What psychological help intensive care nurses and doctors need

Anyone who works in an intensive care unit is working in a place of extremes, with more responsibility, time pressure and care requirements than in any other area. The lives of patients often hang by a thread, and not least the skills of the specialists, whose experience and decisions make the difference between life and death.

The medical technology used is highly complex and requires the corresponding skills. In addition, as everywhere in the healthcare sector, there is a shortage of staff, which means more work for fewer shoulders. Numerous studies have examined what this means for the mental health of employees.

75 percent of nursing staff complain of psychosomatic complaints. Despite a certain routine and appropriate training, those affected often have to deal with considerable stress, anxiety and depression, and the feeling of burnout. The consequences: illness and around 30 percent of employees considering leaving the profession or at least the ward. This would mean even fewer staff on site.

To prevent this from happening in the first place, the Otto von Guericke University Magdeburg, under the leadership of the University Medical Center Ulm and in cooperation with the Charité Berlin, is currently developing a concept to provide long-term psychological relief and psychosocial care for the teams as well as patients and relatives in intensive care units.

After a systematic analysis of existing studies and findings, the researchers examine the situation of all those involved and their need for support in individual interviews and through an online survey. On this basis, an intervention plan with appropriate measures is developed.

This includes training that strengthens psychological resilience and helps to develop coping and stress reduction strategies. Supervision also offers the opportunity to reflect on extreme experiences in individual or group discussions.

There are already international recommendations for psychosocial support in general emergency situations. The special conditions in intensive care units and in acute and emergency medicine have also been examined, especially in the years of the corona pandemic. The tenor of all analyses: the high workload, the great responsibility and the fact that, in addition to medical and nursing care, they also have to bear the psychological burdens of patients and relatives is perceived by those affected as extremely stressful in the long term.

At the same time, they complain about a lack of support and recognition from their employers and superiors. This also includes recognition of the stress and problems, i.e. psychosocial care, for which a concept is now being systematically developed in Ulm, Magdeburg and Berlin.

What is new about this integrative approach is that it is aimed at everyone affected, not just employees, but also patients and relatives. Because if patients and relatives are relieved of psychological stress, the medical and nursing staff will also be relieved.

After evaluating existing studies and the current survey, the researchers will then draw up an action plan. This includes, among other things, the deployment of a psychological specialist per ward team. As part of a pilot study, the feasibility of all of this will be tested for practical suitability in eight intensive care units of the participating university hospitals, and from summer 2025 also in Magdeburg.

If this is confirmed, an effectiveness study will examine the extent to which the psychological stress can be minimized with the means provided. Anyone who would like to support the “IPS Pilot – Integrated Psychosocial Care in Intensive Care Medicine” project and is or was affected because they are a professional or a relative or have had experience in an intensive care unit as a patient can take part in the online survey. It is anonymous and takes about 15 to 20 minutes.

Even if the IPS pilot project focuses on care in intensive care units, the threat to the mental health of nursing staff is a reality in all areas. This is also confirmed by a current study by the Department of Psychology at the PFH University of Applied Sciences in Göttingen in cooperation with the University of Vienna and the Fernuniversität Hagen.

To do this, the researchers examined the mental health of healthcare professionals in Germany and Austria during the COVID-19 pandemic from 2020 to 2022. Data from 421 healthcare professionals showed that the mental stress of healthcare workers remained constant throughout the pandemic, with no signs of habituation to the stressful situation or the new circumstances.

The study differentiated between three professional groups: doctors, emergency workers and nurses. The result: nursing staff were most psychologically stressed at all times. They showed significantly more symptoms of anxiety disorders and depression and overall poorer mental health than the other participants.

For example, while 24 percent of doctors reported moderate or severe symptoms of depression, the figure for nurses was 36 percent. The current findings of the study support the results of other studies that found that nurses were more affected than other health care professionals.

According to current calculations by the Federal Statistical Office (Destatis), the number of available nursing staff will be 90,000 below the expected need by 2034. The ageing of society will further exacerbate the situation in Germany. According to model calculations, there will probably be a shortage of between 280,000 and 690,000 nursing staff by 2049. The results of the Göttingen study are also worrying in this respect, says Stephan Weibelzahl, Professor of Psychology at the PFH and one of the study’s co-authors. This is because the situation on the wards will continue to worsen as a result.