You can find a video of the episode with subtitles here.
Staff wellbeing initiatives – like yoga classes – can feel like a cynical move by employers to paper over the cracks of the very serious issues affecting staff.
But wellbeing is important – not just for healthcare workers themselves, but for patients too.
Dr Peter Donnelly is a consultant paediatric intensivist at the Royal Hospital For Children in Glasgow, as well as being the Chair of the Wellbeing Special Interest Group for the Paediatric Critical Care Society.
He joins Dr Paula Redmond for this episode to explain how staff wellbeing initiatives can be made more meaningful and effective.
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Transcript
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Dr. Paula Redmond: Hi, I’m Dr. Paula Redmond, a clinical psychologist, and you’re 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.
Wellbeing initiatives in the NHS can often be met with derision and eye-rolling, but staff wellbeing is so important and so key, not only for healthcare workers themselves, but for patients too. In this episode, I spoke with Dr. Peter Donnelly about how staff wellbeing initiatives can be made meaningful and effective as long as they are part of wider system change.
Peter is a consultant pediatric intensivist at the Royal Hospital for Children in Glasgow, and also chair of the wellbeing special interest group for the Pediatric Critical Care Society. I started by asking him about the recent pressures faced pediatric intensive care staff.
Dr. Peter Donnelly: I think everyone across every discipline has faced challenges recently. We probably, to be fair, have to look back a little bit further than before the pandemic even started to recognize that there is an issue. There has been research done within pediatric critical care in the UK looking at things such as moral distress, burnout, PTSD scores, et cetera. They have previously been published and shown that there’s quite a high incidence of our teams, be it nurses or physicians or other staff, scoring pretty highly above study thresholds for moral distress and for PTSD.
We have to recognize that, before the pandemic even took cold, we had issues in terms of the environment we work in. It is very difficult. It’s high acuity. There’s a lot of pressure. There’s a lot of pressure we put on ourselves, and it is very challenging albeit rewarding as a career.
Dr. Redmond: Peter, can I just ask what the particular challenges are for staff working with children in intensive care?
Dr. Donnelly: There will be, for want of a better word, generic ones that anyone will place in terms resources that are always stretched. Staffing levels which are always tight. Obviously, when you work in intensive care, the ratio of staff to patient is higher. Therefore you need more staff to be able to provide that standard of care that you wish to achieve. The patient mix that we get is generally sicker. That’s why they’re in critical care. There’s also higher demand in terms of the actual work pressures that we need to do for each patient and as well as that.
Then there’s the emotive and the cognitive stressors that come with managing those sick patients, both for ourselves but also for the families. This is a time for them. It’s going to be probably the most difficult of their lives that they’re trying to live through, and you have to be able to support them as well as support the patient. There’s a lot of different nuances to this that heighten how difficult actually is to do day in, day out. To be able to pick yourself up, go home, be with your own family, and then come back in and do the same again.
Cognitively and emotionally, it is actually a very taxing area to work in.
Dr. Redmond: As you said, levels of moral distress and burnout were high before the pandemic. What impact has the pandemic had?
Dr. Donnelly: In some ways, we have been relatively lucky in pediatrics because we have not seen the same high numbers of COVID patients with respect to how our adult colleagues have been. In some ways, we have been protected from seeing the high number of patients. We have had to, despite that, still take on the same public health measures as everybody else.
In terms of how we work, looking at how we restrict visitors into the unit, how we limit parent numbers into the unit, how we wear PPE within the unit, how we go through all different processes, and put social distancing in place. How that impact on our ability to have breaks, to work as a team, to do education sessions, to do simulation. All of those pretty stringent measures that have been put in place for safety have still applied to us, even though we haven’t had the same mix of patients.
We’ve still had the stressors. I guess it’s just, in some ways, been a little bit more difficult for us to justify those in our own head because we haven’t been stressed as much. The other side to that is you do almost have almost like a survivor’s guilt phenomenon because you know that your adult colleagues are really stretched and pushed, and you’re in work, not feeling the exact same as they are.
