I asked one of our psychologists to join my team safety huddle last week to facilitate our conversation. We reflected that the COVID-19 pandemic has exacerbated a number of issues that were in existence before this latest wave. Coupled with the current national lockdown, this has meant that the risk of burnout has increased and achieving ‘joy in work’ has been made all the more challenging. This is because the normal ways in which nurses de-stress, with wellbeing activities such as going to the gym, the pub or socialising together, are not available to us.
As the NHS prepares to recover from the pandemic, I have found the work of the Institute for Healthcare Improvement (IHI) extremely informative. The IHI (2020a) reflected on the benefits of learning from the phases of disaster, highlighting this learning as beneficial for understanding the ‘predictable’ phases that we will be progressing through in the NHS.
The IHI reflects on the phase of ‘pre-disaster’ in which there is often a warning or threat. This was the case with COVID-19, enabling us to prepare our initial response. The IHI then reflects that when ‘disaster hits’ the clinicians and other first responders are put in positions to act heroically. The next phase described is said to be typically a temporary ‘honeymoon’ period of ‘community cohesion’. We have seen this with the public's response to the NHS. The phase in which I think we are now is described as ‘disillusionment’ and, ultimately, working through ‘grief and reconstruction’ (a new beginning). These phases are described as non-linear, with evolving needs.
The IHI recognises that the COVID-19 pandemic has presented challenges for healthcare leaders above and beyond their typical responsibilities. As with the phases of disaster requiring different actions at different times, the IHI acknowledges that leaders' roles and responsibilities during the pandemic may evolve over time. It advocates that leaders should quickly assess and provide direction for clinical care, and effectively communicate with healthcare workers, among other priorities.
‘The normal ways in which nurses de-stress, with wellbeing activities such as going to the gym, the pub or socialising together, are not available to us’
As we emerge out of the most challenging stage of this wave of the pandemic, the IHI states that leaders need to engage workers in discussions to retrospectively focus on opportunities to make improvements that perhaps were not possible to implement during the crisis. In times of crisis, especially, effective healthcare leaders implement the practices described below (IHI, 2020b).
The authors of a recent article (Shanafelt et al, 2020) noted five requests from health professionals to their organisations during the COVID-19 pandemic. Leaders should endeavour to honour these requests:
The COVID-19 pandemic presents an opportunity to make fundamental and lasting change to better support healthcare workers' health and wellbeing and foster a thriving workforce.