Skip to main content Accessibility help
×
Home

Caring for healthcare practitioners

  • Richard Williams (a1) and Verity Kemp (a2)

Summary

Caring for people in distress or illness is emotionally draining and physically demanding. This article focuses on the experiences and needs of health service staff as professional carers. It overviews the current circumstances in the UK and links readers to the findings of: the Stevenson/Farmer Review of 2017; the report of the General Medical Council on the state of medical education and practice of 2018; and the British Medical Association survey of doctors and medical students published in 2019. We review the sources of stress that affects healthcare practitioners and introduce the concepts of emotional labour, psychological safety and psychosocial resilience. We draw attention to the vital importance of social support and leadership to protecting healthcare staff. We conclude this review of the topic by outlining a stepped model for actions that aim to: develop staff of healthcare services and help them to thrive at work; support staff who are struggling at work; and intervene to care for staff who are distressed or unwell whether they are continuing to work or not.

LEARNING OBJECTIVES

After reading this article you will be able to:

  • recognise the impact that healthcare staff's work has on them and their patients, and how stress may originate
  • describe contemporary conceptual approaches to understanding the psychosocial experiences of healthcare staff and the components of good psychosocial care to mitigate their needs
  • understand how lessons from research and experience might be used to improve employers' evidence-informed capabilities for caring for their staff.

Copyright

Corresponding author

Correspondence: Richard Williams, Welsh Institute for Health and Social Care, University of South Wales, Pontypridd CF37 1DL, Wales. Email: richard.williams@southwales.ac.uk

Footnotes

Hide All

DECLARATION OF INTEREST: None.

