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Hi, my name is Heather Chambers and I am a black Assistant Psychologist working in the MOSAIC CAMHS’s team for children with disabilities. I’m sure by now you’ve all either seen or heard about the very public way in which George Floyd was killed. Like many other black people I’ve spoken to, his death and the way in which he was killed, touched something deep within us. It was something strong and unique, and it was something that united us all in our blackness. It was a united understanding, a united understanding that not only could George Floyd have been any of us, but also that his experience is us. When I watched his killing on national TV, I felt a pain like I had never felt before. I grieved for someone I had never met. I grieved for the world and the human race.

This pain and this grievance led me to think about my own experience of racism, and what that looked like growing up as a black female in the UK. I collected these thoughts into a poem, and I’m going to share those with you today.

Portraits, affixed to the wall of a gallery, tell the story of lands and great leaders of time gone by. Every great period of time has a story to tell. Every great period has something to solidify the greatness as a memory, to permeate that particular moment in time, so that when the future arrived, we would all remember, said greatness.

But do you remember my greatness? Do I even remember my own greatness? Are portraits of my ancestors affixed to the walls of the National Portrait Gallery, the Tate, The British Museum? Are the true stories of British colonialism plastered inside the pages of English history books?

So much of my history is lost. I don’t even know, and don’t think I’ll ever even know my true surname.

Surviving slavery was greatness, surviving racism for 400 years is greatness. Surviving being black is greatness. Being black is laced with the magnitude of greatness. And yet, somehow, I do not see this greatness anywhere. I do not hear it. People do not speak of it. The greatness that is so strong and solidified in my heart has been tarnished with a view of weakness.

You see, I exist in a world in which black history is more than just a month. It lasts for a lifetime. I exist in a world in which people act surprised when I start talking. And proceed to tell me how well-spoken I am. I exist in a world in which I’ve witnessed my brother be stopped and searched by police countless of times, just because. I live in a world in which my teenage self was branded as a bully, because I was strong and vocal enough to stand up to the real bullies.

I live in a world in which I am told all lives matter, and that racism no longer exists. However, if all lives matter, tell me this, why are black people still being killed?

I live in a world which saw the 13th Amendment to the US Constitution passed in December 1865, abolishing slavery for good. I live in a world in which 155 years after the supposed abolishment black people are still being spoken to, and treated like slaves. I live in a world in which George Floyd was allowed to be murdered in cold blood. I live in a world in which this injustice is apparently justice. I live in a world of constant trauma, fear and labelling. I live in a world that is not free. I live in a world that is not for me.

I know that many of you are shocked to see what is going on in America. But I’m not. I’m disgusted. I’m horrified. I’m angered. But I am not shocked. I have grown up around racism. I’ve experienced it first times, countless times, both as a young girl and as an adult. I have lived with it.

I know it exists, and I know it is wrong, and it needs to stop. Society must wake up, open their eyes and start smelling the racial coffee. Stand up for your brothers and sisters, speak out against racism. Be the voice that we need people to be.

So Black Lives Matters does it? In what way does it matter? Ask yourself, how will you show that it matters? How will you educate yourself on black history and what it means to be black? How will you stand up? How will you fight?

The time has come. Let’s fight with our mouths, fight with our words, and fight with our art. Let’s use our voice to make a difference. Let’s make a change. Growing up black was never easy. But I one day hope for a day when it will be easy for the future black generations to come. Because Black Lives Matter.

Thank you for listening to that poem. I just want to note that, although those are my reflections, those experiences are true of many black people across the globe.

And to close I just wanted to draw attention to two words, response and retaliation. In the past when I’ve tried to confront colleagues or friends about racism, they have often retaliated defensively. And their response has often been one of invalidation. The way in which we respond and retaliate to racism is crucial in bringing about change. Responding with empathy, openness, and a willingness to listen to people who have experienced racism first hand is crucial. Similarly, actively looking for racism, challenging racist behaviour, and not staying silent and complacent, are positive forms of retaliation, which are also crucial to change.

I’m tired, and black people are tired. We’re tired of talking and fighting this fight. Talking about being black or being a part of the BAME community, fixing racism, this is not the sole responsibility of those people. It never was. It’s the responsibility of everyone, including white people. To leave you with this, I want you to ask yourself, the next time you witness racism or hear someone say that you’ve been racist towards them. What will your response and retaliation be?

Thank you for listening.

Heather Chambers is an Assistant Psychologist working in the Camden MOSAIC CAMHS’s team for children with disabilities. Heather shares her powerful poem and an accompanying commentary to frame the poem that asks important questions about how all of us can actively do, say, and think things differently when racism is active – our own, or someone else’s. View the transcript to see the images that accompany Heather’s poem.

My name is Melanie Wood and I am a CQC Registered Manager within Independence and Wellbeing, Enfield.

To understand the critical importance of the work that our staff do, it is helpful to understand their working environment and their role.

Our staff go into people’s own homes after they are discharged from hospital, frequently after clients have had surgery, accidents and ill health. We provide rehabilitation and personal care services. Being a front-line carer is not an easy job – you are dealing with people at a vulnerable time of their life, often frail, elderly and recovering from illness, along with balancing the support of their anxious families.

