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Hello everyone, welcome to the Social Work Stories podcast.
I'm Mim Fox and I'm here with Liz Murphy.
Hello Mim. Liz, good to see you and here we are back.
I know for part three, can't wait.
Part three, everybody, this is if you haven't listened to the last two episodes of the Social Work Stories podcast that focused on the amazing seed program in the Yellow柔 Shell Haven local health district in New South Wales, then you've got to go back.
You can't start here. You can't start here.
So come on. Let's press stop right now and go back to episode one and part one and meet us back here.
Meet us back here, absolutely, but like, you've missed a lot because we talked, Liz, part one, we introduced everyone to the context in which this program occurred, the seed program, right?
We talked about the bushfires that happened at the end of 2019, beginning of 2020, down on the South Coast, a little country town, Milton Nala Dollar Hospital, right?
Tiny little hospital that actually is servicing an amazing amount of people.
And we talked about all the different players, we talked about Stuart and Padmene and Gail and Ruth, right?
We met all the characters that actually lived down there in this area and were fundamental in actually making this program happen.
And what an amazing experience, Liz, right?
And then in part two, we heard about all the various programs that were grown from the roots up.
So this was staff driven, beautiful community development work.
And now we're going to focus on the leaders.
Yeah, well now we're going to talk about the transformation.
I just want to take us back for a minute to part one.
Do you remember in part one, Padmene, talking about the theoretical base?
Yes, of seed, right? She was talking about the values, but she was also talking about the theory base.
Do you remember that? I do.
Trauma growth? Yeah, post-traumatic growth and participatory action.
That's right. So she actually went in there, met with everyone, found out what they needed, found out what the potential was, and then, but always, with that eye on the fact that actually there was the potential for post-traumatic growth, right?
That actually we can come through this, okay?
Like such a positive approach and theory base to come from, right?
And I think this is the episode, Liz, where we really see that play out.
This is the episode where we hear from the leaders about the impact on them.
We hear from the healthcare professionals about the impact on their everyday work.
We start to think about, well, if we're going to have a program that's sustainable into the future, what might we actually need?
And what they're describing is quite a different paradigm.
So it's exciting this one.
It's a really exciting episode and great place to finish up on.
So before we kick off, let's hear from Michelle about what was actually like down there at the time of the bushfires on the South Coast.
The acronym for SEED stands for Stability, Encompassing, Endurance and Determination.
And for us, the SEED program was the baby of our organisation after the trauma of the bushfires on the South Coast, 2019, 2020, which seems a lifetime ago now.
So during those times, I was working as a registered nurse in a small rural hospital.
And it was a very different world.
The sky was filled with ash every day.
We were driving to work and ash was just raining on our cars.
The sky was red, fiery, glowing, you know.
Apocalyptic almost. You couldn't help but pull up to work and feel anxiety before you even entered the doors.
So dealing with that every day, as well as worrying about your own home and your own family, was very taxing and draining on all of us.
And in this time, the roads were cut off.
There was police with the roads cut off because burning trees had fallen over the highway, which left us extremely isolated.
We had no communication, no mobile phone reception, no landlines.
And we had staff that were working at our local hospital that were commuting from an hour or 45 minutes away.
That were stuck at the hospital, no clothes, no communication with their family, didn't know if their husbands, their wives or their children had made it to evacuation centres.
So added to that, an already stressful environment in a crisis, a hospital, where you're caring for vulnerable people, it was very, very difficult.
We were exhausted, we were managing the emotions.
There was one particular nurse I remember who was most upset because we had palliative patients and distressed family members that couldn't get through the highway to be with those people when they were dying.
And we couldn't contact them when they were dying.
That was a huge emotional responsibility for us to feel like we had to feel that gap and try and make that the best it could be in that horrible situation.
So being a small rural hospital, our resources were limited.
We ended up having an overflow of patients from the ED set up into a communal lounge room that were on oxygen.
So we put them in a communal lounge room so that they could actually be observed by nurses, but they were not as acute to need an ED bed when the ED beds were sorely needed by other people, but they were not well enough to go home either.
So there were nurses and there were health and security assistants that did double shifts, that slept on site.
And there were staff members that couldn't get to work because the highway was closed.
So that was sort of placing pressure on the people that were here to do that as well, because we had to keep the hospital running.
