Re: Managing mental health challenges faced by healthcare workers during covid-19 pandemic
Dear Editor,
Professor Neil Greenberg and colleagues have raised a really important issue in this article and highlighted the increasingly pressing need for the NHS as an employer to look after the wellbeing of our staff and to provide adequate support during and in the aftermath of this pandemic.
NHS staff are often under significant pressure in normal times but this pressure has inevitably increased during the current crisis. It is almost impossible to remove stress completely from NHS roles as the work is often highly emotional and can involve very difficult decision making. What we can and must do however, is think more widely about how we can create the most supportive environment possible to foster their wellbeing and minimise the need for personal resilience by, for example, reducing stress in areas of their work where this is possible.
At the National Workforce Skills Development Unit (NWSDU) we have been exploring ways to help organisations to support their staff. We believe that a focus on organisational rather than individual resilience is the most effective way of managing psychological distress and supporting the health of the workforce. [1]
Interventions mentioned in this article such as Schwartz rounds (forums where all staff come together regularly to discuss the emotional and social aspects of working in healthcare) are a good way to address specific issues such as psychological distress due to the demands of making morally challenging decisions or what Greenberg Et al. cite as moral injury. Beyond immediate interventions like this, we also need to think about what else organisations can do to be supportive.
To do this we need to take a step back and take time to reflect with our staff on their experience of the organisation. This includes understanding whether they feel supported and are comfortable enough to speak up about their worries and personal issues that might impact their work. Questions must be asked such as: Are we doing enough to make mundane admin processes as straightforward as possible and not an additional burden to our staff? Does the leadership in our organisation engage with staff, listen to their issues and respond appropriately?
By really thinking about what is going on in our organisations we may find that even small things can make a big difference, particularly in times of heightened stress. For example, the absence of break rooms where staff can switch off and relax may have seemed like an inconvenience to staff pre COVID-19 but it becomes a much bigger issue when time spent on wards or in direct contact with patients is highly pressured.
Taking the time to reflect before we rush to interventions can be difficult. When capacity is under increasing pressure we may not feel justified in committing this time but it’s crucial that we do. We need to listen to our staff, engage with them, ask them what their worries are and what we can do to help. And then we must be proactive in our response.
In addition to measures we take now, we must think about the future mental resilience of our workforce. A crisis like COVID-19 can highlight the weaknesses in a system and we need to learn from this period to have a preventative approach to staff wellbeing in the coming years. Ultimately, for our staff as with our patients, we must move towards prevention rather than treatment and create an environment where we support them as much as possible to undertake their difficult work.
Rapid Response:
Re: Managing mental health challenges faced by healthcare workers during covid-19 pandemic
Dear Editor,
Professor Neil Greenberg and colleagues have raised a really important issue in this article and highlighted the increasingly pressing need for the NHS as an employer to look after the wellbeing of our staff and to provide adequate support during and in the aftermath of this pandemic.
NHS staff are often under significant pressure in normal times but this pressure has inevitably increased during the current crisis. It is almost impossible to remove stress completely from NHS roles as the work is often highly emotional and can involve very difficult decision making. What we can and must do however, is think more widely about how we can create the most supportive environment possible to foster their wellbeing and minimise the need for personal resilience by, for example, reducing stress in areas of their work where this is possible.
At the National Workforce Skills Development Unit (NWSDU) we have been exploring ways to help organisations to support their staff. We believe that a focus on organisational rather than individual resilience is the most effective way of managing psychological distress and supporting the health of the workforce. [1]
Interventions mentioned in this article such as Schwartz rounds (forums where all staff come together regularly to discuss the emotional and social aspects of working in healthcare) are a good way to address specific issues such as psychological distress due to the demands of making morally challenging decisions or what Greenberg Et al. cite as moral injury. Beyond immediate interventions like this, we also need to think about what else organisations can do to be supportive.
To do this we need to take a step back and take time to reflect with our staff on their experience of the organisation. This includes understanding whether they feel supported and are comfortable enough to speak up about their worries and personal issues that might impact their work. Questions must be asked such as: Are we doing enough to make mundane admin processes as straightforward as possible and not an additional burden to our staff? Does the leadership in our organisation engage with staff, listen to their issues and respond appropriately?
By really thinking about what is going on in our organisations we may find that even small things can make a big difference, particularly in times of heightened stress. For example, the absence of break rooms where staff can switch off and relax may have seemed like an inconvenience to staff pre COVID-19 but it becomes a much bigger issue when time spent on wards or in direct contact with patients is highly pressured.
Taking the time to reflect before we rush to interventions can be difficult. When capacity is under increasing pressure we may not feel justified in committing this time but it’s crucial that we do. We need to listen to our staff, engage with them, ask them what their worries are and what we can do to help. And then we must be proactive in our response.
In addition to measures we take now, we must think about the future mental resilience of our workforce. A crisis like COVID-19 can highlight the weaknesses in a system and we need to learn from this period to have a preventative approach to staff wellbeing in the coming years. Ultimately, for our staff as with our patients, we must move towards prevention rather than treatment and create an environment where we support them as much as possible to undertake their difficult work.
[1] https://www.hee.nhs.uk/news-blogs-events/news/meeting-challenge-reducing...
Competing interests: No competing interests