Cultivating compassion:

So the aim of the session this evening is to, first of all, to explore nurse attrition rates. Hopefully, you'll be able to, apply this to your area. Initially, we'll just look at the NHS, but then we do look at as a global context. So we'll look at the attrition rates. We'll identify recruitment gaps and possible reasons for those, and we'll also examine compassionate leadership and the application to healthcare to make the most positive impact, about this within our within our systems to improve the workplace the workforce and ultimately for our service users. And I want to give you just turn. Go to the next slide, please. Sure. Thank you ever so much.

So looking at this slide here, it is NHS data, as I've said initially, and we're looking at, looking at nursing workforce, how we've grown it over the few years. And and as you can see, nurses within our healthcare organizations and GP practices, we have having increases year on year. And you can see that actually there wasn't a falloff over COVID over the pandemic. If anything, there was actually an increase in recruitment at that time, We can look at that for various reasons. We can look at it how well respected and thought of and considered the health care sector was within that period of time, a lots of uncertainty, lots of support from the public, and this had, a direct impact on recruitment at that time of training. Thank you, Michelle.

But looking at this next slide, what we do know is that the COVID 19 pandemic brought into sharp focus the global necessity of having sufficient healthcare numbers looking at nurses, looking at the the dire impacts, having shortages within our healthcare systems. We also knew there was a problem with retaining our skilled experienced staff. And the dominant and consistent concentration of the workforce research tended to look at factors including job satisfaction and burnout. We know that compassion fatigue is real within our health and social care sectors. We know that we are in this industry, within this profession because we care. But what we do know is that this does have an an effect on the workforce.

So we know that job satisfaction is heavily linked to high quality care and outcomes, safety outcomes and clinical practice outcomes. So we're looking at that link. Thank you very much, Michelle. So the pandemic had a destructive influence on the working environment for many health and social care staff. What we know about that is that there was lots of redeployment. We know that many colleagues got moved from their area of work, but there was within very structure teams that they was, very familiar with. They knew their day to day role. So actually, what in essence, what they had was a great sense of belonging. But they knew with redeployment going to areas where they weren't always familiar with, teams changing long term sickness. There was a a huge hit to the workforce regarding mental health. We knew that there was a large impact on frontline staff on the call face Now this is this is globally. We know the context of this really did hit every sector within health and social care, and that's really important to not underestimate that it's not just nurses. It was every member of the skilled mixed team that worked together to provide that quality of care.

Mental Health is the most consistent reported reasons for sickness and absence, and that's taken from NHS data, but we know that when we look at global research, We know that we can, see the the patterns, the comparisons from no matter where in the world you are working. We know that the mental health strain of of working under real pressures, has had a massive impact on staff rates, retention, recruitment, stickness, absenteeism, early retirement, so people perhaps who was considering retirement previously, maybe would have stayed working longer, maybe reduced hours. We actually knew then that they wanted to go. They they'd had to they'd reached the level of that compassion fatigue.

So what we're looking here for is as well as staff retention, which is what I've just said. That stability within the health care environment. So we we do know that people get used to working with each other. Again, it's about that accountability in knowing your own role. Knowing the role and responsibilities of colleagues as well. And when there are movements within teams and workforces, It's about understanding how we work within a new team within a new specialty, what our strengths are, what our leadership styles are, what we understand by our own work abilities, how we deal with challenges, how do we overcome some barriers.

It's a huge influence, especially the programme, the MSC healthcare programme, it looks very much at your leadership style, your emotional intelligence. Your self awareness. Do you respond to urgent situations, prioritizing, many competing priorities? How do you respond in an emergency situation? So we're looking at all these different factors that really came to the foresight of after the pandemic. We knew there was issues prior to the pandemic, but actually what that did for us, it put health and social care on the map globally on the media platforms where all eyes were on it, and and that's what we did. So, Michelle, oh, I think you've maybe moved to to the next slide. Is that right? Thank you very much. If you could read my mind, Michelle Perfect. Thank you so much.

We're looking at vacancies. And this slide here, it's about national health service. So this is very much UK led at the moment, but bear with me. We will look at this across across the whole picture globally. Now this is just mental health nurses compared to all nurses. So we're just looking at one particular field. Because we do know that there's certain factors that influence rates, but what you can see is that the vacancy rates for mental health nurses was a lot higher than other fields of nursing. Now that could be because they're actually picking up a lot of the issues from all the other areas. We know there was a backlog pre-Covid. We certainly know there's an even more extended backlog post-Covid.

