This episode is also available with subtitles on YouTube.
Emily Moorhouse is a public health nurse. But in March 2020 she was working in A&E. At the time she thought it was her dream job, but as the pandemic hit the UK she began to struggle with her mental health.
In this episode Emily talks to Dr Paula Redmond about the impact of the Covid-19 pandemic, how she took time off to recover and eventually made a career change.
Emily also mentions how she got help from Frontline-19. Paula spoke to Frontline-19 founder Claire Goodwin-Fee in Series 1, episode 3 so if you want to hear more about that organisation you can check out that episode.
You can connect with Emily on Instagram @emsvibesx
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Transcript
[music]
Paula Redmond: Hi, I’m Dr. Paula Redmond, a Clinical Psychologist, and you’re listening to the, When Work Hurts Podcast. On this show, I want to explore the stories behind the statistics of the mental health crisis facing healthcare professionals today, and to provide hope for way out through compassion, connection, and creativity. Join me as I talk to inspiring clinicians and thought leaders in healthcare about their unique insights and learn how we can support ourselves and each other when work hurts.
This week, I’m speaking with Emily Moorhouse who is a Public Health Nurse. She worked in A&E at the start of the pandemic and talks very openly about the impact this had on her mental health and how she decided to take time off to recover and later made a career change. I started off by asking her what the pandemic was like for her.
Emily Moorhouse: Gosh, it’s just been a whirlwind and it’s all a bit of a blur really so I qualified 2018, obviously, the pandemic hit 2020, and from then on at the start of the pandemic, I have to say I was quite naïve to it and I felt almost, I had just a rush of adrenaline constantly. I worked in A&E at the time. I worked in A&E from six months post-qualifying. Once I’d qualified, I worked on the ward, a medical ward and then decided quite quickly that I wanted to work in A&E. I’d always wanted to do that. It was always my dream.
So I moved to A&E six months post-qualifying and worked there for up until a couple of months ago so during the pandemic, I was working on the frontline, basically in A&E, and like I said, at first I felt really naïve to it, I felt almost a sense of this is going to be fine. We’re going to get through this like a really positive feeling inside of me, like everything was going to be okay. That soon faded, unfortunately, I think as time went on, the burnout was setting in the mental and emotional state of it, that the impact it was having on me was setting in.
Paula: What did you notice? What things were you aware of?
Emily: I was constantly tired, fatigued physically and mentally. I’d go into work and I’d give my all, I’d give everything I had and I’d come home and I’d have nothing left to give anybody else so my family, I didn’t feel like I had any time or emotional space in my head to give them anything, even to hold a conversation I felt was really hard. The anxiety that built up inside of me from the things that I’d witnessed was just so immense and intense for me that I really struggled to open up about anything.
Paula: When you look back at that period now, what do you remember as being really difficult about some of the things that you were experiencing and witnessing?
Emily: There were so many different factors involved I think there government rules that were put in place for everybody to keep everybody safe and seeing people not adhering to those rules and obviously, now it’s come out that the government themselves were adhering to those rules just mid at the time.
I felt a lot of anger towards people that weren’t listening because I was going to work every day, putting myself at risk and looking after people that were so poorly with this virus and people were just not listening. I’d drive home and I’d see people in groups and I would just cry or I’d literally grab my wheel and I felt like screaming. I was that angry and I think that was a big thing for me, was anger and not knowing what to do with it because at the end of the day, there’s nothing you can do about anyone else’s actions but–
Paula: Feeling helpless.
Emily: Really helpless, yes, in lots of different ways.
Paula: Stuff that was happening outside of work. What about some of the things that were happening in work? What was that like?
Emily: It was difficult. At the start of the pandemic, it was very different to how it gradually unfolded so we had the first wave then we had a second wave then we had the third wave and the more waves were had, obviously, it was just a ripple effect and it just felt like it just got worse and worse and worse and the people we were seeing were becoming poorly and poorly, and we were struggling to keep up with the demand of how many COVID patients we were getting through the do so being an A&E nurse, you are the first people there to see these people that were being brought in by ambulance, some were brought in by relatives and they’re on their own.
That was really difficult and obviously, we had a lot of elderly patients that were coming in with COVID and they were obviously asking if they were going to see their family members again, and you couldn’t give them an answer. All you could do was be there to support them emotionally and physically, which is what we did but that, in itself, takes a lot of your energy and a lot of your emotional energy. It just sucks it all up until you’ve got not much left.
Paula: I guess there’s something about the volume of patients being much more than normal and what you said about people being on their own was different to pre-pandemic. What impact did that have for UN patients, people being on the rise?
Emily: During the beginning of the pandemic, we saw less of everything else and lots and lots of COVID cases at the start. During the middle, we saw a bit of everything and that’s when it got hard for us. The first part of the pandemic we found, actually, I don’t know about, I can’t speak for everyone else, but speaking for myself, I found that part a lot easier at the beginning and then we got to the middle and it suddenly got harder because we had pressures from both sides.
