Dr Marie Lewis is the Associate Director for Research and Professional Development at Wallsall Healthcare NHS Trust.
Marie's blog talks about introducing a 'wobble room' to support staff wellbeing during Covid-19.
Follow Marie on Twitter - @marielewis1975
Eighteen months ago, something happened- I had a ‘wobble’
I have lived and breathed the NHS since I was 18 and have enjoyed a fantastic 27-year career. I started out as a Midwife, passionate about supporting women to achieve the birth they wanted, went on to support development of Midwifery staff as a Practice Development Midwife and completed last year a strategic role as A Consultant Midwife. I had a love for research and innovation and tried to inspire others to think outside the box and develop new ideas. During my career in Midwifery I enjoyed a fast pace, gave 110% to ensuring that the care we provided was up-to-date and based on sound evidence. I had achieved many things, travelled far and wide and have been well rewarded and valued within my respective roles. I had a fantastic network of peer support and links to many professional groups worldwide. You could say I had the perfect job, the perfect career and was privileged to be part of such an amazing institution that was the NHS.
The pressure to perform at a high level everyday was eating away at me day and night – I had a wobble.
The frustration that I was not doing enough, I wasn’t being enough and that I could fail was taking away my sleep, eliminating my ability to laugh, and maybe even making me a little paranoid. I felt it, I knew it but I could not show it. The energy it took to pretend that nothing was wrong and to preform even better to hide my inner wobble was all-consuming. My wobble affected every aspect of my life, my family and in the end was a major contributor to me deciding to leave Midwifery- the profession I had worked so hard to be part of and loved so much.
Twelve months ago I picked myself up and I refocused, evaluated the things that were important and began a new journey to use my skills in a different way within the NHS. As a child, I was encouraged by my parents to be strong, to face your fears and stand tall. So, I hid my ‘wobble’, buried it deep as a sign of weakness and refused to let it come to the surface again.
2020: The year we won’t forget
At the start of this year, Coronavirus was a story on the news, something happening in China, sad but not really going to impact on my world. But, six weeks ago it suddenly became real, the NHS was in a state of emergency and senior staff were using language like ‘going to war’ and ‘call to arms’. There was a call for anyone with a registration to be mobilised to support. My adrenaline kicked in and I have to say I think I enjoyed the buzz, the feeling of urgency and the team comradery. We were united in our desire to help, we needed to work together and we rushed to build our army.
In the excitement and rush, we were not always sensitive to the varying reactions of different staff members, the fears, the lives outside of work.
Within a couple of weeks I was more aware of my own team’s complexities, staff members with vulnerable family lives, chronic conditions normally being managed every day without fuss now had added emphasis. The inner turmoil between personal fear and anxiety versus professional responsibility and guilt about supporting our patients. The cohesiveness of team members who were reacting in a similar way to the ‘call to arms’ and the conflict between groups who were managing their reactions in different ways. Never has it felt more important to me that our trust, values for compassion and respect should be central to our response. Yet I know at ‘that moment’ when urgency is pressing and stress begins to show it has not been easy.
A moment in that first week changed the feel at our trust forever, listening to and watching staff who found themselves caring for their own colleague and the emotions felt by all when the sad news spread that she had passed away from Covid 19. We experienced great sadness, fear, anxiety and anger. Yet the work must go on and it was part of my role to ensure that patients continued to receive care from staff and that staff could put on their belt and braces to keep going. A tear wiped, a virtual hug given.
Staff members told me they were scared, they were worried about taking Covid 19 home, they felt torn between protecting their own loved ones and coming to work.
My own feeling of inadequacies as nothing I did was going to take away the pain the staff were feeling. Which is why it is paramount that we acknowledge and support our staff well-being. The pressure I felt this last few weeks especially within the context of ‘NHS Heroes’ reminded me of my ‘wobble’. I realised that so many of my colleagues at this particular time were likely to be having their own ‘wobble’. Perhaps the key skill for NHS workers was the ability to act like we are doing ok ---but what damage will that do to our recovery when this over.Then I saw a post on Twitter- an idea from another Trust to support staff well-being with a ‘Wobble’ room.
I was inspired by the idea and felt hope that maybe a space for staff, permission that it was ok to wobble, would enable people to work through their emotions.
I hoped that they wouldn’t bury them like I had and that maybe we could support them and they wouldn’t give up on their chosen career when this is all over. I believed that we had the skill and expertise within the NHS to support mental health and wellbeing and it was time to explore how we called those people and sought their help. But I also believed that a space like that could be multipurpose and could allow those who were ‘acting ok’ to take a break, to enjoy some quiet reflection to appreciate how they might grow from this extraordinary experience. I also was spurred on by the ‘Get Britain talking’ campaign and how the rooms could provide an avenue for sharing experience and emotions.
