What is the problem
Working in Paediatric Critical Care isn’t just a job; it is a calling. Here, extraordinary people come together to do extraordinary things. They hold the hands of the smallest patients, support families as they brave through the unimaginable, and bring skill, compassion and courage into moments that matter most.
But these heroes, even with their strongest hearts, need care too. Globally high rates of poor physical and mental well-being are widely reported and acknowledged. Burnout levels, compassion fatigue and work-related stress have reached worrying levels for everyone in healthcare, especially Paediatric Critical care (PCC), but more so after the COVID-19 pandemic.
Challenges can arise from the development of strong bonds or from differences in opinion, each of which can lead to moral distress or a blurring of boundaries between personal and professional lives.
Compromised well-being can increase patient mortality and medical errors, lower patient satisfaction, increase staff turnover, and reduce professional effort among staff. That’s why supporting staff well-being isn’t a luxury; it’s essential. Well-being goes beyond “feeling okay”—it’s about creating environments where staff can thrive, reducing unnecessary stress, and making room for strategies that help individuals stay healthy, grounded and resilient.
The challenges in the PCC environment include:
What can we do about it?
First step to support the holistic well-being of PCC professionals.
The PCCS Wellbeing Toolkit is a wonderful framework, created by staff members working within UK PICUs, that showcases good practice interventions for maintaining staff wellbeing across PICUs around the country. It is not a self-help guide to refer to in times of need – professional support is available at an individual level in all trusts. Its purpose was to share learning and ideas on managing wellbeing through collaboration and exposure to initiatives in similar environments.
Some examples include:
| Domain | Initiatives & Examples |
| Leadership | Senior leadership rounds, Civility Saves Lives campaign, Training and development opportunities |
| Safety | Conflict-resolution workshops, Communication courses Pastoral care |
| Environmental | Removing Barriers Programme to increase ethnic diversity in leadership Conferences and network events |
| Psychology | Annual unit surveys by psychology team Peer support |
| Networking | Well-being groups PCCS Masterclass |
| Research | Staff well-being research projects |
| Governance | Exit interviews Well-being on the agenda item in business meetings |
| Spiritual | Multi-faith prayer room Considering staff religious beliefs when allocating patients (especially at the end of life) |
| Social | WhatsApp groups Well-being walks Group mindfulness sessions |
| Emotional | Professional Nurse Advocates |
| Values | Forums for ethical debates |
Well-being is depicted as an interactive tree
Branches – main components
Trunk – elements that are overarching in their reach and impact – local, such as hospital-specific management and HR, or national, such as government departments or services – NHS
Roots – foundational enablers – finances, governance, engagement, networking, communication.
What it needs to move forward
Operational support and role modelling from senior staff within the wider hospital. Its uptake will be enhanced through local stakeholder engagement- for example, through well-being groups and networks.
Staff to consider their own well-being, but also normalises well-being conversations by opening up discussion(s) of well-being amongst staff.
What is the way forward?
What the authors want the toolkit to be
- A collective and significant step in prioritising PCC staff well-being.
- A motivator providing support and guidance, inviting staff to explore its resources, engage with peers, and start on their personal and team well-being journeys.
The PCCS Wellbeing Toolkit can be used to:
- Raise awareness for the PCCS Wellbeing Toolkit around the country. It is available to all on the PCCS website, with no membership required.
- Encourage implementation of the PCCS Wellbeing Toolkit in non-PICU settings where wellbeing is a priority for example, professional bodies, ward settings, adult healthcare environments
- The eventual aim is for wellbeing to become an audit marker of a PICU’s quality, therefore motivating senior staff and managers to prioritise wellbeing consistently