Then we had a waiting more room of people that weren’t COVID, but we also had a waiting room full of people that were COVID as well. I think the people that were coming in with COVID obviously required a lot more attention for different things so they’d be put on by pack machines, some of them would have to be intubated. It would take a lot more people to deal with that so at the beginning of a shift, we’d be allocated where we’d be working.
We had a COVID zone in A&E and it was called purple zone. If I ever saw that I was allocated and then my heart would sink every time and it’d be often, but every time my heart would sink because I just think I’ve got to be in there for so many hours in full PPE. I can’t come out, I can’t have a drink of water and it’s almost that sense of you were trapped in there with all these COVID patients thinking, am I going to come out of here and am I going to get this virus that I’ve just spent all day looking after people who have been really really poorly with it. It was scary and at that point, there was no vaccine so there was none of that.
Paula: I can’t imagine what it must have been like to you, I struggle wearing a mask in shops. I wear glasses so it can be tricky and annoying sometimes. What was that like working in full PPE?
Emily: I really struggled with it, to be quite honest. That’s probably the wrong thing to say actually because I didn’t struggle alone, I just got on with it. I didn’t have a choice, so I didn’t really think, “Oh, I don’t want to wear this PPE today. It’s really annoying me.” I didn’t think that all, all I thought was it’s protecting me. I have to wear it so that’s the only thing that was going through mind.
I struggled in the sense of it was claustrophobic. It was really hot and it made you feel faint. It was that hot sometimes because you’d have a full gown on as well and they weren’t thin gowns. They were really thick. And a big mask on which I had to obviously pull quite tight to my face and your visor and sometimes I’d wear a cap as well if I didn’t have to wash my hair every day.
It was more the physical effects on your face afterwards. I don’t mean to sound. What’s the word? I don’t know the word, but I’d come out and my eye bags, I’ve never been the same since, I feel like I’ve literally got the indent of the masks on my face but I’d come out of a shift in the purple zone in the COVID area and my faith would just physically hurt. It would be bruised, my nose would be the Ridge of my nose, and down under my cheeks would just be painful for days and days after so it was the physical effects as well.
Paula: You mentioned that sense of claustrophobia. I can imagine that and not being able to take a drink or–
Emily: No because we went through a stage where there was no drinks allowed in the COVID era, which was completely understandable. At the same time, we have human rights.
Paula: Yes, human needs, I guess is allowed. [chuckles]
Emily: Human needs, yes, basic needs. We needed to look after ourselves, but the only way to do that was to take everything off and to go out. Then, at that point, it was just so busy. None of us put ourselves first, which you don’t as a nurse. You put other people first, and it’s just what we had to do. Yes, you’d often go home with a headache from not drinking enough.
Paula: You also mentioned the fear of catching COVID.
Emily: Yes. For me, I am really struggling with health anxiety at the minute. I’ve probably had it since pre-pandemics. I’m pretty sure it’s started from working in A&E and witnessing a lot of trauma and seeing so much death and traumatic things happen to people. When the pandemic hit, I wasn’t at the peak of it then. It was just manifesting in a way. Since the pandemic, it has just been horrendous.
The vaccine was a big thing for me, actually. With health anxiety and a brand new vaccine, it just didn’t go very well for me. I was petrified. I’ve had both of my jabs, but it took a lot. It took a real lot. It was almost I had to weigh up in my own head and just rationalize that I had seen all these people really, really poorly with this horrible virus. I’d also seen people die from this virus. In my head, it was a no-brainer. I was going to get the vaccine. Even still, it is a new vaccine, and it scared me, but COVID scared me more.
Paula: It sounds as if having had the vaccines and being where we are now that that health anxiety is still around —
Emily: Yes.
Paula: — for you. That’s had a lasting impact.
Emily: It has, yes.
Paula: I’m also wondering what your thoughts are on your particular experience as a nurse in A&E given the nursing role, and how that might have been different from your other colleagues.
Emily: I think as a team in A&E, I don’t feel like we ever separate ourselves in terms of, you’re the nursing team. You’re the team of doctors. You’re the team of healthcare assistants. In A&E, you work together. Without one of us, it wouldn’t work. Without nurses, it wouldn’t work. Without doctors, it wouldn’t work. We all just got on and worked together. That’s always the case in A&E, I find. That’s the one thing I love about it, because you work together as a team, and you support each other as a team as well. Whenever we had something bad happen, you’d pull together and you’d pick each other up.
Paula: Yes, and that’s something I’ve heard quite a lot that the importance of a team and how that’s really been so key in getting people through some of these really tough times. Looking back now, if we think about 2020, that first year, and the toll that this work was taking on you, can you tell me a little bit about how that was for you? Because I know you decided to take a break at some point.
