and a greater awareness of the informants' own importance in the front line of crisis management. INTERPRETATION: The study elucidates the role of support staff in the face of a crisis for the GP practice. Competent employees with the latitude and tools to tackle the challenges quickly guided the practice from chaos to a new type of working day. The municipality could have supported the process by ensuring the necessary resources and general guidelines for prioritisation of tasks.