The current scenario, characterized by healthcare pressure and emotional overload, leads to many critical situations and with varying degrees of impact on the professionals.

In the country as a whole, some hospitals are treating a manageable number of patients, while other are overwhelmed by the number of confirmed COVID-19 cases.

This website concentrates the experiences and recently published literature on the SARS-CoV-2 pandemic. It also includes the resources conceived by professionals with expertise in the management of COVID-10 patients, middle management of healthcare institutions, and members of the Spanish research team on second victims.

The classification of the pressing situations identified meets the following categories:

Detailed description of the pressing situations identified by category:

馃懁Helplessness when witnessing reckless behaviours from patients and people who accompany them (usually due to unawareness) and mistakes among professionals (from tiredness, stress, etc.):

  • Involuntary errors are possible (which may lead to adverse events) or those made other professionals during patient care.
  • Feel helpless, irritable, and doubting your own ability, which leads to other risk situations for the patients.
馃懁Powerlessness and disaffection at seeing how patients who are afraid of being sick with COVID19 have to be alone, unaccompanied and, in some cases, die in solitude. This situation is having a profound impact on professionals.

馃審 Work in an environment of particular biological risk.
  • This risk can also affect other patients, colleagues and family members. 
馃審 Express substitutions for the loss of colleagues in isolation at home or resulting in cases with COVID-19.

馃審 Be overflown for periods of time that are increasing.
  •  Wanting to not appear weak or incapable to provide an answer all the time.
馃審 No clear horizon of “how long this is going to last”.

馃搶 Fear, and occasionally panic, when finding out a colleague is under passive surveillance or kept in isolation at home.

馃搶 Fear of infecting a family member and/or a close acquaintance.

馃搶Minimize symptoms that may indicate contagion by pressure to not leave services uncovered.

✋Be temporarily working in healthcare settings for which no appropriate training has been provided.
  • New recruitment specific for the crisis or transfers to more complex healthcare facilities and higher biological risk subjected to healthcare needs.
Receive instructions, sometimes contradictory, on the control of risks and procedures (with no clear assignment of tasks).
  • Inconsistencies in the chain of command and individual proposals regarding the use of personal protective equipment (use of facemasks and personal protective equipment (PPE)). 
  • Shortage of material for offering the appropriate care to all patients and reduce the risk of infection.
Reduction in the number of human resources, due to leave of professionals under risk exposures.
  • The working time is extended, frequency of shifts increased, and the periods of physical and mental rest reduced. 
  • Tasks for which specific training has not been received are assumed or are carried out after express training. This may cause insecurity.
Dissolution of stable work teams
  • Incorporation of new professionals, which changes the dynamics of the work group.
  • Overloading of more experienced professionals.
Patients with other pathologies cannot receive the care they had been receiving.
  • Over-the-phone care is provided, which increases the risk of adverse events in many cases due to the omission of actions and low probability of detecting it.
A different perspective from residents
  • They are not under the wing of the consultants but placed in a different situation regarding clinical attitude.
Pre-crisis conflicts between team members
  • Previous conflicts may surface now because of the task distribution in extreme situations.

馃敤 Be obliged to make patient triage and other decisions reserved for major catastrophes that imply relevant ethical matters.

馃敤To face the decision to prioritize levels of attention, generating a new organizational situation unknown until now.