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Abstract
Background Irregular patient volumes, high patient transit and limitless presentations means that Emergency Department (ED) handovers differ from other specialities. Therefore, a degree of handover unfamiliarity results for junior doctors.
There is a high prevalence of stress and burnout in both junior doctors and doctors working in Emergency Medicine. Despite this, no literature was identified exploring if handover can be a source of stress. The aim of this study was to explore junior doctors’ perceptions of ED handover and to investigate if it is considered a stressful experience.
Non-probabilistic sampling methods were used to recruit doctors working at or below the grade of Speciality Trainee year 2 (ST2) or equivalent in the ED of a major acute teaching hospital. Qualitative, semi-structured interviews were undertaken between March and April 2019 exploring participants’ experiences of ED handover. Interviews were recorded and transcribed verbatim. Using NVivo 12 software, data were analysed thematically using an inductive-deductive approach.
10 interviews were undertaken and four themes were identified from the data: ‘stress decreases as familiarity increases’ which included familiarising with handover structure, content and purpose; ‘time pressure is an ongoing stressor’ representing the perceived need to efficiently handover during busy periods and at shift end; ‘handover as a solace’ relating to opportunities to both learn and socialise and ‘it’s nice to be nice’ reflecting the importance of civility.
Junior doctors find aspects of ED handover stressful. These include: wanting to make a good impression; unfamiliarity; time pressures and the negative effects of hierarchy. However, handover can also help to ameliorate stress by facilitating opportunities for socialisation, education and morale boosting. Important recommendations for future practice regarding departmental handover can be made, most notably, the need to create a civil and pleasant working environment where doctors can flourish.
Four themes explained
Recommendations for future handovers