Emily: Yes.
Paula: What led to that decision?
Emily: Gosh, that was a really big step for me. I had just finished a set of four nights. I’d got home, got into bed, felt okay. I’d had a particularly hard shift. Every shift was hard. I can’t remember the reasons why, but I remember it being a particularly really hard shift and coming home and just I’m feeling stressed but feeling okay. I just felt like I normally do after a shift in A&E.
Got in the shower, got into bed and my heart was just racing. It was stomping out of my chest. I felt really anxious. I was shaking. I was just going into a full-blown panic attack, which I knew I was because I’ve suffered with them before and throughout the pandemic, I’d suffered with them. At that point, I just thought I can’t do this anymore. I can’t keep putting everybody else before myself. When I’m not well, I didn’t feel mentally well. I felt like I was just running off adrenaline that was slowly running out. It was burnout. I was just completely burnt out. I’d had enough. I just thought I can’t witness anything else bad because I felt like it was just about to push me off the edge.
Paula: There was something there about exhaustion. You mentioned before being exhausted, but also, the trauma of what you were seeing every day at work that was building and building to that point.
Emily: It was a combination of trauma and exhaustion and burnout and just mental exhaustion. I was just gone. I remember just being sat in the bath trying to calm myself down and thinking, “I can’t do this. This isn’t fair on me. I need to be well to look after my patients.” I didn’t feel like I was well enough to look after my patients anymore, because I felt like I’m not looking after myself and I wasn’t. I remember just ringing work and saying, “Look, I need some time off. I need just a week off just to get myself together.” Well, it started as a week and it just gradually– My anxiety just got worse.
Paula: I guess a lot of people struggle with taking time off when they are unwell, particularly health professionals. How did you give yourself permission to make that call and say, “I’ve reached a limit now. I need some time.”?
Emily: I think I’ve always been quite in tune with my emotions and my feelings and knowing what’s right for me. I know not to push myself over a certain limit, especially now after the pandemic. That’s what I did. I knew I’d pushed myself a bit too far. I knew I needed to take a step back. I’ve always been really passionate and really– Just really passionate about advocating for mental health, especially in nurses and doctors, because I feel like we’re made to feel like we should be resilient. We should be able to put these things to the back of our mind and forget about them, especially the trauma we’ve witnessed.
I think it’s just so expected of us to deal with it and to move on, where in reality that is not the case. It would be fantastic because it would mean that we wouldn’t get to this burnout stage. That is not the reality of it for many people. Some people can and I’ve worked with some nurses and some doctors that can just do that. For me personally, I can’t. I know, for a lot of nurses and doctors, they can’t as well. I think it’s important to recognize that.
Paula: You decided you had afoot that you take a week off.
Emily: Yes.
Paula: What was that week like?
Emily: Absolutely awful. It’s probably the worst thing I could have ever done. [chuckles] I’m not going to lie about this. At the time, it felt awful, and it felt like the worst thing I could have ever done. Actually, it was a good thing for me to take time away, because actually when I removed myself from that situation, I realized just how bad I was, and how much I was masking by being at work. It was very normal for me to go to work and to act like I was okay. I got used to doing that. When I took myself out of that situation, and I didn’t have that to mask me, I actually could see how much damage it’d actually caused to my mental health.
Paula: What was showing up for you?
Emily: Every anxiety symptom you could think of I had. I can laugh about it now because I’ve been through it, and I can see how far I’ve come from that. At the time, I was petrified. I thought I was going crazy. I had severe depersonalization derealization. I felt like I wasn’t myself. I felt like I was an alien. I felt like I didn’t belong here. I couldn’t eat.
I lost probably stone and a half in weight, which I didn’t really have to lose anyway. Working through the pandemic, I wasn’t overweight or anything, so I didn’t really have to lose. I felt like I was wasting away, and it was such an awful feeling because I just felt like I had no purpose anymore and I wasn’t at work. I didn’t know what to do with myself. I just felt like I didn’t belong anywhere.
Paula: It sounds like taking that pause, as you said, made room for some of this stuff that you’d been holding back, and that was maybe a bit like the floodgates opening and it all came to the surface. That sounds really scary.
Emily: It was, and it was exactly that. It was like my cup was so full, and I was pushing it down and pushing it down, and then when I’d stopped pushing it down, it just all came out and exploded.
Paula: It sounds like you then needed a bit more time off, that week wasn’t enough. [chuckles]
Emily: No. I soon realized, it was my GP, that I phoned. I had to phone after a week to get a sick note because you can self-certify for a week, and then you need a GP letter. I spoke to my GP, and immediately she wanted to put me on some medication to help with my anxiety. At the time, I said, “Yes.” because I was so desperate. I was like, “Yes, just prescribe me anything. I just need to feel okay again.”
