The factors impacting on the well-being of Intensive Care (ICU) employees at the Chris Hani Baragwanath Hospital

Abstract

The goal of this study was to explore the factors impacting on the well-being of ICU employees. The objectives of the study were: <ul> <li> To theoretically conceptualise the factors impacting on employees in a hospital ICU.</li> <li> To explore the role of personal factors such as personality, behaviour risks and resilience that impact on the well-being of ICU employees.</li> <li> To explore the organisational and work related factors that impinge on ICU employees and the impact these factors have on their well-being.</li> <li> To make recommendations regarding the implementation of proactive strategies.</li></ul> The research question of the qualitative study is: What are the factors impacting on the well-being of intensive care employees at the Chris Hani Baragwanath Hospital? This is an applied, qualitative research study. The research design used was a collective case study using focus group interviewing. The research study was conducted at Chris Hani Baragwanath Hospital Intensive Care Unit. The sample was selected using non-probability, purposive sampling. The sample consisted of ten doctors, thirteen nursing personnel and seven allied professionals (four physiotherapists and three dieticians). A pilot study was conducted with two doctors, two nurses and a social worker to test the interview schedule. This group did not form part of the sample. The researcher did her best to adhere to ethical considerations. Participants were informed of the nature of the research and completed informed consent forms. Anonymity was ensured through presenting responses collectively. No individual names or responses will be identified. A semi-structured interview schedule was used to collect data during focus group interviewing. The four focus group sessions were tape recorded. After completion of the focus group interviewing, the data was transcribed verbatim and then the data was organised into themes and sub-themes. The findings were released in a mini-dissertation. The report is accurate and reflects the true facts. All sources, references and assistance are acknowledged. The themes and sub-themes identified were: <ul> <li> Theme one: Job Satisfaction and sub-themes-Fulfilment, Meaning to Work, Emotions experienced, Changes healthcare workers would like implemented.</li> <li> Theme two: Stressors and sub-themes- What the stressors are, Control over the Stressors, Self-care techniques utilised, Personal Resources and Ways of de-stressing.</li> <li> Theme three: Trauma</li> <li> Theme four: Interpersonal Relationships and sub-themes- Connectivity amongst team, Impact connectivity has on functioning and Teamwork.</li> <li> Theme five: Role Demands and sub-themes- Job Description, Role Conflict and Balance between work and personal life.</li> <li> Theme six: Job Resources and sub-themes- Adequacy of resources, Resources Lacking and Impact job resources have on functioning.</li> <li> Theme seven: Job Conditions and sub-themes- Work Overload, Job Security and Working Conditions.</li></ul> The findings of the study were as follows: <ul> <li> CHBH employees experience high job satisfaction as they are doing what they want to do. They feel that they make a difference and enjoy trauma work. They are where things happen and where they want to be.</li> <li> The stressors faced by ICU employees can be divided into emotional and physical/resource stressors. The physical stressors were found to be: long working hours, lack of resources, untrained staff, budget, procuring equipment and resources, lack of human resources, equipment and linen shortages. The emotional stressors were related to having to deal with trauma and the impact thereof, dealing with death and dying, decisions regarding the switching off of life support machines, not always knowing if you did the right thing and wondering if you did everything you could for the patient to save their life.</li> <li> Daily, employees are faced with dealing with trauma and the impact thereof. This has an impact on well-being and can lead to compassion fatigue or soul weariness.</li> <li> It is important to examine the interplay of job resources and job demands. If job demands are high and job resources lacking, well-being is impacted. Job resources may buffer the impact of job demands and thus reduce burnout, exhaustion and increase motivation.</li> <li> If job demands are high and job resources low, job demands will exceed the individuals’ capacity to cope and overtax or stretch ability to cope. ICU employees experience being overstretched and overtaxed due to high job demands and being under-resourced. Work overload results in exhaustion.</li> <li> Relationships are an important aspect of organisational support. Employees value their relationships with colleagues and this provides opportunities for discussing patients, sharing knowledge and obtaining assistance with patient care. By pooling resources the team has additional resources to resolve complex situations.</li> <li> The working conditions of ICU employees are impacted by shortages in human and equipment resources.</li></ul> Recommendations arising from the study are: <ul> <li> A lifestyle and health management program dealing with issues of nutrition, exercise, relaxation, self awareness and disease management.</li> <li> An educative stress management program which is presented at induction and orientation.</li> <li> Preventative programs that enhance knowledge and skills on coping and self-care.</li> <li> Self awareness programs designed to assist employees in understanding their own stressors and reactions, enhance their self-esteem by developing strengths, resilience and coping.</li> <li> Human capital management- developing strategies to attract retain and reduce staff shortages.</li> <li> Facilities for exercise and relaxation- the provision of a gym facility.</li> <li> Program to reduce fatigue and recovery time.</li> <li> Group sessions focussing on catharsis and ventilation of feelings.</li> <li> A comprehensive Employee Wellness Program. </ul>