Footnotes

References

Hide All
Aarons, GA, Sawitzky, AC (2006) Organizational climate partially mediates the effect of culture on work attitudes and staff turnover in mental health services. Administration and Policy in Mental Health and Mental Health Services Research, 33: 289301.
Adams, JS (1963) Towards an understanding of inequity. Journal of Abnormal and Social Psychology, 67: 422–36.
Aitken, P, Drury, J, Williams, R (2019) Relationships, groups, teams and long-termism. In Social Scaffolding; Applying the Lessons of Contemporary Social Science to Health and Healthcare (eds Williams, R, Kemp, V, Haslam, SA, et al. : 274–88. Cambridge University Press.
Andrews, J, Butler, M (2014) Trusted to Care: An Independent Review of the Princess of Wales Hospital and Neath Port Talbot Hospital at Abertawe Bro Morgannwg University Health Board. Welsh Government (https://gov.wales/trusted-care-independent-review-princess-wales-and-neath-and-port-talbot-hospitals).
Bailey, KM, Curtis, A, Numan, D (2001) Pursuing Professional Development: The Self as Source. Heinle & Heinle.
Bakker, A, Demoerouti, E (2007) The job demands–resources model: state of the art. Journal of Managerial Psychology, 22: 309–28.
Barsky, A, Kaplin, SA (2007) If you feel bad, it's unfair: a quantitative synthesis of affect and organisational justice perceptions. Journal of Applied Psychology, 92: 286–95.
Bhugra, D (2013) We can cure the mental health crisis. The Guardian, Society section, 24 September ( http://www.theguardian.com/society/2013/sep/24/cure-mental-health-service-crisis ). Accessed 3 December 2014.
Bion, WR (1961) Experiences in Groups. Tavistock.
Black, C, Frost, D (2011) Health at Work: An Independent Review of Sickness Absence in Great Britain. Department for Work and Pensions.
Blanchard, EB, Hickling, EJ, Mitnick, N, et al. (1995) The impact of severity of physical injury and perception of life threat in the development of post-traumatic stress disorder in motor vehicle accident victims. Behaviour Research and Therapy, 33: 529–34.
Bleetman, A, Sanusi, S, Dale, T, et al. (2012) Human factors and error prevention in emergency medicine. Emergency Medicine Journal, 29: 389–93.
British Medical Association (2019) Caring for the Mental Health of the Medical Workforce. BMA.
Brown, T, Ryland, H (2019) Recruitment to psychiatry: a global problem. BJPsych International, 16: 13.
Campling, P (2015) Reforming the culture of healthcare: the case for intelligent kindness. BJPsych Bulletin, 39: 15.
Carter, M, West, M, Dawson, J, et al. (2008) Developing Team Based Working in the NHS: Report Prepared for the Department of Health. Department of Health.
Cicognani, E, Pietrantoni, L, Palestini, L, et al. (2009) Emergency workers’ quality of life: the protective role of sense of community, efficacy beliefs and coping strategies. Social Indicators Research, 94: 449–63.
Clohessy, S, Ehlers, A (1999) PTSD symptoms, responses to intrusive memories and coping in ambulance service workers. British Journal of Clinical Psychology, 38: 251–65.
Clough, M (2010) Shame and organizations. International Journal of Leadership in Public Services, 6: 2533.
Department of Health (2012) Transforming Care: A National Response to Winterbourne View Hospital. Department of Health.
Drury, J, Alfadhli, K (2019) Shared social identities in emergencies, disasters and conflicts. In Social Scaffolding: Applying the Lessons of Contemporary Social Science to Health and Healthcare (eds Williams, R, Kemp, V, Haslam, SA, et al. ): 154–64. Cambridge University Press.
Edmondson, AC (2003) Managing the risk of learning: psychological safety in work teams. In International Handbook of Organizational Teamwork and Cooperative Working (eds West, MA, Tjosvold, D, Smith, KG): 255275. Wiley.
Francis, R (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. Executive Summary (HC 947). TSO (The Stationery Office).
General Medical Council (2018) The State of Medical Education and Practice in the UK: 2018. GMC.
George, MS (2016) Stress in NHS staff triggers defensive inward-focussing and an associated loss of connection with colleagues: this is reversed by Schwartz Rounds. Journal of Compassionate Health Care, 3: 926.
Griffin, BJ, Purcell, N, Burkman, K, et al. (2019) Moral injury: an integrative review. Journal of Traumatic Stress, 32: 350–62.
Haslam, SA, McMahon, C, Cruwys, T, et al. (2018) Social cure, what social cure? The propensity to underestimate the importance of social factors for health. Social Science and Medicine, 198: 1421.
