Critical care work during COVID-19: Sociological insights

How has critical care work changed during the COVID-19 pandemic? How has COVID-19 changed how care is provided, how frontline staff, patients and families communicate, and how the NHS responds under pressure to the ‘new normal’ of pandemic surges in critical care? The CLAP Study sought to answer these questions by asking frontline workers about their experiences during the first wave of the pandemic in 2020. Conducted by a multidisciplinary team, combining sociological and clinical expertise, the CLAP Study interviewed 40 NHS staff members from 4 hospitals in the UK to understand their experiences. Participants came from a range of professions and included nurses, doctors, advanced critical care practitioners, allied health professionals, operating department practitioners and ward clerks. We purposefully sought the experiences of trained and experienced critical care staff and those who were redeployed.

Our findings show that COVID-19 presented staff with a situation of extreme stress, duress and social emergency, leading to a shared set of experiences which we characterised as a ‘community of fate’. This involved fear and dread of working in critical care, but also a collective sense of duty and vocation. Caring for patients and families involved changes to usual ways of working, revolving around the reorganisation of space and personnel, personal protective equipment, lack of evidence for treating COVID-19, an inability for families to be physically present, and the trauma of witnessing extreme patient acuity and death on a large scale. The stress and isolation of working in critical care during COVID-19 was mitigated by strong teamwork, camaraderie, pride and fulfilment.

The study highlights how COVID-19 changed working practices in critical care in the first wave of the pandemic and profoundly affected staff physically, mentally and emotionally. It demonstrates the importance of attending to the social and organisational conditions in which individuals work, addressing both practical resourcing and the interpersonal dynamics of critical care provision.

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The CLAP Study was funded by Medical Research Scotland through a COVID-19 Research Grant [CVG-1739-2020] and supported by the Wellcome Trust [209519/Z/17/Z] through the Centre for Biomedicine, Self and Society at the University of Edinburgh.

This was a guest blog post by Dr Catherine Montgomery, a Chancellor’s Fellow in Science, Technology & Innovation Studies at the University of Edinburgh 


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