Research exposes gaps in mental health support for frontline nurses during pandemic

Researchers have found gaps in mental health support for frontline respiratory nurses and their families during the COVID-19 pandemic.

Glasgow Caledonian University (GCU) health services researcher Dr Nicola Roberts is the Principal Investigator in a new research paper entitled ‘Experiences of nurses caring for respiratory patients during the first wave of the COVID-19 pandemic: an online survey study’.

Dr Roberts worked with colleagues at Edge Hill University and Southampton University exploring the experiences of nurses caring for respiratory patients during the first wave of the pandemic in early 2020. The paper was published in the BMJ Open Respiratory Journal.

The research team analysed responses from over 255 nurses throughout the UK who highlighted concerns over their working environment, the supply and availability of adequate PPE, the quality-of-care individuals were able to deliver, and impacts on mental health to nurses and their families.

Dr Roberts said: “A very high number of participants highlighted their worries and concerns about the impact on their household. These included potentially bringing the virus home, the effect on family members worrying about them, mental health and the impact of changing working patterns, and managing with children. It was evident that respondents were very concerned about the impact of COVID-19.”

Initial findings from the survey published last year found that 21% experienced moderate to severe symptoms of anxiety and depression during the first wave of the pandemic. This study highlights the gaps in mental health support for frontline respiratory nurses and their families during the COVID-19 pandemic.

Dr Roberts explained: “Although nurses working in respiratory areas have adapted and tried to ensure they supported each other there have been gaps in the support and management of staff. There were inconsistencies in provision highlighting the importance of nursing leadership and management in ensuring equity of access to services.

“Lessons need to be learned from this and in the future to ensure all staff have access to appropriate mental health support to ensure that the most vulnerable don’t slip through the cracks. We know from our previous work that younger nurses experienced more anxiety and depression compared to older, more experienced nurses.”

The research concluded: “Support for staff is essential both throughout the pandemic and afterwards, and it is important that preparation of individuals regarding building resilience is recognised. It is also clear that psychological support and services for nurses and the wider healthcare team need to be available and quickly convened in the event of similar major incidents, either global or local.”

Dr Roberts stressed that NHS staff were already experiencing high levels of mental health issues, anxiety and depression even before COVID-19, so mental health support is important at all times but even more so during a pandemic.

“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,” she added.

“Most responses detailed the services that nurses knew about and were available but had not necessarily accessed, such as self-referral to services, email support, signposting services, telephone support, counselling services, chaplaincy, huddles or hubs, occupational support and webinars. Most of the support available was not face-to-face.

“A small number reported that they were uncertain about how to access provision and others were not aware of any current support services from their employers. One respondent reported that different facilities were available for doctors compared to nurses.”

Alison Hughes and Joanne King, Chair and Vice Chair of the Association of Respiratory Nurse Specialists (ARNS), said they recognised the effort that had gone into this important study and were delighted to support it.

They added: “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.”

One nurse involved in the study said: “I have set up a WhatsApp group for my team who are redeployed to the ward for support and also I have made an unused room in my now empty clinic room into a 'wobble room' where the staff can rest and try and gather their thoughts. It has lots of tissues, soft music, coffee and love.”