Humbling by Ken Donaldson

There is no real need for me to remind everyone what we are currently going through; Covid is all over the news and social media as it has been for the past 12 months and it is all becoming a little tiresome. However the past month in D&G has been different as we have been hit hard for the first time in this pandemic with a massive surge in the community, particularly with this new transmissible variant, that has resulted in enormous pressure being put on our secondary care services. The response from across the partnership has been incredible with all staff rising to the occasion to ensure our services continue to function. 

This blog is partly about thanking everyone for those efforts and proving once again that D&G is the best place to live and work but it is also about focussing in on a few specific areas which I feel merit special attention. These areas are our Critical Care Unit and the wards which have taken the majority of our Covid inpatients; B2, C5, D8, D7, Galloway Community Hospital and our front door services the Combined Assessment Unit and Emergency Department.  

Most days I have been wandering around DGRI popping into these areas to see how they are. Every day I leave them feeling proud and humbled. The sense of calm, control and teamwork is beyond my abilities to describe. I am very aware that this sense of calm is deceptive, everyone is incredibly busy and often many of the staff are in full PPE in restricted Covid areas. Those individuals who need to wear ‘sessional’ PPE ie. they put on the full works, gown, FFP3 mask and visor and then wear them for hours on end, need special mention. For anyone reading this who is not familiar with sessional PPE it is onerous and exhausting. For hours you cannot get a drink or nip to the loo and the effect of the mask on your face is best illustrated by this image:

As healthcare professionals working in these areas they are used to their patients dying, it is an unavoidable aspect of the job, however the past few weeks have been relentless with a significant mortality from this disease. That, and the fact that almost all end of life discussions with families and loved ones takes place over the phone, has had an enormous emotional impact. This video clip from the BBC demonstrates how difficult it can be and if you haven’t seen it is worth a watch. 

Our CCU and ward staff have been working in this environment for weeks now. Thankfully the numbers of positive cases in the community are falling and this will mean a reduction in admissions but its likely that these areas have weeks left of sessional work as the length of stay of Covid patients can be considerable. So on behalf of all your patients and their families, on behalf of NHS D&G and from myself I want to say Thank you so much for your dedication and commitment. You are all truly amazing and we are all extremely proud of you. 

At the beginning of this Pandemic I wrote a blog titled ‘Enough Love’ where I postulated that the future was grim but that we in D&G had enough love to get us through it. A lot has changed since I wrote that but the sentiment remains the same. What I have described of our colleagues in CCU and on the wards shows this is the case, as they do what they do for many reasons but a love of the job, their teammates and the welfare of their patients lies at the heart of it. This applies to all of us whether we are in CCU or in a Care Home or a non-clinical role, like mine. 

The end is in sight. Numbers are falling, our vaccination programme is progressing beyond expectations and there is real hope of a return to some form of normality in the months ahead. In the meantime please look after yourselves and each other, be kinder than necessary, and thank you for all that you are doing.

With love,

Ken Donaldson is Board Medical Director at NHS Dumfries and Galloway

New Year, New Us by Kerry Ellis

No-one in Dumfries and Galloway is blind to its beauty. 

To pay homage to probably my favourite Prime Minister to date (Hugh Grant in Love Actually, obviously), our region may be small, but we are great.

And how grateful we are, that during the pandemic, when travel has been restricted, that we live and work in a place as beautiful as this.

Yet the very nature of our unequivocal greatness, comes great tribulations.

The region, in particular the west, has its own challenges just now. However, despite a wide and flourishing region, comes the contrast of urban living in the east compared with the vast rurality extending far west, to Newton Stewart, the Southern Machars, Straraer, Drummore, our most southerly point, and everything in between. 

Like the east of the region, the West is blessed with beauty; picturesque villages and idyllic beaches, yet the treasures often seem to be hidden to anyone outside the Toon.  Consequently, services, agencies and communities have been forever swimming against the tide; working tirelessly to provide services that our communities deserve while often running at a fraction of the capacity.

But what we lack in bums on seats, we make up for in resilience and enthusiasm – in bucket loads. Because without it, I really don’t know where we would be – or where the children and families of Wigtownshire would be.  It is only through commitment, compassion and care for the families on our caseloads, that we have got this far.

The new-year has continues to throw challenges to everyone across the region, and the Wigtownshire teams are no exception.  Like many, continuing to deliver services during a pandemic, manage our own anxieties, organising our families, can be an uphill battle.