Certainly, some of our nursing colleagues were redeployed over to adult intensive care units to support them. Some children’s intensive cares across the country were refashioned into adult intensive cares to support colleagues. That brought in other nuances about us or our teams looking after adult patients, which is not an area of our expertise. We have to be obviously heavily supported by those whose area of expertise it was. That was stressful as well. Adult intensive care is very different from pediatric intensive care in terms of mortality rates and things like that. It was difficult for our teams to go over and experience that and then come back.
Dr. Redmond: We’re heading now two years into the pandemic. Your teams were starting from a place of exhaustion and depletion, and then to have all these added stresses, how do you see things now? How are people coping? How are people managing?
Dr. Donnelly: The NHS and healthcare has been able to exist as it is based on people’s innate ability to be flexible and adaptable. People are resilient and they’re able to cope with quite a lot. That’s how healthcare has survived, just through everybody going that extra mile. The question now is how can we put systems in place where we don’t rely on people having to have the reserve in order to do that all the time? How do we protect our staff? How do we look after our staff so that we’re not relying on always that extra bit, always people doing extra shifts, always people staying a little bit late. How can we protect people a little bit more?
Because burnout was already an issue and it’s not going to be getting better through the pandemic with more people in terms of staff being sick and isolating, that has obviously put a lot of stress on our systems. We need to start looking at systems’ point of view. What are the issues that people on the ground are facing? How are they expressing that? How can we support them better without putting all the focus on the individual? We can’t rely on people and say, “You must do better at this. You must look after your own wellbeing better.” It’s about us being able, as an institution, to put things in place to help make that happen.
Dr. Redmond: That’s where the messaging around resilience gets really sticky, doesn’t it? Where you see a lot of wellbeing initiatives aimed at boosting people’s resilience, but as you said, that really locates the responsibility within individuals and doesn’t look at the wider issues and the wider systemic problems that need to be addressed.
Dr. Donnelly: It’s very easy when people report stress or report difficulties that we say, “Well, what can you do to make your resilience a little bit better?” That’s papering over the cracks in many ways because we do need to address the underlying problem. There is a role for self-care, and there is a role for doing things that refill your tank, if you like, because you do have to have some reserve.
However, that’s not necessarily the be-all and end-all. With all things, there’s balance. In many ways, resilience has become a bit of a bad word in the wellbeing world, because it has been used as a bit of a tool to hit people over the head with. It is important that we do talk about systems resilience because that is important. A straightforward example is the person who’s stressed because they’re having to stay late. The answer to that is not about improving that person’s resilience so that they can continue to stay late. It’s about systems resilience and putting something in place so that they don’t have to stay late.
Dr. Redmond: As you’re talking, I’m all so thinking about the fact that people can be, and gosh, NHS staff are enormously resilient and, as you said, often go the extra mile. Really the system only functions because of people’s willingness to do that. Particularly, in the pandemic situation, those kind of surges to give more and stay later and work longer and harder in these conditions that must be really, really hard must just be exhausting. I guess people can only surge for so long before there’s just nothing left in the tank.
Dr. Donnelly: Yes, that’s in many ways what we’re seeing. That is the definition of burnout, isn’t it? You just feel like you don’t have anything more to give. I think it’s very difficult because the whole way through the pandemic, wellbeing has come to the fore a little bit and people are talking about it more, and there’s lots of conversations happening about how we can improve wellbeing.
That’s a difficult question because wellbeing, firstly, it might mean different things to different people, but also there will be overarching common themes for people in terms of an aging workforce and being understaffed. There’s common themes that will impact upon us all. What you really need to start off with is each individual unit thinking about what are my problems here that I can fix address at a local level? What are people’s actual main concerns? It’s the whole concept of work as imagined versus work as done.
If we try and imagine what we think people’s problems are and fix them, we might be totally off, we might be totally wrong. We have to have the conversations first and actually find out from the people on the front line what we can do to make their working life better. I certainly find that from my role at a national level, one of the main challenges is that people will often ask you, “How are you going to make things better for us nationally?” I only have so much ability to change things nationally.
I can raise awareness and raise questions but I’m certainly not a government policymaker. I certainly can’t have any real impact on staffing levels in different units across the country. I think that it’s very, very challenging. I think you need to start off, “What can you do locally?” Have interest, have champions, have leaders actually keen to do something about wellbeing, but trying to extrapolate that into something more systemic and something more policy driven is much more challenging, and people are already burnt out as you say.
