In September last year, we wrote about burnout in the physiotherapy workforce
This is familiar to many physiotherapists due to the increasing demands on healthcare services and an instinct to ‘do it all’. Add in a pandemic, and levels of fatigue, exhaustion and emotional fragility amongst members are understandably high.
Members tell us that levels of anxiety and stress have significantly increased during the Covid pandemic and it is clear that people will experience different emotions at different times.
It is more important than ever to support each other at work by developing strategies to manage our mental wellbeing both in the short and long term. As the demands on physiotherapy services continue, it is important to consider sustainable supportive strategies.
We asked some of our members to share their stories on how they have developed innovative ways to support staff in the workplace.
Strategies within the armed forces
Lieutenant Colonel Sandra Williams, a physiotherapist with a background in critical care, is the senior staff officer for health improvement in the British Army. Crisis situation or not, mental resilience is a key part of the army’s ongoing health and wellbeing plan.
Sandra likens aspects of working through the pandemic to being on the frontline whilst deployed for sustained periods.
‘It is a marathon not a sprint and you’re doing no one a favour if you’re the casualty. Give yourself permission to step back and put structure in place where you can get rest, stay healthy and get sleep. It is important that we get out of crisis mode and think how we can sustain this way of working for the duration of the pandemic.’
In the army, peer-to-peer support is used to teach mental resilience. Junior soldiers are trained to deliver mental resilience advice to their counterparts and to convey the ethos of looking out for one another. ‘We can all learn to spot the warning signs in others and by accepting that it is normal to struggle during difficult times we will be more open to talking about it and to develop mental resilience skills.’ Several easily accessible resources are recommended by the army’s health and wellbeing plan and Sandra believes they are also useful for the wider physiotherapy workforce (see references).
Innovation in Manchester
Justine Theaker, consultant AHP at Manchester University NHS Trust, says: ‘Health care professionals are good at caring for others but not so good at looking after ourselves.’ Involved in the response to the Manchester bombings and setting up Nightingale north west, Justine and her colleagues implemented simple but effective strategies to help with mental resilience. ‘A gratitude board allowed staff to write messages around kindness and gratitude, alongside the opportunity to say what matters to them. They wrote requests on post-it notes which allowed staff to be heard and meant leaders could take these requests on board.’
Anonymous daily diaries written by staff were reviewed weekly to establish what changes could be made to improve wellbeing. This influenced many processes involving staff and kept them central to the running of the service. A ‘wobble’ room provided a quiet space for reflection, however Justine mentions ‘staff would not be disturbed unless they wanted to have someone with them.’ This idea can be adapted to suit any team and their space or environment.
Chloe Kitto, specialist OT and wellbeing lead at the Royal National Orthopaedic Hospital, and her team introduced the concept of psychological PPE at the Nightingale London. ‘PPE protects us from the viral risk in our workplace but psychological PPE is about looking at how we can protect ourselves from the psychological risk.’ As part of their induction, staff were supported to reflect on their own self-care strategies, recognise their stress responses early and adapt their wellbeing needs during times of change. Chloe says ‘This allowed new teams to talk openly about these issues from the start, get to know each other’s stress responses and share strategies for management.’ Such a relatable analogy means the idea of psychological PPE has already extended beyond the pandemic. More widely applicable training is being delivered to healthcare staff, and those in other sectors. Chloe and her team hope their work will help to change the culture of wellbeing and ‘build the workforce back better’ post-Covid by encouraging us all to talk about these issues even in the absence of access to formal training.
Rebecca Gow, and her OT colleagues in the community independence service in Kensington and Chelsea, set up a ‘Balint’ group for staff working independently in the community. The isolating nature of community work means there is no outlet
to discuss and reflect openly on feelings around patient interactions, so therapists often ‘take their feelings home.’ This is associated with the increased risk of burnout. Hour-long sessions every fortnight provide a safe space for clinicians to debrief and support each other. The team have made a video about their work which can be seen at vimeo.com/488489419
There is no right way to approach burnout and mental resilience in the workplace. There is, however, an opportunity to plan long-term and create an organisational culture where wellbeing and coping strategies are a standard support feature.
For further reading and resources;
The CSP’s Professional Advice Service gives advice and support to members on complex and specialist enquiries about physiotherapy practice, including professional practice issues, standards, values and behaviours, international working, service design and commissioning, and policy in practice. Find out more
- Rachael Wadlow and Julie Blackburn are CSP professional advisers
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