Entering someone’s home with only basic information is daunting at the best of times – dealing with the additional risk of COVID infection, has posed a level of risk we have not experienced before.

In recognising the importance of this role, it is also important to consider how staff have felt during this time about their work.

This key group of staff had to make choices in relation to their work. We had a mixed approach to these, some staff wishing to remain home to protect vulnerable family members, and those who worked above and beyond, working additional hours at times to ensure our clients remained safe.

I experienced carers being tearful and scared, seeking constant reassurance, and as a manager I had to understand this and have empathy. I had to be a leader and had to view things from the perspective of our front-line workers. I had to listen to them!

The key areas of fear being experienced was:

  • Do we have the correct PPE?
  • Disposing of PPE safely
  • Being asked to support COVID clients
  • Risks when going home to family
  • Families in the client’s homes not adhering to lockdown measures or social distancing, and having sometimes difficult conversations with them
  • Social media information verses government information was confusing
  • Lack of testing initially available

It is important to share with you the measures we took to manage this situation, which resulted in all care and support services being delivered and staff being more resilient. When I review this today, I realise how far we have come, and what we have achieved as a service. Staff now have the approach “treat everyone as potential COVID”, which reduces the risk considerably. The staff have adequate PPE, and this has played a vital role in staff feeling safe.

We had no prior experience of such a pandemic across all sectors – we were going in to the unknown.

In those early days we were all adrift trying to find some routine, some structure, some consistency whilst information was being cascaded thick and fast; changing frequently, creating confusion and uncertainty. We went into new ways of working, office-based staff and managers having to work from home, to keep environments safe. I felt vulnerable, fearful and at times irritable. The fears being; what if I don’t get it right, what if I provide incorrect information, or not providing the right support at the right time, we could lose staff, or worst still not have the capacity to meet the needs of those we support.

The starting point was to increase Skype meetings. Moral was low, and no one had immediate answers to all the questions.

The Skype meetings with managers of other services within our organisation provided the backbone and support I needed. We were able to identify key individuals to do specific pieces of work, these being:

  • To contact recruitment agencies to obtain additional staff, to manage the reduction in staff available
  • Temporary redeployment of other staff teams, into front-line services to increase capacity
  • Reviewed the infection control policy, and circulate to all
  • Develop a detailed risk assessment, pulling together the government and NHS guidance
  • Contacting PPE providers to source adequate  PPE supplies
  • Consultation with HR to have the appropriate responses for staff experiencing different situations, and options available to them.

I followed on with a daily meeting with my teams. This enabled me to feedback current information promptly and ensured everything being cascaded was understood. This provided a platform for all staff to feedback openly, and without judgement and feel respected.

It was vital everyone was delivering the same message which was current and accurate.

Melanie Wood is an Independent Living Team Manager for Independence and Wellbeing, London Borough of Enfield. Melanie provides a guide to creating consistency in homecare settings.

Hello, my name is Jane O’Rourke. I’m a Child, Adolescent and Family Psychotherapist, and I’m a yoga and mindfulness teacher. Nadi Shodhana breathing, alternative nostril breathing, is really really good for helping to calm and centre the mind, I call it instant mental first aid because it is so good at helping balance the nervous system. In yoga tradition it is believed to synchronise the two hemispheres of the brain and a study has found that people who practice Nadi Shodhana, or alternative nostril breathing reported lower stress levels.

So if you would like to give it a try now find a comfortable seated posture. So, perhaps sitting on a chair or on a cushion on the floor so your back can be nice and straight, sitting nice and tall. And bringing your hand up towards your face, your ring finger is going to be placed very gently on your left nostril and your thumb is going to be placed very gently on your right nostril, and then the index finger and the middle finger are going to be very gently placed on your forehead. So the aim is to keep the breath nice and gentle and soft and relaxed during the practice, so not any forcing of the breath, and the idea is for a regular and even in breath and out breath and very very gentle and soft, so you can barely hear the breath. And I am encouraging you to go at your own pace if you are finding that I am going too fast or too slow. We are only going to do five rounds so it is going to be quite quick but it will be interesting for you to see what the effects are for you. If you don’t instantly feel calm and relaxed by doing this practice it might be something that you need to practice a few times to get the benefits.

So let’s begin, so just starting to take a normal breath in and out through the nose and then gently close off the left nostril with your ring finger and breathe up through the right nostril. Gently place the thumb on your right nostril and lift the ring finger off your left and breathe down through the left. Breathing up through the left, place the ring finger back on the left nostril and breathe down through the right. Breathing up through the right nostril, place the thumb back on the nostril, lift the ring finger off the left and breathe down through the left nostril. Breathe up through the left nostril, place the ring finger back down and breathe down through the right. Breathing up through the right nostril, place the thumb back on the right and then breathe down through the left. Breathing up through the left, place the ring finger back down on the left and then breathe down through the right. Breathing up through the right, place the thumb back down and then breathe down through the left. Breathing up through the left, place the ring finger back down and then bring the breath down the right nostril. And then gently taking the hand away, placing your hands on your lap and just take a few breaths in and out through both nostrils. Allowing the breath just to return to its normal rhythm, so not forcing the breath in and out, just allowing the breath to move in and out through the nose, nice and gently.