The next day, I thought, “No, I’m not. I don’t want to take medication to mask it anymore.” I just felt like I needed to work through the trauma that had built up and built up. I felt like, medication wasn’t the answer for me at that time. I’m not disregarding anybody that takes medication for anxiety or depression. I think it’s a really good thing that we have it there when we need it. For me, it was about processing the trauma and the emotion.
Paula: How did you do that?
Emily: A lot of hard work. I was off for three months in total. Every morning, I woke up at seven o’clock, I went out for a run, didn’t want to at all. It was the last thing I wanted to do, but I knew it was going to help me.
Paula: When did you start that? Was that week 1, week 2?
Emily: Week 2, I think I started that. Every morning, I’d wake up and go for my run, I do my breathing. I’d breathe in really deeply and swing my arms up, and then breathe out and swing my arms down, every morning when I got out of bed. Then I go for my run, and then I’d meet my friend every day for a walk. We’d go for probably 5-6 mile walks a day.
Even doing that, I wasn’t present at all. My mind was not there.
I was in complete depersonalization, derealization mode. I just felt like I wasn’t there, but I was pushing and pushing and pushing past it. I also received counseling from a fantastic charity, Frontline19, who provide free counseling for frontline workers and still do. They’re doing absolutely amazing. I can’t thank them enough. I got free counseling every week, for 10 weeks from Frontline19, which helped me massively.
Paula: Those things that you mentioned, the running, the breathing, and counseling. Were those things that you had in place before? Had you done the running and the breathing, had you had counseling before or were those new things?
Emily: I’d had counseling before. I’ve had counseling often, not during the pandemic, though, I didn’t. It was pre-pandemic that I had counseling. Running, no, I hate running. [chuckles] I hate it. I’m not going to lie. I prefer to walk to places. I don’t like running at all, it doesn’t do anything. I don’t feel joy when I run. I know that by running, I can release some of that stress. I can release some of that anger that had been built up. It really did, it really helped. I definitely advise to run, if you’re feeling stressed, and you’re feeling overwhelmed even if you don’t like it like me, It’s not something that I think, “Yes, I want to go for a run.” I really don’t, but I’ll do it if it makes me feel better.
Paula: You got into a routine of running, breathing, walking with your friends, and having some counseling support, how did that evolve?
Emily: Again, I really had to push myself. I didn’t want to do any of it. I didn’t want to sit there and talk about all these bad things that were making me feel the way I was feeling. I didn’t want to have to relive it all the time. It’s almost a form of PTSD. I’d wake up in the night having nightmares about what happened and if I’d see something like a car crash or something if you’re going on the waterway or on the bypass. Even now, I get that feeling inside of me, like a scared little girl, that’s what I feel like. I feel like, “Oh, my gosh, I just want to run away from this.”
I really had to push myself to want to talk about it and to process it. The breathing came from an app called Headspace that I downloaded during the pandemic again, which really helped me. I could just switch that on when I felt anxious. I try and do it daily. Again, it was a really hard thing because every time I put it on, it reminded me of the way I feel, which I don’t remind enough. I was just so desperately trying to get rid of this anxiety and this depersonalization, that I just do anything to avoid it, which I soon learned wasn’t the right way to deal with it. You have to live and learn.
Paula: Tell me about that. What were you learning?
Emily: I just found, the more I avoided things, the worse things got. I’m going to use my health anxieties as an explanation for this because I did avoid a lot with that as well. I started avoiding eating any chocolate because I thought it would give me a migraine, which you can if you eat too much. I just totally cut it out and said, “No, I’m not even having a drop of chocolate.” If it wasn’t chocolate, it was something else. If it wasn’t that, it was something else.
It gradually got to a stage where I was avoiding so many things. I wasn’t doing anything. Slowly, I started to not avoid those things. Now I try not to avoid anything. Anything that scares me, I want to do it and I want to overcome it. Something as simple as– Near where I live, we’ve got some stepping stones that go across a river. I went there, probably when I was at the height of my anxiety, I thought, “I’m not going on there. It’s going to make me feel really uneasy.” because even it says on the sign.
It makes me feel uneasy, disoriented because the water is running so fast. In the height of my anxiety, I wouldn’t go across them because I didn’t want to feel that way. I went two weeks ago, and I just walked straight across. I thought, “Do you know what? I’m going to do it.” because I read the sign, I thought, “Uneasy, disorientated. Anxiety makes me feel like that, I deal with that every day. I’m just going to do it.” I did it and I felt fine. For me, it’s about overcoming those challenges and those things that make me feel anxious now.
Paula: That’s so important, isn’t it? I think what you described there about how avoidance can keep us tied up, give us fewer options, than more options because as you said, it can extend itself, and we can get more tied up. It sounds like, through some of these processes, you were able to find ways of opening up to your experience. Although that’s really uncomfortable and really painful at times, that actually in a sense gave you more freedom.
