11

WORKSHOPWORKSHOPCork June 11Cork June 11thth 2014 2014

Resilience, Surviving and prospering Resilience, Surviving and prospering in Health and Social Carein Health and Social Care

Dr Martin LawlorDr Martin LawlorMalcolm Rae OBE FRCNMalcolm Rae OBE FRCN

malcolmrae@blueyonder.co.ukmalcolmrae@blueyonder.co.uk0796989571007969895710

22

Aims of the WorkshopAims of the Workshop

Have a better understanding of resilience in dealing with Have a better understanding of resilience in dealing with pressures, retaining motivation and focus on quality, creativity pressures, retaining motivation and focus on quality, creativity and innovationand innovation

Understand the pressures and factors which negatively impact Understand the pressures and factors which negatively impact on individuals and teams ability to cope and function effectivelyon individuals and teams ability to cope and function effectively

Increase awareness of the benefits of heightened resilience to Increase awareness of the benefits of heightened resilience to - - individualindividual - organisation- organisation Explore what actions, support and positive Explore what actions, support and positive

leadership/management practice may be helpfulleadership/management practice may be helpful Explore how professional organisations might impact and Explore how professional organisations might impact and

influenceinfluence Consider issues for inclusion in personal and professional Consider issues for inclusion in personal and professional

resilience trainingresilience training Highlight individual responsibilities and own strategiesHighlight individual responsibilities and own strategies

33

QUESTIONQUESTION

WHAT IS YOUR UNDERSTANDING OF THE

TERM RESILIENCE?

44

RESILIENCERESILIENCE

An individual’s ability to adapt to An individual’s ability to adapt to challenges, stress, difficulties, challenges, stress, difficulties, problemsproblems

The capacity and resourcefulness to The capacity and resourcefulness to copecope

Accepting your new reality even if it is Accepting your new reality even if it is less than what existed beforeless than what existed before

55

YOU CAN FIGHT IT, YOU CAN DO YOU CAN FIGHT IT, YOU CAN DO NOTHING BUT SCREAM ABOUT NOTHING BUT SCREAM ABOUT WHAT YOU HAVE LOST OR YOU WHAT YOU HAVE LOST OR YOU CAN ACCEPT WHAT YOU HAVE CAN ACCEPT WHAT YOU HAVE

LOST AND TRY TO PUT LOST AND TRY TO PUT TOGETHER SOMETHING THAT’S TOGETHER SOMETHING THAT’S

GOODGOOD

POSITIVE QUOTESPOSITIVE QUOTES

66

Nelson MandelaNelson Mandela

77

Japanese ProverbJapanese Proverb

88

99

1010

QUESTIONQUESTION

WHAT ARE THE KEY PRESSURES WHAT ARE THE KEY PRESSURES CLINICAL STAFF ARE LIKELY TO CLINICAL STAFF ARE LIKELY TO

ENCOUNTER?ENCOUNTER?

1111

Contemporary PressuresContemporary Pressures

Massive imposed structural changesMassive imposed structural changes Financial constraintsFinancial constraints Juggling conflicting demandsJuggling conflicting demands A drive for outcomes without supportA drive for outcomes without support Expected performance improvements/regulationExpected performance improvements/regulation Service user/family expectationsService user/family expectations Changes in complexity of need, dependency and Changes in complexity of need, dependency and

challenging behaviourschallenging behaviours Fear of blameFear of blame

1212

Contemporary Pressures 2Contemporary Pressures 2

Negative media interestNegative media interest Demand for openness/transparencyDemand for openness/transparency Increase in technologyIncrease in technology Having to deal with the unexpectedHaving to deal with the unexpected Abuse, intimidation and violenceAbuse, intimidation and violence

1313

QuestionQuestion

What may help?What may help?

1414

Factors which will be beneficial Factors which will be beneficial 11

Being connected to support networks.Being connected to support networks. Governance frameworks and health and Governance frameworks and health and

wellbeing workplace policies and stress reducing wellbeing workplace policies and stress reducing activities to maintain wellbeing.activities to maintain wellbeing.

Access to confidential support.Access to confidential support. Both health promoting and opportunities for Both health promoting and opportunities for

renewal and recovery.renewal and recovery. Senior managers, board members being visible, Senior managers, board members being visible,

role modelling, supportive behaviours, including role modelling, supportive behaviours, including formal and informal debriefing, listening to staff formal and informal debriefing, listening to staff ideas/concerns, tap into their insights and ideas/concerns, tap into their insights and expertise, actively seeking ideas/suggestions for expertise, actively seeking ideas/suggestions for improvements and push and support the ideas.improvements and push and support the ideas.

