Oracle The The New ESHT Critical Care Journal June 2025
#ICUWeek2025
The Oracle Team Karl Pasamanero Joyce Pasamanero
Rosu Banzuela CHris Thwaites
Contents • Celebrating Intensive Care Week 2025 • The best thing about working in Intensive Care is... • Celebrating Pride Month • Transforming Staff Development: ESHT's New Appraisal System • 8 Powerful Ways to Boost Team Morale in a Critical Care Unit • Incivility at Work • Mental Capacity Act in Critical Care • Team Immediate Meeting (TIM) Tool Refresher
Editor's Welcome
Welcome to our June edition—a month packed with celebration, learning, and practical insights. We're kicking off with ICU Week 2025, celebrating the incredible work our ESHT critical care teams do every day. Your dedication doesn't go unnoticed, and this week is our chance to properly recognise the difference you make to patients and families. As part of the ICU Week celebrations, your lovely lead editor Karl has written an article for the Trust extranet celebrating Intensive Care Week—do look out for it! or just flip in the pages of this journal. Our lovely Buddhi and Holly also made articles on what they think is the best about working in critical care. June is also Pride Month, and we're thrilled to spotlight our LGBTQIA+ Network. Building an inclusive workplace where everyone feels valued isn't just the right thing to do— it makes us stronger as a team and better at caring for our diverse community.
to make the most of your appraisal. Our PNA section tackles something we all care about: boosting team morale in critical care. Eight practical strategies that actually work— because let's face it, maintaining good spirits in our high-pressure environment takes real effort and smart approaches. Megan Fellows, our People Promise Manager, addresses workplace incivility—a topic that affects us all. Her insights will help us continue building the respectful, supportive culture our patients and colleagues deserve. Finally, we've included a refresher on Team Immediate Meetings to keep our emergency responses sharp when every moment counts. Each piece in this edition is designed to support you—whether you're celebrating achievements, developing professionally, or handling the daily challenges that come with critical care.
You'll find details about the new ESHT Employee Appraisal system, including a
Thanks for everything you do.
helpful interview with Stacey Bolingbroke from our People
Engagement Team. She breaks down the new online system and shares tips
Karl & Joyce
Celebrating Intensive Care Week 2025 #ICUWeek2025 Our Critical Care units celebrated Intensive Care Week 2025 from June 2-8 with activities across both Conquest Hospital in Hastings and Eastbourne District General Hospital (EDGH). Both units participated in the Intensive Care Society's #ICUWeek2025 activities, recognising the intensive care teams who work tirelessly to save lives every day.
At Conquest Hospital, the intensive care unit marked the week with special recognition for their team of over 80 staff members. The team celebrated by taking photos and posting what they like about working in the ITU, sharing their personal experiences and highlighting the positive aspects of their challenging but rewarding work.
The Conquest site was visited by the Trust's new CEO Jayne Black together with Associate Director for Nursing Evette Davies and Nadia Cruddis during the celebrations. Senior Sister Emma Rothermel said: "We were visited by our new CEO Jayne Black and had look at what we put up to celebrate the week. It is refreshing to share with her what’s happening in the unit and be listened to”. EDGH's critical care team also celebrated the week in their own simple way. Both units decorated their staff rooms with bunting and posters of what they like about ICU, creating a festive atmosphere throughout the week.
Both teams work together throughout the year, sharing expertise and supporting each other to deliver the best possible patient care.
Sam Bull, Conquest Critical Care Skills Facilitator, led the celebration and reflected on the week's significance: "We just wanted to celebrate ICU and what it means to work in this stressful environment. How our family support and encourage us to work as a team and to do our best for our patients in difficult times. It was a really positive week and highlighted how great it is to work within the critical care unit, and how we, as a unit wanted to celebrate Intensive Care Society #ICUWeek2025.”
Intensive Care Week provided a special opportunity to say thank you to the doctors, nurses, healthcare assistants, and support staff who work in these demanding environments. The celebrations recognised not just their clinical expertise, but also the compassion and emotional strength they show every day.
The best thing about working in intensive care is...