I mean, you know I've been working in health for 30 plus years.
Yeah, I know. You know, I'm completely institutionalised.
Oh yeah. So I come from a place of really understanding health culture in New South Wales, right?
Yeah. And leadership has been a focus for at least the last decade.
You know, there's leadership programs all over the place.
They love a good program in health.
Oh, we love a good program.
We love a good program. We love a good leadership program.
And I've also noticed over those years of being in health, it's amazing how many MBAs people have been leadership now.
That's so true. I would, I think there's a PhD in this, the Rua Nation of the World and the introduction of an MBA.
No, truly. Truly? Yeah.
So but really, why I'm rabbating on about this is what we're going to listen to is a different paradigm about leadership.
Do we go into see and I think there are a number of leaders here whose personal journey becomes a metaphor of their shift in their approach to leadership.
And it's counter-cultural what they're talking about.
And this is why for me, this episode is a really exciting one because this is different leadership to what I've seen and heard about in health.
It's actually a different story being told, isn't it?
Love it. Let's hear from Stuart.
I'm a member of Stuart, I'm director of nursing in charge of Milton, I'll a hospital.
So like, absolutely in that leadership position.
And then we're going to hear from Danny, who's a nursing unit manager as well.
So really interesting perspective.
So my leadership prior to the the current one fire was I think somewhat of a standard style of leadership for health.
I believed I provided an open forum opportunity.
I believed I connected with staff and I was open to change and open to ways of working that were different to what I previously experienced.
I believed that I was a good listener.
And I believed that I had compassion and care at the centre of the way I worked as a leader.
However, the fire has actually taken me to a place where I would challenge each and every one of those things that I just said.
I don't believe that I had care and compassion at the centre of my management and my leadership style.
I think I was very task orientated and focused on outcomes and achievements.
And they were KPIs of the sort.
They were the things that we were recording reports and we benchmark against and they were the things that often as leaders and managers were tested against, were challenged against and not necessarily is any of that ever about the person.
And I think that after the current fire I realised that my role was to care for the staff and to care for the community in a way that I hadn't done before.
The challenge for a leader is that we often determine what works for us and we stay with that because we've got evidence that suggests that it worked last time.
After the fire there was not a model that I could lean upon that was going to work for me.
When you've got a group of people as a leader you often have the ability to adapt and move to support the different staff as they require that support.
But when you've got a group that are so diverse and are experiencing things in such an extreme way they might have a common story but their way they're experiencing it is their own individual experience.
That means that you've got to be adaptable to the unknown.
You've got to be adaptable to being prepared to go out in that limb to be in what we would consider as managers in the unsafe space of not knowing.
So my leadership changes were curious and I've held on to them somewhat tightly now because I recognised that whilst I thought I was doing a fairly good job before this I think that it's clear that as leaders we need to evolve consistently and I reflect now and I wonder how good a job I was really doing as a leader prior to the fires.
So I am very clear that one of the first actions I had to do was model the way and I was under great observational scrutiny for what I said, how I said it, how I reacted, how I held myself and there was an awareness that I've been through my own experience but for the staff they were very much looking to me to be the leader not to dwell or to be a participant as one that had experienced the fires and the way that I had.
So I decided that if I was going to talk about wellbeing, if I was going to be focused on the staff's psychological health, if I was going to be living my own experience I needed to actually model the way.
Because I am a critical care nurse by background and it's exactly what I do.
I put others first and try and prioritise them over my own needs to the point where I didn't acknowledge or communicate with my team how the fires had affected me and what I had gone through with the fires in a personal front.
I tried to put what I had gone through to the back burner so that they could talk about what they had gone through.
It wasn't until I attended wellness warrior training myself that I was able to then speak forward and put forward to the group how it had been a troubling time for me as a person and not just as a manager with fighting the fires and having a husband who was a bushfire volunteer out fighting the fires and all of that stress and the lack of communication that we could have I wasn't aware by withholding from my team what I had gone through personally actually didn't allow them to connect with me.
So by having the wellness warrior training and having a conversation with my team I was able to actually start putting forward to them that it wasn't them alone.
It was us as a team that had managed to get through the bushfires and we've started to see that with connecting personally in a humane way that by telling our stories they were, it was giving us a purpose, it was giving us a shared lived experience that we could then go forward and move forward together in how we could process and grieve and then look to the future of how we could continue to do well for our community and provide well for our community.
