In this week’s blog, Dr Nicola Roberts (@DrNRoberts) discusses some of the research that she and colleagues have been undertaking focussing on the resilience of nurses working in respiratory care during the COVID pandemic. Dr Nicola Roberts, is a Senior Lecturer at Glasgow Caledonian University in the UK and her research looks at improving how to deliver care to those with respiratory disease. This work was carried out in collaboration with colleagues at Glasgow Caledonian University, Solent University, University of Southampton, Edge Hill University and Sovereign Primary Care Network (Dr K McAloney-Kocaman, L Welch, Dr K Lippiet, Dr C Kelly, E Ray)

Resilience is a thought provoking word which has been used a lot during the current pandemic, particularly to describe the NHS and NHS staff. Resilience is defined as the capacity to recover quickly from difficulties and how someone will respond during and after a stressful traumatic event. The ability to be resilient is looked upon favourably in nursing and healthcare and there is some expectation that nurses adapt and find meaning from their experiences and are able to moderate their responses to stressful situations (1), in other words, become more resilient.

We have explored how resilient nurses were during the peak of the pandemic, in particular those working in respiratory clinical environments and those working with respiratory patients. This cohort of nurses possess transferable skills which are vital to the immediate management of COVID-19 management and recovery. They have been key professionals during the pandemic, however the concept of resilience translates across healthcare and the NHS, especially during the COVID-19 pandemic situation.

In order to understand resilience, we needed to understand the nurses and their lives, both at home and at work. The survey was therefore designed to look at anxiety, depression and resilience as well as capturing relevant demographic data on how this cohort was managing at home and at work and how their life had changed. The survey was developed and sent out online via professional respiratory societies (Association of Respiratory Nurses, British Thoracic Society, Primary Care Respiratory Society) and social media. The survey was issued during May 2020 for 3 weeks at the height of the pandemic. Two hundred and fifty-five responses were received, mostly women (88.6%), age over 36 (79.2%) and from mostly white ethnic backgrounds (94.9%). Responses were representative from all geographical areas of the UK. The vast majority had more than 20 years’ experience (56.3%) and usually worked in an acute setting (57.6%). The majority reported that their role had changed as a result of COVID (57.3%) and just under half were undertaking aerosol generating procedures (those that might produce droplets, with much higher risk of contracting the virus). Over 65% reported concerns about catching the virus, just under half reported being exhausted (45.5%), and 21.6% reported not being able to cope. Just over eleven percent (11.4%) reported having difficulties providing support to their household (i.e. heat, food, emotional support). Nearly thirty percent (28.2%) reported concerns about not having enough personal protective equipment. Nearly a quarter (24.7%) believed that they had the COVID-19 infection and had self-isolated within the last 4-6 weeks of completing the survey.

Participants raised concerns about supporting children and families to continue home-schooling, protecting families from the virus especially those shielding and vulnerable and trying to maintain and support good mental health at home. Despite some of the concerns raised we found that the average resilience scores overall were moderately high, however there was a proportion who had a score on the low end (18.9%). Average anxiety and depression scores were low, just over half of experienced minimal anxiety or depression but between 15-20% had higher anxiety or depression scores.

This is just a small snapshot of some of our findings, we have undertaken statistical analysis to understand which of these characteristics are important in predicting resilience, anxiety and depression. These findings will be presented at the Association of Respiratory Nurse Specialist online annual conference in a few weeks’ time (www.arns.co.uk) and submitted for publication.
Further analysis will review as to how nursing job roles have changed, the experiences of those returning to clinical practice, the training given and the formal and informal support from healthcare management.

Although the results found could be perceived as good with moderately high resilience and overall low levels of anxiety and depression. It is important to consider what will happen over the long term, especially with potential subsequent waves and outbreaks. Already some support mechanisms are being withdrawn as we are in the “new normal” phase. We will survey again in the winter to look at the impact of any further waves but it is crucial that we find ways to support those at higher risk of anxiety and depression.

1. McAllister, M., & McKinnon, J. (2009). The importance of teaching and learning resilience in the health disciplines: A critical review of the literature. Nurse Education Today, 29, 371–379.