Earlier this autumn, the BBC aired a show called The Big Hospital Experiment. In my view it should be essential watching for anyone leading volunteer engagement in any setting, especially healthcare.
The programme followed fourteen young people giving their time for four weeks as clinical volunteers on wards at the Royal Derby Hospital in England. The hospital has a long history of volunteer involvement but this was something new, volunteers undertaking clinical tasks alongside nursing staff and doctors in challenging departments like Accident and Emergency (A&E), Cancer, Renal, Paediatrics and the like.
The volunteers undertook a range of tasks, from monitoring patient’s blood pressure to feeding to intimate care (washing and toileting) to simply sitting and having a cup of tea with patients and their families. The roles were part of a pilot designed to assess if clinical volunteers could work effectively alongside medical staff too improve patient care and increase the capacity of medical professionals to do what their specialist training required them to focus on.
It is important to note that the show made no judgement about whether placing volunteers in these roles was ethically good or bad, both in regard to the responsibilities placed on the volunteers but also whether such roles should be undertaken by paid staff, not volunteers.
Almost all the young people were new to this kind of work. Little was said about the recruitment and selection process (were they chosen because they ere the best for the roles or because the producers though they’d make for good TV?) but we did get to see all fourteen of them doing two weeks of training before their first placement. They were also closely supervised throughout the pilot by ward sisters, the senior nurse who trained them, and executive nursing staff motioning the efficacy of the pilot.
Here are my reflections on the four episodes.
It’s fair to say that nursing staff were cautious about the pilot, fearing that too much time would be taken up managing the volunteers, detracting from patient care. This wasn’t helped when cancer ward volunteer Will requested a different break schedule for his shifts so he could have more frequent cigarette breaks.
Very quickly, however, the nursing staff discovered that by investing some time in the volunteers they developed engaged, committed and productive people who were keen and able to help in meaningful ways. This demonstrates that if we get the right people in the right volunteer roles, train them properly, support, trust and encourage them to do a good job, they invariably will.
This episode focused on the emotional impact of the work on the volunteers. What wasn’t really acknowledged was that everyone experiences challenges adjusting to the emotions faced in a hospital setting. On day one you have the same lack of experience and strategies for coping, whether you are a nurse, doctor or volunteer.
Similarly, how everyone copes when they do get onto a ward is different. For example:
- Will (he of the cigarette breaks) came face-to-face with the reality of death as he cared for a patient. After initially struggling he persevered and adapted.
- In comparison, Erik, who had led a sheltered and spoilt life before the programme, struggled more with his role. He made excuses for not turning up one morning because he couldn’t face being with the patients. He arrived four hours late for his shift, leaving the ward short-handed.
- Finally, Aleshpa was placed on the children’s ward with a boy called Blake. She stayed two hours after her shift ended to check on the results of Blake’s MRI, such was her concern for him. So much for volunteers being unreliable!
On the Head and Neck ward the lead sister had already made her mind up about the clinical volunteers – the experiment was extended into subsequent weeks after what she judged as strong early success.
Fittingly there were three key points for me:
- Patients and the families can respond differently (in a good way) when they engage with a volunteer rather than a paid nurse or doctor. This unsalaried credibility was a real asset for the wards involving volunteers.
- The senior executive nurse noted the importance of placing people into the right roles. Piotr had excelled in A&E but struggled with the increased interpersonal engagement with patients on another ward. Finn had struggled on the cancer ward but was very effective when placed on a ward treating older people.
- After Charlotte experienced three patient deaths during one shift on the renal ward I thought about how few of us are exposed to such experiences at such a young age. I’m pretty confident few of the nursing staff would have had such experiences at Charlotte’s age. So, yet again, a person’s ability to cope in roles such as those given to the volunteers is not down to their pay grade. It’s related to their competence, confidence and temperament, all of which can be screened for during recruitment and addressed in training.
The final episode focused (in part) on how different volunteers responded to more challenging patients.
Mark had been admitted to A&E having been found unconscious in the town centre. He was homeless, an alcoholic and had taken an overdose. One volunteer was immediately compassionate towards Mark, whilst another privately remarked that people like him should take personal responsibility and sort themselves out. After spending more time with Mark, the latter volunteer’s views softened as their understanding and empathy for the patient grew.
The point was also repeated that patients can respond differently to volunteers than paid staff. Eric, a patient who has been bed bound during his hospital stay, got out of bed for the first time thanks to the efforts of two volunteers. None of the paid staff had managed this with Eric. The success of the volunteers was attributed by the nursing staff to the strength of the relationship the volunteers had with Eric because of the time they’d spent with him.
As the episode concluded we learnt that the hospital senior management had judged the pilot a success and were rolling it out on a permanent basis across the hospital. Furthermore, two of the volunteers, Piotr and Michael, had decided to join the NHS, as a nurse and paramedics respectively.
As I said at the start The Big Hospital Experiment is must watch TV for anyone working in volunteer engagement. It would help challenge the prejudices and stereotypes some paid staff hold about the competence and reliability of volunteers. Also, when was the last time a programme about volunteering and volunteer management got a four-part prime time series on the BBC?! To not watch it would be a missed opportunity.
Did you watch the show?
What did you think?
Leave a comment below – I’d love to read your thoughts and reflections.
See also, “Patients, volunteers and the NHS were all winners in the Big Hospital Experiment” in which the Chief Nursing Officer for England gives her views on the programme.