Dear Editor,
In the University College Hospital (UCH) Macmillan Cancer Centre we have introduced a reflective practice group session for our nursing assistants, band 5 and band 6 nurses to enable teams to reflect and process the emotional impact of the COVID-19 pandemic. Our support and information service has always been accessible to all staff caring for cancer patients and their families and the team also provide support to our clinical nurse specialists and other clinical cancer staff. In collaboration with the team we started this reflective practice group in April and continued weekly for a period of 3 months. During this time we also had a very sad death from COVID-19 of one of our nursing colleagues and as a result of this existing group we were able to have the support of the support and information specialist team and access to the space as a ‘safe space’, where staff could come and be supported, share their feelings and show their emotion. Having a safe space to grieve, while at work, under such extraordinary circumstances was just as important as having the time.
Our senior cancer support and information nurses were instrumental in guiding the group through this time, using their extensive cancer experience to support our nurses and to facilitate the discussion. We then realised that creating a space for a group clinical reflection has huge benefits in bringing a large team together, to share experiences and learn from each other. Nursing in the cancer centre will expose nurses to traumas such as long-term patients dying, dealing with aggressive patients and managing complex side effects, and for some of our new nurses it can be difficult to adjust to the new environment. Discussing the challenges and trauma of nursing with our colleagues can support this adjustment and critically it reaffirms that we are not alone and we should not feel alone when processing these complex emotions. We have now introduced group clinical reflection into our teaching sessions every 5-6 weeks. We do not have an agenda for the meeting, but it is facilitated by our senior nurses in the support and information service.
The challenges of the pandemic have reinforced the importance of ensuring that our cancer nursing teams have access to formalised clinical reflective practice and that this is framed as a process to address the emotional impact of nursing work rather than problem solving–this we do through other mechanisms such as AAR [after action review] and critical incident analysis. Through this experience we have sought to further establish an open and honest culture where nurses have the space and time to talk and to feel listened to.