Strengthened solidarity in coping
The participants agreed that the crisis had strengthened the solidarity among the GP practice staff, and perhaps also slightly shifted the balance of power between the doctors and the support staff.
'I'm thinking of how we have treated each other. Of how the doctors have treated us, but also how we have treated each other. I feel that everybody has been more considerate and more grateful.' (Participant no. 8)
The staff members described an increased awareness of their own importance and of the role of the GP practice in the management of the crisis.
'We need to acknowledge that we're important. We have shown ourselves to be accommodating and flexible, and that we do the job that's expected of us, no matter what. As long as we march in step and in conformity with the person leading us, that is.' (Participant no 7)
They could clearly see that together they had good tools to face challenges, but also a shared value base and perseverance. Characteristics such as flexibility and stamina were highlighted, but also the care and support they gave each other in a difficult situation. Since all of them could cope with the different job tasks at the GP practice, the absence of some staff members became less consequential.
'I wish to mention the collaboration in the practice. Everybody's ability to adapt, from today onwards we do it like this, tomorrow there could be new plans. These were real challenges, but I for one think that we have done really well through this situation. Yes, with the solidarity between us in the office and the doctors and everyone else, I feel that things have gone well, and it's all been positive.' (Participant no. 5)
All the respondents agreed that their main job was to take care of the patients in the best possible way. As the patients started returning, a number of measures were introduced to reduce the risk of infection in the GP practice. The efforts to ensure the flow of patients were highlighted as particularly important, but also as difficult. The objective was to ensure that a limited number of patients would sit in the waiting room at the same time while waiting for their appointment, blood tests, examination or transport. The management of the waiting room required constant vigilance and gave rise to some logistical challenges.
Healthcare personnel who had been relocated from the physiotherapy service ensured access control to the GP practice for a period of time. Gradually, this function was assumed by volunteers. Patients with fever, respiratory symptoms or abdominal pain were handled in premises that were physically separated from the GP practice.
The staff felt that many of the new procedures were useful and sustainable over time. They wished to continue working in the same way also after the end of the outbreak. The joint morning meeting was highlighted by many as a necessary success criterion for the management of the crisis. Previously, meetings had been held a couple of times per week, but now, the entire staff of the GP practice convened for fifteen minutes before the work started. The brief meeting ensured that everybody was updated regarding the work of the day, as well as any absences. Even more importantly, the meeting reinforced the sense of unity and solidarity between the doctors and the other staff.
'And then we started to have a joint meeting in the morning, where all the doctors and all the office staff attended. I felt that this was a great help, because then we could have a review in the morning. What has happened? How are things developing at the moment? How should we organise ourselves today?' (Participant no. 6)
The interviewees also had some ideas about things that could have been done differently, in particular to divide the doctors and other staff into cohorts to ensure that the practice could continue to operate in case of an infection outbreak among staff member
Even months after the outbreak, daily life in the GP practice is still marked by COVID-19.
'It's not yet normal for us. The question is whether it ever will be, or so I think, regarding the access control, whether they will stand there every day and do a good job. And then there's the matter of disinfecting between each patient, we spend a lot more time on infection control measures. So it's not normal activity in this respect.' (Participant no. 3)