COVID-19 workplace support: initiatives promoting nurse health and well-being

Virtual wobble rooms, PPE marshals, welfare cafés – how employers are supporting staff
A nurse in PPE, wearing a visor, mask and gown

Virtual wobble rooms, PPE marshals, welfare cafés – how employers are supporting staff during the pandemic

  • A Nursing Standard survey found eight out of ten of 1,650 nurse respondents said their mental health has been affected by COVID-19
  • Quiet zones, welfare cafés and PPE marshals are among initiatives introduced at NHS organisations across the UK to support healthcare staff
  • How one trust set up a weekly survey to gauge staff morale and identify issues it could help with
A nurse in PPE, wearing a visor, mask and gown
Picture: iStock

COVID-19 has put the health and mental well-being of nursing staff in the spotlight like never before.

Long hours caring for patients, fears of contracting COVID-19, separation from loved ones, and for some, redeployment: the pressure on nurses has been unrelenting since March last year.

Nursing staff ‘back in the eye of the storm’

And sadly, the situation shows little sign of easing with the recent surge in cases.

The number of patients with COVID-19 in hospital in England stood at a record 28,246 as of 8am on 7 January, according to the latest figures from NHS England.

NHS England chief executive Sir Simon Stevens warned staff were ‘back in the eye of the storm’ amid rising cases of COVID-19.

8 out of 10

respondents to a Nursing Standard survey in October 2020 said their mental health has been affected by the COVID-19 pandemic

Source: Nursing Standard

‘Many of us have lost family, friends, colleagues and – at a time of year when we would normally be celebrating – a lot of people are understandably feeling anxious, frustrated and tired,’ he said in New Year message to NHS staff.

In a recent Nursing Standard survey, eight out of ten of the 1,650 nurses who responded said their mental health has been affected by the pandemic, while six out of ten said their physical health has been.

Nurses who responded to the survey said taking up new hobbies and exercise had proved beneficial to their physical and mental well-being, while others spoke about the support offered by their employers.

RCN national officer for health and safety Kim Sunley says the pandemic has underlined the importance of workplace health and well-being initiatives.

An opportunity to ‘revolutionise’ support for nurses

RCN national officer for health and safety Kim Sunley

‘Health and care leaders must see this moment as an opportunity to revolutionise and sustain the support available to nursing staff that benefits all,’ she says.

‘Even as the NHS has enacted national schemes, local well-being initiatives for front-line nursing staff, supported by managers, are important as this pandemic continues and afterwards.’

Here, Nursing Standard highlights projects from four employers that have improved the health and well-being of nurses and other healthcare staff during the pandemic.

Access Nursing Standard well-being centre

Corona Voice survey: how we know what our staff need

In the early weeks of the COVID-19 pandemic, Northumbria Healthcare NHS Foundation Trust introduced Corona Voice, a weekly survey aiming to gauge staff morale and quickly identify issues that required action.

Staff were asked a series of questions, one of which was: ‘How motivated do you feel for work today?’

They could raise concerns and highlight colleagues who had supported their well-being.

In the first three months, the system received 10,044 responses from staff, with results published weekly and made available to all staff.

Trust chief experience officer Annie Laverty says it helped staff feel valued, and that management was responding to concerns.

‘They felt listened to – supported,’ she says. ‘The health and well-being steering group that met every week would look at the previous week’s data and use that to determine the actions we took to respond.’

More than 1,300 staff welfare calls

The survey highlighted how some staff who were shielding or working from home were missing out on work social connections.

‘Responding to that we made over 1,300 welfare calls. We sent them information on postcards with helpful tips and numbers they could reach at times of distress or if they needed more information,’ says Ms Laverty.

Respiratory ward sister Holly Turner says designated ‘quiet zones’ for staff, which were introduced as a result of the survey, have been beneficial.

‘In terms of emotional and mental support, I made use of our quiet zones in the hospital and access to physiological support made a difference to how I coped.’

We Care Café: a space for staff to take a break and access support

Kettering General Hospital NHS Foundation Trust teamed up with the local community to set up a café for staff, called the We Care Café.

Kettering General Hospital clerical officer Deborah Moore (left) and therapy assistant Linda Smart take a break in the We Care Café

The café was designed as a space for staff to decompress, socialise, access peer support, and talk to ‘active listeners’ who signpost staff to other services if needed.

Since its launch last April, staff have visited the café more than 23,000 times. The trust encourages a culture of taking breaks by texting staff and having teams emphasise the importance of pausing and resting properly.

Kettering General Hospital director of nursing and quality Leanne Hackshall recalls how staff were affected physically and mentally during the first wave.

Place to step back from daily work pressures

‘They had to work in hot and restrictive personal protective equipment (PPE), often for the first time,’ she says.

‘This virus was new to us and very different to other viruses. It brought considerable anxieties, particularly for those staff going home to their families.

‘Some staff left their family homes to stay on site and help in our response.’


staff had visited the Kettering General Hospital We Care Café by the end of September 2020

Source: Kettering General Hospital NHS Foundation Trust

Ms Hackshall says that while initial staff concerns about the pandemic mainly related to fear of the impact of the virus on themselves and loved ones, in the months that followed other concerns emerged.

Nutrition nurse specialist Trish Alga visits the café regularly and says it is a place to take a step back from work and ask for help if needed.

