‘COVID-19 has made me reflect’

For some respondents, it was clear that working in different places and in different ways had brought new opportunities they may never have considered.

But for others, the disruption and stress of this period appear to have been the final straw in their nursing career, with many seeking retirement sooner than they might otherwise have done.

University of Manchester professor of organisational psychology and health Sir Cary Cooper says it is natural that after going through such a major crisis – especially one that involves a potentially life-threatening virus – people start reassessing their priorities.

He says he is not surprised some nurses are thinking of leaving the profession.

‘People are worried, whether they are on the front line or not, and are starting to think “is this what I want to do with my life?’’.

‘For nurses, their life is more at risk than other people, and many will have had to stay at home or take on different roles, so may have had time to reflect.’

He adds that a proportion of those thinking of leaving will be burnt out by their pandemic experience. There needs to be significant support in place to help healthcare staff deal with the trauma of what they have experienced, he says.

‘I think there will be a tsunami of post-traumatic stress disorder in the autumn from people on the front line,’ he says.

A sense of reflection and uncertainty is evident in some of the responses to the Nursing Standard survey, which was conducted online and open from 8-19 June 2020. ‘The pandemic has definitely made me feel more reflective generally about overall circumstances and I have been especially reflective on my current career and thinking about the future,’ one respondent says.

A quarter of nurses who responded (25%) had been redeployed, the vast majority for operational reasons, and a small minority to protect the health of staff or of their family (3%).

Of those who were redeployed, only 30% had returned to their original role at the time of the survey. Many had been moved to COVID-19 or intensive care wards, when their own areas were closed down.

In the comments, nurses describe how they had been told that they may remain in their seconded roles until at least the end of the year, and say there is a lack of clarity about when they may return to their usual roles.

‘We are told there is potential to remain redeployed for up to two years or until there is a vaccine,’ one nurse says. Another says they won’t return to their surgical ward for another 12-18 months. ‘I am unsure what my plans are. I am finding it difficult to return to my role,’ one nurse says.

Another described how their plans had been disrupted as their prescribing course was halted by the pandemic, and it is not clear when it may restart.

For some nurses, the chance to try something new or return to a clinical area after a long absence, has brought about an exciting new career opportunity.

One respondent says they were hoping their redeployment to the hospital discharge team would be made permanent.

Others say their experience in intensive care had inspired a change in specialty.

‘Having intensive care unit (ICU) experience now, I am considering applying for an ICU nurse position when available, thinking that they have the best personal protective equipment (PPE) at the moment,’ a respondent says.

New career opportunities

Another says: ‘I was given the opportunity to have training and consolidate my ICU experience so may consider ICU nursing.’

Some nurses discovered that a return to the bedside was a change they needed. ‘I realised I am a ward nurse and need to look after people,’ a nurse says.

Nurse consultant Helen House (left) with mental health nurse Kim Carter, who was redeployed to a crisis resolution and home treatment team in May (see box, page 10)

How to make changes to your career

University College London Hospitals careers service lead Robert Blaze says there has been a 25% increase this year in nurses approaching his service.

There has also been a rise in interest in moving to intensive care and a greater push for a different work/life balance, he adds.

The service seeks to help nurses either become more fulfilled and satisfied in their current role or support them to find new opportunities at the large trust.

For those seeking a change, Mr Blaze recommends speaking to your manager first. ‘Have a chat with your line manager and colleagues,’ he says. ‘In the career service we focus on identifying nurses’ strengths, as when people are using their strengths, that makes their jobs more satisfying. A manager should know your strengths, and there may be some you didn’t know yourself. Reflect on these and learn about yourself. Your manager may be able to adapt your role to use those more.’

For those who want more advice, Mr Blaze recommends going to the careers service, if available, and if not, looking for coaching or mentoring opportunities.

‘Consider your innate strengths and then develop a career plan,’ he says. ‘It doesn’t need to be really formal, but really focused on you and what you want. Really own it.’

One nurse describes how it has given them the chance to consider an area of nursing they had ruled out. ‘I was looking for a change before the pandemic but it has helped me reconsider acute nursing as opposed to community only,’ they say.

Sadly, for many, working through a pandemic did not prove a positive experience. Some felt too vulnerable to work due to health conditions that put them or their family members at higher risk of becoming seriously unwell if they caught COVID-19.

More than one in five respondents (22%) said they are now considering or actively seeking a role outside of nursing.

Before the pandemic, the NHS was already in the grip of a staff shortage that has led to 40,000 nursing vacancies in England, making staff retention critical.

High numbers of nurses seeking a change of career were also found in a major RCN survey published in July. Of the 42,000 members from the NHS and the independent sector who responded, the percentage thinking of leaving the profession had risen to 36%, up from 27% at the end of last year.

Of those thinking of leaving, 61% cited pay as a factor.

Many nurses said they were seeking rapid retirement, with some saying they would no longer retire flexibly and others saying they may seek an early end to their career.

For some approaching retirement age, working in PPE was proving too difficult. ‘I am retiring at the end of August and it can’t come quick enough,’ one nurse says. ‘I am claustrophobic and struggle wearing masks.’

For others, difficulty and uncertainty in their attempts to get back to their old jobs is pushing them to leave. One respondent says: ‘I would like to get back to my role as lead staff nurse for the outpatient department but if this does not happen in the next 4-6 months I will consider retirement.’

Redeployment helped me find a new career

A mental health nurse who was redeployed to help tackle COVID-19 has since secured a job in her new team.

Kim Carter, who was working as a clinical nurse lead on an inpatient ward at Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, admits she was initially anxious.

‘I was gutted. I had not long returned from sick leave due to stress and felt it couldn’t have come at a worse time,’ she says.

She started on the older adults crisis resolution and home treatment team in May. The team offers assessment and home treatment for people experiencing a mental health crisis.

‘Part of a team where I can make a difference’

Ms Carter, pictured, says she was made to feel like part of the team from day one, and was able to share her knowledge of inpatient services.

Ms Carter has now joined the team permanently. ‘I feel like I’ll really be able to make a difference,’ she says. ‘I often felt that my skills would be better suited to supporting service users and families more directly. My whole ethos is about person-centred nursing.’

Nurse consultant Helen House says: ‘Kim was visibly anxious on her first day. The next day she had a massive smile on her face. She told me she felt a renewed love for nursing.’

A fresh start for some

Care home nurses reported having to work in distressing circumstances, due to losing residents to the virus. ‘Working in a nursing home has been terrible, I am now on sick leave,’ one respondent says.

While others report a desire for a fresh start away from nursing. ‘My friend left recently after 30 years of nursing, got a job as a cleaner and has never been happier. I admire her.’

University College London Hospitals assistant chief nurse Alison Finch, who is a National Institute for Health Research clinical doctoral research fellow, says employers must be flexible and supportive to retain staff. ‘Being asked to step into different roles has felt fulfilling for many people, but given there has been so much emphasis on COVID-19, others feel their original role or specialty may have become overlooked and some nurses may feel lost and unsure of the importance of their role or value of their contribution,’ she says.

Change is inevitable as services try to cope with ongoing COVID-19 cases, as well as capturing positive working changes uncovered during the pandemic.

‘Flexibility is the key to helping people feel valued and stay,’ she says. ‘Nurses should be offered choice, wherever possible, to move where their experience allows within the organisation. Individual teams or departments can’t afford to be too territorial. COVID-19 has helped with this – teams have come together, staff have moved between departments and there’s a sense of professional community.’