Emily: Yes, it did. It still does to this day. I’m going away on Friday, down to Cornwall on my own, which is a huge step for me. I’m just pushing, really pushing myself out of my comfort zone.
Paula: You mentioned specifically about that sense of derealization, the dissociation experiences that you had. Tell me about that. Tell me about how you managed to respond differently to those experiences?
Emily: I know this was a big thing when I’ve spoke about it previously. For anyone experiencing derealization or depersonalization, it’s where you feel like you are– For those who haven’t experienced it, it’s really, really hard to understand. It’s when you almost feel like you are not yourself, you’re looking in the mirror, and it’s not you that’s there. Or you feel like you’re an alien, you feel like your surroundings aren’t real. It’s a really lonely, isolating feeling. I was so scared of it. I was really scared of this feeling.
I was thinking, “Am I ever going to feel normal again?” That’s all I could think all the time. I just want this to go because I want to feel normal again. As soon as I stopped pushing that feeling away, and accepted it and accepted it was there to look after me and to protect me, it slowly faded away. Don’t get me wrong, it comes back on again, to say, “Hello.” Let’s tell it, “Hi”, and it buggers off again. [chuckles] I think that feeling, I’ve never felt anything like that before, and it was petrifying.
That was the only point in my life, I’ve ever felt like, I was going crazy. I’ve truly thought I was going crazy. I thought I’m never going to feel right again. I’m never going to be able to enjoy life again. Any memories, any really happy memories that I was trying to think of, just didn’t feel real. It didn’t feel like mine. It was just awful.
Paula: It sounds like part of what you learned through the process of counseling and all the other work that you were doing that maybe rather than trying to fight with this experience of depersonalization, that opening up to it. It sounds like you were viewing it in a different way that it was an experience that was telling you something important.
Emily: I really did feel like that in the end. I felt like it was my mind’s way of protecting me. That’s the way I saw it in the end. Because of everything I’d witnessed, I felt like it was my mind’s way of shutting it off and saying, ”Let’s just escape from that reality for a minute. Let’s push you away from that.” I really truly feel like that’s probably why you feel depersonalization-derealization?
Because it is your mind’s way of protecting you. The more I accepted that and said ”It’s okay, that’s fine. If you need to stay.” Physically spoke to my depersonalization-derealization as crazy as that sounds, it helps. I said, ”It’s okay if you want to see if you want to help protect me for now, that’s fine. If you feel like I need that. Slowly, but surely, it felt like an eternity, but it soon faded.
Paula: That’s so helpful, isn’t it, to hear how reframing that experience enables you to recover and feel more connected to yourself and your own defence mechanisms that were there to protect you rather than a sign of something being wrong with you. It’s actually healthy thing to kick in when what you’re experiencing is too much for anybody.
Emily: I wish someone had told me that at the beginning, which is why I wanted to say it now because I’ve never felt that feeling before. Ever. Actually, a couple months later, and she won’t mind me saying this, my friend who also went to uni with me at the time, she had the same feelings, the same depersonalization-derealization. She knew I’d been through it. She turned to me and actually said, ”Ann, what is this feeling? Why am I feeling like this?”
It was nice to be able to offer her that support and to say, ”Look, it’s all right.” Because I didn’t have anybody to say that to me. It was nice to be able to offer that and to say, ”Look, you’re going to be okay. I know it’s horrible. I completely sympathize with how you are feeling. I understand that completely, which is hard to say if you’ve never been through it.”
Paula: To be able to normalize that and seeing as a normal response to an abnormal situation. You took this time off, and when did you start to feel like you were coming through the other side of that?
Emily: I never got that feeling of being ready to go back to work. I remember having a conversation with my mom and saying, ”I’m not ready, I can’t go back.” I remember her saying to me, ”You can, Emy, you can do this” and she was so supportive and so good with me, my mom is actually a counsellor as well, which is really helpful, and was really helpful throughout I could not have got through it without her. She was really my number one supporter throughout this, and the one that told me, ”I do have the strength to do this.” She was the one that actually said, ”You can’t avoid it forever.” Which is what I felt I was doing. I felt I was getting signal after signal because I just felt I’m not ready, I’m not ready.
I was off for three months, which in the grand scheme of things, isn’t that long? It was long enough for me and I just felt I just did it. I just said, ”All right. I’m going to go back.” Originally, I didn’t want to go back to A&E, I want it to be transferred elsewhere. Did look at that it didn’t work out for one reason or another, I wanted to go back onto a ward. We weren’t able to facilitate it, basically. When I got the call a week before saying that, that wasn’t going to happen, I was even more petrified because I was like, “Right, I’m really going to have to go back to A&E now.” It was scary. I was so scared going back to the place that I felt had broken me. I felt broken. I did it. I went back.
