Schwartz Rounds: Sharing the impact of the Covid crisis

Categories: Care, Featured, and People & Places.

Patricia McCrossan, Social Work Manager at North London Hospice, describes what it was like to run a virtual ‘Schwartz Round’ – a meeting where staff come together to reflect on the impact of their work.

The Covid-19 pandemic has brought with it different times, new challenges and the word “unprecedented” creeping into our communications. The crisis is affecting everyone – same storm, different boats.

Within the anxiety, sadness and exhaustion are glowing examples of peer support, leadership and acts of kindness. Once things began to feel a bit more settled, it was time to think about how the organisation could provide a framework to explore and reflect upon what was happening and how it was affecting people. One option was a Schwartz Round.

Schwartz Rounds were developed in the USA, inspired by a cancer patient, Kenneth Schwartz, who described how small acts of kindness made “the unbearable bearable”. He recognised what those providing compassionate care give of themselves, and he wondered how that impacted them and how they were supported to reflect on this.

The importance of reflection

The rounds are an opportunity for all staff to come together to explore the emotional and social impact of our work. They are not therapy groups or solution-focussed, and all contributions are valued.

The North London Hospice is registered with the Point of Care Foundation (POCF) and Schwartz Rounds were introduced three years ago, to a good response. The hospice Schwartz Round working party discussed whether we should attempt to organise a round titled ‘Coping with COVID 19’. The Point of Care Foundation were promoting an alternative model called ‘Team Time’ – short, weekly, structured sessions with two storytellers to support discussion in teams.

We wanted something that embraced the whole organisation, and while the format of Schwartz Rounds was familiar, we weren’t sure how it might work with a few people in the room and most joining via Zoom. We thought about whether some people might feel too uncomfortable to attend, and what we would do if someone became tearful and we couldn’t reach out to them. We also discussed possible IT problems and how we’d manage the discussions.

There were lots of legitimate reasons to abandon the idea, but we decided to throw caution to the wind and give it a try, with just two weeks to prepare.

Running a virtual Round

Three panel members, two new to Schwartz Rounds prepared different, but equally powerful stories. Some panel members were in the room and one joined by zoom, representing community nursing, community social work, housekeeping and front of house.

Usually 30 mins before a round begins people gather to socialise and share food, but this wasn’t an option on this occasion. We waited to start and saw the numbers of people joining the meeting steadily grow. Almost 50 people joined the round eventually – a new record.

Each presentation immediately engaged everyone. The stories highlighted many issues including:

  • The reality of coping with visiting restrictions – family members begging to visit a dying relative
  • Anxiety on all levels
  • The advantages and challenges of working from home
  • Working from behind a mask and the impact on engagement
  • Managing home visits – quickly applying PPE in corridors
  • Personal impact on family and friends e.g. daughter not being able to sit exams
  • Efforts of trying to keep everyone feeling safe
  • Telephone, instead of face-to-face, support
  • Remembering to care and support each other

One of the greatest achievements of Schwartz Rounds is that they flatten hierarchies and everyone contributes on a human level. This was demonstrated by members of the executive team, who felt compelled to respond to what they heard. This encouraged others to talk about their personal and professional experience.

The benefits of talking

It was particularly emotive to hear from those who, for various reasons, are working from home and how many of them struggle with the disconnection from colleagues, the chat by the printer or in the kitchen. Though we know there is always someone on the end of a phone the opportunity to spontaneously turn to someone and say ‘that was a difficult call’, is greatly missed.

Some people struggled hearing about some of the challenges faced by colleagues directly supporting patients and families, and talked of feelings of guilt because they’re not physically there to support them. Some live alone and others are juggling space with members of their household, all needing a quiet work, study or relaxation space.

The conversation flowed along with laughter and tears, and the hour went very quickly. I don’t think anyone was left in doubt about the value of the round and feedback received from attendees confirmed this. Comments included “made me feel like part of the team again, lighter, more focussed and positive.”

Everyone who gave feedback rated the session as excellent or exceptional,  and agreed it gave them a better understanding of how patients, families and colleagues were feeling, and coping.

More information

  • To find out about opportunities to network, learn and collaborate with colleagues working in end of life care across the UK visit Hospice UK – What we offer