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Loneliness on the Front Line

To mark International Nurses Day during Mental Health Awareness Week, we have a special blog – it’s actually two blogs in one!

Our brief was to capture blogs about loneliness from people working in the medical profession during the pandemic, to illustrate how working on the frontline affected them.

Our first blog is written by Ben, a paramedic:

Covid, mental health and feelings of loneliness 

The Covid pandemic brought with it marked uncertainty and apprehension as we had not experienced anything like it in recent times. No one knew how it was going to develop and unfold. When it first came to our attention, who could have imagined the changes that it would bring to our lives.

How my work environment changed

As a front-line health worker, we had to learn a new way of working and navigate a new landscape that was changing on a daily basis.

This brought with it challenges, added stress and pressure.

It became clear that when I and other front line workers in the same position, were asked questions like, “How are you managing?”, “I’m sure you are busy”, “Is the hospital full of Covid patients?” we all seemed to have the same or similar answers.   

The changes and the new way of working added pressure to the daily flow of work and we were constantly managing the expectations of others.

No longer did we just ring the doorbell, walk in and sit on the sofa, it was now a case of donning full PPE.

You approached the door with apprehension as to what you would face. If there was a family member on scene, they would open the door and quickly retreat to a spare room to maintain the new 2 metre boundary that had been created.  

How Covid began to affect colleagues and patients

I found that my level of frustration began to increase over time as a result of trying to maintain a high level of patient care and adhere to this new way of working.

This frustration began to turn to resentment.

I found myself begrudgingly driving to work in the mornings instantly thinking about all the challenges I would face that day. This in turn affected my mental health and a general low mood started to set in.

The impact of those living in care

I noticed that the most impact was felt by those of the older generation who were living alone. Suddenly they were isolated to their flats and rooms rather than sat in the communal lounges chatting with friends. No conversation or social stimuli.

It didn’t take long for loneliness to set in. 

A lot of the older people I spoke to were not using modern day tech like computers or mobiles so they were unable to keep in contact with their family and could no longer receive family photos or updates.

The periods of the Pandemic that hit the hardest were during the lockdowns when no visiting was permitted. The lack of social stimulation and being confined to your home induced a state of depression that was becoming ubiquitous in the community.

I started to have the same conversations more frequently and at the time there was no solution to this growing problem. What did make a difference was a friendly phone call from a family member or friend, they really went such a long way and meant the world to these isolated individuals.

I found that the call volume from those of the older generation increased quite rapidly as suddenly there was more time for them to ponder and worry about their health problems. I found quite often that once you were on scene, the patients didn’t want to let you leave as you were the first person that they had conversed with face-to-face for a while.

Our visits gave them back a sense of normality and reduced anxieties.  

The impact on the families of those living in care

This impact was also felt on the other side. Families were now unable to visit their loved ones in care homes. Those that had cognitive impairment were unaware of the pandemic and didn’t suffer any distress. The Pandemic was more brutal for those patients who suffered from dementia. They noted a reduction in family visits but were unable to retain the reason why. This in turn induced a state of anxiety, which further impacted their mental health and potentially caused a further decline in cognition. I spoke with many people that had not seen their relatives due to them living in nursing/care homes.

Some had to experience phone calls from a care home about a declining relative, but were unable to visit them even in their last few days of life. Others unfortunately received phone calls informing them of that their loved one died in the night.  

Not being able to see family members in the last days of life brings with it great distress. Leaving the last face to face visit the most recent encounter.  

After speaking with colleagues, these examples and thoughts were very much shared across many different professionals working on the front line in the community at the time. 

In summary…

Covid spread its web in its own way and we were merely taken along for the ride. It left its debris and destruction in so many ways.  It’s safe to say that many people have a story to tell about isolation, loss, regret, anxiety and loneliness.

Now we look forward and hope that Covid is becoming a memory. But still people live in fear of Covid’s return and how they would deal with it if it did.

There have also however, been many positive changes to life and new ways of working. Sometimes with change comes positive outcomes.

Author: Ben Allaway, Paramedic – Urgent Community Response Team, Dorset HealthCare.

 

Our second blog is from Hayley who recognises the importance of asking someone how they are:

Covid… The Effects on our Patient’s Mental Health 

Without a doubt Covid has had a huge negative impact on our patient’s mental health and wellbeing. Increasing anxiety, depression and loneliness. 

During lockdown and beyond, community services and support have either stopped or dramatically reduced.  This has meant that people have been extremely isolated. So much so, that sometimes they have gone days without having any kind of contact with someone, particularly if they don’t have a package of care or family. 

Wearing masks became commonplace and this has made communication with our patients very difficult. Many people have communication difficulties and rely on facial expression and lip reading to communicate effectively. Not only that, but a smile goes a long way in making someone feel reassured and relaxed.

Suddenly there was just a sea of eyes and masks. 

The freedom of stopping and chatting to a neighbor or popping in for a cup of tea was taken away or made more difficult due to the 2 metre-rule and the fear of “catching Covid.” In truth, it could be that one cup of tea and a chat that helps a person to feel less alone, less isolated and have something to look forward to. 

Even post lockdown I notice that people seem to stay away more, don’t get too close, don’t say hello… All of this because of Covid. 

In retrospect

One of the things that I find incredibly sad, and will always stay with me as a Healthcare worker, is that during lockdown patients who were extremely ill and at the end of their life could not have their loved ones visit them, comfort them and hold their hand. Meaning that they passed away without being able to have those last conversations, last words or last hugs with the people most important to them. I pictured them being extremely alone.  

I feel that the long-term effect on families experiencing this will have an effect on their mental health. They may have feelings of guilt, and as I said words left unsaid. 

As a Healthcare worker, it is really important to me to spend that little extra time talking to our patients about how they feel. Asking them what interests them and letting them know that there are services that are available to help them overcome loneliness, albeit that a lot of these services are over the telephone even now. 

The recovery period

I think we need to really focus on this now. We cannot change that Covid happened or that lockdown happened. But we can start to pick up the pieces by supporting our patients as much as we can to access community support and services that are available now. 

Hayley Stallworthy, Assistant Practitioner – Urgent Community Response Team, Dorset HealthCare.

Guest Bloggers:

Huge thanks to our friends Hayley and Ben for their insightful blogs. They are very different accounts, but with common themes. Covid-19 affected their work environments and the way they treated and supported their patients throughout.

Further Support:

Loneliness affects more and more of us in the UK. It’s had a huge impact on our physical and mental health during the pandemic. Connection to other people and our community is fundamental to protecting our mental health.  We must find better ways of tackling this epidemic of loneliness. We can all play a part in this.     

Reducing loneliness is a major step towards a mentally healthy society. 

If you’re struggling to cope with your mental health in general, please talk to your GP. If you’re in a crisis, treat it as an emergency. Call 999 immediately or The Samaritans, FREE on 116 123. 

Dorset Mind offers group support that can also help with your wellbeing. Our groups offer peer support and helps reduce stigma by normalizing conversations about mental health. You can also check out further support for stress and mental health here.  

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