This article is a guest contribution from Rhiannon Wheeler, Voluntary Services Development Manager at St Wilfrid’s Hospice in Eastbourne, England. I found Rhiannon’s account of managing volunteers during the global pandemic insightful and inspiring – I hope you do too.
‘We couldn’t do it without you’ is a phrase you hear frequently in the third sector. At St Wilfrid’s Hospice Eastbourne, the past few months have proved more than ever that we really couldn’t have served our patients and community as we have done without our volunteers.
Looking back over the time between March and today, volunteers have played a key role in the COVID-19 response and I feel both proud and grateful to work for an organisation that has included them in our efforts every step of the way, and all for the better.
When the pandemic started
Back in the early days of the pandemic, a planning group was set up at St Wilfrid’s. Led by the Chief Executive and involving the leadership team and hospice managers, the Pandemic Planning Group (PPG) met daily at 9.30am to assess new guidance, review our provision and make fast decisions on next steps. Representatives from each department were involved to ensure clear communication of onward plans and that all risks and resources were considered. My inclusion in the PPG meant that I was able to contribute to decisions made about volunteering and work with key colleagues to action these quickly.
As the pandemic began to take hold, many volunteer roles were stood down as the hospice focussed on its core services. When volunteers over the age of seventy and those whose roles, at least temporarily, ceased to operate were sent home, there was a scene that I am sure feels familiar to many volunteer involving organisations: a mix of upset, some protest, and a degree of relief from those happy to have had the decision made for them.
Where possible, services were adapted so that volunteers could provide support over the telephone or video link. Albeit with depleted numbers, three volunteer roles continued to operate on the Inpatient Unit (IPU) in the hospice building: Hosts, Ward Clerks and Young Clinical Volunteers (YCVs). The question that was revisited in the PPG several times was: should we send these volunteers home?
Why we continued to work with volunteers in the hospice
Along with everybody else in the world, we were learning about a new disease and how it spreads. We were supporting very vulnerable patients, some with a positive COVID diagnosis and working tirelessly to ensure there was adequate personal protective equipment (PPE) in place.
On the one hand, there was and remains to be, a potential risk associated with any face-to-face contact with others. Hosts provide meals, refreshments and companionship to patients on the IPU and welcome visitors. YCVs carry out all sorts of clinical support tasks where close contact with patients is part-and-parcel of the role. We knew that despite all our best efforts to protect people, we were exposing volunteers in both roles to risk (and the guidance wasn’t yet clear about whether volunteers in this context were considered key workers).
On the other hand, volunteers were telling us very clearly that they wanted to be there. They were aware of the risks and well informed about what had been put in place to protect and support people. Any volunteer that chose to step back from their role was supported to do so.
Standing down all volunteers would have had a knock-on effect on the IPU. The Nurses and Healthcare Assistants, already stretched, would have had to pick up the additional tasks that the volunteers usually do, and this would have impacted on the support provided to patients.
Ultimately, it felt right for us to continue to involve volunteers in the front-line pandemic response effort.
What we did
Careful language: It was important that we were inviting volunteers to make a decision that was right for them and not because they felt guilty or that they should be volunteering. All communication reiterated this.
Clear communication: The Chief Executive (CEO) sent weekly email and video updates to all volunteers throughout the pandemic period. One email very gently explained that if volunteers who had previously stepped back due to age or other factors wished to return, we would be willing to open a conversation with them about this. Voluntary Services hosted a virtual forum over Zoom so that volunteers could ask any questions they had about life at the hospice and what to expect.
Provide volunteers with all the facts: A thorough risk assessment for the hospice building was emailed to all employees and volunteers along with a Volunteering During Covid-19 information pack with FAQs.
Welcoming back the over 70s: We knew that many volunteers aged over seventy were itching to return once this was possible. We understood the additional risk factors but it felt overly paternalistic to have a blanket ban. Towards the end of May 2020 we began to discuss whether and how we could invite them to return and after a joint decision at the PPG, we quickly put a process in place to make this possible.
Create space for an open conversation about how people feel about volunteering: Acknowledging that each person’s risk factors are unique, an individual risk assessment checklist was devised. All new or returning volunteers are now required to complete an individual risk assessment over the phone with someone from Voluntary Services or their manager. Broad and honest conversations uncover how people feel about volunteering during this time based on their own context and balanced against current facts. The conversation also offers volunteers the opportunity to ask questions or share any concerns or anxieties they may have before reaching a decision about whether and how they will volunteer.
Continue to check in and support decisions to step back: All new or returning volunteers are met by their manager on their first shift and provided with an induction including training on PPE and infection control. Volunteers are always offered the chance to opt in or out of tasks and understand that they can step away at any point.
