Leadership in Compassionate Care by dfsiopmhy6


									Leadership in Compassionate Care
      Enhancing patient care by promoting compassionate nursing practice

                                                                    WINTER 2010 PROGRAMME NEWS

          to the fourth edition of our newsletter
Thank you for the positive feedback we have received about recent newsletters.
I’m delighted to see that these have triggered staff to make contact with us to ask
how they can get involved or become the next development site. I hope you enjoy
reading this latest edition - and please keep the feedback coming.                                     Stephen Smith, lead nurse

                                                                                        Moving on
              Update on development sites                                               Liz Harvey was involved with the
                                                                                        Leadership in Compassionate Care
                                                                                        Programme as a staff nurse at Ground
                                                                                        Floor, Ellen’s Glen House – one of
                                                                                        the original Beacon Wards. Liz and
                                                                                        the team worked with the senior
                                                                                        nurse to unpick how they delivered
                                                                                        compassionate care. Liz has moved
                                                                                        on and is now sharing her experiences
                                                                                        with the new staff she works with.
                                                                                        Liz‘s first move was to Findlay House
                                                                                        where she was acting charge nurse. At
  Roslynlee Hospital                                                                    Ground Floor she had witnessed the
                                                                                        benefit to a relative from a method
Examining current practice and            Loanhead as a development site in the
                                                                                        called emotional touchpoints (ET).
implementing initiatives that will        programme and six members of staff
                                                                                        She saw an opportunity to use the
enhance practice to make it more          across the other sites have taken part.
                                                                                        technique with a relative of a patient
compassionate for patients, their
                                          I have seen a noticeable difference           in Findlay House. Liz had not used
families and for staff
                                          in senior staff morale. People are            ET before so asked her former CN,
Working positively with change            showing more pride in the service             Annette Mohadeb, for assistance.
                                          and their part in it. They are more           Together with the patient’s key worker,
A number of major service changes
                                          engaged, taking more ownership                they were able to hear the relative’s
in Midlothian have posed challenges
                                          and focusing more on planning for             story and this proved to be a valuable
for staff at Roslynlee and Loanhead
                                          the future. There seems to be less            exercise for all. The relative said she
Hospitals. These include the move to
                                          of a problem-orientated approach              felt it helped her situation, while the
a new hospital next year, downsizing
                                          and more ‘can do’ attitude. There is          key worker said she immediately got a
and the risk of lowered morale
                                          more talk about what they’d like to           different perspective and was able to
associated with loss of the familiar
                                          achieve; more expression of ideas             take this back to the rest of the team.
and with change.
                                          for improving their ward or team.             There is still work ongoing but the staff
We needed to find a way of really         They seem to come to me less often            at Findlay House are now aware of the
engaging with the people who will         for help to solve problems, as they           benefits of using ET.
be able to help lead us through the       are taking more ownership of their
                                                                                        Liz has moved on to be the charge
change – the ward managers. We            own issues, and dealing with them.
                                                                                        nurse of Willow Suite, Ferryfield House,
need to take staff ‘with us’ and have     I see more evidence of sharing, not
                                                                                        again bringing with her the experience
a collective vision that people feel      only of ideas but also tangible things
                                                                                        she gained from the programme. Liz
they have ownership of and can            like staffing resources, helping each
                                                                                        has been listening to patients, relatives
communicate effectively with others.      other out and trusting each other.
                                                                                        and staff, helping the team as they try
It is not just about change of location
                                          “Having key ward/team managers                to find out if changes are needed. The
but also how we do things, how we
                                          involved in the same programme has            team always strive to give the best care
treat people on a personal level and
                                          helped gel the service, particularly in       they can, so Liz appreciates the way
how we treat each other as staff.
                                          relation to common goals, a common            things are and what works well. She
To be successful, there has to be
                                          language, and shared values. The              feels she is ‘hearing to heal’ – hearing
effective leadership, but values
                                          programme focuses on relationships            people’s stories to help develop a
have to be reflected in the style
                                          and the people who give and receive           partnership in care. Liz is very hopeful
of Leadership. The Leadership in
                                          the service. This has been important as       that in the long term the staff in Willow
Compassionate Care Programme
                                          it has really included the staff and led to   will be just as confident as she is about
was exactly what was required at
                                          them feeling valued and empowered.”           using listening skills in this way.
the right time – it looked like the
kind of programme that may help           Robert Clement, Clinical Nurse Manager
us, so I supported it. We now have        Ferryfield and Ellen’s Glen
Update on undergraduate strand
Embedding the principles of Compassionate Care within the undergraduate curriculum

