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COVID-19: how to lead and support your team in the second wave

Advice from senior nurses on preparing and assisting depleted staff to cope with the months ahead

Advice from senior nurses on preparing and assisting depleted staff to cope with the months ahead

  • With winter on its way and COVID-19 cases climbing, teams are facing a difficult few months after having little chance to recover from the first wave
  • Four senior nurses share their advice for keeping staff safe, healthy and supported while maintaining team motivation and resilience
  • Advice and tips include being a good role model, conducting thorough assessments and signposting help and support

Nursing staff across the UK are braced for many more months of relentless strain as COVID-19 cases surge once more.

Exhausted staff welcomed a brief respite as the pandemics first wave

Advice from senior nurses on preparing and assisting depleted staff to cope with the months ahead

  • With winter on its way and COVID-19 cases climbing, teams are facing a difficult few months after having little chance to recover from the first wave
  • Four senior nurses share their advice for keeping staff safe, healthy and supported while maintaining team motivation and resilience
  • Advice and tips include being a good role model, conducting thorough assessments and signposting help and support
Image showing nursing team in hospital moving a patient trolley, blurred to give impression of moving quickly
Picture: iStock

Nursing staff across the UK are braced for many more months of relentless strain as COVID-19 cases surge once more.

Exhausted staff welcomed a brief respite as the pandemic’s first wave eased towards the end of summer, but the let-up was short-lived.

Levels of fatigue are high as winter approaches

With the second wave likely to be accompanied by the usual winter pressures, many nurses are already emotionally and physically spent. Senior nurses have spoken of fatigue and burnout among teams.

Francis Fernando, soon-to-be head of nursing for Central London Community Healthcare NHS Trust
Francis Fernando: ‘Nurses are drained after months of firefighting’

Buckinghamshire Healthcare NHS Trust chief nurse Karen Bonner acknowledges a dip in energy as tiredness set has in.

And Francis Fernando, soon to take up post as head of nursing for Central London Community Healthcare NHS Trust, says many nurses are drained by firefighting and constant demand.

‘You can only be resilient for a certain time. At some stage our health and mental well-being will suffer.’

And, as he points out, having burnt-out staff is a threat to patient safety.

So how can nurse managers keep their teams motivated and safeguard nurses’ health as the crisis grinds on?

Listen to your nursing team

Many nurses and healthcare assistants have died as a result of COVID-19, and it has caused serious illness in many more. Staff therefore have real fears for their own safety and that of their families, and managers must acknowledge those fears, says matron Ali Low, of the Westminster Memorial Hospital in Shaftesbury, Dorset.

‘It’s so important that they are able to voice their concerns,’ she says.

Two nurses sitting having a coffee and discussion
Ask staff about their concerns and for feedback on what has and hasn’t worked well Picture: Tim George

Ms Bonner agrees. ‘We’ve created space to listen and have gathered staff feedback to help shape our plans for the next few months.’

Mr Fernando says: ‘I would be having conversations with the staff, not only the nurses but the support staff too – listening to their concerns, understanding where they’re coming from, helping and supporting them, and empowering them too.’

As well as informal discussions and team meetings, Mr Fernando suggests clinical supervision, Schwartz rounds and action learning sets should be used as forums for airing thoughts, ideas and concerns.

Thank staff for their hard work

Illustration showing a thank you note with a smiley face
Picture: iStock

It’s important to mark the outstanding contribution of individuals and teams during the pandemic, says operations manager Caron Sanders-Crook, of residential care provider Canford Healthcare.

Canford’s senior managers have used video recordings to express their thanks to staff who have gone above and beyond in their roles. ‘This has been really appreciated,’ says Ms Sanders-Crook.

‘And our chief executive and chief operating officer are making welfare calls to home managers, some in person – restrictions permitting – and some via Microsoft Teams. We also celebrate what’s working well in the homes. We give praise at every opportunity.’

A month-long ‘positivity challenge’ that Canford homes took part in focused on positive thoughts and actions.

