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Tran Y, Ellis LA, Clay-Williams R, Churruca K, Wiig S. Editorial: Occupational health and organizational culture within a healthcare setting: challenges, complexities, and dynamics. Front Public Health 2023; 11:1327489. [PMID: 38074702 PMCID: PMC10703430 DOI: 10.3389/fpubh.2023.1327489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 11/01/2023] [Indexed: 12/18/2023] Open
Affiliation(s)
- Yvonne Tran
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Louise A. Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Robyn Clay-Williams
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Kate Churruca
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Siri Wiig
- SHARE – Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Shinton R, Ledwith S. Non-Qualified Staff's Experience of Suicidal Behaviour in Adult Mental Health Inpatient Services. Omega (Westport) 2023:302228231212649. [PMID: 37922527 DOI: 10.1177/00302228231212649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Suicide and attempted suicide of people receiving care in Adult Mental Health Inpatient Services (AMHIS) leads to significant emotions amongst mental health professionals, characterised by guilt and shame. A sense of responsibility occurs due to hospital being seen as a safe place. However, little is known about what it is like for 'non-qualified' staff. This study explored experiences of suicide and attempted suicide on 'non-qualified' staff in AMHIS. Semi-structured interviews explored ten staff's experiences. Participants were recruited online and transcripts were analysed using Reflexive Thematic Analysis. Four themes were identified; 'Direct personal impact', 'Unrealistic expectations', 'Attempting to contain the impact' and 'Acclimatisation'. Ten sub-themes outlined; responsibility for assessing risk, shame and protective strategies to aid acceptance. The results provide insight into the unique experience of non-qualified staff in AMHIS experiencing suicidal behaviour.
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Affiliation(s)
- Rebecca Shinton
- Thesis Submitted to Staffordshire University in Partial Fulfilment of the Professional Doctorate in Clinical Psychology, Stoke-on-Trent, UK
| | - Susan Ledwith
- Thesis Submitted to Staffordshire University in Partial Fulfilment of the Professional Doctorate in Clinical Psychology, Stoke-on-Trent, UK
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3
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Mercer L, Cookson A, Müller-Myhsok B, van Vuuren J. Burnout and secondary traumatic stress in staff working with people with intellectual disabilities: The role of adverse childhood experiences, resilience and trauma-informed organisational climate. J Appl Res Intellect Disabil 2023; 36:1297-1307. [PMID: 37533333 DOI: 10.1111/jar.13148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 06/01/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND There has been extensive research into adverse childhood experiences (ACEs), however, less consideration has been given to the prevalence and impact of ACEs for staff working with people with intellectual disabilities. METHOD Participants were staff employed by agencies that care for people with intellectual disabilities. An online survey collected demographic information and measures of ACEs, resilience, trauma-informed organisational climate, burnout and secondary traumatic stress. Correlation, regression, mediation and moderation analyses were used. RESULTS 81.7% of 109 participants had experienced at least one ACE. Burnout, secondary traumatic stress and resilience were greater in the present study than in comparable samples. Trauma-informed organisational climate significantly predicted burnout and secondary traumatic stress. Resilience significantly predicted burnout. CONCLUSIONS Staff working with people with intellectual disabilities are likely to have experienced ACEs. Working in a trauma-informed organisational climate and resilience may be effective avenues for reducing burnout and secondary traumatic stress.