Working with COVID- 19 positive patients: Initially, only employed team members worked in the isolated rooms. However, the Hosts soon noticed that the Nurses and Healthcare Assistants were exhausted and wanted to help. Some suggested that they could support patients in isolated rooms and following conversations with the clinical director and at the PPG, this was agreed.
Host volunteer Gill was asked if it worries her working with patients in isolation:
“Not at all, it feels completely safe. Doing what we do is nothing like being a Nurse. As Hosts we work together in pairs, which helps as we are able to look after one another as well. There’s no time pressure; we have plenty of time to put PPE on and take it off without rushing and also have time with the patients when needed.”
Why it worked
Well established roles pre-pandemic: we have had volunteers operating on the IPU for many years now and embedded routines that were easy to adapt. The Hosts and YCVs were confident in their roles and well supported and valued by the clinical teams. It wouldn’t have worked if it hadn’t been working well already.
One team, one uniform: At the start of the pandemic, all employees and volunteers who entered the building were provided with scrubs and appropriate PPE. Volunteers and employees adapted to this together and feedback has been positive about the sense of comradery that this brought about.
–Continuous review: Risk assessments and processes were continuously reviewed against the latest Government guidance and any changes communicated. We routinely questioned whether to introduce blanket polices about who can volunteer and how, but each time have returned to taking a flexible and personalised approach to this. Volunteering at its core, is about people choosing to contribute after all.
Strong leadership and communication: The PPG ensured that decisions were made as a team and different views about risk, process and policy were explored and discussed. From the top down, everybody was included in decisions and nothing was hidden from anyone.
I had a place at the table: All decisions had to be agreed and actioned quickly. As the Voluntary Services Development Manager, I was able to bring my knowledge and perspective to the discussion and I knew what was needed to progress plans.
Everybody had their eyes open: Our processes have been guided by the information available and what individual volunteers feel comfortable with for themselves and their situation. Clear, open and honest communication from the outset has helped to establish trust in the decisions made.
Making ourselves available: Volunteer managers and the Voluntary Services team are in regular contact with volunteers and invite open conversations at any point.
New models that can be replicated for different roles: Since introducing these processes for IPU volunteers, we have adapted the same process for inducting volunteers back into other roles and activities. Retail volunteers returned the same day shops in the UK were allowed to open and we have begun to re-initiate some volunteer community befriending visits as well as some other volunteer involving support functions.
Learning points
On the 18th June I received the phone call I had been dreading. Three volunteers who had been active in the hospice had tested positive for COVID-19; two hosts and one YCV.
Despite wearing appropriate PPE and following correct protocol, all three had spent some time with a patient who had a false-negative test result. A few days later, another volunteer who had been working in isolation rooms with patients who had a positive COVID diagnosis received a positive test result.
We couldn’t know for sure whether the volunteers caught the virus from the hospice or from elsewhere (two of them had returned to work around the same time) but of course we reported the incidents through the appropriate channels and reviewed our processes accordingly.
We knew that our processes were strong and for the three months up to this point we had managed to contain the spread. Until this point, no patient, volunteer or employee had caught the virus from the COVID-positive patients we had cared for.
This all happened in a very small window of time and coincided with the time that lockdown began easing and people started to go back to normal life. It led to a tightening up of visiting restrictions and some further work to cement a culture of strong adherence to physical distancing and infection control.
Regular contact was kept with the volunteers while they were recovering and all four wanted to return to their roles once they were well enough and had finished their period of self isolation.
On their return, there was a knock to confidence for these volunteers and some anxiety that they had done something wrong. Extra support and ongoing reassurance, regular breaks and shorter shifts soon got them back into the swing of things.
Dancing with doctors
Despite some ups and downs (I believe it’s called a corona-coaster!) and a mountain of work to keep things going, the whole experience of how we engaged with volunteers has been worthwhile and their contribution has been invaluable.
Feedback from the volunteers has been overwhelmingly positive. Managers helped to create a calm and supportive atmosphere and the small things made a big difference. The radio was always on and there was lots of singing and some occasional dancing with passing doctors. A previous feeling of ‘them and us’ has been replaced with a mutual respect for each other’s roles in one big team.
While acknowledging the insurmountable awfulness of the COVID-19 pandemic, volunteers have told us they look back on the past few months as a really positive time and feel that they were part of a unique and meaningful experience. The challenge now is to make sure we keep it going as we progress through this ‘new normal’.
Rhiannon Wheeler works as the Voluntary Services Development Manager at St Wilfrid’s Hospice in Eastbourne. Previously working in education and youth work, Rhiannon has been involved in volunteering for over 20 years, either as a volunteer herself or in roles where she has supported others into volunteering or social action. You can contact Rhiannon via email.
St Wilfrid’s Hospice serves a population of 235,000 people covering an area of around 300 square miles. Expert teams help people to live well until the end of their lives and provide support to their family and friends. Care is provided both in the hospice and increasingly in people’s own homes.