I was back for probably about four or five months before I moved. Going back, they were really supportive. Going back, I had an interview with occupational health before I went back to work, who offered me fare to return. I went back gradually, a day I wasn’t just thrown back into a 12 hour shift, which was good.
The way I see it, if you had a broken leg, you’d be allowed to be off work for a certain amount of time and you would come back gradually to see that you are physically ready. It shouldn’t be any different with your mental health, which is why I’m so passionate about and why I feel people should be able to take that time if they need it. They should be able to put themselves first. I really hope that anyone listening to this will do that.
Paula: A lot of people, when I have this conversation with health professionals, have a sense that doing that, that putting themselves first or taking care of their own physical or mental health is the same thing as being selfish and feel guilty about letting colleagues down. What do you say?
Emily: I completely get that 100%. Just because I took the time off doesn’t mean I didn’t feel guilty. I felt guilty every single day and that contributed to my state of mind as well. That was the only thing holding me back from taking time off. I didn’t want to let my colleagues– Somebody has to be there. I knew that by me going was going to make almost a situation worse because it’d be one nurse less. At the same time, what use am I when I am not well? If I was to have a broken leg, what use would be there, wouldn’t be any use.
I think it’s really important to remember we’re humans, we’re not robots. We can’t just keep going and going and going. Again, another one of my colleagues used to be in the army and she said, ”You want to go to war for eight months at a time?” We were way past eight months. We were totally burnt out. We had witnessed far too much trauma, and we were still going. There still aren’t going that adrenaline only lasts for so long. It runs out.
Paula: Do you think looking back that if you were just thinking about your own health, you might have taken a break sooner?
Emily: Definitely. Saying that I say definitely. I wasn’t just thinking about my colleagues. I wasn’t thinking about the guilt. I was thinking about everything else. I was thinking, gosh, the UK, that my hospital needs me there. It’s my duty. It’s my role to be there.
Paula: Huge weight of responsibility to really carry–
[crosstalk]
Emily: Yes, and I think every doctor, nurse, healthcare assistant, paramedic, even like the cleaners. I think even they felt a sense of responsibility. We all just did it. There was just no thinking about it. You just did it.
Paula: You went back to work after that break and you said that everyone was really supportive, and you were able to do a phased return. What was it on an emotional level going back into that city?
Emily: It was really hard. At that point, we were trying to get back to normal. I say with my speech marks normal, whatever normal is. It was very different. The pressure was still there, the understaffing was still there. The volume of patients we will get in through were very, very large volumes of people coming through the doors in ill people. I’m just trying to put it into words. It’s really hard, looking back and trying to put it into words.
Paula: I’m just wondering because I guess I know that for many people going back to work after a break, is really nerve-wracking. The sense of sometimes people worried about what other people will think of them or you have forgotten what to do, or will I be able to cope?
Emily: Yes. I was scared. I was petrified. I was thinking, oh my gosh, people are going to think I’m such a wimp and I’m a rubbish nurse. Actually, it was the opposite of that. Nobody thought of that at all, that was just my mind making up these scenarios. Being a nurse, it’s like riding a bike. Once you get back on that bike, you just remember how to do it. I didn’t feel worried in the sense of I’d forgotten how to do my job because I was really confident in what I do and I’ve worked hard to get where I am.
In that sense, like we were saying before, it was more the guilt aside, it was more. I felt I’d let my team down but actually, when I got back it was more. Actually, I felt like everyone around me was crumbling. It was really sad. I could almost well up now thinking about how sad it felt. It was like everywhere you looked, you’d smile at someone. There was just nothing, it’s almost like everyone’s eyes were just clear. That’s the only way I can describe it. It just felt like everyone was just exhausted. Everyone was getting Aggy with each other and it just wasn’t the atmosphere it used to be pre pandemic at all.
Paula: I wonder if you haven’t had that time out, enabled you to see that in a way that when you’re in it, you can’t see it.
Emily: You can’t and I couldn’t see it myself until I got home. I was in bed and I was full blown panic attack. It wasn’t until I made that decision that night or that morning to take some time off, if I hadn’t have done that, I would not have realized to the extent that it had really broken me.
Paula: It’s interesting. I’m just thinking about how that also limits our capacity to see it in other people and that when you’d had that time out and being able to recover a bit yourself, you were then able to recognize other people suffering. More too and maybe be able to respond to your colleagues in a way that maybe isn’t possible when you are so in it yourself.
Emily: No, definitely not. Even sort of 3,4 months back into my, back into the job, after having time out, I could feel that burnout setting in again. I thought I’ve just had 3 months off. How is this possible? Why am I feeling like this? I just felt so overwhelmed by everything by the pressure that constantly on you. I remember just going into the medicines room and just crying. My colleague walked in, took one look at me and hugged me. I was just burst into tears. I just thought I can’t I said, I remember saying to her, I can’t do this anymore, which is when I made the decision to look for another job.