The Health visiting team in Stranraer need a mention here – and it is not to discredit any of the other teams across the region; this team have worked at a significantly reduced capacity for a number of years.  But despite this, with fantastic support from the wider HVAP (Health visiting assistant practitioner) and Newton Stewart HV  team, they have continued to deliver health visiting services to the town’s community, as well as committing to training student health visitors, and supporting pre-registration student nurses.  

A heath visitor said recently, “we’ve just got used to it” – and it would be easy to think the future looks bleak – bleaker than Emma Thompson’s face when she unwraps the Joni Mitchell CD.  But we no longer need to get used to it.  Despite all the challenges we face in 2021, this is the year of hope and expectation. 

We have lots to celebrate; new life, new-year, new vaccines, new hope, new teams.

2021 brings new health visitors to the west; Russell and Alison, both who have very definitely been courted by the loveliness of Dumfries & Galloway, and we welcome them with open arms.  In, addition, we also welcome Karin and Harriet, coming to the end of their HV training, and who will continue to work within Wigtownshire, and complete our teams.

2120 is a celebration of what we have and what is to come.

A celebration of the resilience and aptitude to still shine when the going gets tough and the pressure is on.  And it has been tough for a long time.  Even without Covid.

Health visiting services across the region have not stopped during Covid lockdown, but have continued to use creative ways to connect and provide support with families – and all the HV teams have seen first-hand the impact of covid on our communities.

But we rise in the face of adversity, and are now rewarded for our patience.

Our teams in the west are strong, our commitment unwavering, deserving of renewed hope. Deserving of our Christmas angels who have landed to complete the team. The people of Wigtownshire deserve this; deserve to have teams that are fully equipped to meet their needs, and staff that are happy and well.

Wigtownshire is thriving; health visitors and school nurses provide the bedrock of early interventions that support families and reduce inequalities, by creating ambitious, prosperous and confident people who can achieve their potential.  Without these services, inequalities would widen, opportunities would be fewer, and our society would suffer.  

But the people of Wigtownshire wont let that happen. 

This is a new year, and a new us.

Kerry Ellis is a Senior Charge Nurse for Health Visiting & School Nursing (Wigtownshire & Stewartry) for NHS D&G

Join the Conversation by Liz Forsyth

Unless you have been avoiding social media, local press, your emails and possibly your payslip recently I am hoping that you have seen an email, advert or poster about engaging in the process of developing the next Dumfries and Galloway Integration Joint Board Strategic Commissioning Plan for Health and Adult Social Care (SCP). To date, we have shared this information with over 6000 people, organisations, groups and teams within Dumfries and Galloway. 

My name is Liz Forsyth and I am the Programme Manager co-ordinating the development of the SCP and also the person responsible for the any cross posting and repetition of requests for you to ‘Join the Conversation’. I’m happy to report that, despite the need to adopt a virtual approach to engagement due to Covid-19 lots of people have already taken part in the development of the next SCP for Dumfries and Galloway.  

Whilst addressing the challenges of and recovery from the Covid-19 pandemic is a priority for all Health and Social Care Partnerships in Scotland, it is vital that, we also continue to work together to identify health and social care and support needs in the future and plan to make provision for these.

The SCP is a document that is relevant to everyone. It supports the Dumfries and Galloway Health and Social Care Partnership to deliver better outcomes for the people who access care and support, their families, friends and Carers, communities, health and social care professionals and all of the organisations in all of the different sectors that deliver health and social care and support.  

The Integration Joint Board SCP for Dumfries and Galloway is a document that 

• states the vision and strategic direction for health and social care and support in the region
• describes the model within which health and social care and support will be delivered
• identifies the strategic priorities for the IJB over the life of the SCP through a set of strategic commissioning intentions 
• identifies the tactical priorities beneath each of the commissioning intentions and 
• identifies key, high level actions that will be taken to deliver these

The SCP will include details of resources and how these will be prioritised and used to address the challenges we face in the provision of health and social care and support that is sustainable into the future. This includes changing demographics, workforce, finance and performance, as well as those presented by the Covid-19 pandemic.

There can be no one better placed than the people who use and deliver health, care and support to help to develop the next SCP, to ensure it meets their needs…. your views matter and are really important! 

So what have people been telling us so far? 

The feedback we have had so far has highlighted some common themes. Do any of these resonate with you? What would you like to add?