And perhaps watching your breath for the next minute or two, moving in and out of the nose at a nice, gentle, regular rhythm. Even in breath, even out breath. You can practice this everyday if you like as a way of keeping the mind nice and calm and steady.

 

Jane O’Rourke shares a traditional yoga breathing practice, Nadi Shodhana or alternate nostril breathing, that can quickly calm the mind. Jane is a Yoga and Meditation Teacher, and a Psychodynamic Psychotherapist with Children, Young People and Families. She teaches Yoga4Trauma within the Trauma Service at the Tavistock and Portman NHS Foundation Trust.

Wellbeing Quiz Profile: #MoreFrantic #FeelingHopeless

Recently I was with a group of nursing colleagues and we were discussing their particular experiences of nursing at the height of the COVID pandemic. One nurse in particular, spoke with despair about feeling utterly stripped and bereft of any sense of being an effective nurse, he had seen so many patients die, he had felt so helpless that wondered whether he actually justified the title of being called a nurse.

I could see that my colleagues were nodding in some sort of recognition of what he was saying and the quality of his despair. So I asked him to say a little bit more, and he started to describe a particular patient he had been a key nurse for, and this patient unusually had been on the ward for over three months. In that length of time he had really got to know this woman, he had got to understand her he thought, he had provided her with comfort along with his colleagues, she had become quite a known patient on the ward because of the time she had spent there. He had known what had made her comfortable, what she liked to eat, what she didn’t like to eat, what made her irritable, what made her slightly more hopeful, he cajoled her, he tried to revive the life in her and accordingly on many occasions she did appear to be close to recovery, but then, as is often the case with a patient suffering COVID, there would be a very sudden unexpected and catastrophic decline in the state of health. But because she had recovered many of these dips in her health there was a consensus in the ward that she would probably make it. And then one day he turns up for an early shift and he is told the awful news that she had died very suddenly in the night. “What a waste of time!” he exclaimed, it was a shocking thing to say but it was authentic, and I knew that his colleagues understood exactly what he meant. We acknowledged that very painful and angry state of mind, when one’s efforts, one’s real hard dedication seems to have been worth nothing and that’s what nursing COVID patients often leaves the nurse with. It is a particularly cruel aspect of this type of nursing and this type of illness.

But I thought that it might be helpful to think what else was behind that anger and that sense of futility and we started to think about a sort of intimacy that does play a part in nursing patients who are not going to respond to a care plan or to a medication but who are inevitable there to die. It is a cruel travesty, in terms of nursing, to feel that there is nothing actively, there is no process, there is no procedure that is going to make a significant impact and you are left being a human being, ok with skills, with experience, but ultimately you are one human being with another person, with another human being who is dying. And we thought about the exceptional experience of doing that on behalf of society, being there with the patient at the most extreme point in their life and then inevitable death, and we thought about why it is so difficult in the quietness and in the space of being able to reflect, why is it felt so difficult to appreciate that might actually be a terribly important aspect of nursing. To really be with the patient, with their agony, with their despair, with their hope, with their irritability, that the being with all of those different things that one patient can bring, all those confusing and complicated things that the patient brings with them, that being with is implicit in the nursing role, and perhaps it is difficult for us as nurses to acknowledge it because it doesn’t get measured, it is not included in the care plan, it is not something that we easily can describe, but it is there in what we do and in being with the patient who has exhausted all of the doctors initiatives and skill and experience, it is down to the nurse to be with that patient and to do something that no one else is able to do, to watch, to feel, to be with and to witness.

Maria McMillan is a Psychiatric Nurse and a Psychoanalytic Psychotherapist. Maria talks about the importance, if you are working with those who are very ill or dying, of being there even when you can’t prevent the illness from taking its course. This material relates to a piece of work she carried out recently on behalf of the Tavistock and Portman NHS Foundation Trust.

Wellbeing Quiz Profile: #RelivingTrauma #DoingOkay

We know that child and family social workers and team managers have been working hard to ensure children are safe during the COVID-19 pandemic. We have heard about innovative ways of working with families on the doorstep, in front gardens, parks and virtually online.

During our social work training many of us have been told to develop strategies to ‘switch off’ and ‘don’t bring work home’ and develop good ways of separating home life and work life. We are encouraged to distinguish between our personal self and our professional self – and examine where they overlap – both these ‘selves’ come to work every day – now both are at home as well.

What does it mean when we have to discuss very sensitive and emotional things with families and children from our own homes, even our own bedroom. During COVID the boundaries on home and work have become blurred.

Social work is always emotive and the added layers of COVID-19 compounds emotions. So, reflective and supportive supervision is vital to help unravel some of the emotions experienced.

A few years ago, I conducted some research asking newly qualified social workers (NQSWS) to rank their emotions, I did not specify positive or negative emotions. Can you guess what the top three emotions experienced were?

What top three emotions are you experiencing today? You can write them down and reflect on what you think may have evoked these emotions. Think about when you may have felt like this before – and what you did to work through the emotions.

Going through this process of feeling, identifying, understanding and developing strategies to make sense of and live with our emotions can help to build resilience and awareness when negative emotions surface again.

The top 3 emotions the NQSWS said they were experiencing were:

3. Anxiety

2. Anger

1. Sadness

When I shared with them that they were telling me the strongest and most frequent emotion they felt was sadness  – they were at first surprised but then shrugged their shoulders and said – of course, we are sad.  At that stage they did not have the opportunity to express their sadness about the families they were trying to support.

