(Please see below for a transcript of this episode or watch it as a video with subtitles here.)
Dr. Heidi Edmundson is a consultant in emergency medicine at the Whittington Hospital in London.
She actively campaigns to “make wellbeing a thing” for hospital staff – through addressing barriers to basic needs such as taking breaks and access to hot food. She has also introduced creative tools and techniques to foster wellbeing amongst teams.
In this episode we explore these initiatives and why they are so important in enabling staff to be seen as whole people.
She also takes me through a simple creative exercise – grab a pen and paper so that you can take part too. Please share your own drawings with me on Twitter @DrPaulaRedmond #WhenWorkHurts.
You can find Heidi on Twitter @heidi_ed
If you fancy watching the Emergency Department staff animation you can find it here https://vimeo.com/435039026
And you can get hold of the Do No Harm mindful embroidery craftivism project here www.drpaularedmond.com/donoharm
As usual I’d love to connect with you so come and find me on LinkedIn, Twitter or Facebook.
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Transcript
[music]
Paula Redmond: Hi, I’m Dr. Paula Redmond, a clinical psychologist, and you are listening to the When Work Hurts podcast. On this show, I want to explore the stories behind the statistics of the mental health crisis facing healthcare professionals today and to provide hope for a way out through compassion, connection, and creativity. Join me as I talk to inspiring clinicians and thought leaders in healthcare about their unique insights and learn how we can support ourselves and each other when work hurts.
[music]
Paula: In this week’s episode, I spoke with Dr. Heidi Edmondson, a consultant in emergency medicine at the Whittington Hospital in London. Heidi actively campaigns to make well-being a thing in hospitals, and one of the way she does this is by using creative tools and techniques. We talked about all the benefits of this and how to introduce creativity and fun into busy hospital life in realistic and practical ways. Heidi also does a brief creative exercise with me during the episode, so do grab a pen and paper if you want to take part and do listen to the end because I have a special treat for you. We started off by discussing what the COVID pandemic had been like for her.
Heidi Edmondson: I suspect the pandemic’s been for me, the way it’s been for everybody else. It seems to have gone on forever. It’s sometimes hard to remember a time of life when we weren’t living in the pandemic. I think it’s important also to start off how the pandemic’s been for me just as a person because I think maybe a lot of what doctors find a bit stressful sometimes, as we were at the beginning, certainly lifted up to be heroes, which wasn’t really [chuckles] what we thought of ourselves. I think as a person, I was just like everybody else. I was going through my life quite normally.
I vaguely heard of something, I’ll confess, didn’t think it was going to be that bad then suddenly out of absolute nowhere, suddenly we were in the midst of this just dreadfulness that doesn’t really seem to have ended. I was actually in Morocco and got stuck in Morocco for the first four days at that point. I think it’s been difficult. It’s been hard at times when you– my mom lives in Northern Ireland and I felt certain I did see her for over a year and that was very hard it’s difficult. I think dealing with any form of uncertainty is difficult. We’re not good at dealing with uncertainty. I think that that’s when it happens, it’s that level of uncertainty and that level of a panic sometimes.
I think in healthcare, there was the phenomenon that we had to adapt very quickly to something that we had never experienced before. Even now, sometimes we discuss, it’s phenomenal how in less than two years we can see how our approach to an illness has changed because at the beginning, we didn’t really know very much what to do. It was new, it was completely unfamiliar to us. Whereas now it’s something that is very familiar to us. There have been movements in different ways. We approach it differently. It’s not the same now.
We don’t see it the same now as we did at the beginning. It’s insane to think that in this short period of time a vaccine has come into being. Some of us have been vaccinated twice, some of us have been back three times. It’s been difficult at work. There’s been so many different phases. I think times it has been hard, everybody is shattered. I think it’s that chronic exhaustion of running full filters.
There’s a marathon, not a sprint, I suppose. It doesn’t even feel like a marathon now, it feels like Ironman [inaudible 00:03:50] Ironman, a sprint [unintelligible 00:03:52] idea. We’re still, “Oh, it’s the marathon.” What’s that one through the Moroccan Desert? The Marathon des Sables. That’s what it feels like. It’s a different marathon each day and very adverse circumstances. It’s been difficult. I give a shout-out. I’m an emergency medicine doctor, so we saw one aspect of it. To be honest, I give a shout-out to people who worked on wards where they went through the journey with people and had to deal with a lot of deaths.
A lot of people dying alone and when you talk to healthcare professionals who worked in that ward, it’s interesting because that’s the thing that will make them cry. They will remember individual patients that they sat with, that weren’t with their families. That will stay with them forever, I think. I feel quite emotional saying that myself. It’s just been this thing and I also expect that because we are really still in it. We don’t really know what it is, but not knowing how 10, 15 years’ time, or maybe longer I don’t know. We’ve never come out of it to have the reflection to understand what it was.
We’re trying to make sense of it as we go along and we think we’re making sense of it and then something else changes and something else happens and you have to start all over again or you have to pick up where you left off. I think maybe none of us will know what the pandemic [chuckles] meant to us until the pandemic’s long gone and it’s just something that happened in the past.
Paula: I really resonate with that. I think we don’t know where we are in the story. Whether we’re still in the middle or towards the end. I think you’re right that it’s only once we’re safely on the other side that we’ll really be able to process and make sense of what’s it’s been like.
Heidi: I was saying to someday it’s like one of those long-running series that you started off lost or something. [chuckles] You just want it to be over now [inaudible 00:05:51] [chuckles]
Paula: Heidi, I know that you’ve had a real interest in staff well-being prior to the pandemic and I wonder what your– you’ve touched on it already, but what your thoughts are in that respect how these experiences are impacting on the well-being of staff.
Heidi: It is interesting. I very first started to think about this back in 2016, which was in the world of emergency medicine terms, that was when we first began to have the winter bed crisis that still is reflected on. We used to think that it was just a bunch of bad crises. Little did we realize what was coming at us. It was in that first winter bed crisis, it was very difficult to work. There was various events happened that I really began to think of staff well-being. Many things in life, if I was to turn back time, I don’t know if I’d even call it staff well-being anymore, I might give it a different name.
