Nurse Olivia Stephenson was working on a hyper acute stroke unit in Bristol when the pandemic struck last year. Qualified for just shy of two years, like many of her colleagues she felt a surge of solidarity, dedication and sense of purpose, stepping up to face the challenges ahead.
Being a specialist unit, it was impossible to discriminate between COVID and non-COVID patients, and both side and knock-on effects of COVID saw the unit dealing with a dramatically increased patient intake, and more acute and end of life cases.
“It had always been a very heavy, very busy ward,” Olivia says. “But as the pandemic wore on, we were seeing a real shift in patients presenting and more non-recovery strokes. I particularly remember one bank holiday weekend of nights; I started with four patients, three were new, and by the end of the weekend I only had one left. It was really distressing to be losing such a large amount of patients.”
I just broke, I absolutely broke
But it wasn’t just the increased pressures of work Olivia was dealing with; like every other person she was also experiencing anxieties around the pandemic while living in complete social isolation. With a partner in the military who’d been deployed at the start of the year and no family nearby, she found herself trying to cope alone.
“Work became my life,” Olivia admits. “I was working extra shifts to cover and became entirely consumed; it all became overwhelming and I really suffered with my mental health. I think people forget that nurses are just humans too – we are affected by what we see at work but then equally by the lack of social life and connection and from the general anxiety of not knowing whether it’s safe to go to the shops just like everyone else.”
Come September, Olivia was signed off work with severe anxiety and depression. “I just broke, I absolutely broke.”
‘I was willing to try anything’
Even after leaving work, it was completely occupying Olivia’s mind. Struggling to sleep, she was worrying about patients, about maybe having missed something or done something wrong: “I’d wake up every couple of hours just feeling panicked. I really needed something to help me switch off.”
One day a friend recommended cold water swimming. It wasn’t something Olivia had done before but she grabbed a wetsuit and thought ‘why not?’, saying “at this point I was willing to try anything to get some mental space.”
Down at Clevedon Marine Lake, a large seawater lake on the coast outside of Bristol, Olivia donned her wetsuit one cool October morning and made her way down the steps into the water.
“I was feeling a bit anxious about it, of course,” she admits. “I was getting in slowly making lots of ‘ooh’ and ‘ahh’ noises, then suddenly a gush of cold water went down the back of my wetsuit and I laughed – for what felt like the first time in so long.”
An activity that completely takes over both body and mind, Olivia found it enabled her to gain some peace from the stresses and mental whirlwind. “I got out of the water and realised that for those 10, 15 minutes I hadn’t thought of work at all. In fact, I hadn’t thought of anything other than ‘oh my god this is really cold!’ It had allowed me to switch off completely in a way that even sleep wasn’t allowing me to do.”
A gush of cold water went down my wetsuit and I laughed – for what felt like the first time in so long
Is cold water swimming nature’s therapy?
There has long been a dedicated group of fans exalting the benefits of cold water swimming, but over the past year, with people seeking out ways to calm anxieties and outdoor activities to enjoy, it has gained new popularity with people up and down the UK taking the plunge.
Olivia shares the main benefits she’s experienced:
- Being outside and connected to nature. Getting into the water makes me feel so connected to nature and there’s so much enjoyment to be had just from being outside, taking some deep breaths and letting yourself be.
- Building a practice of self-care. It’s not selfish to take time for yourself. The opposite in fact; it’s so important to schedule in self-care – the same way you would make time to brush your teeth or watch a TV show – and it will benefit you, the people around you, and your patients.
- Gaining a sense of accomplishment. Making a plan to go swimming and sticking to it gives me such a sense of accomplishment. It makes me realise that no matter what else is going on, I can still go out and achieve things. This has such a knock-on effect for how I would feel about myself for the rest of the day, or even week.
- Challenging the fight or flight reflex. As your body hits the cold, you naturally have this fight or flight moment. Pushing through makes you realise you have the ability to take control of your mind and body even when anxiety kicks in. It makes me feel brave and like I can handle anything.
- Finding a community and support. At a time when connection isn’t readily available, it’s been so amazing to join the cold water swimming community, where someone is always there with a wave, friendly smile and word of encouragement.
Please note, cold and open water swimming involves multiple risks. Always ensure to take appropriate safety measures (see more in Olivia’s top tips below).
Wading into winter
Recognising these benefits, Olivia signed up for a winter swimming challenge to give her an extra motivation to keep swimming throughout the winter months.
Committing to a minimum of 12 swims between November and March, with at least one swim in each month, enabled Olivia to keep up the practice even as temperatures dropped dramatically – raising over £1100 for Cavell Nurses’ Trust in the process.
“It was helpful to have that added incentive to keep going even when it felt tough,” she says.
There were some particularly grizzly days where that challenge felt extra testing.
“I really wanted to swim on New Year’s Day, to set the intention for the year,” Olivia recounts. “But my wetsuit had been left drying on the line outside and had frozen solid overnight. I was nervous to just wear my swimming costume but I was so determined to get in.”
After that swim, she never went back to full wetsuit. “I feel like I’ve really joined the ranks of the craziest cold water swimmers now,” she laughs.
