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Hearing the voices of Australian healthcare workers during the COVID-19 pandemic
  1. Michelle Ananda-Rajah1,
  2. Benjamin Veness2,
  3. Danielle Berkovic3,
  4. Catriona Parker3,
  5. Greg Kelly4,
  6. Darshini Ayton3
  1. 1 Central Clinical School, Monash University, Melbourne, Victoria, Australia
  2. 2 Psychiatry Department, Public hospital, Melbourne, Victoria, Australia
  3. 3 School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
  4. 4 Intensive Care, Public Hospital, Sydney, New South Wales, Australia
  1. Correspondence to A/Prof Michelle Ananda-Rajah, Central Clinical School, Monash University, Melbourne, Victoria, Australia; michelle.ananda-rajah{at}


Background The statistics of healthcare worker (HCW) COVID-19 infections do not convey the lived experience of HCWs during the pandemic. This study explores the working conditions and issues faced by Australian HCWs.

Methods Qualitative analysis of free-text responses from Australian HCWs from 3 August to 26 October 2020 from an open letter calling for better respiratory protection for HCWs, transparent reporting of HCW COVID-19 infections and diversity in national infection control policy development. The open letter was sent to an email list of 23 000 HCWs from a previous campaign and promoted on social media.

Results Among 3587 HCWs who signed the open letter during the study period, 569 free-text responses were analysed. Doctors and nurses accounted for 58% and 33% of respondents, respectively. Most respondents came from Victoria (48%), New South Wales (20%), Queensland (12%) or Western Australia (11%). Dominant themes included concerns about: work health and safety standards; guidelines on respiratory protection including the omission of fit-testing of P2/N95 respirators; deficiencies in the availability, quality, appropriateness and training of personal protective equipment; and a command-and-control culture that enabled bullying in response to concerns about safety that culminated a loss of trust in leadership, self-reported COVID-19 infections in some respondents and moral injury.

Conclusion Deficiencies in work health and safety, respiratory protection, personal protective equipment and workplace culture have resulted in a loss of psychological and physical safety at work associated with an occupational moral injury. The challenge for healthcare leaders is to repair trust by addressing HCW concerns and fast track solutions in collaboration with them.

  • health policy
  • safety
  • management
  • behaviour

Data availability statement

The free text anonymised responses are available in an open source repository at Bridges Monash University.

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

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Data availability statement

The free text anonymised responses are available in an open source repository at Bridges Monash University.

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  • Twitter @rajah_mich

  • Contributors MA-R, BV and GK conceived the study. DA, CP and DB performed the analysis. MA-R wrote the draft. All authors reviewed the manuscript.

  • Funding MA-R is supported by a MRFF (Medical Research Future Fund) TRIP (Translating Research Into Practice) Fellowship.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.