At that point it was just, maybe it was the staff experience, it was to give a voice and the thought to what is the experience of people at work. Even going back then, there were some very tough times then people would start to talk about it. I remember we held something called a Schwartz Round. I don’t know if you’ve heard of these. These are a recognized way that the King’s Fund championed for hospitals of allowing staff to sit with their experience. I remember sitting in those and people would just tell stories after bad shifts of sitting in the cars and crying for an hour before they can drive themselves home. Various things like that.
I really began to think of staff experience then and ways to– I think at the beginning, I’m always very honest about this, that I was making it up as I went alone. I don’t agree a master plan or action plan and I was very much– I think at the beginning, I always say I wanted to make it a thing. In medicine, you talk about lots of things. You talk about education, you talk about patient safety, you talk about performance. I felt I wanted staff well-being or something. I suppose now it was staff experience, I would call it to be a thing. That was the start of it.
I began to talk and do things about that and a variety of initiatives during pre-pandemic and I started up some initiatives based around fun and creativity and other stuff, which I know we’ll talk a bit more about later. I suppose it’s like everything, the more you talk about something, it did become a thing then I began to talk about it all the time and people began to acknowledge it. I was talking about it because I was interested in it and passionate about it. I suppose I would read about it, not again, in a very organized fashion, but you can fall down Twitter holes and Google holes and find all sorts of things.
I began to read about it and think about it more and more and began to have more and more theories on it and more and more opinions on it. I am a person who loves to have an opinion and talk about it so I began to develop this. I was very invested in it, very interested in it. Interestingly, when the pandemic struck, I can remember as I alluded to the first four days of that end time of March, I did get stuck in Morocco and then eventually got home. I remember sitting in my living room and thinking, “All right, this is it then for me and all my well-being stuff, because high on earth, is it going to stand up in a pandemic? It’s just not going to stand up at all.” Then I realized as time went on, it would stand up.
I think just pre-pandemic, various surveys I suppose, of NH staff that they do like the GMC Survey, the staff survey, they have begun to ask staff how they were feeling about burnout. You are beginning to get official figures from this country. The very first talk I gave in 2017 about it, I used American figures because we didn’t have that many figures. Pre-pandemic 2020, we did a lot of quite big surveys that measured things that were all saying staff were experiencing a high level of burnout and how that, in turn, was affecting both them, but also the care that they could deliver and also just holding the workforce together. There was information at that point.
I think then during the pandemic, all the problems that existed pre-pandemic just continued to exist with the added being ramped up by now, we were working through the pandemic. The things that were issues such as workforce, burnout, all of those things that were already there pre-pandemic, they’ve just become super ramped up post-pandemic. I haven’t had time to read it before this, but I noticed the GMC Survey for this year is just out and they have looked specifically at rates of burnout, et cetera.
There’s huge amounts of burnout amongst all levels of NHS staff and there’s huge amounts of vacancies in the workforce. That’s just a continuing, and it’s like all these things, each thing impacts something else which impacts something else. It’s a very tangled-up complex problem.
Paula: I think you were saying about wanting to make staff experience a thing. I think we know that’s the other things that we talk about and study. Patient experience and quality of care and all of those things are also interlinked, aren’t they? That we can’t separate out staff experience from the experience of patients and of performance and quality of care and sickness and retention and all of those things that’s really core to those other [crosstalk]
Heidi: No, definitely it’s core. Certainly just pre-pandemic, in response to the GMC Survey, they then commissioned a piece of work called the Caring for doctors, Caring for patients document, which was commissioned by a man called Professor Michael West. His name’s quite often quoted in these conversations. He’s a professor of organizational psychology. I have read that document. It’s very long, but I did read it. [inaudible 00:12:20] studied it.
At the beginning, he goes through all the statistics and it’s quite compelling evidence that patients’ experience is directly linked to the staff experience. That is one of the big things that patients will base their experience on it’s the staff experience. Also, organizations for staff report themselves feeling engaged, et cetera, et cetera, do better in all these other parameters that are measured. Again, you make it a thing, but to begin with, I thought I make it a thing, but then the more I began to read about it, I realized it was a thing, but it was a thing that was already intertwined with all the other things. It’s that complex. The further back you look, you see that everything is merged and tangled up together.
Paula: Yes. Heidi, I also am interested in some of the work that you’ve done, which has been about looking after the basics as well for staff. That is actually really core to the staff experiences, some of those really basic things about how people meet their needs as human beings with human bodies.
Heidi: I think it’s funny because as I say, on one hand, I’m very interested in the use of fun and creativity in well-being, but quite often you go on– I think like Twitter, I spend far too much time on Twitter. There is this outcry on Twitter of one of the big, I suppose schisms in wellness is this outcry of we don’t need all this stuff. It’s particularly [unintelligible 00:13:48] yoghurt that gets [unintelligible 00:13:48] don’t need you, we need the basics. I agree with that. We need the basics. If anything, what is interesting after thinking a lot about well-being and wellness, the first actual, if you like, if I had to point out milestones that moved me through this, the first actual milestone was a very basic thing. It was doctors taking breaks.
I actually remember this, it was the summer of 2017. There had been this issue that doctors were not taking their breaks. This had come up in one of our surveys and I was asked, could I do something about it? The issue of doctors taking breaks is not a new problem. From when I was a junior doctor, doctors didn’t take their breaks. It’s something that just doesn’t happen. To begin with, I was a bit– I can’t even think of the right word. Obviously, I did not pick this task with enthusiasm. I did not think, “Yay, I’m going to get my teeth into this.” I just thought, “I can’t solve this problem.”
It floated down to the bottom of a very long list of things that one day I’d get run to. One night, I don’t know, I was walking home and one of the other things I’ve been told to do was put up some posters [chuckles] to remind people to take breaks. What am I going to say? Take your breaks, I don’t know. I don’t know, randomly I was walking home one night and this came– you know the way sometimes you’re just walking along and something pops into your head and you think about it.
Then for some reason, I came up with the idea of, I don’t know where this came from. Like all good ideas, they just come. I think it was the ancient group say, do people have ideas or do ideas people? Maybe the idea people did me. I just thought I’d have some fun with this and I thought, “What I could do is I could make posters, but I could get some commonly missed fractures in the emergency department. Things that are quite often missed in X-ray. I’ll put on it the strapline, if you don’t take a break, you’ll end up broken. Then I’ll put all these posters up and I’ll run it as a competition. It’ll be both educational, but I will be also hammering in to take a break.”
