My job

Travel scholarship opened my eyes to a new way of working

Discover how Louise Hughes benefited from spending three weeks in the United States and learn how you might follow in her footsteps.

During Schwartz Rounds a panel of staff share stories and insights with their colleagues

Picture credit: Alamy

With the help of a Florence Nightingale Foundation travel scholarship, lead nurse Louise Hughes spent three weeks in the United States earlier this year to find out everything she could about Schwartz Center Rounds.

Ms Hughes, head of nurse education and research at Abertawe Bro Morgannwg University Health Board (ABMU), was in Boston to learn how she could promote the development of Schwartz Rounds in her workplace and across Wales.

Boston, in Massachusetts, is the home of Schwartz Center Rounds, which have been used in the US for 20 years. Their aim is to bring staff from all disciplines together to explore and discuss the emotional challenges of their work.

In 2013, newly formed charity the Point of Care Foundation obtained a licence to bring Schwartz Center Rounds to the UK, and ABMU was the first health board in Wales to sign up for them.

‘I have always been interested in the emotional labour of nursing in practice, and have done a lot of work around developing clinical supervision for nursing colleagues,’ says Ms Hughes. ‘Schwartz Center Rounds take this a step further and allow staff from a mix of professions to talk about their practice and learn from each other. They also enable us to share difficulties in practice and discuss the emotional elements of caring for people.’

Ms Hughes, who has 20 years’ experience in critical and emergency care and ten years working in nurse education, helped set up a steering group at ABMU for the rounds. The first took place at Neath Port Talbot Hospital in December 2013, involving nurses, medics, occupational therapists, psychologists, radiographers and hotel services staff.

The rounds have since taken place every month, alternating between Neath Port Talbot Hospital and Singleton Hospital in Swansea, and the aim is to run them at two more hospitals in Swansea and Bridgend.

‘We have a panel of three or four people who sit at the front of the room and tell their story for about five minutes each,’ says Ms Hughes, who acts as a facilitator for the rounds. ‘Part of my role is to help them prepare and to draw themes from their stories. We have covered a diverse range of topics from “the patient I will never forget” and “that difficult conversation” to what it is like to be on the receiving end of health care as a patient or carer.’

The discussion is then opened up, and the audience are invited to talk about things that have resonated with them. The rounds last for about one hour, but people can stay behind to talk further if they need to.

While in Boston, Ms Hughes visited the Schwartz Center for Compassionate Care, founded in 1995 by healthcare lawyer Ken Schwartz, shortly before his death from lung cancer at the age of 40. He believed that what matters most during illness is the human connection between patients and their caregivers.

Ms Hughes observed facilitators being trained, saw Schwartz Rounds in action, and accompanied a regional consultant to hospitals in and around the city. ‘In one particularly memorable round, a clinical psychologist talked about the admission of a family member to the mental health facility where he worked. He held an audience of around 120 people captive, and then facilitated a discussion which was emotive, amusing and ultimately uplifting,’ she says.

Ms Hughes says the challenges experienced by the US facilitators – the practicalities of setting up each round, difficulties in recruiting panel members and the fear that no one will turn up – rang a familiar bell. But she adds: ‘My visits to hospitals where the rounds had been running for two decades confirmed they can be sustained, and that the benefits are worth the continued effort.

‘Understanding each other helps us to work more effectively together. Not only does this benefit those of us who work in health care, it positively impacts on the patient experience too’.

Further information

The Point of Care Foundation – short films on Schwartz Rounds

Schwartz Center Rounds

Florence Nightingale Foundation travel scholarships

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