I really think Liz that being a leader in a crisis like the bushfires would be so incredibly hard right?
Like you know you're bringing with you your understanding of leadership that you probably haven't even verbalized it's just a part of how you work in the environment and now you're faced with this crisis and you kind of have to rebuild after that crisis right?
And you know I think that's one of the gifts that Seed gave was the tools of how to rebuild yourself, how to rebuild yourself in your identity, your personal identity, your professional identity and that was at all levels within the hospital right?
Well I think for me Danny's story really highlighted the the old paradigm of I have my work self, I have my personal self but bring a disaster like a fire onto a community, a lot of that is blurred but it was through that connection point that she made with the rest of her staff that shared humanity of the experience or the lived experience as she calls it that actually changed her relationship both with her staff but within herself and in how she led, how she I would imagine now runs her emergency department.
Yeah I think it's really easy in a big healthcare system for the workers to become numbers in a way to become just part of the fabric of the organisation and to stop being individuals with individual experiences every single day and I love what Danny said about shared humanity, I think that's exactly the essence of Seed is that yes we're all individuals, yes before had our own experiences, let's acknowledge that, let's respect that and now let's come together to build and regrow.
You know it's not just the leaders that were impacted in this way right?
Like it was every single level of people in the hospital and this small little hospital everybody had an impact so let's hear from Gail, you remember Gail?
I do. Part one of our episodes, Gail who gave the money for the ice for those two blocs, yes.
That's Gail, that's Gail.
There was Gail there, let's hear from Mel, we haven't heard from Mel yet and Mel was really interesting character in this story as well, absolutely and Ruth again, Ruth who had her burnout story was the project officer through Seed so let's hear from them about the impact of them in the healthcare system as professionals.
And the executive team decided that if you don't participate you're not going to get your staff to participate.
So I am the admin team leader, I decided to go to the meetings just to see what it was about.
When I went they did like meditation, they gave you opportunities to talk about your stories, what you want, see if anybody could help you.
This went on for months, every Wednesday between 1 and 2.
It was a great time for people to just get away from their desk, the work that they were doing and just listen to other people's stories and to see if you could help other people.
It was a great time for me because being the team leader you sort of had to keep up this front that everything was fine where I'd known people who had lost homes and it affected me too.
So I think the organisation really did a great job for just our small hospital.
The Seed Program changed my life, it made me stop and look at who I am, what coping strategies I need to be a good clinician.
The Seed Program helped me realise I needed tools in my life to be able to give good care to patients but also to support my colleagues and to know how that looks like in the way of support that's important to them.
The Seed Program came to us at a time where I felt that I had a lot of responsibility being a certain charge of hospital at Milton, a rural hospital during the bushfires and I wasn't aware that I needed these tools to help me better cope with situations like this bushfire that I wasn't prepared.
I mean we get taught about all the different codes and we're taught about how to escalate but we're not taught how to know ourselves and understand what we need when times of trouble come and in sense that I put on masks to cope during the bushfires as an in-charge in a rural hospital but what I didn't realise is that when I went home the cracks of not coping and the stress from that started to show in the home, my loved ones copped it and they did because you know you love them so much you do things that you wouldn't normally do at work, you're so professional and the cracks show at home.
The Seed Program I believe is an necessity to all clinicians, I believe it should be taught at uni as a module to doctors, to nurses, to MDT, multidisciplinary teams because I think how can you give to others, patients, colleagues if you don't understand yourself you need to understand what it is that you need to build resilience for you and to know and feel safe to be able to express that.
The Seed Program came at a time that I had a lot of responsibility and I absolutely didn't realise the responsibility to myself was the first and foremost important thing.
December come back to work, there's got to be a big change, come into January, there's seed, I'm reborn I guess into the healthcare system and throughout my project officer role I was very, very fortunate in that throughout that time I was professionally mentored by an incredible lady by the name of Padmini Pye who has given me so much opportunity for new roles and she helped me to identify what my strengths are and what my skills are and how they can be translated to other roles within the healthcare so you know if one day I can't do my clinical work anymore because it's not the right thing for me then I do have inherent strengths and skills that can be transferable to another role that is of equal value and for me that gives me hope that I can work out my days in healthcare I don't have to leave the healthcare system you know I've seen staff along the way who have become burnt out in their clinical role and quietly just leave and they don't come back to healthcare where if they had have had a mentor or a well being coach then perhaps a new opportunity within healthcare might have been identified for them.
