A much more “supportive culture” is needed within health and care services to prevent nurses from burning out and to address the “structural inequalities” exposed by Covid-19, a nursing leader has warned.
Chief executive and general secretary of the Royal College of Nursing, Dame Donna Kinnair, was speaking on Wednesday at a parliamentary discussion on lessons learned during the coronavirus pandemic.
Nurses and colleagues had “lost their trust in their ability to be looked after in times of crisis”, because of their experience of working in the outbreak, she told the House of Lords Public Services Committee.
“If we’re going to prevent those staff from burning out we’re going to have to have a much more supportive culture”
She warned that staff were at risk of leaving the profession because they could become “traumatised” by what they had seen during the pandemic, or that some may feel they would be better rewarded by a less stressful job.
In addition, the nursing leader said there were several issues that needed fixing around the “structural inequalities” faced by nurses from black, Asian and minority ethnic (BAME) backgrounds.
To combat these concerns, Dame Donna warned that more needed to be done to protect both the workforce itself and the wellbeing of individuals.
The final version of a long-awaited workforce plan is set to tackle changing the culture of the health service and will also map out ambitions to improve recruitment, retention and access to continuing professional development (CPD).
It is not currently known when the NHS People Plan will be published in full, due to the pandemic, but an interim version of the blueprint came out last year.
While giving evidence to the committee, Dame Donna said: “We need a cross-government strategy and. whether it’s the people plan or not. we need to understand why we are not able to make staff feel good about working for one of the best services in the world.”
She added that it was important that the workforce saw that “we are learning from the issues that both Covid, but also that we knew existed before”.
Some nurses or colleagues may “leave the NHS and other services. because they can’t hack it anymore or [think] that they’re better rewarded by working in some supermarket without the stresses they have to carry home”, she said.
“If we’re going to prevent those staff from burning out, we’re going to have to have a much more supportive culture and recognise that if you invest in your staff – if you treat them well – they will work very hard for you,” she added.
A Nursing Times survey recently revealed that almost all nursing staff were feeling more stressed and anxious than usual, with a third describing the state of their mental health as bad during the Covid-19 crisis.
Half of nursing staff who responded to the survey considered the current level of support being provided to health and social care staff on mental health and wellbeing as inadequate.
The findings came as part of a new Nursing Times campaign called Covid-19: Are You OK? which aims to ensure that supporting nurse mental health is firmly on the radar of employers and the government.
Lack of personal protective equipment and testing, coupled with “unsafe” work environments during the pandemic, meant nurses had “lost their trust in their ability to be looked after in times of crisis”, said Dame Donna.
“People also get traumatised by the amount of people that die and they have to look after and so we have a number leaving the profession as well,” she told the committee.
“I am hearing people on the ground about a lack of PPE, testing and the unsafe working environments that nurses, and some medical staff, receive may mean that they have lost their trust in their ability to be looked after in times of crisis and, therefore, we have got an issue with that.”
For BAME staff, the nursing leader said the pandemic had “shone a light on” the “structural inequalities” that exist within health and care.
A report by Public Health England this week said that institutional racism and bullying at work had meant BAME nurses were “afraid to speak up” about issues that put them at a higher risk of Covid-19, such as inadequate PPE.
During the parliamentary discussion, Dame Donna highlighted other inequalities such as the fact that BAME staff were “over-represented in investigations” and in “referrals to professional regulators”.
She noted that, annually, the Workplace Racial Equality Standard report was published, which measured the experience and opportunities of BME and white people working in the NHS.
WRES data from 2019 found that nurses from BME backgrounds represented the highest proportion of NHS staff to report being discriminated against and bullied in the workplace.
While collecting and recognising this data was important, Dame Donna said there was a failure to see improvements being made.
“We recognise it, but we don’t actually see it moving in the right direction because we have not put the strategies in place,” she said. “I think there is discourse to be had with those communities about how best to improve it.”
Work also needed to be done to ensure NHS and social care leaders better reflected the communities they served, said she said, highlighting that only 10 chief nursing officers in England and Wales were from BAME backgrounds.
“The structure of NHS and social care leaders need to reflect the communities they serve and that needs to be addressed,” she told the committee.
“If you think about… only having 10 chief nurses across the whole of England and Wales, it’s poor because actually how do we get an understanding, how do those members of staff feel that they can speak up?”
Dame Donna added: “We know that one of the things the pandemic has shone a light on, particularly with the PPE issue, is yet again we saw members of staff being silenced when they tried to raise issues, and this cannot go on.
“For me, we have got to take the learning and make sure our priority is to support our workforce, but particularly BAME members of staff who make up a good percentage and are over-represented in investigations, they’re in our care sector and we need to support them.”