Paula: What did you do you decide to do next?
Emily: I was staying put, I thought I’m not moving anywhere until I found something that I really want to do, but I’m not moving anywhere. I’m going to feel the same feelings and I don’t want that. It’s something that I was passionate about and that I really wanted to progress in. It was really hard for me doing that and taking that step. Even till this day, I feel a sense of guilt. I feel like I’ve let myself down.
I feel like I’ve let my team down almost, not every day, but sometimes thinking about it and reflecting it’s really hard just because it was my dream job. It was everything I wanted of my career. I wanted to be an A&E nurse and I loved my role for the four years I was in there. Well, maybe three, let’s take that last year out because I didn’t love that, but I absolutely loved it and I thrived on it and I loved the adrenaline it gave me, I loved looking after people in those most awful situations. I just really loved my job. To give that up because of how it’s affected your mental health is really hard.
Paula: Such a big loss.
Emily: It’s a huge loss. Even throughout my student nursing years, that’s all I could think of. I was just thinking I want to work in A&E and when I actually got a placement in LGI A&E when I was a student and I was so happy. I loved it. I loved everything about it and then for now, for it to be gone, it was really hard to say goodbye to it.
Paula: What did you decide to do?
Emily: I was actively looking for a new job sort of four months back. I came across a post for specialist public health nurse. I thought, that sounds interesting. I heard of this before and I just decided to go for it because I loved everything that the job description said. I thought, yes, I can really see myself doing that. I can see myself progressing in that role. It’s 9:00 to 5:00, Monday to Friday. I didn’t know what that felt like. [chuckles]
I’m 25 now so when I qualified, I was only 21. For my whole working career, I’ve never known a 9:00 to 5:00 job. I didn’t even know that they existed. I’ve always worked 12-hour shifts like random days, weekends nights, twilight. My Twilight shifts were 11:00 in the morning ’til midnight and I’d get them often. To find a 9:00 to 5:00 job that I felt really passionate and really wanted to do was incredible. Anyway, I applied for that, and luckily, I got it, which is what I’m doing now.
Paula: How have you found that shift?
Emily: It’s been a rollercoaster. It’s been good. A good rollercoaster. Again, I think pulling myself out of that tram and chaotic work life has been a big shift for me, almost I felt when I pulled myself out, when I had time out of work, it was wow, it’s that processing things when that adrenaline’s suddenly gone. It was hard, especially the first few months, because I just felt on edge a lot, especially at work. My colleagues now would say, “Emily, we’re not in an emergency situation anymore. You don’t have to, it’s not an emergency. You can just relax a little bit.”
Because I felt like something bad was going to happen all the time. I’m like, well, we need to do this. We need to do that. I’m like, no, you just need to cut them down. You need to just relax. That’s a harder adjustment for me because I’m used to being on edge and being like ready for something bad to have. That part of it was hard. The other part is not being around a big team anymore. That’s a big adjustment. I’m doing a lot of learn working now. Not having that big team around me has been quite difficult.
Paula: It’s interesting to hear you say about how taking this other step back and creating even more distance from that whole experience has maybe, opened further, I guess, opportunities for processing what you’ve been through, but still quite hard and uncomfortable to go through that.
Emily: Definitely. It’s been a positive move that I’ve made.
Paula: Have you found, because you were talking about that this work is also something that you find that you feel passionate about. What is it about this role that you feel passionate about that you love that keeps you going?
Emily: I think there’s just so many different factors to this job that I’m doing now. I just think we deal a lot with maternal mental health safeguarding children’s development, looking after the whole family, looking after families. I actually get to spend over an hour with a family at a time if I want to, I’m not limited to how long I get with each family. Whereas in A&E, I was very limited to my time, all my time was split between 30 different people. It is really nice to be able to put your time and effort into a family and to help them and to see changes as well, which is it’s a really rewarding job.
Paula: When you think about the future for you in your career, I guess I’m struck by the fact that you really newly qualified, 18 months or so in when the pandemic hits. It’s really a kind of baptism by fire in terms of the start of your career. How do you feel about continuing to work as a nurse and going into the future?
Emily: If you’d have asked me that question a year ago, I said, I don’t want to be a nurse anymore. I want to go and open a florist. That was my idea. Now thinking rationally, I have put a lot into my career. I was told when I was at secondary school that I wasn’t going to get any GCSEs. I was told I’d just fail Math, I’d fail English. I just wouldn’t go anywhere basically.
I overcame so much to get into this job and it’s something I’ve always wanted to do ever since being younger. I’ve always wanted to be a nurse. I think for me now to just throw that away would be a big shame for me as much as I want to sometimes. It’d be so much easier, I’d have such an easier life, but I think I’ve put far too much into this now.
