Ep 25: How to build a thriving community nursing team

Posted September 5, 2023

Show Notes —

District Nursing is tough business. Long hours, solo working in complex and challenging environments. Not to mention the distressing and sometimes dangerous situations nurses are placed in.

This can all take its toll on nurses’ mental health. Which is why it is CRUCIAL to have a compassionate team leader who knows how to support their staff. 

Enter Helen Kelly. In today’s super insightful and practical episode, Helen shares how she transformed a downbeat team of District Nurses into a cohesive, loving, trusting, and effective unit with super patient outcomes.

Today, we embark on a journey to explore the essence of team effectiveness and the art of cultivating a supportive environment.

Join us as we delve into the experiences and insights of this remarkable nursing team leader, Helen, who has not only weathered the storm but has also sown the seeds of compassion, resilience, and well-being within her team.


Key Takeaways from this episode

  • Helen highlights the importance of staff well-being and prioritizing mental health.
  • She also discusses the importance of local-level support for team members and the need for a safe and open environment to discuss emotions and stress.
  • Changes Helen made to a creative thriving team:
    • Having an open door policy, and being present and empathic with her staff at all times.
    • Introduction of calming plants in each office to improve air quality and create a positive atmosphere.
    • The “Guardian Angel” program, where team members anonymously support each other with gestures of kindness and appreciation.
    • A reflective corner with coloring materials and affirmations to provide a space for relaxation and emotional support.
    • A well-being box stocked with essential items
  • Helen discusses the importance of focusing on the well-being of nursing staff to ensure they can provide the best care to patients.


Today’s Guest:

Helen Kelly is an operational team lead for a district nursing service in Sussex, England. Helen’s service had introduced several changes to how they ran things within the group, many different initiatives which had led to a massive improvement in well being within the team and people feeling supported.

Helen’s approach has been genuinely preventative. She created a culture where people feel supported, and their distress is minimized.


Connect with Helen on Twitter here: @HeleMorrison


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Transcript —

Nathan Illman 00:00

Welcome everybody. It is your host, Nathan Ilman. I am a clinical psychologist and founder of Nurse Wellbeing Mission. I’m delighted to bring you another installment of the podcast. Today, we are asking the question, what makes a healthy and effective team and how can we support a culture of compassion and genuine care and support within a team of nurses and other healthcare workers? Today I am talking to Helen Kelly who is an operational team lead for a district nursing service in the south of England. I was introduced to Helen through a mutual colleague who had told me about the incredible success story that had been going on in Helen’s service. After she had introduced a number of changes to how they ran things within the team, a number of different initiatives, which had led to a massive improvement in wellbeing within the team and people feeling supported and this conversation with Helen is just so wonderful. It’s amazing to hear the work that she’s been doing and to hear just the attitude and approach she has towards helping support the team and really genuinely caring about developing connection and empathy and compassion and a sense of belonging for the people she works with. So as people who are district nurses will know, this is a very stressful job at times. But Helen’s approach has been truly preventative in nature. It’s a number of small things that have happened within her place of work that she has led that create a culture in which people feel supported and their distress is minimized. And of course that means people are much more able. to enjoy their work and flourish at work even though it’s stressful. And these are the kind of things in my opinion that we really need throughout nursing and healthcare in general. And not so much of a reactive focus on waiting until people have developed serious mental health conditions. So, I am going to bring you now this amazing conversation with Helen Kelly. Amazing, so I’m really excited about this conversation. Obviously, you and I have spoke before. And we’re going to go into more detail today. And really, I guess what we’re talking about is team effectiveness. We’re talking about how to develop a positive culture within a nursing team, and you’ve had some wonderful experience and success with that recently. So I think somewhere I’d like to start is something I was curious about to get your opinion on. In your experience, what do you think nurse managers and leaders are focusing on? Too much or too little. So what are the things that they perhaps maybe should be focusing on, but they’re actually focusing their attention and energy and resources onto this other thing?


Helen Kelly 03:11

I think I’m lucky in the trust that I worked for. They really have listened to our staff questionnaire and wellbeing came up quite top priority. But I think sometimes that money gets invested. In corporate policies and corporate things that are going on and we have lots of places to go to like mind and connect and things, but I think we need things on a more local level in a more of a team base really. I think a lot of these things people have to access out of their workplace quite often because we’re a community trust. We’d have to travel a long way or you do over teams which. isn’t, you know, if you’ve got crisis or emotional things going on, it’s nicer to talk face to face. So I think it’s brilliant that we have got lots of resources to tap into, but I think more emphasis needs to be on teams and at a local level.