Now this is just within nursing, but we know when we look at the research, this actually can be applied. It is applicable to other professions. Other specialties. We know we have a a problem with recruitment. We know that within the first two years of newly qualified graduates, leaving their profession that they have trained within. And that can be for many reasons often it's because they feel unsupported, unprepared for practice. So as leaders, how are you going to support those new recruits? Those newly qualified members of your team, and you've got to think about that. We we know that the way that the nurse training often changes where where we are within the the country is that if there is an extra barrier, we know that we can always recruit twelve trading programs. So if you're in a position where you need to think about recruitment and look at workforce planning, what are you going to put in place to make sure that your organization locally nationally and internationally is going to be able to cope with the demands of society in that area. So the next slide, five please Michelle. Thank you.

So just looking at this slide, it's actually looks at the reasons for leaving the roles. So this is including both the NHS and other organizations. And as you can see retirement is huge. We know that many of our workforce generation was due to retire. We know that this is what happened. And we know as I've already said that pre covid, many of those colleagues would have decided to retire and return. Actually post COVID, they decided not to. We know that that's what happened. They reached a point of compassion fatigue, They were tired. They felt a little unsupported. So therefore, that was one of the huge issues that actually affected the numbers in our workforce. We know that there's pay and reward issues, to keep retaining our staff. Worklife balance, if you already work within these areas, you'll be very familiar with trying to pick this balance up. So we know that that's what happens. There are some unknown reasons that we don't manage to pick up on. Relocation, health, again, that's huge. Flexibility, progression, CPD. So looking at your own development, when was you last invested in by your organization? When was you last dealing certain value that you was upskilled to develop your role professionally and personally. End of a fixed term contract, and we know commissioning services, your role might not have been recommissioned. What impact does that have on your organization and your service delivery and your provision of care in your area wherever are, whatever specialty you work within. Also dismissal, we do know that at points of stress, burnout compassion fatigue, that some professionals do not always work, abiding to their regulatory body standards. So we know that there are fitness to practice issues, and there have been some colleagues that would be dismissed, dismissed because of that.

Now looking at the next largest one here that peaks on the is workforce transformation, which is really interesting because what you would learn on the programme is about innovation and change in supporting the team members and colleagues and it's looking at what happens when a change is implemented. So we know that if a change is implemented into a workforce within a team, without the appropriate strategy to implement it, staff often feel as though they do not want to be within that change management situation they feel unsupported. They feel it's not for them. They have change fatigue as well, and they almost vote with their feet. They will leave. And if you reflect back on to organizations that you're aware of, where a change is being enforced, usually top down from people who you're unfamiliar with, you don't understand the rationale or reason for this change being implemented, and that's what happens. People then decide to leave because they feel uncertain and confused by this imposed change. Next slide, please, Michelle.

We're just looking at this. This is particularly looking at students as we'll look on, as a global context. So students are completing their programmes, but fewer people are taking up national health service full time equivalents substantive posts. And we know this. So from my own experience working with students on undergraduate programs across paramedic science, operating department practitioners, nursing of all fields, and midwifery, often there is evidence to suggest that after two years, new newly qualified graduates are leaving graduates are leaving their profession. And we know that's because they often feel unsupported within their workplace. They feel burnout very quickly. But because we've got the issue where we had lots of experienced, long serving staff retiring, moving because of another enforced change. Those new graduates are actually feeling unsupported within their area.

And often what we can see is happening is they are applying and being successful with their application for very senior roles, very senior leadership roles without that supporting under Pilling knowledge that they would have by further development and studies such as the MSC healthcare leadership online program or some further experience working within that field. So there's newly qualified graduates actually, hit the wall of burnout much quicker because they are given positions of power influence and responsibility too early without the appropriate support and skills be able to do that role.

So if we just look at the next slide, please, Michelle, this looks at an international context. So this slide's really interesting and And Patrick, you know, we've looked at this previously because we think of our students globally who access this programme, and I always find it really quite interesting how the different programmes are set up and designed. But actually the fundamentals of the programs are very similar. We have a minimum amount of hours practice hours that they've got to study to be able to pass different forms of assessment, different lens of programmes. Isn't there, Patrick? Is there anything in there that stands out to you at all?