Burnout doesn't have to equal leave healthcare you know, burnout can just mean well where how can we support you to look at your strengths and your skills and see how we might be able to utilize them in another setting so that we keep good people in our healthcare system we lose good healthcare workers because we can't support them in their workplace so it's not a hard thing it's actually quite simple the formula is quite simple you know there's kindness there's compassion there's support it's pretty simple formula and I think you know particularly during this time of COVID it's become vital that we care for healthcare workers if we want the healthcare workers to continue to care for our community.
You know what this all tells me Liz what it doesn't matter what discipline you're from it doesn't matter what role you have in the healthcare system when trauma comes when crisis hits we all react the same and if you've got a program like seed and if it's going to work it's going to have to be able to speak to everyone right good point like as much as I've loved hearing people from different disciplines talk about things like holding space and you know react to each other as social workers in ways that we know is second nature at the end of the day if you are actually going to help people get through a trauma and a crisis and you're going to embed the seeds of post traumatic growth then it has to speak to everyone whatever the activities are they have to and look I unlike you I haven't met everyone that was involved in it but the few people that I have it seems like they do represent the various layers in a hospital but it did engage people in really profound ways and I think what we're going to hear now is a variety of those stories that really evident evidence of that yeah not just the evidence but like how do you sustain it Liz I will get to that how do we get going into the future and I'm really excited to hear what the staff of Miltonola Dullar Hospital think about that question what do they think that they need going into the future and that anybody else taking on this program or a program of this sort might need themselves right let's hear from them from their words yeah seed was designed to get us through hard times but it's had an unintentional effect on improving the work culture at Miltonola Dullar Hospital remarkably and it inspires me to believe that positive changes can influence nursing as a profession as well it's helped me to validate my own worth as a nurse and as a leader to demonstrate kindness and it's helped me to remain flexible and face new challenges and you know that's more important than ever with the current covid pandemic that has really overshadowed the bushfires now and made that look pale and insignificant to the challenges we face in health care at the moment and the stress that's on our community as well and the increased workload to the health care system so sometimes we need to just stop doing the whole groundhog thing all over and over again we need to stop and value our workers as unique people we need to give people an opportunity to grow and shine seed for me is more than just self reflection and self regulation it's a method that we can improve the quality of care for patients and families as well as staff members it's a way to increase resilience improve clinical problem solving and develop greater compassion for other people this has further implications yet to be decided you know where does it go does it improve staff retention in small rural hospitals does a better work environment lead to better job satisfaction additionally seed holds great promise to work places on an organizational level it's an accessible platform for workers on the ground to immediately feed back to managers to to innovate new ideas and problem solving getting together and having a voice and self reflecting on problems it helps us to see new ways of being which can only be a benefit if something's not already working this can become empowering it can make better team work and promotes an efficient use of resources which we all know is limited especially with the pandemic in demonstrating how much you value your co-workers and give them the gift of increased respect you raise their confidence and their ability to have their own autonomy and that can only mean good things for the health care system in the years to come true change happens when three simple factors are in place when people have an opportunity to influence the change when people can be part of the change and when people value change and I think these three ingredients where they're in the seed program that is actually led to the success of seed in Milton and beyond and some of the main areas that were very helpful were when you staff start to the organization and we ask consent and say to a new staff member would you like to have the opportunity to have someone come and check in with you at you know within the first week and then at one month and then at three months and that was really quite nice because they're not asking from a truly clinical perspective they're just saying how are you going how you're fitting in with the team and the person the people who actually did that as well as well as warriors took those roles they quite enjoyed the opportunity to extend a welcome to new staff and that was really nice because that's the idea of seed is that it's an encompassing wellness model to help people progress and be the best they can be which then allows us to give more so that was that was something that we're trying to continue to do in growing seed and growing wellness at Milton and looking towards the future of our caring model for not just staff, patients, relatives it's everybody.
So I look it's been an interesting social experiment I would certainly say that from the outside for someone to sit on the outside and I sort of reflected a little bit of why that is and I think that when you start to talk about wellness and these types of things you really are pushing past that sort of from a work environment into a person's personal way of doing life.
