ICS blog two - published 21 July 2020


While we work on our wider wellbeing project, my biggest concern right now is that we have just made it through the first wave of cases, with an indeterminate second wave potentially on its way.

How do we look after staff right now?

Chatting to colleagues, everyone is exhausted, the thought of doing this again, and so soon is terrifying for people and they are describing anxiety dreams in anticipation.  Some are unable to even contemplate the possibility, a state of freeze (when I experience it myself my colleague wittily describes it as my “screensaver mode”).

We can make sense of how exhausted we are feeling right now, not just in terms of the physical effort and hours that everyone has put in (especially while wearing PPE for much of the time) but also in terms of how activated our body stress systems have been during this high active phase of reorganising units and treating a new disease with some distressing outcomes. We have very much been in “Go-Go-Go” mode. Now, for many in critical care, they are attracted to the work because of such high level stimulation and challenge. However, they do then normally have home life to retreat to which of course due to lock down has been very different, taking away some of access to personal resources and blasting us with an infodemic of information.

What this creates for us physiologically is a high-level stimulation of our sympathetic nervous system almost all the time: it is all go and there is almost no down time. Short term we feel restless with nervous energy, long term we fee frazzled and exhausted. This can develop into a feeling of nothing left to give, impacting our ability to achieve at work, and potentially leading to a disconnection to retreat and protect ourselves. In short, this is a pathway to burnout.

So, again, how do we look after our staff right now? Well, from a team leader or management point of view, where you can, rotate staff in and out of PPE zones. It goes without saying you allow your staff some down time from work to rest. However, they may struggle to switch off, as what they have been through is still rattling through their mind.So, this is the time for team meetings and staff Q&A sessions. Staff need a bit of space to vent, be heard, and process their experiences. They will benefit from assurances of planning to manage any second wave we face, as best we can, which may need some higher-level management engagement.

As a peer, when was the last time you had a (socially distant) coffee with your go-to peer/buddy at work? Take that time, check in and re-connect.

As an individual, you can look after yourself by truly taking some time away- be that annual leave, or be that switching off the work WhatsApp on your days off. Work related communication has been high to the point of excessive on WhatsApp groups - now might be the time to dial that down and restore some work-life boundaries. Take some time, if you can, to activate your parasympathetic (self soothing) branch of your ANS. Breathe. Be in nature. Laugh. See your family now that you can.

At the start we called this a marathon, not a sprint. Perhaps we should have called it a triathlon or a relay…we need a whole team approach to get through this.

Dr Julie Highfield
ICS National Director of Wellbeing