Care home nurses left feeling undervalued, report finds

Dr Crystal Oldman CBE

Four-fifths of care home nurses reported ‘very negative experiences’ while working through Covid-19, with many workers feeling undervalued, unsupported and under pressure.

A report on the effect of the pandemic on the UK’s nursing and residential homes, published by the Queen’s Nursing Institute (QNI), found more than half (56%) of those surveyed felt ‘worse or much worse’ in terms of their physical and mental wellbeing.

The institute carried out a survey in May and June of its nurses in care homes to understand the impact of Covid-19 on the workforce.

The survey, which consisted of 163 responses, confirms that for most respondents the pandemic had been a very challenging experience.

Having to accept patients from hospitals with unknown Covid-19 status, being told about plans not to resuscitate residents without consulting families, residents or care home staff, lack of guidance on issues like personal protection and issues of poor access to pay if they became ill were some of the issues highlighted.

One in five (21%) of respondents said their home accepted people discharged from hospital who had tested positive for Covid-19. Seventy respondents (43%) reported receiving residents from the hospital with an unknown Covid-19 status during March and April.

Sixteen respondents reported serious ethical and professional concerns, such as clinical commissioning groups and hospital trusts making resuscitation decisions without first speaking to residents, families and care home staff or trying to enact ‘blanket’ ‘do not resuscitate’ decisions for whole groups of people.

Only 62 respondents stated they could take time off with full pay, while some felt pressure not to take time off at all (15).

Other findings included three-quarters (75%) reported their employer had provided all their PPE, while 20% had a positive or mixed sentiment around the experience of Covid-19.

Crystal Oldman, QNI’s chief executive, said: ‘The care being delivered in a home can at times be as intensive as in a hospital – in particular for end of life care – and it is hugely skilled work. As the majority of respondents to this survey indicate, the people living in their care homes need a combination of support for complex physical and cognitive needs.

‘Overall, as would be expected, the picture presented is of an extremely stressful and anxious period for professionals working to care for and protect their residents. The positives represent a silver lining to this cloud and there are numerous testaments to the skill, dedication, professionalism and teamwork that care home nurses have displayed in 2020.

‘More needs to be done to understand the effect of Covid-19 on the workforce and residents in care homes. Urgent attention must be paid to the sector if the workforce is to withstand the additional demands of the pandemic, particularly in planning, guidance and employment practices.’