Peer support network helped redeployed children’s nurses ‘debrief’ in first wave

Angela Cole, lead clinical nurse specialist for children with intestinal failure at The Royal London Hospital, was instrumental in setting up a support network for fellow paediatric nurses who had been sent to work in unfamiliar areas.

“I just wanted to try and fill a gap where you couldn’t debrief with your team”

Angela Cole

The network saw groups of redeployed nurses allocated a dedicated “team leader” who would check in on them regularly and be available to speak to.

Speaking to Nursing Times, Ms Cole said her aim was to help “fill a gap” and support nurses who were unable to debrief with their regular colleagues after a difficult shift.

Concerns about nurse mental health have been raised since the outbreak of the virus last year and sparked Nursing Times to launch the Covid-19: Are You Ok? campaign to lobby for support for the workforce.

A large-scale redeployment of nurses happened across the profession last spring amid the first surge of Covid-19 – although it was particularly prominent across children’s services.

At The Royal London Hospital, which is run by run by Barts Health NHS Trust, some paediatric staff were redeployed to support adult intensive care units that were presented with increased volumes of patients.

Ms Cole worked in a team with one other clinical nurse specialist and it was decided that she would stay in her role and her colleague would be redeployed, which she said led to feelings of guilt.

“In those initial weeks where you’d sent your colleague off into that environment of being quite anxious and unsure of where they would be going and you were staying put – there was that element of guilt,” she told Nursing Times.

For Ms Cole, redeployment had a negative imprint in her mind, after the loss of a colleague who took their life around 15 years ago when they had been “struggling with being redeployed”, among other things.

“Two to three times a week I would WhatsApp a group of generally about nine nurses just to check in see how they were”

Angela Cole

She was therefore “really conscious” about offering support to her paediatric colleagues who were being moved elsewhere.

“It just worried me that we were sending individual nurses, from established teams into a team that they didn’t know and into an environment that they didn’t know,” said Ms Cole, who started her nurse training 25 years ago.

In addition, Ms Cole said pandemic restrictions meant staff were not able to take time outside of work to “debrief” with colleagues like they usually would following hard shifts.

With all this in mind, she and other nursing colleagues who had stayed in their normal roles sought advice from clinical psychologists and senior nurses at the trust about how redeployed staff could be supported.

“I just wanted to try and fill a gap where you couldn’t debrief with your team,” she told Nursing Times.

“You weren’t in your team any longer and then actually it was really hard to then catch up with your team because you can’t even socialise with them.”

Ms Cole was one of those who took on the role of team leader in the support network.

She explained how the leaders would have different groups of redeployed staff each week to prevent creating “dependent relationships”, in case of staff sickness or others needing to be redeployed.

“Two to three times a week I would WhatsApp a group of generally about nine nurses just to check in see how they were, what shifts they were on, were they OK, see if there was anything we could help with, did you want to chat – those kinds of things,” she said.

Once a week the team leaders would then speak to see whether there were any individuals they were worried about.

They also created a resource pack which signposted colleagues to other support if needed. Around 26% of the group were referred to more formal counselling.

The initiative had worked “really well” and had helped “generate that element of peer support” that could sometimes get lost when colleagues did not see each other on a regular basis, said Ms Cole.

Going forward, she said there needed to be “concentration” nationally around the “long-term impact” of the pandemic and “how we all support each other through that”.

“Generally, nurses do like to talk and generally it is quite well acknowledged that talking does benefit and especially if you can build that into more development and learning exercises so it will benefit everyone,” Ms Cole told Nursing Times.

However, she stressed that time was a barrier for nurses because of staff shortages which she feared could potentially worsen after the pandemic.

“But it is about trying to find the time to protect the wellbeing of staff,” she said.