A lot of this work that we do for wellbeing in different units, we’re doing that as an area– not as much of interest, but an area of need, because we recognize that it’s really essential, but we’re also doing that, trying to fit that around our actual day-to-day jobs, which we’re happy to do but it is difficult and you just wish that there was employed people specifically to look at that, but we continue to try our best. I would stress that although I have a national role and although I coordinate things like webinars, like research, whatever it might be, I don’t in any way class myself as an expert in this. I just class myself as somebody who recognizes how important that is.
Our local wellbeing team, for example, we can look at what interventions or initiatives we can put in place to support our staff. For example, it might be the cold water tanks that we’ve put in the fridges so that people have always access to fresh cold water. It might be our take-a-minute room where we’ve put recliners in it so that, if people are stressed, they can go into and just take a minute to themselves.
It might be the competitions that we run, for example, between ourselves and the emergency department on our respective whiteboards. Who can name the most bands with food in the title? A bit of fun. There’s lots of things that we can do locally, but can I post a job advertisement for more staff? No, that’s not within my control. Can I hold exit interviews personally with people who leave from a wellbeing perspective to find out how we can improve staff retention? That’s really difficult. Can I actually make policy plans for how we cope with our aging workforce in terms of how I allow them to step back off night shifts, off weekends, and how will I employ enough people to cover those gaps?
There are so many things that are out of my ability to control but would probably have a much bigger impact on staff wellbeing, and I think that’s what people recognize. It’s a much bigger base than many of us can manage by ourselves, so the question is how do we take that next step? How can we put something in place at a national level or a Royal College of Pediatrics level or a government level that will actually make a meaningful difference?
What we are doing is trying to help staff retention by making sure that we make life in work as good as possible, and that’s where a large part of our focus is, and that’s about creating a forum where people can feed back to you about what they need, what they want. I’m trying to match that up between what we know helps people in the long run versus ideas that we have for initiatives versus how well they are engaged with.
It’s like the whole yoga thing. I personally feel like yoga is the same as resilience. I think people use it in a very negative way, but no concept from the root term is fully negative. If I went myself into a yoga class and asked them, “Well, why do you do this?” They would all say positive things or I would imagine they would all say positive things about it because it works for them, and if it works for people, that’s a positive thing. Yet, it’s become this, “Oh, we can’t have this yoga introduced, it’s a token, it’s not the answer, et cetera.”
Well, actually, for some people and for their ability to relax and to unwind and to get that work life balance back, for some people, that is actually okay, so I don’t think we can be totally negative about concepts like that.
Dr. Redmond: I think it’s also something about the relationship that people have with the workplace that can make it hard to receive good things when they’re offered.
Dr. Donnelly: Depends who offers it and how it’s offered. If it’s offered by somebody or put in place by somebody who’s a member of your team, who has understanding of where you are and what’s going on, then that’s received differently from somebody who offers it from a remote position who isn’t as personable or isn’t known. I think breaking down those barriers between clinical staff and management staff is really important, where people can actually see each other and be visible, and part of leadership is fundamentally about being visible.
If we can see managers on the floor actually caring and showing an interest, well, when the next initiative is brought in, it’s not going to be seen as a negative way to keep us in work. It’s actually going to be seen in a way that it’s probably intended, which is to try and help us. Albeit they can’t offer these things by asking people to stay late. People want to go home after work, so those sorts of things need to be factored in.
Dr. Redmond: Such an important point, I think, about the transparency and making people in leadership positions visible. Because I think there is a sense of that big machine of NHS management being such an opaque thing and it’s so hard to navigate and often can feel like you’re screaming into a void and nothing coming back, or a sense of sometimes those wellbeing offers are given in the same breadth or the same email the same week as some other kind of punitive measure, another target or another data to collect, or some other pressure to meet. For clinicians, it can feel like that’s coming from the same place, the same person, and they’re undermined–
Dr. Donnelly: It’s all about culture, isn’t it? We certainly find in Glasgow Children’s Hospital, our management have been amazingly supportive actually. Anytime we have approached them about something that we want to do or introduce from a wellbeing perspective, they have been behind us 100% in terms of providing governance structure, providing oversight, helping us with funding, linking in with the children’s hospital charity, and they’re keen when we get things up and running that we actually share that success.
