'Worth … the Nightmares'? A Qualitative Study of Early-Career Healthcare Workers' Wellbeing and Career Decisions After Starting Work During Covid-19.

BACKGROUND

The Covid-19 pandemic placed unprecedented pressure on healthcare systems, education and individual professionals-notably, newly qualified front line nurses and paramedics. While we know wellbeing was negatively affected, qualitative exploration of workplace experiences and how these impact wellbeing and shape career decision making is lacking. This is a critical gap in the literature, given the current healthcare workforce crisis and a need for evidence-based educational reform to better support learners in the workplace. This study explores the experiences of nurses and paramedics during the pandemic and how these influenced wellbeing and career decision-making.

METHODS

We adopted an interpretivist, qualitative approach, and conducted semi-structured interviews with seven newly qualified nurses and two senior paramedics. We utilised reflexive thematic analysis to explore and analyse data, considering the impact of starting work during Covid-19.

FINDINGS

Our findings demonstrated the significant impact of the pandemic on wellbeing and career decision-making. Key issues included a turbulent transition into practice, shaped by increased clinical pressures (including high patient numbers, and workforce shortages) and reduced support at organisational and interpersonal levels. Participants described a shift in career values, with greater emphasis on wellbeing as a determinant for job decisions. Many reported re-evaluating their careers, prioritising roles or teams that offered better support and manageable workloads, or considering leaving healthcare altogether.

CONCLUSION

This study suggests a need for educational policy and practice to consider how workplace experience impacts wellbeing and career decision-making. Beyond indicating the need for further research, this study acts as a critical conversation regarding future workforce planning.