Press release

Study shows soaring mental health challenges for frontline Covid nurses

Published on 31 January 2023

Nurses who worked in critical care during the COVID pandemic are at an increased risk of mental health problems, according to a new study.

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The project, named CANDID, was funded by the National Institute for Health and Care Research (NIHR) and co-led by academics at the University of Dundee and Edinburgh Napier University.

They surveyed more than 400 critical care nurses (CCNs), as well as 200 who were redeployed to critical care (RDNs), across units in Scotland, England and Wales. 45 were also interviewed in depth, with one describing working shifts amid the crisis as being ‘like fighting a fire with a water pistol’.

The survey found growing levels of burnout among staff, compared to a similar study carried out before the pandemic by members of the team with a quarter of nurses planning to leave their role in the next year. Respondents expressed concerns about the quality of patient care and reduced attention to staff wellbeing and development during the pandemic.

Chief Investigator Dr Janice Rattray, of the University of Dundee’s School of Health Sciences, said, “These results are concerning as burnout is contagious, and symptoms of post-traumatic stress do not always resolve on their own. The NHS needs to prioritise the well-being of these nurses.

“Failure to address staff wellbeing is likely to have negative consequences for staff recruitment and retention, patient safety and quality of care.”

Chief Investigator Professor Diane Dixon, of Edinburgh Napier University’s School of Applied Sciences, said, “The challenges thrown at nurses during the COVID-19 crisis have clearly left lasting concerns not just for their own wellbeing, but for the health service itself.

“They are likely to endure well beyond the end of the pandemic.”

CANDID was carried out between January 2021 and June 2022, comparing its survey results directly with those from previous research in 2018. The percentage of nurses self-reporting levels of psychological distress and burnout through emotional exhaustion that would likely have a psychological diagnosis if interviewed clinically more than doubled in that time.

The study, which will now go through a peer-reviewing process, also measured the impact on organisational outcomes. Each of these worsened. Nurses reported reduced job satisfaction, less certainty about their future working for the NHS and were more likely to be planning to leave their role. Nurses also reported that both quality of care and patient safety had declined.

Although it was not recorded in the 2018 survey, a third of the nurses who responded reported clinically concerning symptoms of posttraumatic stress. During interviews, some spoke about the stress of dealing with relatives unable to see their loved ones in hospitals, as well as a feeling of isolation among RDNs separated from their usual teams.

The study recommends the NHS prioritises the welfare of CCNs and RDNs, implements workplace planning, supports them to recover from the pandemic, and creates an environment that will allow them to thrive in future.

Notes to editors

The University of Dundee is helping transform lives, locally and globally, through the creation, sharing and application of knowledge.

We are home to over 17,000 students, with than a quarter of them coming from outside the UK.

We deliver impact through our graduates and students, our research and scholarship, and our contribution to health, society, and the economy across the globe and here in Scotland.

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About Edinburgh Napier University 

We are Edinburgh Napier University, the #1 modern university in Scotland (Times Higher Education World University Rankings 2023), the #1 university in Edinburgh for student satisfaction (NSS 2020, 2021 & 2022), a top 10 UK modern university (Times/Sunday Times Good University Guide 2023), and the top Scottish modern university for research power and impact (Research Excellence Framework 2021). We pride ourselves on being the home of difference makers—an enterprising and innovative community, renowned internationally, with an unrivalled student learning experience. With more than 300 undergraduate and postgraduate courses and nearly 20,000 students from over 140 countries studying on campus in Edinburgh, online and at partner universities worldwide, we deliver meaningful, difference-making education and research for a rapidly changing world. For more information, visit


About the National Institute for Health and Care Research (NIHR)

The mission of the National institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

  • Funding high quality, timely research that benefits the NHS, public health and social care;
  • Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
  • Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
  • Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
  • Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
  • Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.


Jonathan Watson

Senior Press Officer

+44 (0)1382 381489