Carol was just about to go home after finishing her shift when she became aware of a safety incident that had happened in theatre.
蜜桃直播淭he doctor involved was in distress and I just wanted to make sure she was alright. But I didn蜜桃直播檛 have the right or permission to approach her. I couldn蜜桃直播檛 sleep that night. I was so worried about her,蜜桃直播� Carol recalls.
The next morning Carol spoke to the matron about her concerns. The incident had made her think about how important it is for all staff to have quick access to timely support when these incidents happen.
She also found herself reflecting on an error she蜜桃直播檇 made in theatre a few years back when she蜜桃直播檇 accidently passed an unsterilised k-wire to a surgeon, who then drilled it into the patient蜜桃直播檚 bone.
蜜桃直播淎t the time, my very first response was to think that I could get away with it if I didn蜜桃直播檛 say anything,蜜桃直播� she says.
蜜桃直播淚 was panicking of course, and I very quickly came to my senses and raised the issue. But I know that feeling of complete fear. I couldn蜜桃直播檛 help but wonder 蜜桃直播� if I蜜桃直播檇 been working with a difficult surgeon or had an unsupportive matron, would I have owned up?蜜桃直播�
Carol knew she had to do something.
Staff need to know that making a mistake doesn蜜桃直播檛 make them a bad person or an incompetent professional
蜜桃直播淪taff need to know that making a mistake doesn蜜桃直播檛 make them a bad person or an incompetent professional. We蜜桃直播檙e all human and until you蜜桃直播檙e in that situation, you don蜜桃直播檛 know how you蜜桃直播檒l react. However aware you are of your duty to speak up, this doesn蜜桃直播檛 stop you from feeling afraid,蜜桃直播� she says.
蜜桃直播淚f someone doesn蜜桃直播檛 own up to a mistake immediately, it doesn蜜桃直播檛 automatically make them a bad nurse, midwife, HCA or doctor. It might just be that their overriding emotion is that of fear and they蜜桃直播檙e panicking.
蜜桃直播淭hat蜜桃直播檚 why we need safe spaces, peer support and an open and honest culture. To get these in place at work, I needed to get organised.蜜桃直播�
Supporting staff
Gathering local support was essential, so Carol gave a presentation to her department outlining the importance of getting quick help to staff involved in safety incidents.
Before long other managers asked her to present to their teams. She also shared her thoughts on the Royal Free London’s staff intranet and people started to pay attention.
To take things further Carol knew she needed evidence to back-up her case, so she wrote to the , a charity that focuses on the prevention of suicide and the mental wellbeing of doctors in England and Wales, and shared her ideas with them.
She was delighted when they offered £500 to provide furniture for a staff safe space, a place for staff to go to when they needed a safe psychological space to sit comfortably and feel supported.
“Their endorsement of my ideas was as important as the money,” Carol says. “I approached the Royal Free Charity to handle the donation and they were so impressed that they funded three more safe spaces across the trust."
I had to break the mould by proactively offering help
At this stage Carol sought further advice, writing to national and global experts on the issue, to share her thinking.
“It’s important to get expert support for your ideas and if it turns out you’re wrong, you’ll learn from it,” Carol explains.
Although things were going well and Carol’s confidence was growing, she was still concerned that people wouldn’t use the new spaces. She put a counting box in each safe space and found that more than 50 people were using them every week.
“I then knew this was an important resource to enable staff to step aside and unwind and that I had to break the mould by proactively offering help,” she says. “We work in a kaleidoscope of systems – just one small movement and we can be confronted with a very different picture.”
Building a team
Four years on and Carol蜜桃直播檚 work has gone from strength to strength. The trust蜜桃直播檚 charity has provided advice and support for buying equipment while also paying the salaries for two posts that specifically support staff involved in safety incidents.
