‘How I turned a demoralised group into a strong, diverse team’
Sandra Bennett’s leadership unlocked the potential of a struggling multicultural team
Sandra Bennett’s leadership unlocked the potential of a struggling multicultural team
When Sandra Bennett took up her role as integrated sexual health lead nurse at Whipps Cross and Newham university hospitals in London, she soon realised her team was struggling.
‘There was lots of infighting, pain and confusion,’ says Ms Bennett, who is employed by Barts Health NHS Trust. ‘There was no management structure, job descriptions or record of any recent appraisals.
Lack of direction
She says the lack of training and management for the nursing team caused such problems in the service that many local people gave up trying to get contraception.
‘Nurses could not prescribe or offer contraception, so waiting times and complaints had increased as patients had to wait to see the doctor. Footfall was dropping.
‘I believe there was a direct impact on unwanted pregnancies, abortions and a loss of education for the east London population.’
Fast-forward three years and, thanks to Ms Bennett’s leadership, the team is unrecognisable – diverse and strong.
‘The diversity of the team brought challenges – you have to understand people’s culture – but it also brought a richness’
‘I feel privileged to have seen my staff, who are from more than ten different countries, develop rapidly into a robust, motivated and enthusiastic team,’ Ms Bennett says proudly.
‘We have nurses from South Africa, England, Zimbabwe, the Philippines, Ghana, Sierra Leone, Nigeria, Uganda, Trinidad and Tobago, Barbados, Malaysia and Ethiopia. And our medical and admin staff are just as diverse. This diversity brought challenges – you have to understand people’s culture – but it also brought a richness.’
‘Starting at the bottom’
Having arrived in the UK from South Africa in 2000, Ms Bennett knows how difficult the road to career success in nursing can be for overseas nurses. Unfortunately, she says, many staff from other countries ‘have to start at rock bottom’ as their new workplace will be unsure about their skills and competence. ‘That can be very demoralising for some, as they may have been senior nurses wherever they have come from,’ she says.
Some nurses will also have left all their family behind. ‘They are expected to be fully functional in the workplace, but do not have any friends or relatives to go home to,’ she says. ‘All these significant social factors have a huge impact on an individual’s service delivery within the workplace.’
Ms Bennett’s determination to develop more leaders from BME backgrounds was set in motion when she attended the chief nursing officer for England’s BME forum in 2012.
‘A question was put to the floor about why there were not many BME staff in middle management,’ she recalls. ‘I wanted to empower and build confident, diverse teams and increase their career prospects.’
Access to training and development opportunities
At Whipps Cross and Newham she started with in-depth interviews with each member of staff. ‘It was clear from the outset that they’d had a difficult experience over the past few years, with a lack of access to educational resources and lack of senior support,’ she says.
‘Morale, motivation, trust and confidence were very low and sickness absence was high. They said things like “I get palpitations when I enter the building” and that they did not want to raise issues for fear of losing their job. One nurse said “I just put my head down, do as I’m told and go home”. One had just lost four members of their family to Ebola.’
As the team’s lead nurse, Ms Bennett provided role descriptions and objectives embedded in an appraisal programme, held regular team and one-to-one meetings with staff to maintain motivation, and enlisted the help of medical staff for supervision, teaching and sign off.
‘Consistency, sticking to the objectives and praise and recognition were important,’ says Ms Bennett. ‘I voiced my gratitude, thanked them for coming to work and reminded them that I couldn’t do it without them.
‘I accommodated individual learning styles and supported staff when they struggled. But in challenging situations I made thorough use of the trusts’ policies.’