We've asked a couple more colleagues to share with us what they like best about working in our unit / being an ITU nurse. Here is what they said:
Holly Makin Senior Sister Critical Care EDGH Critical Care Rehabilitation and follow up clinic nurse
There are many things that I love about working in Critical care. We have the privilege of looking after a patient at potentially one of their most vulnerable times in life; entering as a stranger and often leaving a memorable impact for them and/ or their loved ones for life. I believe that due to the incredible team work on Critical care a holistic approach is embraced. I am fortunate enough to see the patients whole journey from admission and MDT
meetings, the ability to look at comprehensive plans, to at the follow up clinics assisting with ongoing rehabilitation needs in the community. I always feel particularly lucky that our MDT at ESHT has ensured that rehab and Critical care follow up continues to have high benefit for patient and develops. I also acknowledge the incredible skill of the team, often having different areas of interest and experiences to bring to the unit.
Team work and strong patient advocacy is what makes working in Critical care an incredible place. Looking after a patient is often one of the most humbling experiences, and to be able to show kindness, support and compassion in someone's time of need is truly special and what I cherish about being a nurse in Critical care.'
Buddhini Abeysekera Critical Care Staff Nurse
When people think of nurses working in the Intensive Care Unit (ICU), their assumptions often fall into two extremes. Some imagine the job is unbearably intense, surrounded by life-or-death decisions every minute. Others believe it is easier after all; ICU nurses often care for just one patient at a time. Both views, while understandable, miss the deeper reality of what ICU nursing truly involves.
As ICU nurses, we are not just clinical professionals; we are humans first, driven by empathy, resilience, and a deep sense of purpose. We meet patients and their families at some of the most challenging points in their lives. It is true: we cannot always save everyone. However, what we can do, and do every single day, is fight alongside our patients with everything we have. We provide not just medical care, but emotional strength, presence, and compassion when it matters most. What many do not see is the intensity that comes with managing a single ICU patient.
Each case can be incredibly complex, involving advanced technology, critical thinking, and moment-to-moment decisions. Beyond the monitors and machines, we carry the mental and emotional weight of each life in our care. The work is as much about heart as it is about skill.
For nurses stepping into the ICU for the first time, especially without previous critical care experience, it can feel like entering a new world. The pace is different, the expectations are high, and the learning curve is steep. Nevertheless, here is the good news: you are never alone. ICU teams are known for their strong culture of support. From seasoned colleagues to dedicated practice educators, there is always someone ready to help you, guide you, and remind you that you are part of something bigger. It truly feels like discovering your
professional dream team.
in ways words cannot fully capture. It is a role that pushes you, teaches you, and humbles you. In addition, most importantly, it reminds you every day why you chose to become a nurse. Here is to every ICU nurse working tirelessly behind the scenes, your work matters more than you know. Cheers to your courage, your care, and your commitment.
Over time, something remarkable happens. You begin to grow, not just in clinical knowledge, but also in confidence, strength, and clarity. You develop sharper decision-making skills, you face each day with greater purpose, and you start to see your career not just as a job, but also as a calling. The ICU becomes more than just a unit; it becomes a place where you evolve both personally and professionally.
No, ICU nursing is not easy. Nevertheless, it is rewarding
June is Pride Month
Celebrating Pride Month ESHT LGBTQIA+ Staff Network
T his June, East Sussex Healthcare Trust's LGBTQI+ Staff Network has embraced Pride Month with a series of vibrant and meaningful celebrations. As we
reflect on this month of visibility, community building, and advocacy, we are delighted to share the network's journey to the readers of The Oracle. From educational workshops to collaborative community events, the
LGBTQIA+ network has worked tirelessly to create spaces that honour diversity and promote inclusion throughout our Trust.
T he LGBTQIA+ Staff network has been set up to promote equality and respect for and/or gender identity, which in turn, creates a fairer and more inclusive work place and helps us care for our patients in a better way. The network has grown to over 100 colleagues of any sexual orientation
members, we attend Pride events, arrange training, guest speakers, support the community and listen to any concerns and input into trust policies and protocols, whilst working closely with our leadership team.
