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What healthcare leaders need to do to protect the psychological well-being of frontline staff in the COVID-19 pandemic
  1. Neil Greenberg1,
  2. Derek Tracy1,2
  1. 1 King's College London, London, UK
  2. 2 Oxleas NHS Foundation Trust, Dartford, Kent, UK
  1. Correspondence to Professor Neil Greenberg, King's College London, London WC2R 2LS, UK; neil.greenberg{at}kcl.ac.uk

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Delivery of high-quality care is dependent on staff with the right skills, experience and motivation. National Health Service (NHS) staff are performing in extraordinary ways while being scrutinised by a watchful media that currently describes them as heroes and a presently enthusiastic public that regularly claps them.

Nonetheless, it is inevitable that exposure to significant stressors will lead to some experiencing mental health problems. Like the rest of the population, staff are likely to be anxious about the future while contending the challenges of societal shut-down, which makes it difficult to destress by having a drink with a friend, playing sport or being part of social gatherings. Some will no doubt worry about their exposure to COVID-19 that could directly endanger them and their families. News of unexplained higher mortality in BAME groups and inadequate hospital supply chains for personal protective equipment (PPE) may also cause disquiet.

At work, staff wearing burdensome PPE will find that patients die despite their best efforts. Distress resulting from feeling that a life could have been saved if only you knew more, had better equipment, experience or training, or if there were not so many patients to deal with may result in ‘moral injury’. This describes the suffering that occurs when circumstances clash with one’s moral or ethical code.1 Our understanding of moral injury remains somewhat immature, but many people with moral injuries develop mental illnesses such as depression or post-traumatic stress disorder (PTSD).2

Leaders will know that protecting staff mental …

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