Project IIRP04

THRIVE: Understanding the distinct challenges for Nurses in Care Homes

Understanding the distinct challenges for Nurses in Care Homes: Learning from Covid-19 to support resilience and mental wellbeing


Care home staff have experienced increased work stress during COVID-19. In discussions with Nursing and Midwifery Council (NMC)-registered nurses working in care homes, we know that they have often been the senior person on shift and have then had to take difficult clinical decisions. For some this may have impacted on mental wellbeing. We want to understand their experiences and look to collaborating in developing ways to support their resilience and mental wellbeing. 

Project aim

The project aimed to understand the experiences of care home nurses during COVID-19, through working with small groups NMC-registered nurses to identify ongoing support to sustain resilience, mental health and well-being. In Phase 1  a group of NMC-registered nurses from care homes across the East of England were interviewed. In Phase 2, to widen opportunities for participation and seek diversity in experiences, a different group of  NMC-registered nurses from care homes were invited to attend two deliberative workshops to consider early findings and a blue print for local support groups. 

Research Questions  

  1. For NMC-registered nurses working in care homes during the Covid-19 pandemic, how has this experience impacted positively or negatively on their resilience, mental health and wellbeing, what kinds of support were available, and did this change over time?
  2. How may collaborative working facilitate the development of focused strategies to support long-term resilience and wellbeing in NMC-registered care home nurses?

Objectives: Research Q1 (Phase 1)

  1. Interviewed NMC-registered nurses practising in care homes to describe and understand their distinct experiences of working during Covid-19 and its impact on their resilience, mental health and wellbeing.

Objectives: Research Q2 (Phase 2)

  1. Undertook a series of deliberative workshops to discuss findings and issues through constructive, co-produced dialogue to consider ideas (old and new) for developing strategies and interventions that support care home nurses’ resilience, mental health and wellbeing. Their suggestions for support and learning needs were collaboratively developed as a blueprint for local support groups, with care home nurses and the research team, and aimed to be sustainable beyond the project duration.
  2. Collaborated with practising nurses throughout the study, to empower nurses to act as agents of improvement


Working collaboratively with nurses working in UK care homes, our team have released a report making six recommendations for strategies aiming to support care home nurses’ mental wellbeing and resilience as they move forward from COVID-19.

Six recommendations :

  1. Develop formal, bespoke mental health and wellbeing strategies for nurses working in care homes;
  2. Regular debriefing sessions; 
  3. Support for emotional support networks; 
  4. Improved communication from external agencies to care homes, as well as within care homes; 
  5. Providing training and career development opportunities for the whole care-home workforce; 
  6. Improved planning for future pandemics and major unplanned events.

It is anticipated that these recommendations will have wider benefits to all care home staff.

Next steps

We are now seeking funding to explore the effectiveness of these recommendations in practice.

Who was involved?

Principle Investigator

Diane Bunn, University of East Anglia

Researchers and institutions

  • Linda Birt, University of East Anglia
  • Kristy Sanderson, University of East Anglia
  • Andrea Deakin, Care Home Manager
  • Kathleen Lane, University of East Anglia
  • Jason Corner, University of East Anglia

Contact us

Diane Bunn,

Related papers

A paper co-authored with our Advisory Group nurses: 'Nurses in care homes as advisors in research: benefits for all?explores tensions that may arise when nurses take part in public involvement activities which relate to their professional roles.

The full details of our study can be found in two published papers:

Birt L; Lane K; Corner J; Sanderson K; Bunn D. care-home nurses’ responses to the COVID-19 pandemic: managing ethical conundrums at personal cost: a qualitative study. J Nurs Sch. 2023; 55:226–238.

Chapman-Wright J, Parnell SA, Bunn D et al. Perspectives: Nurses in care homes as advisors in research: benefits for all? J Res Nurs. Vol 27(4), pp401-405.