Paula: The idea of the competition was that people had to guess what the–
Heidi: We didn’t actually let’s say, Paula, we wanted them to guess, we wanted them to go away and learn what the fracture was so that when they saw that in the department, they would recognize it. I could also say to people, “Look, I’m killing two birds with one stone here. I’m promoting breaks, but I am also educating the doctors in the 16 combinist fracture. I’m proving patient safety and education.” The more I began to think of that in my head, the more I began to– I was just doing anything. I found this idea quite funny and I got more and more in my imagination was thinking about it.
Then I thought, “I’m going to do this, I’m not going to just think about doing this. I am actually going to do this. This was a very important moment in my progress.” I thought, “Not just think about it, I will go in and I will do all that TDM of getting these things and putting them on, printing them out and laminating them, sticking them right, and promoting it.” I started to do that and the more I did that, I then began to tap into this idea that actually this was a problem that nobody could solve because it was one of these so-called wicked problems that are very difficult to solve.
That’s why nobody had solved it and it was so complex and it was tangled up in so many other things to do with culture to do with how we behave, probably to do with staffing levels. Actually, the posters were just the tip of the iceberg, if you like they were the thing that brought it to attention. Actually, you had to keep on and on and on talking about it. The more you talked about it, the more you began to make it real. Actually, the more you talked about it, you began to have to confront what all the problems were, but you could do that. The first time I got some of the trainees, they always liked doing projects and I said, “Do you want to champion this?”
They went and we took feedback on it, which was the first time, it was a very good lesson for me from doing anything, get feedback and then it just grew from there. We’ve really run it now. That started in 2017. I’ve really promoted taking breaks all the way through that and I talk about it. We’ve done various posters, I’ve written a couple of things, gotten the BMJ about it. It’s interesting, we look at different things that have helped doctors take breaks and what doesn’t.
One of the most interesting ones did come out from just something to do with where we were at last year that actually when people saw themselves as a team, they were more likely to take their breaks and encourage each other to take their breaks. That was actually a very interesting thing. We particularly have begun to promote this idea, particularly things like night shift, which can be very difficult. You’re all starting the shift together, look after each other, courage each other. That was one of those things we did. I began at the beginning just to tell people that there are new doctors coming, there’s an induction. Tell them an induction.
Then I realized that maybe just telling them an induction wasn’t enough, so I quite often send out little emails saying, “Just come on, take your break, it’s hard, I know, but it’s important.” At one time, the posters were all– interestingly, I thought the quiz would be great, but the quiz has been– there’s always some people who love a quiz and winning,
there’s a lot of other people who just can’t be bothered. I’ve always given a prize for it. The first person with all the answers. To begin with, the posters were all over the department hidden, so I thought they’d all like a treasure hunt. I think that [inaudible 00:19:34] we’ve got too many other things to do.
Then pushes were all put together. Then they kept on falling off the wall, then they had to be taken down. Then I just now email them to everybody in one batch and say, “These are them. You can look through them if you want to look through them for your own education. They are commonly missed fractures as well. You can learn what they look like.” That was really the first one that started. The thing that that twisted and twined into was this idea of 24-hour food provision. Which is also a huge thing. If you’re on Twitter, you can see, I think a doctor has started a campaign about it.
Again, this is a huge issue. We are very lucky in the Whittington that then we now recently got this company meals for the NHS provide these vending machines that are full of– when I say vending machines, they’re huge chiller cabinets so that [sound cut] food that you’d really want to eat. Proper food. We got one in the staffroom. It’s again one of these things. I think there’s something about food, it is important. [chuckles] Having that in the staffroom has just– again, it has been I think one of these things that has really worked for people because if you’re on night shift, sometimes you don’t have time to prepare food and bring it in.
Actually, some people say to me in almost a confessional way, but I was delighted by this, by saying, “We do three long days. We’re exhausted.” They’re always guilty. “We bought some and took some out and took it home. That’s what we had for our family dinner,” that kind of idea. “That’s great because that is actually looking after– after three days, you are exhausted. You don’t want to go home and cook for a whole lot of children and yourself. You can get some food that you actually might like to eat and just take it home and that makes life easier.” That has been one of the things that I have done with breaks.
Paula: I think there’s an organizational acknowledgment of humanity in that, isn’t there? That people aren’t just names on a rotor and providing function and a role. They are human beings that have needs that an organization can honor in those ways. Maybe we could move on now, Heidi, to thinking about creativity and fun and how and why you’ve brought that into the workplace.
Heidi: As a doctor, creativity is not necessarily something that’s in your life. [chuckles] You go through medical school, it’s not something that is particularly felt to be important. As school felt myself, I liked writing. It started by like writing and wanted to write. When I became a consultant, for a whole lot of different ways, which I’ll not go into, I ended up having the opportunity to be part of a writing group, which met every Monday.
In this writing group, we were taught a style of writing, which is called creative flow. This is very much free writing, where you’re given a free essay and you just keep on writing and writing and writing. You don’t stop and do things like that. That became very much part of my life, I suppose I do every Monday night. I’ve done it every Monday nights for a decade now. That began to grow and grow and become more and more important to me in my life.
It seemed to have no relevance to my workplace. They were there just two completely separate things. Back in 2013, I answered an advert. An email we got that they were– St John’s Hospice, I think were designing a course and they wanted to pilot it. It was to look at communication, teaching doctors communication, but being taught by actors because the theory is, if you’re a great actor, you’re a great communicator. That’s how you do it.
It was run in conjunction with the Central School of Speech and Drama. We all went one night a week for six weeks and we looked with various different sections. I find this fascinating because it began to appeal to that creative side of me and that side of me that had not really got any education since I’d been at school. The last module of it touched upon a style of theater called Forum Theater, which is again, one of these things that’s very complex, but to summarize it very succinctly, it was devised by a Brazilian called Augusto Boal in the 50s.
