Chapter 1

Problem and Its Setting

Background of the Study

The world has not seen a pandemic like covid-19, which swept rapidly around the globe

over the last nine months. Medical workers—some laboring in challenging conditions and

without enough personal protective equipment—say they have done their best to save as many

patients as possible. Still, the death toll continues to rise. With more than one million deaths,

covid-19 has become one of the deadliest viruses in history. It first appeared in Wuhan, China,

and has spread to virtually all countries around the world. Some of its worst effects were felt as

far away as Brazil, Italy, and the United States. (Farr, 2020)

People in the countryside such as Sao Paulo, Brazil have been led astray by a lack of

leadership, which led to many people not wearing masks or keeping their distance from others

socially. Which has now reported roughly 4.7 million coronavirus cases and more than 140,000

deaths. (Farr, 2020)

Nurses and Doctors in Wuhan, China as front-line workers during the COVID-19

pandemic, can provide important information about their hands-on experience to address an

infectious outbreak like COVID-19. Medical Workers' concerns about their well-being and the

well-being of their patients have implications for education, particularly in the time of a
pandemic when medical workers’ own personal health is at stake. Simultaneously, organizational

factors that enable Nurses, Doctors, and Medical technicians to provide care to patients with

confidence are also being considered. (Wiley et al., 2022)

Nationwide, medical workers have been stressed and overwhelmed with challenges due

to the covid-19 pandemic crisis. Nurses and doctors have shown amazing medical efforts and

sacrifices to help their patients who need medical attention amidst the difficulties and lack of

resources. This represents the hard work and dedication of the healthcare workers in combating

and ending the illness in our country. (Sadang, 2020)

Most reports regarding challenges of medical workers have always been focused on their

health issues such as depression, burnout (overworked), and also stressors that may cause them

to not do their job properly, though it is also essential to look into their rights, freedoms, and

financial conditions as this define their decision to partake in covid-19 responses in the

Philippines. During the pandemic, many Filipino nurses resigned and/or migrated to other

countries for better opportunities, affecting our healthcare system greatly. (Alibudbud, 2022)

In the Philippines, Christmas to New Year seasons have been the happiest and most

festive time of the year but during this time it will be a predicament for medical workers

especially due to the Coronavirus Pandemic which strives to spread during large gatherings. This

leads to a surge of people getting hospitalized especially when health protocols are not followed.

(Lagman, 2021)
 Locally, it has been reported by several hospitals, that many of the staff and nurses have

left their job due to the hardship and low wages from risking their lives. With the surge of covid

and the lack of medical workers, the number of waitlisted covid patients has been steadily on the

rise. This is a major threat to the health system of our city, mainly because we don't have enough

resources to cope with the pandemic. (Rebollido, 2021)

Review of Related Literature

Common Struggles among medical workers in Covid-19 facility

The COVID-19 pandemic has left the rest of the world with significant mortality rates as

well as psychological issues. Medical practitioners working in assisted living facilities, large

tertiary care centers, community hospitals, and all isolation units experience hysteria, dread, and

anxiety as a result of a mass quarantine. Medical professionals who are exposed to and in close

contact with proven and suspected coronavirus infections are at risk for developing a serious

infection as well as mental health issues such as anxiety, fear, and stress. Aside from the

significant danger of infection, poor protective gear, isolation, weariness, and a lack of family

contact.(Mukhtar, 2020)

The harshness is contributing to further mental health issues that have a negative long-

term impact on the general well-being of medical professionals as well as their capacity to make

decisions.(Mukhtar, 2020)

Precautions taken by medical workers

The rise in COVID-19 cases has created anxiety among medical workers; they worry that

by taking care of infected patients, they might bring the virus home to their loved ones. This
remains a top priority for medical workers, leaving them wondering: How do I keep my family

safe after caring for patients infected with the COVID-19 virus? Many medical workers do not

know what kind of disinfection has to be done before coming home and greeting their loved

ones. In trying times like this, we must find ways to keep ourselves and our families safe. (Berg,

