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Hospital-based rehabilitation professionals value professional autonomy, as it makes them feel needed, connected, and energized. The needs of hospital-based rehabilitation professionals, however, may be in conflict with organizational rules and structures, and may lead to moral distress. This is the outcome of a qualitative study conducted by researchers from the Rehabilitation department of the Radboudumc. They explored the experiences of rehabilitation professionals working in hospitals during the COVID-19 pandemic. They also investigated the ethical issues and moral distress these professionals might have experienced. The study is published in Physical Therapy & Rehabilitation Journal on May 5th.
Two years ago, in the midst of the first wave of COVID-19 in the Netherlands, hospital-based rehabilitation professionals - dieticians, occupational therapists, physical therapists, and speech-language therapists - were suddenly tasked with a variety of new roles in the care of patients with COVID-19. Simultaneously, the working environment changed as a result of limited availability of personal protective equipment. The professionals had to make difficult decisions with limited knowledge of optimal precaution and treatment strategies. Due to the crisis, the work process was often task-based instead of human-based and holistic. Insight into their experiences would help to empathize with the newly acquired unusual working situation and identify requirements of rehabilitation professionals during this pandemic.
A qualitative analysis of interview data from 39 hospital-based rehabilitation professionals revealed four themes: “a disease with great impact,” “personal health and safety,” “staying human in chaotic times,” and “solidarity and changing roles.” Participant experiences showed that the virus and COVID-19 measures had a significant impact on the in-hospital working environment due to the massive downscaling of regular care, infection prevention measures, and unknown risks to rehabilitation professionals’ personal health. At the same time, participants experienced a certain freedom, which made room for authentic motives, connection, and solidarity. The study participants felt welcomed and appreciated at the COVID-19 wards and intensive care units, and were proud that they were able to fulfill important roles. The results of the current study reflect a wide range of situations that were morally complex and led to moral distress. To diminish the long-lasting negative impact of the COVID-19 pandemic and moral distress in rehabilitation professionals, the researchers concluded that employers should empathize with the experiences of hospital-based rehabilitation professionals and create conditions for ethical reflection.
Publication
Roel van Oorsouw, PT, MSc, Anke Oerlemans, PhD, Emily Klooster, PT, MSc, Manon van den Berg, PhD, Johanna Kalf, PhD, Hester Vermeulen, PhD, Maud Graff, PhD, Philip van der Wees, PT, PhD, Niek Koenders, PT, PhD. A Sense of Being Needed: A Phenomenological Analysis of Hospital-Based Rehabilitation Professionals’ Experiences During the COVID-19 Pandemic. 2022. Physical Therapy & Rehabilitation Journal.