We know that when we experience emotions our body responds in certain ways for example a change in heart rate, blood flow, different hormone secretion and we might even walk differently and our posture changes. Sometimes when lots of people are in the same space experiencing similar emotions our bodies can mimic each other. This is one thing when we are working in our offices – but what does it mean when we are frequently at home with our families?

Can you think about where in your body you experience negative and positive emotions? What happens? Do you sweat, breathe differently, what do your hands do? Do you feel any sensations in your stomach, your head, your neck? What do you notice about your body posture and the way you move when you are feeling strong emotions. What do you notice about those around you?

Sometimes simply being aware of what is going on in our bodies can help us to recognise what is going on and put things in place to balance our feelings. We all know that diet, exercise, spending time in nature, mindfulness, reading and writing, yoga –  all can help us balance emotions. However, we are all juggling a number of things and with the best intentions we can sometimes overlook time for ourselves.

We are all often either thinking about the past – what we saw, what it means – or thinking about the future, what needs to happen, what we need to do – what about thinking about right now?

Here are 3 very quick ways that you can help you to pause and could help with starting and ending the day calmly and servicing your emotional resilience.

This 5 minute morning routine can help you set the day. – how do you wake up? Is it an alarm clock, children or pets jumping on you, the news on the radio or tv?

  1. Spend the first minutes waking up to soothing sounds… actually listen to the sounds
  2. For the second minute lay and stretch in bed. Stretching out all the parts of you body from toes to the crown of your head
  3. Minute 3 Get up and breathe – as your feet hit the ground spend one minute breathing in and out deeply – focus on the sensations of you breath filling and emptying your body
  4. Minute 4 – Stretch standing up – your arms,  legs, shoulders, neck
  5. Finally – maybe after brushing your teeth drink a glass of water – hydration for the body, mind and soul

This 5 min morning routine is something you can do by yourself or with others in the household.

During the day – you have a 5 min timeout to lose your mind come to your senses. Pause in the day to notice what you can hear, see, taste, touch, and smell. This will help to focus on the right now – not the past or the future.

As you head hits the pillow you can try colour breathing. This is when you think of a colour – and imagine breathing it in and breathing it out you could follow colours of the rainbow. Observe if a different colour makes you feel differently. This exercise will help you to focus on your body and mind as you end the day.

These quick and easy ideas do not require any fancy equipment and can be done anywhere at any time.

I hope these ideas for reflection and practical exercises help you to hit the pause button.

Let’s end by taking 3 breaths together- afterwards you might want to take 5 minutes out deciding how and when you will try these techniques and when you might do the written reflecting exercise.

So, are you ready for some 7 – 11 breathing?

With your feet flat on the floor, legs uncrossed and arms in your lap. Breathe in for the count of 7 – hold

And breathe out for 11 hold

Here we go

Nimal Jude is a Practice Development Lead at the Social Care Institute for Excellence (SCIE). Nimal discusses the blurring of boundaries between work and home life during the pandemic and the positive and negative emotions it can illicit in social care staff. She also shares 3 quick ways to support our emotional resilience throughout the day.

Hello, my name is Jane O’Rourke. I’m a Child, Adolescent and Family Psychotherapist, and I’m a yoga and mindfulness teacher. Today’s practice is about allowing and letting be.

We spend an awful lot of our time trying to resist anything that’s difficult that is going on inside our bodies, or any strong feelings or emotions, but today’s practice will help us discover what the benefits are about allowing and letting be whatever it is that we are feeling.

So coming to find a comfortable seat, it could be on a cushion or maybe in a chair, and if you are sitting in a chair then perhaps moving away from the back of the chair so you can sit nice and tall. So, finding an upright spine, but not too tense, and maybe allowing yourself the intentionality of being alert for the next few minutes, being alert to whatever it is that you might be feeling.

So first of all finding a steadiness of your feet on the floor, or maybe your bottom on the chair or on the cushion, so finding the solidity that’s there. And then bring your focus to the tip of your nose, where the breath is coming in and leaving. So breathing in and out through the nose, noticing the texture of the breath as it comes in. Perhaps a slight warming as it leaves the body, and having the focus here on the breath allows the mind to have a rest, so it can just settle, and all the while feeling the steadiness and connection to the ground.

So not trying to change the breath, just being present to it flowing in and out with a steadiness and ease. And then with some curiosity asking yourself where there might be some tension in your body. Notice what happens when you do that, there might be a little bit of resistance, if your back is aching a bit, or your shoulders, or your neck or wherever it may be. Just staying present to whatever the sensations are just for the next few moments…

How intense is the discomfort? Notice how your mind might race off and try and think about something else but just gently try and bring it back. And you might notice the intensity waxes and wanes, so it fluctuates and then with your next in breath take your breath to wherever the discomfort is, filling that area of discomfort with your in breath, and then with the out breath feel a releasing and letting go. And do this a few times, so it is bringing compassion and care to this area of your body that might be feeling discomfort, you might even like to visualise the breath as a colour going to that area of the body. And then notice how that part of the body is feeling now… and notice whether you are still feeling resistance to feeling the discomfort.