Nathan Illman 04:16

There’s something about the support that’s being offered being somewhat removed from actually the day-to-day concerns and distress, perhaps, of the actual team, and that approach feels kind of catch-all. It doesn’t feel like it’s very tailored or bespoke for what your people actually need.


Helen Kelly 04:34

Yeah, I think because people, if they were going to access those services, they feel like they’ve got to have a really big event going on. They have to be really suffering with, you know, they have to be off sick or, you know, really suffering with something that’s been recognized by their GP. Whereas, you know, we all face stress. you know, things like that every day. So I think if you’ve got it more a local level, it becomes more second nature for people to talk about how they’re feeling or to express how they’re feeling. And it’s not such a big deal. It’s just, you know, becomes everyday practice really.


Nathan Illman 05:12

Yeah, I guess one of the problems we have is that after COVID as well, there is more awareness of there being high levels of distress and psychological difficulties in the healthcare workforce in general. And there’s the problem we have, I guess, in society, in general, is trying to firefight and have kind of tertiary services to work with people who’ve already developed these serious difficulties. I guess what you’re talking about sounds much more like on a local level, what are the day-to-day things we can do to be managing day to day stresses to help people feel heard, understood, empathise with, to actually prevent that stuff happening in the first place?


Helen Kelly 05:50

Yeah, I think if you can target it as a team if you can all be coming together and not worry about things you’re saying or how stressed we are, then you feel more relaxed.
And obviously, those services at a high level are really needed. And there’s some issues that, you know, you really can’t solve it. It’s also local level, but I think a lot of the things, the day-to-day things, the stresses that we experience can be helped with your team members and, you know, all just working together.


Nathan Illman 06:25

So we will dig in then into specifically what you’ve been doing in your team. So do you want to just give a little bit of context as to what the service is and your role to begin with?

Helen Kelly 06:37

Okay, so our service, I work for RMPCN, which is a community nursing team, district nurses and community nurses. I’m actually the team leader. I’ve been with the team for the last 10 years. I started as a band five and became band six and so on. So I’m now team leader and we’ve always been a very close-knit. team anyway. I went away for a while. I was a practice nurse, development nurse, and then I got this role. And when I came back, it was just after COVID.
And where we were, we’re a big team. There’s about 40 of us with admin and everything. And where we were, there are, it’s just a corridor and we have lots of rooms. We don’t have one big open area. We have lots of little offices. dotted around everywhere. So after COVID, a lot of people hadn’t seen each other for months on end. And I just remember the days when we had handover updates, we call it. That was an opportunity to, yes, obviously hand over, update everyone on all your patients. But also it was a time just to see how people were and just kind of, you know. Judge whether they’re having a good day or bad day and all that being missed.
So I kind of tried to think of ways to bring the team together. I was always walking around all the rooms and checking everyone was okay. And there’d be people hiding in some rooms, didn’t want to see people. And so it was quite difficult. So I just. you know, tried to rack my brains as to what would make all this, you know, come together a bit. So first of all, I got a grant from the Wellbeing Trust and in our trust, and we got a whole load of plants from quite an exclusive plant. So I was, it was lovely to get the money. I was like, like went on a brilliant shopping trip, but we got plants for every room and these plants. were ones that are meant to put calming things into the atmosphere, but also take out any toxins in the atmosphere. And they’ve gone down really well.


