COVID-19: ‘extra emotional burden’ for nurses providing end of life care

Barriers due to PPE and reduced services have increased strain on healthcare staff, Marie Curie says

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COVID-19 has placed an additional emotional burden on nurses and other healthcare staff caring for people at the end of life, according to the charity Marie Curie.

The charity, which provides care for people with a terminal illness, held interviews with 44 of its staff, including clinical nurse specialists, community nurses and hospice managers, to discover how the pandemic was affecting them and their patients.

In the interviews, conducted over the course of a week in May:

  • Most staff (40, or 89%) mentioned challenges posed by personal protective equipment (PPE) when trying to comfort distressed families.
  • More than half (25, or 56%) said they knew of people who had declined Marie Curie care because of anxiety about COVID-19.
  • Nearly half (21, or 47%) said there had been positive changes to how care was delivered as a result of the pandemic.

Urgent referrals that would usually have been seen earlier

Edinburgh hospice charge nurse Katherine Burnett said: ‘I’ve seen somebody get really upset because their relative had just died, they’re sobbing and displaying huge amounts of grief. 

‘The tears are rolling down their face, it is sticking to their hair, their hair is sticking to the visor, they’re trying to stuff the tissue up the visor that they are wearing to wipe their eyes and their hair is stuck everywhere.’

A hospice-based community nurse specialist said she had received four urgent referrals for people who would have been seen earlier in normal times.

‘We would have sorted out medicines and symptoms in a gradual way, but we are hitting crisis and complexity that we haven’t had before.’

Staff also spoke about positive things that had come out of the pandemic, such as fostering closer working relationships with colleagues at and outside of the charity. 

Helping staff cope with the additional emotional burden on staff

Marie Curie chief nurse and executive director of caring services Julie Pearce said: ‘These barriers are difficult and distressing, and place an additional emotional burden on staff.

‘We have put measures in place to ensure support is available for all our staff, in whatever roles they are working, to help them with any difficulties they are facing, including online resources, debriefing, peer support and clinical supervision.’

Ms Pearce said the charity was looking at the longer-term impact of new ways of working to plan for future services.

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