We have had interviews for TV, we have been on radio, we have had our work published in various magazines, so our management are very supportive. What I think is really excellent is that they support all of this stuff, but they are happy to let the people who are in the teams lead on it and drive it, so that it’s seen as, “This is what we are doing for you guys, as one of your colleagues.”
It’s a way of dealing with that boundary of it’s not being dictated to you from unknown or unseen management. It’s being supported by management but very, very heavily supported and encouraged and facilitated. That’s one of the biggest plus points that we have in Glasgow, that our management team have been so good with us about all of these things and continue to be.
We’re going to be bringing in Schwartz Rounds to our hospital very shortly. Again, management have been absolutely behind us on that. If you have that culture of leadership in the background, it absolutely makes a difference.
Dr. Redmond: Can you tell us a bit more about some of the initiatives that you’ve introduced and have worked well?
Dr. Donnelly: From our approach point of view, we divided our wellbeing work locally into two real strands, the first being wellbeing in terms of can we improve things day-to-day basis for our team, and then the second separate strand was peer support and how can we support people when things get a little bit too much. The recognition that if we optimize the wellbeing perspective, we might find that the peer support side is used less, but there will always be a need because at times events will overwhelm somebody’s individual capacity, so we divided it up into two different streams if you like.
From a wellbeing perspective, we looked at hierarchy of needs, as I mentioned earlier, it’s about cool water, it’s about making sure that there’s access to food, it’s making sure people get their break times, it’s about making sure that break times are protected and not clinical. Simple things like taking away all of the clinical messages from the tea room about training, about education, about courses. Taking all of that stuff away and replacing it with fun stuff like the competition that we have is A&E, or at the moment we’ve got a huge whiteboard that’s just covered with a big drawing for the team to color in, and everyone’s just coloring it in with their felt-tips pens like a tiny bit at a time.
Then once that’s done, we’re going to get that framed and put it up in a room as our own team’s artwork. Just a bit of contribution.
Dr. Redmond: You have a room, a space, a break space?
Dr. Donnelly: We have a break room within our unit because we always stay close to our patients. Then we have refashioned a smaller little room that’s used– it’s kind of a multipurpose room if you like, but we’ve put two recliners into that that have been donated to us. It just allows people when they need just a bit more of a minute away from people to go into that and to have a little bit of time to ground themselves, I guess. Or at night shift, they could go and take a break, and I think that’s really important. Recognizing people’s ability to take that break and take the time.
We’ve got various resources in there in terms of sign posting and whatnot for support depending on which area people need support in. I think that’s important. We’ve done a couple of things from the wellbeing point of view and those rooms are going to be redecorated and new furniture put in them over time, again, just to optimize things. Then from a peer support point of view, initially, what we did was form a peer support network across critical care.
It was our intensive care unit. It was the anesthetic theater department and it was A&E. Between those departments, we had a number of people in a team trained in critical incident stress management, and put processes in place where we could provide one-to-one peer support or group sessions for peer support in relation to major incidents or organ donation or any adverse event that we felt, as a team, meant that people would benefit from a group peer support session.
That took a bit of time getting that up and running, getting people brought into the teams from all of the areas, getting training, getting governance in place, and then rolling that out. It’s done really, really well to the point where it’s now grown towards the neonatal teams and the general pediatric teams as well. It’s all almost hospital wide now such as the recognition that actually it’s really beneficial for people.
Dr. Redmond: Are you able to say a bit about how it’s beneficial? In what way does that help?
Dr. Donnelly: It helps people because the feedback we’ve got from it is that, when they go home, people obviously think back over the event of the day, particularly if they’ve been difficult. Sometimes people don’t know what normal reactions to abnormal events are. Having a forum where you can actually talk about how you have reacted to something and understand how reactions and lack of sleep and flashbacks, how things can be normal reactions to adverse events. There’s a bit of normalizing that is really helpful.
There’s also a little bit about relatability and connections and understanding that everyone in the team has gone through similar things either in relation to that episode or can relate to it from events of the past. Just acknowledging that actually my manager was at this meeting and they felt the exact same thing as me and not on my own, that helps. It also helps foster communication and connections between different teams, so if there’s an event or a resuscitation in A&E, and you hold a peer support session and you’ve got people from the intensive care teams, you get to know each other at acute events.