‘It is just a chance to chat with other people and get away from the daily pressures. It’s a place where you can have a proper break,’ she says.

‘Also, there is usually someone to talk to on the counselling side if you feel the need to speak about something that has concerned you.’

Access to confidential one-to-one help

While the café is an open area where staff can support each other, the trust also decided to set up the open office space – a smaller area designed for one-to-one conversations where staff can get confidential help and be signposted to services if needed.

Kettering General Hospital’s director of nursing and quality Leanne Hackshall

Kettering General Hospital also provides outreach services to staff who cannot access the café or open office areas as readily as other groups, such as those working in intensive care, theatre and the emergency department.

By October last year, nearly 900 visits had been made to the open office, and funding for the office and café has been secured until April.

Ms Hackshall says she can see them continuing beyond then, depending on need.

‘I can’t see us stopping. The uptake and use of it has blown us away,’ she adds.

PPE marshals: support for ward staff

The trusts’s PPE marshal service initially relied on redeployed staff Picture: Twitter

Last March, at the start of the first wave of the COVID-19 pandemic in the UK, South Tees Hospitals NHS Foundation Trust began the enormous task of training 6,500 clinical staff in how to correctly don and doff personal protective equipment (PPE).

Despite training, some still had uncertainties and anxieties about the process, so designated PPE marshals were introduced to support staff.

‘It felt like we were entering the great unknown and the marshals could, if we got it right, be a valuable support for ward staff’

Beth Swanson, assistant director of nursing, South Tees Hospitals NHS Foundation Trust

‘We wanted to make our staff feel confident in their practice,’ the trust’s assistant director of nursing Beth Swanson says.

‘It felt like we were entering the great unknown and the marshals could, if we got it right, be a valuable support for ward staff.’

The marshal service runs alongside the trust’s face-fit testing and donning and doffing training programmes.

Marshals also intervene if needed, where staff became fatigued and could unknowingly become complacent in donning and doffing practice.

Practical support when staff are fatigued

‘The marshals acted like a barometer,’ Ms Swanson says.

They would alert the trust’s infection prevention and control (IPC) team when fatigue was growing, and they would take practical measures to help, such as offering food and water and signposting staff to psychological support.

Initially, the marshal service relied on redeployed staff, but there are plans for five full-time seconded roles aligned closely to the trust’s IPC team.

The role has also expanded to include other IPC duties, such as checking PPE supplies, training for new and returning staff, meeting with colleagues to discuss PPE concerns, and helping to remind staff about social distancing in break rooms.

Virtual wobble rooms: helping remote-working nurses stay in touch

So-called ‘wobble rooms’ where staff can take a much-needed break became common features in hospitals across the UK during the first wave of the pandemic.

One organisation that has managed to adapt the model for staff working in a community setting is Locala Community Partnership, a not-for-profit social enterprise that provides NHS community healthcare services in West Yorkshire.

It introduced a virtual wobble room amid concerns about staff social isolation during lockdown.

Locala’s virtual wobble rooms allow nursing staff to join online video conferencing group chats Picture: iStock

Regular group chats via online conferencing

Quality improvement programme manager and mental health nurse Krishna Nair said providing a virtual wobble room where staff can join in via online video conferencing helped those who were working remotely.

‘They wanted a place where they can see and talk to other people,’ he said. ‘They can come and dip in and out whenever they have the time between patient visits.’

Mr Nair says the virtual wobble room is held regularly, with group sessions where everyone can chat to each other. One-to-one chats are also available for individuals who feel they would benefit from further support.

The rooms have proved popular with staff. Mr Nair says around 80 staff members have used the group virtual wobble rooms, and 30 have used the one-to-one sessions, the majority of whom are front-line staff.

Tailored support for redeployed nursing staff

One issued identified by the virtual wobble rooms during the first wave of the pandemic was the need for tailored support for redeployed staff.

‘We developed a specific forum for redeployment especially for the workforce and listened to colleagues’ specific problems,’ he adds. ‘That worked well and significantly reduced anxiety, concerns and worries due to redeployment.’

Advice on supporting staff during COVID-19

The British Psychological Society has offered advice on how healthcare employers can support staff through the pandemic.

It says maintaining staff morale and motivation is essential as the outbreak progresses. The ‘active’ phase of the pandemic is the highest period of psychological risk, where staff may neglect their physical and psychological needs by putting their work above their own well-being, it adds.

Advice to employers includes:

Line managers should encourage staff to take a break when needed Picture: iStock
  • Have a clear, open and transparent communication strategy regarding plans, as well as visible leadership. Staff should be encouraged to raise concerns and ask questions
  • Enhanced support from line managers Support line managers to have psychologically informed, compassionate and supportive conversations with staff. Line managers should be aware of and able to confidently signpost to relevant sources of mental health support available through their local occupational health service
  • Promote peer support systems This could include staff encouraging each other to take breaks and checking in to see if colleagues need a chat to offload emotionally
  • Normalise psychological responses Remind staff that this an unprecedented situation and encourage them to step back, take breaks and discuss their emotional well-being when they need to
  • Deliver formal psychological care to support the mental well-being of staff. Organisations may want to review their support for staff and expand provisions where possible, which could include debriefs, trauma risk management, Schwartz rounds, and using existing in-house clinical psychology teams

Adapted from NHS Employers advice

View our COVID-19 resource centre

Find out more

Locala Community Partnership