When put on the spot, most people will be hard-pressed to name a profession that’s more stressful and as relentlessly pressurised as nursing.
There – as they always are – at the very frontline of patient care, NHS nurses work almost ceaseless hours; often work when they’re ill themselves (59% do, according to a recent poll by the Nursing Times), and thanks to a combination of below-inflation pay rises and poor working conditions, many now want to quit the profession altogether.
But despite – or possibly in spite – of all this, nurses have to be consummate team workers. “As pressures increase, and as nurses increasingly have to work with more diverse and other multi-disciplinary teams, the role of nursing is more and more about excellent team working,” says Dr Ruth Pearce, head of school of nursing, AHPs and Midwifery, University Hospitals, Birmingham.
To ensure the next generation of nurses are able to be top team players, Pearce and her colleagues are developing what they’re calling a ‘student-led clinical learning environment’. Comprising a unique handing over of the reigns, learners themselves are now teaching/collaborating with other students – for instance second-year students will now work with first-year ones, to enhance and expand nursing standards. The scheme is barely over a year old, but the intent is to really embed a much better and more predictable team ethos.
“It’s hard to ‘teach’ or ‘instil’ teamwork,” says Pearce. “But better teamwork starts to happen when you give people a sense of autonomy; create a shared sense of responsibility; allow people to give support to each other; and encourage students to rely on other members of their team to help them out.”
She adds: “These people will also have practice supervisors who will help role-model what working collectively is all about.”
While it may not seem like such an innovation for those used to corporate team environments, the programme is breaking new ground in the NHS.
It is an offshoot of the NHS’s ‘Civility Saves Lives’ campaign – which uses the phrase ‘healthcare is dependent on teams, and teams work best when all members feel safe and have a voice’.
It also seeks to build what Pearce calls an environment where “people’s tanks are topped up.”
She says: “In our profession people often talk about people being ‘armoured-up’– that is, when they are questioned, they armour themselves up to protect themselves.” She adds: “What this is really about though is nurses reacting to a form of at-work micro-aggression – and it’s one that can get people down.”She says: “What we’re trying to do here is reduce the need for this, by creating a more nurturing place, where there is more cohesion in a team.”
Because Pearce says the NHS “can’t recruit itself out of some of the problems it has,” she’s passionate about bringing in as many outside experts as possible – people who have different experiences/views about how great teams work – experience that they can share, and which the NHS might be able to learn from.
It was by having this mindset that Creative Huddle recently got involved with Pearce – chairing an event that assembled speakers and subject matter experts from a wide variety of specialisms, to talk and mull over how improvements in the NHS could be made.
“Creative Huddle helped by chairing this event, and by teasing out areas we could think more about – such as challenging us about why things are always done in a certain way by teams – things which create inefficiencies,” she said.
She continues: “Very valid questions were raised – such as ‘why don’t physiotherapists help get patients out of bed and insist that this is a nurse’s job?’ They could do this, and if they did-so, it would free up the time of already busy nurses.” Says Pearce: “When you start to have these sorts of conversations, the topic then becomes a wider conversation about empowerment and what people’s capabilities should, or ought to be. But just solving this single issue could make a big difference.
Other areas discussed covered everything from time-and-motion studies (such as why are medicines kept in hundreds of different cupboards, each with different keys, and people who look after them?), to how teams could be more sympathetic with each other.
“There will always be push-backs when this type of work is undertaken, but it will succeed in creating a more efficient NHS if team members can see the value in it,” Pearce says.
Says Pearce: “I think the essence of good teamwork is to always challenge your assumptions, and then to do things that might not always be popular.”
She concludes: “We can’t go back to our pre-Covid-19 days. Hopefully, the new staff we have in training right now will see the improvements we’re fostering as just ‘normal’. The key for the future of nursing is for those just coming through to be exposed only to this new culture we’re developing – not the old one.”
