Gender Matters: A Gender Analysis of Healthcare Workers’ Experiences during the First COVID-19 Pandemic Peak in England
1.1. Our Approach to Gender
1.2. Gender and Healthcare Workers
1.3. Gender and the National Health Service
Data Extraction and Analysis
3.1. Division of Labour
3.3. Burden on Nurses
3.5. Mental Health Support
3.6. Leadership and Decision-Making
3.7. Beliefs and Values
3.8. Gender and Sexism
3.9. Caring Responsibilities
3.10. Pregnant Healthcare Workers
4.1. A Feminized Burden of COVID-19 Care
4.3. The Stretching of Nurses
4.4. The Ideal Worker
4.5. Pregnant Healthcare Workers and the Othering of the Maternal Body
4.6. Gender Blindness
4.7. Gender Matters
4.8. Supporting our NHS Heroes
4.9. Strengths and Limitations
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A. Interview Guide
- Background: Can you tell me about your role?
- Can you tell me a bit about your role? (e.g., Daily tasks, department, responsibilities)
- Have you been in contact with patients who had suspected and/or confirmed COVID-19?Probes:
- In what capacity?
- How have you found working around these patients?
- PPE physical effects? (e.g., dehydration, discomfort, restriction in movement, difficulties communicating)
- How has PPE impacted the type of care you provide patients?
- What psychological/emotional impact did this have on you?
- How has the COVID-19 outbreak affected health services in your department?Probes:
- How has this affected your normal daily tasks/responsibilities? Change of role?
- Impact of COVID-19 on the delivery of services to non-COVID-19+ patients (i.e., cancellation of elective surgeries)
- What tasks are you able to do more or less effectively?
- How do you manage the isolation of suspected cases and confirmed cases?
- Has there been appropriate transfer of patients within and out of hospital?
- Has there been an impact on staff’s ability to make diagnoses and act on them?
- Has the supply of drugs, equipment and PPE been affected?
- Have staff been redeployed from or within your health facility
- What were the preparedness strategies implemented locally (department, hospital or Trust)?
- Did you feel these strategies were enough?
- What do you feel was particularly successful?
- Should the Trust have prepared differently?
- Did you receive any training? (including but not limited to PPE training such as mental health and well-being training)
- Did you have access to guidance on PPE?
- Do you currently have any concerns or fears in relation to…
- Work (response efforts, PPE, services)
- The national effort
- Over the past months, have you experienced any problems with aspects of your daily life such as sleeping, eating, concentration, or additional worries or anxiety?
- Mental health support (to address risk of moral injury, trauma and developing severe mental health problems)
- Are you aware of any support available for staff wellbeing and mental health?
- Have you had the opportunity to talk about your mental health with your supervisor/team leader?
- Have you had worrying experiences in the last week? Did you receive support after? If so, what type of support? (including formal and informal support)
- Interactions between peers: Do you have time to socialise with your team? What has changed with COVID-19?
- Have you been involved in caring for patients who are dying or expected to die soon?
Ask about each of these specifically:
- (If relevant based on previous discussion) Can you please tell me about the palliative care tasks you are involved in with COVID-19 patient?
- Advanced care planning
- Symptom management and patient comfort at end of life.
- End of life decision making (e.g., triage of limited equipment)
- Working with families (e.g., updating on health, organising visits)
- How have you found these tasks? (e.g., difficulties? patients’ reactions? preparedness? what works well?)
- Was this part of your normal role prior to COVID-19?
- What difficulties have you faced in these tasks?
- How does this differ to normal palliative care?
- How much choice do patients have?
- What are the rules/policies relating to this? Do you feel these are suitable?
- Was there training or support available relating to this?
- Do you feel this has had an emotional impact on you?
- What do you feel is most important to offer COVID-19 patients at end of life and their families?
- What is working well?
- What should we do more of?
- What can we improve?
- What support do we need to offer HCW delivering palliative care?
- Do you have any concerns for the future?
- Are you able to offer bereavement support to families?
- OTs/PTs and others in charge of rehab: What are your main concerns about the impact of COVID-19 on the body (e.g., muscle degeneration, dexterity, impact to the lungs etc.)?
