Posted 28 August 2020 - 17:30
Posted 28 August 2020 - 17:30
Analysis
Has your COVID-19 experience made you rethink your nursing career?
Nursing Standard survey reveals the pandemic’s wider impact on nurse retention
Nursing Standard survey reveals the pandemic’s wider impact on nurse retention
- A survey by Nursing Standard highlights the changes felt in the profession as a result of disruptions to working lives during the pandemic
- Half of all respondents are seeking a job change, with some wanting to leave the profession or take early retirement after the strain of the pandemic, and others wanting to switch to the area where they were deployed
- Tips for nurses who want to make a change to their career and advice for managers on retaining staff
About half of all NHS nurses are considering or actively seeking a job change after the upheaval of working through the pandemic, an exclusive Nursing Standard suggests.
Of the 1,850 NHS staff who responded, only half (51%) said they were currently happy in their role.
More than one in five (22%) said they were considering or actively looking for a role outside nursing, while over a quarter (27%) said they were considering or already seeking a different role within the profession.
51%
of NHS nursing staff are happy in their current role
Source: Nursing Standard survey
The survey, which overall drew responses from more than 2,300 nurses, reveals the scale of change rippling through the profession after the disruptions to work as a result of COVID-19.
COVID-19 has been the final straw for some nurses
For some respondents, it was clear that working in different places and in different ways had brought new opportunities they may never have considered previously.
But for others, the disruption and stress of this period appear to have been the final straw in their nursing career, with many seeking retirement sooner than they might otherwise have done.
post-traumatic stress disorder’
University of Manchester professor of organisational psychology and health Sir Cary Cooper says it is natural that after going through such a major crisis – especially one that involves a potentially life-threatening virus – people start reassessing their careers and priorities.
He says he is not surprised some nurses are thinking of leaving the profession.
‘This is writ large across the UK, not just with healthcare workers,’ he adds.
‘People are worried, whether they are on the front line or not, and are starting to think “‘is this what I want to do with my life, or should I be doing something different?’’.’
Professor Cooper says for nurses there was the extra worry of being in close proximity to those with COVID-19.
‘For nurses, their life is more at risk than other people, and many will have had to stay at home or take on different roles, so may have had time to reflect on their careers.’
He adds that a proportion of those thinking of leaving will be burnt out by their pandemic experience. There needs to be significant support in place to help healthcare staff deal with the trauma of what they have experienced, he says.
‘I think there will be a tsunami of post-traumatic stress disorder in the autumn from people on the front line,’ he says.
‘The pandemic has made me more reflective’
A sense of reflection and uncertainty is evident in some of the responses to the Nursing Standard survey. ‘The pandemic has definitely made me feel more reflective generally about overall circumstances and I have been especially reflective on my current career and thinking about the future,’ one respondent says.
Nursing Standard conducted an online survey, open to UK nursing staff between 8-19 June 2020.
The results confirm that the level of disruption to nurses’ normal working lives. A quarter of nurses who responded (25%) had been redeployed, the vast majority for operational reasons, and a small minority to protect the health of staff or of their family (3%).
‘People are worried, whether they are on the front line or not, and are starting to think “‘is this what I want to do with my life, or should I be doing something different?’’’
Sir Cary Cooper, professor of organisational psychology and health, University of Manchester
Of those who were redeployed, only 30% had returned to their original role at the time of the survey in mid-June.
Many had been moved to COVID-19 or intensive care wards, when their own areas, especially those connected to elective surgery, were closed down.
In the comments, nurses describe how they had been told that they may remain in their seconded roles until at least the end of the year, and say there is a lack of clarity about when they may return to their usual roles.
‘We are told there is potential to remain redeployed for up to two years or until there is a vaccine,’ one nurse says. Another says they won’t return to their surgical ward for another 12-18 months.
‘I am unsure what my plans are. I am finding it difficult to return to my role,’ one nurse says.
Another described how their plans had been disrupted as their prescribing course was halted by the pandemic, and it is not clear when it may restart.
Deployment has brought new career opportunities
For some nurses, the chance to try something new or return to a clinical area after a long absence, has brought about an exciting new career opportunity.
One respondent says they were hoping their redeployment to the hospital discharge team would be made permanent.
Others say their experience in intensive care had inspired a change in specialty.
‘Having intensive care unit (ICU) experience now, I am considering applying for an ICU nurse position when available, thinking that they have the best personal protective equipment (PPE) at the moment,’ a respondent says.
22%
of staff have been redeployed for operational reasons
Source: Nursing Standard survey
Another says: ‘I was given the opportunity to have training and consolidate my ICU experience so may consider ICU nursing if it means staying at my local hospital.’
A welcome change to return to the bedside
Some nurses discovered that a return to the bedside was a change they needed. ‘I realised I am a ward nurse and need to look after people,’ a nurse says.
One nurse describes how it has given them the chance to consider an area of nursing they had ruled out. ‘I was looking for a change before the pandemic but it has helped me reconsider acute nursing as opposed to community only,’ they say.
View our COVID-19 resources centreSadly, for many, working through a pandemic did not prove a positive experience. Some felt too vulnerable to work due to health conditions that put them or their family members at higher risk of becoming seriously unwell if they caught COVID-19.
More than one in five respondents (22%) said they are now considering or actively seeking a role outside of nursing.