And then start to shift the focus again back to the breath at the tip of your nose, feeling the breath move in and out, at a nice, steady and regular pace. Feeling the connection to the floor… And perhaps extending your focus to a dual one of being present to the breath and also whatever it is that you might be feeling or thinking. Can everything be accommodated and accepted for how it is in this moment? And if it might feel a bit difficult perhaps stay with your presence of your feet on the floor, feeling the connectedness there with the steadiness of the earth. Noticing what is happening when you are not resisting and just being with whatever it is that might be difficult.

Just taking a few more gentle breaths here and then starting to wiggle the toes, perhaps softy reach the arms overhead and stretch, giving yourself time to come back into the room whenever you’re ready.

Jane O’Rourke guides us through a breathing exercise to help us be with whatever difficulties we might be experiencing. Jane is a yoga and mindfulness teacher and a Psychodynamic Psychotherapist with children, young people, and families. She teaches yoga for trauma within the Trauma Service at the Tavistock and Portman NHS Foundation Trust.

Wellbeing Quiz Profile: #MoreFrantic #RelivingTrauma

In this podcast I’m going to spend a bit of time reflecting on self-care and resilience. Not because I’m an expert on it, rather because I’m not very good at it to be honest. And evidence suggests it is something that social workers can sometimes struggle with. For colleagues working in children’s services (whose jobs are a thousand times more emotionally draining than mine, I should note), it is essential to pay attention to personal wellbeing.

Kanter said in 2007 that “While social workers focus daily on caring for others, issues of self-care are too often neglected”. I would add, taking care of our needs is something we must do not instead of supporting others, but partly because we want to support others to the best of our ability. Self-care is not a self-indulgent act, but rather it is an act of self-respect. In these times of high-emotion, when many of us feel very let down by those in power and distressed by the myriad structural inequalities in our society, taking care of ourselves so we can keep caring – and fighting – for others is an act of resistance.

As I come out of a slightly tough few weeks myself, one revelation is that the really basic stuff, the stuff that can sound trite when people advise you to do it, is actually really important.

Here are some very basic rules that sound obvious but bear repeating:

  • Eat something every day that is not beige. Dipping bread into anything runnier than bread whilst you hunch over your computer is not a meal. And Jaffa cakes are not one of our 5-a-day.
  • No matter how much coffee you drink, drink twice as much water.
  • Get dressed for work. Top and bottom half.
  • At the start of the day or week, identify which things on your list are absolutely essential – make these your priority and forgive yourself if you don’t get through everything else.
  • Do something that makes you out of breath every day, even if just for 10 mins. Shouting swear-words at the news doesn’t count, apparently.

Some other things that I’m finding helpful at the moment:

  • Treating my news intake in the same way I’m trying to think about my food. This means consuming less news, consuming it less often, and avoiding the junk. Scrolling through Twitter endlessly is the equivalent of grazing on pick & mix sweets – but some of the sweets are actually rusty nails.
  • Being thankful. I used to find those ‘gratitude diary’ things a bit cheesy. But I have been inspired by the wonderful Pooky Knightsmith, a mental health trainer and author, who logs ‘3 Good Things’ to take joy in every day, no matter how small. I’m still too self-conscious to tweet mine, but I have started writing them down every evening. It honestly makes a difference to my mindset.
  • Telling my colleagues how I’m feeling. This might feel a bit uncomfortable for those in a management role (perhaps we think we should show we are in control and don’t want to ‘overshare’?)… But I think part of respecting our team mates is letting them in on how I’m feeling – it means we can contextualise each other’s’ behaviour, support each other on an emotional level – and (importantly for me) it gives them permission to call me out when I’m being a grumpy so-and-so.
  • I’ve also been thinking about how not working together in a physical space means we might not be getting the daily ‘micro-affections’ that allow everything else to flow… that cheery wave in the car park, complimenting someone’s hair by the office kettle, sharing a joke before the meeting starts… all of these seemingly inconsequential interactions form a little ‘bounce mat’ on which the work stuff lands. Without these, we can fall into only interacting in a way that is entirely transactional. Making time to do the relational stuff can be the first thing to slip when we are stretched.

So, back to social work…

Harry Ferguson, in his excellent 2011 book ‘Child Protection Practice,’ notes that “Workers’ state of mind and the quality of attention they can give to children is directly related to the quality of support, care and attention they themselves receive from supervision, managers and peers…

This really highlights the important role of supervisors in this moment. My colleague Alison Domakin recently blogged about how practice supervisors have noticed that their primary focus in supervision has shifted to one of providing containment. For supervisors and managers maintaining (and strengthen) emotional connection, giving thanks, acknowledging effort and providing containment, all make a difference – and, crucially, supervisors and managers need these things too! For more on how organisations can behave to support practitioners’ resilience, do check out the SWORD project we’ve been doing (link in page notes).

There is also something about knowing when to be vulnerable – articulated beautifully in a blog by Camden social work manager Kim Christodoulou. She talks about ‘Acknowledging the pain of isolation and harnessing inner strength…being present, actively listening and acknowledging what we do not know. Through this, she says “I have come to know the people I work with more profoundly despite the isolation. It has been painful and real. I have learnt that we can feel connected despite the separation and that we can draw resilience from being vulnerable and being present.”

