Tuesday 28th April 2015
Mac Voice, the magazine for Macmillan Professionals: Spring 2015
When colleagues communicate about the emotional impact of providing care, it can have huge benefits, Russ Hargreaves has discovered
In October 2013, I was approached by Chelsea and Westminster Hospital to run ‘Schwartz Rounds’. Over one year later, I can safely say that Schwartz Rounds are the most rewarding project I’ve ever been involved in.
Schwartz Rounds were first established in the USA in the 1990s. A relatively young Boston lawyer called Kenneth Schwartz had been diagnosed with lung cancer. In this last short year of his life, he noticed something crucial about his healthcare providers: those who he felt were best able to provide good, compassionate care were the very people who were themselves able to talk about their own hopes and fears. They offered him something personal when he was at his most vulnerable. In contrast, the staff that he felt offered the poorest care were those that did everything by the book and kept him at an arm’s length.
Ken decided to leave a legacy and founded The Schwartz Centre for Compassionate Care. An idea was hatched for a monthly Round – an opportunity for staff to get together in a closed meeting to discuss the emotional burden of caring for the sick and dying.
These Rounds were so popular they eventually arrived in the UK in 2013, where they were developed for a UK healthcare setting by the Point of Care Foundation. Initially there were 23 pilot sites in the UK. At last count, there were 93 NHS acute trusts, primary care centres and hospices running regular Rounds, and this number is increasing.
How Schwartz Rounds work
The format is simple: a panel of around four members of staff are selected to tell their story for five minutes each. We have heard from professors to porters, often on the same panel. Afterwards, the audience is asked to reflect on what they have heard. The subject matter can be anything from ‘the patient I will never forget’to ‘weathering the storm’ (the feelings that arise when we are the subject of a complaint). The intention is to move away from problem-solving and to talk about the impact it has on us when we care for people with serious illness.
These Rounds are open to all NHS staff. However, Macmillan has recognised their potential and supported every London acute NHS Trust to develop Schwartz Rounds.
I am now mentoring several other trusts in Kent and sharing our experiences. Every Round is evaluated and the feedback has been staggering. Perhaps most heartening has been the number of junior doctors and nurses telling us how humbling it has been hearing about their senior colleague’s fears and insecurities. For me personally, the Rounds have elevated my visibility at Chelsea and Westminster and this has had a very positive effect on the numbers of staff referring to our Macmillan Centre.
I would really encourage you to become involved if they appear in your area of work. I would be surprised if they don’t: the Department of Health is keen to roll out Schwartz Rounds throughout the UK, and not a moment too soon.
Email Russ Hargreaves, Macmillan Counsellor, The Macmillan Centre Chelsea and Westminster NHS Foundation Trust