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Affiliation(s)
- Louise Mercer
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Alex Cookson
- Learning Disability Community Team, Merseycare NHS Trust, Liverpool, UK
| | | | - Julie van Vuuren
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
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4
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Malins S, Boutry C, Moghaddam N, Rathbone J, Gibbons F, Mays C, Brooks D, Levene J. Outcomes of psychological support skills training for cancer care staff: Skill acquisition, work engagement, mental wellbeing and burnout. Psychooncology 2023; 32:1539-1547. [PMID: 37559503 DOI: 10.1002/pon.6200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/17/2023] [Accepted: 07/28/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE Psychological support skills training has the potential to improve both the ability of cancer staff to help their patients, and staff wellbeing. However, few recent studies have assessed both these outcomes or incorporated current developments in psychological skills training, such as deliberate practice, which includes the use of iterative, corrective feedback to identify and improve individualised skill deficits. No studies have evaluated the contribution that psychological skills training could make to cancer care staff wellbeing and expertise in the wake of the COVID-19 pandemic. This study aimed to evaluate staff skill acquisition and work-related wellbeing following psychological support skills training that applied deliberate practice principles. METHOD A 2-day training and monthly supervision was offered to 145 cancer care staff that focused on brief assessment and intervention skills for patients experiencing mental health problems after cancer diagnosis and treatment. Deliberate practice principles were used to focus training on skills practice and feedback, over technique description. Self-reported ability to perform key skills taught, staff mental wellbeing, work engagement, and burnout were assessed at baseline, 3-month and 8-month follow-up. RESULTS Significant improvements in skills, mental wellbeing, burnout and work engagement were reported at 8-month follow-up. Full engagement in both training sessions was predicted by poorer baseline mental wellbeing, more positive evaluation of initial training, supervision attendance, and shorter follow-up. CONCLUSION A 2-day psychological support skills training using deliberate practice principles may support improvement in staff skill, mental wellbeing, burnout and work engagement.
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Affiliation(s)
- Sam Malins
- University of Nottingham, School of Medicine, Nottingham, UK
- Nottinghamshire Health Care NHS Foundation Trust, Nottingham, UK
| | - Clement Boutry
- University of Nottingham, School of Medicine, Nottingham, UK
| | | | - James Rathbone
- Nottinghamshire Health Care NHS Foundation Trust, Nottingham, UK
| | - Felicity Gibbons
- Nottinghamshire Health Care NHS Foundation Trust, Nottingham, UK
| | - Chloe Mays
- Nottinghamshire Health Care NHS Foundation Trust, Nottingham, UK
| | - Daniel Brooks
- Derbyshire Community Health Services NHS Foundation Trust, Bakewell, UK
| | - Joanna Levene
- Nottinghamshire Health Care NHS Foundation Trust, Nottingham, UK
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5
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Martland R, Gaughran F, Stubbs B, Onwumere J. Perspectives on implementing exercise bikes for use by inpatient mental health staff in the workplace: A qualitative study investigating staff attitudes. J Psychiatr Ment Health Nurs 2023; 30:1027-1039. [PMID: 37038723 DOI: 10.1111/jpm.12929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 01/30/2023] [Accepted: 03/21/2023] [Indexed: 04/12/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Mental health nursing staff may experience psychological stress and burnout. Exercise provision for mental health staff may improve staff physical and mental wellbeing and mitigate against psychological burnout. Existing research suggests the provision of exercise equipment for mental health nursing staff may improve staff attitudes towards physical activity and staff confidence in motivating physical activity amongst patient groups they care for, although more research is needed, and research investigating the attitudes of mental health staff towards such initiatives is warranted. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Access to fitness facilities in the workplace for mental health staff was endorsed. Logistical and practical concerns (i.e. shower access, time) were noted as barriers to implementation of fitness facilities in the workplace for staff use. Mental health staff expressed desire to have access to varied gym equipment at work WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The introduction of fitness facilities in the workplace environment for staff use was actively endorsed by mental health professionals, suggesting such initiatives may be warranted in mental health settings. However, barriers to successful implementation were noted and are worth considering in preparation for trialling provision of exercise equipment for staff use. ABSTRACT INTRODUCTION: Exercise equipment for mental health staff may improve staff wellbeing, mitigate against stress and improve staff attitudes towards physical activity. This said, there is a lack of researching investigating the attitudes of mental health staff towards the provision of fitness facilities in the workplace. AIM The study investigated staff attitudes towards being offered exercise bikes in the workplace. METHOD Three focus groups and one individual interview were conducted with 12 healthcare professionals. Data were subject to a thematic analysis. RESULTS Three themes were identified. (1) 'This sounds like a good idea', which reflected positive views in the provision of exercise in the workplace for staff use. (2) 'I'm not sure it would work because …', which reflected implementation concerns including not having access to shower facilities and time constraints. (3) 'Balancing choice', which reflected participant's desire to have access to varied gym equipment. DISCUSSION The introduction of fitness facilities in the workplace for staff use was endorsed. However, implementation barriers were noted. IMPLICATIONS FOR PRACTICE This research provides justification for the exploration of the feasibility and benefits of providing exercise equipment for mental health staff in the workplace but presents implementation barriers that are worth considering before trialling provision of exercise equipment.