It’s a bit of a fog as to who was there and what everybody was doing, and being able to reconnect afterwards through those shared experiences actually helps really foster connections. You see each other in the corridor and it’s a nod and it’s a hello, and just the teamwork comes better. I think there’s loads of benefits to actually just helping people to process and to know how to ask and reach out for support. Should they not be doing okay? I think that’s really important. They don’t feel lost, they feel listened to.
Dr. Redmond: The people who facilitate those sessions, are they people from within your team who have had special training to do that or do you get external people coming in?
Dr. Donnelly: We have a team of people who are trained. Originally, within each of the three departments, we had up to about 10 or so trained in each team on being able to provide one-to-one group support or one-to-one peer support. We had at least two from each, two to three in each team trained on how to provide group peer support. It’s done in-house and we’ve outsourced the training for that from a company called PSA Limited.
Angela Lewis who runs that, she’s absolutely phenomenal. She’s been great with us because actually what she has done is anytime we are running a group event, we just link in with her and say, “Listen, these are the events, this is what we’re doing, this is what’s happened,” and she will absolutely– she has no obligation to do so, but she will support us through that. There has been many events where she has just said, “Listen, I’ll just swing by either before or after, see how you’re getting on, see if it’s anything I can do to help you, help you guys as peer supporters debrief afterwards.
Definitely somebody that can always be reached out to and will continue to provide us with help and support just because she believes in it. I think having that person there as a resource is phenomenal. We didn’t want to rely on that one person having to be free to come in and deliver all of the sessions, which is why we developed our own team. I think there’s a strength in peer support being delivered by peers. It’s not seen as it’s not seen as, “Well, is this going to get flagged to my manager if I go to this and all the rest of it?” That’s why we took the approach that we did.
Dr. Redmond: Also, I guess it sounds important that those who are delivering that support have the support themselves in order to feel contained and process their own experiences.
Dr. Donnelly: It’s about safety, isn’t it? I think we’re doing this to look after our colleagues and friends, but we do have to look after each other as well. To be honest, we all work in these acute departments as well so it’s not unusual to find that when we’re debriefing a or having a peer support event about a particular episode, that one of us has been involved clinically in that episode as well.
We do need to make sure that we have that capacity. It’s a lot to take on other people’s feelings and to process them and to give them fair and due consideration. It’s a lot because they’re all genuine and they’re all very powerful emotions. When you are listening to those, it’s impossible not to be empathetic and to feel for your friends and colleagues. I think having that safety net is really, really important.
We made sure that we had buy-in from our psychology colleagues as well. We don’t have an intensive care psychologist yet, although one is going to be appointed in the next few months, but we have got buy-in from clinical psychology that are happy for us to reach out to them at any time which is really, really helpful as well. It’s just about all your teams being invested in each other, isn’t it?
Dr. Redmond: Yes and as you were saying, that managerial support and the resources is to be able to access that and the governance around it is really important to make it sustainable as well.
Dr. Donnelly: It needs to be sustainable. It needs to be safe and it needs to be something that doesn’t hinge on one person. If one person goes off sick or leaves, then everything can’t fall apart. All of those things need to be considered when you’re putting a scheme in place. It’s not to say that critical incident stress management is the be-all and end-all of peer support options. There are others, as people know. TRiM is probably the most well known of all of them, but it’s the one that works for us and it’s the one that we think is best suited to our workplace.
I think when people are putting in peer support systems within their unit, they do need to think a little bit about what will work, how it will work, and how it’s made sustainable.
Dr. Redmond: I’m just wondering, thinking about where we’re at now and I know I’ve seen things in the news around real staff shortages in pediatric intensive care. Is that your experience as well?
Dr. Donnelly: I think there can be no denying there is a shortage of staff, whether that is inability to fill posts or not, I’m not entirely sure that I can totally say that it’s because there aren’t nurses out there that want to work in intensive care. I think it needs a much deeper to delve into it than that. Why are we not employing more people straight out of university? Are we genuinely saying that people don’t want to work in intensive care? I’m not sure that that’s necessarily true. I’m not sure that we, as a rule of thumb, employee enough people.
