Coronavirus has had a significant and direct impact on the life and work of healthcare workers.
In our volunteers' conversations with healthcare workers, six key themes were raised: stress, exhaustion and burnout, the changing nature of distress, anxiety about going to work, lack of resources and support, guilt and the impact of the pandemic on their relationships with others.
Stress, exhaustion and burnout
Healthcare workers were much more likely to raise concerns about work compared to other people contacting Samaritans. Concerns about work or study were raised in half of healthcare worker contacts (51%) compared to 10% of other contacts to Samaritans.
The data we collected in both November 2020 and March 2021 relating to our conversations with healthcare workers identified stress, exhaustion and burnout as a common theme. Volunteers generally cited three main causes; working long shifts, the nature of the work, and the length of the ongoing pandemic.
Volunteers told us that callers often discussed working extremely long shifts which could be physically and mentally demanding. As a result, many volunteers had received contacts from healthcare workers at the end of a shift, who wanted to ‘offload’ or ‘vent’.
As well as the time spent working, the nature of the work was contributing to stress, exhaustion and burnout. Volunteers noted that callers were under extreme pressures at work and were struggling to deal with such high volumes of death and critical care. In addition, volunteers spoke about callers who had been re-deployed as experiencing additional pressures for instance working in jobs they did not feel adequately trained for, worrying about doing a bad job, and being forced into excessive responsibility in a short amount of time.
In relation to the length of the pandemic, callers were concerned about the future and the possibility of another wave of coronavirus, which would extend the stressful working conditions they had already endured for so long.
Undoubtably the death rate caused the most anguish, and the inability to give the standard of care they felt they should. Also, people working in areas where they had little experience.
Changing nature of distress
As with many callers, many healthcare callers felt the pandemic had taken its toll on their mental health and were often concerned about the long-term impacts to their mental health. On calls to the dedicated NHS line in England and Wales, volunteers noted that callers’ distress levels had remained similar over the course of the pandemic, although the nature of distress had changed. For instance, volunteers reported a sense of callers “running on adrenaline” during the early pandemic peaks and therefore contacts were primarily focussed on what was going on in the here and now. Volunteers described a ‘Covid comedown’ later on, where the long-term impacts of the pandemic built up, resulting in exhaustion and strong emotions due to callers having more time and space to reflect on both the past and the future.
Anxiety about going to work
Volunteers reported that healthcare workers were often anxious about going to work. In many cases they feared what they would see that day, often as a result of distress about the number of deaths and amount of severe illness they had witnessed. Some callers showed signs of trauma from the current situation or previous traumas being triggered. Volunteers also noted that callers were fearful of contracting coronavirus, and in particular, were worried about passing the virus onto friends or family members, especially older or vulnerable people. Many volunteers had heard from callers who were considering leaving their job, as they did not enjoy their job as they had done before the pandemic.
Lack of resources and support
A large number of volunteers, on both helplines, had spoken to healthcare workers who felt a lack of resources and support in the workplace. Concerns included not having access to practical resources such as Personal Protective Equipment, mostly in the early days of lockdown, or being under-staffed due to staff sickness, placing additional pressure on them. Callers were also concerned about not receiving adequate emotional support, alongside a sense of being underappreciated by their employer. Volunteers in the focus groups recalled callers discussing a crisis in management, and feeling misunderstood, isolated and disempowered at work. In addition to not knowing where to seek emotional support at work, volunteers stated that callers were often very reluctant to seek help due to a fear of losing their job or being viewed as inadequate.
Despite feeling stressed, exhausted and burnt out, volunteers described guilt being common among frontline healthcare callers. This included guilt among those not able to work due to shielding or healthcare issues, including time off for mental health problems. The camaraderie among some healthcare workers led to some callers feeling guilt about the burden on their colleagues if they were not able to work.
Among those who were able to work, volunteers described callers’ strong sense of guilt at not being able to do more to help patients. Particularly, volunteers cited callers feeling guilty about families and loved ones being unable to visit those who were dying, at not being able to prevent more deaths and at not being able to show compassionate responses to patients and families such as hugging, due to social distancing restrictions. Volunteers also heard from callers who said their exhaustion and burnout meant they were unable to give their best support to patients.
Relationships with others
As with contacts that weren’t from healthcare workers, family concerns and concerns about loneliness and isolation were common. However, healthcare workers’ relationships with others have been affected in unique ways. Across both helplines, this included callers who had moved away from their families to reduce their exposure to the virus, or due to being relocated to a different workplace. Because of this, many healthcare workers were feeling isolated and lonely.
Where callers were still living with their families, volunteers noted that this, too, placed additional strains both on the frontline healthcare worker and their family. Volunteers regularly heard from callers who were concerned about long working hours, meaning they had little time to spend with their family. Other healthcare workers reported feeling unsupported by their family, for instance pressure from family members who did not want them to work in such dangerous conditions. In addition, many callers felt unable to share their emotional stresses with families, as they didn’t want to burden them.
Frontline workers living away from home [are] frightened of infecting the family, I’ve had quite a few doctors/nurses in this situation… Several were living at the hospital because of vulnerable family members.