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Affiliation(s)
- Rebecca Martland
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Fiona Gaughran
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
- Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
| | - Juliana Onwumere
- South London and Maudsley NHS Foundation Trust, London, UK
- Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
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Hill C, Sims S, ap Robert M, Collier S. A thematic analysis of staff perspectives on the impact of a mental health nurse (RMN) in a critical care unit. J Intensive Care Soc 2023; 24:292-298. [PMID: 37744079 PMCID: PMC10515331 DOI: 10.1177/17511437221116474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
Background Recent guidelines in the UK have shaped Critical Care Units (CCUs) to bring the mental health needs of patients, and staff wellbeing to the forefront of service provision. A health board based in NHS Wales has trialled the secondment of a Mental Health Nurse (RMN) within a CCU to help service provision adhere to such guidelines. Methods Critical care staff were invited to attend focus groups to share their experiences of how the RMN influenced service provision. Results Thematic analysis identified five main themes; including 'smoother care pathways', 'a holistic approach to care', 'co-production', 'knowledge and confidence' and 'staff wellbeing'. Each of these themes reflected how the RMN had both direct and indirect benefits on patient and staff wellbeing. Conclusion This qualitative exploration suggests that staff perceived value in the role of the RMN for both staff and patient outcomes, although further measures were considered necessary to improve staff-wellbeing within a critical care environment. This service evaluation supports recommendations for commissioning a RMN permanently in a CCU.
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Affiliation(s)
| | - Sarah Sims
- Liaison Psychiatry, Swansea Bay University Health Board, Swansea, UK
| | - Magdalena ap Robert
- Mental Health & Learning Disability, Swansea Bay University Health Board, Swansea, UK
| | - Sarah Collier
- Mental Health & Learning Disability, Swansea Bay University Health Board, Swansea, UK
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Pavithra A, Mannion R, Li L, Westbrook J. The impact of vulnerability and exposure to pervasive interprofessional incivility among medical staff on wellbeing. Front Public Health 2023; 11:1168978. [PMID: 37521972 PMCID: PMC10375044 DOI: 10.3389/fpubh.2023.1168978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/28/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Traditional methods for modelling human interactions within organisational contexts are often hindered by the complexity inherent within these systems. Building on new approaches to information modelling in the social sciences and drawing on the work of scholars in transdisciplinary fields, we proposed that a reliable model of human interaction as well as its emergent properties can be demonstrated using theories related to emergent information. Methods We demonstrated these dynamics through a test case related to data from a prevalence survey of incivility among medical staff. For each survey respondent we defined their vulnerability profile based upon a combination of their biographical characteristics, such as age, gender, and length of employment within a hospital and the hospital type (private or public). We modelled the interactions between the composite vulnerability profile of staff against their reports of their exposure to incivility and the consequent negative impact on their wellbeing. Results We found that vulnerability profile appeared to be proportionally related to the extent to which they were exposed to rudeness in the workplace and to a negative impact on subjective wellbeing. Discussion This model can potentially be used to tailor resources to improve the wellbeing of hospital medical staff at increased risk of facing incivility, bullying and harassment at their workplaces.
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Affiliation(s)
- Antoinette Pavithra
- Faculty of Medicine, Health and Human Sciences, Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Russell Mannion
- Faculty of Medicine, Health and Human Sciences, Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
- Health Services Management Centre, School of Social Policy, College of Social Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Ling Li
- Faculty of Medicine, Health and Human Sciences, Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Johanna Westbrook
- Faculty of Medicine, Health and Human Sciences, Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
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Nnate DA, Nashwan AJ. Emotional Intelligence and Delivering Bad News in Professional Nursing Practice. Cureus 2023; 15:e40353. [PMID: 37456491 PMCID: PMC10339355 DOI: 10.7759/cureus.40353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Delivering bad news often impacts nurses' emotional well-being and relationships with patients. However, most practice models do not offer a sufficient solution to the distress and reduced job satisfaction that may thus arise. This paper offers a critique of theoretical frameworks for breaking bad news in clinical settings, with the aim of highlighting the inadequate evidence available to guide nursing practice with regard to managing the emotional burden of breaking bad news. Firstly, the concept of emotional intelligence is introduced, followed by an overview of the impact of delivering bad news on the psychological well-being of healthcare workers. Several models for delivering bad news in clinical practice were then presented to emphasise the lack of evidence regarding ways of mitigating the burden associated with breaking bad news. Key components of emotional intelligence are highlighted to increase awareness of this factor among nurses and enable them to improve their interpersonal skills to mitigate the impact of breaking bad news. Enabling nurses to develop emotional self-awareness before utilising these frameworks will likely lead to increased nurse retention rates and improve reflective practice and communication skills, which could, in turn, strengthen nurse-patient relationships and subsequent care planning.
