Team work makes the Dream Work..Part 3 by Alison Howie

Emotional Intelligence- your greatest strength can be your greatest weakness.

For the last 6 months I have been fortunate to be part of a leadership journey with the #dNMAHPs, NES, digital leadership course. As part of my leadership journey I decided to Log my journey in a 3 Blog series.

So what have I learnt on this journey? Have I achieved the program aims of developing leadership skills- Yes. The program has given me the confidence and opportunity  to be more bold, more innovative, more digitally enabled and encouraged me to reflect more routinely. I have also learn that not acheiving the end result is not quite as improtant as I once thought. It is not failure if you dont achieve the inital aims as long as you  have learnt and developed along the journey.

In order to lead others, we must first understand ourselves and be aware of our reactions and how we are precieved by others. Our Emotional Intelligence has a significant impact on our perfromace and capabilites as well of those around us.

Emotional Intelligence: is the ability to understand,use, and mange your own emotions in positive ways to relieve stress, communicate effectively, empathise with others, over come challenges and defuse conflict.

“It is the key to both personal and professional success.”

Goleman (1995) states the 5 domains of emotional intelligence:

Self awareness, motivation, empathy, social skills and self regulation

I was once told, 10 + years ago, that my emotion was my greatest strength but that it was also my greatest weakness. Emotional intelligence has an amazing impact on both the person and the team and therefore the organisation.

As we all Know nothing stays the same, change is happening all around us, and to be able to cope with change in a constantly changing (home and work) environment we need resiliance and for me emotioanl intelligence is part of that resilence. It is a key skill of a good leadership and healthcare.

The infographic shows us how our intrapersonal skills can inflence our interpersonal abilities.

By working on the components of emotional intelligence and being aware of where we need to develop and grow, we can potentially achieve in a number of areas shown in the infographic below.

Taking some time to think about your own emotional intelligence  can be uncomfortable, we all have days when we wish we had said something differently or been more empathetic to a colleuge. By developing  this self awareness is our inital step to developing EI. The ladder of inference mentioned in my First Blog is a great tool to reflect on how we react to situations and how we can infulence and self mange our reactions and emotions.

Top Tips for leading with Emotional Intelligence:

1. Stabilse- Know your triggers– if you can’t mange your triggers, them you will destabilse yourself and therefore the team. Anticipate stressors, have a plan, COUNT TO 10. Practice makes perfect, looking after your health will allow you to look after others.
2. Recognise emotions in others- empathy is the ability to understand other peoples perspective. Acknowleding and understanding peoples concerns results in people being more motivated and willing to be part of the solution.
3. Mobilise: Once you have self awareness of your emtions and the emotions of your team you can then mobilse to acheive your goals- looking for the help, ideas and perspectives of your team will move everyone towards your goals.

I am at the end of a small chapter in my leadership and team work journey. And although I still have a lot to learn I have cetainly come a long way. Team work makes the dreamwork, and that through my 3 blogs I have explored what team work means and how we can do it well, the ability to achieve more than you thought you could by having a clear vision and purpose (Vaccinating the Nation) in “The good we do today become the happiness of tomorrow” and finally that after 6 months, one of the strongest traits of good leadership is Emotional intelligence.

I hope sharing some of my thoughts on this journey with you have been helpful.

Be Kind to yourself, be self aware, be kind to others and be aware of others emotions and perspectives. Seeing all sides of the story helps us to work more effectively as a health care team.

Thank you for reading this Blog, any comments on this or any of my 3 blog series would be greatly appreciated.

Ali Howie MSK Team Lead- Life long learner.

#Teamworkmakesthedreamwork #dNMAHPs #Thegoodwedotodaybecomesthe happinessof tomrrow #Emotionalintelligence

Improvement Advisor Reflection by Kim Britton

Kim Britton was an Improvement Advisor for the Patient Safety and Improvement Team at NHS D&G.

Under pressure … by Emma Whitby

You may remember seeing the videos and the great work some teams did to highlight national stop the pressure day last November. 