Working with students in practice
Work on the Beacon Wards                    moment in time and describe why            “I think it was quite useful. In
continues. On 101, the stroke unit at       they feel that way. Using images           university we are encouraged to
the Royal Infirmary, they are now           selected enables students to reflect       reflect. It was interesting to be
focusing on the student experience,         on their experiences and learning.         reflective using different concepts.”
hearing what students have to say           We have found that it is sometimes         “It is anticipated that by using a
about the unit. Placement staff are         easier and more descriptive to             variety of techniques while students
looking at how different techniques         use this method rather than                are with us we will learn and
can meet students’ needs at                 ask questions.                             provide a more flexible approach
different stages of their placement.        The initial focus of this work is at the   to reflection.”
This will enable us to continually          beginning of the students’ placement
evaluate what we do well and what           on the ward, when they have
we could do better. Using emotional         commented on ‘feeling overwhelmed’.
touchpoints creates a balanced way          Staff are keen to understand and
of hearing their experiences.               explore these feelings to try and
We recognise how valuable reflection        help overcome or alleviate them.
is in learning. We are seeking creative     Feedback has been positive,
ways to help students explore. One          including comments from
of the techniques we are testing is         students, such as:
‘men in trees’ – a simple pictorial tool.
                                            “The pictures evoked feelings
This depicts characters with a variety
                                            which might not have come out
of expressions on different levels and
                                            during a traditional reflective
branches of a tree. Students choose
                                            session. I enjoyed using imagery
where they feel they are at that
                                            and found it thought-provoking.”           Billie Morrow, charge nurse

The Robert Fergusson Unit (RFU),            Sessions lasting 45 minutes at the         • On allocation students will be
a Leadership in Compassionate Care          start, middle and end of placements          directed towards the student-
development site, offers student            are structured around processes              portal RFU information page.
nurses from the mental health and           such as imagery, values clarification        Here they will find an accurate
learning disabilities branches unique       and emotional touchpoints to help            overview of RFU and what learning
learning opportunities to work with         students and mentors reflect and             opportunities are available.
patients with brain injuries and            learn from each other. Sharing             • Students will be advised to attend
behavioural rehabilitation needs.           experiences as a group has                   for an informal visit prior to their
                                            proved valuable to gain a better             first shift to meet their mentor and
                                            understanding of each other’s                the ward team. This will provide
                                            expectations and roles. A common             an opportunity to discuss the
                                            theme emerged that events such as            placement, and receive the RFU
                                            aggression, physical interventions,          student induction booklet.
                                            choking and seizures are familiar
                                                                                       • Within the first week of placement,
                                            everyday events to staff but are
                                                                                         time will be allocated with the
                                            not to students. We recognised that
                                                                                         student’s mentor to reflect on how
                                            when students were provided with
                                                                                         they are feeling about their first
                                            timely opportunities to reflect, a
                                                                                         shifts. Tools such as imagery and
Alison Thompson and students on             better understanding of potentially
                                                                                         touchpoints will be used.
Robert Fergusson Unit                       traumatic events was achieved.
                                            Another common theme was the               “The challenge with this work
                                            build-up to placement – specific           is establishing consistency and
Over the last six months, Senior
                                            actions have been identified               sustainability, which by working
Nurse Scott Taylor and Practice
                                            that aim to improve a student’s            directly with mentors, practice
Education Facilitator Alison
                                            experience prior to their first shift:     education facilitators and Edinburgh
Thomson have worked with mentors
                                                                                       Napier, will hopefully be achievable.”
and students to identify how to
get the best out of placements.                                                        Scott Taylor and Alison Thompson
Update on leadership strand
Supporting the development of leadership skills
in Compassionate Care in NHS Lothian
Working for accreditation through           like to see, it’s given them a sense of      Support is important; the ward
the leadership strand                       ownership. If they see it can improve        team have been very supportive
I’ve enjoyed being a part of the            care and cut down paperwork, they            of all the changes we have made.
leadership course. The content is easy      are willing to try new ideas.                The leadership team and my senior
to understand and put across in a           “I have started my degree twice              managers have been very supportive.
way that enables me to relate to work       before and never finished it. This           The opportunity to share issues with
and my everyday life. It has given me       time I have already done the work as         my colleagues on the course has been
a new perspective on my role as a           part of this course so for a little extra    valuable. I know I am not alone in
charge nurse and how I can influence        effort I can work towards my degree.         the issues my staff and I face.
my staff.                                   I can also see the relevance to my
                                            work area. I feel very motivated and
I feel a renewed enthusiasm for
                                            excited. I think it’s great that I can fit
nursing. Like many nurses, I felt
                                            my work achievements into a module
bogged down with some changes
                                            and get accredited for it.
implemented in the NHS. Sometimes
I have found it hard to see the benefit     Looking to the future I see a
to patient care and staff. I now feel       challenge of keeping the motivation
the balance has moved and we are            and enthusiasm going when the
making changes for a better ward            course finishes, but I have been
environment for everyone.                   proud of the staff’s attitude towards
                                            change and how little I had to do
There have been challenges, such as
                                            for them to embrace it.                      Suzanne Walker, charge nurse,
enabling staff to move with you but
by asking about changes they would                                                       Roslynlee Hospital.

