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The power of storytelling through the pandemic

Isabelle Mundy 24 November 2020

Our Programmes Coordinator Isabelle Mundy writes about two evaluations of the first phase of our Team Time initiative to support healthcare workers during the Covid-19 pandemic.

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But in the end, stories are about one person saying to another: This is the way it feels to me. Can you understand what Im saying? Does it also feel this way to you?” Kazuo Ishiguro

At the Point of Care Foundation, we believe in the power of storytelling as a way to build understanding and empathy, and to support health and care staff to reflect on the emotional impact of their work.

Our immediate concern in the Covid-19 pandemic was the barrier social distancing rules would have on the running of Schwartz Rounds at a time when health and care staff would need emotional and psychological support more than ever. In response, we launched Team Time: a team-based online reflective practice, providing a safe space for staff to share their experiences and the emotional impact of their work during the crisis. Since April, we have trained over 500 Schwartz Rounds facilitators to implement and run Team Time across the NHS, HSE Ireland, the children’s care sector, vets, higher education institutes, and hospices. We have also been tasked by NHS England to implement Team Time in 30 NHS Trust sites that don’t currently run Schwartz Rounds and who have faced particular challenges during the COVID crisis. 

To help us understand the feasibility of running reflective practice sessions for staff online, with the support of the Health Foundation we have evaluated the implementation of Team Time. This involved interviewing facilitators who had attended the Team Time training and analysing over 800 online feedback entries from those who have taken part in a Team Time session.

We’ve found the Team Time model has been adapted by organisations to suit their own needs. We proposed that virtual sessions should be run in small team groups – up to 30 – to help create a more contained, safe space for dealing with the raw, unprocessed material which may present given the landscape of Covid-19. Whilst some have stuck to this model, others have chosen to open these sessions out to the whole organisation. Some have tried a mix of virtual and physical sessions, with some attending in a socially-distanced physical space and others joining virtually. 

So, is it better to run this sort of practice on a team level or at an organisational level? Whilst some found team conversations to be really powerful, others felt there was more benefit from connecting staff across the organisation. Although feedback on group size varied, generally smaller groups were preferred as these felt safer.  

Having a small sized group and a team I was familiar with was helpful

The use of an online forum was a key concern prior to implementing the sessions.  However, many found that the stories and conversations did translate, and that staff were still able to connect with each other online. Participants talked about how the sessions enabled them to connect as a team and hear that colleagues were having shared experiences and feelings, which was reassuring and made them feel less alone. Participants were able to understand their colleagues more and feel reassured and validated.

Just found it so supportive hearing and knowing that colleagues are facing similar challenges to me and that I am not alone with this struggle

There were however a handful of participants who found the sessions made them feel disconnected from their colleagues. We recognise that Team Time is not for everyone, and that it is one among a mosaic of staff support interventions. The important thing is that the right intervention is offered to the right person, at the right time.  

We heard other concerns about scalability and equity. Which teams should be offered Team Time? This is where organisational buy-in is important to ensure there is enough resource to run Team Time at an impactful level.  

Despite these concerns, online access was a huge benefit, particularly in community settings and other geographically dispersed organisations. Team Time is reaching people who would not ordinarily have attended an in-person meeting such as a Schwartz Round. 

I have found attending the sessions difficult in the past due to work timetable, commitments and travel. This was a great way for me to engage in these sessions

We have learnt valuable lessons along the way: about the need to be flexible and pragmatic, for example about having cameras on or off, the length of the sessions, and the definition of the ‘team’. We have learnt too about the importance of proper preparation and follow up when running Team Time sessions. This means setting expectations, providing clear guidelines on the use of technology, making sure attendees are aware that the session may be emotional, and having a clear plan for follow up are all crucial to ensure the safety of the sessions. 

We are delighted that Team Time has been so warmly received by both facilitators and participants. There is widespread acknowledgement of the need to continue reflective practice despite the barriers we are currently facing. Facilitators and participants alike have found Team Time to be a valuable outlet for discussing the emotional impact of their work and for promoting team understanding and cohesion. Whilst face-to-face reflective practice remains the ‘gold standard’, there is still a place for an online team-based intervention, even when we’re able to meet again. 

I think it is probably singularly the most important thing we have done for our staff mental and emotional wellbeing during this whole period

You can find the evaluations in full below: 

Team Time phase one evaluation

Team Time phase one online feedback evaluation

Acknowledgements:

We are grateful for the generous support of the Health Foundation, which enabled us to develop and evaluate phase 1 of Team Time. We would also like to thank our Schwartz Community for supporting the implementation and delivery of Team Time. Special thanks to our associates Aggie Rice and Rhiannon Barker, who did the bulk of the work in developing and delivering Team Time training. Thank you to our Schwartz Rounds mentors and facilitators for supporting this work and its evaluation, and to every Team Time participant who has taken part in this intervention and generously taken the time to give their feedback.