Intensive care during COVID 19 – stress, collaboration and safety climate

Background and objective

The COVID 19 pandemic has put society, and healthcare, under pressure. In some hospitals the number of patients in the Intensive Care Units (ICU) have increased with several hundred percent over a few weeks. Studies from China suggest that healthcare staff have suffered psychologically by stress at work.

New ICU wards staffed partly by professionals without intensive care background has been necessary to meet the needs in intensive care. The new staff has after a very short introduction cared for patients with support of intensive care professionals (doctors, nurses and nurse assistants).

Challenges regarding work environment have been huge including stress, worries, conflicts, risks of harmful mistakes and exhaustion.  Scheduling has at some hospitals been changed to longer and more frequent shifts as well as frequent changes of shifts. 


To map and analyze work strain, stress including ethical stress, stressors, communication/collaboration and perception of teamwork- and safety climate in all professional groups involved in intensive care of COVID 19 patients during and after the pandemic. Knowledge gained in the study will be used for better understanding of stressors contributing to work related illness, factors protecting from stress and hopefully gain tools to prepare for the next pandemic.


Cohort, multisite


During the first wave of COVID 19 pandemic: Data on staff reactions regarding stress, communication/collaboration, teamwork- and safety climate will be collected using validated questionnaires (Oldenburg Burnout Inventory and The Safety Attitudes Questionnaire ICU version) and open-ended questions. After the first phase of the pandemic: Follow-up questionnaire as above and semi structured interviews with staff and managers to gather data on stressors, coping and recovery.

Ethics and dissemination

The study has been approved by the Swedish Ethical Review Authority (DNR: 2020-02370) and will be conducted in accordance with the ethical principles of the Declaration of Helsinki. All participants will sign a consent form and receive written information about the study. Participants recruitment began in June 2020 and will end when the pandemic has petered out. We aim to publish results in open access scientific publications and at scientific conferences and meetings.


Lisbet Meurling, MD, PhD, Perioperative Medicine- and Intensive Care, Karolinska University Hospital.

Content reviewer:
Åsa Catapano