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Following the virtual event on 16 June 2020, session leads Simon Gill, Julia Wood, Hilda Campbell and Matthew Mezey share the outcomes.

People walking by a tree in a park

Who cares for the professional Carers?

How do we look after ourselves and each other, in order that we can offer the safest service possible to the people in our care? This was the challenge posed in the recent Wellbeing during COVID: what have we learned? webinar (includes slides and video) hosted by three Q community Special Interest Groups and their conveners:

Some really interesting themes emerged and there was great energy in the chat box, so thank you everyone for making it such an animated session!

There was a really great mix of people with various skills, experience and focus of work from primary care, to community, to education, to improvement, to secondary care and more. This shows that wellbeing and the wellbeing of professional care givers is a universal concern.

The 10 key themes that emerged

We identified a number of themes which are summarised below:

  1. Wellbeing overview

Wellbeing means different things to different people, but includes feeling comfortable, healthy, happy, being resilient, and having a sense of meaning/purpose. Many factors impact on wellbeing including work, relationships, how we look after ourselves, and of course how we are managing the impacts of COVID-19.

2.  Adapting and learning

Many of the participants reflected that getting the simple things right can have a massive impact on staff wellbeing. The concepts shared included being mindful of what our colleagues have been through, considering the tone we use in our engagements, focussing on giving time to members of our teams to talk and employing active listening to understand how they are really feeling.

We must not rush into this without giving our colleague’s time to process and grieve, to accept these changes and to co-create this ‘new’ normal

Simply being kind was mentioned many times with an acknowledgement that we need to find ways of offering random acts of kindness in a virtual world. We must make sure we truly connect despite often not being present together. “Liberating Structures” as a tool and virtual teamworking technology can help provide different ways of interacting, with breakout rooms, chat boxes, polling, emojis and so on. (There is a Q SIG on Liberating Structures so please join if this is of use.) There is also a recognition of the fact that many of our teams have changed, with new staff joining and old being re-deployed. Fully integrating new team members and fostering relationships with them is critical to ensuring overall team wellbeing.

It is clear that many things around us have changed, we have changed. We must not rush into this without giving our colleague’s time to process and grieve, to accept these changes and to co-create this ‘new’ normal.

3.  Challenges to feeling included

It’s important to think of the different dimensions through which there can be exclusion: gender, race, ethnicity as well as character and experience. Staff who are shielding can feel particularly left out too; and others whose sense of purpose is now challenged, as their work has stopped.

For some, use of Microsoft Teams has led to a culture of instant responding – which may be quite different to the previous norm. Work is needed to build bridges between each others’ worlds and experiences, even more so with the sensitive stuff that needs time and careful facilitation.

4.  Exploring

It is critical we keep exploring how individuals in our teams are doing and allow a more open conversation about wellbeing. Three participants shared ideas – weekly surveys to find out how everyone was feeling, how valued they felt they were and how they were being supported, and encouraging blogs from individuals in the team to explore these issues.

5.  Grief

Many people have suffered from grief for numerous reasons during COVID-19. Normal comforting behaviours, such as holding a grieving person’s hand or giving them a hug is currently not possible for many. However, reaching out in other ways (phone, virtual calls using Skype or WhatsApp, social distancing face-to-face contact, sending cards etc) can still be very comforting for those going through the grieving process.

6.  Remote working

Participants shared various dimensions to the rapid adoption of remote working. Some recognised the flexibility it allows, the minimisation of travel time and improvement in work life balance. However, others saw challenges in maintaining personal boundaries, the requirement to invite colleagues into their private spaces and the breakdown of normal rules of when meetings can be held. Some embrace the flexibility and want to fit their work around other priorities and others prefer to stick to their normal working hours.

With remote working likely to continue into next year and potentially beyond there is a recognition that we must be proactive in dealing with the challenges and implementing a solution that takes into account this diversity of views in our teams, and the effective blending of virtual and physical presence.

7.  Technology

Many comments made during the workshop outlined the negative effects of the use of technology and how to overcome these. It was felt that online meetings (through forums such as Zoom or Microsoft Teams) can be improved by building in time for virtual social activities, having regular breaks between meetings, establishing small group check-ins, and using the breakout room facility (Zoom). Some stated that emails should be sent only during working hours to reduce stress to the recipient/s. Also, people were asked to consider whether a phone call would be more appropriate than an email, particularly if the email is lengthy or if the content might cause stress to others.

8.  Time and space

Many people miss the serendipitous meetings that our workplaces offered: the ‘kitchen conversations’ where you just bump into someone. Here are some of the ways being used to create more time and spaces for staff to connect:

    • ‘Wobble rooms’
    • Ad-hoc phone call catch-ups, including ‘Walk and talk’ ones
    • Facebook and Twitter (usually asynchronous, making it easier to drop in and out)
    • Slido, Miro, or using Liberating Structures*, to make engagement in Zoom easier (*Happy offer free training for NHS staff)
    • Breakfast club, Daily drop-ins
    • Newsletters
    • Book clubs and quizzes
    • Side-by-side walking meetings (less confrontational that ‘facing’ meetings)

9.  Safety

We have undoubtedly experienced a period of uncertainty, rapid change and adaptation. Some have relished it but others have struggled. Our personal diversity (e.g. “introvert” verses “extrovert”), the diversity of our roles we play (clinical verses policy) and the area in which we work (community verses acute) leads to this varied response. Some have seen this as a time where command and control was prevalent and opinion was not welcomed, with others seeing it as a time when people are “enjoying a sense of ownership” and “empowerment” with localised decision making. Despite being a “unifying” experience, some feel “guilt”, others “grief”, some enjoying the change, others are struggling. One participant reflected it well: “Recognise diversity of reactions to uncertainty, some of the most seemingly robust people have been toppled recently”.