I think there’s always limitations and stretches in healthcare and we’re always employing, in my opinion, this is a personal opinion, the bare number of staff that we need from a cost effectiveness point of view. We don’t overstaff our rotors, so therefore we don’t support ourselves by giving our systems flexibility. We could have foreseen this coming. It’s been two years. People are going to be off sick. People are going to isolate. Winter time, things are going to get worse. This is all known stuff. This is all to be expected, so are we genuinely saying that when we put out job advertisements, nobody wants to do it?
That may would be an element to it, but if that is the case, what are we doing about it? Why do people not want to work there? What research have we done? How deeply have we looked into this? Fundamentally, why don’t we pay people what they’re worth? Why don’t we give people a fair wage? Again, these things are all out of my control, but maybe if you paid nurses a better salary, they would be less likely to walk. As I said, that’s my own personal bugbear.
Dr. Redmond: I guess, that’s part of what we were saying about a resilient system. That the system is always stretched and always creaking, and only just about managing it. It doesn’t take a lot for real cracks to show.
Dr. Donnelly: People will go the extra mile, but they’ll definitely go the extra mile if they feel valued and appreciated. Giving people good education on the job, prospects within the job, a salary that is fair for the job, opportunities. We have to be careful that we don’t ask people to take on more and more work yet we don’t actually give them anything back other than giving them extra responsibility. I don’t think that’s fair. I think there’s a couple of different strands to that. My personal feeling is that education and things have become a lot more difficult because of restrictions placed because of COVID.
People aren’t getting the same training courses. There’s so much about a person’s job that’s not just the clinical work. You have to explore the things that somebody loves about their job that is not just the clinical stuff. That might be education. That might be teaching. It might be working on peer support systems. It could be anything. We have to find out what gives people joy in work, and we have to enhance that element of their work so that they feel valued, they feel listened to, they feel appreciated. Then people, they’ll go the extra mile. They already do, but I feel like there’s something not quite right about relying on people doing that bit extra.
Dr. Redmond: I guess, it’s a social justice issue, isn’t it? If people are making a lot of sacrifices and working really hard and not being protected and rewarded as they should be.
Dr. Donnelly: People are nice people. They go into healthcare because they want to help people. It’s very difficult to say no if somebody asks you for help, or if somebody asks you to do a little bit more. By and large, if you’re able to, we all say yes. It’s very difficult to train yourself to say, “Actually, I can’t do that because I need some work-life balance,” or, “I need to switch off,” or, “I’ve got other things I need to prioritize in my own life.”
It’s very difficult to program yourself to do that. It’s very difficult to say no. I think we can all accept that with restrictions in place and everything turning to being online, or via Zoom, or via Teams, we’re so accessible. We just agree to meeting after meeting after meeting. It takes a bit of practice to be able to say, “I actually can’t do that. Actually, I’m off that day,” because even when you’re off, it’s easy to jump on a call, isn’t it?
Dr. Redmond: I think that’s a really important point that you made about people’s opportunities for development and education. I think one of the things that I hear a lot in terms of what people find really painful about work is when they’re not able to do their job well because of the constraints of the system. All people want is the opportunities to feel like they’re doing a good job and caring for patients well. When that’s not possible for a variety of reasons, that can just be so painful for people too. I think that is part of what erodes the ability to keep going.
Dr. Donnelly: It gives people genuine fear. If you’re looking after somebody and you don’t feel that you’ve been able to do everything that you would normally do, and then you’re trying to hand that patient over to your colleague, who’s taking over, and there’s things that you feel you should have done that you just haven’t physically been able to do, how does that make you come across to the patient, to the patient’s family, to your colleagues?
Are you coming across like you haven’t done your best or you haven’t done as much as you should have? What happens if something goes wrong? How would you be supported? How would your colleagues support you? How would your line manager support you? Is there a legal ramification of that? All of those are absolutely genuine fears and genuine concerns that people have. They’re absolutely justified.
Again, I don’t have an answer to that, but I can absolutely resonate with that message because there’s certainly things that I have heard from a number of colleagues across the country. It’s a real concern. People are scared and people are burnt out and people are wearying themselves thin.
