Mental health study finds nurses ‘forever altered’ by pandemic
Nurses have been ‘forever altered’ by what they have seen and experienced during the coronavirus pandemic, the authors of a new study have warned.
The research involved in-depth interviews with 27 nurses in the UK about the impact of the pandemic on their mental health and wellbeing, and found that many were considering leaving the profession.
“I think there is an attitude in the NHS that you have to be strong and not show weakness”
Of the participants, 19 were redeployed during the first wave of the pandemic either to an intensive care unit (ICU) or to another Covid-19 “hotspot” area.
The majority of those who were redeployed felt unprepared due to a lack of training to take on their new roles.
The researchers said the nurses found it difficult to voice their concerns because they “seemed to fall on deaf ears or cast them as troublemakers”.
The high number of patient deaths has been called “traumatic” for nurses who were unaccustomed to working in settings where death was common.
A nurse, Laura, who was redeployed to intensive care, said: ‘Three of my patients have died [in one night]and one of them was younger than my mother and only eight years older than me, it was just awful.
“And you come back the next day and you’re just like, ‘What new hell am I in now? “”
The findings, published in International Journal of Nursing Studiesare part of the University of Surrey’s ongoing Impact of Covid on Nurses (ICON) longitudinal study.
Researchers said many nurses said intense workplace pressures meant they could not provide their normal high standards of care, causing them “moral distress”.
Staffing shortages have also added ‘extra pressures’, with an intensive care nurse having four intubated patients to care for alone when standards say she should have only had one.
Study participants also reported “challenges and frustrations” with obtaining personal protective equipment (PPE).
Community nurses interviewed said they were “upset” that acute services seemed to be prioritized for resources such as PPE.
A community nurse, Sue, said: ‘What little PPE they had…it all went to acute trust, not us.’
The majority of nurses in the study reported experiencing “short-term physical stress symptoms” such as sleep problems, higher rates of alcohol consumption and unhealthy diets.
There was also evidence of compassion exhaustion, burnout and post-traumatic stress disorder among the participants, the researchers said.
Some nurses went into “survival mode” or “autopilot” to get through this period.
“We have a duty as a society to care for frontline staff who have experienced such extreme psychological and emotional distress during this pandemic”
All participants said that they sometimes felt unable to talk about their experiences with partners, families or friends because they did not want to worry or disturb them.
Mental health nurse Alison said: ‘I didn’t tell them for about the first six weeks that I was working on a Covid-19 ward, which is terrible, but I chose not to… I thought that it would make them much more anxious. ”
According to the study.
The researchers found that ‘stigma’ may also have been a factor in some not having access to counseling during the first wave of the pandemic.
Sarah, who has been redeployed to intensive care, said: “[Counselling is] just like almost a sign of weakness that I feel.
“I think there’s an attitude in the NHS that you have to be strong and not show weakness and few people show that much emotion.”
The study saw 27 nurses interviewed after the first wave of Covid-19 in July 2020, and 25 of them were then interviewed again at the start of the second wave in December 2020.
Only two nurses during the first interviews had had access to psychological support. In the second interviews, “many more” had sought advice, although this was “mainly” through sources outside their workplace.
In contrast, the peer support that nurses were able to give and receive from their colleagues was described by most as “the main positive aspect of the pandemic” and created a feeling of “comradeship”.
The researchers concluded: “The nurses said they were deeply affected by what they saw and experienced and were forever changed.
“It is clear that for these nurses the impact of Covid-19 is felt on a deeply personal level and may linger.”
They said there was an “urgent need to address stigma to create a psychologically safe working environment” for nurses and called for the development of a national Covid-19 nursing recovery strategy.
Professor Jill Maben, Professor of Health and Nursing Services Research at the University of Surrey, and one of the study’s authors, said: ‘We have a duty as a society to care frontline staff who have experienced such extreme psychological and emotional distress during this pandemic.
“To avoid a mass exodus of our nursing and midwifery staff, it is important to provide them with the care and support they need.”
His calls to action match those of Breastfeeding time in progress Covid-19: how are you? campaign, which raises awareness of the mental health needs of nurses before, during and after the pandemic.