Survey of UK nurses and midwives finds worries over health, training and workload during COVID-19

The results of @RCNResearchSoc survey published today (21 Apr) have highlighted the concerns of #NHS nurses and midwives in the UK about COVID-19, and the risks it poses to their physical and #MentalHealth and that of their families.

Respondents also reported training for staff redeployed to front line care was inadequate or non-existent.

The team carrying out the research, including the University’s Professor Bridie Kent, said the results show an urgent need to provide support for the health and wellbeing of staff, and to ensure they have access to ongoing training.

The ICON study is a longitudinal survey to evaluate the impact of COVID-19 on the UK nursing and midwifery workforce. The survey is being undertaken at three time-points: prior to the COVID-19 peak, during the COVID-19 peak, and in the recovery period following COVID-19. The results from each point are being reported in real time, so the findings could be used to inform workforce strategies within the NHS and social care. Early results of the first survey, prior to COVID-19 peak, have now been released.

The study, led by the Royal College of Nursing (RCN) Research Society steering group, is a collaboration between the University and King’s College London, University of Warwick, Cardiff University, Nottingham University, University of Surrey and St Bartholomew’s Hospital.

The first survey was open for responses between 2-14 April 2020. All members of the UK nursing and midwifery workforce were eligible to complete the survey, including registered nurses, registered midwives, student nurses, healthcare support workers, nursing associates, and trainee nursing associates. The survey was distributed by social media, the Royal College of Nursing, Nursing and Midwifery Council, and other key professional organisations.

2,600 people participated in the survey and provided complete or near-complete data.

Initial findings include:

• 74% feel their personal health is at risk during COVID-19 due to their clinical role
• 92% are worried about risks to family members during COVID-19 due to their clinical role
• Almost one-third (33%) of respondents reported severe or extremely severe depression, anxiety or stress
• Of those being redeployed within the NHS, 62% reported that their training was either non-existent, or inadequate
• 52% of respondents had worked over their contracted hours on their last shift, two-thirds of these respondents will not be paid for their additional work
• 25% disagreed that correct PPE was always available (with only 44% agreeing that it was available)
• 52% were either lacking in confidence regarding COVID-19 infection control and prevention training that they had received or had received no training
• 26% of respondents had needed to self-isolate, of which 37% did not have personal symptoms and 64% missed four or more shifts due to self-isolation

Bridie Kent is Professor of Leadership in Nursing in the University’s Faculty of Health, and sits on the committee of the RCN’s Research Society. She said:

“This project came about because myself and several Research Society colleagues were keen to find out how nurses and care staff were affected by the changes introduced to help meet the demands of COVID-19.

“What our first set of results show is that many report negative psychological effects as a result of their current working environment. Urgent research is needed to develop and evaluate interventions to support these staff, which may need to continue long after the peak of the pandemic has passed.

“We owe it to our workforce to do our best to minimise the psychological impact of the next few weeks and months, whilst COVID-19 is placing unprecedented demand on the NHS. Front line staff are the nation’s heroes, so let’s make sure they are properly supported to come out the other side in good mental and physical shape.”

Commenting on the implications these results have for the nursing and midwifery workforce, Ruth Harris, Professor of Health Care for Older Adults in the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care at King’s College London said:

“These initial findings show that individuals do not feel adequately prepared for the pandemic and are concerned about the risk to themselves and their families. They also highlight a need for ongoing training and confidence building, and that optimising healthcare worker testing may reduce the number of missed shifts due to self-isolation.”

Dr Keith Couper, Assistant Professor in Emergency and Critical Care at the University of Warwick and the project lead said:

“The responses from this first survey show there is a need to provide supportive interventions during and after COVID-19 to support individual’s psychological and physical needs. Healthcare employers should advocate self-care and provide a psychologically safe workplace where individuals can openly discuss their concerns. Urgent research is needed to develop and evaluate interventions to support individuals.”

The ICON team acknowledges support and advice from the Royal College of Emergency Medicine Trainee Emergency Research Network CERA study team, on which parts of this study are based.