He was a dramatist, but he also became a political activist. This style of theater was not as entertainment. This style of theater was to go into a community and take the community’s experience of a longstanding problem, make it into a play, play that to the community, but the main protagonist ends up badly. The community would all look at him and say, “We know exactly where you’re coming from because this is our life.”
Then the theater director or one of the members of the company would get the audience to discuss what they’d seen, and ask the audience, “Could that lead character by changing his behavior, have changed the outcome?” Then there’d be quite a heated discussion and people would say, “They should have done this. He should have taken no shit. No, no, he should have shown compassion.” I know you could go through this all, and then you say, “Fine.” Then you start the play at the beginning, but you keep on getting audience members to come up and be the lead character at these pivotal points and see if they can make a difference.
Because it’s done not like in a role play scene, but in proper acting where the actors are very invested in their characters. They know they are not going to change if they can help it. Every now and again, in the midst of this drama, somebody will be able to say or do something that just tilts it and you can see everything going in a different direction. It’s also called Theater of the Oppressed because it meant to get the oppressed. I became very interested in this and thought, “This actually touches upon quite a lot of the problems that are really affecting people in the NHS, because there are these long, standing complex problems where people are coming in.
I suspect anybody who’s in a system sometimes feels that the system has developed in such a way it’s now not working against them being how they want to be in the system. I ran quite a lot. I was lucky enough there again, a whole series of events that between 2016 and 2019, we ended up doing a project once a year using this style of theater. We did it once with Cardboard Citizens Theater company who are quite a famous company in London. Then the other times we go to contact in Central School of Speech and Drama and they sent us master students.
That was again, bringing in this idea of abusing drama, of taking problems, but really sitting with the problem and understanding the experience of the problem, and trying to take it away and reflect upon it and watch it play out. I became very interested in that. Every fast forward to 2016, when I was doing this, when I became interested in this idea of well-being, and I wanting to make it a thing, to make it a thing you have to have an action to go. [chuckles]
You just can’t talk about it. You have to create a little action. This was incredibly challenging because I had no time and I had no money. It was very difficult. What we had in those days, and what we still do is, we do our teaching that for 10 minutes every day in the department, emergency departments are very difficult to stop, to get people together. You have to keep on going. For 10 minutes a day at ten o’clock, we tried to give 10 minutes of teaching to anybody who could come.
We called it 10 at 10. Some of these slots were empty. I thought, “Right, I’m going to take these slots, and I’m going to put wellness things into them so that will do that. What can I do?” I wanted to do something. I remembered from these theater projects, and I think this is something that I might touch upon again later, the very important thing about creativity, it’s not just the product at the end, it’s the process in which you go through to get to it.
Part of the process when you devise a piece, you play a lot of these games that actors and actresses play that sound like they’re just games. Games sound silly, they sound trivial. Actually, the games are there to again, energize people, to connect people, to get people to bond, to get people to just be with each other in a slightly different way. I suppose one of the things, they turn individuals into an ensemble cast. I thought, “No, we won’t work. We want people energized in this ensemble cast and maybe to be together.”
In those 10 minutes, on the first day, I did not do this. I sent one of the nurses who’d been a child entertainer, and had done the project in and took everybody around the back and for 10 minutes, she played a couple of these warm-up games. I sat hyperventilated slightly [sound cut] earth. If anything happened to her, I could just apply this but I’d sent people to play a game for 10 minutes.” Everybody came out, everybody’s energized, everybody was laughing, everybody was bonded. I began to slowly bring that idea of games and we started to try to do them. The more I did them, the more I began to– I did them and then it was after I did them, I began to really try to understand why they worked, or why it should work because it seems very silly and trivial, but actually is there anything behind it?
The more I began to look at it, the more I was convinced. I still am and was because there was the elements of fun and particularly laughter. As I say now in lots of talks, laughter is shown to be very healthy. It reduces your blood pressure, reduces cortisol, it increases bonding hormones, it inhibits your flight or fright response. People who laugh together, bond together, all of these things. It is very healthy.
Again, there’s that creative aspect I began to bring into it as well that creativity is a bit– again, people are taught to do mindfulness, but there’s nothing magical about mindfulness. It’s just getting you to focus on the present. Some people love those mindfulness apps. They really work for some people. They didn’t work for me. My mind was always going all over the place. Actually a lot of these games they’re just counting games or things like that. They’re things that you play at parties or even the students at drinking games. You have to focus on the game. Your mind can’t be shooting off all over the place. You have to focus on what you’re doing in that game.
It’s just a very simple when you call out each other’s names in a sequence, you have to focus on it. Actually, that’s just acting the same as mindfulness. You’re just focused on the present. You’re not worried is the day going to be awful? You’re not worried about yesterday. You’re not worried about, is the day going to be awful? Is the week going to be awful? Is the year going to be awful? You’re just in that moment.
Even breaking that cycle of just worries is why mindfulness works. Creativity does work like mindfulness. That’s very good. As time went on and I’d gotten to read up about it, there was a big meta-analysis by the World Health Organization in 2019. They looked at all these papers to see does being involved in creative activity improve both physical and mental well-being. They concluded that it does and that even being involved in 10 minutes of creative activity a day can improve people’s well-being scores. It can increase empathy.
I think that was the beginning of really thinking that there was a space for this. They did relate to directly affecting your wellness as being in that environment at the hospital. When the pandemic struck, I couldn’t really play games for a whole lot of other reasons, but that’s when I just thought, “Is there a place for this?” Then I did read there was an article by the British Psychological Society on how to look after your team in the acute phase of the epidemic.
They talked very much about you needed to create a space where people felt that they could express their feelings, and you also needed to create this environment that we’re all in this together. Those things help. I thought, “Actually, this is back to this. There is a role for creativity in this.” That was when I came up with the idea I got people to draw how they felt and that [inaudible 00:31:59] for 10 minutes once a week we’d just say everybody could say how they felt, and then draw how they felt.
Again, some people liked that, some people didn’t, but again, it was all those benefits of wellness. I think anything creative allows you to be with the experience of what you were in, in a way that is easier than just asking for words. That was how it all started with that.