Helen Kelly 08:50

So each office has got a plant and it’s a little bit of a competition to see whose plant will survive and one of my plants unfortunately died so that was like a bit unfortunate but you know the plants are doing really well and I think it’s just that that in itself just brought people together and it was just a bit of a talking point and then I moved on to just thinking. What we could do to kind of, again, just bring everyone together. And my senior manager had mentioned to me, one of her teacher friends had said they run this scheme called Guardian Angel. And I thought, oh, that that would be really good. And Guardian Angel is where you put everyone. name into your hat of the team and everyone picks out a name and you don’t let anyone else know who you’ve got or that person and it started off that you might just make that person a cup of tea if you noticed they were having a bit of a rough day or you really it’s. Really just looking out, it’s kind of like a body, but you don’t know who it is. So you might get a little note on your desk or, but then people started buying presents and really thoughtful gifts. If someone was having a rough day, if someone had something to celebrate. So we actually now have a little basket, guardian angel basket and people just put things in there for their body and people have got amazing gifts.
It’s, you know, mugs with nice thoughts on it, or, you know, just down to some chocolate or lots of different things. And because we always like to say you want to say thank you to whoever’s bought you, but we don’t know who’s bought it on our WhatsApp group. You quite often just get people saying thank you so much, guardian angel. So that person knows. It’s really appreciated. So that’s worked really well. And we’re in our second year of doing that. After the first year, we all had to try and guess who our guardian angel was. But nobody could guess. Nobody got it. And then we had to check. Yeah, I know. Everyone does it very secretively and things and not let anyone know. So that’s really, really good. So then, so that was going down really well. And then I saw on Twitter. a mental health nurse somewhere had was talking about sort of coloring and mindfulness things. And I thought, you know, it’d be really nice to make one area of the offices into kind of like a reflective corner.


Helen Kelly 11:27

So I got a very big poster that you could color in. I’ve got some colouring pens, I’ve got some little doodle books, and we have affirmations and things in this little area. And it’s, I must say, I didn’t think people would use it. But it’s really used and it’s so lovely that people when they’re sometimes when people have are having a rough day and they’re chatting with someone, they’ll both be standing at this poster just sort of coloring and talking and you know, there are a lot of it’s been colored in. So that’s lovely. You know, if someone does need some time out, it’s somewhere to go and sit and just get their thoughts together, you know, because sometimes we’ve just had. You know, a bad morning. There’s nothing we really need to talk about. We just need to get our heads together. We’re really lucky down here being by the sea that I used to find that I used to drive by the sea and just stop and look out to sea for a little while. And that would sort of gather my thoughts. So we kind of need areas that we can just come back down to ourselves, really. So that’s been lovely. And then we kind of just moved on to all sorts of caring things really. We’ve got a wellbeing box that’s full of, has hair bands in, it has sanitary product, headache tablets, chocolates, lots of just essential things. And as with everything, there’s no one, one person responsible for any of it. Once it’s kind of, once all these things have been implemented, they kind of run themselves, all the staff run them all together. So with the wellbeing box, people will just bring things in, or if someone uses something, they will replace it. Or somebody might think, oh, that would be nice to have in that box and put it in there. So you don’t need someone. It doesn’t take anyone’s time up to do any of these things. It’s, you know, they all just work beautifully together. And so future plans, I really want to get some, I really want to do some more teamwork things, and going to ask the Wellbeing Fund again for some money to get some outdoor games like a big Jenga and a big Kinect 4 and maybe play some rounders because although we’ve, you know, it’s been lovely since we implemented all these things, everyone comes back for update.


Helen Kelly 13:55

Now, we’ve had to split it into two because there’s too many of us to be in small rooms, but no one does update from home at all anymore, which is lovely. Everyone comes into the office, everyone, you know, looks out for each other and will point out if someone is having a bit of a rough day, will say to me or one of the seniors, Oh, you know, I think they just need to, you know, a chat or something. But like I say, quite often, I just see people standing at the coloring or Standing, you know, going to the reflective place and just chatting together. Another thing we have is we have quite a few mental health first aiders and the team know who they are and they get used a lot and they are fully aware to look out for people that are just having a little bit, you know, of day or whatever. And obviously, we also have all our phone numbers up of all the outside services and all the services, the trust. You know, supplies, because like I said at the beginning, there is a big place for those as well. And you know, some people, you can’t just solve things on a day-to-day local level. So we have all those phone numbers and all everything. Anyone can contact those. So yes, that’s what we’re. Doing and it feels amazing. Yeah, it feels like a lot but you know, it’s so lovely that the whole team just run it, you know, it’s no hassle to anyone. It’s so easily implemented and has no upkeep at all. So yeah, I’m very lucky.

Nathan Illman 15:31

And one of the things about a workplace culture is that kind of thing of, this is how we do things around here. And it really sounds like you’ve created that. So this is just how we do things around here. It’s not leadership management telling us to do it. So that’s what we’re doing is we look out for each other. Everyone’s looking out for each other now.

