Exploring how to enhance healthcare worker wellbeing on a Labour Ward: insider participatory action research

Background Good healthcare worker (HCW) wellbeing impacts positively on patient experience and outcomes, yet there are long-standing global concerns for HCW welfare. Excessive workloads are leading to burnout and retention issues, with consequent impact on quality of service. As a practising midwife on a National Health Service (NHS) Labour Ward, I had witnessed the impacts of the challenging workplace environment on my colleagues. A review of the literature proposed participatory interventions for effecting favourable change. Research question How can we as maternity HCWs enhance our individual and collective wellbeing? Methodology This qualitative Wellbeing Project used Insider Participatory Action Research to identify and build on experiences which uplifted colleagues' workplace wellbeing. All grades of every HCW group were invited to participate. Data were generated from individual and group interviews, questionnaires, data displays, Action Groups (AG), and peer participant data reviews. Ethical approval was granted by the Health Research Authority and Health and Care Research Wales (HCRW). Analysis and Findings Thematic analysis found emotional, physical, and professional nourishment fuelled wellbeing. Three main areas of impact were reported. Firstly, heightened attention on wellbeing prompted a currency of conversation around these factors. Positivity and morale increased as the culture shifted towards adopting more compassionate and inclusive behaviours. Secondly, new interdisciplinary AG dialogues initiated many change projects for colleagues' and childbearing women's benefit. Thirdly, the insider-researcher presence was reported to have independently benefitted wellbeing. A new Colleague Support Worker role was established, providing an informal wellbeing resource during duty periods. Many wide-ranging activities continue, including wellbeing sessions in Preceptorship Midwife programmes, and an interdisciplinary Wellbeing Group. Conclusion The Wellbeing Project heightened awareness of factors which nurtured HCW wellbeing. Caring behaviours, within and between occupational groups increased and a culture orientated to enhancing wellbeing developed. This bottom-up, positive, participatory initiative offers a practical example of a readily implementable and low-cost strategy for cultivating compassionate and inclusive cultures in diverse workplaces. It serves as a strategy for the NHS to meet the basic human needs of HCWs and to positively impact on widespread retention and HCW welfare concerns. Recommendations are offered in relation to healthcare policy, practice, education, and research.