This is part 2 on my guide to managing burnout in your staff. I'll link part 1 at the bottom.
Today, I'll be concentrating on the hardest bit: What happens when COVID starts to recede.
The third part will cover long-term plans.
1/
Today, I'll be concentrating on the hardest bit: What happens when COVID starts to recede.
The third part will cover long-term plans.
1/
When the vacc campaign gains momentum along with other measures, COVID will recede. One day you'll get to a point your COVID appointed staff start to see patient numbers drop off, people will start to think back on what they've seen.
You must start planning for this now.
2/
You must start planning for this now.
2/
This is where management will earn their pay, this is the most dangerous point for staff mental health as people will start to find the capacity to process all the trauma and moral injury of the last year.
Here's a skeleton plan for you to shape your local version:
3/
Here's a skeleton plan for you to shape your local version:
3/
Rather than create something from scratch, I'm basing this on the army's post-operational plan, altered to fit the NHS.
Plan sections
- Managing the COVID tail
- Decompression
- Normalisation
- Aftercare/Support
I'll walk through the sections then give suggestions.
4/
Plan sections
- Managing the COVID tail
- Decompression
- Normalisation
- Aftercare/Support
I'll walk through the sections then give suggestions.
4/
THE COVID TAIL
Eventually acute/emergency COVID will become a minority service rather than a major aim. You will start to see more long-COVID than new COVID+. Long COVID is a plan for someone else to manage, not this plan.
(cont'd)
5/
Eventually acute/emergency COVID will become a minority service rather than a major aim. You will start to see more long-COVID than new COVID+. Long COVID is a plan for someone else to manage, not this plan.
(cont'd)
5/
THE COVID TAIL pt2
You must intervene here to support the staff still working on acute/urgent/emergency COVID, this is a key burnout time with busyness dropping and still seeing COVID+ patients will start to hit. You can't let these staff members feel abandoned.
6/
You must intervene here to support the staff still working on acute/urgent/emergency COVID, this is a key burnout time with busyness dropping and still seeing COVID+ patients will start to hit. You can't let these staff members feel abandoned.
6/
DECOMPRESSION
Many military incidences of PTSD occur once people have a chance to think through their experiences and "what if?". For the NHS, this is likely to be enhanced as you can't take a solid break from the work. You can't skip this part of the plan.
(cont'd)
7/
Many military incidences of PTSD occur once people have a chance to think through their experiences and "what if?". For the NHS, this is likely to be enhanced as you can't take a solid break from the work. You can't skip this part of the plan.
(cont'd)
7/
DECOMPRESSION pt2
This is where you allow people to express their frustrations. Make people attend group sessions, disguise them as mandatory debriefs if you must. Let them express their emotions, these expression must never go on permanent records or identifiable notes
8/
This is where you allow people to express their frustrations. Make people attend group sessions, disguise them as mandatory debriefs if you must. Let them express their emotions, these expression must never go on permanent records or identifiable notes
8/
NORMALISATION
This is where you support staff to return to their old roles (or new ones!) in a structured way. It allows them to return to normal while healing. Think of this stage as the crutches and physio supporting someone healing from a broken leg.
(cont'd)
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This is where you support staff to return to their old roles (or new ones!) in a structured way. It allows them to return to normal while healing. Think of this stage as the crutches and physio supporting someone healing from a broken leg.
(cont'd)
9/
NORMALISATION pt2
Your aim here is to process all staff through it, returning most to work normally but catching as many as possible who will need targeted care. This must be sensitively handled as too many have outdated views and see mental health issues as weakness.
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Your aim here is to process all staff through it, returning most to work normally but catching as many as possible who will need targeted care. This must be sensitively handled as too many have outdated views and see mental health issues as weakness.
10/
AFTERCARE/SUPPORT
Your plans must be long-term, they can't be targeted short term. Often issues will present years later. There must always be a non-judgemental help service available. This is a bit often ignored.
Important: don't forget your temp/locum staff and leavers!
11/
Your plans must be long-term, they can't be targeted short term. Often issues will present years later. There must always be a non-judgemental help service available. This is a bit often ignored.
Important: don't forget your temp/locum staff and leavers!
11/
YOUR PLAN
You know the foundation skeleton, now build your local body of the plan. One size does not fit all. Look at your teams, their roles during the pandemic and what they'll return to post-COVID, include those on the edge of the COVID work.
12/
You know the foundation skeleton, now build your local body of the plan. One size does not fit all. Look at your teams, their roles during the pandemic and what they'll return to post-COVID, include those on the edge of the COVID work.
12/
YOUR PLAN pt2
What resources do you have to do this? This will shape your plan.
What in-house staff can you leverage? Must you bring in some?
Key tip: Beg, borrow or sell your soul for a good clinical psychologist (or similar) to help you at least review your plan!
13/
What resources do you have to do this? This will shape your plan.
What in-house staff can you leverage? Must you bring in some?
Key tip: Beg, borrow or sell your soul for a good clinical psychologist (or similar) to help you at least review your plan!
13/
YOUR PLAN pt3
Build a list of champions, senior clinical and non-clinical folk who will be your face of your plan. Go outside your chain of command and leverage both the respected mavericks and grumpy old seniors.
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Build a list of champions, senior clinical and non-clinical folk who will be your face of your plan. Go outside your chain of command and leverage both the respected mavericks and grumpy old seniors.
14/
TIMING
START NOW. This plan will take 2-3 months to get right, it'll take iteration, haggling for money, bringing in resources, getting approvals. Leverage professional bodies, unions, NHSE and others for resources, funding and comms. And... And...
Please don't leave this.
15/
START NOW. This plan will take 2-3 months to get right, it'll take iteration, haggling for money, bringing in resources, getting approvals. Leverage professional bodies, unions, NHSE and others for resources, funding and comms. And... And...
Please don't leave this.
15/
SUMMARY
In the above 15 tweets, I've covered at extreme summary level a lot of work. You must start now, even if you're overrun with today's work. If you don't, you will have a second disaster when the consequences of the pandemic start to be processed by your staff.
16/
In the above 15 tweets, I've covered at extreme summary level a lot of work. You must start now, even if you're overrun with today's work. If you don't, you will have a second disaster when the consequences of the pandemic start to be processed by your staff.
16/
SUMMARY pt2
Simply put, if you DON'T do this, you'll be breaching your duty of care to your staff. If you leave it until you find time, then you're already too late. Find the time to start your plan for decompressing from COVID, and don't forget to include yourself!
17/
Simply put, if you DON'T do this, you'll be breaching your duty of care to your staff. If you leave it until you find time, then you're already too late. Find the time to start your plan for decompressing from COVID, and don't forget to include yourself!
17/
p.s. here's the first part that I did yesterday:
https://twitter.com/CraigNikolic/status/1348649730801344512?s=20
Part 3 on longer term plans.
https://twitter.com/CraigNikolic/status/1349336634555301891?s=20
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