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1. Politics
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Not being able to act and being hindered by external circumstances
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Type of difficult situation: duration, frequency, and intensity
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2. Difficult priorities
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3. Cultural aspects in the work context
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4. Lack of resources and enormous needs
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5. Being hindered by the organization
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6. Not being able to act
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7. Not being able to give care and comfort
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8. Own security hindering giving care
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1. Not standing up for values
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Actions perceived as insufficient
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2. Making different priorities
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3. Frustration in not having enough capacities to act sufficiently
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4. Inequalities between you and the population/local colleagues
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5. Balancing collaboration with other partners and authorities
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6. Having to build trust before acting
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7. Frustration due to lack of coordination
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8. Frustration due to lack of leadership
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1. Creating false hope
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Imposing harm instead of helping
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2. Causing harm instead of helping
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3. Different motivations and attitudes among colleagues causing bad reputation
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4. Being part of a bad decision/act
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5. Colleagues’ wrongdoing
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6. Being accused of a decision taken
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7. Contributing to/causing inequalities
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1. Constructive solutions
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Resolving the situation
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Managing difficult situations
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2. Focus on solutions rather than problems to adapt to the context
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3. Create collaborations and ask for help to resolve
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4. Using experience
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5. Do something instead of nothing
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6. Sense of teambuilding
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7. Fighting and using courage to resolve
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8. Discontinue the mission
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1. Realizing unforeseen consequences
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Consequences of unresolved situations: moral distress
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2. A sense of powerlessness and ruminating
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3. Feeling isolated and surreal
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4. Feeling scarred
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5. Not worth it, leaving earlier
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6. Leaving earlier, to save yourself
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7. Depending on the time in the field
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8. More tough to come home than to be there
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9. Finding a new everyday life
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10. Feeling alienated
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11. Feeling lonely
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12. It eventually hits you
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13. Losing something
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14. Having a pause before going back to work
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1. Contribute to improvements and better support
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Positive consequences of managing difficult situations
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2. Creative solutions
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3. Learning from mistakes
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4. Self-confidence and learning things about myself
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5. More aware of inequalities
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6. Growth and being more grateful
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1. Relying on informal support while there
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Informal support
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Tools and support
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2. Creative support-seeking while there
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3. Lack of access to normal social support while there
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4. Lack of social support when home
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5. Creating your own support when home
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6. Not being lonely with the feeling
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1. Lack of accessible formal support from the organization while there
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Formal support
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2. Formal support when home (debriefings, psychological support etc.)
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3. Lack of appropriate support when home
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1. Preparations, courses, and trainings
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Preparatory support
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2. Briefings and information before
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3. Lack of adequate information before
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1. Other tools used to relieve stress while there
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Other tools
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2. Going back to work, or take a pause
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3. Own methods used to resolve/adopt when coming home
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1. Achieve good for others
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Altruistic motivation
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Engagement as a protective factor
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2. Making a difference
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1. Creating learning and experience
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Professional and personal motivation
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2. You do what you can
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1. Working within a structure
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Framed by the professional role
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2. You must follow guidelines
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1. We have problems in our own health care system
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Challenges are part of the work
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2. Have agreed on the conditions
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1. Risk-taking in dangerous environments, security risk
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Work environment
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Work environment stressors as a risk factor
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2. Not being able to go back to normal work directly, financial, and personal health risk
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3. Traumatic events
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1. Malfunctioning team
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Stress and exhaustion
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2. Facing continuous suffering
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3. Having a role of responsibility in stressful environments
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