Managers' toolkit

The 4 Pillars model is part of a wellbeing plan designed for people, with prevention in mind. When put into place as part of your daily plans, they will help you minimise any build-up of emotional distress and anxiety. The pillars help you to consider the different wellbeing factors that you need to be aware of and manage in a way that helps you.

Click on each Pillar's title in the table below to find a wealth of information. Or download our 4 Pillars pdf.

A weekly checklist (such as this one from Anxiety Gone) can help you to sense-check your daily routine, reflect on how you are and help you consider which of the different wellbeing elements you are practising from the 4 Pillar model.

One of the 4 Pillars is to understand more about COVID, this questionnaire helps managers work with their staff, to better understand if anything is currently worrying people, either at work or at home. This can be used to provide the right support or action to help staff.

This questionnaire has been designed to be used anonymously to help organisations to plan their response and support for this outbreak. Should managers wish to use this to monitor individual staff anxiety levels they should make sure their staff are comfortable with that approach.

When in the middle of busy and challenging times, often it can be hard to stop, take a step back and look at what is going on.

Firstly, to spot the signs that you are under stress, but also look at what you can do about it.

This information gives you a toolkit to sense check how you are feeling now. It also gives you steps to access support, helping you deal with your worries at whatever level you feel you need. Download the 'Dealing with stress' infographic.

Are you experiencing any of these more frequently than usual?

• Always feeling overwhelmed, worried, anxious or scared
• Having racing thoughts or difficulty concentrating
• Having trouble sleeping or feeling tired all the time
• Eating more, or less, than usual
• Feeling irritable or impatient
• Avoiding certain things or people

Once you recognise signs of stress, you can take steps to deal with it.

• It's often helpful to speak to a trusted friend, colleague or your manager.
• Every Mind Matters has lots of tips for dealing with stress.
• Dorset Mind has a range of support services which have been moved online. You can refer yourself to these.
• If you've been affected by a disturbing event, a session of Flash therapy might help. You can book a session for yourself by emailing dhc.ipts@nhs.net.
• For support with mental healthand other issues, you can contact your employee assistance helpline, take a look at your intranet or speak to your HR team.
• If you're struggling to cope with stress, or you've experienced a traumatic event, Steps 2 Wellbeing have psychological therapists and counsellors who can help. You can refer yourself online for support.

In some departments, staff have been redeployed from their home teams.

Team leaders need to consider that new staff could feel dislocated and disconnected from their points of security due to the lack of familiarity with processes, team members and logistics.

They may also feel deskilled due to their lack of familiarity with their new roles.

Equally, services which are being stepped down may still have staff who are retained within their original teams and may face a sense of erosion, a sense of loss and lack of control.

To effectively manage this, team leaders could work with staff and teams to complete this Personal Wellbeing at Work Plan.

The 4 Pillars model is part of a wellbeing plan designed for people, with prevention in mind. When put into place as part of your daily plans, they will help you minimise any build-up of emotional distress and anxiety.

Understanding how staff are truly feeling and encouraging the adoption of self-care practices in your teams is especially important now.

Working with staff in one-to-ones using the discovery questions listed below as a guide can help people reflect on what they are already doing, or how they could help themselves for both work and their own wellbeing.

It also gives an opportunity for staff to voice what support they need from you as their manager.

How are you? What sort of things are you feeling or thinking now?

What are you working on now?

Tell me more about the progress you have made with…….

What learning have you achieved in the last week?

What else do you feel you have you achieved this week?

What activities have contributed towards your goals both personally and professionally?

What things are you doing to create moments of enjoyment in your day or week?

What are you doing for your own health and wellbeing this week?

What sort of things have you built into your daily routine to look after your wellbeing?

What do you need from me?

What other support do you need?

When we're facing difficult times of any sort, reacting from an emotional perspective is inevitable as we respond to challenging situations which may be infused with threat and uncertainty.

As managers, it's really important to check in and then out of meetings at a human level. It means we can gauge the feelings and mood of the team, create space for people to talk about their day if they want to, and make sure people can finish their day in a supported way, knowing their hard work has been genuinely appreciated and acknowledged.

Meeting check-in questions

• What sort of day is everyone having so far?
• What has made you feel proud recently?
• What do you feel has got your attention today that you wish to share?
• What is needed to help you through these challenges?
• In a word, how are you feeling about the day ahead?

