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Nurses left with no time for training amid “workforce crisis”

Disruption in health services has meant that face-to-face nursing courses had to move online

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After they led the fight against Covid, nurses remain four times more likely to take their own lives than people working in any other profession. 

The impact of the pandemic on healthcare services has been immense, reads a 2021 BMJ report. For the over 500,000 nurses in the UK, Covid’s mental health toll has been intensified by physical and emotional exhaustion and an increased risk of burnout.

Despite interrupted training and fear of exposure to the virus, surveys have shown that nurses strived to provide excellent care and support for their patients and colleagues, sometimes at personal cost.

“Nurses were stretched more than ever during the pandemic,” says Michaela Nuttall, cardiovascular nurse specialist and founder of the online educational platform Learn With Nurses.

“At a time when they were forced to work extra hours, look after their kids and take care of their parents, they were left with little to no support and no time for training.”

The sudden disruption in health services along with staff shortages have meant that face-to-face nursing courses had to move online.

However, letting people have time off for training proved extremely difficult, says Nuttall. “Because nurses can’t be at work during training, many were left with no access to training.”

Having worked in cardiovascular disease training herself, Nuttall decided to host a Zoom meeting about the importance of blood pressure control at the start of the pandemic and invited people to join through social media nursing groups.

“I was really missing training and I wanted people not to forget about cardiovascular disease,” she explains. “I put the Zoom link online and about 200 people registered for the first session.

“The need was definitely there. So, I started working with other nurses to build a bigger platform and we went from nothing to everything in a very short space of time.”

Learn With Nurses, now a global online community of specialist nurses, provides free educational support to healthcare professionals and helps them improve the quality of care while promoting evidence-based clinical practice guidance.

“It is not meant to replace formal training,” the founder says. “Our aim is to make training much more accessible and give people a free platform where they can learn, ask questions and interact with other healthcare professionals. We now use a platform called MedAll instead of Zoom because it makes our job much easier and allows thousands of people to join and we try to have a relaxed style that almost feels like you’re talking to a friend over a coffee.”

The courses, delivered in bite-sized sessions of 30-40 minutes, cover a different subject each week, allowing nurses to understand some of the most common health conditions they treat in hospital.

“We’ve made a commitment at the beginning that we will always provide our courses without any barriers to learning,” Nuttall says.

“People tell us how much Learn With Nurses has helped them and although we are looking at memberships and donations to help us fund the training, we don’t want money to be a barrier.”

Nurses like Nuttall say that the NHS is still facing challenges. According to the cross-party Health and Social Care Committee, health services in England are currently facing “the greatest workforce crisis in their history” with the NHS losing millions of full-time equivalent days to staff sickness caused by anxiety, stress and depression.

“Nurses remain under extreme pressure,” says Nuttall. “Almost 90 per cent of them are female and they need our support more than ever.

“Our ambition is to give more visibility to all nurses, but particularly to those from minority backgrounds. I hope that through Learn With Nurses they will find a diverse community where they could feel represented and supported.”

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New research centre aims to tackle gender health gap

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Wales has opened its first women’s health research centre, backed by £3m to tackle health inequalities through research and innovation.

The centre, led by Women’s Health Research Wales, marks the first anniversary of the Women’s Health Plan for Wales, published in December 2024.

First minister Eluned Morgan and minister for mental health and wellbeing Sarah Murphy visited staff, researchers and collaborating communities at the launch.

The work covers prevention, early-onset conditions, rare diseases and care for under-served communities.

The centre brings together researchers, NHS partners, industry, policy makers and communities to develop more effective treatments and ensure services meet women’s needs throughout their lives.

It is designed to strengthen investment in women’s health research, including representation in clinical trials.

Morgan said: “I am passionate about improving women’s healthcare.

“To do that, we must invest in research to gather the evidence we need.

Morgan added: “I am delighted to see how the Welsh Government’s £3m investment, through Health and Care Research Wales, is supporting research based on the experiences of women.

“This will result in better care and better health outcomes for women.”

Projects in development include exploring symptom reporting tools to help manage conditions such as diabetes, heart failure and chronic obstructive pulmonary disease.

Researchers are also investigating how chemicals in menstrual products might affect health, ways to help young people stay active during periods, and pathways to prevent people with polycystic ovary syndrome developing conditions like diabetes and heart disease later in life.

Other projects are exploring fertility issues, including a decision-making tool for women with kidney disease considering whether to have children.

One project is working with women undergoing fertility treatment, investigating why this can lead to mental health issues such as PTSD (post-traumatic stress disorder), with the aim of creating guidance for trauma-informed fertility care.

Morgan said: “This innovative new research centre is a key part of the Women’s Health Plan and will help us better understand women’s experiences.

“It will lead to more effective treatments and make sure that our health service delivers improved outcomes for women in Wales.”

