Protecting staff health and wellbeing

Photo of Roz Blackboro, Director of Nursing Care Group 3 The pandemic highlighted the importance of maintaining staff wellbeing as never before. Director of nursing of care group 3 Roz Blackboro, describes how we have drawn on that learning to build a stronger future.

To do the best for our patients, healthcare professionals have to be at their best themselves. But for many years, across the NHS, staff wellbeing was taken for granted. It never became enough of an issue to make everyone sit up and take notice, and mostly people just ‘got on with the job’. Then the pandemic shone a huge spotlight on the NHS, and it was widely recognised that staff wellbeing had to move right up the agenda.

As Director of nursing for one of our sites and, formerly, Head of Nursing for Critical Care, I had developed a good understanding of our culture on the wards. At MSE, like other trusts, before the pandemic our health and wellbeing provision was predominantly reactive. If somebody was having a difficult time at work, you’d refer them to occupational health, or to counselling for issues arising outside of work. Provision was reasonable but not extensive. Staff morale was fairly good. There were fluctuations during winters, as they’re always harder – but staff were generally buoyant and most departments had good staffing levels.

Then Covid arrived, and it hit us like a tsunami. Intensive care units (ICUs) are accustomed to seeing the sickest of patients, in the worst situations, but we’d never seen anything like this. During normal times, our ICU might see around one person each day who needed intubation, but by the peak, they were intubating six every day. At the other end, they were seeing three or four deaths a day. Suddenly, our staff were seeing death and suffering beyond anything they’d ever imagined.

Clearly, there was an urgent need for these staff to have a space where they could go to contemplate or have a cry. At the same time, other staff were struggling with a host of difficulties, from feelings of isolation during home working or lockdown, to ill health, anxiety, depression or bereavement. They needed support, too, to help them stay strong.

What we did

Over the months, a palette of health and wellbeing initiatives emerged, to build up the health and wellbeing of all our staff (see the box), but beyond these individual initiatives, we also began to see a wider cultural shift.

Today, health and wellbeing is high on the agenda at a strategic level, but it’s also becoming a normal part of daily working lives. Everyone is more aware of what’s on offer beyond occupational health and counselling, so staff find it easier to ask for support, and managers and leaders are more able and willing to offer it.

Wellbeing initiatives introduced during the pandemic

Health and Wellbeing Hub during the first wave, a team of play leaders and other creative colleagues performed a 48-hour transformation, converting a former admissions lounge. The new hub is split between a quiet contemplation area and a sociable area with a TV, offering comfy chairs, hot drinks and biscuits, counselling and signposting to support, with a significant impact on wellbeing of ICU staff

Online wellbeing support including mindfulness apps and bitesize learning offered through NHS England.

Health and wellbeing champions include staff from across the trust, volunteering to signpost colleagues to healthy ways of working and additional support.

Psychological support for ICU staff, with the trust investing in 2.8 whole-time equivalent psychologists plus a clinical nurse specialist for psychological health and wellbeing and a whole-time equivalent nurse.

Health and wellbeing email updates from HR business partners, detailing the current offer.

Building for the future

Now we’re seeing this change, it's vitally important that we keep it going – because the challenge isn’t over yet. Across much of society, there is a sense of returning to normality. But for healthcare staff there is no let up: we’re still going at 100 miles per hour because there’s a huge backlog of people waiting for essential care. Meanwhile, the NHS is facing a widespread staffing shortage. So we’ve got to give our staff the support they need to sustain their workload going forwards – and to stay with us in the longer term.

For some, the daily working pressures are compounded by the after-effects of working through the pandemic. Some trauma-related mental health conditions, such as PTSD, can take a while to manifest, so I suspect we’ll see a higher level of these conditions among our staff – certainly in the next few years – highlighting further need for excellent wellbeing support.

As a trust, we recently merged and this, too, has led to further uncertainty and anxiety. One opportunity it offers is the chance to spread our best practice across all our sites. I feel strongly that all our people, whatever their specialty, should be able to work in an environment that supports their health and wellbeing. It’s not all necessarily about having a psychologist on hand, though: often, it’s the little things that will get you through a hard shift, like having a proper canteen where you can sit down and eat a hot meal.

Why it matters

My raison d’être is to make sure our patients are getting the care I’d expect for the person I love most. Often, it’s assumed that health professionals will push themselves beyond the limits because it’s a vocation. But if they aren’t well enough mentally and physical to do the job properly, then it’s not just them who suffers: the patient suffers too.

It’s sad that it’s taken a pandemic to change this mindset. But today, people at all levels across Mid and South Essex – and actually across the wider NHS, too – understand that staff health and wellbeing has to stay at the top of the agenda. And that’s brilliant.