For NHS workers the pandemic is far from over. As they enter a tough winter season, their mental health is in crisis and they urgently need help. Join Grazia as we support the charity Duty to Care in the run-up to Christmas
it’s around lunchtime on a Wednesday when Hirah Ahmed holds up an iPad so a woman who is dying on her Covid ward in London can say goodbye to her husband and sons. As the family cry out for each other, Hirah fights back tears behind her PPE. Afterwards, the 26-year-old ICU nurse goes outside, where she lets herself cry for as long as her short break allows. Then it’s back upstairs to clear the bed so there’s space for another Covid patient to be admitted.
She carries on like this for months, until she starts having nightmares and panic attacks; she imagines seeing patients who have died when she’s walking down the street. ‘In February of this year I called my GP and said, “I need time off and therapy as soon as possible,”’ she says.
‘I’ve never seen so much death and then not had time to process it. I can’t unsee it now. When you watch people die en masse, as a nurse you feel worthless, and like you can’t do anything to help. People have called us heroes, but we weren’t mentally prepared for this. It feels like everyone else has gone back to normal and we’re just left floating. Now I feel absent when I’m with friends; like I live in a different reality and I don’t think I’ll ever be the same again.’
We spent last year briefly clapping for carers but, as restrictions eased, it seems many assumed we were through the eye of the storm. And yet, for NHS staff the nightmare is far from over. Even before the pandemic, a spate of suicides among junior doctors prompted a conversation about the pressures they were under. Now add 21 months of a pandemic, record waiting lists, unsatisfactory pay rises and a looming winter wave of Covid infections and other seasonal illnesses to the equation.
‘In February of this year I called my GP and said, “I need time off and therapy as soon as possible”’
According to a survey by the British Medical Association (BMA) in September, 62% of doctors are living with one or more mental health conditions as a result of work. Another BMA survey this year found thousands of doctors in the UK are considering leaving the NHS in the next year as they battle stress and burnout without adequate respite. The stark reality is that many NHS workers are in trouble and desperately need help. That’s why Grazia is joining forces with the charity Duty to Care, who provide wellbeing support for all NHS staff, as they enter another challenging period.
‘[NHS workers] are already exhausted,’ says Harriet Hunt, founder of Duty to Care. ‘Depleted numbers of staff add additional strain. The festive season is the busiest time of year for many NHS workers, and it can be a time when they’re at their most vulnerable.’
Duty to Care has seen an increase in the number of sign-ups in recent weeks, coinciding with rising Covid cases and the colder weather. They try to offer support immediately, with everything from psychotherapy to meditation available – and not just for doctors, but for everyone with an NHS email.
Rachel Clarke, doctor and author of Breathtaking: Inside The NHS In A Time Of Pandemic, says the Government has paid lip service to the idea of supporting staff, but in reality there’s very little in the way of actual resources. Even where support on the NHS is available, waiting lists are often long.
‘Staff are struggling on, traumatised and exhausted, being told that there are no unsustainable pressures on the NHS, that everything is functioning just fine. But we know this is nonsense – the NHS is overwhelmed and cracking up,’ she says. ‘Staff desperately want to address the huge backlog of care postponed due to Covid, but we can only help patients properly if we’re healthy ourselves.’
Hirah has considered quitting and only the existing shortage of nurses has kept her in the job. Her GP did, however, sign her off for six weeks in February this year and she had 10 sessions of therapy on the NHS because she was lucky enough to be fast-tracked through her trust. ‘That was pure luck of the catchment area that I live in. If they weren’t doing this fast-track I would have to wait months to be seen.’
For Louise*, an NHS midwife, it was a terrifying journey in March that made her realise she was heading towards breaking point. The 38-year-old said she had no recollection of driving herself and her two-year-old son home. ‘I’d been on the motorway but I was so wound up that I didn’t remember how I’d got home. I walked in the house and was hysterical because I’d had my little boy in the car. I was completely exhausted,’ she says.
Soon after, she was signed off work for six months. As a senior midwife in a Midlands hospital, she’s been working 70-hour weeks trying to keep on top of new protocols from the Royal College of Obstetricians and Gynaecologists (RCOG), while looking after a worried team and very anxious pregnant women.
‘Lots of midwives have lost any sense of a work/life balance during the pandemic and it’s felt traumatising,’ she says. ‘It came to a head in April when I couldn’t stop crying at work. I hadn’t slept properly for about three months because I was so worried about my team and their wellbeing. The stress of it all meant I didn’t even want to spend time with my son because I was so burnt out.’
‘Lots of midwives have lost any sense of a work/life balance during the pandemic and it’s felt traumatising’
First, she self-referred to occupational health within her NHS trust, but they were overwhelmed and had no services to offer. Then she self-referred to the NHS’s Improving Access To Psychological Therapy (IAPT), but they had no face-to-face appointments available. ‘I knew I was beyond an online course,’ she says. In the end she sought a private therapist.
Nicky Perl, a psychotherapist with Duty to Care, says NHS staff have been preoccupied with looking after other people and are now realising the impact the pandemic has had on their own mental health. ‘They’re beyond drained. They haven’t had a chance to regroup or take a breath. And having got through the height of the pandemic, people are left feeling like they ought to be doing better than they actually feel,’ she says.
Any support from the NHS would come too late for Shen White, 26, who last week resigned from her job as a physiotherapist in London. ‘It wasn’t an easy decision but I feel relief. I can’t cope with another wave,’ she says. She was redeployed to an intensive care unit, before eventually being signed off with burnout for three months. She’s had to move into temporary accommodation a couple of times to protect her mum and grandmother, who she lives with. When it came to asking for help, she consulted a local charity as she was only offered an emergency one-off counselling session plus three additional sessions through her NHS trust.
‘The expectation of me became too much. I lost autonomy as a person and I felt I had no control,’ she says. ‘I don’t think the support was there and I think that’s why I got signed off. If the support had been there I probably wouldn’t have got to that point in the first place,’ she says.
These workers’ dedication to their job is clear. They all went into the NHS out of a desire to help others but now many have been left with the feeling that no one is caring for them. Rachel cites a phrase they use in the NHS – ‘moral injury’ – which refers to the sense of failing to live up to the care you long to provide, she explains. ‘I think we’ve all experienced this. Guilt and trauma and a desperate wish to have been better, done more, helped prevent more of the suffering. It means everything to know the public is behind us. I know my colleagues would do it again in a heartbeat – even though at times it felt like it would break us.’