I think I’ve still got so much more to give. I feel there’s so many places nursing can take you. That is the beauty of nursing. You’re not stuck in one place just for like in A&E, I didn’t have to stay there and I didn’t stay there. It was a stepping stone. I feel there’s lots of stepping stones on the way throughout your career, which is how I’m looking at it now.
I didn’t start in A&E, I started on a medical ward. My next stepping stone was A&E, my next stepping stone is the job I’m in now. Who knows where the next step in stone may be. I just think I’m just going with how I feel and what I’m passionate about. That’s all I can do.
Paula: It’s lovely to hear you talk about your career so far. I think it’s really helpful to think about things in chapters or seasons, and not getting stuck in one way of working, or one place, or one way of being when it’s hurting us. Having a sense that there’s room for movement. That change is never easy, but there’s hope for a way of doing something different. That, for you, it sounds like a way of working that is still really aligned with your values, but that allows you to look after yourself as well. Maybe create time for the recovery that you need. Your next step might be going into something more adrenaline-focused than your current role, or maybe not. Giving yourself some time and space for recovery right now.
Emily: That’s exactly how I see it as well. That’s how I’ve pictured it in my head. When I took this new job, that’s what I thought as well. I just thought it’s a stepping stone. If eventually I would decide I want to go back to A&E, I can do that. There’s nothing to say you have to go in this direction or you have to go in this direction. You can go in whatever direction you want. I think, like you say, you’ve just got to do what’s right for you at that time. At this moment in time, this is what’s right for me.
Paula: It’s lovely, that metaphor of stepping stones you were talking about earlier, in terms of crossing that stream, where the waters are running fast.
Emily: I didn’t realize
[crosstalk]
Paula: That sense of disorientation and danger and anxiety, but being able to just think about taking just the next step that’s right for you in the midst of that rushing stream that is the chaos of life. That you’re just focusing on the next step. What would you say, Emily, to– We hear so much about colleagues in the NHS who are really struggling with so much of similar things that you’ve described in terms of burnout and exhaustion and trauma, having absorbed so much. What would you say to someone who is feeling some of those things that you’ve been through?
Emily: I would say, don’t be so hard on yourself. I know nurses and doctors and paramedics, healthcare, we paint it to be these really resilient superheroes that can just swoop in and save people’s lives and then go home and forget about it. That’s not the reality. The reality is, we have feelings. We have emotions. We have trauma that needs processing. That’s often put aside. It’s pushed to one side far too much. It is something I’m really trying to get across to people at the minute. We need to stop pushing our emotion and our trauma aside. We need to bring it to the forefront and we need to deal with it sometimes.
I think by reaching out and getting help, maybe speaking to a counselor or speaking to a colleague, there’s lots of services that we can reach out to that can help us. Not dealing with it on your own as well, because it’s such a lonely place and such a lonely feeling. I think, please, don’t deal with it alone. Just reach out and get some help. Speak to a friend. Speak to a colleague or a family member. Just remember that you are important too.
Paula: Emily, what are the things that keep you going now? What are the things that sustain you when work hurts?
Emily: The main things that stem me are friends, the TV show. I have it on constantly. I’ve been told it’s an anxiety thing, is that when you watch a TV show over and over again. Who cares? I have it on. It makes me feel happy. Just something lighthearted. I always have to have it in the background because, like I said, it makes me feel happy. It makes me laugh. It’s just something easy. Being outdoors, walking. I don’t tend to run often now, but I do go for a brisk walk with the dog.
I’ll go out for a walk, be in the fresh air. I think being in the fresh air reminds you to breathe properly again. I do that. When I’m inside, I don’t breathe properly. I feel like I hold my breath a lot and that causes a lot of anxiety symptoms. Being outdoors helps me to breathe properly. Just meeting your basic needs, I think that’s a big thing. I think it’s undervalued, especially as a nurse or a doctor because you forget to eat, you forget to drink. How can you do anything when you’ve not eaten or you’ve not had anything to drink and sleep as well? I think just looking after those basic needs are a huge factor in your mental health and physical health.
Paula: Thank you, Emily, so much for sharing your experiences and for your openness and your honesty. It’s lovely to hear about your sense of compassion for yourself and for other people, and a sense of energy and hope for the future. Thank you so much.
Emily: You’re welcome. Thank you for having me.
Paula: Thank you for listening. If you enjoy this episode and you’d like to help support the podcast, please do share it with others. Post about it on social media or leave a rating and review. I’d love to connect with you, so do come and find me on LinkedIn or Twitter. You can also sign up to my mailing list to keep up-to-date with future episodes and get useful psychology advice and tips straight to your inbox. All the links are in the show notes. Thanks again. Until next time, take good care.
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