Setting up a ‘Wobble’ room
To provide a safe space for staff who need time to breath: A safe ‘haven’ or #wobble room is a place to go for a few minutes to share worries, shout out loud, have a little cry, scream, or just sit quietly.
One of the first considerations for us was what we would call it, some staff felt the ‘Wobble’ implied people weren’t coping or that the room could only be used if you were upset. Our palliative care team already had a room set up in community for quiet reflection that they were calling the ‘peace pod’ and someone else had suggested ‘The Haven’. We debated and consulted with staff before settling on ‘The Haven’.
Second consideration was where do you put it? Too close to the wards and people might not use it as it wouldn’t be private, too far away and they wouldn’t go as it was too far. Too small and social distancing would be an issue- too big and it would not feel relaxed enough. So we compromised and developed different spaces for different people and varied usage.
The garden room, small room for individual staff time. Individual reflection available 24/7- self- help resources. This room will just allow staff an opportunity for 5 mins of private reflection and breathing space. Room will be stocked with drinks, snacks, two comfy chairs and a music player with self-help mindfulness tapes. Available 24/7 as and when staff need to access it.
Bay A- Space for small group debrief and team counselling , comfy furniture, drinks, snacks, aromatherapy oils and access to face to face psychology through wellbeing Rota.
Bay B- Space for small groups to reflect, comfy furniture, drinks, snacks, and access to virtual psychology/ mindfulness through digital technology set up in room.
Setting up our ‘Haven rooms’ have embodied another of our Trust values- teamwork. From one idea came a whole team approach to making it happen. We involved senior staff, our Director of Nursing was instrumental, Divisional Directors, Allied Health professionals, nurses, midwives and domestics. Our patient and staff experience team gathered together an army of volunteers to help transform the spaces in just over 24 hours. Our digital transformation and IT colleagues were able to set up the technology in one of the rooms for digital connectivity with our clinical psychology colleagues.
Our team of clinical psychologists joined the initiative and offered several methods of support from a 24/7 telephone support service, face time mindfulness sessions and face to face listening support via Haven room rota.
The emotions cards from NHSE are a good way of staff feeling like they have permission to feel sad, angry or frustrated. We ask people to fill out the card but to then post it in the box [anonymous] we will collect cards daily/ weekly to see how people are feeling and to collect that data for interest when we are reflecting back on all this in a few months’ time. We will make word bubbles from the card to show people how others are feeling and to reiterate that they are not alone in how this feels.
Our rooms have only been open for a week and it’s too early to say how well used they were or if staff found them effective.
From my new role as staffing coordinator [Organising and prioritising staffing and supporting matrons to make staff redeployment decisions] in the Covid 19 staffing hub, I know how it feels to be redeployed to an area that you are unfamiliar. I know about frustrations with how things work or processes that we didn’t have time to perfect before having to ‘run with them’. I also know about anger and frustration that your core role, your job is no longer important right now. I understand about feeling lost as teams are split up to cover different areas and the need to build new teams for the short term ‘call to arms’. I feel for staff who had to find immense bravery to enter areas of high risk care, to show strength in doing tasks that they felt unprepared for. I have watched in awe the teams of students, volunteers and staff groups who have taken a breath and thrown themselves into responding to whatever support the NHS needed. I don’t know if the rooms will work, if people will use them or if it will prevent anyone suffering long term. But to do something is better than to do nothing. There is nothing to lose from trying and it gave me hope. I have also paused to think about our colleagues who were battling with their own situations, home lives, chronic conditions and how we can support them as the ‘wobble’ rooms will not help these unless we can think of a digital ‘wobble’ room.
We have seen and heard many difficult things that will have etched a picture inside our brains that in time may fade but may never be forgotten. We have formed opinions and judged each other for our reactions to an issue that we were not prepared for or really expecting to deal with. Strip away the bureaucracy, the hierarchies and the political/ media hype. We will all have been changed by Covid 19. It is important for our recovery that we understand and learn lessons from this in respect of staff wellbeing.
About the author
Dr Marie Lewis trained as a Midwife in 1993 and was part of one of the first case loading Midwifery projects. Marie moved to Powys Teaching Health Board as a Practice Development Midwife, progressing to become a Consultant Midwife.
Marie completed her PhD in 2015, which started her journey into research, exploding her passion for improving care through developing evidence-based pathways.
She became the Assistant Director for Research, Innovation and Improvement and set up an innovation hub to allow staff to develop their ideas into practice. Marie then moved to Wallsall Healthcare NHS Trust to take up the role of Associate Director for Research and Professional Development. In this role, Marie enjoys using her skills to bring together research and Professional Development into one Faculty to support evidenced-based care.