I don't know what else to say it was a nightmare and it went on for months and months and months but I think we've come out on the other side the hospital is starting to get back to where it was before we've just had like COVID hit now and like we've been going for that for over a year so we went from bushfires to floods to COVID and we're still standing and it is a great place to come and visit and the hospital is just fantastic.
You know, Mem, one of the things I keep all wondering about is do you have to have a disaster for something as I guess something as profound as seed to occur?
Like would it have happened without the fires?
Yeah, I hear your question Liz, I know what you mean.
In some ways, my instinct says no but I think that's because of the ingredient that was organisational support.
For me, organisations don't invest and don't from historically, organisations don't invest and don't put the resources and time in if there's not an impetus.
Right. So it's not like suddenly in 2019, 2020, over that summer period, suddenly you had staff who weren't well, who weren't coping.
No, but so we have a few planets in alignment though.
What you're talking about is yes, there was a key event, yeah, the fires.
But in support of that was an organisational response that was far deeper than what we might have seen in other disasters or in other situations ever.
Right. So if ever there was a key time to see if this is transferable, we are in the middle of a pandemic.
That's it. Is this a model that is transferable?
So that's a really interesting question.
I think the whole world, we're having a global crisis, right?
So this is the time to try new ways and new ideas.
And you know, since the bushfires and we moved into the pandemic, seed has been picked up at other locations, at other hospitals, at other areas.
And it's now, you know, being trialled in different ways and is going to continue to be.
And I guess what's really fascinating in that is how impactful can it be in the longer term.
Right. Like it's one thing to say, I went through wellness warriors, it changed me in this way.
Here's how I work now. But are you still sustaining that in a year?
In two years? In five years.
And if you are sustaining it still, what are the ingredients that are helping you to do that?
Is it because the culture shift was able to continue?
Is it because the organisation continued to invest?
Is it because you learnt stuff about yourself and your strengths and your coping that you've been able to capitalize on or use in your professional life in different ways?
Do you know what I mean? That's what I'm saying.
That the crisis is just one kick off component.
But there are all these other pieces to the puzzle.
And so the next step will be to see how is seed or a program because it can't be exactly like seed, can it?
Right. So because the beauty of seed was it was as a response to what the staff said they were needing.
That's exactly right Liz.
That's a really key point that actually if you brought seed to another environment, which has happened and they're looking at the key message from that is, it has to be responsive to the staff at that place, in that context, in that time.
So some of those activities that happened at Milton other Dullar aren't going to be relevant to the other staff and group.
The easy of party was specifically important for that group of people, right?
That's just one example.
So I'm really curious about what it looked like in those other organisations that are now experimenting with it because it's got, I guess, from the most senior person in our local health district has supported it.
And I think now what the challenge will be is it transferable?
Is it going to work? Yes, it's starting up or it's playing out in other areas.
Like I think about the difference between the hospital that I sit in versus the Milton L Dullar approach is the size.
Like that's what I'm really curious about.
Do you start in smaller departments?
Do you start in clinical wards?
But it has to be, but you have to have buy and write.
Yeah. And I have noted in COVID, there is a different, a lot of staff relating differently to each other.
Yeah, I think so too. I think there's definitely, there's definitely been a shift that's happened and I think this comes back to, you know, what actually happens?
Where do we go forward with this?
How do we, you know, I was thinking about Michael and I was thinking about how he said this is an interesting social experiment, right?
And some, I'll have to say in the last 18 months or so, it's felt like the world is in the middle of an interesting social experiment, right?
So this is the time, this is the time to get creative, this is the time to start to relate to each other differently.
And to instead of getting up every day and just surviving the really difficult work that we're all doing, let's think about what we need to actually keep going and to maximise and to thrive.
So if I was a social worker, like it's, I need to share with you that I was also one of the people that were asked to go down to Milton A.
LaDalla. All right. And I said absolutely, like I wouldn't know where to begin.
Yeah. And I'm also not part of that community.
But let's just imagine now that we are being that person, we're being dropped in there.
What are the, I mean, what are the the take home messages that Padmini and the Milton A.
LaDalla staff have taught us?
So it's been a community development approach.
It's been from both the ground up.
So it's been informed by the people who work in Milton hospital.
But as you say, MIM, it's been supported from the most senior levels.