Paula: I know that you’ve put together a video of these drawings to look at people’s responses to the pandemic, and how it affected them, and how they coped. It’s a beautiful animation. Again, you get a sense of I guess the people behind the PPE. I think one of the things that struck me about that is how inclusive it feels because they are all kind of stick drawings. There’s a sense of people just being able to express something of their experience in a way that was able to be seen by their colleagues. That also feels important that being seen in just how you are, not needing to have those filters about creating something very artistic or meeting any standards is just meeting people where they’re at.
Heidi: I think as I say, as time’s going on and if I rebranded it, I also think other terms that come up now, it is things about engagement. There is also something that I have– I think that one very important aspect is that people need or want to be seen as whole people, not just carrying out the tasks of their job. Because I think there’s something very important to get to allow people to be seen as whole people. The next question how do you get seen as a whole person?
I don’t think there’s any one answer. There’s probably multiple answers, but I do think creativity is a process that allows people to express themselves as whole people or they let something of themselves out that is very difficult to do under other circumstances. It’s very difficult to do quite often, to begin with, if you’re just all working, and you’re running around, and you’re focused on the tasks of your job. It’s also even difficult to do if you take people into a room and just say, “Okay tell me–” I think you have to do more than ask people, “Just talk about how you feel,” because some people will talk, some people won’t talk.
Some people will not want to talk, some people will start to talk but they’ll not get to the core of it. There’s something if you give a creative task, it levels the field for everybody and then people can express something of themselves that is harder to express in normal ways. Then it does touch upon things. Then as you say, those stick drawings it sounds ridiculous, but some of those stick drawings made people cry. [chuckles]
Paula: Oh it made me cry watching the video. It’s so meaning.
Heidi: You see some of those stick drawings and they make you cry. Sometimes somebody will look at it and sometimes some people draw something and everybody will look at it and go– and then that person will say something, and then it just inches you along to seeing people in a different way. I think to me, that was vitally important both pre-pandemic. in the pandemic because I think ultimately it is these moments of humanness that are incredibly important to everybody in the job. They’re incredibly important to patients.
The more you allow that humanness out, the more it connects people I think. Once it starts creeping out, it keeps on creeping out. It doesn’t go away. The more you allow it to happen, it slightly becomes more and more and more human. Even I think when I did it, I realized that I’d put down so many layers if that makes sense, about my humanity in a way that I didn’t bring to work, but that that slowly began to erode away and came into more and more of what I did at work. That’s what became incredibly important to me.
Paula: So important I think you talk about connection there, particularly in this context of this pandemic where disconnection has been such a thing we’ve had to grapple with in terms of social isolation, and PPE, and seeing each others as a threat, other people become a threat rather than a comfort in our lives no matter whether we’re going to the shops, or going to work. That sense of being able to connect has a really helpful antidote to that.
Heidi: I think it is but I think it was a huge thing and I think even if you think for society at the beginning, the need to go out and clap healthcare workers which I know was a very controversial thing. I knew lots of people have used that and lots of healthcare workers have used that. I didn’t really see it as applauding us as heroes. I didn’t think that’s what it was about. I felt it was about communities wanting to connect around something. They were applauding themselves, they were applauding getting through it.
They were applauding humanity really. I think that that was why I think was important to people. I think there was a moment that you need to connect and I think it is very important to people. Just one other thing about connection that I think it’s quite important to say is if we go back to Professor Michael West in that paper Caring for doctors, Caring for patients, he talks a lot about this idea that you are motivated in work, there’s this intrinsic motivation and it comes from– to get that in people, what people really want is they want autonomy.
They want to feel that they’re seen and they’re head, they want to feel connected to other people and they want to feel competent. They’re in a job in which they’re competent and progressing. Actually, if you provide those things to people, that’s what people want and that’s what motivates them. I remember actually it was during a workshop with the Forum Theater. I was with some of the nurses and then we did these series of workshops.
We were looking for something to make a scene for a bad day, so they were talking about a bad day. At the end of that conversation, I said, “What gives you a good day? What do you want at work? What gives you a good day?” Nothing this conversation [unintelligible 00:38:32] but one went, “I like to come in and feel I’ve really connected with my patient. You have a chat with them, you sit with them, you hold their hand for a bit. That’s what’s important.” Somebody else said, “I like to feel that we are seen and we are important and what we say is valuable.”
Somebody else said, “I like to think we’re doing a good job and we’ve scop to progress through our job.” I thought, “Oh my God, they have just actually demonstrated that.” I remember saying to them semi-jokingly, none of you have said to me you want more money. They all looked at me and then everybody started to laugh. Now, again, this is not some sort of plea that people don’t need money, but then actually one of them said, “Look, when you have a really bad day and it’s awful, you want more money to compensate for having a bad day. Actually, we just want a good day at work [chuckles] and that’s what makes a good day.”
I think you have to keep on coming back to that because it’s very hard in the midst and it’s very stressful and society’s stressful and everybody’s working incredibly hard. You think “Oh well, what can I give people?” Sometimes you think you need to give people a lot but actually, if you come back to they want to feel they’re seen and important. They want to feel they connect. I think that connection is so important to people or maybe not everybody but a lot of people, they like that connection, and that’s such an important thing, a valuable thing really to do.
Paula: I certainly hear, as you say, not just for people having a bad day, but when things start to get chronically difficult and a real struggle with going into work, and it absolutely is those things, like that sense of not feeling able to contribute in a meaningful way at work, feeling disconnected or an emotionally cut off from maybe not having the capacity to foster those connections anymore. To not being seen, not being valued. That can be very basic things, just not having breaks or space, or time.
Heidi: Yes.
Paula: I was thinking, Heidi, about when you was talking about the creativity and the benefits. A couple of things that really struck me was about how the experience of having creative time and creative spaces in your day can, on an individual level, really help to calm the nervous system. Just having that little bit of time out to recover, particularly in a very hectic work environment. You were talking about the impact it can have on stress hormones and the fight-flight system. We need our nervous systems to be calmed in order to maintain connections with people.
In order for us to be able to have a compassionate human connection with colleagues and patients, we need our nervous systems to be calm. I can really see how creativity is quite a quick access way. As you said, you can take a 10-minute snippet of the day in order to cut out almost the logical language filtering process that we go to and feed straight into our nervous systems in that playful way. The other part, I guess, that you’ve been talking about is the communal connection that that can offer.
