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Community nurses must take time out for their mental health during the COVID-19 crisis

Prioritising time for yourself during the COVID-19 pandemic is not optional, it's critical, says a leading nurse

Community nurse
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In my role as chief executive and nurse director of the Queen’s Nursing Institute Scotland, I hear nurses trying to make sense of the COVID-19 situation, and realise the enormity of what we are facing collectively.

As nurses our greatest skill is in problem-solving, and we are doing that at pace right now. We are redeploying our skills in new ways and in new settings. We are implementing virtual working, something that would usually be years in the planning has now happened in a matter of weeks.

Every time we see a need we bring our creative, solution-focused genius to bear.

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Wobble rooms can help unravel emotions during times of stress and distress

So-called wobble rooms, which are springing up in hospitals across the UK, are one such example.

They act as a place where staff are offered a workplace sanctuary to let go, unravel and express emotions at this time of extraordinary stress and distress.

Yet for community-based staff that’s trickier – how many of our cars have become wobble rooms? Taking a moment, sitting in the driver’s seat before the next visit, can sometimes provide the only safe space to cry.

Community nurses are being creative about coming up with ways to support each other: from using online meeting apps to check in with one another, to the district nursing team in Edinburgh that has implemented a ‘going home’ checklist as part of an end-of-shift debrief.

Acknowledge the enormity of the pandemic – and ways to process it 

I was on a Zoom call with a group of Queen’s Nurses recently, where phrases such as ‘roller coaster’ and ‘plate spinning’ were used to describe the speed and intensity of what we are experiencing.

And that emotional dial is way up just now. I turn on the radio and hear poetry of a woman describing losing her sister to COVID-19, a powerful reminder that behind the statistics every life is someone’s sibling, friend or cherished aunt or uncle.

‘Our greatest expertise is in communicating our support and compassion to others. And yet we sometimes fail to show that to ourselves’

It can feel overwhelming, so how do we begin to process it all?

As nurses and midwives, we are good at coping. Our calm professional faces are well rehearsed, and we give the impression of taking crisis in our stride. Sometimes we genuinely feel okay. We are making a difference and doing what we have been trained to do and that feels good.

But many nurses are telling me that they have never had such disturbed sleep, with some experiencing vivid dreams and even nightmares. We may or may not be conscious of our stress, but sometimes our unconscious minds are letting us know that all is not well.

Looking out for yourself – and each other

That’s why it’s so important we are serious about self-care right now. We need to reach out to each other and share how we are feeling.

It’s only together that we can cope with the challenges we are facing: coping with feelings of anger as personal protective equipment still isn’t reaching everywhere it’s needed; or the pain of listening to someone who has just been told of a terminal cancer diagnosis and then finds out that the team who would normally support them has been redeployed to COVID-19 initiatives; and the emotional impact of having conversations about anticipatory care.

‘Personal space is even more important at the moment. Remember the old adage about putting on your own oxygen mask before helping someone else’

Our greatest expertise is in communicating our support and compassion to others. And yet we sometimes fail to show that to ourselves. 

Chronicling experiences is a powerful way to get in touch with your feelings

Personal space is even more important at the moment. Remember the old adage about putting on your own oxygen mask before helping someone else. Only you know what ‘oxygen’ is for you – whether it’s that precious hour of exercise outside or mindfulness, yoga, baking, or singing along to power ballads – prioritise that time for yourself. It’s not an optional extra, it’s critical.

And as we try and make sense of all this, chronicling experiences can provide a powerful way to get in touch with our thoughts and feelings. Only you will read it, so it doesn’t need to be perfect prose. Open a book, turn on your tablet and just write. What are you noticing about yourself? What do you need to let go of? What is beginning to emerge?

Managers can help by monitoring breaks and signposting sources of support

Crucially, employers need to play a key role in supporting the mental health of their workforce.

A recent RCNi article, How COVID-19 is affecting nurses’ mental health, and what to do about it, includes some useful advice and suggestions on how managers can help their teams during the COVID-19 pandemic, including monitoring breaks and signposting sources of support.

Above all, let’s continue to innovate in the way we care for ourselves. Let’s find new ways to remind each other that we are enough.

And let’s prioritise those moments of stillness just to ‘be’, to bring kindness to ourselves so we can continue to share it with others.


Clare Cable is chief executive and nurse director of the Queen’s Nursing Institute Scotland

 

 


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