Yahoo Finance 'I had to be sectioned': the NHS staff broken and burned out by Covid
In April, when the coronavirus outbreak was at its peak in the UK and tearing through hospitals, junior doctor Rebecca Thornton’s mental health took a turn for the worse and she ended up having to be sectioned.
Even now, three months later, she cannot face going back to her job and thinks it will take her a year to recover from some of the horrors she saw while working on a Covid ward in a deprived area of London.
“It was horrendous,” Thornton recalls. “It’s so harrowing to watch people die, day in, day out. Every time someone passed away, I’d say, ‘This is my fault’. Eventually I stopped eating and sleeping.”
Thornton’s case may sound extreme but her experiences of working through Covid are far from unique. More than 1,000 doctors plan to quit the NHS over the government’s handling of the pandemic, according to a recent survey, with some citing burnout as a cause.
And as early as mid April, YouGov polling for the IPPR thinktank found that 50% of 996 healthcare workers questioned across the UK said their mental health had deteriorated since the virus started taking hold of the NHS. Meanwhile, latest sickness rate data for NHS staff in England found that April had the highest levels of sickness absence since data was first collected in 2009. Anxiety, stress, depression or other psychiatric illnesses were the most reported reasons for absence, at 20.9%, compared with about 14% each for respiratory problems, colds and flu, and infectious diseases. Data for the months following is yet to be released.
However, recent research from China suggests that healthcare workers were at greater risk of developing stress and other mental health problems at the beginning of the pandemic, including post-traumatic stress disorder.
Related: Health experts on the psychological cost of Covid-19
Linda Berry, who has been working as a paramedic in the east of England for 10 years, can also attest to the high levels of poor mental health among staff during the peak of the pandemic. “The stress levels were immense,” she explains. “A lot of ambulance service workers’ mental health was quite frayed, with PTSD at some level.” She adds: “I experienced stress, anxiety, trouble sleeping. I had palpitations and panic attacks. I came out in hives.”
Worries about what the future may hold have now permeated all levels of the NHS. A survey conducted in June by the NHS Confederation’s health and care women leaders network reveals that the health service risks losing a significant chunk of its workforce to stress and exhaustion as a result of the Covid-19 crisis. Three-quarters of the 1,300 respondents – including managers, nurses, admin staff, doctors, and allied health professionals – reported that their job had a greater negative impact than usual on their emotional wellbeing as a result of the pandemic.
This comes as no surprise to Thornton, who is in her late 20s. She has a history of mental health problems and had already experienced signs of burnout in 2018 when she was working on an understaffed ward, but had always been able to overcome any issues. At the beginning of this year, she had moved on to a different rotation and was once again happy to be pursuing her lifelong dream of being a doctor.
In early March, she contracted Covid-19 from a patient she was caring for on a surgical ward and was off work sick. When she returned, she was redeployed to a ward specifically for Covid patients. Working there for a month pushed her over the edge.
Many patients she cared for were elderly and could not receive visitors until it was clear they might not survive the day. Thornton says she bore witness to their pain and suffering and felt helpless. “It was so different from what usually happens when people are surrounded by their loved ones,” she says. “The hospital had one iPad. A lot of families couldn’t say goodbye ... It got to the stage where a frail person would be brought in, I’d look at them and think ‘I don’t think you’re going to go home again. I’ve seen what the future holds and it’s grim.’”
Related: Coronavirus is whipping up a mental health storm for NHS workers | Ankur Khajuria
At the same time, her mental health support had been pared back to phone appointments, which she says weren’t as helpful as face-to-face appointments. Nevertheless, she kept updating her therapist on how she was feeling. After one shift, she remembers: “I was really not with it and I think my therapist phoned the police, who came and picked me up.” She was sectioned for three weeks.
A psychologist offering services to NHS staff throughout the UK, who asked to remain anonymous, has witnessed the toll on staff. “I’ve seen signs of PTSD in some healthcare workers,” she says. “Staff really stood up to the plate and worked incredibly hard. It was a crisis situation that moved very quickly ... After it subsided a little bit, the tiredness became very clear.”
Stress and the threat of burnout are not new problems in the NHS. The latest NHS staff survey, carried out before Covid hit, revealed that 40% of staff reported work-related stress. “The thing with Covid is it isn’t as if it’s a crisis that ended, and that’s the difficulty now ... winter’s coming and there may be a second wave,” says the psychologist.
Roisin Fitzsimons, who is head of the Nightingale Academy, which provides a platform to share best practice in nursing and midwifery, and consultant nurse at Guy’s and St Thomas’ NHS foundation trust, also worries about the looming threat of an uncertain future. “Are our staff prepared? Do they have the resilience to go through this again? That’s the worry and that’s the unknown. Burnout is hitting people now. People are processing and realising what they’ve gone through.”
The issue has not gone unnoticed. The NHS people plan for England has recognised that staff must be supported, particularly after working through the pandemic. Many individual trusts have found their own ways of prioritising staff health. At Guy’s and St Thomas’, for example, Fitzsimons has overseen a range of measures. When the pandemic first began, she went round the wards asking staff what would help them. At the start, people wanted the basics – toilet roll and pasta – and they were concerned about safety. A free supermarket was set up with donations the hospital received and the hotel next door offered to wash scrubs after a shift so staff didn’t have to take them home. There were recharge zones with massage chairs and space to rest with free tea and coffee.
At the end of June, when the situation began to calm down, focus turned towards helping staff process what had happened. “We’re doing lots of reflective sessions and our wellbeing offer has moved away from physical needs ... Staff are offered free help from psychologists in the occupational health team, trained peer support and wellbeing advisers,” says Fitzsimons.
Dr Andy Coley, a retired GP and chief clinical officer of the NHS Clinical Leaders Network, has assembled a national steering group to look at the subject. “I think [the rate of] burnout is high,” he says. “There are problems and there were worries about burnout in the system before the pandemic ... I’m not sure what’s going to happen if we get a second wave and with winter pressures. I don’t know whether staff will be more robust or whether they will struggle because they’re already feeling like they’re on an edge.”
The network is now working with a group of NHS trusts in north-west England that have signed up to be part of a 12-month programme looking at mental health resilience. The results will be passed to NHS England and the Cabinet Office to help inform future national and international pandemic planning.
For now, though, the future remains unclear. Thornton, whose mental health is stable at the moment, but isn’t able to go back to work , says: “The general public seems to have moved on and forgotten what happened. It’s very easy to forget how bad it was. I feel sorry for my colleagues going into winter.I have to hope a second wave isn’t as bad. What I worry about is that we will have a peak in Covid cases alongside the usual rate of presentation of other illnesses and that will make it even more challenging.”
• Some names have been changed
