Table 2

Five R3P themes and their potential discussion points

ThemeExamples of group discussion points
Morally challenging decisions
  • Consequence of limited resources, lack of equipment, staff shortages.

  • Managing risk: the balance of one’s own health with that of patients.

  • Delivering a different quality of care, as good as it could be but not good enough.

  • Perceptions of end-of-life care and ability to deliver it.

  • Wanting to do more for patients and for the national response.

  • Dealing with the wishes of patients and family members.

  • Guilt associated with an individual leaving their own family, supporting their family while absent and posing a risk on return.

Vulnerability
  • Anxiety and fear during the response.

  • Realisation of risk to self and thoughts about care pathway.

  • Fear of family’s vulnerability and of infecting them.

  • Hearing about healthcare workers contracting COVID-19.

  • Hypervigilance about symptoms and trust in PPE.

  • Contagion outside workplace.

  • Discomfort of PPE.

Death and suffering
  • Dramatic deterioration caused by the illness and the effect on preparedness.

  • Sense of powerlessness, acknowledging what was possible to achieve but also what was not.

  • Caring for patients and learning their stories.

  • Caring for relatives, delivering bad news and facilitating final conversations.

  • Relatives unable to be with dying family members.

  • Impact on children.

  • Connecting laboratory samples to patients.

  • Guilt about not doing more, making an impact, being part of a global response.

  • Messages of thanks.

Professional and personal challenges
  • Camaraderie, openness, inspirational colleagues, sharing common purpose, learning from each other.

  • Contribution to global effort.

  • The media, public perception, symbols of support.

  • Intense workplace, time spent in red zone - tension, emotion.

  • Communication within organisation.

  • Agreed length of time on task.

  • Correct kit, concerns about protecting safety.

  • Slow processes and bureaucracy, working conditions.

  • Downtime: adequate or inadequate, limited range of things to do, feeling isolated, moral obligation to return to work.

  • Not disclosing worrying information to family, providing reassurance, additional worries from home, effect of bad news on families.

Expectations/post-traumatic growth
  • Deflation on leaving the team, missing friends, missing the experience.

  • Returning to mundane day jobs, sense of unfinished business.

  • Others could not possibly understand, people too interested.

  • Being avoided by others for fear of contagion.

  • Growth at professional level, new skills, experience.

  • Growth at personal level, increased confidence, greater appreciation.

  • New career options.

  • Networking.

  • PPE, personal protective equipment; R3P, Recovery, Readjustment and Reintegration Programme.