#TeamNightingale Staff wellbeing and psychological support Dr - PowerPoint PPT Presentation

Welcome #TeamNightingale

Staff wellbeing and psychological support Dr Peter Trigwell Mental Health and Psychological Care Lead Nightingale Hospital – Y&H

Setting up a hospital • Building • Facilities • Army… • Equipment • Processes • Staff

Staff are the most important thing • You provide the clinical and other services • You deliver treatment and care for the patients • We need you to be able to keep on doing it…

The plan • Up to 500 beds • Large clinical areas • Staff in full PPE • Long shifts (2 x 1hr breaks) • Unfamiliar team / team structure / staff:patient ratios • Difficult decisions

The plan • All patients arrive unconscious and ventilated • Stay that way through most of their admission • Extubated (tube out) / conscious for up to 24hours pre-discharge • Clinical outcomes: 1. Patient survives / return to their local general hospital 2. Patient doesn’t survive

The plan • Confused and frightened • Large bright environment • Everyone in full PPE • Difficult to see faces or hear people easily • Alone / no relatives

The experience… • Challenging • Practical difficulties • Emotional pressures • On the “front line” • Need to be able to stay, and do what you do

Stress (and what we want to avoid…) • Short-term: – Emotional distress – Poor performance • Longer-term: – Burnout (exhaustion, depersonalisation, reduced efficacy) – Post-traumatic stress

In setting up the Nightingale Hospital there is nothing more important than the psychological support and wellbeing of the staff…

What do we need…? • A culture of psychological support • At all levels / across all areas • Everyone knowing about it…

What needs to happen…? 1. Environment and space 2. Team structure and behaviours 3. Individual actions (what do you need to do?) 4. Psychological support system (NWT)

Environment and space 1. Team space to assemble (hotel reception areas) 2. Clinical “step - out spaces”… 3. Wellbeing hub… 4. Wellbeing support rooms 5. Rest areas - canteen / lounge for breaks

Team structure and behaviours • Pre-shift assembly and briefings • Open and honest about the challenge • Clarity of roles / check understanding • Clear leadership • Modelling the right behaviours

Team structure and behaviours • Pairing up (“buddies” / senior -junior) • Supporting and looking out for each other • Encourage staff to voice concerns • Consider team feedback post-shift • Act on feedback - if it can’t be done, explain why

Team structure and behaviours • Encourage colleagues to talk • Use psychological support • Remove barriers / no stigma • Nipping it in the bud…

Individual actions • What do you need to do…? • Look after yourselves: – Rest and sleep – Food and exercise – Contact with family and friends – Engage in activities that distract – Time away from social media / news

Individual actions • What do you need to do…? • Look after yourselves: – Take breaks (everyone!) – Share concerns – Talk to your team, leaders, managers – Support each other – Use the psychological support system

Nightingale Wellbeing Team • Skilled clinical professionals • Sole purpose is to support all of you • Around before and after shifts • In hotel team assembly and wellbeing hub areas • Around during all team breaks…

Nightingale Wellbeing Team • Talk to / chat / informal conversation • Advice / techniques: – Individual coping – Peer support – Social support • Signposting to self- help resources / online portal / Apps…

Nightingale Wellbeing Team • A bit more help: – Time to talk (wellbeing support rooms) – Thinking about options – Assessing needs • Easy access to more psychological support

Psychological support options • Clinical psychology team – Expert in supporting clinical teams – Remote access options… – Face to face appointments – Wellbeing support rooms (or local?) – Helping you cope well / helping you ‘return to duty’

Psychological support options • Occupational Health • Primary Care • Other healthcare services • Chaplaincy

After working at the NH(Y&H) • No “psychological debriefing” • Most people won’t need anything else • “Active monitoring” system • Identifying all specialist services across the region • Prioritising Nightingale Hospital staff

For now… Nightingale Wellbeing Team • We’re part of the set -up • We’re here to talk to, to listen, and to help • Talk to us early… talk to us now… • Don’t forget… nipping it in the bud!