We’ve had several online and in person events this year in addition to our bimonthly network meetings and staff training: January- our first ever network quiz night fundraiser at The Hart pub in Eastbourne February- Guest Speaker Libby King from Bourne This Way LGBTQIA+ parent support charity and parents telling their story April- MS Teams demystification session with Elizabeth Holland from Digital
Quiz night fundraiser at The Hart Pub July- 10th- Listening Circle for Trans, Non-Binary, Gender fluid and Ally colleagues 12th Trans Pride Hastings social 19th parade at Eastbourne Pride 22nd: Q&A session with Erk Gunce August- Hastings Pride parade November- Trans Awareness Week and launch of our new trans training
June-Pride month! Guest speaker Erk Gunce, EDI Lead for South East Region at NHS England: Through my intersectional lens: my story, my work and the inequalities I work to address Listening Circle for Trans, Non-Binary, Gender fluid and Ally colleagues
Transforming Staff Development: ESHT's New Appraisal System
Y our appraisal is a focused conversation around you, the appraisee. Your appraisal is yours to own, and a key tool in demonstrating the development you need, the value you bring and setting out where you want to be heading on your career journey. The appraisal process is about taking personal responsibility for your own success and how you contribute to the success of
Ensure you know who your appraiser will be as you will be asked to ‘select a participant’ (ie select your appraiser). If you don’t know who is going to be doing your appraisal please check with your line manager (the person who signs off your annual leave etc).
your team and the organisation. Before you start your appraisal
We have created a video and published guidance around how to complete your appraisal on the MyLearn appraisal dashboard. Please watch and/or read the guidance before you begin. You can also attend one of our upcoming lunch and learn sessions.
Key points to know:
about your ambitions and your challenges.
Our values underpin the appraisal process and show how we can all play our part in ensuring everything we do is done with kindness, inclusivity and integrity. When giving an appraisal, give some thought to: Time – Give plenty of time Location – Give thought to the location Conversation – Give the conversation your full attention.
during the meeting. You (the appraisee) will then need to log back into MyLearn to add your goals and check your appraiser’s submission and comments before adding your own comments and submitting. Only once both parties have added any comments and clicked ‘submit’ will the appraisal be recorded as completed. Managers: you can help your teams by making sure to let them know who will be appraising them so they can enter this information. We want you to feel rewarded and able to do a good job, and your appraisal is an opportunity for one-on-one time with your line manager and a chance for them to hear directly from you
Managers: you can help your teams by making sure to let them know who will be appraising them so they can enter this information. When you complete your self-assessment please make sure to take your time and check all entries before you submit it. You cannot amend the self-assessment after this time. The sections titled ‘Time to Review Together’ and ‘Looking Forward’ will be completed by your appraiser during your appraisal meeting. The last section, ‘Setting Goals and Signing Off’, will be completed by the appraiser
Transforming Staff Development: ESHT's New Appraisal System
O ur Trust has recently implemented a new online appraisal system designed to enhance staff development and ensure consistent, high-quality appraisals across the organization. To gain deeper insights into this important initiative, we spoke with Stacey Bolingbroke, People Wellbeing and Engagement Manager at ESHT and has agreed to answer key questions about the new approach. In this interview, Bolingbroke shares valuable information about the system’s features, benefits, and how it’s transforming the appraisal experience for staff throughout the Trust.
Q1: What prompted the change to a new appraisal system and how does it differ from the previous approach? The new ESHT appraisal system was implemented in February 2025 to empower appraisees and to address inconsistencies that we've seen." Key problems with the previous system included: - Lack of consistency across the Trust - No way to track the quality of appraisals
- Staff fedback they didn't always receive paperwork after appraisals and goals were not always known, especially when line managers had changed. - Staff would "go from one year to the next without discussing their goals" The new system on Mylearn differs significantly by being electronic rather than paper-based, providing consistent trust-wide coverage, and emphasising personalised development. "This new system gives that consistency across the trust
and It also places greater emphasis on staff self-assessment, and the previous scoring system has been replaced by narrative based scoring” notes Stacey Bolingbroke.