Hochschild, AR (1983) The Managed Heart: Commercialization of Human Feeling. University of California Press.
Jayatilleke, M, Mackie, A (2013) Reflection as part of continuous professional development for public health professionals: a literature review. Journal of Public Health, 35: 308–12.
Johnson, S, Osborn, DPJ, Araya, R, et al. (2012) Morale in the English mental health workforce: questionnaire survey. British Journal of Psychiatry, 201: 239–46.
Jones, S, Seddon, R, Fear, NT, et al. (2012) Leadership, cohesion, morale, and the mental health of UK armed forces in Afghanistan. Psychiatry, 75: 4959.
Junker, NM, van Dick, R, Avanzi, L, et al. (2018) Exploring the mechanisms underlying the social identity-ill health link: longitudinal and experimental evidence. British Journal of Social Psychology, 18 Dec: doi 10.1111/bjso.12308 [Epub ahead of print].
Kaniasty, K, Norris, FH (2004) Social support in the aftermath of disasters, catastrophes, and acts of terrorism: altruistic, overwhelmed, uncertain, antagonistic, and patriotic communities. In Bioterrorism: Psychological and Public Health Interventions (eds Ursano, RJ, Norwood, AE, Fullerton, CS): 200–29. Cambridge University Press.
Kirkup, B (2015) The Report of the Morecambe Bay Investigation. TSO (The Stationery Office).
Kuoppala, J, Lamminpää, A, Liira, J, et al. (2008) Leadership, job wellbeing, and health effects: a systematic review and a meta-analysis. Journal of Occupational and Environmental Medicine, 50: 904–15.
Latham, GP, Pinder, CC (2005) Work motivation theory and research at the dawn of the twenty-first century. Annual Review of Psychology, 56: 485516.
Litz, BT, Stein, N, Delaney, E, et al. (2009) Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clinical Psychology Review, 29: 695706.
Lock, S, Rubin, GJ, Murray, V, et al. (2012) Secondary stressors and extreme events and disasters: a systematic review of primary research from 2010-2011. PLoS Currents Disasters, 29 Oct: doi: 10.1371/currents.dis.a9b76fed1b2dd5c5bfcfc13c87a2f24f.
Maslach, C, Leiter, M (2016) Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry, 15: 103–11.
Murray, E, Krahé, C, Goodsman, D (2018) Are medical students in prehospital care at risk of moral injury? Emergency Medical Journal, 35: 590–4.
National Workforce Skills Development Unit (2019) Workforce Stress and the Supportive Organisation: A Framework for Improvement through Reflection, Curiosity and Change. Health Education England.
Neal, A, Williams, R, Kemp, V (2019) Caring for the carers. In Social Scaffolding: Applying the Lessons of Contemporary Social Science to Health and Healthcare (eds Williams, R, Kemp, V, Haslam, SA, et al. ): 289301. Cambridge University Press.
NHS England (2018) Clinical Guidelines for Major Incidents and Mass Casualty Events. NHS England.
NHS Improvement (2019) Interim NHS People Plan. NHS Improvement.
Norris, FH, Stevens, SP, Pfefferbaum, B, et al. (2008) Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. American Journal of Community Psychology, 41: 127–50.
Norris, FH, Tracy, M, Galea, S (2009) Looking for resilience: understanding the longitudinal trajectories of responses to stress. Social Science & Medicine, 68: 2190–8.
Ntontis, E, Drury, D, Amlôt, R, et al. (2019) Community resilience and flooding in UK guidance: a review of concepts, definitions, and their implications. Journal Contingencies and Crisis Management, 27: 112.
Patel, SS, Rogers, MB, Amlôt, R, et al. (2017) What do we mean by ‘community resilience’? A systematic literature review of how it is defined in the literature. PLOS Currents Disasters, 1 Feb: doi: 10.1371/currents.dis.db775aff25efc5ac4f0660ad9c9f7db2.
Pepper, JR, Jaggar, SI, Mason, MJ, et al. (2011) Schwartz rounds: reviving compassion in modern healthcare. Journal of the Royal Society of Medicine, 105: 94–5.
Reicher, S (2019) Making connectedness count: from theory to practising a social identity model of health. In Social Scaffolding: Applying the Lessons of Contemporary Social Science to Health and Healthcare (eds Williams, R, Kemp, V, Haslam, SA, et al. ): 213–26. Cambridge University Press.
Ripullone, K, Womersley, K (2019) What we don't talk about when we talk about professionalism: resilience. BMJ Opinion (https://blogs.bmj.com/bmj/2019/03/14/what-we-dont-talk-about-when-we-talk-about-professionalism-resilience/). Accessed 30 April 2019.