There’s something about the creative process as an individual that can be really helpful, but doing it in a communal way can have all sorts of other benefits. As you were saying, in terms of bonding as a team understanding each other better. Something about, I guess, cutting through hierarchies. [crosstalk]
Heidi: This is the other thing I’m really interested in, because I only began to really think of this as I was moving well into the project. The other big thing that comes up again, and again, and again is what makes a good team. What makes a good team, what’s the most important thing in the team. Something that comes up a lot is this concept of psychological safety [unintelligible 00:43:00]. I think [unintelligible 00:43:01] since the woman that has written a lot about psychological safety, and undone a lot of things.
Psychological safety is important, because it’s his idea, people need to feel safe to say things they need to say if come up with ideas. They need safety to do things. That’s important, both in an acute situation. Everybody needs to be able to say something, the airline industry. I’ve do some work with airliners too, and they will talk about, “Your people, everybody needs to be empowered to speak up if they think there’s a problem. It shouldn’t have to go through these hierarchies.” I think in longer term things, not just in the emergency situations, just in looking how to develop a place, solve problems, move things forward. Everybody needs to feel they’re able to speak up.
I’m very more and more interested in psychological safety, and I’ve noticed it’s coming into some emergency medicine forums. There’s an infographic about how psychologically safe is your team. That is becoming more and more talked about. Again, how do you create psychological safety? Because you can’t just go in and say, “Okay, everybody, let’s be psychologically safe. I’m senior, but I need you to just– everybody in this team, even if you’re a day one, very junior, you’ll have to be safe.” It probably doesn’t work like that.
I definitely think there was something about taking everybody and making everybody in the team play a game together, because that flatten the hierarchy. Everybody slightly nudged out of their comfort zone, so everybody’s slightly under that kind of but not healthy place. Because you have to do it [unintelligible 00:44:40] where everybody feels slightly– I mean, say, “I’m going to play a game,” you can see some people are going like, “Hey, games,” and other people thinking, “Oh, no, please not.” Everybody’s slightly pushed into these slightly unknown areas. Everybody’s leveled and everybody’s starting to connect with each other in a different way.
I think that’s quite a healthy place to be. I can see it in the microcosm, because actually one of the things I’ve done since the pandemic to progress the work is, I don’t know if you’ve heard about Project Wingman, who were the Furloughed airline staff that committed [unintelligible 00:45:23]. Waiting rooms, first class lounges in NHS hospitals. We had a lot of conversations with them just because they were there. Then a group of them are formed a company called WingFactors that I’ve now started to work with. Together with them, I devised– there’s a lot of work in medicine with the pilots, which there are some that WingFactors do.
I work particularly with the cabin crew to create a communications course, because we worked out a lot of their challenges that they have in communication are the same ours. We were looking at specific things that we look at. How to create a good first impression, we can’t give you what you want, and how to– what’s the word? Deescalate problems. I’ve devised this course with them, but I intersperse that those modules with some of my more wellness games. You’re getting people to play the games, because I also think communication is actually connection. The key to good communication is just good connection.
I feel that those two things sit well. It’s been a fascinating thing. I love doing this, I just love it so much, we do this. Then also, in the end, in the afternoon, we have to do some form of, as they say, the dreaded role play where we get people to do that. I tried to make a bit more form theater like. I also think people are more open to being in these practical things. Because they’re not just a group of semi strangers who have just sat in a room together and listen to somebody talk. They’ve moved around, they’ve interacted, they’ve played games, they’ve all been pushed out of their comfort zone together.
They all move into this acting out together more easily than they would have done if we had not done this. It’s been a phenomenal experience to do that. I’ve run about nine of these courses now, this year, really. That’s been very good.
Paula: Heidi, I wonder if it’s a good point to maybe think about how practically we might be able to use some of these ideas, both as individuals, but maybe something we can bring into the workplace if people are excited about these ideas.
Heidi: Yes, certainly. I’ve found drawing helps. Again, so when you say the word “drawing,” again, some people go “Yes.” Probably very few, other people look horrified. You can do this at the beginning of any kind of meeting. You can do this at the beginning of a teaching session. You can do this at the beginning of a board meeting. My goal creative things, it will have a product, but it’s the process and the process might [unintelligible 00:47:58] I think like exercise, you know the way if you do your exercise, you’re still burning your metabolism, still breaking afterwards.
I get you into creative zone, which is quite good. That’s where you want to be in a meeting. For drawing, it’s very simple. People will be horrified and look at you. The first thing if you want to do this, you have to just bracing yourself through it. As you say, “Okay, everybody I want you to draw something simple.” Good idea if you really [unintelligible 00:48:22] tell them to draw something simple. I always say a cat, because cats are simple to draw.
Paula: Okay, I’m going to do this along with you, Heidi. [crosstalk]
Heidi: Draw a cat, please, with your dominant hand.
Paula: Okay. Gosh, okay.
Heidi: Remember, you don’t even have to show it, you’re on a podcast. Nobody is going to see your cat. [crosstalk] [chuckles]
Paula: I might be brave and put it on Twitter [crosstalk]
Heidi: As you were doing that, did you feel anxious when you were doing that? Because you know what, it doesn’t matter. What you now have to do is take your non-dominant hand and draw the same thing or try to draw the same thing.
Paula: Okay. [chuckles] Oh dear.
Heidi: Now, quite often what happens is when you look at your two cats, although their non-dominant hand is obviously all shaky and funny, and a bit strange looking, there is something about it and a lot of cases it looks a bit more charming or cartoony, or maybe it’s the shaking that it makes more live or something. They do look more alive, they look more funny. Then the final one to really go for it is look at the paper then close your eyes and draw the cat again with your eyes shut.
Paula: With my dominant or non-dominant? [crosstalk]
Heidi: [unintelligible 00:49:28] say dominant hand. You could go for it with your non-dominant. This is art, there are no rules. [chuckles] You could draw with your foot if you wanted to try it that way, you’re like.
[laughter]
Already see you’re exploring all the numerous means, already.
[laughter]
Paula: Okay.
Heidi: [unintelligible 00:49:50] it’s completely strange, but it also does look like Casso [unintelligible 00:49:55]
Paula: Yes, mirror, should I show you?
