'The cavalry has arrived': therapeutic care volunteers

A pioneering programme is using volunteers to improve the experience of hospital patients, relieve the pressure on staff, and attract new recruits to nursing. 

A pioneering programme is using volunteers to improve the experience of hospital patients, relieve the pressure on staff, and attract new recruits to nursing 

Therapeutic care volunteers are trained to interact with patients to prevent
anxiety and boredom. Picture: Getty 

'We have volunteers working with patients from their first breath to their very last,' says Debi McKeown, nursing sister in therapeutic care at James Cook University Hospital (JCUH), part of South Tees Hospitals NHS Foundation Trust.

Ms McKeown leads an innovative therapeutic care programme at the trust, where hospital volunteers are trained to relieve patients' anxiety and boredom, helping to improve the hospital experience. 'What makes our programme different is that the hospital volunteers are all ward-based and are interacting face-to-face with patients,' she says. 

In 2013, Ms McKeown was appointed as challenging behaviour nurse at JCUH. 'At that time, there was a large caseload of patients with challenging behaviour. Most were over 75 and about 60% had a diagnosis of dementia,' she says. 'But it was clear that a lot of their behaviour stemmed from feelings of anxiety and isolation.'

Determined to address this, she contacted the school of social sciences at Teeside University and asked for psychology students to volunteer at the hospital. 

Pilot project

'They nearly bit my hand off,' she says. 'I got eight students straight away. I told them to treat the patients as if they were a member of their family and talked about the importance of the 6Cs and of making the environment playful and enjoyable. I explained that you don't need clinical experience to make a real difference to a patient's day.' 

There are now 420 therapeutic care volunteers at the trust, ranging in age from 16 to 82. All have had a disclosure and barring service check and provide two references.

They receive a day of therapeutic care training, including an overview of dementia, learning disabilities, pain, infection prevention and control, managing challenging behaviour and safeguarding. 

The volunteers, who wear a uniform, carry out a range of activities, depending on their skill level and the patients' interests. 'The patients love them,' says Ms McKeown. 'One lady told me that as soon as she sees them arriving, she knows something good is about to happen.' 

This year, Ms McKeown is piloting a joint project with Teeside University, where nursing and midwifery students spend one academic year at the hospital. 'We have a conversation with each student about what they are interested in,' she says. 'So if they want to be a midwife, we offer a 26-week rotation in maternity and paediatrics. 

'They meet with me every other month and we set targets to match their specification. They all want to develop a career in health care: this way they are getting real-life experience.'

Right care, right time

Ms McKeown says the therapeutic care programme has created new roles at the trust and improved care. 'A recent assessment found a huge reduction in the number of patients flagged as needing one-to-one observation,' she says. 'We've established a system that gives the right level of care at the right time, provided by the right person.' 

Funding has now been secured to employ 52 therapeutic care support workers. Most were already volunteers, with others being recruited from job centres. 

'People would come in wanting to work, or wanting a complete career change,' she says. 'It was always meant to be a stepping stone programme, and one person who was doing a graphic design course is now training to be a nurse.

'We're making savings, but more importantly we have developed a community of people who are enhancing the patient experience while getting experience themselves. It's giving us a home-grown workforce.'

Role recognition 

Ms McKeown says the biggest challenge is getting staff to understand the volunteer role. 'Once they embrace it, they are more than happy,' she says. 'As soon as the volunteers set foot on the ward, staff think "great, the cavalry has arrived".'

She is especially proud of the 30 volunteers who have learning disabilities themselves. 'They are outstanding, and in some ways are the shining stars of the programme.'

The volunteers are now joining forces with community organisations to create a programme of events. They have support from Ageing Better Middlesbrough as well as a local primary school, which sends children into the trust to read to patients. 

'I would love to see therapeutic care volunteers interacting with patients throughout their hospital journey, from the minute they come into accident and emergency to home visits after discharge,' says Ms McKeown. 'It has been fantastic to be a part of this. It is exactly what we should be doing for our patients.'

'I understand the importance of making a patient feel better' 

Chris Carey is 19 and has lived with diabetes since the age of five. He was a regular patient at James Cook University Hospital, which then inspired him to become a therapeutic care volunteer.

Chris Carey: all would-be nurses
should be a volunteer first

He joined the programme when he was 16, volunteering in paediatrics and on the spinal unit. Mr Carey started training as a nurse in September last year, and believes his experience as a therapeutic care volunteer prepared him well.

'It has massively improved my confidence, and enabled me to understand how my personal experiences have helped me to engage with patients,' he says. 'I understand the importance of making a patient feel better, and taking the time to chat with them and make a difference to their day. Without the therapeutic care programme, I don't believe I would have had the opportunity to study nursing. I think anyone wanting a career in health care should be a volunteer first.'



Alison Whyte is a freelance health journalist 

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