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Community nurses ‘drained’ from surging end-of-life care



Community nurses and GPs feel ‘emotionally and physically drained’ because of surging demand for end-of-life care during the Covid-19 pandemic, a study has found.

University of Sheffield research, published last week, revealed 58% of community nurses and GPs have reported providing more end-of-life care than usual during the Covid-19 pandemic. This has led to stress, anxiety and working longer hours, it found.

Of the 500 respondents (387 community nurses, 156 GPs and 16 unspecified roles) from across the UK, 53% also reported caring for patients who had died with confirmed Covid while 67% said they had cared for those who had died with suspected Covid.

Dr Sarah Mitchell, lead author, warned nurses are feeling ‘isolated, emotionally drained and frightened coming into work after witnessing high volumes of people dying as well as managing anxiety around Covid infection control’, when commenting on the data.

One respondent said: ‘Staff have been left broken and there are symptoms of post-traumatic stress disorder, depression and anxiety.’

Nurses and GPs also felt their contribution to community end-of-life care during the Covid crisis was undervalued, with a sense that the virus ‘only existed in hospitals’, the research found.

‘Community nursing team members particularly described a sense of abandonment and perceived that other services, including general practice and specialist palliative care, had withdrawn,’ the study said.

Community nurse respondents also reported working more hours to tackle the rising need. One from Northern Ireland reported ‘working well over shift times due to symptom management and workload’ and being subjected to ‘informal changes to work patterns’.  This was made worse by ‘staff shortages due to Covid-19 and shielding,’ they added.

Both nurses and GPs suggested the surge in demand was because of increasing numbers of patients with complex healthcare needs choosing to be treated at home during the pandemic.

A district nurse from England said: ‘I feel more patients stayed at home for non-Covid related end-of-life care. Which was good. Think the staff that were at the front line went above and beyond to keep patients at home.

‘Patients and families did not want admission as then they could not see family etc., and then die without family there. Staying at home was seen as best option for most patients and families, even if it was tiring,’ they added.

A sessional GP, also from England, explained: ‘We have had more complex patients being managed at home, which has been a challenge, whereas if Covid-19 and visiting wasn’t an issue they may have been hospice inpatients or even admitted to an acute hospital bed.’

In May, Nursing in Practice looked in depth at the pressure on palliative and end-of-life care services increasing because of more people waiting longer for hospital since the start of the Covid pandemic, and more people dying at home.

Research published in July last year showed that deaths at home increased by 77% and deaths in care homes increased by 220% during the first ten weeks of the pandemic.