A porter something special

Supporting staff mental health and wellbeing is seen as key to ensuring NHS staff capacity is sustained; essential to surgeons, doctors and nurses – this is also relevant to clinical support services and porters too. Rates of sickness for NHS workers in England for the month of April 2020 were the highest they had been in a decade! The most common problem? Stress, anxiety, depression or 'other' psychiatric illness.^[1]

The cause for this can be attributed to the pressures of dealing with Covid-19. Studies show that NHS staff have been affected mentally in many differing ways throughout the pandemic – be it through anxiety, PTSD or burnout. A lack of attainable PPE (personal protective equipment) ^[2] can contribute to fears of feeling vulnerable to catching the virus, leading on to feelings of anxiety – and with great reason too, with over 600 NHS health and social care workers having died from the virus ^[3]. Also witnessing a greater number of deaths due to Coronavirus; seeing sights which cause the same trauma as seen in veterans returning from a battlefield of war ^[4]. Overall, the increased workload in an already exceptionally stressful environment can lead to exhaustion, and finally, burnout ^[5].

Most research documents on mental health and wellbeing within NHS staff tend to be focussed on that of the clinical side, but we know these pressures are there just as much for non-clinical staff such as porters. Porters can affect every corner of every hospital, keeping it ticking through movement of equipment and patients, ensuring they are where they need to be at the correct time, allowing operations and appointments to remain on schedule – porter efficiency and patient flow go hand in hand, but add mental health or wellbeing issues into the mix and it's easy to see how that could be affected.

Working closely with many portering teams across the country, the team here at MyPorter have heard how difficult work has been for porters during the pandemic. Porters are responsible for transporting Covid patients, often in small, confined spaces such as lifts, whilst having to deal with a potential lack of available PPE. They have the task of moving the deceased to the morgue – of which there are much higher numbers since the beginning of the pandemic ^[6] – with greater numbers comes with it the higher chances of having to deal with something closer to the person. All this, alongside the increased workload, also means that porters are seeing increases in exhaustion and burnout too [5]. Add all these various possibilities together and it gives us great concern for porters' wellbeing and psychological state.

This poses the question – what is the best route for maintaining good porter mental health and wellbeing, not just for the remainder of the Covid-19 pandemic but into the future and beyond? A S. Brown and K. Klassen report ^[6] highlights a previous study using porter utilisation analysis and showed that utilisation over 70% is so physically demanding that staff can experience increased stress, illness and injury.

Based on research to determine mental health risks during pandemics Steve Kisely – professor of Psychiatry & Epidemiology suggests taking the route of PFA (Psychiatric First Aid) as opposed to debriefings ^[7]. The difference between PFA and debriefings is that PFA isn't compulsory and focuses more on safety, comfort & connection, whereas sometimes debriefings can be known to heighten stress, anxiety or PTSD.

The study also suggests considering personal and economic situations, such as: the stresses of having children at home, ill family members and those with a lower-household income as these are a few factors associated with adverse mental health outcomes. Although the organisation isn't responsible for these things, by helping the individuals who are struggling with them it can improve their mental wellbeing despite not being directly considered mental health support services. Solutions such as easing of childcare or care-giver burdens and hazard pay for those paid hourly who cannot afford to be off work sick are some of the suggestions worth consideration.

Flexible working when possible, as well as encouraging staff to take care of their own wellbeing with regards to sleeping, eating well and exercising are also recommended; all enhancing their ability to care for others. ^[8] The use of Schwartz Rounds as an alternative to PFA, which allows groups to discuss difficult experiences with colleagues and helps with psychological support, also acts as an effective space for reflection. Other support suggestions include free staff parking and better working conditions. Extra funding has been made available by the Government to help with such things ^[9] Milton Keynes University Hospital NHS Trust committing to a 3-year programme of benefits for staff such as free staff parking, free tea and coffee in all staff rooms, enhanced bereavement and special leave, flexible working and childcare provision.

Dr. Richard Jackson at the University of California Los Angeles School of Public Health states: "We now know that developers and architects can be more effective in achieving public health goals than doctors in white coats." According to the Forbes article ^[9] about workplace design, a nice and well-designed working environment is good for mental health and staff retention. We spend a large proportion of our lives at work, so a pleasant working environment, especially in spaces within healthcare such as staff rooms where people spend their downtime to relax and take a break from the stresses of the day – is it worth taking a look at your porter lodge, are their some quick fixes that would improve this environment for your staff?

Figures show that 300,000 healthcare workers are at breaking point, while two million days off due to mental ill health were recorded between March and June 2020 at an estimated cost to the NHS of £160 million ^[4] as well as it being important from a duty of care perspective, it is also a costly one when not dealt with. If you work in healthcare and are suffering from poor mental health, or if you know of any colleagues who are, we urge you to access the NHS Support Now services at: https://people.nhs.uk/help/ as well as trying some of the suggestions or suggested apps such as Headspace (downloaded by over 90,000 healthcare workers) and Calm (which can sometimes be helpful when struggling to get a good nights sleep).

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