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Challenges to well-being in critical care.
Rachel L Shaw1, Rachael Morrison2, Sarah Webb2
1Institute of Health & Neurodevelopment, College of Health & Life Sciences, Aston University, Birmingham, UK.
Nursing in Critical Care
|January 17, 2024
Summary
Staff in paediatric critical care (PCC) face significant well-being challenges. Addressing needs for support, rest, and resources is crucial for improving staff well-being in this high-pressure environment.
Area of Science:
- Critical care medicine
- Occupational health psychology
- Human factors engineering
Background:
- Paediatric critical care (PCC) environments present unique stressors leading to burnout, post-traumatic stress, and moral distress among staff.
- High-pressure work settings in PCC negatively impact healthcare professionals' mental health and overall well-being.
Purpose of the Study:
- To identify and understand the specific challenges impacting workplace well-being within paediatric critical care.
- To inform the development of targeted interventions aimed at enhancing and sustaining staff well-being in PCC units.
Main Methods:
- Utilized the Enhanced Critical Incident Technique (ECIT), involving semi-structured interviews and thematic analysis.
- Collected data from 53 nurses and doctors in a UK quaternary PCC unit to identify critical incidents and influencing factors.
- Categorized challenges to well-being experienced by staff in high-acuity paediatric settings.
Main Results:
- Key themes emerged including the general context of PCC work (including during COVID-19), moral distress from complex patient care, the impact of teamwork and leadership, workforce changes (staffing shortages, aging workforce), and unmet basic needs (food, rest).
- Staff highlighted the necessity for psychologically informed environments that facilitate vulnerability sharing and mutual support.
- Identified critical incidents related to patient care, teamwork dynamics, and resource availability significantly affected staff well-being.
Conclusions:
- Experiential accounts underscore the need for psychologically informed environments to support staff vulnerability and foster well-being in PCC.
- Findings align with self-determination theory and Maslow's hierarchy of needs, emphasizing requirements for psychological fulfillment and self-actualization.
- Addressing systemic issues and promoting supportive work environments are essential for maintaining staff well-being in paediatric critical care settings.
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