Psychological wellbeing of nurses and midwives during the COVID-19 pandemic by Dr Holly Blake, Associate Professor of Behavioural Science, University of Nottingham, UK.
The outbreak of COVID-19 in the UK has been identified as a pandemic and a health emergency of global concern. The health and social care workforce is facing unprecedented demands in managing the outbreak. Extreme measures are being taken to boost the workforce, with retired staff and students asked to join the frontline, and community workers needing to rapidly up-skill to care for patients with coronavirus amidst staffing shortages (Gilroy, 2020). A multitude of staff will assume new or unfamiliar clinical roles, and expanded workloads during a period of increased demands and pressure.
This situation will undoubtedly take its toll on the workforce, and the impacts are likely to continue over a significant period. A pandemic is a marathon, not a sprint. The World Health Organization advocate that feeling under pressure is quite normal in the current situation, and that ‘managing your mental health and psychosocial well-being during this time is as important as managing your physical health’ (WHO, 2020). Early research from China, the first country to be affected by the pandemic, has already identified psychological impacts of COVID-19 on healthcare staff, particularly those working on the frontline.
We must protect the psychological wellbeing of staff during and after the crisis, to help them to cope and to reduce the risk of longer-term psychosocial problems.
At the University of Nottingham, we have compiled an e-package ‘Psychological Wellbeing in Healthcare Workers’ – you can read more about the project here: https://www.nottingham.ac.uk/news/online-resource-for-healthcare-workers
Our e-package is relevant to any healthcare worker or healthcare students. It can be circulated widely and is free to access here:
https://www.nottingham.ac.uk/toolkits/play_22794
This package outlines the actions that team leaders can take to demonstrate leadership approaches that promote wellbeing, and the need to provide psychologically safe spaces for staff to raise concerns. We have included guidance on workplace communication strategies, the use of appropriate language to avoid social stigma, and the importance of accessing support from colleagues, friends and family. The package includes guidance on being equipped to support and signpost others at work, at home and in the community, through Psychological First Aid.
Self-care approaches have never been more important – and we know that nurses’ own health and wellbeing can affect care quality (Blake, 2014). We have included information on rest and work breaks, working the night shift, the importance of sleep and managing fatigue. This resource also covers specific impacts of covid19, such as making morally challenging decisions around providing for patients with limited resources, and balancing the needs of patients with the needs of self. The package includes insights into the challenges of coping in demanding environments, managing feelings of guilt (e.g. when choosing between difficult options or self-isolating) and dealing with grief and death. There are a wealth of resources to manage emotions such as fear, anxiety, depression and low mood and strategies to prevent burnout, psychological trauma and emotional exhaustion. This resource includes tips and advice from experts in mental wellbeing as well as those with direct experiences from the frontline.
The Royal College of Nursing gives advice which is relevant to all of us: ‘It is normal to feel sad, stressed or overwhelmed during a crisis. These feelings are no reflection on your ability to do your job. This is an unprecedented situation: it’s OK not to be OK. Look after yourself and ensure you seek advice and support’ (RCN, 2020).
References
Blake, H. 2014. Nurses recognise their own health can affect care quality. Nursing Times. 110(38), 9. https://www.nursingtimes.net/holly-blake-nurses-recognise-their-own-health-can-affect-care-quality/5074945.article
Gilroy R. Community nurses ‘need new skills and more resources’ for Covid-19. Nursing Times, 31 March 2020. https://www.nursingtimes.net/news/community-news/community-nurses-need-new-skills-and-more-resources-for-covid-19-31-03-2020/
Royal College of Nursing, Self-Care during COVID-19, March 2020 Publication code 009 215. https://www.rcn.org.uk/professional-development/publications/pub-009215
World Health Organization. Mental health and psychosocial considerations during the COVID-19 outbreak. 18 March 2020. https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf
Perlis, RH. Exercising Heart and Head in Managing Coronavirus Disease 2019 in Wuhan. Invited Commentary, JAMA Netw Open. 2020;3(3):e204006. doi:10.1001/jamanetworkopen.2020.4006
Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, Wu J, Du H, Chen T, Li R, Tan H, Kang L, Yao L, Huang M, Wang H, Wang G, Liu G, Hu S. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020;3(3):e203976. doi:10.1001/jamanetworkopen.2020.3976.