Q2: Can you walk me through the key features and process of the new system? The trust-wide appraisal system features a structured yet flexible digital approach accessible through "MyLearn" with four main components: 1. My Goals: Where staff review their achievements over the past 12 months 2. My PDP (Personal Development Plan): For specific development opportunities like training needs 3. My Appraisal (Self-Assessment): Where staff reflect on their role, challenges, and how they've applied trust values 4. Appraiser Section: Only visible to those involved in the appraisal (the appraiser/ appraisee) The process follows these steps: meeting with their appraiser - The appraiser reviews the self-assessment - They meet to discuss "where you are, where you want to be and what support you need to get there" - Together they set and agree on goals for the coming year - Staff complete their self-assessment before
- The appraiser finalises comments and submits the appraisal - The appraisee can add final comments and sign off "Ensuring that as the appraisee you complete the My Goals, PDP and Self-assessment parts before you meet with the appraiser is important, so they can review what you thought about your overall role and performance over the last 12 months" explains Stacey Bolingbroke. The system provides real-time access to documents throughout the year, allowing staff to continuously track progress on their goals. Q3: What has the initial feedback been from staff and managers who have used the new system? Feedback on the new electronic appraisal system has been mixed but generally positive. "We've had a mix of feedback," notes Stacey Bolingbroke, with some initial challenges being reported: - Finding protected time to complete the self-assessment - Booking confidential spaces for appraisal meetings - Initial technical issues with saving documents
- Adapting to the new terminology and question format However, many positive aspects have been highlighted: - "It's been a really positive experience and actually although it's something new, it's a lot more simplified" - Staff appreciate having constant access to their appraisal documents - The step-by-step guided process makes navigation easier - The ability to update goals throughout the year is valued. Stacey Bolingbroke acknowledges that “it may take time to learn the new process on Mylearn, this could be down to a variety of factors, including, fear initially because it is a change" but it is expected the initial concerns will diminish as staff become more familiar with the system. There are email addresses that have been introduced to support colleagues with any queries they have and further information and resources can be found on the extranet under the title ‘Appraisal’
Q4: What specific outcomes is the Trust hoping to achieve and how will success be measured? Stacey Bolingbroke notes “Focusing on the Purpose, Aim and Measure really supports us to articulate to our people why this process has been introduced”. " The previous paper-based process noted inconsistencies across areas of the Trust and there was no central recording of appraisal content (excluding scoring and date)" notes Stacey Bolingbroke The purpose of implementing the electronic appraisal system is to: Establish Consistency- Ensure a standardised approach to appraisals across the Trust. Centralise Records via digital means- A single, accessible location for securely storing and reviewing appraisal documentation. Provide Assurance - Offer clear visibility that appraisals are being conducted, aligning with organisational expectations. Empower Staff- Encourage appraisees to actively engage in their development journey.
designed to enhance staff engagement and organisational efficiency: Empowerment Through Responsibility -Staff encouraged to take ownership of their professional growth and development. Shared Ownership of Development - The process fosters collaboration between appraisee and appraiser through self-assessment and appraisal meeting. Digital Transformation - A move away from paper-based systems promotes sustainability and modern working practices.
standardised format ensures a high-quality approach across teams. Streamlined and Efficient Once embedded, the process saves time and resources while reducing administrative burden. Enhanced Staff Recognition -A meaningful appraisal experience helps individuals feel valued, which in turn supports better service delivery and patient care. We will measure the above through Staff Feedback, Role-Based Insights, Quantitative and Qualitative Data, Accurate Recording and Content Quality It is important that the appraisal assists colleagues to feel valued, listened to, supported in their role and on their future career journey as we know that having a good appraisee feels, which has a big impact on the service they provide, and ultimately supports to improve the quality of our patient care The Trust plans to review the system in "September/ October 2025 and all themes and feedback from our people will be collated, and any necessary adjustments will then be made”. appraisal will make a difference to how the
Robust Governance -All records are located in
MyLearn, ensuring transparency and accountability.
Year-Round Access -Staff can regularly view and update their personal profiles on MyLearn, promoting continuous reflection and progress tracking. Real-Time Documentation -Appraisal meeting notes are recorded in ‘real time’ , supporting accuracy, accountability, and quality assurance.
Aims of the Electronic Appraisal Process
The transition to an electronic appraisal system is
Quality and Consistency - A
Q5: What have been the main implementation challenges and how are they being addressed? The Trust has encountered several implementation challenges and developed strategies to address them: Time constraints: Finding protected time for self-assessment has been difficult. The Trust emphasises that "this should not have always required to have a review and reflect on the year before following the previous process." Ensuring you plan ahead and schedule in time for you to complete the self assessment as the changed and some protected time was
appraisee is vital, as the appraisee this is about You, this is your appraisal. We recommend completing the self assessment two weeks prior to the appraisal.
Trust offers: - Regular "Lunch and Learn" sessions with recordings available afterward - A dedicated email address for process questions - A separate email for
technical system issues - Development of a Q&A page on the Trust extranet in progress Stacey Bolingbroke notes “The Trust is actively collecting feedback to refine the system further: "We encourage you all to share your feedback with us. Tell us your experience, good or indifferent." Technical issues: Some staff experienced problems with the system not saving their work. The Trust now emphasises the importance of using the "save" function frequently.