On-line learning and resources • To support your learning before you join us at the Nightingale Hospital please log on to our Online Induction Programme. • This is available on our Nightingale microsite https://www.leedsth.nhs.uk/nightingale-staff which is regularly being updated with new information

Equality and Diversity Everyone matters 31 |

Information Governance 32 |

Infection Prevention Nightingale Hospital Conventional Hospital

Infection Prevention and Control Coronavirus (COVID-19) • Coronaviruses are a large family of viruses - they cause infections ranging from the common cold to Severe Acute Respiratory Syndrome (SARS) • Coronaviruses circulate between animals and humans; sometimes new variants of the coronavirus emerge - such as COVID-19 • COVID-19 has the ability to spread widely as lack of immunity means everyone in the population is susceptible 34 |

How is COVID-19 transmitted?  Exposure to respiratory droplets  Coughing/sneezing droplets onto mucous membranes  Mouth, nose, eyes  Close contact required for this to occur (within 2m)  Contact with respiratory secretions  Directly or via contaminated surfaces  Tissues contaminated with respiratory secretions  Transferred by touching mucous membranes Social distancing – stay 2 metres apart Decontaminate hands frequently 35 |

Standard Precautions • Essential to minimize risk of transmission between staff • Will reduce the risk of transmission of healthcare associated to patients  Hand hygiene  Protective clothing for contact with body fluid  Safe disposal of waste  Clean equipment & environment 36 |

Hand Hygiene • Immediately before touching a patient • Before a clean/aseptic procedure • Immediately after touching patient or their surroundings • After removing gloves Alcohol gel is effective against COVID-19 Soap and water should be used if hand are soiled 37 |

Cleaning, waste & laundry • Cleaning – Wear appropriate level of protective clothing  Detergent & water followed by disinfectant  Chlorine at 1000ppm effective – Body fluid spills - as usual local policy • Waste - discard as clinical waste • Laundry - as infected laundry 38 |

Risk Areas Green, Amber, Red • Green = no PPE needed. Continue usual respiratory hygiene and Social Distancing • Amber = gloves and surgical masks • Red = full PPE

Removal of protective clothing (Doffing)  Discard mask when moist or damaged  Remove PPE in this order: 1. Gloves (then decontaminate hands) 2. Apron/gown (avoid touching contaminated front surface) 3. Eye protection (then decontaminate hands) 4. Mask  Decontaminate hands after all PPE has been removed 40 |

Remember! Don ’ t touch your mouth, nose or eyes. Decontaminate your hands thoroughly on leaving the doffing area 41 |

Staff with COVID-19 • If you develop symptoms of a flu-like illness then DO NOT come into work: – Acute onset fever >37.8 o C and/or new persistent cough • Inform your manager • Self-isolate at home for 7 days from onset of symptoms – If your symptoms worsen contact NHS 111 – Other household members of self isolate for 14 days 42 |

Fire Safety Induction If you have any questions contact fire.info@nhs.net

Action in the Event of Fire Raise the Alarm, Pass on information Contain, Evacuation, Attempt to Fight the Fire.

Red and Green Areas Investigating Fire Alarms Green Areas • Normal procedure for HCC fire investigation - by HCC staff, BAM FM and Showsec • Update messages provided via Tannoy System to keep staff informed Red Areas • Dedicated number will be given to staff to ring if they can confirm reason for activation – i.e. false alarm or fire • If cause cannot be readily identified Clinical staff and BAM FM will investigate the cause • Update messages provided via Tannoy System to keep staff informed

Fire Safety Fire Alarm Activates: The primary consideration is only evacuate patients as a last resort. The concept of defend in place is to be used. Patients are on oxygen and will survive longer in smoke than those without. Staff will need to consider withdrawing efforts on evacuation as they will be at greater risk.