2020)

The most important step is not what you do when you get home, but what you are doing

at work is what is really going to count. Whether you work at a hospital, clinic, or a small

practice, it is important to take precautions during your work; this will help minimize your risk

of exposure to the virus and, in turn, will also keep your loved ones safe. The wearing of masks,

gowns, gloves, and droplet protection is a good example of taking precautions at work. It is also

important to make sure that everybody who comes to work is properly screened for any sort of

fever or symptoms of the virus. (Berg, 2020)

Wearing of PPEs protect us from the virus, but that does not mean you are 100 percent

safe from the virus. Another thing we can do is wash our hands carefully, before you leave work,

or before you enter your house it would be reasonable to wash your hands carefully before

greeting your family. Medical workers need to be diligent in wearing protection, washing hands,

and not touching their face. These are the most important things that medical workers can do to

avoid infecting their families and loved ones. (Berg, 2020)

While social distancing is important for both our own safety and our family's safety, It is

important to not completely separate ourselves from our loved ones because this is not necessary

if you take the right precautions. Being isolated from your loved ones for a long period of time is
also not good for your mental health. During times like these, we need our family to obtain

optimal mental health while facing the challenges brought by the COVID-19 virus. (Berg, 2020)

Support for medical workers during the pandemic

Medical workers play a vital role in our fight against the pandemic, but providing care for

COVID-19 patients can also lead to stress, anxiety, and fear. Witnessing life-threatening or

traumatic events could impact everyone in a different way. How you cope with these emotions

also matters, because this could affect your well-being, the care you give to your patients, and

your loved ones. (Centers for Disease Control and Prevention, 2021)

These are some of the ways you can cope with the stress and fear of being a frontliner

during a pandemic. Communicate with your peers, talk openly with them about the stress that

you are all experiencing, and work together to identify a solution. Accept that some of the

unfortunate things that are happening are out of your control. Remember that you are a crucial

part in fighting the pandemic and that you are doing your best with what you have. (CDC, 2021)

Low salaries during the pandemic

A year into the pandemic, nurses in the Philippines have been quitting their jobs and

moving to other countries in search of a better life. This has caused a shortage of nurses in

hospitals all around the nation, and the most common reason for their leaving is low salaries.

Their low wages cannot support their necessities, and some nurses do not receive any benefits in

spite of treating people with infectious diseases that can affect their health and safety.(Alibudbud

,2020)

The government of the Philippines has made questionable actions with regard to Filipino

nurses who are planning to earn a living abroad for a better life. They have limited the number of
nurses who can go abroad, disregarding their rights. However, if we do not do this, we may not

have enough manpower to combat the pandemic.The government also said that they would give

additional compensation for those who are working at the frontlines against the pandemic, but

until now it seems that the situation has remained the same as how we started. Low wages, bad

support from the government, and struggles as a nurse.(Alibudbud,2020)

Preventing medical errors made by medical workers

Nurses described the medication errors after removing an infusion with the incorrect

concentration from supplies left in patients’ rooms. Various drug concentrations may be

accessible for one patient in response to essential fluid limitations owing to renal and/or heart

failure. Several infusion mix-ups have occurred commonly, as well as programming errors and

titration errors. Numerous errors arise when the incorrect concentration of fentanyl was

administered. Many mistakes were made, frequently as a result of using an infusion bag of

fentanyl that had been left in the patient's room's closet or drawer. Nurses also describe titration

errors when the patient continued to spiral downward, with no response to the norepinephrine

titration, and subsequently died.