Kayleigh Shanks – A Student Nurse on Pressure Ulcers

Hollie Gordon – Pressure Ulcer Prevention in Critical Care

Jennifer Ross – Pressure Ulcer work in C6
Alice Wilson – Stop the Pressure
Emma Whitby – Pressure Ulcers using a SSKIN care bundle approach

It’s important to mark the National day and raise awareness but it’s also important not to lose sight of the prevention of pressure ulcers every other day as they are one of the greatest healthcare challenges. Pressure ulcers are injuries to the skin and underlying tissue caused by prolonged pressure to the skin.  They can happen to anyone of any age where there is a period of prolonged immobility.  This could be due to a number of reasons but primarily they affect people who are unable to move and change position themselves – patients that are confined to bed or who sit in a chair or wheelchair for long periods of time. 

They frequently occur within the first ten days of being admitted to hospital, negatively affecting patients’ quality of life and extending duration of hospital stays.

The management of these ulcers is ever evolving but as the saying goes “prevention is better than cure” and this should be an everyday nursing priority.

Pressure ulcers have been described as one of the most costly and physically debilitating complications.  Pressure ulcers are the third most expensive disorder after cancer and cardiovascular diseases.

The total cost in the UK is £1.4-£2.1 billion annually which is 4% of the total NHS expenditure.  Most of this cost is nurse time.  The cost of treating one pressure ulcer varies from £1,064 (Grade 1) to £10,551 (Grade 4) per episode without complications.  Some common complications may include sepsis, cellulitis, which is an infection of the layers of skin and osteomyelitis which is an infection that has spread to the bone which may be visable in a grade 4 Pressure Ulcer. 

The monetary expense explicitly highlights the importance of prevention. The argument for prevention becomes even more evident when you also consider the social costs, personal and economic loss to the individual.

A pressure ulcer story..

When my 80+ year old Mum was admitted to hospital following a fall at home our concerns were initially focused on her fractured hip and resulting surgery. However it soon became clear that having lain on the floor for some time before she was discovered she had sustained damage to the tissues of her lower back and sacrum which over the coming days manifested as a significant pressure ulcer. This affected almost every aspect of her recovery and rehabilitation. She needed intensive input from the nursing team and expert assessment and advice from Emma to manage the wound. In practice this meant using a vacuum device which worked remarkably well to heal the wound but further reduced her mobility and independence. Unfortunately the wound also had a significant odour, especially when the dressing was being changed which was embarrassing and unpleasant for Mum and those around her. She needed regular pain relief, and her memory impairment meant that she frequently forgot why her back was sore and that she couldn’t stand up or walk unaided while connected to the vacuum device, increasing her falls risk. 

Emma and the nursing team worked together to heal the wound completely following a prolonged stay initially in DGRI then community hospital and Mum was discharged to residential care where she is settled and happy. The pressure ulcer had a huge impact on her recovery and we are so grateful to Emma and the nursing teams for their expertise and care in ensuring that the wound healed and Mum is now pain free.

In October 2020 Healthcare Improvement Scotland released an updated version of the standards (click here) for the prevention and management of pressure ulcers.  They are intended to enhance improvements in health and social care.

The standards make reference to the SSKIN care bundle, which is a tool designed

to help identify risk factors linked to the development or deterioration of pressure ulcers. The SSKIN care bundle is a tool which defines and ties best practice together.

• It allows the process of Pressure Ulcer Prevention to be visible to all.
• Minimises variation in care delivered.
• Provides reliability of delivering all elements of the care bundle at every opportunity which will improve the pressure ulcer care that each person receives 

The elements include:

• Surface – assessment of the appropriateness of mattresses and/or cushions and review of the functionality and integrity of equipment intended to reduce risk of pressure ulcers
• Skin inspection – assessing pressure areas and monitoring skin reddening
• Keep moving – assessment of regularity of movement intended to prevent

pressure ulcers or deterioration of existing pressure ulcers

• Incontinence/Increased moisture – assessing bowel and bladder function and

control, and other body fluids on the skin

• Nutrition – ensuring the right diet, fluids and supplements

The standards apply to any person at risk of developing, or identified with, pressure ulcers regardless of age (including babies and children) services and organisations responsible for pressure ulcer care across health and social care, including:

• primary and secondary care
• hospices and independent clinics
• care at home services
• care homes

If you haven’t had the chance to read these standards I would advise that you do so and share with your teams. 

Also please visit the e-learning module on learnpro if you have not done so in the last year to refresh yourself.  

Remember…. 

Prevention is better than cure.

Emma Whitby is a Tissue Viability Nurse Specialist at NHS Dumfries and Galloway