At the time of writing (11th April 2020) there are 1.72 million Covid‐19 infections and 104,889 deaths worldwide. In the UK the first recorded death was on the 5th of March 2020 and in just 37 days 9,875 deaths in hospital have been recorded. The 10th of April saw the highest number of UK daily deaths (980) to date. These UK figures do not include those who died in care homes or in the community. Similar death rates have been experienced in China earlier this year (3,339) and are rising globally with particularly high death rates in the US (18,761 with over half of deaths in New York State), Italy (18,939), Spain (16,353) and France (13,197).

As the Coronavirus disease 2019 (Covid-19) pandemic takes hold, nurses are on the front line of health and social care in the most extreme of circumstances. We reflect during a moment in time (week three of lockdown in the UK and week 5/6 across Europe) to highlight the issues facing nurses at this unprecedented time.

At the bedside 24 hours a day seven days a week, in similar outbreaks, nurses have had the highest levels of occupational stress and resulting distress compared to other groups (Cheong and Lee, 2004, Maunder et al., 2006, Nickell et al., 2004). Nurses are already a high-risk group, with the suicide rate among nurses 23% higher than the national average (ONS 2017). Despite this, the RCN (Royal College of Nursing in the UK) has reported that nurses feel “repeatedly” ignored by their employers when they raise concerns about their mental health (Mitchell 2019). A focus on personal responsibility for psychological health and well-being and an over-emphasis on nurses being ‘resilient’ in the face of under-staffing and often intense emotional work is consistently challenged by nurses and nurse academics (Traynor 2018). Treating resilience as an individual trait is seen to ‘let organisations off the hook’ (Traynor 2018); yet has often been the focus of organisational strategies to date. This does not work at the best of times and certainly is not appropriate now in these most difficult of circumstances.

Here we discuss the stressors and challenges and present evidence-informed guidance to address the physical and psychological needs of nurses during the Covid-19 pandemic. We stress the importance of peer and team support to enable positive recovery after acutely stressful and emotionally draining experiences, and outline what managers, organisations and leaders can do to support nurses at this most critical of times.