Page 34 - QARANC Vol 18 No 2 2020

32 The Gazette QARANC Association
Our overall priority was to support staff and make a high risk clinical model as safe as possible. We used task based competencies and our adapted NHS and military SOPs coupled with an extensive education programme.
The build was completed in 10 days by a mix of military, NHS, contractors, and architects. An ambitious task some might say but it clearly demonstrated that the impossible is sometimes possible with the right attitude and people.
We had to adapt practices quickly and have the moral courage to make decisions quickly, usually without the information with which to do it, but what we needed were clear processes and procedures with quick dissemination.
The military also supported and influenced staff mental health and wellbeing. This was my non-clinical role; my main clinical role was rewriting and implementing the Covid-19 tracheostomy guideline practices.
People are our key assets; most will excel but the experience may break some, and we were very aware that
Covid-19 Family Support and Liaison at NHS Nightingale London
I never imagined that in 2020 on international Nurses Day and 200 years since Florence’s birth, I would be saying goodbye to NHS Nightingale Hospital London after just over seven weeks, and all down to a call from Deirdre Barr.
the mental health challenges would be heightened. Risks of moral injury occur where one feels unprepared and where actions or inactions challenge an ethical code particularly prevalent in psychologically and practically ill-prepared, inexperienced, poorly suited personnel. For us this was our biggest challenge, as we didn’t know the people who were coming to work at the Nightingale and we had no idea of previous experiences and abilities. Most would be working out of their area of expertise and of course we would be working in an unfamiliar environment - a conference centre - in teams we didn’t know. All of this may find people questioning their competency or ability exacerbating the risk of moral injury. The Nightingale mental health program was a multi- layer process preparing people for the role ahead. We did not sugar-coat it and were very clear what staff would face. The psychological PPE programme at induction would help individuals manage their own mental health/ coping strategies. Staff ‘buddied’ up
and welfare walkers (cabin crew) kept watchful eyes on each other. The ethos was very much a ‘nip it in the bud’ approach.
Nightingale promoted visible and compassionate leadership and effective two way communication. We developed a new role called the ‘bedside learning coordinator’, very much like the military trauma nurse coordinator. Collection and recording of risks in the clinical arena offered immediate coordination and liaison with the quality and learning governance teams to improve safety and practices. It all went towards creating a sense of worth and a sense of belonging. Validating swift decision- making based on mutual respect and trust rather than singular decision making was always encouraged.
Although the Nightingale was not in operation for long, it followed the evidence and provided a blueprint for how future, rapidly established healthcare facilities might support staff carrying out essential, highly challenging tasks in the years ahead.
For me the true measure of leadership is the ability to confront and support the anxiety of the people at the time and I believe we managed that in a short space of time. The care and compassion embedded in this extraordinary logistical challenge and the compassionate leadership I hope is something that stays with us as we move forward.
Lieutenant Colonel Jo Cooke 256 (City of London) Field Hospital