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“Well, I Signed Up to Be a Soldier; I Have Been Trained and Equipped Well”: Exploring Healthcare Workers’ Experiences during COVID-19 Organizational Changes in Singapore, from the First Wave to the Path towards Endemicity

Author

Listed:
  • Celene Ting

    (Saw Swee Hock School of Public Health and National University Health System, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, Level 09-03J, Singapore 117549, Singapore
    These authors contributed equally to this work.)

  • Alyssa Yenyi Chan

    (Saw Swee Hock School of Public Health and National University Health System, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, Level 09-03J, Singapore 117549, Singapore
    These authors contributed equally to this work.)

  • Lai Gwen Chan

    (Department of Psychiatry, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore)

  • Zoe Jane-Lara Hildon

    (Saw Swee Hock School of Public Health and National University Health System, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, Level 09-03J, Singapore 117549, Singapore
    National Centre for Infectious Diseases (NCID), Ministry of Health of Singapore, 16 Jln Tan Tock Seng, Singapore 308442, Singapore
    These authors contributed equally to this work.)

Abstract

(1) Background: As COVID-19 transmission continues despite vaccination programs, healthcare workers (HCWs) face an ongoing pandemic response. We explore the effects of this on (1) Heartware, by which we refer to morale and commitment of HCWs; and identify how to improve (2) Hardware, or ways of enabling operational safety and functioning. (2) Methods: Qualitative e-diary entries were shared by HCWs during the early phases of the outbreak in Singapore from June to August 2020. Data were collected via an online survey of n = 3616 HCWs of all cadres. Nine institutions—restructured hospitals ( n = 5), affiliated primary partners ( n = 2) and hospices ( n = 2)—participated. Applied thematic analysis was undertaken and organized according to Heartware and Hardware. Major themes are in italics (3) Results: n = 663 (18%) HCWs submitted a qualitative entry. Dominant themes undermining (1) Heartware consisted of burnout from being overworked and emotional exhaustion and at times feeling a lack of appreciation or support at work . The most common themes overriding morale breakers were a stoic acceptance to fight, adjust and hold the line, coupled with motivation from engaging leadership and supportive colleagues . The biggest barrier in (2) Hardware analysis related to sub-optimal segregation strategies within wards and designing better protocols for case detection, triage, and admissions criteria . Overall, the most cited enabler was the timely and well-planned provision of Personal Protective Equipment (PPE) for front-liners , though scope for scale-up was called for by those not considered frontline. Analysis maps internal organizational functioning to wider external public and policy-related narratives. (4) Conclusions: COVID-19 surges are becoming endemic rather than exceptional events. System elasticity needs to build on known pillars coupling improving safety and care delivery with improving HCW morale. Accordingly, a model capturing such facets of Adaptive Pandemic Response derived from our data analyses is described. HCW burnout must be urgently addressed, and health systems moved away from reactive “wartime” response configurations.

Suggested Citation

  • Celene Ting & Alyssa Yenyi Chan & Lai Gwen Chan & Zoe Jane-Lara Hildon, 2022. "“Well, I Signed Up to Be a Soldier; I Have Been Trained and Equipped Well”: Exploring Healthcare Workers’ Experiences during COVID-19 Organizational Changes in Singapore, from the First Wave to the Pa," IJERPH, MDPI, vol. 19(4), pages 1-20, February.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:4:p:2477-:d:754526
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    References listed on IDEAS

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    1. Pavani Rangachari & Jacquelynn L. Woods, 2020. "Preserving Organizational Resilience, Patient Safety, and Staff Retention during COVID-19 Requires a Holistic Consideration of the Psychological Safety of Healthcare Workers," IJERPH, MDPI, vol. 17(12), pages 1-12, June.
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