Heidi: I can’t see it very well. Oh yes, you look great. Move it up a bit, I can’t see the bottom. You see that it is true that the non-dominant hand always becomes more charming. Then you did quite well but it’s still quite funny, that slightly Kilton funny cat. Then you can show those. You could just do that at the beginning of the meeting for five minutes and there’s a lot of science behind doing some form of an icebreaker at the beginning of a meeting, again, to get everybody into the room and everybody in the same wavelength. If you wanted to do it, then you can just move on to what you’re talking about.
That took, what, three minutes? It’s absolutely no time at all, and it just is done and then everybody’s a bit of a laugh, and then there’s no time lost. You can laugh and then still have a serious conversation. There are not mutually exclusive to each other and actually, if you’ve laughed, you’re probably a bit more creative now and you’re bit more open to new things. Other ways you can take it if you want to do a bit more of a wellness session, then I’ve moved on from that. I’ve drawn you onto something that would make you happy, something that you want, something like that, what do you feel you need? Then you can see them. Then you can discuss them.
Another one, if you want to take drawing, that’s quite a good exercise that I use. I use this quite often with the doctors as a communication exercise, is you divide the doctors into pairs and they sit back-to-back with each other. I’ve done it on a Zoom meeting, which has worked. You put all into that you can’t see what they’re doing and you tell one doctor in the pair, you say to draw something. Just a very simple something. Don’t tell anybody what it is, draw it. Then then trick is then to your partner, you describe what you’ve drawn and you see if they can replicate it, and then you compare them.
I use this as a very good exercise in communication as well, because it highlights the point that even when you’re communicating, you might have an image in your mind that you’re trying to communicate, but actually how that other person sees what your words are, there is quite a big gap. I always think another thing about communication, it’s not just what you’re saying, it’s how it’s being understood by other people. I think I use that and it’s quite a fun one. Some people end up thinking they are almost identical and everybody is a bit like, “Wow, how did you do that?” then other people don’t. I think it’s just another good exercise if you want to just highlight something and do something a bit different.
Paula: Creativity as a tool for achieving other things, like improving communication, problem-solving, as well as having a real wellness benefit alongside that.
Heidi: I think also problem-solving is another interesting aspect of creativity because this is what I’ve become to believe more and more. Another big buzzword that you read about from the problem-solving is this idea that a lot of problems are being described as these complex, wicked problems that just can’t be solved. What you can do with a wicked problem is you can make it better. Instead of trying to solve it, you constantly try to make it better. They talk about do you need an emergent process to make it better, where you have to sit with the problem and gradually work your way out.
I think that’s very similar to a creative process. In the creative process, you sit with what you’ve got a lot of times, and you’re just trying to develop and work forward. Somebody said about writing. When you try to write something, it’s like you’re driving along a dark, foggy road at night, and all you can see is what’s in the light of your headlights. You just have to keep on moving in the light of your headlights and trust you’ll end up somewhere better at the end of it. That’s what you do in the creative process, but I actually think that’s the process you need to really tackle these complex, wicked problems.
You can’t solve them. You can’t think of I want to be a solution B, I’m more good at that, which is how you solve a simple problem. We do that. A lot of these problems we’re dealing with, that there is no place B to work yourself. You just have to possibly try to get yourself each day into a better place. I think it’s that creative process is very similar to that emergent process that you have to use. I think it’s another reason why creativity’s important because it’s something to do with a mindset to tackle things that are very difficult to tackle.
Paula: Is there anything else on these issues, Heidi, that I haven’t asked that you wanted to?
Heidi: I suppose maybe the final thing is, do I believe in creativity, [unintelligible 00:54:35] Probably my final thing would be that probably at the beginning of the pandemic, as I said, I’ve alluded to this, I was in my friend’s creative writing retreat in Morocco. Some people there made me laugh about why we thought this was a good idea to go, but we went. On the 15th of March, we were in Morocco and Morocco shut their borders. It was incredibly stressful. You couldn’t get in or you couldn’t get out. There was these incredibly stressful four days where we had to try and get out of Morocco, which was a bit ridiculous, but it was very difficult.
I was looking on all my emails, so I could see my work emails, the mounting rising pressure about what was happening at home. I was trying to get out to somewhere at times I didn’t really seem to think sounded that great either. It was incredibly stressful. I remember my friend who was taking the creative writing retreat, she was doing a lot of phone calls and then every afternoon she would say, “We came here to write, now we’re going to sit and write.” She handed over to her husband at home. He took the baton to make all these phone calls for how we could get out.
To begin with everything, we can’t possibly write. Well, how can we be doing this? We’re in this awful situation. We can’t just sit here and write. This is ridiculous. Then I realized if I wasn’t going to do it, if I wasn’t writing, I was just going to sit there and worry. I couldn’t stop. I didn’t have time to write because I just wanted to do all the time and worry. We were made to write and you could feel that we were resistant in our minds but then we’d get into it and we did it.
There’s this very much what she calls create a flow writing, where you start off with a random word and you play with things, and you’re told not to stop, to keep on writing, don’t worry about what you’re saying. It can be nonsense, it can be rubbish, just write, write, write, write, write. I find this did keep me going through that four days. When I came back and I arrived back in the pandemic, and that was back in March 2020. It was very stressful. We used the word stressful, maybe another word that we should use is, it was frightening. We were all scared.
I think that’s very important. Everybody was very, very scared. It was easy to go home and be scared, and then do all the activities you do when you’re scared. To start, I don’t know, just Googling things and then following down the Twitter hole. I thought, “I can’t do this.” I decided I would write a hundred words a day and I set myself that task, “I’m going to write a hundred words a day.” I did write a hundred words. I had an idea for a short story, and you always end up writing more than a hundred words, so I wrote it.
I wrote, and I wrote, and I wrote, and then I discussed it with various people that I know because I do a lot of creative writing class every Monday night, and I have my other friend does creative writing workshops, and they were both very supportive, and I did a lot of work around that. Then they said, “Why don’t you turn it into a novel?” I thought, “Well, I can’t write a novel.” [chuckles] It was a short story. I can’t possibly write a novel. I thought, “I’m going to go for this.”