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Affiliation(s)
- Daniel A Nnate
- Urgent Care Division, Countess of Chester NHS Foundation Trust, Chester, GBR
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9
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Griffith B, Archbold H, Sáez Berruga I, Smith S, Deakin K, Cogan N, Tanner G, Flowers P. Frontline experiences of delivering remote mental health supports during the COVID-19 pandemic in Scotland: innovations, insights and lessons learned from mental health workers. PSYCHOL HEALTH MED 2023; 28:964-979. [PMID: 36408950 DOI: 10.1080/13548506.2022.2148698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
COVID-19 restrictions drove rapid adaptations to service delivery and new ways of working within Scotland's mental health sector. This study explores mental health workers' (MHWs') experiences of delivering their services remotely. Twenty participants, who had worked in mental health professions in the National Health Service (NHS) in Scotland throughout the COVID-19 pandemic, took part in online semi-structured interviews. Data was transcribed then analysed using an inductive thematic analysis. Two major themes are reported: (1) 'Improved Flexibility for both MHWs and Service Users' and (2) 'Teletherapies Challenge Therapeutic Boundaries'. In relation to (1) virtual platforms were seen as vital in maintaining patient care throughout the COVID-19 pandemic and a valuable resource for service users (SUs) who had previously struggled with mobility or social anxieties when accessing face-to-face services. Some MHWs' also noted benefits for their productivity and comfort. Regarding (2) MHWs highlighted that whilst conducting teletherapies from home, work-life boundaries became blurred and, in some instances, typically comforting spaces became associated with the traumatic content discussed by SUs. These stressors seemed to be compounded by MHWs' isolation, as they were less able to draw upon their colleagues for support. Further, confidentiality could not be assured, as MHWs and SUs alike had to accommodate their family members. These findings highlight important insights from MHWs in adapting to rapid changes in mental health working practices, particularly in relation to the challenges of delivering quality, safe and equitable services and the increased use of teletherapies. Such insights are vital in informing service developments and supporting future pandemic preparedness across a range of healthcare contexts and countries seeking to adopt hybrid models of mental health service delivery.
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Affiliation(s)
- Bethany Griffith
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Heather Archbold
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Isabel Sáez Berruga
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Samantha Smith
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Karen Deakin
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Nicola Cogan
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Gary Tanner
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Paul Flowers
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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10
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Harris O, Jacobsen P, Searle-Barnes R, Wilkinson-Tough M. Surviving and thriving - a mixed-methods study of staff experiences of occupational wellbeing in a psychiatric place of safety service. J Ment Health 2023; 32:158-165. [PMID: 33191828 DOI: 10.1080/09638237.2020.1844870] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Under the S136 of the UK Mental Health Act, people experiencing a mental health crisis may be taken to a locally agreed location (Place of Safety) by police for urgent assessment. Research has shown that mental health professionals (MHPs) face high levels of burnout, but we know very little about the particular challenges staff who work in extreme clinical settings such as a Place of Safety service face. AIM This study aimed to fill this gap by exploring the wellbeing experiences of staff in a Place of Safety service. METHOD A mixed-methods approach was used, with quantitative data on job satisfaction (Job Satisfaction Survey) and burnout (Maslach Burnout Inventory-Human Services Survey) and qualitative data from focus groups. Purposive sampling was used. Qualitative data was analysed using thematic analysis and descriptive statistics were calculated for the quantitative data. RESULTS Twenty staff scored within the moderate range for emotional exhaustion, depersonalisation and personal accomplishment, and in the satisfied range for job satisfaction. Three overarching themes were identified: (i) united as insiders, (ii) surviving and thriving, and (iii) narratives of coping. CONCLUSIONS Despite unique setting-related stressors, participants showed comparable levels of wellbeing to other MHPs. Implications are discussed.
