Showing Well Led and Caring support in emotional or traumatic circumstances
I was reminded yesterday of when my husband went in for an operation last year, he had just come out of theatre and was wheeled into his room. His face was what can only be described as the palest green with a hint of blue. He was conscious and I could see his wound on his neck with a dressing and it was blood stained. The children were packed off to Grandparents, and my sole job was to care for him and keep him company.
True to form (and I really do mean to form), I began to feel overwhelmingly dizzy, clammy and I knew what was coming next. I made a decision that he was in a much worse state than me (which is what had set me off), so got down as near to the floor as I could, and reached up and placed my hand on his hand. From this rather embarrassing position, I told him he would be OK. That I would not leave him, but I hope he understood it would be from a place as close to the earth as I could get (I can’t tell you how good the cold floor felt).
It was a funny picture as nurses and doctors passed by. Me on the floor reassuring someone who had actually had the thing happen to them, but my feelings were strong for my nearest and dearest and it had been a long road of worry to get to this place.
I don’t think the picture I have just painted is far off how health and care workers sometimes feel emotionally (or maybe sometimes physically!). Inside you can be near to the ground working to support someone else when exhausted and hurting supporting them through difficult circumstances.
I have spoken with numerous care workers on inspection who’s tears and stories tell this tale. I feel sad when a staff member tells me ‘they shouldn’t feel like this’.
However well-trained, health and care workers deal and view people in the most vulnerable of situations, often at the end of life with people often they have come to have a long standing relationship. We are all different, and whatever our reaction, we all need help to better manage and support our wellbeing, to continue to support people with kindness, care and in a professional manner.
Public Health England records show that over 100,000 people die in care homes each year in England which equates to almost a quarter of deaths. As population age increases and more people live longer inevitably more interventions and care will be necessary.
Work-related stress, anxiety and depression estimated figures from the Health and Safety Executive for 2016 are summarised on their website and make interesting reading including;
- The total number of cases of work-related stress, depression or anxiety in 2015/16 was 488,000 cases, a prevalence rate of 1510 per 100,000 workers
- The total number of working days lost due to this condition in 2015/16 was 11.7 million days. This equated to an average of 23.9 days lost per case. Working days lost per worker showed a generally downward trend up to around 2009/10; since then the rate has been broadly flat
- In 2015/16 stress accounted for 37% of all work-related ill health cases and 45% of all working days lost due to ill health
- Stress is more prevalent in public service industries, such as education; health and social care; and public administration and defence
Where is the research for Care workers?
There is little research that has taken place regarding care workers’ need for support – but there is no doubt in my mind that this is necessary.
I find it strange that most information and articles talk of support for workers after bereavement. I believe continued support through difficult times is essential.
Top tips for supporting workers
Ensure Induction touches on difficult situations and loss, where to go for help and acting sensitively. It may be taken for granted, but it is good to ensure this is covered from the outset – there are appropriate times to let out how we feel away from situations. It isn’t always possible, but training and support can help. The Social Care Institute for Excellence has a great short video which is a useful resource here.
Dedicate space within team meetings to allow people to express how they are feeling about situations. Although this is helpful in 1-1s and sometimes requires confidentiality – peer support is also a healing process. Information on effective supervision can be found here at SCIE.
Hold a memorial day for those that have died – allowing both families and carers to reflect. Avery HealthCare have an annual memorial and they have posted a short video – which I have sat listening to with a tear in my eye. I love what they have done with wooden hearts with the names of people who have passed on.
Dedicate a Senior Manager as champion with the right training and skills to pastorally care for staff. This can be a form of matrix management where those that direct the work are not the same person who would listen to pastoral problems.
Signpost individuals to voluntary services who specialise in having a listening ear. The recent highlighting of Mental Health issues is important to explore when choosing services to signpost to.
Incorporate a workplace counselling service. The Royal College of Nursing recognise this need as a professional body and dedicate resource to work placed counselling. They produce a very informative report found here on their work.
Debrief: Find workers out and allow them to debrief after a difficult situation. This should not be forced. Debriefing can often highlight where people need additional support and early referral to an appropriate service or to the GP.
Create a feelings box: This can be anonymised, but a place that staff can write and post a note to say how they feel or to simply express a message to someone who has passed on.
Create a physical place for people to go – such as a thinking tree or flower garden.
Don’t forget those indirectly involved: As a care coordinator, cleaner or member of the reception team, you will also experience and see things that are distressing. Ensure that support is offered to all.
So hats off to every one of you and a very big thank you. You are often dealing daily with things some may only deal with a handful of times in their life. Have a look with fresh eyes at how you and your team are supported so you can support standing strong, rather than from the floor!