“Extremely concerning” levels of psychological distress were seen among the UK’s nurses and midwives during the COVID-19 pandemic, new research has revealed.
From information collected at three points during the first wave of the pandemic in 2020, high levels of distress were found, including experiences consistent with post-traumatic stress disorder (PTSD), stress and anxiety.
A combination of pre-existing workforce challenges, rapid changes to professional life and ways of working, high patient mortality rates, risk of illness to both the individual and their family, and the way in which healthcare organisations responded to the pandemic, may all have had significant impact, the research found.
“We know that even prior to the pandemic, the UK nursing and midwifery workforce was under significant strain due to high levels of attrition and ongoing recruitment challenges,” said Dr Keith Couper, assistant professor in emergency and critical care at the University of Warwick and project lead.
“Our study clearly highlights that staff experiences during the COVID-19 pandemic has had significantly exacerbated this strain.
“The findings of our research show that the psychological impact of the pandemic on the UK nursing and midwifery workforce has been extremely concerning. The ongoing challenges during subsequent pandemic waves have likely exacerbated this impact.”
The Impact of COVID-19 on the Nursing and Midwifery workforce (ICON) study is a longitudinal national survey which aimed to assess the mental health effects of the pandemic over time on the nursing workforce and identify the personal and workplace factors associated with wellbeing to inform the response to the current pandemic and support preparation for future pandemics.
Key findings include:
- A significant proportion of participants were identified as having probable PTSD. While this declined over the three surveys, almost 29.3 per cent continued to report experiences indicative of a probable post-traumatic stress disorder diagnosis three months after the first pandemic peak
- Severe or extreme stress was reported by almost 17.5 per cent of respondents three months after the first pandemic peak
- 40 per cent reported that they lacked confidence in infection prevention and control training that they had received, or that training had not been received
- Six per cent felt that the correct personal protective equipment was not always available
- Prevalence of some psychological issues decreased following the first pandemic peak, but a significant proportion of participants continued to experience negative psychological effects during the pandemic recovery phase.
The surveys were taken at three time points between 2-14 April 2020, 28 April-12 May 2020 and 30 July-20 August 2020 and provide insight into psychological impact of the pandemic during the first wave and into the recovery period.
The ICON study was developed by the Royal College of Nursing Research Society and led by the University of Warwick and King’s College London, with collaborators including Barts Health NHS Trust, City University of London, University of Nottingham, Cardiff University, University of Plymouth, and University of Surrey.
All members of the UK nursing and midwifery workforce were eligible to complete the survey, including registered nurses, registered midwives, student nurses, healthcare support workers, nursing associates, and trainee nursing associates. The survey was distributed by social media, the Royal College of Nursing, and other key professional organisations.
Across the three surveys, a total of 7,840 analysable responses were received.
These findings can inform how healthcare organisations should respond to staff wellbeing needs both during the current pandemic, and in planning for future pandemics, said the researchers.
The study concluded that healthcare organisations should urgently implement evidence-based strategies to support the wellbeing of members of the nursing and midwifery workforce affected by the pandemic, and develop robust workforce plans in preparation for future pandemics.
Ruth Harris, professor of health care for older adults in the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care at King’s College London, added: “Our findings should drive healthcare employers throughout the world to address shortcomings in their organisational response to COVID-19, and future health emergencies, to both prevent psychological issues developing and ensure that those affected receive timely high-quality evidence-based support during the pandemic and as needed thereafter.”
