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21 April 2020

Survey of UK nurses and midwives' highlights their concerns about health, training and workload during COVID-19

Results from a survey of UK nurses and midwives show their current concerns during the pandemic.

Graphic of healthcare workers in protective clothing

Results of a survey published today have highlighted concerns nurses and midwives in the UK have about COVID-19 and the risks it poses to their physical and mental health, as well as the health of their families. Respondents also reported training for staff redeployed to front line care was inadequate or non-existent. These survey results show there is an urgent need to provide support for the health and wellbeing of staff, and to ensure they have access to ongoing training.

The ICON study is a longitudinal survey to evaluate the impact of COVID-19 on the UK nursing and midwifery workforce. The survey is being undertaken at three time-points: prior to COVID-19 peak, during the COVID-19 peak, and in the recovery period following COVID-19. The results from each point are being reported in real time, so the findings could be used to inform workforce strategies within the NHS and social care. This summary concerns the early results of the first survey (prior to COVID-19 peak).

The ICON study, led by the Royal College of Nursing Research Society steering group, is a collaboration between King’s College London, University of Warwick, Cardiff University, University of Plymouth, University of Nottingham, University of Surrey and St Bartholomew’s Hospital.

The first survey was open for responses between 2-14 April 2020. All members of the UK nursing and midwifery workforce were eligible to complete the survey, including registered nurses, registered midwives, student nurses, healthcare support workers, nursing associates, and trainee nursing associates. The survey was distributed by social media, the Royal College of Nursing, Nursing and Midwifery Council, and other key professional organisations.

2,600 members of the nursing and midwifery workforce participated in the survey and provided complete or near-complete data.

Initial findings include:

  • 74% feel their personal health is at risk during COVID-19 due to their clinical role.
  • 92% are worried about risks to family members during COVID-19 due to their clinical role.
  • Almost one-third (33%) respondents reported severe or extremely severe depression, anxiety or stress.
  • Of those being redeployed within the NHS, 62% either reported that their training was either non-existent, or inadequate.
  • 52% respondents had worked over their contracted hours on their last shift- two-thirds of these respondents will not be paid for their additional work.
  • 25% disagreed that correct PPE was always available (with only 44% agreeing that it was available)
  • 52% were either lacking in confidence regarding COVID-19 infection control and prevention training that they had received or had received no training.
  • 26% respondents had needed to self-isolate, of which 37% did not have personal symptoms and 64% missed four or more shifts due to self-isolation.

Commenting on the key implications these results have for the nursing and midwifery workforce, Ruth Harris, Professor of Health Care for Older Adults in the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care at King’s College London said:

These initial findings show that individuals do not feel adequately prepared for the pandemic and are concerned about the risk to themselves and their families. They also highlight a need for ongoing training and confidence building and that optimising healthcare worker testing may reduce the number of missed shifts due to self-isolation.

Ruth Harris, Professor of Health Care for Older Adults. King's College London

Dr Keith Couper, Assistant Professor in Emergency and Critical Care at the University of Warwick and project lead said:

'The responses from this first survey show there is a need to provide supportive interventions during and after COVID-19 to support individual’s psychological and physical needs. Healthcare employers should advocate self-care and provide a psychologically safe workplace where individuals can openly discuss their concerns. Urgent research is needed to develop and evaluate interventions to support individuals.'

Professor Daniel Kelly, RCN Chair of Nursing Research at Cardiff University said:

‘These results point to stress and worry within the nursing workforce with almost one third of respondents reporting symptoms of depression. This is a situation that must be addressed by providing testing, safety equipment and support in all settings where nurses and midwives are working with great goodwill and bravery.’

The ICON team acknowledges support and advice from the Royal College of Emergency Medicine Trainee Emergency Research Network CERA study team, on which parts of this study are based.

Follow-up surveys will be advertised on social media - please follow @RCNResearchSoc for updates.