By Dr Veronica O’Doherty and Psychology Team Tallaght University Hospital.
We are now over a year and half since the first lock down was initiated to prevent our hospitals from being overwhelmed with COVID-19 cases. Currently we are experiencing our fourth wave of cases courtesy of the DELTA variant. Acute hospital staff are now dealing with over 110% occupancy rates and the ongoing pandemic rising rates in the community and subsequent numbers of patients arriving onto the wards and ICU. The numbers in our hospitals are lower than the first phase but a slow steady increase in evident nonetheless. How is this continuing to impact on Healthcare staff and what can we do to support them? In the spirit of compassionate leadership the Psychology Department in Tallaght University Hospital spearheaded a timely bespoke evidenced based suite of supports when the first wave hit Ireland. Others replicated similar systems across the acute hospitals including within CHI. Many of these services included psychological first aid support telephone consults, team resilience training, educational blogs and videos and mindfulness-based audios and other supports. The Psychology Department, (with a wonderfully collaborative approach from our colleagues in Health and Social Care Professions), also created an evidence-based, whole-person rehabilitation and recovery guide to support patients and staff post COVID-19 infection to self-manage their recovery. With generous funding from the Meath Foundation this colour printed manual is now available for patients attending TUH for follow-up COVID Clinics. The guide was created to give patients and families the knowledge to be actively involved in their own recovery and support them with information on physical and psychological health, including what they themselves may notice or experience during the process of recovery following COVID-19. Topics include managing fatigue, sleep, thinking skills, and information on nutrition, goal setting, and managing breathlessness. The guide received very positive feedback from patients with comments such as “this is brilliant as I didn’t know any of this and it will help my family understand what I am going through”.
Healthcare staff are just human beings who are skilled professionals trained to take care of people and we have a duty of care to ensure we continue to take care of them.
All of these initiatives were only possible to roll out when other services had temporarily been reduced. Many of these services have been wound down or are operating skeletally on the goodwill of individual staff members lending support when requested. Our services are still being requested as we continue to get call requests from staff from many different areas within the hospital. The psychological support now needs to be embedded as a stand-alone service as staff are struggling to cope in a health service that has been running on empty for decades, dealing with the ongoing pandemic plus a cyber attack to top it all. Michael West discusses that ‘staff stress in the NHS had been steadily increasing, with more than 40% of staff in the NHS reporting they had been unwell in the previous year because of work stress, and one in four nurses leaving the NHS within three years of joining’. We may not have similar large scale health and safety surveys to draw upon but that does not mean we don’t have similar issues with staff burn out and resultant recruitment crises across the board, in many healthcare professions.
West further demonstrates that ‘compassionate leadership results in profoundly better staff wellbeing and commitment, improved care quality, and fairer, more transparent and kinder workplaces. From the NHS national staff survey, running over 18 years and completed by more than half a million staff each year, clear associations were found between supportive leadership and care quality, staff wellbeing, financial performance and lower levels of patient mortality.
Healthcare staff are just human beings who are skilled professionals trained to take care of people and we have a duty of care to ensure we continue to take care of them. It remains unclear what long-term impact the pandemic will have on staff, but prevention is clearly the best route to adopt to maintain a healthy functioning an compassionate health service that takes care of its key resources, the people that deliver the care. The psychology team in TUH would advocate strongly that one pandemic lesson we need to pay attention to during this difficult experience is that health care staff matter and onsite timely support can prevent the long term impact of stress and ultimately foster a culture of compassionate care that impacts directly on everyone working or using the health services. Can we afford not to?