Covid-19's Impact on NHS Staff Mental Health

by Sam Head 

Image: Ashkan Forouzani (Unsplash)

For three months, hospital staff have faced the pressure of a major critical incident every day. This is due to the Covid-19 pandemic. Covid-19 is a highly contagious virus, the effects of which range from mild to severe respiratory problems. This has resulted in many people being admitted into ICU wards that specifically care for those infected. In ICU wards that have 24-hour care, seven staff are required to work with each patient. This is a labour intensive process, which creates pressure on NHS staff. This stress has dramatically increased because the number of patients in ICU wards has grown. Thus, this piece is aimed at examining the mental health of hospital staff on the front line. Can they manage the trauma? 

Due to the velocity of the number of patients contracting Covid-19, and it being a new strand of disease with no present research or vaccine this has left all doctors and nurses in the NHS and around the world without a tried and tested method of treatment. Covid-19 has become an unknown variable. Humans psychologically have a fear of the unknown and that renders people incapable. This is a new situation for medical staff to find themselves in. Furthermore, staff who have been enlisted into an ICU ward with no previous experience are left feeling unprepared. It is this lack of preparation that can cause stress and a feeling of overwhelming alienation. For example, a renal specialist could have anxiety confronting respiratory issues, which relate to this disease. 

Another stressor in these current conditions is that physical interaction is limited, to prevent spread. This can impact upon patient-staff interactions as personal protective equipment does reduce face to face communication as well as identification. The daunting masks and protective heading gear can mean there is no individuality in the staff. Due to this building rapport is difficult, maybe even impossible. We have all seen hospital staff on news reports who have written their names on their headgear to try to overcome these barriers. The anxiety this causes to the patients reflects onto the staff. Anonymity is known to hamper human interactions. 

Staff have also had increased stress worrying whether they would have enough personal protective equipment for their full shift. Due to high demand, resources have been limited in the UK, and thus whether the second delivery of equipment, which is later in the day, has always been uncertain. This has left staff being unprotected from the virus themselves. In turn, this has a knock on effect, as contracting the virus means they cannot look after the patients they are trained to look after, but they could pass on the killer virus to their loved ones. A double jeopardy. Isolation has been difficult for all, however within the hospital context this has meant patients suffering and dying have been without close relatives by their side. Staff have also had to deliver damning news remotely, a phone call – which is not the optimum way to communicate. 

This continual persistent pressure and stressors build up overtime. Creating such exhaustion both mentally and physically. All involved require residual strength. This pandemic has tested the NHS and the staff to its utmost limits. The guilt of not being able to perform at peak condition will be rife within the profession of medicine. Thus, a lack of readiness, a feeling of uncertainty, encountering individuals who have the virus putting themselves and their own families at risk and dealing with patients who have a high risk of mortality results in hospital staff potentially experiencing serious negative psychological effects. This is called vicarious traumatisation, where hospital staff through empathy take on board the suffering of those in their care. Trauma can be defined as an emotional response to an abhorrent experience. Responses include lack of sleep, feeling of anxiety, depression, and suicidal thoughts. So let me ask you this when the NHS staff are looking out for us who looks out for them? Who is responsible for the health and well-being of these selfless individuals? 

There are a number of ways to deal with the effects of trauma. One of the main options is to offload your thoughts and feelings to another individual. Talking to colleagues who are in the same situation and who understand is often useful. However if the symptoms persist then medical help maybe warranted such as counselling or psychological intervention. To prevent hospital staff, a precious resource, from suffering emotional and behavioural responses to trauma in the first place is to build up their resilience. Resilience training is used in the military. This to enable staff “to bounce back from adversity” (Shortland, 2020). One-step to resilience is self-awareness, having an understanding of the signs, which link to stress. Then being proactive and knowing the coping strategies that mitigate the anxiety. For example, physical exercise. As the pandemic progresses and there is a suggestion of a second wave, where there is another peak in the number of people contracting the virus, preparing the staff in readiness is key. Hospital management can reduce the shock polarity of an ICU ward, by having staff familiarise themselves in that environment by working a few shifts there every month or few weeks. This is to produce sustainability. 

This unprecedented situation that has faced all nations around the globe has led to medical teams having to face trauma, both from their patients and their own, on a scale never seen before. It is testament to the NHS staff in the UK that they have dealt with this pandemic without many immediate repercussions. Any long-term ones only time will tell. Now, counselling and psychological help needs to be provided to staff to ensure that there is enough resilience in case of a second wave.