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Leading at a time of crisis such as Covid-19 is challenging. Running your services to respond to the needs of people under your care, and looking after your teams and staff while maintaining your own resilience adds layers of extra responsibility. We would like to support you with some tools.
These tools will also help you and your team members recognise what they are achieving. During your conversations, please take the opportunity to celebrate with staff the successes in these uncertain times linked to their own values, and the work of the team.
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.
Once you recognise signs of stress, you can take steps to deal with it.
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.
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?”
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.
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.
Leading a team and providing care consistent with values
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 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.
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.
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.
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 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.
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
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.
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.