Helen Kelly 15:50

Yeah, very much so. It’s so lovely. You know, nursing, as we all know, is such a stressful, difficult job. Especially these days, in the community, we’re getting much more complex patients. We have loads of deferrals every day, which leads to quite angry patients. And, you know, my team of nurses are going out and having to deal with that on a daily, on an hourly, half-hourly basis of, you know, so you have the morning where every person you turn up to is cross and down. And, you know, it’s. It just, it rubs off on you and, you know, we, I want our nurses to feel that they go in, you know if we look after our team, then our patients are being, you know, really well looked after because, you know, a confident, happy team gives good patient care. So it does benefit our patients and helps our staff because like I say, it’s stressful out there and it’s kind of like, I want them to feel like they come back to their safe place. They come back and they can just kind of go, you know, this has been going on and no one judges or, you know, thinks so they’ve lost it or, or they need help. Kind of, you know, it’s just how we are as humans. We need to let those emotions out. So, yeah.

Nathan Illman 17:14

I think what really strikes me is how you’ve really focused on some of our basic human needs in your workplace. You know, you focused on safety, psychological safety, and creating a climate in which people feel safe to come back to. It’s a safe haven. Like you said, it’s a threatening environment out in the community, isn’t it? Dealing with Anger and abuse and sometimes maybe even physical threat of or physical abuse from people and knowing you have a safe space to come back to is something that is so important, which I think a lot of people probably don’t really consider.

Helen Kelly 17:51

Yeah, you know, I, I’ve always seen because I’ve worked for the team for a long time and I’ve always seen this as a good happy place. And that’s why when I came back after, I don’t know, COVID had really disjointed a lot of. You know, a lot of teams and a lot of things, but I was really shocked to see how disjointed the team had become after it being such a supportive and a place that I felt I could go to. I had a period of being quite unwell and it was my work colleagues and work that really kept me going and I just felt that was lost. So that was kind of my motivation behind. Getting what we used to do, kind of, and just extending that and just making it, not official, but a little bit more, like you say, in team culture. It is, this is just, this is us, this is what we do. And I think it has a good reception. You’d have to talk to the rest of the staff, but I’m sure, um, you know, it does, because like I say, they work it, they do it. So. Yeah.

Nathan Illman 18:58

Do you have any specific stories or feedback that you can share about things that people have shared with you around what has been particularly helpful for them?

Helen Kelly 19:07

I think the Guardian Angel has been really, really lovely. I think it’s just, even, we know ourselves, if you receive just some praise, it just inspires you to do whatever again. And I think the Guardian Angel, lots of people really appreciate that and have had some, you know, some lovely gifts, but also just some lovely letters, just to say, I know how hard you work, and I’m sorry if, Whatever happens or well done for achieving whatever you achieved. So I think staff would say that that probably was a good point. And the plants have been lovely. I think, again, they’re all flourishing and it feels like they’re like the team. It’s, they’ve given, the team have given the plants energy and really looking after their plants well. And it’s, like I say, it’s a bit of a competition to see who’s got the best plants, and our proactive care team at the moment are winning. Their plant has just grown and grown, but yeah, all our offices have amazing plants in, so that’s been lovely as well.

Nathan Illman 20:16

I guess it’s not just about having plants, is it? Like you said, it’s spiraled into this other thing. It’s, yeah. It’s a sense of connection over the plants and a drive and motivation to keep something going. It’s kind of a metaphor, isn’t it? For keeping the team going and helping the team flourish. They’re using the plants to kind of enact that, aren’t they?

Helen Kelly 20:38

Yeah, very much so. It does feel like that, you know, you might think, Oh yeah, we all have pot plants and, you know, it’s a very funny thing, but it’s really worked, you know, I see, and people will say, I’ve, I’ve looked after all the plants, you know if they work in the weekend or it’s a holiday time, and they’re really invested in these plants and I think that shows their investment in the team. And like I say, it’s not just me. From a top-level saying we will do this, we will, you know, I want to see this. I don’t get involved in it at all really, apart from just pray, you know, going around and being really thankful for the work that everyone does. You know, it’s the team that are really driving it, you know, and I think that helps a lot.