Physical space: Booking confidential rooms for appraisals has been challenging. The Trust suggests using "any safe space or confidential space... within your areas" when formal meeting rooms aren't available. Planning ahead may also support this. Training and support: To ensure staff understand the new system, the
Powerful Ways to Boost Team Morale in a Critical Care Unit
Vera Quintas Critical Care Sister, PNA
S ignificant changes are currently being experienced within our Critical Care teams. Secondments are being undertaken, valued colleagues are leaving or temporarily reassigned, and new staff are being welcomed into the team. As always, such transitions are accompanied by impacts on routines, practices, and,
inevitably, team morale. Morale is known to influence patient outcomes, staff retention, and the overall performance of the unit. For that reason, eight strategies are being outlined this month to support the morale of the Critical Care team and to ensure that a positive, resilient environment is maintained.
Issues Should Be Addressed Promptly and Constructively When concerns are raised, they should be addressed without delay and with empathy and fairness. In doing so, a respectful and psychologically safe working environment is upheld, trust is built, and a positive team culture is reinforced.
Contributions Should Be Recognised and Celebrated Efforts and hard work — whether related to patient care, covering an extra shift, or offering emotional support — should be acknowledged regularly. Recognition is already
Staff Should Be Empowered Rather Than Micromanaged Junior team members should be supported through mentoring, but space must also be provided for growth and development. Instead of being micromanaged, individuals should be guided within a culture of collaborative oversight. Confidence is built, learning is promoted, and a strong sense of team cohesion is fostered when responsibility is shared appropriately.
All Team Members Should Be Treated Equitably A culture of fairness is reinforced when all individuals are treated equitably. Policies, feedback, and recognition should be applied consistently across the team, helping to prevent division and promote unity.
being provided through initiatives such as “Staff
Member of the Month” and the “You’ve Been Mugged” mug. However, day-to-day achievements should also be praised — both privately and publicly — so that motivation is strengthened and individuals are made to feel valued.
Support and Resources Should Be Provided Effectively Resources — whether staffing, equipment, or emotional wellbeing tools — should be made readily available. Staff should be encouraged to reflect on their own wellbeing and to seek support before burnout occurs. Support can be accessed through line managers, senior team members, and Professional Nurse Advocates (PNAs), who are available to help identify issues and provide assistance.
Expected Behaviours Should Be Modelled by All Leadership is demonstrated in many forms, and examples can be seen across all roles — from a nurse calmly managing a complex admission, to a junior doctor stepping forward in an emergency, or a physiotherapist promoting early mobilisation. When integrity, empathy, and resilience are modelled, a powerful example is set for others to follow.
Information Should Be Shared Transparently In a fast-paced and high-pressure environment, clear communication is essential. Updates on patient care, policy changes, new protocols, or even team events should be shared openly and consistently. Staff should be encouraged to use various channels — including shift handovers, trust email, and WhatsApp groups — to ensure information is passed on effectively. PNAs can also be approached at any time, whether on shift or via email/message.
Team Successes Should Be Celebrated Collectively In Critical Care, achievements are rarely accomplished by one individual alone. Every successful outcome is underpinned by collaboration — from subtle changes in patients conditions noticed by a vigilant nurse, to decisions taken by a doctor, or the critical care technician who ensured vital equipment was ready and functioning. When collective success is celebrated, a sense of loyalty and mutual respect is strengthe
Incivility at Work I ncivility may seem minor at first glance—an offhand comment, an eye roll, a joke that lands or discourteous actions. Whether it’s gossiping, being ignored, or receiving a cutting remark, incivility is
more common than we might think—and more harmful than we often realise.
poorly. But these seemingly small
Megan Fellows People Promise Manager
behaviours can have a powerful and lasting impact. As part of our work, we explore the concept of incivility—a term that encompasses a range of rude, dismissive,
The good news? Incivility can be addressed. It starts with each of us choosing to contribute to the kind of culture we want to be part of. When you encounter someone behaving in a way that feels dismissive or rude, try pausing and asking: “Are they okay?” “What’s the most generous explanation for their behaviour?” Choosing curiosity and compassion over judgement helps interrupt the cycle. Let’s remember our Trust Values, and lead with kindness. It’s not about perfection—it’s about intention. To explore more on this topic, check out the Civility Awareness resources on MyLearn.
