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COVID-19 and nurse well-being: how to ensure staff aren’t afraid to come to work

What exhausted, overstretched and anxious front-line staff need now from senior leaders

What exhausted, overstretched and anxious front-line staff need now from senior leaders

Since the COVID-19 pandemic hit the UK, front-line nurses have spoken about being frightened and anxious.

Worse, a third are considering leaving the profession, according to a recent RCN survey, with nearly half (44%) stating this is due to how they have been treated during the COVID-19 pandemic.

Leading healthcare teams in unprecedented times

To face this years challenges, our matrons, ward managers, sisters and charge nurses had to be resilient and flexible.

Front-line leaders were managing their teams in unfamiliar environments, dealing with seconded staff and following often inconsistent and confusing guidance.

What exhausted, overstretched and anxious front-line staff need now from senior leaders

A nurse wearing a face mask and scrubs
Picture: iStock

Since the COVID-19 pandemic hit the UK, front-line nurses have spoken about being frightened and anxious.

Worse, a third are considering leaving the profession, according to a recent RCN survey, with nearly half (44%) stating this is due to how they have been treated during the COVID-19 pandemic.

Leading healthcare teams in unprecedented times

To face this year’s challenges, our matrons, ward managers, sisters and charge nurses had to be resilient and flexible.

Front-line leaders were managing their teams in unfamiliar environments, dealing with seconded staff and following often inconsistent and confusing guidance.

There was confusion about what the correct personal protective equipment (PPE) was and when it should be worn, as well as issues with the supply chain.

As national and international guidance emerged, it felt like rules were changing as equipment became available or unavailable, not because the science was saying it was safe.

Anxieties over supplies of personal protective equipment

Police officers don’t face a rioting crowd without protective clothing, firefighters don’t enter a burning building without the correct equipment, yet many nurses were left without PPE.

The press – in its attempt to highlight failings in the systems responsible for providing PPE – frightened the people who relied on them to provide it.

It is difficult to convince an already anxious workforce there is enough PPE in the building when the media says there is a national shortage.

Members of the military delivering much-needed PPE in the COVID-19 first wave
Members of the military were brought in to deliver much-needed PPE in the first wave
Picture: Getty

Finding ways to keep healthcare workers safe

Meanwhile, as news headlines focused on the tragic deaths of healthcare staff, many staff were frightened to come to work.

Large, well-resourced hospitals, with infection control teams able to activate major incident plans and create COVID-19 response units at short notice, appeared to fare better than most.

But a vast number of healthcare workers do not work in these environments.

Small care homes, of which there are thousands in the UK, do not have access to such services.

Such organisations do not employ consultant nurses for infection control or have a palliative care team to step in and support staff to care for the dying. They do not have access to psychological counselling services when they need them.

Staff are reliant on their workforce leaders. In a crisis, these are the people who they must trust to guide them through the procedures to keep them safe.

For many of these leaders, this is unchartered territory.

COVID-19 presented unprecedented daily staffing issues and will continue to do so. Leadership support and training for our front-line teams needs to change.

Our leaders need to train hard and quickly to become flexible, adaptable and pragmatic and to enhance their skills in leadership under extreme conditions.

Helping to heal a traumatised workforce

Large numbers of healthcare staff have been traumatised by working during the pandemic, but there is little consistency on what front-line mental health support for them should look like.

Many organisations have provided access to staff counselling services throughout the pandemic, with little uptake or reported benefit to the majority of staff.

Hospitals have hosted Schwartz rounds, had team debriefs, given out certificates and awards, yet still staff report anxiety, exhaustion and concern for the well-being of their nursing colleagues.

‘Front-line staff kept safe and well-informed, with leaders they trust… will flourish and thrive and cope with whatever comes next’

Before COVID-19, our front-line nurses were already stretched, battle weary and drained.

Hospital staff on a ward putting on PPE
Staff must be able to rely on PPE supply Picture: PA

At the onset of the pandemic, teams rallied, pulled together and found an inner strength that got them through an unprecedented three months of healthcare crisis. We cannot rely on this as a strategy for front-line carers again.

It is not enough to applaud them for their compassion and care, provide counselling and expect that they can just carry on. We must:

  • Provide consistent, clear guidance that only changes if scientific evidence dictates.
  • Provide the correct PPE, ensuring the supply will never run out or become an issue again.
  • Invest in our front-line leaders to become agile, flexible experts in infection control.
  • Regain the trust and confidence of our front-line staff by ensuring visible senior leaders speak with one honest, open and up-to-date voice.

Front-line staff kept safe and well-informed, with leaders they trust, will not need emergency mental health support, but will flourish and thrive and cope with whatever comes next.

It is critical that senior nurse leaders support and protect the nurses and other healthcare workers on the front line.

To lose the experience and knowledge we have already gained would be disastrous, but for nurses to opt to leave their jobs because they are too frightened to be at work is unforgivable.


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