1515

Factors which will be beneficial Factors which will be beneficial 22

Skills to manage competing demands i.e. quality and Skills to manage competing demands i.e. quality and safety standards v cost improvements, understand safety standards v cost improvements, understand business v compassion imperatives.business v compassion imperatives.

Skills in pragmatism, persuasion, relationship building, Skills in pragmatism, persuasion, relationship building, handling pressures and conflict, managing change and handling pressures and conflict, managing change and improvements.improvements.

Opportunities for team support and development.Opportunities for team support and development. Time and space for shared reflection, support and Time and space for shared reflection, support and

supervision to obtain a sense perspective, supervision to obtain a sense perspective, development of self awareness and trust and give development of self awareness and trust and give attention to different parts of their life.attention to different parts of their life.

Opportunities for mentorship/coaching.Opportunities for mentorship/coaching. A culture of support to consider alternative options, A culture of support to consider alternative options,

try out different strategies for solving problems.try out different strategies for solving problems.

1616

Factors which will be beneficial Factors which will be beneficial 33

Opportunities for professional development and Opportunities for professional development and updating following needs assessment, including updating following needs assessment, including tailored programmes, peer support projects, tailored programmes, peer support projects, secondments, shadowing, visits etc.secondments, shadowing, visits etc.

Debriefing and support after incidents/complaints.Debriefing and support after incidents/complaints. Opportunities for fun, humour and celebration of good Opportunities for fun, humour and celebration of good

work and achievements.work and achievements. Nominate for awards, encourage application for Nominate for awards, encourage application for

scholarships.scholarships. Role modelling of emotional intelligence, positive Role modelling of emotional intelligence, positive

practice and attitudes, acts of kindness by senior practice and attitudes, acts of kindness by senior managerial/clinical leaders.managerial/clinical leaders.

Effective communication and information channels (A Effective communication and information channels (A two way street).two way street).

1717

QuestionQuestion

What are the benefits of a What are the benefits of a heightened focus on heightened focus on resilience toresilience to

1The individual1The individual

2 The organisation2 The organisation

1818

Benefits to individualBenefits to individual

Maintain/enhance self confidence, value base, Maintain/enhance self confidence, value base, self esteem.self esteem.

Ability to make informed decisions.Ability to make informed decisions. Ability and confidence to apply courage and Ability and confidence to apply courage and

appropriately challenge systems, decisions to say appropriately challenge systems, decisions to say no, and raise concerns of poor service quality and no, and raise concerns of poor service quality and in managing conflict.in managing conflict.

Develop inner strength to keep going in tough Develop inner strength to keep going in tough circumstances, and bounce back.circumstances, and bounce back.

Heightened job satisfaction.Heightened job satisfaction. Improved personal safety.Improved personal safety.

1919

Benefits to organisationBenefits to organisation

A positive organisational culture.A positive organisational culture. Staff feel valued, optimistic, energised, pride.Staff feel valued, optimistic, energised, pride. Effective staff management.Effective staff management. Loyal, well motivated and informed workforce, Loyal, well motivated and informed workforce,

working to optimum levels, committed to working to optimum levels, committed to organisations strategy and goals.organisations strategy and goals.

Healthier workforce, reduced sickness and absence Healthier workforce, reduced sickness and absence and less emotional fallout.and less emotional fallout.

Increased awareness of prevention of ill health and Increased awareness of prevention of ill health and staff advocating for prevention and health staff advocating for prevention and health promotion with service users.promotion with service users.

Less turnover and recruitment, retention of good Less turnover and recruitment, retention of good staff.staff.

2020

Benefits to organisation 2Benefits to organisation 2

Heightened focus on patient care.Heightened focus on patient care. Consistent delivery on performance Consistent delivery on performance

standards.standards. Likelihood of innovative practice.Likelihood of innovative practice. Maintenance/enhancement of reputation.Maintenance/enhancement of reputation. More effective MDT/interagency relationships, More effective MDT/interagency relationships,

communication and partnership working.communication and partnership working. Reduced mistakes, less adverse incidents, Reduced mistakes, less adverse incidents,

formal complaints, litigation, Improved formal complaints, litigation, Improved learning from adverse incidents.learning from adverse incidents.

2121

QuestionQuestion

What is the role of our What is the role of our professional organisations in professional organisations in raising awareness and lobbying raising awareness and lobbying for support?for support?

How can they best influence and How can they best influence and impact?impact?

2222

Role of Professional Role of Professional organisationsorganisations

Advocate for good employment policies and Advocate for good employment policies and practice. Provide a blueprint for organisations to practice. Provide a blueprint for organisations to work towards. work towards.