For me, something that grounds me when I feel a bit overwhelmed is noticing the positives: stories from SWs and families have given me a much needed sense of hope in recent months…

Practice supervisors have described to us how some practitioners are finding it easier to build relationships with children, young people and their families. Something about the experience of COVID-19 (perhaps a blurring of rigid personal and professional demarcations when we are ‘all in this together’) seems to have allowed a more relational approach to practice to bloom. 

Similarly, my colleague Susannah Bowyer together with Prof Brigid Featherstone  held a series of seminars with child & family social workers to explore what impact Covid is having on practice. They found that the overriding theme was of people experiencing potential arising from shifts in practice. 

  • Some children in foster care saying they feel ‘more in control’
  • Some families describing a sense of levelling between social workers, children, families and carers.
  • Some foster carers and practitioners finding the increased levels of trust more ‘empowering’.
  • Some managers noticing that an opportunity is emerging to rethink the purpose of social work practice altogether…

None of this is to suggest that things aren’t worrying, difficult and sometimes scary. They are to me. And I’m not suggesting for a moment that swapping your jaffa cake for an actual orange will fix the feelings of stress or existential dread. But being hopeful helps us to cope, and makes us more able to help others to feel hopeful. As the very wise Professor Louise Grant often says in her work on resilience “Please put on your own oxygen mask before assisting others”.

References

Ferguson H. (2011), Child Protection Practice, Basingstoke, Palgrave Macmillan

Kanter, J. Compassion Fatigue and Secondary Traumatization: A Second Look. Clin Soc Work J 35, 289–293 (2007). https://doi.org/10.1007/s10615-007-0125-1

Links:

Dez Holmes is the Director of Research in Practice. Dez reflects on self-care and resilience for colleagues working in children’s services and how paying attention to personal wellbeing is essential. Resources to support this are shared throughout.

Wellbeing Quiz Profile: #MoreFrantic

Gratitude is a funny thing – sometimes we are only able to feel grateful for something when it has gone, or is at risk. Sometimes it can be hard to express because it means really acknowledging our dependence on somebody or something. But gratitude also comes out at times of celebration and the marking of life over time – birthdays, anniversaries, key moments and memories.

The NHS, on which we all depend, and to which many of us contribute, has an anniversary on Sunday July 5th, marking the 72 years since this extraordinary collaborative system of care for others was put into motion. There’s  no doubt that the global pandemic has raised the profile and the nature of our dependence on the NHS in  a profound and powerful way – and the individual as well as the organisational challenges that we have faced in Covid, and continue to face in sustaining life and development within  the NHS.

We also know that at times of enormous systemic strain, simple but authentic connections with others are key. So we thought it would be a good way to mark the anniversary by asking some system leaders in North Central London to share key moments from the past few months, as a way of saying thank you. You’ll  hear from nurse leader from the Whittington, leaders from Primary Care and from the NCL CCG, and  CEO’s from  Acute Services and  Mental Health – and from all of them you will hear about a specific interaction or memory from these turbulent months as a way of saying a thank you that recognises what the NHS means to us all as individuals as well as a community.

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Hello, my name is Michelle. I’m so incredibly proud to be a nurse in the NHS and to have led our organisation through the acute phase of the COVID-19 pandemic. I am equally, if not more so, incredibly proud and in awe of our staff over this period. There are so many stand out moments that I would like to talk of, but one really does stand out to me.

It was at the height of the peak with our hospital and community health services caring for a high number of patients with COVID infections. I went to one of the acute assessment wards where we were caring for high dependency patients and I met two staff – one newly qualified nurse and one healthcare support worker. They were both wearing full PPE, which they did for the 12 hour shift, and working in a bay with some very sick patients.

We shared a moment of reflection on their experience, the incredible sadness of patients who had deteriorated and died. They were devastated. We also then shared a happier moment of how their ward team had all worked together so well and the camaraderie was fantastic and got them through the dark days. We also laughed which was so lovely, their spirit and resilience was wonderful. Thank you.

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Hello, my name is Jo Sauvage. The last few months have been really hard work for everyone. What has made me really proud to be in my role is the fact that across our system we’ve worked hard together. We’ve tried to connect with each other and we’ve shown care for each other. I cannot count the number of emails I’ve received that start “how are you? I hope you’re well” and end “stay well, stay safe”.

We’ve remind ourselves and each other of the importance of thinking about each other and caring for each other as people. This has made me proud to be who I am, where I am, at this moment – the fact that we have remembered to treat each other well.

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I’m Kay and I’m the Executive Director of Quality for NCL CCG. There were many moments I witnessed during the COVID pandemic that made me feel unbelievably proud to work for the NHS and to work with the most amazing group of people. But there were nine outstanding days that really stood out for me

This was when the Quality team came together to provide Infection Prevention and Control training for over 200 care homes in North Central London. It was at the peak of the pandemic and this group of heroes worked night and day, weekday, weekends including the bank holiday and did the impossible.

They negotiated the release of 17 nurses from different organisations, trained two super trainers and 15 train the trainers and just did the most amazing job of speaking to all of the 218 care homes often 3 or 4 times until they got through to the right person who realised how much they needed this support.