 

The clock is ticking, so if you have not already done so, please read the consultation document (see link below) ‘join the conversation’ and tell us what you think.  We record and consider every comment or suggestion we receive so believe me when I tell you it matters. 

You can complete the survey as an individual or as a team/group. We have extended the deadline for the engagement to midnight on the 31^st of January to provide more opportunities to get involved. 

The feedback that we receive from people through this period of engagement will shape and influence the SCP as it develops. A draft of the full SCP will be made available for consultation in the spring of 2021.

 Thank you

Liz Forsyth is Strategic Planning Programme Manager for NHS Dumfries and Galloway

Well, Well, Wellbeing By Sarah Geidesz

On World Kindness Day I posted a blog about how we need to be kinder to ourselves. Here I am, back again, to talk about other things we do to keep ourselves well. As part of my work at the Organisational Development and Learning (ODL) Team we have focussed on supporting health and social care staff wellbeing over the winter months. Recently we have given a lot of thought to the things we can do to recharge our batteries and subsequently keep ourselves well. 

The self-care battery 

The concept of keeping your batteries charged may be a familiar one. The idea is that certain things that happen in our everyday life consumes our physical and mental energy (Hayman, 2018). These may be things like work commitments, lack of sleep or even domestic tasks. Unfortunately, there is often no avoiding these. If we continue to run low on energy it can have a significant impact on our health and wellbeing. We are more likely to experience burn out, changes in sleeping patterns, headaches, muscle pains and reduced efficiency of our immune systems making us more prone to illnesses (Smith, Segal and Robinson, 2020). Yet all is not lost, we can recharge ourselves. 

We can recharge ourselves by building up a variety of activities to engage in when we start to feel like we are running low on energy. These activities will be ones that we know help us to feel more energised such as reading, a bubble bath or arts and crafts. As we have entered a New Year it feels like the perfect time to really consider our own wellbeing needs and start building up a library of things that we can do to recharge our batteries and reduce the risk of us becoming unwell. 

Recharging your batteries 

So, what are the things I recognise that deplete my own battery and what activities do I do to recharge? Well my battery often feels depleted. This is usually due to working too much, studying too much, lack of sleep and drinking mainly caffeine. You would think by noticing I would be able to put time aside to re-energise but that is not always the case. I find it too easy to continue running on amber or red. Like I said in my last blog, these are the times that I find myself in a bathroom stall weeping at cowboy hatted pigs. 

Yet, the past few months I have took the time to step back, to recharge by doing things I know help to keep me well. One of my favourite recharging activities is being out amidst nature or visiting new and unfamiliar outdoor spaces. This always make me feel calmer, less overwhelmed, helping me to put things back into perspective by filling me with gratitude. 

I absolutely love nothing more as an energy boost than seeing live music, having a sing-along and a good boogie. As this is not happening at the moment, I have instead put together a playlist of all the songs that make me feel happy. I turn on my speaker and play them full blast. Another thing that works wonders for me is laughter. When I feel a bit low on energy, I seek out laughter like a bloodhound. It perks me back up. If I struggle to find it in the everyday, I will revisit old TV programmes that I know make me laugh until my stomach hurts. These are just a few things that I do to recharge my battery, replenishing my energy.  

Sharing our battery charging stories 

Given the challenges we faced last year, things that we used to do to reenergise might no longer be easy to do. Especially social ways of recharging such as seeing friends and/or family or my beloved concerts. Therefore, we need to consider new ways to keep ourselves well. 

To support this, throughout January we want to create a digital photo quilt. This will include images of all the things we do to recharge. By sharing stories through the quilt, we can support each other to consider new ways of doing. We can help each other build up our charging supplies and learn what works for us when our batteries need a little oomph! 

So, lets support and encourage each other to keep ourselves well this New Year. Please share with us what it is that you do to recharge your batteries? 

If you wish to contribute to our photo quilt, please send your images (like the ones above) to dg.odl@nhs.scot and/or share them on Twitter using the hashtags #RechargeMyBattery #WellbeingDG #Ontheground. 

Sarah Geidesz is a Student Occupational Therapist at Edinburgh Napier University 

References

Hayman. 2018. Self-Care Battery Image. Available at: https://gpandhuman.com/2018/05/17/the-self-care-battery/ 

Smith, M., Segal, J. & Robinson, L. 2020. Burnout Prevention and Treatment. Available at: https://www.helpguide.org/articles/stress/burnout-prevention-and-recovery.htm