It was given resources and it was given attention from the most senior person in that LHD.
So that's got to actually count for something too.
Yeah. I think it's taught us something as well about that idea of shared humanity and that idea of being an individual within a system and being able to come together as a united force as well.
That actually coming together doesn't mean losing who the individuals are and the needs that they have and the reality for them every day.
It means acknowledging that and respecting that holding space for that, right?
And then coming together to support and grow into the future.
So don't rush to. Don't rush.
And you know, one of the things I hate more than anything is when an organization does an empty self-care statement.
So we talked in this three-part episodes about what happens when you're given a phone number to call for support, right?
And you don't know that person on the other end of the line.
I hate it when organizations do things like say, you know, go and turn your computer off for a day.
Go and sit by the beach, right?
They've done nothing about your workload, by the way, but they've told you to turn the computer off, right?
You know, for me, self-care needs to actually be tailored to the individual.
It needs to respond to the person's needs as they say that they have them.
And it needs to be something that's workable within the confines of your job.
Okay? So giving people coffee vouchers so that they can go and have coffee with someone else in work time, and that coffee's paid for, is only good if someone's covering your work while you're there.
Having wellness sessions where people are doing massages or yoga or whatever it is they're going to do, only works if you haven't now given someone double the work because you've gone and attended it.
And that's the issue is that often someone's wellness sacrifices the wellness of someone else.
And that's why I really do believe that if the organisation doesn't provide a strong structure around a program like this and doesn't resource it and doesn't really think through the support for staff around it, it has an unintended consequence that actually doesn't speak properly to the needs of the staff.
The other thing that struck me, what you just said, and it also needs to have leaders who have been transformed themselves and who are willing to take risks, who are brave enough to say, look, I don't know.
This is new territory for me too, but let's get through it together and I'm going to listen to you because together we'll get through this.
I mean, kind of that doesn't sound so radical but it sure is.
Oh, that vulnerability in a leader is immense, isn't it?
Yes. Yeah. And for that to be, and to also, for that leader to be sitting in those groups, to be listening to the impact because sometimes that disconnect between you know, what's actually happening with my staff and the impact of their work is often there.
Yeah. But these are leaders who have actually taken the time to listen and experience the impact, even shared their own.
And so there's a connection there that's quite deep and real that you often don't see.
And I'd like to think, in my fantasy, I'd like to think that what's happened at Milton is a culture change that's sustainable for all the reasons that we've talked about, but that we can go back there, say this time next year, and that new staff have been brought on board, and they're also being part of it, while say, you know, may not have been through the trauma that they're still now part of a culture that's quite different to how it was say many, you know, years ago.
But you know, I would love that.
And I have heard people say that that they've gone to see, gone to Milton, L.A.
hospital, and that they've had to different experience that they've had at other hospitals.
Like the luck we've spoken about, you know, hashtag kindness works here, does seem to have been a realised, a realised hashtag, which is amazing.
And I really do hope, Liz, that going into the future, this is not just being able to be sustained for Milton, L.A.
hospital, but actually throughout the local health district, and then as an example to others as well.
Such an impressive program, Liz.
And the other thing I feel really moved by is, again, people sharing their stories with us.
Because again, you and I, Justin, social workers, social students are really going to learn from their stories of, you know, their experience of trauma and transformation as a result.
And I say a heartfelt thank you to all the people that have shared their stories with us, because they have moved me, and I've learnt a great deal from them.
So thank you. I couldn't agree more Liz.
And on that note, see you later everyone.
Take care. We know this has been a bit of a hardgoing three-part episode, but we appreciated you sticking with us.
And we'll be back with our normal releases from December on.
So take care everyone. Bye for now.
Thanks in the production of this episode.
Goes to the Ilawara, Shulhaven, local health district, and the staff at Milton, Ula Dola Hospital, and to the University of Wollongong.
This episode of social work stories has been funded by the University of Wollongong Community Engagement Grant and the National Health and Medical Research Council.
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It would mean so much to us.
You can connect with us on Instagram, Twitter, Facebook, and LinkedIn, where you can share our posts with your friends to help spread the word, and you can always find us at our home on the web, socialworkstories.com.
The social work stories podcast is made by Justin Stesch, Liz Murphy, and Dr.
Mim Fox. Thanks so much for listening.
