Emergency Department staff take solace in ‘Coffee and Vent’ sessions at Devon hospital

Dr Annette Rickard, Consultant in Emergency Medicine

When the global pandemic hit the UK, NHS emergency teams knew their challenging jobs were about to get harder.

Staff that work in the Emergency Department at University Hospitals Plymouth NHS Trust (UHP) are no strangers to working in a high-pressure environment.

As the largest acute hospital and major trauma centre for the South West Peninsula, they could anticipate what was coming. For many clinicians across the UK this was a terrifying time.

“The problem was perceived before it had really hit us. We know emergency medicine is hard at the front door.”

The Trust’s Clinical Psychologists, Counsellors, Occupational Health and Organisational Development teams came together to help. They wanted to provide psychological and practical support to those experiencing difficulty or mental health crises.

mug of black coffee on wooden table

There was also a need for early intervention to protect the workforce from psychological distress and the potential for sickness absence that could put further pressure on the service.

From the resulting multi-pronged strategy, one of the projects implemented was a safe space for colleagues to talk.

Dr Annette Rickard, Consultant in Emergency Medicine at UHP said that in normal times, she would be able to invite close colleagues who were struggling for a coffee and chat. As Covid-19 made that impossible, she set up a virtual space to talk, in an informal setting. The virtual ‘Coffee and Vent’ sessions were launched.

Annette said: “The problem was perceived before it had really hit us. We know emergency medicine is hard at the front door. We know that frontline staff are at risk from burnout and PTSD. My first job was to publicise the virtual invitation into my space for a cup of tea and chat.”

The resulting conversations were a great success. 20, one hour-long Coffee and Vent sessions took place between March and October 2020, with varying numbers of attendees from just five people, up to 20 participants.

Helping to facilitate the safe discussion was Staff Counsellor Natalie Ashley, who helped hold the space and support people if they became upset or distressed. The Trust lead for Safety Culture and Psychological Safety, Matt Hill – with experience of working in the Emergency Department – was also on hand.

Staff Counsellor Natalie Ashley

Annette explained: “I gave a pre-amble at the start of each session for the benefit of any newcomers, stating that this would have been an actual coffee at my house where people could relax and chat about whatever was on their chests, or just enjoy coffee and listen to colleagues.

“You could say anything you liked. If people had any concerns about safety they could escalate those to an Emergency Medicine Consultant.

“Using the private chat function, we were able to signpost people directly. We had all sorts of conversations, sometimes related to Covid, and sometimes not.”

Themes discussed included work rotas, managing time for non-clinical work, team working and how to avoid silos, communication and leadership, and how to manage ‘post-COVID extraordinary effort fatigue’.

Image of online group chat

Annette added: “It was an opportunity to talk about issues where we could affect change within the department, but some of the conversations were just about listening.

“Some of our colleagues were at home with Covid at the time, some were shielding and feeling isolated, and it was a way of connecting us all.

“Many colleagues become regulars at dialling in, and it was particularly popular with the last rotation of doctors.

“The psychologist that joined us on those calls has become a friend of the Emergency Department and has been able to reach out to individuals on a more personal level. It worked really well.”

Comments from participants:

“The last group I found extremely beneficial especially after you all left, I had a sort of unofficial counselling session with Natalie, which I really appreciated.”

“Great session today and well hosted. There were some really interesting points in the conversation. I really liked the talk of teams and huddles and how they build connection and have practical benefits. I also liked the way the leadership behaviours were identified and recognised as being helpful. These are incredibly powerful.”

 “Truly everyone is a legend and we need to keep that respect for each other, we are the ones who need to clap for each other.”

“We have the best ED in the world with the best people in the world. We are the only ones who can make it a better place for all of us.”

 “Great session, really well hosted! I am keen and happy to be part of future sessions. Really interesting themes that definitely need attention and thinking about by us and the wider Trust.”

“Thank you and love you all amazing people. It will all be over soon and history for our children to learn from. Keep the ED family together”

For more information about support for NHS staff visit: https://people.nhs.uk/

Further reading:

NHS People guides and bitesize learning

Click here to visit the University Hospitals Plymouth Support Hub.

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