Experiences inside pandemic bubbles in regional health

  • Woman wearing a mask
University of Melbourne Department of Rural Health
A/Prof Jennifer Weller-Newton, Ms Sarah White, Dr Rowan O’Hagan, Dr Nicole McGill

Throughout 2020, regional health services along the Victoria and New South Wales border prepared themselves for managing a pandemic. Guidelines for healthcare workers were, and continue to be, constantly updated by state governments. Border closures were enforced ‘border bubbles’, established and disbanded as the pandemic unfolded. How did the pandemic impact on healthcare workers’ professional lives, while managing family and households outside of their work?

A project initiated by the Department of Rural Health, University of Melbourne, in partnership with three regional health services explored the experiences of healthcare workers during 2020.  Healthcare workers who volunteered to participate in the project captured their reflections over a six-month period in writing, using images or poetry.

Twelve healthcare workers participated across the three health services from a range of disciplines, including physiotherapy, nursing, pharmacy, and occupational therapy. Seven of the participants also participated in an interview at the end of the six months to share their experiences of doing reflections.

Analysis of the reflections and interviews has revealed several themes. Of note, concern was expressed by the healthcare workers in relation to the relentless fatigue. They shared the fatigue was related to the demands of added requirements, such as screening clients for COVID19 before every contact; the constant adapting to new ways of working; learning new skills to be able to deliver care/treatment by Telehealth; and constant change.

Being in a ‘border bubble’ added to the strain, making work more complicated as CEOs had to advocate for staff to be able to cross the border.

“Battling to cross the border each day, now having to wear face mask and visor at all times and living in Victoria under the level three restrictions seem to make time go slowly. A general feeling of malaise and frustration at the loss of anything that looks like “normal” and trouble seeing when it will return,” one health professional said.

 For another healthcare worker, the border closures reminded them of WW2 with the strict passport controls and permits to move from one region to another.

One healthcare worker provided an image of a roller-coaster, describing their experiences of feeling like they were in turmoil with an increased workload due to the reorganisation of staffing. They described going home from work feeling exhausted and drained, but still having to support their family and teenage children who were home schooling. They shared strategies for managing their sense of well-being during moments of feeling sheer overload.

One commented, “So many things were changing so rapidly that I constantly felt uncertain and ill-informed which was very stressful and challenging. New protocols and new information had to be rapidly developed and quickly distributed to all affected staff. False or inaccurate information became a huge issue also, with so much uncertainty and fear for everyone”.

Healthcare workers also shared their reflections of the positives that have emerged from the changes implemented because of the pandemic. The creativity that has materialised in the ways that some services are now delivered. Some health professional students undertook their clinical placements virtually, which demonstrated the innovative technology and teaching approaches that were used.

The transition to more online delivery of care and professional development  opportunities made some health professionals feel less isolated as a regional practitioner from their metropolitan colleagues.

This project has provided various insights into how healthcare workers made sense of, and gave meaning to, the events happening around them during 2020, along with their role, personal reactions, and strategies for managing their wellbeing. It is anticipated that on completion of the data analysis, recommendations will be made to assist healthcare services in preparing and supporting their staff.

Reflections on the ‘mask’

People everywhere masks on all
Rushing, talking, noises abound
Faceless people with only eyes 
Brown eyes, green eyes, angry eyes, rolling eyes 
Oh, my nurse has smiling eyes. 

Kind soft voice, gentle hands 
She smiles with her eyes; I don't need to see under the mask 
Warm blanket, warm drink, feeling secure 
I don't feel so bad, with her warm happy eyes.

The mask is needed, a precaution for all 
But never forget what the patient can't see 
Have you a smile, a snigger, a scowl 
They all look the same if your eyes don't smile.  

Affiliations:  Department of Rural Health, University of Melbourne; Albury Wodonga Health;  Northeast Health Wangaratta; and Echuca Regional Health.

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