Table 3

Qualitative analysis of free-text comments. Topics identified as important to explore in future research on the psychological impact of working in paediatric critical care (n=98)

Topic (number of participants who described this topic)Example quotation
Tailored support for PICU staff (30) ‘We all need support and advice tailored to the same to ensure we do not 'burn out' working at such an intense fast pace.’ (P24)
‘Not enough continued support to staff, expected to get over things and if not seen as not coping with feelings and emotions.’ (P400)
Staffing levels and capacity (17) ‘Yes I do get burnt out it’s not the children it’s the staffing levels endless paperwork and the fear of making mistakes.’ (P703)
‘I think the questionnaire did not ask about the effect of chronic lack of capacity where most days there is a struggle to admit and discharge patients, leaving you feel chronically as if you are not able to provide the service you aspire to.’ (P66)
Staff relationships and bullying (15) ‘My worst experiences have been with other nurses—feeling insulted and bullied by senior staff nurses has left me wanting to quit more than any issues with patients/families.’ (P907)
‘A lot on moral dilemmas not a lot on emotional feelings re working conditions, working alongside difficult team members, that can cause burnout in my opinion in a hierarchical setting. When you have worked on a unit as long as I have then it’s not the patients that stress you out but some of the staff! Personality issues, poor leadership issues etc.’ (P1591)
Impact on family and social life (14) ‘Questions on your relationships with friend and family. these can be adversely affected by pressures at work.’ (P422)
‘How the job effects your personal life, your relationship with partner family, friends.’ (P822)
Impact of working patterns (13) ‘But it's not the clinical side that does it—it’s the long shifts.’ (P583)
‘More questions about work patterns…working on a 1 in 3 rota is tough and means some months there are only 4 days a month where I'm not physically in work. Whereas on the other side, some nurses can do 4 12/13 hour shifts in a 5 day period. I think that may have an effect.’ (P4)
Challenging relationships with families (8) ‘Nowhere is the behaviour of families included and I think that has a major effect on how staff cope.’ (P596)
‘More questions about interactions with families, this can be a massive source of stress and anxiety.’ (P1445)
Demoralised, under paid and undervalued staff (7) ‘The psychology of feeling completely dispensable, for example, being sent to the wards as soon as we have 1 nurse free. This makes us feel undervalued and unable to recover from the relentless pressure within critical care. We need a higher wage for being dispensable and the skills/risk/burn out we are exposed to, this might actually help with attracting staff and retaining staff.’ (P1164)
‘Topics asking about daily struggles at work due to lack of recognition financially or from the trust.’ (P745)
Education and training (7) ‘Education support and learning packages.’ (P502)
‘Having patients above your skill set and no support.’ (P196)
Patient death and decisions about withdrawal of care (6) ‘Patient withdrawal should be included and patient death.’ (P794)
‘I think it could have gone into more depth regarding patients who are withdrawn from life support and the upsetting process surrounding this matter, especially considering recent highly publicised cases in the media.’ (P621)
Impact of the media (including social media) (6) ‘The greatest issue I have with PICU at present is society’s expectations of what we do… In my opinion recent cases in the media have shown we are treating parents and being vilified in social media at the detriment of the child and doing all in the face of futility is the most disheartening aspect of the job.’ (P614)
‘The effect social media/the press have and the distress they cause staff.’ (P186)
Managerial pressures (3) ‘Would have been good to have a question about management.’ (P941)
‘Questions about management pressures.’ (P7)
  • PICU, paediatric intensive care unit.