Nathan Illman 21:25

I think something I’d like to dig into a little bit more is the road to going from having a collection of initiatives to it being this self-sufficient thing. And I know that that is going to come down to the way in which things are introduced and the mindset of the leader or manager and your attitude towards these things and the relationship you have with your staff. So the way in which you treat your people. So some people might be listening to this thinking, oh great, like there’s that initiative, there’s that tactic, I can try this, that, and the other. But as we both know, sometimes these things don’t work out. They fail. Yeah. Talk to us about you. What is it about you and the way you introduced things and maybe some of the little interactions you have on a day-to-day basis with people that has helped all this?

Helen Kelly 22:17

I think possibly as team lead and everything, I’ve always made sure. That’s the door is open as we all know and but I’ve always made sure that if I notice anyone but I asked people if they want to come and talk to me so I’ve always had a very open relationship with the team. I’m, you know, very flexible so if people have got things going on, or they need to have some time off quickly then we accommodate that as much as we can. Obviously, the team needs the work is paramount. But you know, you have to be flexible with your team. They work so hard and so many of them work over their lot of time and don’t come back. So we’ve got a very flexible approach. I feel that I’m quite approachable person that people can come and tell me things. I think I’m just, I like to look for a solution. I always feel that there are solutions for everything that’s happening out there that if we look hard enough, we can find that solution. And one thing I forgot to mention, which my PA will kill me for, is I forgot to mention, we also have a wall of good days on our notice boards and that captures everything at home. Like our pets are, it has yoga poses and initially to get those kind of things started like getting posters and things. I’ve really got my PAs and admin staff on board with that because they’re in the offices all the time and they’re very, they’re with on the computers and everything. So it’s really trying to get, you know, staff behind you that know, that have a similar interest to you. I’ve got quite a few other team members that love their affirmations or their mindfulness. So it’s just finding out what people like and what people will sort of go with and just building up from there really. And then letting people run with it. You know, if things don’t work, try something new, try something different, you know, that I always have lots of ideas and things going on, but now people are coming up like the other staff members come up with ideas as well. So it’s lovely. I think.

Nathan Illman 24:35

You may not consider yourself this way or thought about yourself in this way, but to me, you sound like a real true compassionate leader. There’s someone who really takes time to understand, to listen to, to empathize with your staff. You’re flexible. You meet them where they’re at. You don’t, it sounds like you don’t create a kind of system or culture in which it’s very hierarchical. You’re meeting them at that, at their level. You are opening your door. You said sort of physically and metaphorically. They listen to their concerns and you’re solution-focused.
You’re trying to help work through problems and solutions and at the same time giving people autonomy to do that for themselves. And I think this is so important, those qualities for creating the culture and climate which you’ve created, which then becomes self-sufficient and people flourish. And as you mentioned earlier, that is what leads to better patient outcomes as well.

Helen Kelly 25:35

Definitely, you know, it, it certainly, it just brings everyone together. And like I say, we’re in a very pressurized NHS under lots of pressure. And, but we need to recognize that. And we do recognize it, but quite often, we don’t come up with solutions that staff are actually asking for on the ground floor. So it’s, I just see it’s really important. The directors of my trust don’t get to see. How the staff, the personalities of my staff, or, or what works. So it’s my job really to, you know, work with my staff and, you know, and then let managers know what we’re doing and things. And like I say, you know, at the corporate level, all those telephone numbers and websites are so useful, but I’ve found that we don’t need to use them as much anymore. That everyone is looking after everyone’s mental health on a daily basis, which is brilliant.

Nathan Illman 26:36

It’s amazing. Something I’m interested in is, do you find yourself having to resist, certain pressures or demands or ways of doing things that are coming from above you? Do you have to kind of interpret that and then sort of apply your own way of doing it to meet, to sort of meet the objectives that you’re being given?

Helen Kelly 26:58

Not really, because I think I’m very honest with the team because I really want them to be honest with me. And I think all these things work both ways. So I think, you know, if we have got some pressure on us from above to complete something or to do something a certain way, I really like to tell the team how it is and what we’ve got to accomplish and then discuss with them how, how are we going to do this? This is what they want. How do we go about that? So I don’t usually, I mean, there’s things obviously as team lead, you do protect your staff from, you know, the ins and outs of little things every day that you can deal with. But on the whole, if it’s something that’s It’s going to affect the whole team, then the whole team needs to know and they need to know the truth and they need to know what’s expected and If it’s extra work, it’s extra work, but we’re all taking it on together, you know, and I feel they can be honest with me and say, Oh my goodness, can’t do that. Or what are you going on about? So I, you know, as I’m honest with them, and I think I’ve been in the post two years now, and a lot of them knew me before, but any new stuff, um, You know, know that’s how I am as sort of team lead.