There were other memorable occasions, such as a snowy, windy February day with an air temperature of minus two. “To be honest, I really didn’t want to get in,” Olivia admits. “I almost had to dare myself and I remember this almost searing pain when my body hit the water. I made a mad dash for the buoy and got straight back out again.”
Although not every experience pleasant, Olivia emphasises it is the commitment to taking time for yourself and your mental health that is instrumental.
“It’s about building bravery and discipline to make sure you're prioritising your wellbeing. As nurses especially, we need to practise some self-care and ensure we’re in a space to provide compassion and care to others.”
As nurses, we need to practise self-care and ensure we’re in a space to provide compassion and care to others
Swimming towards self-belief
The clear positive impact of swimming on her wellbeing and outlook keeps Olivia going back time and again.
“I found the more I swam, the better I felt generally. It got to a point where if I hadn’t been for a week or so, I could tell the difference; I felt less lifted, less energised, and like my stresses were able to overcome me more easily.”
Dipping into ice cold water is clearly no easy feat – but it’s the very challenge and discomfort itself, Olivia insists, that is part of the magic.
After I began swimming I found I was able to stay more positive and motivated
“The moment you take that plunge you realise you have the ability to take control of your mind and your body, even when it’s telling you not to get in the water.”
This feeling of accomplishment and courage is one that Olivia found was beginning to filter in more generally, lifting her spirits and resilience in a way nothing else had managed.
“Before, negative thoughts had felt overwhelming and things would easily batter me, whereas after I began swimming I found I was able to start rising above this, to stay positive and motivated and to truly believe that things were going to get better.”
Community and connection
Human connection, a few words of encouragement, a friendly smile; these are things we’ve all realised we can no longer take for granted after this year. In being welcomed by the wild swimming community, Olivia found a group of diverse, inclusive and like-minded people that alleviated the social isolation and disconnect she’d been experiencing.
“The wild swimming community is just fantastic,” she enthuses. “There’s no snobbery. It doesn’t matter if you have all the equipment or no equipment, if you are tall or short, fat or thin, going in for a dip or a really long swim, if you’re inexperienced or have been swimming for years. Everybody is so friendly and willing to give advice and support.”
The wild swimming community is just fantastic
Several nationwide initiatives have popped up around the activity, with one such being a group focused on the mental health benefits. Through their Facebook page (Mental Health Swims), Olivia connected with other nursing staff who had also discovered the benefits of cold water swimming, similarly finding it an invaluable tool for dealing with the pressures of the pandemic.
“I’d really love to share this discovery more with the health care community,” Olivia says.
So what would she say to encourage other health care staff to consider cold water swimming?
“I would say, yes, it probably seems a little mad – and maybe starting in winter is! – but just give it a go. I guarantee that at some point in the experience you will laugh.”
Changing the conversation
Since heading back to work in March, Olivia feels “like a completely new person” and is keen to do what she can to evolve the culture around mental health within health care. She’s taken on a role as the wellbeing nurse link on her ward and is helping to set up a programme dedicated to staff wellbeing.
Shedding the stigma and encouraging people to ask for help early is key, Olivia says: “I know my colleagues were shocked when I went off work, because I had felt too ashamed to share how much I was struggling.
I want to get rid of that fear that people with mental health issues will be judged or not believed
“I was diagnosed with stress-induced alopecia soon after leaving and I remember feeling devastated that my hair was falling out, but also relieved that I now had a physical symptom and would be ‘believed’. No one should feel like that; I want to get rid of that fear that people with mental health issues will be judged or not believed or told they just have to ‘crack on’.
“I’d love to one day progress and manage my own ward where wellbeing is one of the most important aspects. As health care staff, we of course have a responsibility to our patients, but also to ourselves and our colleagues – to recognise when people are struggling, to engage with each other and to listen without judgement.”
Olivia’s top tips
Even if you’re an experienced swimmer, cold water swimming carries its own set of risks so it’s important to always be sensible and stay safe.
• Swim somewhere safe, and make sure you’ll be able to exit the water easily.
• Always go with someone, and if possible with someone who’s more experienced than you.
• Have something to eat before you go in to keep your blood sugars level.
• Be prepared for the shock of the cold, get in slowly and let your body acclimatise – breathe!
• Don’t stay in for too long. The general rule is 1 minute per degree of the water temperature – even if you feel like you can stay in longer, you shouldn’t as your core body temperature will continue to drop once you’re out.
• Bring a hot drink with you to warm up from the inside once you get out. It’s important to let your body warm itself up slowly – jumping in a hot shower can actually cool your core and be dangerous so you should wait until you’ve warmed up naturally first.
• Even if it’s sunny or feels warm outside, make sure you bring lots of warm layers and get changed as quickly as possible into your dry clothes.
• Be aware of the signs and symptoms of hypothermia and make sure to seek urgent medical attention. The first signs of hypothermia can include confusion, loss of coordination and you will stop shivering becoming a lot more rigid.
Visit the RCN COVID-19 and your mental wellbeing pages for details about where you can get information, advice and support to help you with your mental wellbeing during the COVID-19 emergency.