Mental health needs of frontline nurses ‘not met during pandemic’

The mental health support offered to respiratory nurses working with Covid-19 patients during the first wave of the pandemic was “inconsistent”, the study found.

“We want nurses to ask for help if they need it, there are lots of different options out there”

Nicola Roberts

It highlighted that nurses in some places were not offered any extra support at all, despite working under conditions of extreme stress.

The study, published in the journal BMJ Open Respiratory Research, was led by Glasgow Caledonian University and also involved researchers from Edge Hill University and Southampton University.

It was based on survey data from 255 registered UK nurses who were working with respiratory and/or Covid-19 patients in primary, community or secondary care settings during the first wave of the pandemic in June 2020.

Initial findings from the survey, which were published last year, found that 21% of the nurses experienced moderate to severe symptoms of anxiety and depression during the first wave of the pandemic.

Causes of stress included concerns over adequate personal protective equipement (PPE), the quality of care that nurses were able to give to patients, and the risk of transmitting Covid-19 to family and friends at home.

Meanwhile, the latest part of the study highlighted the gaps in mental health support for frontline respiratory nurses and their families during the Covid-19 pandemic, said those behind the research.

Although most nurses who took part in the survey knew about mental health services that were available to them, including self-referral to services, telephone support and counselling services, less than a third of the nurses felt they had received additional support from their management team, and some stated they had received no support.

However, although the study found inequity in the provision of psychological support services to nurses from different organisations, it also found examples of good mental health support, often organised informally by the nurses themselves.

These included social media support groups, “buddy” systems for more senior nurses to provide support to junior colleagues, and the setting up of “wobble rooms” that provided a safe space where staff could take a short break when they felt overwhelmed.

Lead investigator Dr Nicola Roberts, a health services researcher at Glasgow Caledonian University, said: “It is about recognising that support needs to be tailored, it’s not just about sending people on resilience courses.

“We need a more personalised approach to how we manage mental health and resilience in organisations at all levels individually, teams, departments and organisations as a whole, and in a more supportive way rather than just a tick box exercise.”

In the early stages of the pandemic, Nursing Times launched the Covid-19: Are You OK? campaign to highlight the mental health needs of nursing staff before, during and after the coronavirus crisis.

Since then, a range of service providers and other organisations have signed a pledge to support the principles of the campaign and to show their commitment to protecting nurse wellbeing.

Dr Roberts said she supported the aims of the campaign and that it was essential for nurses to get the psychological help and support they needed.

She warned that previous research carried out in Canada had shown nurses experiencing this kind of psychological stress to be at increased risk of suicidal thinking.

“We want nurses to ask for help if they need it, there are lots of different options out there.  They can use independent resources if they don’t want to use organisational support – but get help,” she told the Nursing Times.

She added that mental health support for nurses who had been caring for Covid-19 patients would continue to be important over the months and years ahead:

“This is only the start for this group of workers,” she said. “What you might find is you have more incidences of post-traumatic stress disorder, fatigue, burn-out.  So we can’t take our eye off the ball.

“Everybody thinks things are improving but in actual fact the long-term mental health lag of this is probably just around the corner,” she said.

Dr Nicola Roberts recently wrote an opinion piece for Nursing Times on how adults with learning disabilities are much more likely to experience respiratory problems, compared with the wider population, and this can lead to serious illness or death.

• ‘Covid-19 has highlighted the importance of respiratory health monitoring in people with learning disabilities’

Alison Hughes and Joanne King, chair and vice chair of the Association of Respiratory Nurse Specialists, said they supported the study and its findings.

“This valuable study shows that investment in quality research highlights the principal role respiratory nurses have played during the pandemic and the need for ongoing enhanced psychological input to minimise long term impact.

“It is important to highlight that nurses set up and supported their teams and colleagues in some really innovative ways but we need to make sure that the support is equitable and available in an appropriate format,” they added.