Challenges to Well-Being in Critical Care: What Leaders Need to Know
Staff well-being in critical care is undermined by moral distress, poor team leadership, chronic staffing shortages and unmet basic needs — with psychologically informed environments identified as essential for sustainable workforce retention.
Context
To understand the specific challenges to workplace well-being in paediatric critical care (PCC) in order to inform the development of targeted staff interventions that improve and maintain well-being.
Outcomes included:
- Critical incidents and challenges to well-being
- Factors that helped and hindered staff in difficult moments
- Impact of COVID-19 on PCC working environment
- Role of teamwork and leadership in staff experience
- Influence of staffing shortages and workforce demographics
Methods
- Enhanced Critical Incident Technique (ECIT) used as the study design.
- Semi-structured interviews conducted with 53 consented nurses and doctors from a large UK quaternary PCC unit.
- Thematic analysis applied to identify critical incidents and categorise challenges to well-being.
- Factors that helped and hindered staff in challenging moments were systematically identified.
Outcome measures:
Thematic synthesis of critical incidents; identification of helping and hindering factors; resonance with self-determination theory and Maslow's hierarchy of needs.
Results
- Five themes identified: (1) Context of working in PCC — including the amplifying effect of COVID-19; (2) Patient care and moral distress — caring for increasingly complex and chronically ill patients created significant psychological burden; (3) Teamwork and leadership — team-belonging and clear, visible leadership were protective factors for well-being; (4) Changing workforce — staffing shortages and an ageing workforce compounded existing pressures; (5) Satisfying basic human needs — absence of adequate food, rest and recovery time was a recurring and underappreciated challenge.
- Findings resonated with self-determination theory and Maslow's hierarchy of needs, framing well-being as dependent on meeting both psychological and physiological requirements.
- Recommendations included flexible rostering, advanced communication training, psychologically informed supervision and mentoring, and provision of adequate accommodation and hot food.
MORE FROM THIS CATEGORY
Value-Based Payment Models and the Quiet Threat to Independent Practice
A JAMA viewpoint argues that value-based payment models — despite their quality and cost-containment intentions — are inadvertently accelerating corporate consolidation of healthcare, placing independent practices at a structural disadvantage and raising serious questions for policymakers about the future of clinician-led care.
Physician and Nurse Well-Being: What Clinicians Actually Want Leaders to Do About Burnout
A large-scale survey of over 21,000 physicians and nurses across 60 US hospitals found burnout rates of 32% and 47% respectively — and a striking consensus that management action on staffing and work environments matters far more to clinician well-being than wellness programmes or resilience training.
GET IN TOUCH
Expertise. Leadership. Outcomes.
Let's Build the Right Solution Together
Schedule a free, no-obligation discovery call to discuss your requirements and how we can support you.