RCoA calls for anaesthetists to take holiday in preparation for second COVID wave

Published: 18/06/2020

Stress and burnout could affect staff capacity to cope with normal clinical services and COVID surges

The Royal College of Anaesthetists is calling for healthcare staff to take leave, and recover physically and mentally, prior to a possible second wave of COVID-19 infections later in the year.

During the pandemic many anaesthetists and other healthcare staff have been working longer hours than normal, often not in their usual area of clinical practice and in physically and mentally demanding conditions. The College’s latest membership survey reported high levels of stress and exhaustion, with 42% reporting mental distress in the last month and 10% close to burnout.

Pressure on COVID services is easing and the next few months will see the gradual resumption of non-COVID services such as planned surgery. Now is the time for anaesthetists to take leave, to recharge their batteries and ensure they are recovered and able to cope with future pressures from combined COVID and non-COVID services. As outlined in guidance on resuming surgery, staff capacity will be one of the most important factors in maintaining safety patient standards.

Dr Fiona Donald, Vice President of the Royal College of Anaesthetists:

“The pressure of this pandemic has had a big impact on anaesthetists. Whether a hospital is nearly back to normal or still in the thick of pandemic-related activity, thoughts are now turning to further surges and what they might mean for healthcare staff.

“The College supports and encourages anaesthetists to use their allocated leave during this slower period, rather than waiting for later in the year. They should not feel guilty or conflicted about taking well-deserved time off. Sleep, rest, and recovery are very important to them being able to care for patients properly and safely, and to being able to cope with the high pressures of the pandemic and resumption of services.

“Unfortunately, we know from our survey that a third of respondents have experienced difficulty taking annual leave over the last month, with some saying that they had cancelled their own leave because they wanted to postpone taking a break until they could actually go away. This is understandable but possibly misguided now that we know what we are facing.   It is a cliché to say that this is a marathon not a sprint, but it is also true, so we need to get ourselves ready to cope.”

Dr Mike Farquhar, consultant in sleep medicine at Evelina London Children’s Hospital:

“The COVID19 pandemic has put anaesthetists and intensivists front and centre during one of the most extraordinary challenges the NHS has ever faced. During the pandemic, the importance of looking after staff has never been clearer. The RCoA has long championed the idea that when staff work without regular rest and breaks, risks to both staff and patient safety rise, and we work less effectively and less efficiently.

“When stressed, our sleep also becomes more vulnerable, with many of us experiencing unsettled nights and shorter sleep as a result of the pandemic. Across the NHS, there has been an increased emphasis on basic principles of regular rest and strategies to maintain as best quality sleep as possible, supported by wellbeing hubs, and even sleep pods for staff to nap in during a shift, springing up in many hospitals.

“Although we are through the first peak, there is likely still a long way to go and NHS staff, anaesthetists and intensivists in particular, will remain at the forefront of that. Just as taking a break within a shift is essential to make sure that we deliver the safest, most effective, most efficient care to our patients as we work, focusing on supporting the long-term health and wellbeing of our teams must now take priority. All of us will need time and space to be able to recharge, to take the time to care for ourselves, supported if needed, if we are to continue to minimise the harms that COVID19 causes.”

Dr Fiona Donald’s key tips for healthcare workers:

  1. Cut yourself off from work commitments and responsibilities. Even the most important of us are not indispensable.  Do not look at emails. I know this is difficult, however by looking you bring work worries back into your mind and often get embroiled in tasks that can take a long time to accomplish. Rest assured that if anybody really needs to get hold of you for something so urgent it can’t wait, they will find you.
  2. Don’t use your holiday time to catch up on work tasks. As with your emails, these things will still be there when you get back to work and by then you may be able to manage them more effectively.  If you find that you absolutely have to do some of this work then allocate a designated amount of time to it and stick to that time.
  3. Give your days some structure by planning activities this could include exercise, socially distanced meetings with friends and family or virtual meetings with those who are further away. Also try and avoid staying up later than you normally would or getting up later in the morning. Routine helps your sleep pattern which helps your state of mind.
  4. Think about devoting some time to a hobby – new or old. Sourdough bread making seems to be popular and the concentration required blocks out any thoughts of work.
  5. Don’t feel guilty. You work hard when you are not on holiday and you deserve some time off. No one will criticise you for not working during your holiday, but they will expect you to come back refreshed and ready to start again.