Schwartz rounds can boost workplace well-being for nurses, report finds

Delegates at UKONS annual event hear how structured group discussions on experiences of working in care can reduce stress

Delegates at UKONS annual event hear how structured group discussions on experiences of working in care can reduce stress

Dr Cath Taylor at the UKONS annual conference  Picture: UKONS/Michael McGurk

Nurses should consider using elements of the reflective practice known as Schwartz rounds within their teams to help release their ‘bag of emotions’ and enhance their well-being at work.

That is the message that cancer nurses, educators and researchers heard while attending the UK Oncology Nursing Society (UKONS) annual conference held in Glasgow.

Speaking in an interactive session during the two-day event Cath Taylor, reader in healthcare at the University of Surrey, explained Schwartz rounds to delegates and told them about their benefits and limitations. Dr Taylor presented the findings from a three-year national project evaluating their implementation in the UK.

Act of kindness

The final report, published this month, highlights how the rounds helped staff to feel less stressed, better able to communicate with colleagues and more compassionate with patients.

Dr Taylor, an organisational psychologist by background, has been part of a national evaluation group led by University of Surrey professor of health services research Jill Maben and independent healthcare consultant Caroline Shuldham.

She explained that Schwartz rounds were coined in the 1990s following the death of lawyer and lung cancer patient Kenneth Schwartz. He observed how small acts of kindness from carers and staff made the ‘unbearable more bearable’, said Dr Taylor.

‘The rounds are a structured intervention where all staff come together voluntarily, perhaps on a monthly basis, to see a pre-prepared panel and discuss a theme [around patient care],’ she said. 

‘Let the gates open’

There are nearly 200 Schwartz rounds in various organisations across the UK. She asked the room of around 40 delegates whether they knew what Schwartz rounds were and only one third had heard of them. 

Nurses in the room discussed a patient that they would never forget and the thoughts and emotions that were evoked by the exercise. Afterwards, one nurse said: ‘I actually cried, but it was good because it helped me to remember why I chose a career in nursing.’

‘Schwartz rounds are complicated so it’s not just about getting them into your organisation and ticking a box’

Dr Cath Taylor, University of Surrey

The nurse said she had not cried or expressed sadness while looking after the patient or at their funeral and this session was the first time they had broken down.

Her partner for the exercise said: ‘We have to control our emotions because we’re professionals and to keep our ‘face on’ because we could not keep going day-to-day otherwise. 

‘It’s a protective feature. But at some point we need to be able to let the gates open in a safe place.’

Many nurses remembered patients from a long time ago but who they had not discussed since their care experience. They talked about how it is important to remember the good experiences, rather than just the sad memories, and to celebrate the positive outcomes they have on patients.

Staff well-being

Dr Taylor said that even if nurses do not implement Schwartz rounds they could still incorporate elements of them into their teams on a regular basis. 

She emphasised that facilitators for the rounds must be pre-prepared and have sufficient skills and training in providing safe spaces for people to share their stories, as well as providing opportunities for debriefs.

‘Staff well-being is a huge priority. Schwartz rounds are complicated so it’s not just about getting them into your organisation and ticking a box,” she said. ‘There are other ways to introduce this type of approach.’

‘Compassion buckets’

The link between nurses’ well-being and their ability to give compassionate care was mentioned by several speakers at the conference.

During the opening address, Scottish Government associate chief nursing officer Diane Murray talked about the need for nurses to find ways of filling their ‘compassion buckets’. 

She said: ‘People who demonstrate more compassion have better immune systems, have more resilience and a better work-life balance. 

‘To care for others, you need to be able to care for yourselves first and that is not selfish, it’s selfless.’

Further information

A Longitudinal National Evaluation of Schwartz Centre Rounds®: an intervention to enhance compassion in relationships between staff and patients through providing support for staff and promoting their wellbeing

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