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Affiliation(s)
- Olivia Harris
- Department of Psychology, University of Bath, Bath, UK
| | | | - Rachael Searle-Barnes
- Bristol Inpatient Psychology Service, Avon and Wiltshire Mental Health Partnership NHS Foundation Trust, Chippenham, UK
| | - Megan Wilkinson-Tough
- Bristol Inpatient Psychology Service, Avon and Wiltshire Mental Health Partnership NHS Foundation Trust, Chippenham, UK
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11
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Beavis J, McKenzie S, Davis L, Ellison N. Implementation and evaluation of clinical supervision for support workers in a paediatric palliative care setting. Clin Child Psychol Psychiatry 2022; 27:369-384. [PMID: 34865519 DOI: 10.1177/13591045211055565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Support workers represent a large proportion of the NHS workforce and yet their supervisory needs are often overlooked. This study focused specifically on a cohort of support workers in a community paediatric palliative care setting. Peer supervision was implemented for this group, initially face to face and then virtually. The experiences of clinical supervision for this group were investigated through responses to an online survey (n = 25) and two focus groups (n = 7). Survey data were analysed concurrently with a thematic analysis. The following themes and sub-themes were developed from transcribed focus groups: (1) Barriers to engagement (2) Being Listened to (3) What Worked Well: Logistics. Overall, delivery of supervision was effective to a mixed degree - though support workers appreciated a space to be listened to, their distrust of colleagues and other barriers impeded the capacity of supervision to achieve more than support and catharsis for this group. Future projects should focus on introducing more preliminary interventions to promote reflection and peer support for these groups as well as continue to consider the supervisory needs of support workers.
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Affiliation(s)
| | - Sian McKenzie
- Department of Psychology, Lifetime Service, Bristol, UK
| | - Lucy Davis
- Department of Psychology, Lifetime Service, Bristol, UK
| | - Nell Ellison
- Department of Psychology, Lifetime Service, Bristol, UK
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12
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Branjerdporn G, Bowman C, Kenworthy S, Stapelberg NJC. Interventional Response of Hospital and Health Services to the Mental Health Effects of Viral Outbreaks on Health Professionals. Front Psychiatry 2022; 13:812365. [PMID: 35273530 PMCID: PMC8902291 DOI: 10.3389/fpsyt.2022.812365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/27/2022] [Indexed: 12/17/2022] Open
Abstract
The aim of this integrative review was to examine the impact of past viral epidemics on staff mental health interventional responses, with a specific focus on healthcare provider response in the context of the COVID-19 pandemic. Following PRISMA methodology, databases were searched for relevant articles. A total of 55 articles with a range of methodologies (e.g., commentary papers, cohort studies, qualitative studies) were included to ensure broad coverage of this rapidly emerging research area. The literature showed that many healthcare providers implemented a variety of wellbeing initiatives to support their staff during a viral outbreak. Most of these interventions, however, were not formally evaluated. Interventions included leadership/team support; online psychoeducational resources and updated information on the pandemic; respite spaces; peer support outreach; staff resilience training; telephone hotline support; staff support groups; and individual counseling. Staff were generally supportive of the initiatives offered by hospital and health services, with certain interventions being more appreciated (e.g., staff respite areas). Rapid, locally, and culturally appropriate workplace-based responses may counter the negative mental health impact on staff; but a stepped response is required for a smaller number of staff at risk of mental illness, or those with pre-existing mental illness. Systematic Review Registration: Unique Identifier: CRD42020222761.
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Affiliation(s)
| | - Candice Bowman
- Gold Coast University Hospital, Southport, QLD, Australia
| | - Sean Kenworthy
- Gold Coast University Hospital, Southport, QLD, Australia
| | - Nicolas J. C. Stapelberg
- Gold Coast University Hospital, Southport, QLD, Australia
- Faculty of Health Science and Medicine, Bond University, Gold Coast, QLD, Australia
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13
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Kramarz E, Mok CLM, Westhead M, Riches S. Staff experience of team case formulation to address challenging behaviour on acute psychiatric wards: a mixed-methods study. J Ment Health 2022; 32:412-423. [PMID: 35037548 DOI: 10.1080/09638237.2021.2022611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Team case formulation on acute psychiatric wards aims to support staff to manage significant levels of challenging behaviour. However, there is limited research on staff experience of case formulation in this setting. AIM This study aimed to investigate staff experience of team case formulation sessions on acute psychiatric wards and their impact on staff wellbeing. METHODS Eighteen multidisciplinary staff (nurses, doctors, occupational therapists, support workers, activities coordinators) from five acute wards at a South London psychiatric hospital completed a semi-structured interview and visual analogue scales on their experience of attending case formulation. Thematic analysis was employed to analyse qualitative data. RESULTS Participants reported that case formulation supported staff to develop a holistic understanding of service users, provided a safe space for staff to discuss the impact of challenging behaviour and improved teamwork and communication. Participants reported that these benefits increased their ability to identify and support the needs of service users and improved therapeutic relationships. Challenges with establishing continuity of care were highlighted. CONCLUSION Team case formulation is an important intervention to support ward staff and has significant benefits to staff wellbeing and quality of care. Greater integration with existing ward practices may benefit both staff and service users.
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Affiliation(s)
- Emilia Kramarz
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK.,Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Che Ling Michelle Mok
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK.,Division of Psychology and Language Sciences, Faculty of Brain Sciences, University College London, London, UK
| | - Megan Westhead
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK.,Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Simon Riches
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK.,Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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14
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Dyson JL, Lamb D. From front line to battle planning: a nursing perspective of covid-19. Int Nurs Rev 2021; 69:80-85. [PMID: 34825709 DOI: 10.1111/inr.12731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/17/2021] [Indexed: 11/27/2022]
Abstract
AIM The aim of this paper is to reflect upon the experiences of a senior nurse in a patient-facing role, who led a tea providing direct care to those with coronavirus disease 2019 (covid-19). This would establish what those experiences meant to nurses during the initial outbreak to enable their coping mechanisms to face subsequent waves in the United Kingdom. BACKGROUND The worst infectious disease outbreak of a generation rapidly made its impact known to the medical profession and its support infrastructure across the globe. It imparted unprecedented challenges, not only for managing the care of the most critically ill but for minimising its spread and protecting the workforce. SOURCES OF EVIDENCE Reflections of working on the covid-19 frontline during the initial stages of the pandemic, the challenges faced, and lessons learned enabled the development of a strategy to better support nurses in the ongoing pandemic. DISCUSSION Visible, invested and consistent leadership was key in forming a strong foundation to support clear communication, peer support and increasing confidence. Consequently, strong bonds were forged to enable the team to face further challenges as they felt 'in it together'. SUMMARY AND IMPLICATIONS FOR NURSING AND HEALTH POLICY The experiences described in this paper are those of a senior nurse leader within a particular care context. However, the lessons learned are likely to resonate with many nurses who are facing the same challenges in very similar care contexts and who are urged to reflect upon their own experiences. Furthermore, the associated lessons may help support others and inform their strategy for coping throughout potential future admission surges of this pandemic.
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Affiliation(s)
- Jennie L Dyson
- Senior Sister, Joint Hospital Group (South-East), Frimley Park Hospital, Portsmouth Road, Frimley, Camberley, Surrey, United Kingdom
| | - Di Lamb
- Defence Professor of Nursing, Academic Department of Military Nursing, Royal Centre for Defence Medicine, Birmingham Research Park, Vincent Drive, Edgbaston, Birmingham, West Midlands, United Kingdom
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Olabi Y, Campbell S, Greenhill B, Morgan A. NHS frontline staff experiences of an in-house psychological support service during the COVID-19 pandemic. PSYCHOL HEALTH MED 2021; 27:131-138. [PMID: 34311610 DOI: 10.1080/13548506.2021.1954674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The COVID-19 pandemic has led to enormous practical and emotional challenges for healthcare workers globally, including NHS staff. Psychological support provisions have been established by an NHS healthcare trust in the North of England, including 1:1 psychological support provided by the in-house psychology team. This study sought to understand how staff experienced the service, what worked well and what could be improved. Five participants who had accessed the staff support service took part in semi-structured interviews. Data were analysed using Interpretative Phenomenological Analysis (IPA). Three main themes emerged from the data: 'The need for a flexible, responsive approach', 'Individual and group benefits' and 'The future of staff support: "we need to invest in staff mentally"'. Accessing the service was seen as personally and professionally rewarding for the NHS staff interviewed. These findings are discussed in relation to the relevant literature. Clinical implications, methodological limitations and directions for future research are discussed.
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Affiliation(s)
- Yasmine Olabi
- Clinical Psychology Programme, The University of Liverpool, Liverpool, UK
| | - Sophie Campbell
- Clinical Health Psychology Service, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Beth Greenhill
- Clinical Psychology Programme, The University of Liverpool, Liverpool, UK
| | - Andrew Morgan
- Clinical Health Psychology Service, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
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Magner C, Greenberg N, Timmins F, O'Doherty V, Lyons B. The psychological impact of COVID-19 on frontline healthcare workers 'From Heartbreak to Hope'. J Clin Nurs 2021; 30:e53-e55. [PMID: 33963628 PMCID: PMC8206860 DOI: 10.1111/jocn.15841] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Claire Magner
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Neil Greenberg
- Health Protection Research Unit, King's College London, London, UK
| | - Fiona Timmins
- Department of Anaesthesia, National Women's Health, Auckland City Hospital, Auckland, New Zealand
| | | | - Barry Lyons
- Dept. of Anaesthesia & Critical Care Medicine, Children's Health Ireland, Dublin, Ireland
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Abstract
We propose that strengthening citizenship could help realise some of the substantial changes that are being called for in mainstream health policies. We highlight the way that current healthcare improvement agendas entail, and depend upon, large-scale and complex cultural change. But, we suggest, there is a severe limit to how far such cultural change can be engineered from above or through conventional quality improvement methods. In summary, we argue that supporting what we call 'civic culture' - a culture that encourages and -enables effective citizenship - may be a precondition for -bringing about policy aspirations and related improvements.
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Abstract
Providing home care to children with complex physical health needs is an emotionally challenging role. Extant literature and documents such as the Cavendish Review (2013) have reported that a large proportion of care for this population is carried out by non-registered staff (support workers). Provision of clinical supervision for nurses working in palliative care is increasing, however, supervision needs of support workers are commonly neglected. This paper sought to synthesise what is known about clinical supervision practices for support workers in paediatric palliative care (PPC). A literature review was conducted in accordance with integrative review guidelines. 315 papers were identified initially, 15 studies were included in this review. Four commonalities were identified: importance of team cohesion, varying degrees of formality, self-awareness and practicalities. Support workers received varying forms of supervision and some facilitators faced organisational difficulties involving staff in supervision. Support workers who received staff support generally appreciated it in recognition that their work is complex and emotionally difficult. This paper highlighted that further research should investigate the efficacy of clinical supervision as a method of reducing stress and burnout for support workers. Any implementation of supervision should involve a considered approach to training and supervision to ensure fidelity.
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Affiliation(s)
- Jonathan Beavis
- The Lifetime Psychology Service, Sirona Care & Health, Bristol, UK
| | - Lucy Davis
- The Lifetime Psychology Service, Sirona Care & Health, Bristol, UK
| | - Sian McKenzie
- The Lifetime Psychology Service, Sirona Care & Health, Bristol, UK
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Abstract
The emotional toll of working in healthcare is widely recognised, but staff rarely have time to reflect on their experiences. Schwartz Rounds provide an opportunity for all staff in a healthcare organisation to meet regularly and reflect on the human connections made with patients and the emotional impact of their work. They are now running in over 200 organisations across the UK & Ireland. In the first evaluation of a national sample in the UK, we review feedback received from a large sample of 402 Schwartz Rounds in a total of 47 organisations, including acute and non-acute NHS trusts and hospices. Analyses were undertaken to explore self-reported experiences of the Rounds, and differences between the proportions of professional staff groups attending. The overall experience of Schwartz Rounds was very positive across all settings. In particular, staff reported that Rounds helped them to gain insight into the working lives of their colleagues. There were no differences between the responses of clinical and non-clinical staff, indicating that all staff value a reflective space regardless of background. Healthcare staff value an opportunity to reflect on the emotional impact of their work. In increasingly overstretched and hurried services, it is a priority to provide this.
