In this blog, Sabine Schwaebish, Care Team Leader, RNLD at Helen and Douglas House children’s hospice shares her reflections on supporting staff.
Our hospice is nearly 40 years old and over the last three years many of its long-serving nurses have retired or moved on. The balance has clearly shifted from a mature workforce to a younger team. Both are qualified and dedicated, but do the emotional demands pose more of a challenge to a younger workforce? Do they have the same degree of resilience? How can we best nurture and support them?
The ‘parental generation’ of carers and nurses were part of the generation who defined the children’s hospice movement and who developed the deeply caring philosophy which makes paediatric palliative care so holistic, unique, therapeutic and effective. They have a wealth of life experience which brings with it emotional maturity and wisdom.
The emotional demands on staff
Is end of life care harder for our younger colleagues? The answer is Yes and No as so much depends on the individual. Life experience is not only measured in lived years. Maturity, resilience and passion can come from unexpected sources. Age does not guarantee emotional and social intelligence.
It is the ability to confidently ‘hold and contain’ a traumatic and deeply painful situation, which requires emotional strength. We need to acknowledge and face the pain with families, while calmly radiating hope for a peaceful and dignified death and for a future that may offer some peace.
To be with a family and walk alongside them requires staff to strike a balance of empathy and professional distance, so that they are still able to provide therapeutic care to the children and families. The ability to manage this balance; to have high self-awareness and to find job satisfaction in these meaningful, but distressing experiences requires personal and professional passion.
Diversity is key
Carrying on the ethos of the children’s hospice movement does not depend on the number of years in service, but on collective experience. It is influenced by many factors and particularly by diversity and teamwork.
What’s key is the variety of professional backgrounds. At Helen & Douglas House, we have Children’s Nurses, Learning Disability Nurses, Adult Nurses and one dual trained Mental Health Nurse (RNLD) – as well as carers and nursery nurses from wonderfully versatile backgrounds. They all complement each other.
Diversity is healthy and can be very energising, not just for the staff team itself, but also for our children. I think families embrace the wealth of talents and variety of skills offered, which contribute to a rich experience of care.
“We need to value and trust in our experience, whether or not that is measured in years.”
Supporting younger colleagues
Paediatric palliative care is a skill that requires time to develop, so we need to be patient with each other and nurture our colleagues, particularly those ‘young’ in Helen & Douglas House years. Supporting a family at the most desperate of times is intense emotional labour, which needs to be recognised. Every carer responds and recovers in individual ways.
What seems most supportive is sensitive, respectful and flexible teamwork. We need to look out for each other. We need to guide, mentor and share our learning – both ways! To support non-judgementally, while accepting the responsibility to develop self-awareness and self-care. All staff need protected time and space for reflection
Nurturing them as sector leaders
One young colleague recently noted that her generation are (or are becoming) the new leaders of the sector and that they need to take on the role of protecting the children’s hospice movement’s heritage whilst leading its development.
The wealth of knowledge passed on from our retired colleagues is unmeasurable and I am deeply grateful to have learned from them. To humbly rise to the privilege of supporting our children and their families on their unique journeys, is one of the most meaningful and rewarding jobs. We need to take on the challenge – to embrace change and to merge old and new wisdom. We need to trust in our passion and take inspiration from the incredible children and families we support.
My top tips for supporting staff:
- if regular protected time is difficult to find use short, ad-hoc moments to reflect, nurture, coach and bond (night shifts, tea breaks, pre-admission periods etc.)
- check in with colleagues, even if they say they are fine – being asked may make all the difference
- encourage a gentle and open culture within the care team about how experiences affect us (if nobody says that experiences make them feel sad, others may think they are not meant to either)
My top tips for new staff
- for new starters, provide a staged introduction to end of life care
- offer a buddy system for new starters to help them settle into the hospice environment and provide reflective support sessions
- acknowledge the importance of time (potentially years) to develop specialist skills