Organisation

Southern Health NHS Foundation Trust

What was the aim/problem?

Having commenced the Professional Nurse Advocate (PNA) programme, which includes emphasis on staff wellbeing and the impact this has on quality of care given to service users, I began to think about the holistic wellbeing of the Community Nurse Team I work in. The programme was particularly timely in that services had returned to business as usual following some changes in service delivery required because of the pandemic. In addition, a component of the programme was to undertake a project with the overarching aim of improving health and well-being.

The pandemic had impacted on the team for a variety of reasons both work-related and some more personal. Some felt disconnected to the team as a result or remote working, reduced face to face visits and redeployment opportunities. I initiated the completion of the World Health Organisation-5 (WHO-5) wellbeing index as a means of measuring wellbeing within the team.

Although there is extensive well-being support available to staff through the Trust, the outcome of this process identified that our nurse team would benefit from additional more localised supportive approaches. This included attention to physical health and exercise as a means of improving wellbeing.

I took the opportunity to ensure that all nurse team members were aware of Trust wellbeing resources and wider support services and signposted to our organisations Wellbeing hub.

What was the solution?

Using the Plan, Do, Study, Act (PDSA) cycle in addition to the completion of the wellbeing index, I reviewed Nurses experience of exercise more generally, potential impact of this, and the impact that being a Nurse can actually have on our physical health. Evidence suggested when Nurses were taking part in exercise, they in turn became more mindful of what they were eating (Tucker et al. 2011) and were also more inclined to deliver appropriate health promotion messages to service users (Blake et al. 2011). Although a core element of the role of the learning disability nurse, there is the added benefit of being able to role model and share through experience.

Brogan et al. (2020) identifies that due to the amount of time spent in work and shift patterns, this can make it much more difficult for them to complete the recommended daily/weekly amount of exercise. Batt (2009) had previously noted that 60% of our waking hours are spent at work.

It is widely acknowledged that not only does physical exercise have a positive impact on our physical health, it also has a positive impact on our mental wellbeing.

Recognising that our nurses have a range of responsibilities and demands upon them outside of working hours, I thought it sensible to include some opportunity for physical exercise into our working day

I undertook a wider scoping exercise with the nurse team including the use of a questionnaire which I developed specifically looking at how they would like their wellbeing supported within the workplace. Responses identified that some focus on exercise/physical wellbeing would be of benefit, as they felt that they already had access to a wide range of alternative wellbeing support options.

Analysis of the data and further discussion with the nurse team members led to the inclusion of walking breaks within our working day. Initially we started using our lunch breaks to include 10 mins of walking time each day. To support the positive impact of these scheduled walks we also downloaded a free app that keeps track of the 10-minute walking sessions and measures briskness to optimise effectiveness and positive impact.

What were the challenges

There have not been any difficulties with the walking breaks other than at times not all team members are available at the same time. At these times, efforts are made by all to partner up with at least one other nurse team member, so they still have their walking break. We have also included walking breaks in our regular Nurse meetings so that there is an occasion where we can all enjoy this activity together.

Pre-empting the changes in weather ahead, we have already agreed that as an alternative we will use the time dedicated for our walking breaks to undertake some form of exercise in our meeting room, utilising some new equipment recently purchased.

What were the results?

Due to the timescales of the programme and the development and implementation of the project, there remains more to do. I intend to repeat the WHO Wellbeing Index exercise, as well as gathering additional feedback and comments to measure the impact that the introduction of the walking breaks had had on our wellbeing. This will inform our next steps.

What were the learning points?

Informally, team members have stated that they have been generally more mindful in terms of their physical health and exercise, and others have said that the walking breaks have supported them to reconnect as a team.

With there being more of a focus on our physical health this in turn has led us to be more mindful of our contributions to the teams “sharing snacks area”, with us now sharing much healthier options.

Next steps

Following evaluation, it is my intention to share the findings across our wider service and organisation.  Emphasis will be placed on the positive impact of physical exercise to staff wellbeing and the impact this then has on the quality of care for our service users. Considering my own reflections in undertaking this project, I think it’s important to remind ourselves that sometimes the smallest of changes can make a really big difference.

Want to know more?

Amy George, Strategic Health Facilitator, amy.george@southernhealth.nhs.uk