Covid-19 is proving to be a long and difficult battle, with a conclusion that is barely

visible on the horizon.These are some recommendations for medical workers to avoid errors,

which is to Identify errors during the pandemic. Medical workers must maintain trustworthiness

and credibility with each other. The reporting system must be confidential, clear, and easy to use,

as well as useful. Preventing errors during the pandemic: Time is an extremely valuable resource

during a pandemic spike, but after it has been reported and investigated, certain actions can be

taken to reduce the likelihood of a medical error. Avoiding blaming attitudes during the
pandemic, following safeguards is a must as recommended by the Centers for Disease Control

and Prevention to prevent the spread of COVID-19 infection and to avoid harming the lives of

others. Medical workers need to demonstrate trust, respect, and appreciation for the workforce.

Solutions in avoiding future pandemics

Deforestation and wildlife trade plays a big role in the development of pandemics,

COVID-19 was caused by the consumption of a bat in China and around two viruses a year have

come from animals to humans, and their "hotbeds" are located in areas where part of the forest

are gone due to deforestation.(Dobson, 2020 )

Around 22 Billion Dollars a year is the fund that can effectively help us to avoid another

pandemic. These funds will focus on programs that will educate people regarding the trading of

endangered or dangerous species, improve monitoring of forests from deforestation and wildlife

trade worldwide, observe and prepare for any new diseases transmitted by animals, and many

more. This is just a small amount compared to the 10-20 Trillion Dollars we estimatedly lost.

(Dobson, 2020)

Handling Severe COVID-19 Patients

In order to maintain patient care during the ongoing COVID-19 pandemic, medical

professionals are assigned to evaluate and treat COVID-19 patients. Their condition is a threat to

the system due to the high prevalence of severe acute respiratory syndrome coronavirus 2

(SARS-CoV-2) infection among medical workers. They are in touch with severely infected

patients, often with family members, friends, and co-workers, or they might reside in areas where

active transmission is prevalent. The risk has increased because of the requirement to scale up

intensive care unit (ICU) capacity promptly in affected areas and the relocation of medical

workers to frontline positions (e.g., ICUs or COVID-19 wards).

is opt to submit nasopharyngeal and oropharyngeal PCR testing and a full blood count.The

results of these tests will determine the next course of action, but if they are negative, they will

be watched for a week and may return to work if they remain asymptomatic. Infection with

COVID-19 virus is considered to be very low for medical workers in the event of proper use of

personal protective equipment (PPE) and adherence to IPC protocols. For contact with

coworkers, such as at meetings, shared meals, and in office settings, physical distancing is

encouraged.

Information Systems and Technologies used in primary care

The primary care for COVID-19 in technology and information systems is to focus the

treatment by identifying, reporting, containing, managing, and mentioning it. Information and

communication technologies (ICTs) provide efficient case and contact identification, reporting,

and analysis; early case search and detection; and case and contact identification and monitoring

for populations at risk. This regulation can enable the transmission of information about

precautions to the entire society. Health professionals at the first level of care can manage

medical treatment and make home monitoring of COVID-19 patients easier thanks to platforms

for telemedicine visits, remote patient monitoring, and remote communication. In conclusion,

information systems and technologies assist in referring patients with severe symptoms or risk

factors to the hospital.

COVID-19 Planning Scenarios

The Centers for Disease Control and Prevention, and the Office of the Assistant Secretary

for Preparedness and Response have made five COVID-19 Pandemic Planning Scenarios to help

public health administrators and hospital administrators better prepare and plan for COVID-19.
Scenario 1 is for when the virus has lower infectivity and is not too severe; lower percentage of

people transmitting the virus before the symptoms starts to show, and lower percentage of people

with COVID-19 showing no symptoms and lower contribution of those people infecting others.

Scenario 2 for when the virus has lower infectivity and is not too severe; higher percentage of

people transmitting the virus before the symptoms starts to show, and higher percentage of

people with COVID-19 showing no symptoms and higher contribution of those people infecting

others. Scenario 3 is for when the virus has higher infectivity and is severe; higher percentage of

people transmitting the virus before the symptoms starts to show, and higher percentage of

people with COVID-19 showing no symptoms and higher contribution of those people infecting

others. Scenario 4 is for when the virus has higher infectivity and is severe; higher percentage of

people transmitting the virus before the symptoms starts to show, and higher percentage of

people with COVID-19 showing no symptoms and higher contribution of those people infecting

others. Scenario 5 is the best estimate of parameter values for disease severity, viral

transmissibility, and presymptomatic and asymptomatic disease transmission.

