Opinion: nurses are already high risk for mental illness due to the nature of their jobs and dealing with the pandemic will add more pressure
The current pandemic has altered care delivery at all levels. The change is a necessary one, but this new work environment poses a hazard to the welfare of healthcare workers. It will have an impact not only on their physical health, but also their mental and emotional wellbeing.
It's normal to be anxious during a pandemic and it is even expected for healthcare staff and carers as they deal with the uncertainty that unprecedented situations and new roles bring. In normal circumstances, though, nurses are high risk for mental illness due to the nature of their jobs and recent events will just add more pressure to this already vulnerable group. Organisations, nursing leaders, educators and even society must endeavour to address this in some way.
Staff resilience and health will be challenged, during and after this crisis; either from a particular case, or a series of cumulative events. One nurse on the frontline, who is currently in isolation stated: "the first few days I was off work I was so tired. My mind was very active though, and I was constantly thinking about work and feeling guilty, everything that was happening was really weighing on me".
From RTÉ Radio 1's Ryan Tubridy Show, nurse Terrie McEvoy Fitzpatrick on what day-to-day life is like on the wards of Ireland's hospitals in these difficult times
Another nurse reported the difficulty around informing people about their positive test results. "We have the professional training and skills to deal with these situations, and we do our best, but we are not immune to the distress of our patients". Over on the wards, one staff nurse spoke about the events of their last shift: "some patients beat the virus and some sadly left this world with only us by their sides, which is just heartbreaking. This is what we are trained for, but it is really so hard right now".
Currently, the Health Service Executive and some other employers offer access to an employee assistance programme which provides a number of free counselling sessions. But will this be enough? One study looking at the impact of the SARS outbreak in 2003 on healthcare workers found that 50% of participants experienced psychological distress. It only follows that access and availability of current supports will need to be expanded.
Dublin City University's Psychotherapy Department have extended their services to develop additional support packages. These include remote individual and group assistance for staff working at their contract tracing centre, and for student nurses redeployed to front line services. Extra initiatives like this are a welcome addition and will go some way in aiding the wellbeing of staff.
From RTE Radio 1's Morning Ireland, how staff like cleaners in hospitals and nursing homes are coping with Covid-19
Furthermore, mental health is intrinsically linked and influenced by physical health, and vice versa. Nursing leaders can play a role by ensuring staff take sufficient breaks to hydrate, eat and rest throughout their shifts. They can also facilitate debriefings, and advocate for staff, regarding safety measures and equipment. The nurses and healthcare staff on the ground are highly skilled, but these professionals must have the relevant supports, equipment and conditions in place, that allows them to do their job to the full extent of their abilities and training.
Our healthcare leaders and managers are not immune to psychological distress either. Buddy systems may be helpful for them and other members of staff. Informal or formal networks like these, aid colleagues to support and lean on each other; but most importantly, watch out for each other’s wellbeing. No doubt, they are also dealing with similar struggles or feelings.
Many healthcare staff are worried about contracting the virus and, worse, infecting their loved ones. As a result, some staff have become very isolated. Family members and friends can also play a role by providing support or practical assistance where possible and staying connected. We must also encourage and remind frontline staff to take care of themselves by getting sufficient rest between shifts, eating healthy, exercising and engaging in pastimes that help them relax and unwind.
From RTÉ Radio 1's News At One, Phil Ní Sheaghdha from the Irish Nurses & Midwives Organisation on frontline nurses treating those with Covid-19
It has long been ingrained in nursing history and culture that the patient comes first. This lingering ethos is not healthy as you can’t help anyone if you don’t take care of yourself first. Nurse educators must endeavour to eradicate this rhetoric for future generations. During this pandemic, we have seen that the health of nurses and carers has never been more important. However, it should be a priority - not only now but always.
It is very heartening to see the appreciation the general public are showing for frontline staff, but I hope this support will act as a catalyst for action, in what is the year of the nurse and midwife. A recent report by the World Health Organisation on world nursing stated that governmental policies must "ensure that nurses are represented at all levels of decision-making" and "have a voice in influencing key health system decisions and public health policy matters".
This call for action becomes more urgent with the current pandemic, which has highlighted once again the value of nursing professionals and the consequences of underinvestment. The voice of the nurse is vital in identifying the kind of resources and supports they need to do their jobs. It is also imperative in influencing and shaping policy that translates into action on the ground that is practical, sensible and safe for both staff and patients.
The views expressed here are those of the author and do not represent or reflect the views of RTÉ