Research shows that 98% of workers have experienced uncivil behaviour and 50% encounter it at least weekly (Pearson & Porath, 2013). Its effects are far from trivial. When someone is subjected to incivility, cognitive performance can decline by up to 61%—our brains become distracted, reactive, and less effective. It doesn’t stop there: 25% of recipients go on to unintentionally pass incivility to patients and service users, creating a ripple effect. At the team level, outcomes worsen across multiple clinically significant measures. There are serious financial
implications, too. Kline and Lewis (2018) developed a tool to calculate the cost of incivility, disrespect, bullying, and harassment in NHS organisations. Their research factors in employee turnover, sickness absence, decreased productivity, presenteeism, and legal costs. According to their estimates, incivility costs the NHS approximately £83.46 million annually. Using our 2021 organisational data, the tool estimated that incivility cost ESHT £14.64 million—a stark reminder that culture affects more than morale.
Mental Capacity Act in Critical Care T he issue of mental capacity in the critical care environment can be fraught with difficulty and can cause challenges and dilemmas for staff working in these environments.
Please do reach out if you ever have any queries relating to Mental Capacity or DoLS. No question is too small. Esht.mcadols@nhs.net Meike Weststrate (Mental Capacity Lead) 07815460756 Yvonne Laatz (Mental Capacity
Practitioner) 07483978941
Many patients in critical care environments are often too ill to understand the treatment options and are therefore deemed to lack capacity to decide for themselves when considering procedures and treatment. It is therefore
important that in all cases a proper assessment of capacity is undertaken when treatment decisions are required. The Mental Capacity Act 2005 (MCA) is the legal framework that outlines how capacity is assessed in England and Wales.
It is important to remember that capacity is decision specific, so at any time a patient may have capacity for some decisions but not for other more complex ones. It is also important to remember that capacity is time specific and may fluctuate due to the clinical condition of the patient. In circumstances when a patient lacks capacity, the medical team must make a treatment decision in the
made in the past, any advance statements or advanced decisions, and involving the patient as much as possible, and seeking information and views from family members, friends and staff that may aid the decision making. The MCA Code of Practice contains a Best Interests checklist for guidance, to ensure a broad approach considering all aspects of a patient’s life is taken when making a Best Interests decision.
Some people may have made written advanced statements before becoming unwell, giving the medical team an idea of what would and wouldn’t be acceptable to the patient in the event of losing capacity. These are not legally binding but contribute to the Best Interests decision making process. Some patients also make a formal advanced decision to refuse a specific treatment in certain circumstances. These decisions are legally binding, and must be written and signed as witnessed by an independent person to apply to refusing lifesaving
best interests of the patient. This should include not only
considering what is medically the best treatment option, but also consideration must be given to what the patient would likely want to be done in the given situation. This will include considering treatment decisions they may have
treatment; for example invasive ventilation or cardiopulmonary resuscitation.
Tue 22nd July 2025 – 1.30-2.30pm: Independent Mental Capacity Advocates (IMCA) - guest speaker Claire Lambert (manager of the local IMCA service) Join the meeting now
Tue 23rd September 2025 – 1.30-2.30pm: MHA &MCA overlap / interface – guest speaker Amy Leadbetter (SPFT Legal Educational Advisor ) Join the meeting now
Tue 21st October 2025 – 1.30-2.30: Challenges in assessing capacity - fluctuating capacity and difficulties in engagement – speaker Meike Weststrate (ESHT Mental Capacity lead) Join the meeting now
Tue 25th Nov 2025 – 1.30-2.30pm: Q&A ReSPECT – guest speaker Chris Penhale (Sussex Community NHS Foundation Trust -ReSPECT Lead) Join the meeting now
Tue 16th Dec 2025 – 1.30-2.30pm: Sensory impairment: communication and capacity– guest speaker Donna Waddington (ESCC Social Work Senior Practitioner Sensory Impairment Reablement Team) Join the meeting now
Either click extranet links to join or email us on esht.mcadols@nhs.net and we will send you an MS team invite.
New ‘MCA: How to assess capacity’ workshops Upcoming dates:
24 July 2025 (9:30 – 12:00) - EDGH 16 September 2025 (9:30-12)-CQ 23 October (9:30-12:00) EDGH More dates throughout 2025
Who should attend?
This course is aimed at clinical staff who are required to assess capacity and support patients through the decision-making. Meike will explain how to complete a mental capacity assessment by way of group discussion and use of case scenarios.
Team Immediate Meeting (TIM) Tool Refresher Supporting Healthcare Professionals After Distressing Clinical Events
When to Call a TIM?
situations - Supporting families through impossible decisions Personal Impact Situations - Any event that leaves you feeling shaken or overwhelmed - Moral distress from ethical conflicts - Times when you question your decisions or competence - Situations that remind you of personal experiences
What is the TIM Tool?