Carol is the SISOS (Safety Incident Supporting Our Staff) lead nurse in one of these posts. To support the people involved in adverse advents, she uses three levels of support:
- Listeners 蜜桃直播� who have awareness training and signpost people to SISOS
- Key listeners 蜜桃直播� who are trained to give peer support and signpost to the third level of professional support. Patient safety and clinical governance teams work alongside key listeners to support staff on this level
- Professional support 蜜桃直播� such as occupational health, chaplaincy, psychological support and the employee assistance programme, with access to the organisation蜜桃直播檚 legal support teams.
Carol, who蜜桃直播檚 also a mental health first aider, has been instrumental in making changes to the organisational culture, building staff resilience, managing a staff helpline, providing peer-to-peer support and helping staff access urgent help if needed.
Having established a support hub in her hospital, she蜜桃直播檚 now looking to replicate the set-up across the trust, so part of her role also involves spreading the word about what support is available 蜜桃直播� presenting at inductions, staff wellbeing days, sharing posters, developing badges and lanyards for listeners and key listeners, so they蜜桃直播檙e easily recognisable and people feel confident to approach them.
And all staff in the trust are encouraged to use the service. 蜜桃直播淎dministration staff, for example, may seek support if they key-in data incorrectly, or there蜜桃直播檚 a breach of confidentiality. They get every bit as distressed,蜜桃直播� Carol says.
Using local knowledge
Carol found that using local knowledge and contacts is the best way of organising and making things happen. She explains:
蜜桃直播淏y involving staff, what you come up with is rooted in reality and can be cheaper. It also helps to build trust so people are more likely to use the service, which they might not if it蜜桃直播檚 just imposed on them.
蜜桃直播淪ome staff feel ashamed if they蜜桃直播檙e involved in a safety incident 蜜桃直播� they don蜜桃直播檛 want people to know so it helps if they know and trust the people who will provide the emotional support. And by talking about the situation from induction onwards, it helps normalise things.
Some staff feel ashamed if they蜜桃直播檙e involved in a safety incident
蜜桃直播淲e share the message that these things can happen and I蜜桃直播檓 happy to talk about my own experiences.蜜桃直播�
The benefits for the trust, staff and patients are clear to see. Patients and staff feel more comfortable about opening up about sensitive issues to 蜜桃直播渓isteners蜜桃直播�, who are easily identified as they wear badges. The number of safety incidents is being reduced too, with a focus on a learning, rather than a blaming, culture.
Sickness levels have also been reduced as staff now feel more supported to take time out if they need to and importantly, they have a safe place to go.
Carol蜜桃直播檚 next goal is to raise public awareness about the issue so a more understanding culture can benefit everyone. 蜜桃直播淚 want to go national, and then I蜜桃直播檒l retire,蜜桃直播� she says.
Carol’s tips
Carol is a keen advocate for local organising.
“I’m one nurse who has shown that by being innovative you can bring about change from the ground up, for the benefit of everyone, including patients,” she says.
“Be courageous and don’t be put off by challenges. Write business cases, write letters to trust executives, show up at meetings and seek support from local staff.
“I wouldn’t want anyone to think that it’s going to be easy. It’s not. But it is possible if you have a genuine belief in what you’re setting out to achieve.”
With her organising experience behind her, what advice does Carol have for RCN members?
- Be patient. Sometimes getting results can take a long time.
- Be realistic. An organised approach that’s rooted in reality is more likely to succeed.
- Get evidence. Don’t be afraid to approach experts for advice.
- Don’t get disheartened. If you get something wrong, learn from it and keep going forward.
- Be local. Use your local contacts and knowledge.
- Get staff support. People respect what they’ve worked to get.
- Use resources available to you. Carol used the RCN Library where staff helped her with downloading the evidence she needed.
Want to organise for change?
Carol attended the London Organising for Power course where she realised that she is already an organiser.
We’re on a mission to train thousands of RCN members to develop their organising skills to help them fight for whatever issues matter to them, including fair pay.