Meeting check-out questions

• What are you all taking away from the meeting today?
• How are you all feeling as we finish today?
• What is the next thing you are going to do today?
• What sort of things are you all doing to recharge today?
• Are we all ok for the next meeting? Any final comments?
• Thank you for all your input, it's been very valuable

Download these 'Leading teams in a crisis' tips as a pdf

It’s ok to say you’re not ok

Team leaders can model this to their team. This is an unprecedented crisis, we are all under more stress than usual. Remind yourself and staff that struggling doesn’t mean you aren’t up to the job; it means you’re human.

Don’t be afraid to ask “It’s tough, are you OK?”

Compassionate leadership

Be visible, available and supportive.

Communicate regularly. Model optimism in your communication. Panic and pessimism can be infectious too. During a crisis people look to their leaders for containment and direction.

Beware the superhero cape

Remind self and team - “I do not need to have all of the solutions all the time”. You will need to tolerate and manage uncertainty for yourself and your team.

Connect with Values

Leading a team and providing care consistent with values

Ensure staff’s basic needs are met

Ensure adequate breaks, hydration and nutrition. Give permission for staff to step back when they need it. Make sure staff feel safe at work and are getting adequate sleep when off shift. This may mean allowing staff to not participate in debriefing or supportive exercises where this encroaches on their recovery time, break time or natural way of coping.

Create Supportive Space

Create supportive space for the team to be together. Team cohesion and peer support acts as a buffer against stress and trauma. Existing structures like handover or team huddles are naturalistic opportunities for debriefing.

Consider extending handover to include a chance to debrief or spend a moment practicing mindfulness. The opportunity for staff to talk about and process experience can enhance support and team cohesion.

Wellbeing huddles

These can be a quick and effective way to check on colleagues on the shift, remind them to take a break, hydrate and eat.

Consider setting up a “buddy system” of staff on each shift – giving explicit permission to look out for your buddy. Partner less experienced workers with their more experienced colleagues.

Allow yourself, and others to do something unrelated to work which you find comforting, relaxing or fun, humour is a powerful moderator of stress.

Compassion

Beware of your own inner critic

Your wellbeing is important. Show self-compassion and be to kind to yourself. Practising self-care will show your team that it is important and help them to sustain their ability to care for those in need.

Complement each other

Confidence can be a powerful motivator and stress moderator. In contrast, we know that rudeness increases clinical error.

Although we can all become stressed in this environment we know that civility saves lives. Some staff need to talk while others need to be alone.

Recognise and respect differences in yourself, your patients and your team. Respond to feedback on what is helpful and what is not.

Check in with self

Check-in and monitor yourself over time. Notice any prolonged sadness or difficulty sleeping intrusive memories or hopelessness talk to a peer, supervisor or seek specialist support.

Implement flexible schedules with team members who are struggling directly or as a result of their responsibilities outside of work.

Additional information

We hope you find this guide useful. If you think it is just common sense, you are probably right. Many of these basic supports are the most powerful. However, these are often disrupted or forgotten during a busy shift or a crisis so it is important to maintain a focus on keeping them going.

But remember that hands-on help is at hand: consult with your ward psychologist or the wider inpatient psychology team. We are here to provide support to managers, team leaders and shift coordinators who often end up holding and containing much of the stress for their teams. We can support you and your team to sustain your collective wellbeing.

Our aim is to be proactive and preventative. If we can support you now then we may be able to prevent unnecessary build-up of distress and prevent further issues developing in the future.

However, we can also help you support your staff who are struggling or those who may be more psychologically vulnerable.

We can offer this locally to your team and can also help you and your staff navigate the wider resources available in the Trust. As your psychology team, we will continue to offer this support during the pandemic and when it recedes and the psychological after-effects become

Based on national guidelines

British Psychological Society (2020). The psychological needs of healthcare staff as a result of the Coronavirus outbreak.

Wellbeing resource pack developed by the Intensive Care Society with Dr Julie Highfield, Consultant Clinical Psychologist with the Intensive Care Society and Cardiff Critical Care.

Adapted locally by:

Dr Jon Boakes (Consultant Clinical Psychologist) – Inpatient Rehabilitation Psychology

Mark Draper (Clinical Psychologist) – Acute Inpatient Psychology

Sammie Floyde (Assistant Psychologist) – Acute Inpatient Psychology

The self-care tree is applicable to all staff and gives tips and advice for managing your wellbeing during the COVID-19 pandemic.

The guidance gives a self-care sense check on a page and will help individuals manage stress at work and at home.