Debbie Shaffer is founder and director of Fair Treatment for the Women of Wales and chair of Women’s Health Wales Coalition.

Shaffer said: “Research into health issues experienced by women throughout the life course is vital.

“By working co-productively, in partnership with women and communities, we have a fantastic opportunity to reduce health inequalities and improve treatment options and support.

“We look forward to helping facilitate more opportunities for those with lived experience, whose voices may not have been heard before, to get involved.”

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Early prenatal support cuts postpartum depression by over 80%, study finds

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Early pregnancy therapy can cut postpartum depression and anxiety by tackling prenatal anxiety, new research has revealed.

A trial of 1,200 pregnant women in Pakistan found those receiving cognitive behavioural therapy (CBT), a talking therapy that changes patterns of thought and behaviour, had 81 per cent lower odds of postpartum depression or moderate-to-severe anxiety than those receiving usual care.

Only 12 per cent of women in the intervention group developed postpartum depression, compared with 41 per cent in the control group.

The research was led by Pamela Surkan at Johns Hopkins University, in partnership with the University of Liverpool and the Human Development Research Foundation Pakistan.

Surkan said: “We hope this research doesn’t end with evidence, but with implementation.

“Every pregnant woman deserves the chance to thrive, and mental health must be recognised as a core part of maternal health everywhere.”

Among women who attended five or more sessions, the risk of low birthweight (under 2.5kg) and small-for-gestational-age births (smaller than expected for weeks of pregnancy) decreased by 39 per cent and 32 per cent respectively.

The approach was designed to be scalable: therapy was delivered by trained non-specialist counsellors in a public hospital in Rawalpindi, making it accessible and low-cost for health systems without specialist clinicians.

In Pakistan, up to 49 per cent of pregnant women experience anxiety, yet access to mental health care remains limited.

Prenatal anxiety is rarely addressed in public health systems despite long-term consequences for mothers and children.

What began at a global mental health meeting in Washington DC in 2012 evolved into a research partnership spanning 2017 to 2024. Findings from the main trial were published in March 2024.

Beyond clinical outcomes, the research linked better social support, reduced stress and fewer pregnancy-related difficulties to improved mental health outcomes.

To date, 29 peer-reviewed articles have been published from the project, which has established one of the world’s largest datasets on prenatal anxiety in low and middle-income countries and developed an intervention manual ready for wider use.

The team is now focused on scaling, with proposals submitted to test the intervention in new contexts and plans to make the manual publicly available.

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Menstruation linked to longer football injury recovery

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Football injuries during periods are more severe and take longer to heal, though menstruation does not itself raise injury rates, according to new research.

The study monitored 33 elite players competing in Spain’s top women’s football league over four seasons, from 2019/20 to 2022/23, tracking self-reported menstrual cycle data alongside injury records.

The research was led by Dr Eva Ferrer, who specialises in sports medicine at Sant Joan de Déu Hospital and is a female health specialist at the Barça Innovation Hub in Barcelona.

“We show that menstruation itself does not increase how often injuries happen,” said Ferrer.

“Although athletes were not injured more often during their period, the injuries that happened during menstruation caused three times more days lost than injuries occurring at other times of the cycle.”

Players logged bleeding and non-bleeding days, the only phases of the menstrual cycle that can be reliably identified without blood hormone testing.

A total of 852 menstrual cycles and 80 lower limb injuries were recorded, 11 of which occurred during menstrual bleeding phases.

The findings showed that injury burden was significantly higher during bleeding phases.

The burden of soft tissue injuries, affecting muscles, tendons and ligaments, was more than three times as high when injuries were sustained during bleeding days compared to non-bleeding days, with 684 versus 206 days lost per 1,000 training hours respectively.

“Hormonal levels may not cause the injury, but they may influence how severe the injury becomes and how long recovery takes,” Ferrer explained.

Low oestrogen levels may reduce muscle repair, while increased fatigue, pain and poor sleep can alter neuromuscular control.

Iron loss can lower endurance and slow recovery, and inflammation heightened during menstruation may cause worse tissue damage.

“Small modifications such as longer warm-ups, adjusted high-speed workload, or added recovery support may help reduce the severity of injuries if they occur,” Ferrer said.

The researchers said their findings have implications beyond professional football for women who exercise regularly.

“You do not necessarily need to avoid training during your period, but you may need to adapt it,” Ferrer said.

“Tracking your cycle and symptoms can help guide training intensity and recovery strategies.”

The study’s limitations include all participants belonging to the same club, the unequal number of bleeding and non-bleeding days in a cycle potentially limiting statistical power, and the absence of hormone measurements or data on external factors such as stress, sleep and nutrition.

“It supports a growing movement toward female-specific sports science instead of applying male-based research models to women,” Ferrer concluded.

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