15 steps to transforming your team
Sandra Bennett’s tips for leading and developing staff:
- Make sure you are academically and practically trained and qualified to teach, mentor and lead your team confidently
- Be knowledgeable about everything in your department – this will set you up as a good role model
- Be clear about practice and employment policies, as they are the backbone to decision-making and a vital resource during challenging conversations
- Be kind and consistent with all staff
- Develop a compassionate leadership style, and lead by example. Hold your team ‘by the hand and by the heart’ – this makes work feel more personal
- Never underestimate the power of transparency and honesty. Lose the cloak and dagger approach, build trust and reduce anxiety
- Encourage team members to express their opinions about how things are done, so they feel they have contributed to the outcomes
- Listen more than you talk. Your team will have a wealth of information to help achieve their success and your objectives
- Delegate work to the team and rotate these tasks. This allows staff to develop new skills and competence, prepares them for the next step up in their career and allows the service to continue in your absence
- Set aside time for appraisals, ideally away from the workplace, and ensure individuals know that this time is all about them. Review set objectives at regular intervals and ensure team members are given the opportunity to meet them
- Be aware of individuals’ strengths and development needs and use this knowledge to develop the team
- Spend time with each member of the team, as well as the team as a whole. This will enhance the team’s cohesiveness and support system
- Celebrate individual and team success constantly. This keeps the team buoyant and eager to achieve more
- Ensure that team members have access to the education and training they require for their role
- Be the best that you can be 100% of the time
Overcoming infighting and cliques
Since the hospital and community teams were amalgamated, the number of nurses and healthcare assistants has increased from 18 to 29. Under Ms Bennett’s leadership, the expanding team has developed in competence and confidence; as well as attending leadership courses, eight nurses have gained sexual and reproductive health diplomas, nine can fit and remove subdermal contraceptives, five can insert intrauterine devices and three have become non-medical prescribers. All nurses are using patient group directives, healthcare assistants have completed the care certificate and some staff members have completed project management courses.
The patient journey through the clinic has been transformed. ‘It’s just been amazing,’ she says, adding that it wasn’t always easy, and it took time for the team to trust and accept her and her intentions – and to trust each other.
She says there were obvious cliques within the team, with people from the same country often sticking together, and a huge doctor-nurse divide. All of that has changed for the better, with nurses feeling more confident to speak up now.
‘Access to courses was so exciting for people. And I made sure they had time to do the work’
This new cohesiveness has been helped by all the sexual health staff coming together to work under one roof at Stratford Olympic Village medical centre, but the effort put into staff development and training has been key.
‘To get people to buy in you have to make the “why” clear,’ Ms Bennett says. ‘It was about making the team see that in order to deliver an outstanding service, they needed the tools to do the job and to avail themselves of the development programme.
‘There was infighting in the team when I arrived, but I learned that the heart of the person is the same. The people in my team were so different, but when you touched their heart they reacted the same.
‘The challenge was to get them to value themselves and believe in themselves. In the beginning they all said that my plan was unachievable, and could not believe it was possible to be supported onto these various programmes that had been denied to them in the past. Access to the courses was so exciting for people. And I made sure they had time to do the work.’
A motivating leader
Nurse practitioner Claudee Pompa says that her team previously had no direction, but that changed when Ms Bennett joined them.
‘Sandra is so positive and empowering that it brought us hope,’ she says. ‘It also brought many amazing changes to our clinical area, challenging us and motivating us to develop.
‘Sandra believed in each one of us. She listened to her nurses when they told her they were not valued or looked after’
Claudee Pompa, nurse practitioner
‘She invested so much in her team, despite the seemingly insurmountable circumstances she faced. She always valued and believed in each one of us. She listened to her nurses when they told her they were not valued or looked after. There had been nurses there a decade and still doing the menial tasks they started with and she developed them.’
Ms Pompa adds that Ms Bennett went above and beyond to achieve a positive, ‘non-tumultuous’ working environment and involved everyone in both basic and complex decision-making.
‘She tirelessly supported us in our appraisals and made every effort to help us attain our objectives,’ she adds. ‘She was a manager who was easy to talk to.
‘She was humble and would say if she had been wrong. She talked to us closely not just because she had a duty of care for us, but because she really cared for us.’
Patients feeling the benefits
It is not just staff sickness absence and career motivation that have improved as a result – patients are experiencing safe, competent practice and vastly improved outcomes.
‘Patients do not complain about the waiting times as they used to and are extremely complimentary about the knowledge and skill of our nurses,’ says Ms Bennett. ‘Any patient can walk into our service, whether for sexual or reproductive health needs or both, and they will never be turned away. Before the development of the nursing team, that was not true.’
There has also been an increased uptake in contraception among service users. ‘And it has been achieved by a phenomenal group of staff from band 3 to 8,’ says Ms Bennett. ‘Everyone has something different to bring. I could never done it on my own. If you are not empowering people, you are not leading.
‘There are many challenges facing nurses from overseas and more often than not this has a direct impact on the nurse’s training and development. Leaders can change this to have the most positive and productive outcomes for both nurses and patients.’
Elaine Cole is editor, RCNi projects