Be seen, be available and be a good role model

Karen Bonner, Buckinghamshire Healthcare NHS Trust chief nurse
Karen Bonner: ‘We’ve created space to listen’

‘It’s really important that matrons have an open-door policy,’ says Ms Low.

‘And every day before I leave I go round and say goodbye and ask if there are any problems.’

Mr Fernando adds: ‘As head of nursing I would be very visible, and also model the values and behaviours of the trust I’m working for.’

Ms Bonner says she is increasing her visibility within her trust, creating more time to hear from staff through forums and drop-in sessions.

She is also encouraging other senior nurses to innovate as they endeavour to support and motivate staff.

‘For example, intensive care unit teams are developing a way to record how long staff are in full personal protective equipment and creating a flag system to identify when they require a break.’

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Conduct thorough risk assessments

Some staff, such as those from black and minority ethnic groups, may be more vulnerable than others to the threat of COVID-19.

‘We need to ensure that leaders allay any anxieties and concerns,’ says Mr Fernando.

High-risk staff, as identified by risk assessment, should be redeployed or shielded, he says. ‘It’s obviously a nightmare for managers to back-fill the post, but our first priority is to protect the staff.’

That may also mean encouraging nurses to take leave if they are at risk of burnout, he adds.

Reviewing work patterns can help identify opportunities for regular rest and breaks, Ms Bonner says.

Work with other teams to ease the pressure

Caron Sanders-Crook, operations manager at residential care provider Canford Healthcare
Caron Sanders-Crook: ‘Our teams can concentrate on service delivery’

Ms Sanders-Crook says her workplace has increased the number of admin staff to help with the management of COVID-19 testing .

‘That’s taken some of the workload off the main teams in our homes so they can concentrate on service delivery,’ she says.

The company’s marketing team has also increased the number of newsletters sent out to residents, families and staff to keep them up to date with developments, and the human resources department has provided clarification for staff on payment schemes available to support them during the pandemic.

Ensure staff have time for breaks

Small, practical steps such as ensuring staff take proper meal breaks can help them through a difficult shift, says Mr Fernando.

In his previous role as a clinical matron, that often meant stepping in for half an hour and taking over from a nurse who hadn’t had a break.

Be prepared to signpost staff to appropriate support

Nurse managers can’t be expected to be the only ones their teams rely on to get them through the crisis.

Occupational health, psychology support, wobble rooms and trust counselling teams are among the resources there to help. There is also a wide range of resources available via the NHS People website, including a guide on supporting others in difficult times.

Mr Fernando says: ‘I would encourage staff to link up with support networks within their trust as a safe space for them to express any frustrations, anger and anything they want to discuss.’

Think about how to steer people to sources of help, Ms Low suggests. For example, many nurses have partners who have lost jobs or been furloughed and directing them to financial support and advice can ease concerns.

Consider printing and displaying relevant information for the benefit of those with little time to access emails.

Look after yourself and take time to unwind

Accountability and responsibility can be exhausting and knowing when and how to switch off is challenging.

Ms Low admits that even when off duty she checks in via her laptop so that when she goes to work the next day she’s aware of what’s waiting for her.

‘So yes, it is difficult to switch off.’

But not impossible. A ‘very, very supportive husband’, grandchildren and a dog that needs walking help her relax.

A nurse in PPE visor and facemask staring out a hospital window
With the pressures of wearing PPE and rising patient numbers, it is more important than ever to ensure staff take their breaks Picture: iStock

For Mr Fernando, self-compassion is important and making sure life and work are well balanced.

He tries to model the values he expects of others – seeking support as required, for example, and ensuring he has adequate breaks and rest. Try to keep in mind managers and their staff require the same things, he says: ‘We’re all human, after all.’

Ms Sanders-Crook uses meditation to unwind, while care home residents and a supportive team help her maintain her drive.

‘Speaking with residents and hearing that they feel well looked after and safe, and they are still smiling in the face of adversity, motivates me and keeps me grounded.’

Ms Bonner also meditates and uses long cycle rides to switch off. Caring motivates her, as does making sure her nurses are looked after so they can give the best care.

‘My staff motivate me too. They continue to make me proud as we provide care in an ever-changing environment.’


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