- What resources do you have to deliver rehabilitation care? - ask their opinions on the Mary Seacole rehab hospital
- Is there a difference in resources for COVID-19 and non-COVID-19 patients?
- did you feel prepared to deliver respiratory care?
- (If relevant based on previous discussion) Can you please tell me about the rehabilitation care tasks you are involved in with recovered COVID-19 patients?
- Have you received any guidance on how to deliver rehabilitation services to recovered COVID-19 patients?
- do you feel prepared to deliver this care?
- do you have any concerns about capacity to deliver this care?
- OT: How does this differ from normal rehabilitation care, e.g., delivering care at home?
- OT: How has COVID-19 impacted your contact with patients?
- Has the pandemic impacted the flow of your patients through hospital e.g., are more or less patients being discharged to homes and bed-based rehab?—What is the impact of this?
- How do you think your role will be impacted as a growing number of people will need rehabilitation? Any concerns?
- What criteria do you use to decide to discharge a covid patient?
- Where do patients usually get discharged (e.g., home or rehabilitation centres?
- How do you communicate to patients and their families the care they will need?
- How have health services been strengthened, or how could they be strengthened during the outbreak?Probes:
- Support to HCWs from the health system and partners?
- Capacity for rapid response
- Policies? e.g., Guidance and emergency protocols?
- What would help HCWs to maintain normal services as well as COVID related services?
- If GP: Health promotion and community engagement. How?
- If GP: Linkage to other support organisations, e.g., charities, schools?
- Is there anything you feel should be changed to make health services more effective in future emergencies?Probes:
- Support to HCWs? From whom and How?
- Coordination and official guidance of COVID-19 response.
- Early detection and reporting.
- On-going health promotion and community education, e.g., potential sources of infection, safe practice?
- Mobilisation? e.g., identifying and coordinating trusted community volunteers and support?
- Disease outbreak control activities?
- Testing (public and staff)
- Do you feel your experience has been different from other HCWs? Does gender play a role? How about ethnicity?
- How has your life at home been impacted by COVID-19?
- Do you have any caring responsibilities, such as children or elderly family members?If yes:
- How are you managing care during the COVID-19 pandemic?
- (If they have children) How has being a HCW during the pandemic impacted your ability to parent?
- What fears, worries, or emotions arise from the responsibility of caring for others during this time?
- Are you pregnant?
- If so, how has this impacted your work and experience as a HCW during the COVID-19 pandemic?
- Is there anything else you would like to mention that you feel is important?
Appendix B. Coding Framework
- Access to resources (training and preparation)
- Beliefs and values
- Burden on nurses
- Caring responsibilities
- Coping strategies
- Division of labour at home
- Division of labour at work (care work and emotional labour)
- Emotions (guilt; worries, concerns, anxieties)
- Gender differences (lack of an impact of gender)
- Impact of ethnicity
- Impact on career development
- Impact on home life
- Leadership and decision-making
- Media and social media
- Protection of staff
- Social norms and ideologies
- Social support
- Team and co-worker dynamics
- Work/life balance (changes to working patterns)
Appendix C. Vignette of a Pregnant Healthcare Worker
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|White and Black African||2|
|White and Asian||2|
|Allied Health Professionals||13|
|Pregnant (or recently pregnant)||4|
|London Trust 1||14|
|London Trust 2||21|
|Other NHS Trust||2|
|Years in Service|
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Regenold, N.; Vindrola-Padros, C. Gender Matters: A Gender Analysis of Healthcare Workers’ Experiences during the First COVID-19 Pandemic Peak in England. Soc. Sci. 2021, 10, 43. https://doi.org/10.3390/socsci10020043
Regenold N, Vindrola-Padros C. Gender Matters: A Gender Analysis of Healthcare Workers’ Experiences during the First COVID-19 Pandemic Peak in England. Social Sciences. 2021; 10(2):43. https://doi.org/10.3390/socsci10020043Chicago/Turabian Style
Regenold, Nina, and Cecilia Vindrola-Padros. 2021. "Gender Matters: A Gender Analysis of Healthcare Workers’ Experiences during the First COVID-19 Pandemic Peak in England" Social Sciences 10, no. 2: 43. https://doi.org/10.3390/socsci10020043