#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!

• 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

On-line learning and resources

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Equality and Diversity

Everyone matters

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Information Governance

Conventional Hospital

Nightingale Hospital

Infection Prevention

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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

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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

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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

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Hand Hygiene

• Immediately before touching a

patient

• Before a clean/aseptic procedure
• Immediately after touching patient
• r their surroundings
• After removing gloves

Alcohol gel is effective against COVID-19 Soap and water should be used if hand are soiled

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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

Risk Areas Green, Amber, Red

• Green = no PPE needed. Continue

usual respiratory hygiene and Social Distancing

• Amber = gloves and surgical masks
• Red = full PPE

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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

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Remember!

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

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Staff with COVID-19

• If you develop symptoms of a flu-like illness

then DO NOT come into work:

– Acute onset fever >37.8oC and/or new persistent cough

• Inform your manager
• Self-isolate at home for 7 days from onset
• f symptoms

– If your symptoms worsen contact NHS 111

– Other household members of self isolate for 14 days

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.

Confirmed fire in a Hall

Fire:

• Raise the alarm
• can it be extinguished with no evacuation
• Smoke spread – move patients away from fire to other parts of the hall
• Smoke affecting staff – staff evacuate leave oxygen running and patients

defended in place

• Fire and Rescue Service will take over fire fighting and rescue operations

Oxygen Safety

• Oxygen enriched atmospheres make it

easier for a fire to start

• Oxygen alarms are present to warn if
• xygen levels reach high concentrations
• There is a small risk of combustion when
• xygen comes into contact with paraffin
• Paraffin based hand creams, lotions and

petroleum jelly must NOT be used

• Water based products should be used to

treat nasal dryness, chafing, & skin irritation associated with oxygen therapy

Summary

• Aim to do the most for the most
• Think fire prevention
• In the event of a fire raise the alarm

Evacuation is last resort

• Try to extinguish the fire before to

negate need to evacuate

Thank you #TeamNightingale