Each Planning Scenario is based on a category of numerical values for all characteristics

of COVID-19 illnesses that are being caused by SARS-CoV-2 virus. On the other hand, those

values, called parameter values, are used to evaluate the possible effects of Covid-19 in U.S

States, when the opinions regarding the effects are confirmed, they must circulate the awareness

and further security for the whole society in terms of the effects discovered. There are many

sources that would benefit to persist updating COVID-19 data over the time, such as COVID

DATA TRACKER, COVID-19 Case Surveillance Public Use Data, and COVID-NET. Covid

data tracker were used to gather data from across the answers about what they found about the

possible effects and gives specific statistics by category. COVID-19 Case Surveillance Public
Use, on the other hand, are the data from Covid-19 cases that are reported to lCDC, which it also

includes data about demographics and information such as the hospital’s state if their efforts are

a success or not, and regarding the patient’s condition as well if they are still troubled about the

situation or otherwise. And the last source which is COVID-NET, it is used to gather data on the

laboratory-confirmed COVID-19-associated hospitalization through the networks, however those

data from this source contains the state of the patients being infected by Covid and they must use

these data to analyze the covid infection to find specific treatment that could deal with covid.

Purpose Statement

This study aims to describe the lived experiences of medical workers assigned in Covid

facilities in Hospitals. More importantly, this seeks to answer its central question: How do

medical workers describe their lived experiences in covid facilities in hospitals?

Significance of the study

Nurses. This study will give a glimpse of the lived experiences of nurses in covid

facilities. It will explain the duties, workload, and difficulties experienced by nurses in covid

facilities.

Doctors. The findings of the study would guide doctors on how to deal with future

pandemics, from experienced doctors, they explained how to treat covid patients, how to stay

safe from infected patients, and how to manage their schedule.

faced in covid facilities. The study also provides information on how medical technicians run

tests when needed.

Future medical workers. The study will not just spread awareness of the lived experiences

of healthcare workers in covid facilities but it will also prepare the medical world on what to

improve on for future outbreaks. The findings present information for future medical workers to

be more prepared and organized.

Scope and Delimitations

The investigators limit the boundaries on lived experiences of doctors, nurses, and

medical technicians assigned in covid facilities in hospitals. The participants in this study must

have first-hand experience in covid facilities in hospitals and must have been assigned to covid

facilities for at least six months.

Definition of Terms

To have a common frame of reference, the following terms were defined conceptually

and operationally.
 Covid. It is a disease caused by a coronavirus that was first reported in 2019 and became

a pandemic. (Oxford Learners Dictionary, 2022). In this study, this refers to the virus that has

been affecting the world for the last three years.

Facilities. Defined as buildings, services, equipment, etc. that are provided for a

particular purpose. (Oxford Learners Dictionary, 2022). In this study, this refers to facilities

where covid patients are treated.

Hospitals. It is a large building where people who are ill or injured are given medical

treatment and care. (Oxford Learners Dictionary, 2022) In this study, this refers to hospitals that

have covid facilities.

Lived experiences. As it is understood in qualitative research, it is a representation and

understanding of a researcher or research subject’s human experiences, choices, and options and

how those factors influence one’s perception of knowledge (SAGE Encyclopedia, 2008). In this

study, this refers to how the researchers make sense of the events and experiences of the

individuals.

Medical Worker. They provide essential services that promote health, prevent diseases

and deliver health care services to individuals, families and communities based on the primary

health care approach (World Health Organization, 2022). In this study, this refers to medical

workers who have first-hand experience in covid facilities