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COMMENT CSJ THE CLINICAL SERVICES JOURNAL Editor


Louise Frampton louiseframpton@stepcomms.com


Technical Editor Kate Woodhead Business Manager


Dean Walford deanwalford@stepcomms.com


Sales Executive Holly Goldring hollygoldring@stepcomms.com


Journal Administration


Katy Cockle katycockle@stepcomms.com


Design Steven Dillon Publisher


Geoff King geoffking@stepcomms.com


Publishing Director Trevor Moon trevormoon@stepcomms.com


THE CLINICAL SERVICES JOURNAL is published in January, February, March, April, May, June, August, September, October and November by Step Communications Ltd, Step House, North Farm Road, Tunbridge Wells, Kent TN2 3DR, UK. Tel: +44 (0)1892 779999 Fax: +44 (0)1892 616177 Email: info@clinicalservicesjournal.com Web: www.clinicalservicesjournal.com


Tackling burnout and bullying


As fears mount that the NHS could be hit hard by a second wave of the pandemic, an already exhausted workforce is having to prepare for another round in the fight against Coronavirus. In this latest edition of CSJ, Kate Woodhead reflects on the impact that the pandemic has had on the wellbeing of nurses and midwives, as well as the familiar story of toxic working cultures that – 10 years after the Mid Staffordshire Inquiry – we are still no closer to resolving. We know from a recent RCN survey (May 2020) that more than a third of nurses working in England are considering leaving the health service. Furthermore, 44% of respondents to the survey indicated that the way nursing staff have been treated during the pandemic has made them consider leaving the profession.


© Step Communications Ltd, 2020 Single copy: £19.00 per issue. Annual journal subscription: UK £114.00 Overseas: £150.00


ISSN No. 1478-5641


The Publisher is unable to take any responsibility for views expressed by contributors. Editorial views are not necessarily shared by the journal. Readers are expressly advised that while the contents of this publication are believed to be accurate, correct and complete, no reliance should be placed upon its contents as being applicable to any particular circumstances. This publication is copyright under the Berne Convention and the International Copyright Convention. All rights reserved, apart from any copying under the UK Copyright Act 1956, part 1, section 7. Multiple copies of the contents of the publication without permission is always illegal.


The impact on the nursing workforce has been unprecedented and will be felt for a long time to come. But the crisis has also laid bare and exacerbated longstanding problems faced by nurses and midwives – including inequalities, inadequate working conditions and chronic excessive work pressures. These core issues are addressed in The courage of compassion: Supporting nurses and midwives to deliver high-quality care – a King’s Fund report, commissioned by the RCN Foundation, which makes for sad and difficult reading. This emotive report reveals the frustration and stress that staff find themselves under, as they share their accounts of being ‘broken’, ‘exhausted’ and ‘on their knees’. Many nurses routinely work long shifts without proper breaks and with limited access to food and drinks. Among the many recommendations, The courage of compassion calls for an urgent review of how 12-hour shifts affect the mental health and wellbeing of staff, as well as patient safety – pointing out that work periods of more than eight hours have been evidenced to carry an increased risk of accidents, as well as job dissatisfaction and burnout. The high toll of burnout and exhaustion on family life and relationships outside of work is laid bare in this report, with one nurse commenting: “I am a single mother of a 12-year-old boy, and he has recently transitioned to secondary school. I cannot remember the last time I finished a shift on time, nor can I remember the last time I finished and had the energy to give my


NOVEMBER 2020


son the positive attention he deserves.” As a mother, this interview really hit home and highlights the personal cost of working in an over-stretched, under-staffed NHS. We cannot allow this situation to continue. It is isn’t safe and it is isn’t fair. However, one thing that has shone through during the coronavirus crisis has been a sense of camaraderie. The King’s Fund heard how some teams became stable entities – staff felt more part of a ‘home team’. Check-ins and huddles, with the whole team having protected time to have lunch/coffee breaks together, helped build belonging and support. Interviewees also reported the blurring of hierarchical and professional boundaries during the pandemic. Organisational identities were


The impact on the nursing workforce has been unprecedented and will be felt for a long time to come.


relinquished, and cross-boundary working became the new normal – with collaboration between primary care, secondary care and social care. Ways of working were transformed in a matter of days and in ways that were unimaginable just a few months previously. In the long term, we must learn these lessons from the pandemic and strive to foster a sense of belonging, team working and cohesion. We must care for those who care for others; they have shown extraordinary resilience in the face of one of the greatest challenges in the history of the NHS, but it has come at a personal cost. We need to embrace the recommendations of this report as a matter of urgency.


Louise Frampton l Editor louiseframpton@stepcomms.com


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