Every day of the pandemic, I’ve got up before I went to work and I wrote a hundred words of this novel. Then on my days off, I put it into longer bits and chunks, and I finished it in the summer. I’ve written a 165,000-word novel during the pandemic. Now it’s being edited. What happens to this novel? I don’t know, but I still think sometimes I look back and think, “Oh my God, I cannot believe I wrote a whole novel during the pandemic,” but I did.
Again, it’s not the product, it was the process and that process was one of the things that really kept me going, and that was my time in the morning. I created a world that I went into that I didn’t think about everything that I was scared of, and I did it. I felt that I developed my own creative practice, which did help me. [chuckles] Other people might think it’s not going to work, but actually having a creative practice really, really helped me go through it.
In the evening, I started to draw a lot from, you saw the stick figure things. I started to actually draw out presentations. You have to prepare a lot of presentations for work, so instead of writing slides, I drew them and I got more into that. Certainly, what kept me going during the pandemic was a creative practice, so whatever. That did work for me and I suspect it may work for a lot of people. You hear about other people, that’s why I think all these things like baking.
Lots of people did reach for that kind of practice themselves and they may not have thought it was a creative practice. They may not have termed it a practice. They might say, “No, I don’t have a creative practice.” “Do you like this to be it?” “Oh yes, I like to be it.” I think there is something that I do believe in the process because it also helped me going as well in my own personal life, not just in work.
Paula: Absolutely. For me, it’s knitting and sewing, and just making stuff, all kinds of things. I do know that if I don’t have that in my life, I start to not feel very well. It’s a real, it becomes a real gap and it’s definitely a go-to process for me. I think what I love about what you’re saying, both in terms of how we could infuse creativity into our personal and work lives, is that it doesn’t have to be big massive projects. It can be little ways of sprinkling it through our day, in small chunks that do feel manageable, and are realistic even within the hecticness of working in the NHS through a pandemic, there are still ways of being able to find little pockets and little ways of bringing creativity.
Heidi: Yes. I think at the height of often it was really bad, and at one time about last year, I couldn’t even do these 10-minute sessions. That wasn’t conceivable, even, that was too long. There still is what do you do? What do you do? Then at the beginning, I then when I was the consultant, started at eight o’clock in the morning, you have to start the day. I felt it was very important to get everybody who was starting the day, to just have everybody stand for a moment, for one moment for people to take down their mask so we could see each other’s faces, and then the person to say their name.
It sounds bizarre, but sometimes you can see so many people you don’t really know each other’s name, say their name and what their role was in the department. Even if you go around that, it’s one of these jobs that I don’t have time for those, or this is ridiculous, we need to start. It takes two minutes. There’s a rhythm and there’s the fact that you will stop every day and you develop that rhythm. There is something quite connecting about that. It then sometimes recently, because we’ve done it so often, everybody knows everybody’s names now very well.
Then I one day, this was about a month ago, but it wasn’t– we weren’t quite probably are now, a little bit more time. I said, right just say your name and tell me if you had one last meal to eat Earth, what that meal would be. That sounds a very basic question, but actually that is I think one of these most incredibly joyful connecting questions, because your relationship with your last meal and food is more than just food and eating. It’s to do with family, it’s to do with memory, it’s to do with happiness. It’s quite often to do with home. It’s quite often to do with something your mother or your grandmother made you.
Actually, even for people to say that, and particularly if you work in a multicultural workforce, there’s something very uplifting that people would say, “Oh, I’ll have my mom’s–” Somebody will say, “I have my mom’s stick, my mom’s shepherd’s pie,” and the next person said, “I’d have my mom’s chicken curry,” and then somebody said, “I’d have Jollof Rice,” and then somebody else said, “I’d have my mom’s rice and peas.” Then there was something about it that just, again, it’s just these little connections that remind us that we’re human. That actually I think people do value and it just starts from a very slightly different place from where it would be if they weren’t starting from that place.
Paula: Yes. Just being seen, as you said, literally and figuratively. I know, Heidi, that I follow you on Twitter and that’s probably a good place for people to connect with you. I really appreciate your Twitter feed because it is a joyful, colorful adventure. You post a lot of beautiful artwork and lovely food. I imagine that’s also part for you of keeping going and keeping connected with some of those joyful things that life can offer even in the midst of–
Heidi: Yes, and it is. Sometimes, like again, I have to say, I’ve had a bit of a, the last few days I felt you really don’t want to look at anything to do with the news or Twitter. You just feel, “I don’t want to,” and it sometimes think, “I’m not going to look at it.” I do think it is important. Yes, I do think there is something important about doing it and there’s something that to me there is now important of just looking at those. I always try to post at least one or two pictures or artwork, or a recipe.
Sometimes I’ll just go on and do that and then I’ll get out again. I’m not going to start to read all the other stuff because you can just go down that Twitter or hole. I think it is just to have something, and then even in the midst of you, even all the time in the midst of it, then there will be something that will be quite funny. [chuckles] Some people find some slightly hilarious thing or so ridiculous thing that you just don’t, you do laugh. I think that is quite connecting. It’s I suppose it’s the dark side of social media versus its positive points.
Paula: Well, thank you so much, Heidi. It’s been lovely and very inspiring.
Heidi: It’s been lovely. Thank you for asking me. [chuckles]
Paula: I hope you enjoyed this episode and that you feel inspired to think about ways of bringing more creativity into your work and life. I’d love to see your cat drawing, so please do post them on Twitter and tag me @DrPaulaRedmond. I also have an extra bonus treat for you to say thank you for listening and supporting the podcast. Also, because today is Inspire Your Heart with Art Day. I’ve teamed up with Cath Janes, who’s an amazing anatomical embroider, and we’ve put together an exclusive free bundle for listeners, which includes a simple embroidery pattern that’s suitable for beginners with the motto, “Do no harm, but take no shit.”
It also comes with video instructions and guidance from Cath on mindful embroidery. I’m really excited about this because I think it embodies creativity and fun, but also a really important message about health professionals taking a stand for their wellbeing. You can find out more and download it at drpaularedmond.com/donoharm. Please, do share your embroidery projects with me. I can’t wait to see them. Until next time, take good care.
[music]
[01:06:39] [END OF AUDIO]