As we learn from the adaptations we have made, being able to express ones’ mind openly is critical

As we learn from the adaptations we have made, being able to express ones’ mind openly is critical at this time. Psychological safety is a fundamental pillar to how we respond and learn from the pandemic. One participant expressed what we should be aiming for, where speaking up (or out) is not seen as exceptional – high performing teams don’t recognise the concept of “speaking up” as expressing ones’ mind is entirely normalised. Managers have a responsibility to create this safety meeting-by-meeting. Participants shared examples of this in the need to welcome participants into a call, checking in and out to ensure that people feel included, encouraging their participation.

Virtual meetings were shown by participants to be both positive and negative in this regard, they break down power differentials and barriers, ensuring team members are seen as human with a view into their home lives, the messiness, children, pets and partners being part of who we are. However, some find it difficult to participate in virtual meetings, and it is more difficult for managers to gauge team engagement with a lack of body language cues.

10.  Wellbeing activities

There is evidence through healthcare research which demonstrates staff wellbeing is linked to improved patient outcomes. There are many wellbeing activities to choose from, and what works for one person might not work for others. There were a considerable number of examples of wellbeing activities shared during the workshop, including walking meetings, exercise classes or running clubs, mindfulness drop-in clinics, weekly zoom lunches/coffee clubs, or receiving a good morning email each day in your inbox.

 

Critical resources to help us address these challenges as people, as professionals and as organisations:

Join the Improving Joy in Work SIG for further resources. If you are interested in joining the conversation about the adaptation and organisational resilience aspects of this call please visit the Organisational Resilience & Safety-II SIG (and see a blog on the outcomes of that SIG’s previous Zoom on Safety-II and COVID here).

Further resources

We’ve collated the resources shared on the day, these have been broken into themes to reflect the previous point, of course, some will touch on more than one theme:

Resources that are useful for us as individuals

Personal promise wellbeing cards

Where joy hides and how to find it (video)

Professional Quality Of Life Measure

Free Mindfulness resources

Wellbeing tips and sign up for daily good morning your mental health matters

Action for happiness

Working from home tips

Cope Scotland’s advice on remembering what matters and a sense of purpose, workbook and affirmations

NHS’ mental health hotline for staff tackling COVID

Compassion fatigue

The Scottish Social Services Council for Care Providers who are providing support to people with palliative and end of life care needs

Iriss – For tips and information for staff resilience as well as the wider public

BASW – Help for key workers during the COVID-19 pandemic

Mental health and wellbeing for staff

Scottish national wellbeing hub

Clear Your Head – Campaign to look after your mental health


Resources which are useful for us as health professionals in teams


Resources which are useful for our organisations

The write-up from the virtual session on COVID-19 and Safety-II hosted by Simon Gill

Recording: Promoting Enjoyment and Wellbeing at Work – with Annabelle Burns

Book: “Compassionomics” by Trzeciak and Mazzarelli

Book: “The Fearless Organisation” by Amy C Edmondson

Book: “Implementing Patient Safety; looking at culture and conditions for safety” by Suzette Woodward

Harvesting tool from IHI website

Amar Shah’s blog series 

Mindfulness: the shift from self-improvement to organisational and social change’ – Mark Leonard

NHS Horizons: Caring 4 NHS people

Suzette Woodward’s blog on ‘taking five’

Kinder communities  

’Kindness, emotions and human relationships: The blind spot in public policy’’ Julia Unwin CBE

Ideas on supports for an ageing workforce

Comments

  1. The Zoom events run by the group during lockdown have been excellent and thought provoking. Thank you for organising.

    With regard to Wellbeing is a key factor to have an organisational culture and mindset encompassing Wellbeing that persists beyond the current crisis if real sustained progress is to be made, whilst putting on meditation sessions on a Thursday lunchtime is beneficial at the individual level organisationally its much more than that.

    I don't work in the NHS but am passionate about the NHS and have spent the best part of the last ten years assisting a number of Trusts in the area of safety culture.

  2. I don't think that I have many more to add in this excellent blog! I just feel sorry to have missed the webinar!!

    The only comment that I would like to make is the importance of "emotional safety" (together wit other features e.g. clarity of role/scope, ability to see the impact of the work on organisational level etc.) for well functioning teams/groups/organisations. Prof. Amy Edmondson (Harvard Business School) has done a lot of interesting work/research in this area and I am happy to see her name among the recommendations for further information.

    Once again, excellent work, well done to Hilda, Julia, Matthew and Simon!

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