Evidence Hub

Starting work during Covid-19: How early-career healthcare workers’ wellbeing shaped their future careers

Quick-read summary

During the Covid-19 pandemic, newly qualified nurses and paramedics entered the NHS workforce under intense pressure, with limited support. This study explores how their early experiences shaped wellbeing and career choices.

Using in-depth interviews with nurses and paramedics, we found that many felt unprepared and unsupported, and experienced trauma, anxiety, and burnout. Some even questioned their future in healthcare.

Despite staying in their roles, participants described prioritising their wellbeing more than before. Many changed jobs or career plans to find more supportive, flexible roles. This study shows how early work experiences can shape the future NHS workforce.

Who is this evidence useful for?

• Health education providers
• Clinical educators and mentors
• Senior NHS Trust leaders and HR teams
• Researchers in health workforce
• Student support services

What is the issue?

This research explores how starting work during the Covid-19 pandemic affected the wellbeing and career decision-making of newly qualified nurses and paramedics. It addresses a critical gap in understanding how early workforce experiences during a crisis shape retention, mental health, and professional values.

Research summary.

• Qualitative study using in-depth semi-structured interviews
• Nine participants: seven early-career nurses and two senior paramedics
• All had experience of working (or supporting those working) during the Covid-19 pandemic
• Reflexive thematic analysis was used to explore and interpret the data
• Focused on wellbeing, transition into practice, and career decision-making

What did the research find?

• Transition into practice was especially difficult during the pandemic, due to high clinical demands and reduced support
• Participants described moral injury, trauma, and anxiety linked to organisational failures and lack of protective equipment
• Many experienced lasting impacts on wellbeing, including burnout and sleep disturbances
• Wellbeing became a key consideration in career planning. Some changed roles or settings, others considered leaving healthcare
• Most remained in the NHS but sought roles offering greater support, flexibility, and alignment with personal values

Why is this important?

These findings show how early-career experiences can have long-term consequences for staff retention and workforce sustainability. If newly qualified staff feel unsupported or unsafe, they are more likely to burn out, switch roles, or consider leaving healthcare. Supporting wellbeing from the outset is critical to building a resilient and sustainable NHS workforce.

How were people involved in this work?

This study did not directly involve patients or community members, but included the voices of frontline NHS staff, offering vital insight into their lived experiences during a time of crisis. These perspectives are crucial for designing more supportive systems and training environments.

Participants in this study were nurses in four NHS Trusts and paramedics in one Ambulance Trust in one region of England. Trusts were located in the North East of England and included a mix of urban/rural service areas. Participants worked across a range of acute and community settings.

Recommendations for policy and practice

• Prioritise wellbeing as a core element of workforce retention strategies
• Improve early-career support, including structured peer networks and supervision
• Recognise the long-term impact of traumatic work experiences and provide access to psychological support
• Embed flexible and wellbeing-focused career planning into nurse and paramedic training pathways

What happens next?

Findings will be shared with NHS partners, education providers, and policy audiences. Further research is planned to explore the long-term impact of early-career experiences on healthcare careers and workforce resilience. This includes work to design more supportive early-career transitions in the NHS.

Read the full research paper: ‘Worth … the Nightmares’? A Qualitative Study of Early‐Career Healthcare Workers’ Wellbeing and Career Decisions After Starting Work During Covid‐19 – Brown – 2025 – The Clinical Teacher – Wiley Online Library

Get in touch to find out more

Dr Megan Brown
Email: megan.brown@newcastle.ac.uk

Acknowledgements

This research was funded by the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria (NENC).

The project was supported by colleagues at Newcastle University.