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ED Wellbeing: The Whole Team Approach

Winter 2017/18, just typing that makes me shudder a little. After over 10 years in Emergency Medicine I had never experienced the level of emotional, physical and professional exhaustion that I did on the night shift of 27th December 2017. That was the shift that broke me. The volume of patients and their acuity was making each shift harder and harder, and after morning handover on 28th December 2017 I broke down in tears and they wouldn’t stop. Thankfully my consultants were supportive, and I arranged to have 3 weeks off. It was just the break I needed and I definitely felt more human when I returned to work. It then lead me to think about how my colleagues must also be feeling.

The first thing we managed to quickly arrange was some local Beauty students coming into the department to give hand/arm/head/neck massages to staff for free. It was definitely a nice pick-me-up but we also recognised the need to look deeper into the problems. We met with the Trust Wellbeing service lead and began to develop a plan to improve morale and wellbeing within the department. Something we were able to initiate straight away was the Trust Counselling Service providing a service directly in the department on a weekly basis that staff were encouraged to drop in to use. These encompassed group defuse sessions, 1:1 sessions and some relaxation sessions.

We are now proud to have members from staff groups and have achieved loads of things so far:

  • A WellBeing Room that is separate from the staff room – a quiet space with comfy chairs, low lighting and books

  • The Hangry Box – we stole this idea from someone on Twitter (but all the best ideas are stolen). It’s a box of snacks if you need an immediate fix – funded by the senior team, we also run an honesty box system so we can keep it stocked up, including healthier options too

  • House Rules – these aim to reduce bullying and belittling behaviour and try to flatten the hierarchy and empower staff to call out unacceptable behaviour

  • Wellbeing Day – a whole afternoon dedicated to all aspects of wellbeing including displays from local gyms, counselling services, nutritionists and it was kindly sponsored by the RCN so we could provide “goody-bags” to everyone that attended.

  • CISM Training – Critical Incident Stress Management training is something we are now providing to all ED staff, and it has been added to the induction programme for new nurses as well as the junior and senior doctor teaching programme.

  • Staff Room renovation – between some fund-raising and a successful application to Staff Good Causes we have been able to give it a face lift. We’ve even got a small freezer for ice-creams and ice pops in hot weather.

  • GREATix – our monthly nominations for reporting good work are constantly and they are a great way to show appreciation for colleagues

We can even call ourselves an Award Winning Team after collecting the Wellbeing Initiative of the Year Award at the annual Trust Awards Ceremony. We’re still coming up with other ideas all the time, and have some interesting things coming up in the future, including some work on how to support colleagues with Menopausal symptoms and an ED staff awards night.

Some top tips:

  • Get the basics right – staff room, tea/coffee/milk etc. As Maslow described in his hierarchy of needs – a strong foundation is essential

  • Ask staff what they want – do a survey monkey

  • Develop a strategy – include some “fluffy” things but it is also important to look at more serious issues

  • Get a team together – no-one can do this kind of work alone without it becoming detrimental to your own wellbeing.

  • Don’t be afraid to ask for resources. We’ve managed to get money from internal fundraising, staff good causes and sponsorship from the RCN.

  • Be prepared for negative attitudes – for some, the idea of wellbeing at work is unnecessary. Keep going for those that benefit from it

  • Connect with like-minded people – social media is a great resource and the recent RCEM Wellbeing Conference helped validate our work and was great for networking.

The demands we face every day in ED are growing; and that is unlikely to change anytime soon. I hope to never get to the point I did on 28th December 2017 again, nor for any of my colleagues to feel like I did that morning. The things we deal with and experience together provide a bond like no other, and that is why it is imperative to consider every single member of staff in the ED when considering strategies to improve wellbeing.

Hannah McKee


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