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Managing uncertainty

02 January 2021
Volume 26 · Issue 1
Alison While

The COVID-19 pandemic has tested populations, political leaders, health systems and healthcare professionals globally. The World Health Organization (WHO) (2020a) issued a briefing note about mental health and psychological considerations and setting out guidance to minimise the detrimental effects for both populations and healthcare staff. More recently, WHO (2020b) has reported that the mental health services in many countries have been disrupted, as we know is also the case in the UK (British Medical Association (BMA), 2020). There is evidence that the pandemic has not been good for mental health in the UK (Daly et al, 2020), with psychosocial stressors increasing anxiety and depression and stress disorders, as well as risky behaviours (Moreno et al, 2020). Additionally, the experience of COVID-19 appears to have psychological implications (Moreno et al, 2020).

While the general population has struggled with major behaviour changes, confinement to home, disruption to daily life, physical distancing and economic uncertainty, healthcare staff have additionally reported stress from potential SAR-CoV-2 exposure and increased workloads (BMA, 2020; Moreno et al, 2020). Community and primary care nurses have had to change their working practices with remarkable speed (Green, 2020), and, while some of these changes may have been welcomed, it has required considerable resilience and personal flexibility.

Greenberg at al (2020) have recommended that healthcare managers proactively protect their staff's mental health through regular contact and discussions, so that those struggling are identified and appropriately supported. The cost of failing to cherish staff was acknowledged before the pandemic in terms of retention and attrition (Buchan et al, 2019) and, to that end, Health Education England (2019) published a ‘framework for improvement through reflection, curiosity and change’ to reduce workforce stress and promote staff wellbeing.

In recognition of the emergency situation, Public Health England (PHE) is promoting psychological first aid as a means of offering caring and compassionate support without judgement, thereby helping people to cope in a positive way despite uncertainty, loss of control and disruption to normal life. Anyone may take the free 3-hour PHE online course designed for those working in health and social care (https://tinyurl.com/y7t9kjxc).

Although it is hoped that the COVID-19 vaccination roll-out will herald the end of the pandemic, the most challenging months for influenza and chest infections have yet to be negotiated, and it is likely that there will be several more months of high demand on NHS services and uncertainty for both the general population and healthcare staff. It will be interesting to see how many innovations (Queen's Nursing Institute (QNI), 2020) inspired out of necessity during the pandemic are retained when community nursing services return to ‘normal’.

‘… it is likely that there will be several more months of high demand on NHS services and uncertainty for both the general population and healthcare staff.’