National review of end-of-life care withdrawal guidelines for non-invasive advanced respiratory support using document analysis.

Objectives: This study aims to understand the breadth of practice around end-of-life withdrawal of non-invasive advanced respiratory support (encompassing both continuous positive airway pressure and non-invasive ventilation) by analysing NHS-published guidelines and guidance for clinicians. This study seeks validity in the guidelines through a confluence of findings and reassurance of practice despite having little to no high-quality research to inform the content of the guidelines. Ultimately, where discordance is found between guidelines, there will be a strong mandate for future research.

Can compassionate leadership of senior hospital leaders help retain trainee doctors?

Background: High burnout and low retention rates among trainee doctors threaten the future viability of the UK medical workforce. This study empirically examined factors that can sustain trainee doctors.

Method: A total of 323 trainee doctors from 25 National Health Service (NHS) Trusts in England and Wales completed an online survey on their training and employment experiences.

Role of coproduction in the sustainability of innovations in applied health and social care research: a scoping review.

Background: Innovations such as toolkits and frameworks are developed through applied health and social care research, to address identified gaps in quality or safety of care. The intention is to subsequently implement these innovations into practice to bring about improvements. Challenges can arise from poor choice of implementation strategies or lack of alignment to local contexts.

"They say they listen. But do they really listen?": A qualitative study of hospital doctors' experiences of organisational deafness, disconnect and denial.

The sharing of information and feedback directly from service-providing staff to healthcare organisational management is vital for organisational culture and service improvement. However, hospital doctors report feeling unable to communicate effectively with management to provide evidence and affect improvement, and this can impact job satisfaction, workplace relations, service delivery and ultimately patient safety. In this paper, we draw on data elicited from a Mobile Instant Messaging Ethnography (MIME) study involving 28 hospital doctors working in Irish hospitals, to explore the barriers preventing them from speaking up and effecting change, and the impact of this on staff morale and services.

Feeling like the enemy: the emotion management and alienation of hospital doctors.

Introduction: Globally, an epidemic of psychological distress, burnout, and workforce attrition signify an acute deterioration in hospital doctors' relationship with their work-intensified by COVID-19. This deterioration is more complicated than individual responses to workplace stress, as it is heavily regulated by social, professional, and organizational structures. Moving past burnout as a discrete "outcome," we draw on theories of emotion management and alienation to analyze the strategies through which hospital doctors in the face of resource-constraints and psychological strain.

A catalyst for change: Developing a collaborative reflexive ethnographic approach to research with hospital doctors during the COVID-19 pandemic.

The understanding of what ethnography looks like, and its purpose, is continuously evolving. COVID-19 posed a significant challenge to ethnographers, particularly those working in health-related research. Researchers have developed alternative forms of ethnography to overcome some of these challenges; we developed the Mobile Instant Messaging Ethnography (MIME) adaptation to ethnography in 2021 to overcome restrictions to our own research with hospital doctors.

Employee silence in health care: Charting new avenues for leadership and management.

Issue: Health care management is faced with a basic conundrum about organizational behavior; why do professionals who are highly dedicated to their work choose to remain silent on critical issues that they recognize as being professionally and organizationally significant? Speaking-up interventions in health care achieve disappointing outcomes because of a professional and organizational culture that is not supportive.

Critical Theoretical Analysis: Our understanding of the different types of employee silence is in its infancy, and more ethnographic and qualitative work is needed to reveal the complex nature of silence in health care. We use the sensemaking theory to elucidate how the difficulties to overcoming silence in health care are interwoven in health care culture.

'Today Was Probably One of the Most Challenging Workdays I've Ever Had': Doing Remote Qualitative Research with Hospital Doctors During the COVID-19 Pandemic.

In this article we outline how a team of qualitative researchers responded to the challenging circumstances of the COVID-19 pandemic, describing how we successfully and speedily adopted remote/digital methods to research the experiences of hospital doctors. In 2020, we used Zoom to conduct qualitative interviews with 48 hospital doctors; in 2021, we used Zoom and WhatsApp to conduct a Mobile Instant Messaging Ethnography with 28 hospital doctors. We explain how we adapted to a virtual setting and provide clear insights (case study vignettes) into the additional demands on researchers and respondents, in particular, the impact on the research team.

'…the way it was staffed during COVID is the way it should be staffed in real life…': a qualitative study of the impact of COVID-19 on the working conditions of junior hospital doctors.

Objectives: COVID-19 has prompted the reconfiguration of hospital services and medical workforces in countries across the world, bringing significant transformations to the work environments of hospital doctors. Before the pandemic, the working conditions of hospital doctors in Ireland were characterised by understaffing, overload, long hours and work-life conflict. As working conditions can affect staff well-being, workforce retention and patient outcomes, the objective of this study was to analyse how the pandemic and health system response impacted junior hospital doctors' working conditions during the first wave of COVID-19 in Ireland.

"I feel I have no voice": hospital doctors' workplace silence in Ireland.

Purpose: Workplace silence impedes productivity, job satisfaction and retention, key issues for the hospital workforce worldwide. It can have a negative effect on patient outcomes and safety and human resources in healthcare organisations. This study aims to examine factors that influence workplace silence among hospital doctors in Ireland.

"We All Really Need to just Take a Breath": Composite Narratives of Hospital Doctors' Well-Being during the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic poses a challenge to the physical and mental well-being of doctors worldwide. Countries around the world introduced severe social restrictions, and significant changes to health service provision in the first wave of the pandemic to suppress the spread of the virus and prioritize healthcare for those who contracted it. This study interviewed 48 hospital doctors who worked in Ireland during the first wave of the pandemic and investigated their conceptualizations of their own well-being during that time (March-May 2020).

COVID-19 and doctor emigration: the case of Ireland.

Background: Since the 2008 recession, Ireland has experienced large-scale doctor emigration. This paper seeks to ascertain whether (and how) the COVID-19 pandemic might disrupt or reinforce existing patterns of doctor emigration.

Method: This paper draws on qualitative interviews with 31 hospital doctors in Ireland, undertaken in June-July 2020.

Hospital doctors in Ireland and the struggle for work-life balance.

Ireland has a high rate of doctor emigration. Challenging working conditions and poor work-life balance, particularly in the hospital sector, are often cited as a driver. The aim of this study was to obtain insight into hospital doctors' experiences of work and of work-life balance.