The COVID-19 pandemic has created disaster conditions for healthcare in the US, and has intensified the need for adaptive practices in healthcare work. The pandemic has brought high patient loads, rapidly-changing expertise, and shortages of personal protective equipment to hospitals, and consequently it poses significant adaptive challenges for healthcare workers. This problem is especially acute in intensive care units (ICUs), where the healthcare workforce must alter how they interact with their peers and with patients' families while working in close proximity to a contagious agent. Such changes are broadly understood as "resilience." However, the specific conditions of adversity and the creative responses healthcare workers may employ to adapt to them remain underexplored. Understanding how these workers adapt, and how these adaptations might promote resilience against adversity is critical to preventing the transmission of COVID-19. A social scientific study of an ICU's pathways to resilience can help researchers and policymakers understand what might promote resilience, which is important for addressing the current conditions of the COVID-19 pandemic, and for preparing for future possible challenges.
The research will be conducted in an intensive care unit in a hospital in North Carolina, where the COVID-19 pandemic is now beginning its localized peak. This is a key setting for research, because unlike larger cities but similar to many smaller cities and rural areas, the severity of cases in this study setting is predicted to maximize during the course of the research activities. This will offer the researchers the opportunity to gather detailed data about the dynamics of adaptive processes. The research will focus on different groups of workers in the ICU, and will examine possibly unique aspects to changing healthcare worker resilience practices, and how these social practices might be affecting how people relate to the transmission and spread of the virus. The study methods will include: (1) Semi-structured interviews conducted with ICU staff that address perspectives on the pandemic, to understand how workers perceive effects of the pandemic on their daily work activities and on their relationships with patients and families; (2) Open-ended interviews with a purposive sample of key decision-makers in the hospital, to understand how and to what extent care worker perspectives factor into guidelines and protocols; (3) Participant observation in the ICU to describe and understand practices of care work; and (4) Discourse analysis of best-practice materials circulated to staff in the hospital and in the ICU to track how changes in the pandemic register with official protocols and media sources. The multidisciplinary research time of an anthropologist and intensive care physicians offers a uniquely diverse approach to document this under-examined phenomenon of resilience among ICU workers, and to detail the social and workforce aspects of the COVID-19 pandemic.
This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.