Nathan Illman 28:15

It really sounds like you respect the people that you work with. Yeah, very much. And trust and honesty is really important.

Helen Kelly 28:21

Yeah, very much so, very much.

Nathan Illman 28:24

I’m sure there’s a lot of people listening to this, you will listen to this and be thinking, Oh, I wish she was my manager.

Helen Kelly 28:29

Aww. I know that’s, but the thing is, I don’t feel I’m doing anything special. It’s really odd when people, like you’ve said, you know, you’re a compassionate leader because that wasn’t my intention to be this wonderful leader and excel at whatever, you know, my striving sort of driving force was to make our team to our nurses and our patients, you know, lives a bit better really, so.

Nathan Illman 28:59

I think I always found that about myself as well. There was such a core value of compassion and I see a lot of my own sort of quality things that are important to me is similar to yours. And in previous leadership roles, it’s sort of just the way I would do things. When people would comment on it, you’d sort of, surprised. Well this is, I’m not trying anything different. This is, this just feels natural, right?

Helen Kelly 29:23

Yeah, very much so. I, when people say, oh, that’s amazing. You know, when I did this talk at a showcase day and it got really good reception and, you know, I’m so proud of it and I’m so proud of the team. I don’t see. That I’m anything special that, you know, done anything special. It’s just, you know, it’s worked as a team and, um, you know, it’s, it’s brilliant. It’s lovely. I feel very, very humble, you know because I don’t get to go through the hard things that the staff go through every day. So I need to help them, you know, deal with that.

Nathan Illman 30:01

I really believe that most people who go into healthcare, you know, particularly nurses and midwives, they, they do have all of this stuff at their heart, but it’s, unfortunately, it’s the systems that we work in that prioritize other things, the wrong things, efficiency and targets and ineffective styles of leadership and things like that, which unfortunately suppress people’s natural motivation and drive to be compassionate or to care about connecting with people, that sort of thing.

Helen Kelly 30:33

It’s funny because we connect and we’re compassionate to our patient, but that’s not always, we’re not with our team members sometimes. So, you know, we need, and like you say, nurses, you know, are compassionate. You know, we, we do feel and we want to help people. So this is really where this has all come from. And it’s just giving people time to digest that and get used to it. And I think we reach targets and accomplish things better now than we did a couple of years ago. Unfortunately, I’ve got no statistics to prove that, but I feel that we are in a much better place than we were a couple of years ago.

Nathan Illman 31:16

Well, Helen, thank you so much for the work that you do. I’m sure your team are very grateful. The patients that they work with might not know it, but I’m sure it’s benefiting them enormously. And for anyone listening to this, I’m sure you’ve been an inspiration and giving some people some really concrete ideas about ways they might be able to improve their team effectiveness and culture of compassion and wellbeing. So thank you so much for joining me.

Helen Kelly 31:43

Thank you.

Nathan Illman 31:44

Well, everyone, that is almost a wrap on another episode of Nurse Wellbeing Mission podcast. Thanks again to my guest Helen there. You may be wondering who I am. Who is Nathan Illman, the guy who does this podcast? Well, I’m a clinical psychologist and I also run my business, Nurse Wellbeing Mission, of the same name. And I help nurses and midwives prepare for emotionally challenging work. And I do this through a number of different things, through coaching, supervision workshops and training. So if you’re interested to find out more about me and what I do and how I might be able to help you and or your organization, then head over to my website. It’s www.nursewellbeingmission.com. You’ll find all of the previous episodes of the podcast on there as well. So more information about me, how you can get in touch with me. And different things about the services that I provide, including support for PNAS and support for nursing leaders in general. So hopefully I’ll have some kind of contact with you in future. Reach out to me as well. If you wanna come on the podcast, you think you have an interesting perspective or something to share about wellbeing, I would love to hear from you. Okay. So until the next time, stay well everyone.