Sustaining safe and quality care during the Covid-19 pandemic has centred on the mental wellbeing and health of frontline healthcare workers.

Historically, nurses bring compassionate care to their patients, particularly during a disaster response, but as we know, the pandemic has drastically altered the rule book we are used to operating from.

Nurses caring for Covid-19 patients are dealing with physical exhaustion, mental stress, separation from families, stigma, and the pain of losing colleagues and patients – not to mention the risk of contracting the virus themselves. 

We need to acknowledge that as one wave of the pandemic subsides, another is around the corner. Fatique has set in, and we need to find ways to give nurses additional support – and for nurses to support each other.

1. Nurses should prioritise their own wellbeing 

Whether at work or outside of work, as much as possible nurses should focus on their own wellbeing, paying attention to meeting their essential needs for rest and sleep, comfort breaks, food and water. In times of crisis, human physiological and safety needs tend to come first (security, shelter and safety), but without taking care of their mental wellbeing and physical comfort, nurses will face burnout. 

At the start of the pandemic, many psychological services were launched across the globe to support healthcare workers, but uptake was low, mainly because healthcare workers were concerned with more immediate worries, such as not wanting their families to worry, being able to get sufficient rest without interruption, accessing adequate PPE and receiving support and training to cope with unprecedented levels of anxiety and panic. 

Because of this, in the UK, for example, psychological intervention measures were adjusted. Places to rest were created, and food and daily living supplies were guaranteed. Nurses were also encouraged to make videos of their work to share with families to alleviate concerns, and training to manage patients’ psychological problems was prioritised. 

In South Africa, we also believe that ensuring that the mental health and basic comforts of our frontline health workers is critical, particularly as the pandemic stretches on. 

2. Peer support is critical

Unfortunately, nurses experiencing extreme stress may not recognise it, or they could believe that admitting they need help could put an added burden on their colleagues. They could also believe that there is a stigma to admitting that they are not coping. Nurses are hardwired to look after others and not themselves, which is where peer support comes in.

Fortunately, healthcare work is driven by teams. Supporting colleagues is another form of helping someone else, which means if nurses are encouraged to look after each other, even in small ways, the overall care of the team will improve.  #CaringforourCommunity is a wonderful example of how communities can support each other on social media – even as people are isolating or being careful about seeing each other. A bit of recognition goes a long way.

3. Put processes and controls in

place that boost teamwork

During the peaks of the Covid-19 pandemic, registered nurses and healthcare assistants in the United States identified the benefits of nursing teams using mid-shift cluster discussions to check in on each other’s wellbeing. In South Africa, this may not be possible, but it’s still impartant for nurses to check in with their colleagues. Because many nurses aren’t always working with their usual team of colleagues during a health crisis, structures that support nurses and formalise how they can assist each other are important as well. It is also critical to reinforce that everyone on the team is safe and valued to drive group camaraderie. Finally, robust processes give teams the tools they need to navigate this crisis together.

4. Understand the long-term impact

of a pandemic

It’s normal to have heightened fears and anxiety during extraordinary and scary situations. In most cases, these resolve themselves without a long term impact. We have no way of knowing the long-term mental welfare impact of the pandemic on nursing staff however. South African nurses are exhausted, stressed, and at high risk for physical and mental illness.

It’s therefore essential that nurses have access to adequate support to avoid a generation of nurses with poor psychological health. Unresolved grief, burnout, long-term heightened stress are just some of the potential areas that could impact nurses. We don’t know what the future will bring. We do know that we need to be ready for it. 

This is one of the reasons why we launched our Covid Assist Care Network initiative and the Imbewu Recognition Programme. The programme gives nurses the ability to control whether they increase or decrease their monthly hours and the rewards they receive based on the tiers they reach if they increase their hours. Nurses can handle long hours – but choice, reward and recognition are necessary to support them.

5. Treat resilience as a team sport

In Europe, a #ClappingForTheCarers initiative has encouraged publicly applauding frontline workers, and nurses have reported that public gratitude lifts their spirits and alleviates some of the stress they are carrying.

In South Africa, we have also acknowledged our frontline healthcare workers and must continue to do so, not through lip service but our actions. Nurses need to feel their needs are cared for and that they are safe with adequate PPE equipment, training and support. They need access to areas where they can rest, good peer and team support, and leaders that will continue to care for them well after the pandemic is over.

As South Africans, we tend to speak about how resilient we are, and our nurses have certainly proven themselves in this regard, but resilience should never be seen as an individual responsibility. It’s a collective and organisational responsibility and one we are proud to champion at Charisma Healthcare Solutions.

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