In recent months, it has been almost impossible to socialise with family members, friends and work colleagues. Telephone conversations and online chats have been the only ways to stay in touch and share our experiences of surviving the pandemic, as well as of being nurses on the Covid-19 ‘frontline’ caring for extremely ill patients. In telling our stories to each other, it became clear that most frontline staff are exhausted and scarred, physically and emotionally. They also feel undervalued, being ignored by the government in the recent public service pay review. One of our London-based colleagues told us (in early September 2020):
“…Gradually our work has gone back to normal, we are trying to reopen the out-patient clinics that were stopped during the height of the Covid-19 pandemic. We were redeployed to work on the frontline. We managed to pull ourselves, and the healthcare system, through the main part of the crisis, but now staff members are incredibly tired: just exhausted. Sickness absenteeism levels on the ward remain high; in fact, I have never known them to be so high in my entire working life. I manage a ward in our hospital, and I feel exhausted. After a long day shift, I come back home, and have no energy left to do anything. My husband says I am more tired now than I was during the peak of the crisis, how long can I continue like this?”
Despite being contracted to work full-time with the NHS (National Health Service) at 37.5 hours a week, there has been no week since the crisis began in mid-March when she did not work extra hours. On one occasion we needed to contact her while on duty, expecting her to reply to a simple text message in her lunch break (as she suggested she would). She responded late afternoon, after five o’clock, and told us later that she was lucky to have this break, as even short coffee breaks are in short supply these days. There are many absences on her ward, with staff off sick or in quarantine. A recent study on frontline female healthcare workers in the UK corroborates this account, reporting that, on average, staff worked 11.22 additional hours each week in recent months. It found too that many frontline staff are experiencing burnout, due to ongoing work-related stress, caused primarily by the pandemic.
Here in the UK, we are now seven to eight months into the Covid-19 crisis. Many of us have family and friends who have been ‘shielding’ (self-isolating), and who have now been advised to emerge, slowly and cautiously, while children are going back to school. To support business, various economic schemes and incentives have been developed and introduced by the government. The initial panic this pandemic caused within the healthcare system has calmed down, and as related above, clinics and outpatient services are gradually resuming. The situation remains highly volatile however. In some ways, we find this endless alienating monotony of the ‘new normal’ actually more exhausting than the initial adrenaline-fuelled crisis. While politicians and public health experts have failed to work collaboratively, or agree on coherent guidelines, vulnerable people have been paying the price. In terms of finding a vaccine or any other effective treatment, there is still no clear direction, and everyday life for everyone remains uncertain. For many it feels as if we are at a breaking point.
Caring for Caregivers
In order to cope with such unprecedented levels of distress, those on the frontline of care in the UK (and many other countries) have engaged in various stress-relieving activities to manage their emotional wellbeing. They have found meditation, yoga, Tai chi, and other culturally specific activities extremely helpful, coming from diverse backgrounds. They have also recorded their personal stories of extreme stress experiences and their coping strategies in video format, and shared them with wider groups of colleagues via Facebook and other social media outlets. Efforts have been made to support each other in a variety of ways: by offering online yoga sessions, by supporting vulnerable colleagues and families with food shopping, and with other practical help. However, living in fear of a ‘second wave’ has become our everyday reality. Frontline workers’ occupational vulnerability cannot be mitigated by the applause of the public, or indeed even by these forms of self-care.
All frontline care staff have been exposed to Covid-19. Whether they are nurses and doctors in the NHS or workers in the social care sector, significant numbers of them have been infected. Some have tragically lost their lives, while others have recovered from the virus. Some have been left with considerable long-term effects on their health, due to what is now described as ‘long-Covid’: a post-viral legacy yet to be fully understood. Those from what in the UK we call BAME (Black, Asian, Minority Ethnic) backgrounds, as well as those in the working class and who have underlying health conditions, are considered especially vulnerable, given their higher rates of infection and death. Significant number of frontline healthcare professionals, who continue to be the backbone of the health and social care system, fall into these categories.
Staff are applauded for their ‘dedication and care’ in saving the lives of Covid-19 sufferers. Supermarkets and those in the business community have shown their appreciation by offering NHS and other key workers free ‘goodies’, discounts in their food bills, dedicated shopping hours, and a fast-track priority shopping system. The government’s appropriation of health professionals as ‘NHS Heroes’ has been mainly a way of keeping the issue of economic and social justice at bay, without making any meaningful political commitment to improve workers’ long-term wellbeing.
After much public outcry and media pressure, the NHS and social care sector have developed precautionary guidelines to support and protect high-risk and vulnerable groups, including the BAME workforce, from Covid-19 infection and its transmission. However, now that virus-related hospital admissions and deaths are reducing, health and social care workers are slowly being forgotten. The national government is currently prioritising reviving the national economy, and managing contagion by tightening and releasing lockdown measures, at national, regional and local levels. The Government is also supporting small businesses. Strategies such as ‘Eat out to help out’ have also been developed and implemented. However, when it comes to the frontline healthcare staff, apart from applauding ‘the NHS Heroes’, there have been no substantive measures to support this exhausted workforce, or to protect them from burnout. Frontline colleagues feel forgotten by the government, like our colleague in London, who not only felt undervalued but as if they have been ‘slapped in the face by the government’. Witness the recent pay review for public service workers, where nurses received no recognition or pay rise. Government applause now appears a patronising and hollow gesture. This clear lack of true respect for the ‘NHS heroes’ is unacceptable. Government policy-makers and health and social care managers should waste no more time. The workforce needs urgent care and attention before we have a mass workforce burnout, potentially leading to further crises in the healthcare system.
Tagged: #Abuse #Arts #Borders #Care homes #Class #Colonialism #Economy #English #Geopolitics of care #Health care #Migration #Mutual aid networks #Quarantine #Race #Religion #Self-care #Violence #Welfare state
Radha Adhikari, Sushila Karki-Budhathoki, Kate Weir
Radha Adhikari is a Nurse Lecturer at the University of the West of Scotland. She has worked with migrant healthcare professionals and is the author of ‘Migrant Health Professionals and the Global Labour Market: the dreams and traps of Nepali nurses’ (2019, Routledge). Contact: firstname.lastname@example.org
Sushila Karki-Budhathoki, is a Specialist Clinical Nurse with extensive experience in Dermatology, Paediatric and Adult Health, in Nepal and on various NHS Boards in England. She is one of the founding Executive Board Members of the Nepalese Nursing Association, UK. Contact: email@example.com
Kate Weir has worked as a midwife in Scotland and Nepal. She is a passionate advocate of United Nations’ Sustainable Development Goals 5 (Gender Equality), and 8 (Decent Work). Contact: firstname.lastname@example.org