Exploring the experience of cardiothoracic ICU clinicians during the COVID-19 pandemic: A grounded theory study.
Leah Hughes, Benjamin Shelley, Joanne McPeake
PMID 39455424WHAT IT FOUND
Clinicians in a non-COVID ICU said visiting restrictions made them feel like barriers to families, causing guilt, distress and repeated experiences that felt morally wrong.
Some said there was no psychological support strategy in place. This describes staff experience, not patient outcomes.
Key findings
01Four categories emerged: the impact and implementation of visiting restrictions, the dehumanization of patients, end-of-life care, and witnessing distress.
02The study developed a theory that staff experienced recurrent exposure to Potentially Moral Injurious Experiences.
03Allied health professionals reported that therapies took longer to deliver because they needed to provide additional support to patients.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was done in one cardiothoracic ICU in Scotland, so the experiences may not match other units. It included staff, not patients or families, so it describes staff perceptions rather than patient outcomes. Participants chose to volunteer, so the study may not represent all staff. Twenty interviews produced themes, not measured effects, and no support strategy was tested. One researcher led analysis, with discussion by another researcher, so other interpretations of the data are possible.
Declared interests
Funding: LH was funded through a Royal College of Nursing Foundation bursary, and JM was funded through The Healthcare Improvement Studies Institute Fellowship, University of Cambridge.
The easy way to misread this
Do not read this as evidence that visiting restrictions harmed patients or that a staff support programme prevents moral injury. The study reports 20 staff experiences and a qualitative theory, not patient outcomes or tested interventions.