Call a TIM whenever you or colleagues might be struggling after: Distressing Patient Events - Unexpected patient deaths or unsuccessful resuscitations - Difficult end-of-life situations or treatment withdrawals - Traumatic clinical scenarios or prolonged emergencies Challenging Family Interactions - Delivering devastating news or difficult conversations - Family conflicts during emotionally charged
The TIM Tool is a wellbeing support framework developed by the Intensive Care Society UK to help healthcare professionals after distressing clinical events. Launched in ESHT Critical Care on November 6th, 2023, it prioritizes staff wellbeing and provides essential support when we need it most.
Remember: If you're thinking about calling a TIM, you probably should. How to Run a Wellbeing TIM (5-10 minutes) 1. Create a Safe Space - Gather those affected by the event - Find a quiet, private area - Emphasize confidentiality and support 2. Check In - "How is everyone feeling right now?" - "That was difficult - how are you coping?" - Listen without judgment 3. Acknowledge and Normalize - Validate that feeling distressed is completely normal - Remind everyone that seeking support shows strength - Acknowledge the difficulty of what you've experienced 4. Plan Immediate Support - Who needs to step away temporarily? - What support is needed right now? - Follow-up arrangements
Normal Emotional Responses
colleagues Listen - Give people space to share their feelings without judgment Link - Connect people with appropriate support services
them a drink) - Know when to escalate to senior staff
After distressing events, you might experience: - Sadness, anger, or guilt - Anxiety about future situations - Physical symptoms (headaches, nausea, fatigue) - Difficulty sleeping or All of these responses are normal reactions to abnormal situations. Psychological First Aid Principles Look - Watch for signs of distress in yourself and intrusive thoughts - Feeling numb or disconnected
Remember
Using the TIM Tool doesn't mean you're not coping - it means you're being professional and caring for yourself and your colleagues. Every time we support each other through difficult experiences, we build a stronger, more resilient team.
If You're Struggling:
- Ask for support - don't wait for others to notice - It's okay to step away from patient care if needed - Remember that feeling distressed shows you're a caring professional If You Notice a Colleague Struggling: - A simple "how are you doing?" can make a huge difference - Offer practical support (covering duties, getting
When in doubt, reach out - your colleagues are here for you.
The TIM Tool exists because we care about each other's wellbeing. Use it.
Matron's Corner Marta Soares-Preece Critical Care Matron
F irst of all, I would like say thank you for the warm welcome across both units. Stepping into the role of cross site Matron has been both humbling and energising. As I complete my first week as Matron, I feel incredibly privileged to step into this role alongside such a dedicated and compassionate team, My first week has been a whirlwind of introductions and rapid learning. From day one, I’ve been focused on building relationships
and approachable on both units. Over the next two weeks, a formal handover will start between myself, Caroline and Julie to ensure continuity, understand team dynamics, and identifying key priorities. I will also start planning 1-2-1 meetings with the senior team and continue to take time to listen, learn and lay the groundwork for collaborative work. I plan to spend two days at Eastbourne and two days at Conquest weekly. There will be an updated calendar at the Matron's office on a weekly basis. Looking ahead to the Patient Safety Week which
starts on the 30th June, I would like to bring your attention to communication, particularly team working, speaking up and following processes. Patient safety is very important to me and and as I embrace this role, I'm eager to ensure we strengh our communication, team building and create safe spaces for voicing concerns. Although, I won't be located at just one office, I want all of you to know that my door is always open.
but also I’ve begun reviewing existing
protocols, identifying areas for quality improvement, and making myself visible
Critical Care Outreach Team Updates Tori Privett Critical Care Outreach Sister
May data Number of referrals: ˜ 276 ICU Admissions: ˜ 32 (12% of those referred to service admitted to critical care) Total amount of assessments: ˜ 455 2222 calls: ˜ 146 ICU step downs: 30
Advice only: ˜ 72 Call4Concern: ˜ 0 Following successful interviews, we look forward to welcome both Chelsey Bristow and Grace Wade to the teams! Both will join the team in the ongoing implementation of Martha’s rule (Call for Concern) across site.
