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A cancer nurse specialist has spoken out about her experiences during the first wave of the coronavirus pandemic including the challenges around redeployment and the impact on her mental wellbeing and that of her team.
Denise Crouch, Macmillan cancer lead nurse at a hospital trust in the East Midlands, has told MPs how every day felt like “Groundhog Day”, filled with long hours, fatigue and anxiety.
“At one stage I was doing a 60/70-hour week purely to keep the wheels on the bus really”
She was speaking during an evidence session with the Health and Social Care Select Committee earlier today as part of its inquiry into workforce burnout and resilience in the NHS and social care.
Ms Crouch, who during the first wave continued to juggle some of her usual responsibilities after being redeployed to a discharge lounge, recalled the anxiety she felt during those first months of the pandemic and flagged the fear she felt for the staff who were now going through a second surge.
At the first peak, some services across the NHS were paused or altered to help mitigate the pressures and impact of Covid-19 and many nurses were redeployed.
Ms Crouch told the group of MPs how “a lot” of staff across the East Midlands had to be retrained and redeployed as part of the Covid-19 response.
A change in roles meant that some cancer nurses were moved into ward settings for the first time in several years and were working longer hours than normal, she said.
“I myself as the cancer lead nurse was also redeployed, but…my job doesn’t stop, I still manage staff and still needed to do my job, but I went to work in the discharge lounge, discharging patients,” she said to the committee.
“At one stage I was doing a 60/70-hour week purely to keep the wheels on the bus really.”
She added: “I know myself personally, I’ve been nursing for 43 years, I’m 62, I was absolutely shattered and exhausted at the end of each week – dealing with all that extra workload and emotion…but also I have to say very privileged that we were able to do our bit and help.”
During their redeployment, cancer nurses were concerned about where their patients would get the emotional support that was normally provided by nurses, noted Ms Crouch, who highlighted the “key role” nurse specialists played in supporting people through their diagnosis.
“The nurses were worried about their patients and what was happening to their patients”
“The nurses were worried about their patients and what was happening to their patients,” she said.
“Having that emotional support while they were working in other places caused quite a lot of concern.”
When asked about staff burnout, Ms Crouch said she felt “fatigued” and anxious.
“It very much seemed like Groundhog Day, every day,” she said, noting how it “felt as if there was nothing to look forward to because every day you just got up to come to work”.
“It was that anxiety that was there and there is still that anxiety. We are in a big second wave again and that anxiety is there.”
As part of her role as a lead cancer nurse, Ms Crouch had undertaken regular meetings during the early months of the crisis to discuss how staff could be supported.
From these conversations, she told the committee that concerns were raised about post traumatic stress disorder among the workforce and discussions were had about what action was needed to support these nurses in the future.
She noted that her trust and Macmillan had both offered wellbeing events and initiatives to support staff through the pandemic.
She was thankful that in this second peak of the pandemic her team was able to continue in their cancer nursing roles, but said they were “fearful for the people that are in that second wave in our intensive care [units] and respiratory wards.”
“We have got a shortage of nurses as it stands and we know that in a few years’ time that increase of cancer diagnosis is going to be one in two people”
Throughout the committee meeting Ms Crouch also flagged serious concerns about a shortage of cancer nurse specialists and said thought was needed on how to recruit more staff.
“We know we have got a shortage of nurses as it stands at the moment to look after these patients and we know that in a few years’ time that increase of cancer diagnosis is going to be one in two people,” she said.
There was also the challenge of an “ageing population of nurses that are likely to be retiring very soon”, she added.
The next phase of the NHS People Plan, which will be based on workforce numbers and funding and is due after the next spending review, needed to include commitments around training more cancer nurses, said Ms Crouch.
She was particularly concerned about catching up on work that was paused throughout cancer services during the first wave, as well as the number of late referrals services were seeing which needed “more input and more support” from nurses.
With these challenges in mind, Ms Crouch said nurse staffing levels in this setting needed to be reviewed.
Today’s virtual meeting was the second session of the committee’s inquiry, which aims to investigate the toll of burnout and excessive workload on the mental wellbeing of NHS and social care staff.
Nursing Times launched the Covid-19: Are You OK? campaign in April to first raise awareness of the mental health pressures and wellbeing needs of nurses during and after the coronavirus pandemic.
We have now launched the second phase of the campaign, which involves actively asking employers from the health and care sector to back the aims of the campaign.