Open Response Comments
Post-hoc review of open-response comments identified 4 dominant categories of frustration sources: (1) Time constraints, (2) Lack of administrator support, (3) Insufficient psychosocial support resources, and (4) Inadequate staffing and/or turnover. Time constraint comments reflected perceptions of insufficient time to complete assigned tasks or feeling generally overwhelmed with expected workload. Lack of administrator support generally characterized desires for management to involve staff in policy development, process changes, and to provide greater support in conflict resolution with families, patients, or colleagues. Insufficient institutional support for self-care reflected the need for additional resources to process the emotional toll of providing care for seriously ill and dying children. Staffing and turnover frustrations were often described as threats to department-level culture or morale. See Table 4 for exemplar comments representing these themes.