How Swedish healthcare workers managed the early weeks of the COVID-19 pandemic: sensemaking across organisational, interpersonal and individual levels

Background In times of crisis the need to make sense of the situation becomes particularly evident. The perspective of sensemaking captures how individuals seek to clarify and understand what is going on when they encounter ambiguous, unexpected or confusing events, such as the COVID-19 pandemic. Sensemaking may occur at different but mutually interrelated organisational, interpersonal and individual levels. During the COVID-19 pandemic, healthcare workers (HCWs) faced multifaceted challenges related to their work. This study aimed to explore how HCWs managed their daily work during the early weeks of the COVID-19 pandemic through the perspective of sensemaking across organisational, interpersonal and individual levels. Method The data was collected through individual interviews with 18 nurses and physicians between March and May 2020, and analysed using a reflexive thematic analysis. Findings The analysis revealed an overarching pattern of sensemaking as a way of holding clinical practice together throughout uncertainty. At an organisational level, sensemaking included how organisational structures contributed to stability in the organisation of work. The interpersonal level captured how understanding of uncertain circumstances was grounded in a collective understanding wherein HCWs reflected together and in relation to others. The individual level of sensemaking captured HCWs´ capability and commitment to continuing to provide care, despite uncertain circumstances. Conclusions/Implications The findings imply that sensemaking at organisational, interpersonal and individual levels is an important consideration for healthcare organisations when facing future crisis or other uncertain events. Clear organizational directives are important for fostering a shared understanding of how uncertain situations should be interpreted and managed in practice. Furthermore, HCWs need opportunities and time for interaction with colleagues, enabling them to collectively construct meaning and maintain a sense of stability when managing uncertainty. It is also important to acknowledge HCWs´ individual knowledge, experiences and capability to sustain clinical practice despite conditions of uncertainty.