After the sustained pressures of winter, nursing teams need time to pause and reflect on what changes can be made to improve health, well-being and cohesion

Those of us working in urgent and emergency care are now just emerging from a winter of sustained pressures. Many teams encountered a perfect storm of increased demand, rising acuity, complex discharge pathways, persistent delayed transfers of care and workforce gaps compounded by fatigue.

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The result was not just congestion in the department, but a cumulative toll on staff resilience, morale and well-being, amounting to moral injury in many colleagues. It is important to name that reality and acknowledge it is not a weakness.

But we are nurses, and we are good at learning and reflecting; so, what have we learned this winter?

Informal check-ins, buddying up and asking if a colleague took a break all matter

Peer support matters more than ever. The informal check-ins at the end of a shift, buddying up after a difficult resuscitation, or a simple ‘did you eat, drink, take a break?’ can make a tangible difference, especially when normalised and modelled by senior teams.

‘Change happens when we act early. If we wait until the next surge hits to review processes, we will always remain reactive’

Well-being must be operational, not aspirational. Breaks, hydration, nutrition, access to quiet space, and handovers that briefly check in on the team are not optional extras, they are safety critical.

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When breaks are routinely missed, that is a system signal of failure, not a personal failing.

Change happens when we act early. If we wait until the next surge hits to review processes, we will always remain reactive.

5 practical steps to take together and improve processes

There are practical steps we can take together:

1. Scheduled debriefs to reflect on difficult shifts, acknowledge good work and identify one small improvement.
2. Resilience habits that encourage realistic self-care goals and micro-breaks to reduce cognitive overload during intense shifts.
3. Buddy systems to check in on well-being and workload, particularly across shift changes, in high acuity or high emotional stress areas like corridors, or for new starters and returners.
4. Service-improvement conversations to check in on processes and what needs to be escalated beyond urgent care and emergency departments.
5. Advocacy for protected learning and recovery time.

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But we should not forget that what we do is extraordinary; we meet the alarms, the unpredictability and relentless pace with skill, compassion and courage. Or that the quality of care we give our patients is inseparable from the care we give ourselves and each other.

So, pause when you can, check in when you should, speak up when you must, because you matter.

Matthew Osborne, lecturer at the University of Essex, on behalf of the RCN Urgent and Emergency Care forum steering committee