Highlight cost benefits.Highlight cost benefits. Articulate the negative impact on patient care if Articulate the negative impact on patient care if

nurses are struggling.nurses are struggling. Seek to influence locally, regionally and nationally.Seek to influence locally, regionally and nationally. Develop a cadre of advisors, mentors, coaches Develop a cadre of advisors, mentors, coaches

(support and value them).(support and value them). Provide personal/professional development Provide personal/professional development

opportunities local/regional.opportunities local/regional.

2323

Role of Professional Role of Professional organisations 2organisations 2

Hold organisations to account.Hold organisations to account. Point to where good practice is working Point to where good practice is working

well.well. Consider incentives of accreditation of Consider incentives of accreditation of

good health and wellbeing employment good health and wellbeing employment policies and practice. policies and practice.

Advocate for evidence based research and Advocate for evidence based research and resilience to feature in pre and post basic resilience to feature in pre and post basic training programmes, which enable staff training programmes, which enable staff and students to develop coping skills for and students to develop coping skills for difficult situations.difficult situations.

2424

Training and Professional Training and Professional DevelopmentDevelopment

Question: If we are to equip staff Question: If we are to equip staff with the necessary skills and with the necessary skills and capacity to withstand pressures capacity to withstand pressures and cope, what are the themes and and cope, what are the themes and issues which should be considered issues which should be considered for personal and professional for personal and professional resilience training and resilience training and development development programmes/workshops?programmes/workshops?

2525

Development ProgrammesDevelopment Programmes

Stress awareness, protective factors and Stress awareness, protective factors and management.management.

Self awareness of emotional health and wellbeing, Self awareness of emotional health and wellbeing, and that of your team.and that of your team.

Dealing with disappointment and learning from Dealing with disappointment and learning from adversity.adversity.

Self care, promoting self resilience through accessing Self care, promoting self resilience through accessing support, reflective practice and supervision.support, reflective practice and supervision.

Improving self esteem and self belief.Improving self esteem and self belief. Social competences and friendships.Social competences and friendships. Celebrating your strengths and assets.Celebrating your strengths and assets.

2626

Development Programmes 2Development Programmes 2

Avoiding victimhood.Avoiding victimhood. Being adaptable, flexible, learning, Being adaptable, flexible, learning,

innovative and the capacity to walk in innovative and the capacity to walk in another person’s shoes.another person’s shoes.

Putting perfectionism into perspective.Putting perfectionism into perspective. Sleep hygiene.Sleep hygiene. Effective time management.Effective time management. Understanding why things go wrong.Understanding why things go wrong. Problem solving.Problem solving. Communication skills.Communication skills.

2727

Development Programmes 3Development Programmes 3

Keeping well including 5 Ways to Keeping well including 5 Ways to Wellbeing (Protective factors).Wellbeing (Protective factors).

Creating a sense of belonging.Creating a sense of belonging. Motivational skills.Motivational skills. Importance of physical, emotional Importance of physical, emotional

and spiritual health.and spiritual health. Recognition of unhealthy behaviours.Recognition of unhealthy behaviours.

2828

Development Programmes 4Development Programmes 4

Learning resilience skills from sport Learning resilience skills from sport including:including:

PreparationPreparation Managing expectationsManaging expectations DecatastrophisingDecatastrophising Focus on positive thinking, confidence, self Focus on positive thinking, confidence, self

belief and motivation and mindfulnessbelief and motivation and mindfulness Visualising and optimising expectations of Visualising and optimising expectations of

success, opportunities and hope buildingsuccess, opportunities and hope building Aspects of CBT and emotional controlAspects of CBT and emotional control

2929

The Survivor TreeThe Survivor Tree

3030

The Survivor Tree: A Story of HThe Survivor Tree: A Story of Hope and Healingope and Healing

A  pear tree became known as the "Survivor Tree" A  pear tree became known as the "Survivor Tree" after enduring the September 11, 2001 terror after enduring the September 11, 2001 terror attacks at the World Trade Center. In October attacks at the World Trade Center. In October 2001, the tree was discovered at Ground Zero 2001, the tree was discovered at Ground Zero severely damaged, with snapped roots and burned severely damaged, with snapped roots and burned and broken branches. The tree was removed from and broken branches. The tree was removed from the rubble and placed in the care of the New York the rubble and placed in the care of the New York City Department of Parks and Recreation. After its City Department of Parks and Recreation. After its recovery and rehabilitation, the tree was returned recovery and rehabilitation, the tree was returned to the Memorial in 2010. New, smooth limbs to the Memorial in 2010. New, smooth limbs extended from the gnarled stumps, creating a extended from the gnarled stumps, creating a visible demarcation between the tree’s past and visible demarcation between the tree’s past and present. Today, the tree stands as a living present. Today, the tree stands as a living reminder of resilience, survival and rebirth. reminder of resilience, survival and rebirth.