“It’s an Honor and Privilege to Do What We Do”: A Qualitative Study of Professionalism Among Physicians and Nurses During the COVID-19 Pandemic

Goal: Solutions to address healthcare worker well-being since the COVID-19 pandemic have been tested with varying acceptance and effectiveness. Little is known about how the values underpinning medical professionalism might be leveraged to support healthcare workers during a public health emergency. We sought to characterize the experiences of frontline physicians and nurses during the pandemic through the lens of medical professionalism and identify potential levers that could be activated in future emergencies to better protect the healthcare workforce. Methods: We conducted semistructured interviews with 23 physicians and nurses who worked in emergency departments, ICUs, or other acute care settings at two urban teaching hospitals at the start of the pandemic. Interviews were conducted in spring and summer 2022, and were audio recorded, transcribed, and thematically analyzed. Principal Findings: Three themes emerged reflecting different orientations of professionalism that helped clinicians persevere through the pandemic but were also threatened by the most challenging stages of the pandemic: (1) the call of duty to a greater good (service orientation); (2) a shared identity as a specialized professional (team orientation); and (3) the ability to maintain a human connection with their patients (humanistic orientation). These central orientations of professionalism helped healthcare workers to continue providing care during the pandemic by focusing on achieving a greater good in the face of unprecedented challenges, accessing a shared identity with other healthcare workers to find peer support and maintain a sense of pride in their work, and finding ways to connect on a personal level with patients and families despite strict isolation requirements and fear for personal safety. When these values were not realized, or when they were noticeably absent, healthcare workers felt discouraged, abandoned or alone, and burned out. Practical Applications: Leveraging common aspects of medical professionalism during a public health emergency may help healthcare workers find meaning in their work and mitigate feelings of burnout. Simple actions, such as maintaining a leadership presence on the floors, encouraging peer-to-peer activities or huddles, and acknowledging the need for human connection, are likely feasible to implement during an emergency and effective at fostering a sense of professional community that could buoy healthcare workers during extremely challenging times.