Rona, RJ, Jones, M, Sundin, J, et al. (2012) Predicting persistent posttraumatic stress disorder (PTSD) in UK military personnel who served in Iraq: a longitudinal study. Journal of Psychiatric Research, 46: 1191–8.
Rousseau, DM (1989) Psychological and implied contracts in organizations. Employee Responsibilities and Rights Journal, 2: 121.
Royal College of Physicians (2015) Work and Wellbeing in the NHS: Why Staff Health Matters to Patient Care. Royal College of Physicians.
Salinsky, J (2003) Balint Groups and The Balint Method (revised 2013). The Balint Society (https://balint.co.uk/about/the-balint-method/). Accessed 30 April 2019.
Shanafelt, TD (2009) Enhancing meaning in work: a prescription for preventing physician burnout and promoting patient-centred care. JAMA, 302: 1338–40.
Shuffler, ML, DiazGranados, D, Salas, E (2011) There's a science for that: team development interventions in organizations. Current Directions in Psychological Science, 20: 365–72.
Smith, P, Cowie, H (2010) Perspectives on emotional labour and bullying: reviewing the role of emotions in nursing and healthcare. International Journal of Work Organization and Emotion, 3: 227–36.
Stamm, BH (2002) Measuring compassion satisfaction as well as fatigue: developmental history of the Compassion Fatigue and Satisfaction test. In Treating Compassion Fatigue (ed Figley, CR): 107–19. Brunner-Routledge.
Stevenson, D, Farmer, P (2017) Thriving at Work: The Stevenson/Farmer Review of Mental Health and Employers. Department for Work and Pensions and Department of Health and Social Care.
Varker, T, Creamer, M (2011) Development of Guidelines on Peer Support Using the Delphi Methodology. Australian Centre for Posttraumatic Mental Health, University of Melbourne.
Warner, M, Williams, R (2005) The nature of strategy and its application in statutory and non-statutory services. In Child and Adolescent Mental Health Services: Strategic Approaches to Commissioning and Delivering Child and Adolescent Mental Health Services (eds Williams, R, Kerfoot, M): 3962. Oxford University Press.
Wilde, J (2016) The Social Psychology of Organisations. Routledge.
Williams, R (2000) A Cunning Plan: Integrating Evidence, Judgement and Passion in Mental Health Strategy (Inaugural Lecture). University of Glamorgan.
Williams, R, Fulford, KWM (2007) Values-based and evidence-based policy, management and practice in child and adolescent mental health services. Clinical Child Psychology and Psychiatry, 12: 223–42.
Williams, R, Kemp, VJ, Alexander, DA, et al. (2014) The psychosocial and mental health of people who are affected by conflict, catastrophes, terrorism, adversity and displacement. In Conflict and Catastrophe Medicine (eds Ryan, J, Hopperus Buma, A, Beadling, C, et al. ): 805–49. Springer.
Williams, R, Kemp, V (2016a) Psychosocial and mental health care before, during and after emergencies, disasters and major incidents. In Health Emergency Preparedness and Response (eds Sellwood, C, Wapling, A): 8298. CABI.
Williams, R, Kemp, V, Neal, A (2016b) Compassionate care: leading and caring for staff of mental health services and the moral architecture of healthcare organisations. In Management for Psychiatrists (4th edn) (eds Bhugra, D, Bell, S, , ABurns, ): 377402. RCPsych Publications.
Williams, R (2019a) Health and society: contributions to improving healthcare from the social sciences. In Social Scaffolding: Applying the Lessons of Contemporary Social Science to Health and Healthcare (eds Williams, R, Kemp, V, Haslam, SA, et al. ): 19. Cambridge University Press.
Williams, R (2019b) Suit the action to the word, the word to the action. In Social Scaffolding: Applying the Lessons of Contemporary Social Science to Health and Healthcare (eds Williams, R, Kemp, V, Haslam, SA, et al. ): 329–40. Cambridge University Press.
Williams, R, Kemp, V (2019c) The nature of psychosocial resilience: coping with adversity. In Social Scaffolding; Applying the Lessons of Contemporary Social Science to Health and Healthcare (eds Williams, R, Kemp, V, Haslam, SA, et al. ): 87104. Cambridge University Press.
Williams, R, Kemp, V (2019d) Psychosocial resilience, adaptive capacities and the psychosocial approach. In Substance Misuse and Young People: Critical Issues (eds Crome, IB, Williams, R): 3750. Routledge.

Keywords

Caring for healthcare practitioners

  • Richard Williams (a1) and Verity Kemp (a2)

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Caring for healthcare practitioners

  • Richard Williams (a1) and Verity Kemp (a2)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *