Prue Thimbleby, arts in health co-ordinator at Swansea Bay University Health Board (SBUHB), provides an insight into a recent arts-based training pilot programme to address self-care and stress management for staff.
Background
NHS staff can experience significant stress due to the conditions and contexts in which they work, which impacts the quality of life for healthcare professionals both in and out of work, as well as the quality of care. During the pandemic this has been accentuated further.
Today, high levels of stress among healthcare workers is common, and by helping to improve mental health and wellbeing, we can support healthcare professionals to continue to deliver invaluable work. Stress levels do not only affect the individuals directly experiencing them, but they are also associated with compassion fatigue leading to a negative impact on patient care. High levels of sickness-related absence also has a reciprocal effect on colleagues who struggle to achieve high quality patient care with fewer staff.
With Swansea Bay University Health Board (SBUHB) supporting a population of around 390,000, and employing more than 12,500 staff, mental health and wellbeing are a priority. Arts are at the heart of service transformation in Wales with a focus on raising awareness of the benefits of the arts on people’s health and wellbeing, both patients and staff. There are many arts initiatives that have been embedded in the NHS across Wales over the years.
Challenges
Dealing with Covid-19 has resulted in many healthcare professionals suffering with exhaustion and mental health problems such as stress and trauma, which impacts the quality of life both in and out of work, and the quality of care. In addition, staff are facing challenges of communicating with patients in a different way, created by the mandatory need for social distancing, PPE, and online consultations.
NHS Wales’ Working Differently, Working Together report identified that between 2011 – 2015, 9,979 staff members across NHS Wales were off work for more than seven days due to stress, anxiety or depression. This has markedly risen during the pandemic and is a growing problem at SBUHB with a 2-3% per cent increase per month in staff reporting mental health issues as the reason for sickness.
Our staff are working so hard that we are hearing some feel they have nothing left to give. Improving staff mental health and wellbeing is therefore a high priority, and we identified that staff across three hospitals involved in the care of older people with mental health problems recorded the highest levels of absenteeism.
Solution
To fully support and engage staff in delivering excellent care, Swansea Bay University Health Board, Swansea University and Performing Medicine collaborated on a pilot programme to improve staff wellbeing in the mental health and learning disabilities unit.
More than 80 staff participated in the programme and its assessment including nurses and health care support workers, allied health professionals, doctors, and hospitality and administrative staff. Led and delivered by Performing Medicine, a provider of arts-based healthcare training, the interactive workshops encouraged healthcare professionals to think about, practise and demonstrate high-quality compassionate care.
The arts-based sessions encourage self-care, help staff cope better with work-related stress, be more confident in their work, and interact with patients and colleagues in a more engaged and attentive way.
There was a focus on good and calm communication with patients and colleagues, taking time for self-care, and engaging in low stress (and de-stressing) non-verbal behaviours (NVBs), such as moving gently and calmly, being aware of how you enter and exit a room or corridor, the impact of one’s own NVBs on others, not rushing, and taking time to listen and communicate effectively with patients and colleagues.
Through implementing this approach, it has been possible to address the extraordinary pressures of working in the current healthcare environment; enabling us to build vital self-care into staff members’ daily routine, encouraging new habits to form and behaviour to change, in order to safeguard mental health.
Benefits
The impact of our pilot project is remarkable and has resulted in invaluable, sustainable change for frontline staff.
Staff reported that they have experienced significant gains in understanding a range of issues including the need to make time for self-care, how to improve communication skills with patients and colleagues, as well as how posture and pace and non-verbal behaviours affect patients and colleagues.
One of the biggest changes that staff experienced was recognising how work-related stress affects their health, and the workshops empowered them to make meaningful change. There is now an increased understanding of other people’s behaviour, and greater awareness of individual pace at work. Staff are more conscious of the need to slow down to become more approachable.
There was also an increased understanding of the need to take more time during conversations, be more willing to listen to others, and to step back from responding too quickly. A number of participants said they planned to increase their use of stress management techniques, including using the body scan, be more effective in their work-life balance, and to recognise and avoid getting overly stressed.
The programme has also enabled SBUHB to continue to provide an environment in which change is both sought and supported. Importantly, the active engagement and ‘buy in’ of managers enhanced and supported change engendered within them; this synergy proved highly effective.
Next steps
Following the successful pilot programme, SBUHB is taking it to the next phase and will be running further sessions throughout 2021 for staff who are struggling with the effects of the pandemic and the stress that it has created.
Healthcare workers who are better supported and equipped with improved skills for safeguarding their mental health, in turn provide safer, more compassionate care for patients. The impact of a healthier workforce would be a better-functioning, more resilient NHS, better positioned to recover from and respond to Covid-19 and future public health crises.