Update on newly-qualified practitioner (NQP) strand
Supporting newly qualified nurses during their first year in practice to facilitate      groups and individual interviews held
the transition from student to competent and compassionate staff nurse                   each NQ study day. Staff who attend
Study day summary                           of the day each participant had useful       are given information about the
                                            material from the workshop and               study and volunteer to participate.
Around 40 practitioners attended
                                            afternoon group work to add to               The aim is to discuss the support for
our August study day which started
                                            their Flying Start portfolio.                NQ staff nurses in practice, whether
with Mike Sabin’s inspirational
                                                                                         this meets their needs and to explore
account of his personal and                 What participants said about the day:        their perceptions of the meaning of
professional journey to his present
                                             “I‘ve really enjoyed my day. What           ‘compassionate care’.
post as a nursing officer at the
Scottish Government. Using                  it has done for me is give me the            Analysis of the data so far indicates
insightful anecdotes from his               chance to renew some contact                 that many RNs immediate post-
experiences in clinical nursing             with fellow new starts and share             registration experience is ‘being flung
and education he shared some                experiences which I think is one of          in at the deep end’ and that support
of the joys and challenges he has           the most important things if you             from colleagues is variable, depending
faced along the way. Lead Project           have that sinking feeling. It’s good         on ‘the luck of the draw’ rather than
Nurse Stephen Smith led a creative          to share it with others who are              planned and embedded within the
workshop that helped participants           going through situations and may             NHS culture. Some participants
think about sources of pride and            be in similar boats but to get a good        recognise that their NQ experience
challenges they face when focusing          awareness of improving your coping           made them realise how much support
on caring, compassion and dignity           and to offer ways of dealing with            they received whilst students,
in their workplace.                         new situations to others.”                   compared with that available to
                                            Evaluating the Newly Qualified               them following registration.
After lunch there was a presentation
by Belinda Dewar and Richard Mackay         (NQ) Strand                                  A theme that has arisen is that, in
about how they have helped ward             As part of the Leadership in                 order for activities to be labelled as
staff discuss their experiences of          Compassionate Care Programme                 ‘caring’, compassion is a prerequisite.
caring in practice. The final part of the   an evaluation of all project strands         It involves active acknowledgement of
day focused on the NES Flying Start         is being undertaken. There is little         patients as unique individuals but is
Programme with several activities and       research about the experiences of            complex to deliver due to competing
group discussion designed to build          newly-qualified staff nurses and a           commitments and sometimes the
self-confidence in newly qualified          study exploring their perspectives           negative attitudes of other staff and
healthcare professionals. By the end        is being carried out through focus           patients. Compassion is not seen
as confined to the nurse/patient                     volunteers as possible to participate.         Future dates of NQP at
relationship but should be evident                   If you’re interested in finding out            Craighouse Campus:
in interactions between staff and                    more, please contact Dorothy
between patients.                                    Horsburgh (d.horsburgh@napier.                     Thursday 1 April 2010
                                                     ac.uk) or Janis Moody (j.moody@                    Thursday 5 August 2010
“Focus groups and individual
                                                     napier.ac.uk) who will be happy to
interviews with newly-qualified                                                                         Thursday 7 October 2010
                                                     provide further information.”
staff will continue for the duration
of the LCC Project. To ensure that                   Janis Moody, Lecturer.                             Thursday 9 December 2010
their experiences inform practice                    d.horsburgh@napier.ac.uk
development, we need as many                         j.moody@napier.ac.uk