I think one of the the interesting things about this particular programme is that we have a module which specifically looks at the global impact and global perspectives on healthcare, which is unusual, I think, and often MScs. They pretend to be more about their own healthcare systems, but it is really interesting and I think important. That people understand that the NHS is not the only way of doing health care. And I think sometimes people in the NHS get kind of really kind of wrapped up in their own experience. And whilst it's it has many strengths. It also will have some areas where other kinds of healthcare provision in other parts of, you know, the world across, you know, the whole world in, not just in terms of Europe or English speaking countries. Actually, they can deliver universal health care, which is what the NHS is there for. Often without a cost at that point of care, you know, so you haven't got to find the money if you're struggling or you're not well. But they do it with different ways. So it's funded differently, it's structured differently, and it can actually have, perfectly legitimate outcomes, which is really interesting.

So you're right, Jane, that the the challenges exist across all healthcare systems. And the solutions will be somewhere among all those healthcare systems because different healthcare systems will have real strengths in areas that other healthcare systems don't because they don't notice. But one of the the crucial areas of you know, practice that we need to constantly pay attention to his leadership. And of course, what you're gonna go on to in terms of the the type of leadership that's gonna make it work for healthcare professions and healthcare professionals, to get them through this pretty much challenging world in which they all exist. Think COVID just brought that to her head, didn't it? Just made that sharper.

But in fact, it's always been the case because you've always been dealing with people who are very poorly. Who are vulnerable, who are, you know, have needs and the health care professionals of the people at that front line who deliver that care. Yes. Yeah. Oh, goodness. I think I must maybe lost there, but you still got me. Yeah. So that's absolutely fine. So, yes, what we was looking at there is that we've got a lot to learn from each other, haven't we? We've, we can learn from different parts of the world. We can look at different training courses. What works in one country really successfully. We can maybe adapt and and look at the lessons learnt there and apply them to our earlier. Area.

So thank you, Michelle, for just bringing that on to the next slide, which is mental health and well-being of nurses and midwives in the UK report. So Kim Minnetau, looked at, studies, a hundred studies. So it was a systematic review and looked at satisfaction with job demands, and we do know that job demands play heavily on job satisfaction, and we do know from research that if we enjoy our job further, if we enjoy it more, we tend to be good at to be good at it, we've got to enjoy it. Research tells us that. So we've got to be well informed. We've got to be clearly skilled and know what we're doing.

So there's there's lots of, evidence here to know that if we feel better at work, we have a greater sense of belonging, and also we have much more camaraderie, much more team, a stronger team. So we know there's, in teams where there's high levels of burnout and stress that there is more harassment and bullying higher risk of compassion fatigue, and there's actually evidence to say that there's a really high risk of of suicide, particularly within female healthcare workers as well. Is really quite staggering, isn't it? So thank you thank you very much there, Michelle.

So what can leadership do? Well, that's the whole point of the programme and why we are fully invested in changing the world and using this to support us, is leadership can increase nurses' intentions to stay by meeting their needs. Of appreciation, a better work environment, competence development, professional and career development, and that what we are here to do and that brings us on really nicely to compassionate leadership. So this is just one model. And and what we can do here is look at the sense of autonomy.

What do we earn? What can we do? What's our scope of responsibility and our skill set, and that's our autonomy there. And you can see what that feeds into there. It's about the authenticity of leadership, credibility being able to do your job play, which then takes us onto that sense of belonging, and I have spoken about belonging. Throughout the the presentation, really, and it's about teamwork and culture and leadership. Within any health or social care organization, there is a culture that we've got to be mindful of, and it can be very easy to turn a culture into a negative one, and we know from evidence and research in our own anecdotal evidence where we have worked ourselves that a culture that is positive and supportive brings out the best in the workforce.

So this model in particular is just one of many models, which is really supportive of that. And what We know it does if there's autonomy and belonging, it improves contribution. So we know that that, therefore, your ability to cope with the workload is better. The management and supervision of yourself and your colleagues is better education learning development. So there's there's a real trajectory of career development as well and sustainability. We're able to stay within our workforce and teams for longer. We keep our staff. We retain them and we recruit. A good team will recruit other colleagues to come and join you.