Dr. Redmond: I wonder, Peter, if there are particular difficulties, which you touched upon earlier in terms of emotional and cognitive work that goes into work, but the particular issues around working with children in these really acute situations, I wonder how that is for people.
Dr. Donnelly: I think that’s a tricky one because people’s reactions to things are always quite personal to some extent. Equally, we’ve all gone into pediatrics, those of us who are in it, because it’s what we want to do and it’s an area of medicine that we love. I think pediatric critical cares in many ways is quite nuanced compared to other areas of pediatrics. If our patients are on ventilators or on organ support modalities, a lot of the time they are sedated and we can keep them comfortable and we can keep them pain-free. We can manage those outward signs of distress that would obviously be much more difficult for patients who are in pain presenting to the emergency department, for example.
I think the patient mix that you get probably feeds into that emotional element to it. We all gravitate towards the areas that we find most rewarding. I can’t imagine working in a pediatric emergency department, but some of my colleagues couldn’t imagine working in pediatric intensive care. It’s funny how we all just find our own little area that is our happy place. Then it’s about making it as happy a place for us and for our teams as we can.
Dr. Redmond: What are the things that keep you going, Peter? What are the things that sustain you?
Dr. Donnelly: For me, fundamentally, banter, to be honest. For me, it’s about having fun in work and enjoying your work. I obviously moved to Glasgow after a couple of years in London, obviously, from Northern Ireland originally. For me, it’s a brand new team in a brand new city. That teamwork becomes a social network as well. For me, it’s about having those meaningful connections that you work with colleagues, and yes, first and foremost, it is work. Actually, there’s good friendships that are formed there. There’s good fun. We remember what we like about the job that we’re all doing. As I said earlier, it’s about making the joy in work one of our primary concerns, and how can we make work-life more enjoyable and more fun?
Like the competition with A&E, trying to come up with bands with food in their name or with boys or girls names and their titles. It makes you think but it’s a bit of fun, a bit of coloring in, so we can promote artwork. All of those things, they’re not going to be cures to wellbeing, but they’re what keeps the job fun and meaningful. That’s from a team perspective.
You’ve obviously got the fundamental stuff of actually how rewarding is to help families through what is the most difficult time in their lives and see when patients get better and progress through the unit. There’s probably very little in the world that could be as rewarding as that from a work point of view, in my opinion, which is why I’m in the job that I’m in.
You go from doing the clinical job and helping families and helping patients, seeing the difference that you can make to then being on break with friends and colleagues and having fun times with each other. Those are the things that make a difference.
Dr. Redmond: I’ve seen some tweets around bake-off competitions. [chuckles] Can you tell me about that?
Dr. Donnelly: The Royal College of Pediatrics and Child Health started doing bake-offs, where one of the trainees, Ash, he’s a phenomenal baker. He has had two different people from around the country at one time learning to bake something whilst discussing a certain topic. I was asked to take part in that, and myself and Anna had the ability to make some Nutella-stuffed cookies, being taught by Ash whilst we talked about all things wellbeing. It was good. Again, it’s that element of fun into the work, talking about something important, but having fun with it.
Also, sharing the message, getting fun videos out there that all of the membership of the Royal College will be able to see. Getting that visibility about the message. Trying to have some leadership on the area. I think those things are all really helpful. If people see it being taken seriously, but they see what you can do for fun as well, I think that’s all part and parcel of helping.
Dr. Redmond: Brilliant. Thank you. I really like that idea of thinking about what gives people joy in work, and the importance of taking fun seriously, I guess maybe.
Dr. Donnelly: I mean, just because you have fun in work and you have banter in work doesn’t mean that you’re not taking your job seriously, or you’re not doing a good job. It’s that balance of being seen to be jovial in work, but actually making it very clear that your work is serious because it is. That is balance, but equally, that’s important.
Dr. Redmond: Thank you for listening. If you enjoy this episode and you’d like to help support the podcast, please do share it with others, post about it on social media, or leave a rating and review. I’d love to connect with you, so do come and find me on LinkedIn or Twitter. You can also sign up to my mailing list to keep up to date with future episodes and get useful psychology advice and tips straight to your inbox. All the links are in the show notes. Thanks again, and until next time, take good care.
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