Paradoxical experiences of healthcare workers during COVID-19: a qualitative analysis of anonymous, web-based, audio narratives

ABSTRACT

Purpose

To gain a deeper understanding of healthcare workers experiences during COVID-19 using an anonymous, web-based, audio narrative platform.

Methods

Data were collected from healthcare workers in the midwestern United States using a web-enabled audio diary approach. Participant recordings were analysed using a narrative coding and conceptualization process derived from grounded theory coding techniques.

Results

Fifteen healthcare workers, in direct patient care or non-patient care roles, submitted 18 audio narratives. Two paradoxical themes emerged: 1) A paradox of distress and meaningfulness, where a harsh work environment resulted in psychological distress while simultaneously resulting in new rewarding experiences, sense of purpose and positive outlooks. 2) A paradox of social isolation and connection, where despite extreme isolation, healthcare workers formed intense and meaningful interpersonal connections with patients and colleagues in new ways.

Conclusions

A web-enabled audio diary approach provided an opportunity for healthcare workers to reflect deeper on their experiences without investigator influence, which led to some unique findings. Paradoxically, amid social isolation and extreme distress, a sense of value, meaning and rewarding human connections emerged. These findings suggest that interventions addressing healthcare worker burnout and distress might be enhanced by leveraging naturally occurring positive experiences as much as mitigating negative ones.

KEYWORDS:

• COVID-19
• healthcare workers
• paradoxical experiences
• social isolation
• social connectedness
• distress
• meaningfulness
• qualitative
• web application
• audio narratives

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17482631.2023.2184034

Data availability statement

Data are available on reasonable request. Raw transcripts of the data analysed in the study are available from the lead author.

Ethics approval

Approval for this study was granted by the Institutional Review Board of Beaumont Health, #2020–103.

Additional information

Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. Support for this study was provided internally by the Beaumont Research Institute and Oakland University William Beaumont School of Medicine.

Notes on contributors

Lori Lackman Zeman

Lori Lackman Zeman is Director of Behavioral Medicine in the Troy Beaumont Family Medicine Residency Program and Associate Professor in the Oakland University William Beaumont School of Medicine. She is a board-certified clinical health psychologist. Her research, teaching and clinical work focuses on the integration of mental and physical health care. She is also involved in several provider wellness initiatives.

Sujoy Roy

Sujoy Roy is a Research Assistant Professor at the Oakland University William Beaumont School of Medicine. His work is focused on the development and application of data and text analytics solutions in the biomedical and clinical informatics domains.

Pranjali P. Surnis

Pranjali Surnis is a Software Engineer working at USHR, Inc. She obtained her MS in Computer and Information Sciences at Oakland University where she was a graduate assistant in the Oakland University William Beaumont School of Medicine. Her work is focused on designing, developing, and maintaining user-friendly software applications in a variety of technologies.

Jason Adam Wasserman

Jason Adam Wasserman is currently Associate Professor of Foundational Medical Studies at Oakland University William Beaumont School of Medicine, where he also holds an appointment in Pediatrics, is the course director for the Medical Humanities and Clinical Bioethics curriculum, serves as Director of Student Professionalism, and conduct ethics consultations for area hospitals. His current scholarly work focuses on clinical bioethics as well as integrating social science into clinical medicine.

Kathleen Duchak

Kathleen Duchak is a family medicine physician in a practice affiliated with Beaumont Hospital - Troy. She was co-chief resident in the Troy Beaumont Family Medicine Residency Program. Her interests include healthcare delivery and provider wellness.

Ramin Homayouni

Ramin Homayouni is Professor and Director of Population Health Informatics at Oakland University William Beaumont School of Medicine. He has nearly 20 years of experience in development and implementation of informatics solutions for genomic and clinical applications.

Elie Mulhem

Elie Mulhem is Professor and Vice Chair of Research and Women’s Health in the Department of Family Medicine & Community Health Troy Beaumont Family Medicine Residency Program and Associate Professor in the Oakland University William Beaumont School of Medicine. His clinical work, teaching and research focuses on women’s health, chronic pain, hearing loss, pelvic floor muscle strengthening to prevent urinary incontinence in pregnant women, and provider wellness.