This month we wanted to share with you all a good example of staff call for concern (Martha’s Rule). Pharmacy Technician at EDGH reported her concern regarding a gentleman whom on last review was mobilising round the ward making himself drinks etc. Upon reviewing him a few days later she found him in bed with decreased response, twitchy, wearing mittens with a DOLS in place and a security guard sitting outside his room. This chap was Polish and had no relatives or visitors only a daughter in contact by phone from Poland. He was initially admitted for Gastritis due to excess alcohol use. Notes revealed 2 falls over the weekend and 2 seizures. Patient had a CT Head which
was NAD, No further investigations undertaken. Reviewed by CCOT A to E assessment and repeat observations – showed NEWS 7 (Moderate risk of deterioration) Witnessed seizure with Right sided facial twitching. This was new so significant. Respiratory alkalosis on ABG with borderline K+, normal blood sugar.
Fluid balance chart commenced
Referred for MRI and neuro review (MRI showed changes in Lt temporoparietal lobe)
Lessons to be learnt
NEWS2 score on ward inaccurate as response
recorded as ALERT he was in fact at best confused (new confusion is a significant soft sign of deterioration) which would add 3 in one area which should trigger an alert for review. Clearly a significant deterioration over four day weekend with poor oral intake of fluid and food which were not reassessed or addressed. Patient is now improving, eating and drinking NEW2 score 0.
Right sided weakness (new)
Minimal oral intake for 4 days as too confused / unwell to get his own drinks.
Referred to Medical Registrar for urgent review.
Patient had I.V Thiamine, fluids and electrolytes prescribed.
Critical Care Practice Education
Robert Maley Practice Educator
We will soon be organising places for the STRICT transfer course in October at EDGH. Unfortunately, as ever, there are more people who need to do it than we have places available so we would ask people to please be patient, we aim to get everybody to have attended eventually. Please note that new mandatory training has been added to everyone's MyLearn portfolio. There are still virtually no places available on the ILS, and only a few on the PILS, at Conquest - so it is vitally important that staff book themselves on a BLS update f they are out of date.
Angela Mehmet Practice Educator
We have recently run our first team development of the year which was for the green team. This included making flatbread in the occupational therapy kitchen, above cord vocalisation and passy muir valve training, an update from physio which allowed staff to trial the virtual reality sets and a psychology team building exercise with our psychologist Benny. The day also included some SIM training with Gags Sekhon ACCP around airway management. Thank you to everyone who was able to come and share their expertise and knowledge with the team. Also a big thank you to Sarah Johns for facilitating this for her team We have also been able to restart Clinical Supervision this month and you will over the next few months see this being added to Health Roster. Pressure Ulcer and Skin Management has been added to MYLearn as mandatory training. Please can I ask that all staff who have Safeguarding - Think Family Level 3 training outstanding book it as soon as possible. Supporting Learners in Practice does not currently come up as mandatory training but there is a requirement to complete it yearly. This E-learning has taken the place of the old mentorship update. If you complete the training and MYLearn does not update please either e-mail myself or Development and Learning who will update it for you.
On the Good News...
We are very honoured to have been visited by our newly appointed Chief Finance Officer Andrew Stevens in our Conquest Site. He is joined in by - Dr. Nick McNeilis, Evette Davies, Nadia Cruddis and team and had a visit in our new escalation unit. Welsome to ESHT!
The Oracle would like to congratulate Christa Wood, Critical Care Data Lead Nurse and Harriet Wilkinson , Senior Sister for their long service certificates. Well done to you ladies!
Critical Care Doctor of the Month
Dr. Chamara Abeywardhana
Dr. Aoife Seery
Critical Care Staff of the Month
June Caroline Ellis
May Jem Marcroft
Marie Middleton
Critical Care Bewl park and picnic day.
The Oracle would like to congratulate Sam and Kim for organizing another successful Patient support group session. We encourage everyone to join and be part of this wonderful program. Please contact Sam or Kim for queries.
We will miss you Pat! Last Thrusday was our Pward clerk Pat Price's last day. Wishing you a fulfilling and joyful retiement filled with new adventures and cherished moments!
Good luck to you Jasmine! Our dear friend Jasmine is embarking on an exciting journey to Australia to pursue a new chapter in her career. We wholeheartedly wish you all the best and much success!
We extend our heartfelt wishes for all the best to you, Becky. This month marks the final day of Becky Dodds, our dedicated unit psychologist, in our unit. We will truly miss you, Becky! Wishing you all the best in your future endeavors!
This month has also signified the concluding shifts for both Bethan and Sadie prior to their upcoming maternity leave. Wishing you both safe and pleasant deliveries!
See you on the next Edition The Oracle
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