                                                     in October to see what had been                Nursing time conference
News in brief                                        developing in the programme. On                Simon Pullin and Ria Tocher
International conference                             visits to two of the development               presented work at a dignity and
on Compassionate Care                                sites, Loanhead and the combined               compassion conference in London in
The conference will be held at                       assessment area, they met patients,            September. The presentation worked
Edinburgh Napier University on                       staff, participants in the leadership          with a relative’s experience to debate
9 – 11 June 2010. Register now                       strand and student nurses. Dr                  the complexities and challenges
for this inaugural conference at:                    Gloag and Professor Dame Stringer              in delivering compassionate care.
                                                     said they were impressed with                  It generated interest from other
www.napier.ac.uk/ICC                                 the confidence participants had                participants about the programme.
                                                     delivering compassionate care.
Robin Youngson
On 11 September 2009 staff from                      NMC visit
NHS Lothian and Edinburgh Napier                     During their visit to Scotland on the
University had the opportunity to                    4 November 2009, the new Nursing
hear and discuss issues around                       and Midwifery Council came to visit
compassion and caring with Robin                     Ward 50 at the Western General
Youngson. Robin, from New Zealand,                   Hospital, one of the Compassionate
is the founder of the website                        Care Programme’s original Beacon
Compassion in Healthcare which                       Wards. They heard about the ward
hosts links, forums and stories                      team’s efforts to understand what
around compassion:                                   compassionate care looks like, in
www.compassioninhealthcare.org                       the form of stories from patients,
                                                     families and staff. They were very
Congratulations                                      impressed with the positive care               Melanie Hornet, Executive Director
Many congratulations to Liz                          practice statements shown on a                 of Nursing, NHS Lothian
Adamson, Linda King, Janis Moody                     digital photo frame and how this
and Anne Waugh for the publication                   is used to reinforce how Ward 50
of their article on the origins and                  deliver compassionate care.
overview of the Leadership in                                                                                Missed any
                                                     New member of the team
Compassionate Care programme.                                                                             previous editions?
                                                                                                                                             Designed by Corporate Affairs. Ref. 1279. Edinburgh Napier University is a registered Scottish charity. Reg. No. SC018373.
The article appeared in Nursing                      Jenny Kalorkoti, charge nurse from
Times on 4 September 2009.                           Ward 4 at the Western General
                                                     Hospital has been appointed as the                       Download them at:
Dr Anne Gloag’s Visit                                fifth senior nurse for the programme.
Dr Anne Gloag and Professor                          Jenny will focus on working with                     www.napier.ac.uk/
Dame Joan K Stringer, Principal of                   staff in the department of clinical
Edinburgh Napier University, met                     neurology at the Western General.
Director of Nursing Melanie Hornett                  Welcome Jenny.

                             Tell us about your experiences or stories
      If you would like to comment on any work related to this programme, please contact one of the team:
    Stephen Smith             Belinda Dewar                   Scott Taylor            Ria Tocher                    Simon Pullin
    ste.smith@napier.ac.uk    b.dewar@napier.ac.uk            s.taylor@napier.ac.uk   r.tocher@napier.ac.uk         s.pullin@napier.ac.uk

    The Compassionate Care programme is a joint venture between Edinburgh Napier University and NHS Lothian

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