In Mindcast

Lydia Hartland-Rowe – difficult decisions and emotions during the outbreak

Lydia Hartland-Rowe is a Consultant Child and Adolescent Psychotherapist and Portfolio Manager for Psychological Therapies for the Tavistock and Portman NHS Foundation Trust. Here Lydia talks about the difficult decisions we are making as a health and social care worker during Coronavirus outbreak and the emotions this may trigger

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“Well this is a time that isn’t like anything else I think any of us can remember working in the NHS and social care, and this is the first of what we hope will be frequent and relevant short podcasts that come from staff across the North Central London STP, really just aimed at providing each other with the contact and support and ideas that will help us to be able to come back tomorrow at the end of today.

My name is Lydia Hartland-Rowe and I’m the Clinical Lead for a Workplace Mental Health and Well-being project that we have at the Tavistock, and I’m really just speaking now with a few thoughts just to get us started. These are things that I’m aware from contacts, professional colleagues, friends, family, that are on people’s minds in relation to the work that we are all needing to do as part of the NHS and social care workforce.

There are three parts to this and they are connected, and in a way they’re all to do with the first thing which is the difficult decisions that the COVID-19 situation is forcing us all to make and to find a way to feel okay about. The decisions range from; the decision to, if you have a choice, to be working remotely, the decision to visit elderly relatives, the decision to send your children to school or not given your position as an NHS worker. So every decision that we are faced with making, even on that level, feels like it has an impact on other people and of course for some people those difficult decisions will be acute, painful, professional decisions that have to do with providing care for others. Of course some members of the workforce are very used to making decisions of that kind every day, anyone working in acute services where life and death are around are used to making those sorts of decisions, but possibly not with the frequency, possibly not with the sort of heavy constant public scrutiny and public awareness of what’s going on, and not in the context of something that is happening simultaneously all over the world so it adds a weight to decisions that may normally feel like they’re part of ordinary professional life.

Of course for people returning to the frontline or perhaps being exposed to the frontline in a way that has not been encountered before, the need to make those decisions and to find a way to manage them and balance them internally is an additional challenge. One of the things that perhaps is around for all of us, in all sorts of ways, from you know the question of whether you visit your mother on Mother’s Day, to a really difficult decision about who gets a ventilator, is something to do with the guilt that is around for many of us, potentially, and the disabling nature of guilt and the isolating nature of guilt, so that very often, you know one can feel as if the guilt that we feel about the decisions we are having to make at the moment kind of needs to be kept private or that we need to be keeping ourselves to ourselves, and I guess one of the things that we’re certainly finding where I work and that I’m hearing and seeing partly in the sort of proliferation of all the stuff that is coming out on the internet is that actually it is our connections with each other, the groups that we create, whether they are virtual or real, those human contacts and the places where we can talk openly about what we’re experiencing, you know what we need from each other, that those connections are probably more important now than ever have been.”

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