Last Sunday evening saw a flurry of tweets appear from @EmmaSelby following an article in the Mirror about the numbers of nurses who had died by suicide https://www.mirror.co.uk/news/uk-news/more-300-overworked-nhs-nurses-14822382 The wonderful @AlysColeKing in response shared the ‘Staying Safe’ https://www.stayingsafe.net/intro resources for people at risk of suicide and those supporting them, which is well worth taking a look at.
Sadly during my career I’ve lost two nurse colleagues to suicide, it’s something that makes me feel incredibly uncomfortable. Helen and Mike will never be forgotten and I am grateful for all they have taught me. However I never want to have to go to a funeral again of a colleague who decided to end their life by suicide, seeing the distress of their families, friends and colleagues is heartbreaking.
Day in and day out staff are faced with the emotional challenge of caring in pressurised environments. So how can we create a culture that thinks and takes action on the psychological safety of staff, allowing us all to ask for help when we need it and experience responses that are compassionate? Achieving this consistently could also help retain our most experienced clinical staff in practice.
The emotional burden of working within in the NHS is not a new one, but increasing mental health pressures, demands on health services to do more for less and reduced funding streams to other public sector services all bring added complexity. There are also often many other pressures that NHS staff face outside work that cause additional emotional distress. For example it worries me that staff in caring roles are significantly affected by domestic violence which is often ‘hidden’ in their day to day professional lives. 1 in 7 nurses experience domestic abuse and NHS staff are three times more likely to suffer domestic abuse than the general public https://www.mirror.co.uk/news/uk-news/nurses-three-times-more-likely-9154697 Financial pressures, caring responsibilities and relationship breakdowns at home, along with complexity at work can result in feelings of being totally overwhelmed. We clearly need to strengthen approaches to staff wellbeing.
Organisational commitment and a range of approaches are essential, no one intervention will solve these issues. Having access to independent advice, support and, if appropriate grants to allow choices to be made can be a life line. The Cavell Nurses Trust https://www.cavellnursestrust.org/ who are #HereforNurses is one team we can signpost colleagues to so that they get practical, responsive support when things get tough. I am grateful to John, the CEO and the team at Cavell for their amazing work to support nurses and midwives facing crisis or hardship.
Strategically though I wonder if we can be more proactive and work ‘upstream’? I was reading a blog this week about the 5 ‘life skills’ the World Health Organisation @WHO thinks we should all be equipped with https://bigthink.com/personal-growth/5-critical-life-skills-everyone-should-have
1. Decision-making and problem-solving
2. Creative thinking and critical thinking
3. Communication and interpersonal skills
4. Self-awareness and empathy
5. Coping with emotions and coping with stress
This seems like a really practical ‘curriculum for life’ that could change the future….
The team around us has a profound role in offering direct support too. I recall a difficult incident very early in my career when a child’s precious Hickman line split, we couldn’t work out why it had happened, previous lines this child had had split too and things just weren’t adding up, things seemed ‘odd’ and even though it all got sorted and the child was kept safe. I went home at the end of the day emotionally drained by the complexity of the situation, I felt hopeless and helpless. I ‘hid’ underneath my duvet and remained there for much of the following day. Of course a hot bath, good sleep, tea & hobnobs, debriefs, supervision with wise colleagues put things into perspective.
Looking back for me this incident highlighted the complexity of healthcare, situations like this can and do lead to staff questioning themselves relentlessly and can result in an emotional downward spiral.
So what can I do personally to stop this spiral, personally and for the team around me? Well I will:
1. ‘Ask for help’ role modelling that this is the norm is so needed by us all I think…
2. Ask questions and be curious, ask how are you, and use ‘tell me more…?’
3. Listen and validate concerns of colleagues
4. Pay attention to my body language and the body language of colleagues when I’m engaging
5. Value the ‘encouragers’ the #EarlyRisersClub on twitter, the tweets of @CreateTheRipple we all need positivity
6. Support and share the work of organisations like Campaign against living Miserably (CALM) https://www.thecalmzone.net/2019/04/call-for-help-make-sure-no-call-goes-unanswered/ and the Samaritans https://www.samaritans.org/
7. Encourage staff to attend their local Schwatz rounds https://www.pointofcarefoundation.org.uk/our-work/schwartz-rounds/ Or similar supervision/debrief sessions
Being there for each other, recognising that little things can make a huge difference, a thank you when things have been tough, a coffee with colleagues, these things matter. I loved this thoughtful message from Ruth May at a recent event, reinforcing that we all need to take time to recharge.
What are the action/s you’ll take to make self care and staff care a priority, I love some of these suggestions shared on Twitter this week….
And a wise play specialist (thanks Marilyn) gave me these words which I often share and will remain on my wall….
I’ve also been listening to ‘Trauma Stewardship’ on ”Audible’ which was recommended by @MrsBosanquet it’s fascinating, thanks for signposting to this Joanne!
I’d love views on how we can strengthen our approach to caring for each other?