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Affiliation(s)
| | | | | | - Christy Ford
- Department of Clinical Psychology, University of Teesside, UK
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Taylor C, Xyrichis A, Leamy MC, Reynolds E, Maben J. Can Schwartz Center Rounds support healthcare staff with emotional challenges at work, and how do they compare with other interventions aimed at providing similar support? A systematic review and scoping reviews. BMJ Open 2018; 8:e024254. [PMID: 30341142 PMCID: PMC6196967 DOI: 10.1136/bmjopen-2018-024254] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/27/2018] [Accepted: 08/23/2018] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES (i) To synthesise the evidence-base for Schwartz Center Rounds (Rounds) to assess any impact on healthcare staff and identify key features; (ii) to scope evidence for interventions with similar aims, and compare effectiveness and key features to Rounds. DESIGN Systematic review of Rounds literature; scoping reviews of comparator interventions (action learning sets; after action reviews; Balint groups; caregiver support programme; clinical supervision; critical incident stress debriefing; mindfulness-based stress reduction; peer-supported storytelling; psychosocial intervention training; reflective practice groups; resilience training). DATA SOURCES PsychINFO, CINAHL, MEDLINE and EMBASE, internet search engines; consultation with experts. ELIGIBILITY CRITERIA Empirical evaluations (qualitative or quantitative); any healthcare staff in any healthcare setting; published in English. RESULTS The overall evidence base for Rounds is limited. We developed a composite definition to aid comparison with other interventions from 41 documents containing a definition of Rounds. Twelve (10 studies) were empirical evaluations. All were of low/moderate quality (weak study designs including lack of control groups). Findings showed the value of Rounds to attenders, with a self-reported positive impact on individuals, their relationships with colleagues and patients and wider cultural changes. The evidence for the comparative interventions was scant and also low/moderate quality. Some features of Rounds were shared by other interventions, but Rounds offer unique features including being open to all staff and having no expectation for verbal contribution by attenders. CONCLUSIONS Evidence of effectiveness for all interventions considered here remains limited. Methods that enable identification of core features related to effectiveness are needed to optimise benefit for individual staff members and organisations as a whole. A systems approach conceptualising workplace well-being arising from both individual and environmental/structural factors, and comprising interventions both for assessing and improving the well-being of healthcare staff, is required. Schwartz Rounds could be considered as one strategy to enhance staff well-being.
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Affiliation(s)
- Cath Taylor
- School of Health Sciences, University of Surrey, Guildford, UK
- Florence Nightingale Faculty of Nursing , Midwifery & Palliative Care, King's College London, London, UK
| | - Andreas Xyrichis
- Florence Nightingale Faculty of Nursing , Midwifery & Palliative Care, King's College London, London, UK
| | - Mary C Leamy
- Florence Nightingale Faculty of Nursing , Midwifery & Palliative Care, King's College London, London, UK
| | - Ellie Reynolds
- Florence Nightingale Faculty of Nursing , Midwifery & Palliative Care, King's College London, London, UK
| | - Jill Maben
- School of Health Sciences, University of Surrey, Guildford, UK
- Florence Nightingale Faculty of Nursing , Midwifery & Palliative Care, King's College London, London, UK
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Abstract
BACKGROUND Musculoskeletal disorders significantly contribute to staff sickness and absence in the NHS. District nurses are especially at risk because patient handling tasks are often carried out outside a clinical environment. STUDY AIM To explore district nurses' lived experience of musculoskeletal wellbeing. STUDY DESIGN An exploratory qualitative study using interpretative phenomenological analysis. METHOD Semi-structured interviews with a purposeful sample of seven district nurses. FINDINGS Study participants accepted musculoskeletal pain as part of nursing and reported little time for physical activity, often because of work and family commitments. Participants identified treating patients' leg ulcers as a risk factor for developing MSD, while generic workplace wellbeing initiatives delivered via email failed to engage their interest. CONCLUSION This study provides a useful insight into district nurses' experiences of musculoskeletal wellbeing and represents an important first step in producing recommendations for future research with the aim of developing strategies for improving workplace musculoskeletal wellbeing that would be acceptable to staff.
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Affiliation(s)
| | - Sudip Ghosh
- Honorary Clinical Professor of Community Medicine, School of Health and Life Sciences, De Montfort University, UK
| | - Lisa Robinson
- Honorary Senior Lecturer, Faculty of Medical Sciences Graduate School, Newcastle University, UK
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