A survey has revealed the growing mental health strain on UK nurses and midwives who are working during the coronavirus peak, with signs of post-traumatic stress disorder (PTSD) already being reported.
The findings come from the second of three surveys being undertaken as part of ongoing research called the Impact of Covid-19 on the Nursing and Midwifery workforce – known as ICON.
The three reports plan to retrieve data from the periods before the Covid-19 peak, during the peak and one in the period following the initial outbreak.
The first survey in the ICON series founds nurses in the UK were lacking the crucial training they need to tackle Covid-19 and also painted a picture of a nursing workforce under major psychological strain.
More than 4,000 nurses and midwives have been surveyed for the project, which is backed by the Royal College of Nursing Research Society, academics from King’s College London, University of Warwick, Cardiff University, University of Plymouth, University of Nottingham, University of Surrey and St Bartholomew’s Hospital.
The ICON surveys are open to all members of the nursing and midwifery workforce in the UK, including registered nurses, registered midwives, student nurses, healthcare support workers, nursing associates, and trainee nursing associates.
“The experts are warning ministers and officials again just how worried nursing staff are for their own safety and wellbeing”
Ann Marie Rafferty
The second survey, collected between 28 April and 12 May, during the coronavirus peak, found that 88% of respondents said they were worried about risks to their families because of their clinical role.
There were also reports of depression, anxiety, stress and emerging signs of post-traumatic stress disorder (PTSD).
However, very few nurses and midwives have accessed mental health support. The survey found that 12% of respondents had used NHS wellbeing apps such as Unmind, Headspace and Sleepio.
Only 17% had been accessing “time out” rooms and 1% had used Silvercloud – a digital mental health platform that offers behavioural therapy for conditions such as anxiety and depression.
On a more positive note, 61% of respondents felt that the care they were providing patients who did not have Covid-19 was better than, or as good as, care provided under normal circumstances.
When comparing responses from this survey with the first, there has been no improvement in access to training prior to redeployment – with almost two thirds agreeing that this is still an issue.
The availability of personal protective equipment (PPE) has improved – yet 40% said that correct PPE was not always available.
Ruth Harris, professor of health care for older adults in the Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care at King’s College London, said: “Our second survey demonstrates that a large majority of nursing and midwifery staff continue to worry about the risk to their families and to their own personal health of working in a clinical role during the Covid-19 pandemic.
“Providing support for psychological wellbeing, adequate training for redeployment and complete confidence in the availability of PPE is of paramount importance.”
“Learning from previous pandemics we know that the timing of access to support and type of support available for nursing staff is crucial”
Jill Maben, professor of health services research and nursing in the School of Health Sciences at the University of Surrey, highlighted that this fresh evidence was crucial to preparing for future pandemics.
She said: “Learning from previous pandemics we know that the timing of access to support and type of support available for nursing staff is crucial for their overall wellbeing.
“However, our survey results suggest few are currently accessing such services for the stress and anxiety they are experiencing,” she noted.
“It is important to find out why this is in order to protect the workforce. In our forthcoming interviews we will be exploring nurses’ experiences further – asking them what strategies have helped in these difficult times and what do they need going forward.”
Professor Anne Marie Rafferty, president of the Royal College of Nursing, responded to the findings by calling on government action.
She said: “The experts are warning ministers and officials again just how worried nursing staff are for their own safety and wellbeing. The government must act to address this.
“The emerging signs of post-traumatic stress disorder are a particular concern, and there must be proper planning to ensure support is available on an ongoing basis,” she said.
“Nursing staff are not just working relentlessly to provide care in extreme circumstances – they are doing so while worrying about the safety of their families, especially given the ongoing lack of proper PPE.
“It takes extraordinary courage, as well as commitment, compassion and expertise, especially in risk management to do this. Nursing is a safety-critical industry and profession.”
She added: “The government must do all it can to equip our nursing staff and support them, now and over the longer term.”
A spokesperson from the Department of Health and Social Care said: “Supporting the mental health and wellbeing of our heroic staff during this unprecedented period is a top priority, and we understand the huge pressures they and their families are facing.
“We have a range of services available to staff, including the launch last month of a mental health hotline. Other services range from practical and financial assistance through to specialist bereavement and psychological support.
“Anyone struggling should come forward to a colleague, their occupational health team or the helpline so that they can get the help and support they need,” they said.
Nursing Times has launched a campaign called Covid-19: Are You Ok? to highlight the mental health needs of nurses on the frontline and to lobby for immediate and long-lasting support.
A recent survey for the campaign found that 33% of respondents rated their overall mental health and wellbeing as “bad” or “very bad” and 50% described themselves as “a lot” more anxious or stressed since the pandemic.
The survey, which had 3,500 respondents, also revealed nurses’ concerns around access to personal protective equipment, contracting Covid-19, being redeployed and witnessing the death of patients without family present.
More on the Covid-19: Are You OK? campaign