Emotional support for embedded knowledge specialists working in clinical settings: Policy recommendations to NHS employers

Approved by the Health Education England Knowledge for Healthcare Board on the 14 December 2020.

Increasingly, NHS organisations are deploying knowledge specialists within clinical settings to bring evidence to bear in the ward, and in primary and community care, which aligns to our vision of Knowledge for Healthcare.

Health Education England’s (HEE's) (2020) recommendations to take incremental steps to improve the staff ratio between qualified librarians and knowledge managers per member of the NHS workforce identifies the need for more clinical librarian roles to drive improvements in both the quality of care and productivity. (NHS Knowledge and Library Services in England)

Rationale

Our expectation is that the number of embedded roles for knowledge specialists will grow. Therefore, it is timely for NHS organisations to review and put in place appropriate mechanisms for psychological support for this specialist workforce to ensure their health and wellbeing.

Librarians working in clinical settings report that some situations they witness are distressing. It is a challenge for them to know who to approach to talk about what they have encountered. They report that inclusion in team debriefs within the clinical department is rare but helpful.

The benefits of team debriefing [*] and clinical supervision are well understood as support mechanisms to aid reflection and provide a confidential space to discuss work, with a focus on improving practice and patient care. (Bifarin and Stonehouse) Debriefing in the clinical environment enables a whole team perspective, supporting both personal and professional needs. (Clark and McLean)

A case study of a Schwartz Round for Clinical Librarians illustrates that the emotional impact of working with patients should not be overlooked for embedded knowledge and library specialists and similar arrangements should be made as those already established for clinical colleagues. (William, White, and Burgess)

References

Health Education England (2015). 'Knowledge for healthcare: a development framework for NHS library and knowledge services'. [online] Available at: https://www.hee.nhs.uk/sites/default/files/documents/Knowledge_for_healthcare_a_development_framework_2014.pdf

NHS Knowledge and Library Services in England (2020). 'Recommendations to improve the staff ratio for the number of qualified library and knowledge specialists per member of NHS workforce'. Available at: https://www.hee.nhs.uk/sites/default/files/documents/HEE%20LKS%20Staff%20Ratio%20Policy%20January%202020.pdf

Bifarin, O and Stonehouse, D (2017). 'Clinical supervision: an important part of every nurse’s practice'. British Journal of Nursing, Volume 26, Issue 6, pages 331 to 335. Available at: https://doi.org/10.12968/bjon.2017.26.6.331

Clark, R and McLean, C (2018). 'The professional and personal debriefing needs of ward based nurses after involvement in a cardiac arrest: An explorative qualitative pilot study'. Intensive & critical care nursing, [online] Volume 47, pages 78 to 84. Available at: https://doi.org/10.1016/j.iccn.2018.03.009

Williams, H, White, J and Burgess, S (2018). 'A Schwartz Round for Clinical Librarians – a case study'. Journal of European Association for Health Information and Libraries, [online] Volume 14, pages 9 to 11. Available at: http://ojs.eahil.eu/ojs/index.php/JEAHIL/article/view/237/231/ 

[*] Medical team debriefing, distinct from individual psychological debriefing of stress casualties.