They didn’t give up. They really knew how much care homes needed this and they needed it now. And most importantly their key single unrelenting focus was to make sure everyone who needed it, got it – and I know this had an impact on patients’ lives.

I am so proud of what they did, how they did it and what they achieved. Thank you.

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Hello, my name is Siobhan, I’m Chief Executive of Whittington Health. One moment that actually sticks with me most among many times is when I was in the queue at a lunchtime with our 2m distancing and I was chatting to one of our speech and language therapists (SALT) from the community, who actually had been redeployed to the ITU unit. Firstly, I was struck physically talking to her, she had marks from her face mask where she had just come off ITU for a break. I recall her telling me about her skin and I then followed up finding some face cream which could be given to staff in ITU, which was donated to us, which was really, really great.

She talked to me about what was really happening for her, and her family, and in her life, and in her working life. She talked about how at the beginning she wasn’t sure as a SALT she could or would be able to be helpful in ITU and that actually she that her skills were really quickly transferable, especially some of the analytical skills that you use within SALT and how that helped her with the observations in ITU.

She also had a young family so she was obviously worried about taking the virus home. She told me how she had decided to sleep in a different room from her husband, from her kids, and how hard that had been for all of them as a family. She also really spoke about how excited she was to care for people in ITU and how professionally she really did relish her new role, even though she was pretty tired. I suppose what I would really like to say is, thank you.

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My name is Caroline Clarke, I’m the Group Chief Executive at the Royal Free London. it seems like ages ago that we started treating patients with the COVID virus, in fact it was back in February, and as we mark the NHS 72nd birthday it’s a chance to pause and reflect on how the last few months have been.

I remember very early on, early one morning, meeting a senior doctor in the car park who told me that she had just sent her kids away, to Scotland, where they would be safe and she wasn’t sure when she would see them again. And then later that day, talking about hotels and where our staff were going to be so that they could shield their families, and thinking through what a massive sacrifice that was.

Then of course seeing people cheer themselves up on social media with songs and Tik-Tok dances, and thinking what amazingly resilient people we have, as well as people who are willing to give and sacrifice. And then hearing from colleagues who would do all that, and then go home and look after vulnerable members of their community, and make sure that they were safe.

It just makes you realise what an amazing group of people you are who work in the NHS – kind, caring, and just the very best. So, I just want to say, thank you.

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Hello, my name is Paul Jenkins and I’m the Chief Executive of the Tavistock and Portman NHS Foundation Trust. This Sunday 5th July marks the 72nd anniversary of the NHS, one of the country’s best loved and most important institutions. The last couple of months have provided a significant test of our resilience and ability to deliver, probably of the kind that few of us have seen in our working careers. It is a test that I think we have responded to brilliantly.

At the heart of that has been the efforts of all of our staff, working well beyond the call of duty, to meet the needs of patients. By staff, I very much mean all staff. One of the best things about the last couple of months is how the profile of different groups of staff has been increased – both the contributions of frontline staff but also those who provided support in IT, in catering, in cleaning, and in back-office functions.

We’ve also had a time where people have had to undergo a lot of personal challenges, working incredibly hard, but also those who have experienced bereavements or who have even seen the loss of colleagues. There is no doubt that COVID is not yet off the scene.

Our commitment as leaders in NCL has to be that we continue to put staff wellbeing right at the centre of our focus and ensure we provide the support to staff to get through the challenges of the months ahead. Thank you very much.

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So, as part of our celebration for the 72nd birthday of the NHS on Sunday, this is our #ThankYouTogether, from Together in Mind.

To celebrate the 72nd anniversary of the NHS on 5th July 2020, leaders from across North Central London have come together to share key moments from the past few months, as a way of saying thank you. Our speakers are:

  • Michelle Johnson, Chief Nurse and Director of Patient Experience at Whittington Health NHS Trust
  • Jo Sauvage, GP City Road Medical Centre and Chair at North Central London CCG
  • Kay Matthews, Executive Director of Quality at North Central London CCG
  • Siobhan Harrington, Chief Executive at Whittington Health NHS Trust
  • Caroline Clarke, Group Chief Executive at the Royal Free London NHS Foundation Trust
  • Paul Jenkins, Chief Executive at the Tavistock and Portman NHS Foundation Trust

Please use #ThankYouTogether to share your experiences in celebration of the NHS.

Hello, my name is Dominic O’Ryan and I am the Lead Psychologist for Substance Misuse Services in Camden and Islington NHS Foundation Trust.

I am going to talk about something that many of us might be facing.

During these strange times it is very common to find we have increased our use of substances.

By substances, I mean different types of stimulants, depressants, cannabinoids, psychedelics and opioids; substances like nicotine, caffeine, alcohol, sleeping tablets and strong pain killers.

And we do these things often because substances help us make the best at the good times – they help us to celebrate, they help us to mark occasions, whether that is a large event or simply making it through the week or the day.

We use substances to make something better of the difficult times as well – we use them to commiserate – we use them to switch off and unwind and sleep – to get rid of difficult thoughts, feelings and body sensations.

And we can use substances because they are a way of connecting with people, they become integral to our social network, we drink when a friend is drinking; we have our next cigarette often because our smoking buddy is smoking.

And there isn’t anything necessarily problematic about this. It may be fine.

