Wardipedia – 75. Reflective practice groups

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Releasing time to share

That’s the gag, and the point really, in homage to the very excellent Productive Ward. It’s essential to release time for staff to share in order to cope with the emotional impact of all the time released to care. Reflective practice groups are a sanity-protecting opportunity for staff to express the very intense and often painful feelings that inpatient care evokes. Confidentiality issues prevent talking about patients outside work, so these groups are essential in order for staff to consider, communicate and process these complex feelings.

Reflective practice groups also:

  • play an important role in sustaining safe practice
  • help continually improve ward life
  • allow staff to examine their thoughts and actions and understand how these elements interrelate within the ward community.
  • Help ‘close down’ or at least comfortably compartmentalise feelings about difficult experiences with patients. Among the benefits are preventing these feelings interfering with how staff respond to subsequent similar experiences.

Mutual support is a well-established way of getting advice, comfort, the hilarity that only people who’ve been there can generate, and the insights that we only feel safe in fully sharing with others who will definitely get it. From the companionship of posh Gentleman’s Clubs to the inspiration of peer supporters, it takes the perspectives of others for us to be truly self-aware. We just made that up but it sounds plausible! OK. We’ll try this one. Reflective practice groups are a form of therapeutic feedback for frontline staff.

  • Reflective models usually consist of three core processes:
  • Retrospection: thinking back on events
  • Self-evaluation: attending to feelings
  • Reorientation: re-evaluating experiences

Ward examples

  • Case formulation group is forum for qualified nurses to get support re: clients emotions and behaviour.
  • Clinical psychologist runs drop-in consultations for staff.
  • “We have a fortnightly reflective group on our ward. It’s facilitated by a Senior Psychotherapist from our Therapeutic Community. It is an hour long and takes place after the midday handover while more staff are around. It’s utilised to reflect on the challenges we have with our patients with personality difficulties. It’s useful to have a space to reflect on our work (including our own responses and reactions) and to gain a fresh perspective. It’s good that the group is facilitated by someone who isn’t based on the ward, especially when we can’t see the wood for the trees. Both qualified and unqualified staff attend.”

Categories: Empathy, Wardipedia