Redeployment helped me find a new career
treatment team, Kim Carter and nurse consultant Helen House
A mental health nurse who was redeployed to help tackle COVID-19 has since secured a job in her new team after loving the change.
Kim Carter, who was working as a clinical nurse lead on an inpatient ward at Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, admits she was initially unhappy and anxious about the move.
‘I felt totally gutted. I had not long returned from sick leave due to stress and felt it couldn’t have come at a worse time,’ she says.
She started on the older adults crisis resolution and home treatment team in the beginning of May. The team offers assessment and home treatment for people experiencing a mental health crisis, as an alternative to hospital admission.
‘Part of a team where I can make a difference’
Despite her initial concerns, Ms Carter says she was made to feel like part of the team from day one, and was able to share her knowledge of working in inpatient services.
Ms Carter, who has joined the team permanently, says: ‘I feel like I’ll really be able to make a difference. In my old role I did a lot of audits but often felt that my skills and time would be better suited to supporting service users and families more directly. My whole ethos is about person-centred nursing and supporting families.’
Nurse consultant Helen House says: ‘When I met Kim on her first day she was visibly anxious and hesitant about going in. The next day she was back with a massive smile on her face. She told me she had felt a renewed love for nursing and it was clear Kim’s heart and energy was very much driven by her desire to support the most vulnerable people.’
Career changes will add to staff shortages
Before the pandemic, the NHS was already in the grip of a staff shortage that has led to 40,000 nursing vacancies in England, making staff retention critical.
High numbers of nurses seeking a change of career were also found in a major RCN survey published in July. Of the 42,000 members from the NHS and the independent sector who responded to the survey, the percentage thinking of leaving the profession had risen to 36%, up from 27% at the end of last year.
Of those thinking of leaving, 61% cited pay as a factor.
Many nurses told Nursing Standard’s survey that they were seeking rapid retirement, with some saying they would no longer retire flexibly, as they had originally planned, and others saying they may seek an early end to their career.
‘Working in a nursing home has been terrible, I am currently on sick leave as couldn't cope with the deaths of older people’
Nursing Standard survey respondent
For some approaching retirement age, working in PPE was proving too difficult. ‘I am retiring at the end of August as I am 60 and unfortunately it can't come quick enough,’ one nurse says. ‘I am claustrophobic and struggle wearing masks, at present I only have to wear a mask when I go on a ward but from mid-June I will have to wear one constantly and I am struggling.’
Early retirement has become an option for many
For others, difficulty and uncertainty in their attempts to get back to their old jobs is pushing them towards leaving. One respondent says: ‘I would like to get back to my role as lead staff nurse for the outpatient department as soon as possible, but if this does not happen in the next 4-6 months I will consider retirement. I was planning this for next summer as I will be 63 then and my husband will also be retiring.’
55%
of redeployed staff had not returned to their previous roles by mid-June
Source: Nursing Standard survey
Care home nurses reported having to work in incredibly distressing circumstances, due to losing residents to the virus. ‘Working in a nursing home has been terrible, I am currently on sick leave as couldn't cope with the deaths of older people,’ one respondent says.
While others report a desire for a fresh start away from nursing. ‘My friend left recently after 30 years of nursing, got a job as a cleaner and has never been happier. I really admire her.’
Employer flexibility and support is key to retaining staff
together during the pandemic’
University College London Hospitals assistant chief nurse Alison Finch, who is a National Institute for Health Research clinical doctoral research fellow, says employers must be flexible and supportive to retain their staff.
‘Being asked to step into different roles has felt fulfilling for many people, but I know that, given there has been so much emphasis on COVID-19, others feel their original role or specialty may have become overlooked and some nurses may be left feeling lost and unsure of the importance of their role or value of their contribution,’ she says.
Change is inevitable as services move forward, trying to cope with ongoing COVID-19 cases, as well as capturing positive working changes uncovered during the pandemic.
‘Flexibility is the key to helping people feel valued and stay,’ she says. ‘Nurses should be offered choice, wherever possible, to move within the organisation where their experience allows. To do this well, individual teams or departments can’t afford to be too territorial. COVID-19 has helped with this – teams have come together, staff have moved between departments and there’s definitely a sense of professional community.’
How to make changes to your career
University College London Hospitals careers service lead Robert Blaze says there has been a 25% increase this year in nurses approaching his service.
There has also been a rise in interest in moving to intensive care and a greater push for a different work/life balance, he adds.
The service seeks to help nurses either become more fulfilled and satisfied in their current role or support them to find new opportunities at the large trust.
Think about your strengths and develop a career plan
For those seeking a change, Mr Blaze recommends speaking to your manager first.
‘Start with a chat with your line manager and colleagues,’ he says. ‘In the career service we focus on identifying nurses’ strengths, as when people are using their own strengths, that makes their jobs more satisfying. A manager should know your strengths, and there may be some you didn’t know yourself. Really reflect on these and learn about yourself. Your manager may be able to adapt your role to use those more.’
For those who want more advice, Mr Blaze recommends going to the careers service, if available, and if not, looking for coaching or mentoring opportunities.
‘Consider your innate strengths and then develop your own career plan,’ he says. ‘It doesn’t need to be really formal, but really focused on you and what you want. Really own it.’