Substance use becomes more problematic when it feels like we don’t have any other way of doing those things – we lose sight of other ways of celebrating or switching off or connecting with people.

And when we disregard the risks associated with the substance use it can transform itself into substance misuse.

This is something that can happen slowly over years but at confusing and stressful times, it can very quickly sneak up on us, catching us unaware.

And so it is important to realise that often these using behaviours are happening in autopilot.

And then to spend some time reflecting on why we are using substances and what thoughts and feelings, and body sensations are present as part of our urge to pick up a drink or to have a smoke or sniff.

Stepping out of autopilot is a very particular and also learnable skill of gentle, curious and compassionate self-observation.

We need to reflect on what the function might be of our use the substances – what might we be avoiding or trying to achieve.

What is it that is so tricky about these tricky thoughts, feelings and body sensations that we would rather do something potentially harmful in the long term than experience them in the here and now?

Having noticed and become aware of these things, are we ready to be open to these tricky experiences, to unhook from stories that maybe we have fused with, stories that tell us the experience is unbearable, or that we are not able to manage?

We can unstick and de-fuse from these stories sometimes just by naming them – “there’s that old story about failing playing again”, “I’ve tuned in to Radio Idiot again.”

Maybe we can sometimes be truly courageous and thank our minds for nudging us. “Thank you mind for reminding me that I need to unwind tonight.”

And then, at the choice point, when we have given ourselves space to decide rather than to act on autopilot, have we identified alternative workable actions that can help us with our short-term goals and connected them to longer term important personal goals and values?

So when next you need to celebrate, switch off or connect, give yourself permission to pause, step out of autopilot, become aware of your internal and external experience, be open to tricky thoughts, feeling and body sensations and make a more active, sustainable choice in the direction of your long term wellbeing.

Dominic O’Ryan qualified as a Clinical Psychologist from UCL in 2000. He is the Lead Psychologist in Substance Misuse Services and the CBT Training Lead for Camden and Islington NHS Foundation Trust. Dominic speaks about the use of substances during this time.

Wellbeing Quiz Profile: #MoreFrantic

Hello, my name is Jane O’Rourke. I’m a Child, Adolescent and Family Psychotherapist, and I’m a yoga and mindfulness teacher, and today we are going to be doing a grounding exercise.

So if you can find a position sitting down on the floor, or perhaps in your garden or in the park and find a comfortable posture. So, allowing the spine to be nice and tall, and the shoulders sliding down the back. Then I invite you to put your right hand connected to the floor, to the earth, and the left hand over your heart. In this position you can get a sense of the right hand touching the earth and the left hand in touch with yourself and how you are feeling in this moment.

So feeling the steadiness of the earth underneath your right hand and the qualities of the earth that is there, the steadiness, the resilience of the earth… and that is a resource for us, to help us feel steady and calm, and resilient as well. And sensing the breath underneath your fingertips over your heart… and we might need the steadiness of the earth underneath our right hand to feel a steadiness so that we can make an enquiry about how we are feeling. What is your left hand over your heart telling you about how you’re feeling in this moment? There is nothing that you shouldn’t be feeling, it is opening up to whatever it is that is here in this moment. So it is cultivating a curiosity about what is going on at the moment. And if you feel any tension arising, connect with the steadiness of the earth under your right hand as you feel this breath of life moving through your body. And this left hand over your heart is also a gesture of self-compassion, taking care of yourself, connecting in…

And now start to sense the breath through the tip of your nose, meanwhile the right hand is connected to the floor and the earth below. As you breathe in, through the nose and out through the nose… noticing the pause on the in breath and the out breath, and maybe a slight warming of the breath as it leaves the body… Our breath is our lifelong companion, it is with us from the day we are born until the day we leave this earth. So sensing the breath is being a companion in this moment, as you feel a sense of steadiness and calm that is connected to the earth… and your presence in this moment… and if you notice your mind has wandered off just gently bring it back to the focus of the breath at the tip of the nose….

So just taking a few more breaths here before moving out into your daily activities asking yourself what you most need to help in the day ahead… Perhaps it is a sense of connecting in, all this steadiness that is always there. Perhaps just taking a moment just to notice a few more breaths and if the day feels a little overwhelming giving yourself some time and attention.

And then whenever you are ready coming back into the room in your own time.

Jane O’Rourke guides us through a brief mindfulness exercise that connects us with the earth to help us feel resourced and steady. You can try this breathing exercise sitting on the ground as Jane suggests, or sitting in a chair with feet firmly on the ground. If you are sitting in a chair, try moving away from the back of the chair so you can sit nice and tall.

Jane is a yoga and meditation teacher and a Psychodynamic Psychotherapist with children, young people, and families. She teaches yoga for trauma within the Trauma Service at the Tavistock and Portman NHS Foundation Trust.

Wellbeing Quiz Profile: #MoreFrantic #RelivingTrauma

What are podcasts?

Podcasts are regular, short messages from wellbeing and mental health practitioners within this network. They will be directly responding to what we are hearing from you through both the Wellbeing Quiz and the ‘How Are You Today’ survey, as well as offering more specific presentations for targeted staff groups, for example social workers.

Once you have completed the Wellbeing Quiz, keep an eye on the hashtags underneath each of podcasts to help identify those which might be most helpful for you.