Experiences of delivering Schwartz rounds

What are Schwartz rounds?

Schwartz rounds provide a structured forum where all staff, clinical and non-clinical, come together monthly (sessions attended are optional) to discuss the emotional and social aspects of working in healthcare. The main idea is that compassion is shown by staff which consequently improves patient care, but for staff to deliver compassionate care they must feel supported in their work too.

It was named after a gentleman called Kenneth Schwartz, an attorney. He had lung cancer and was impressed by the compassionate care he received so wanted to leave a legacy around compassion. He asked staff what would help them, and they came up with this reflective event. In 2009, Schwartz rounds were brought to the UK by the point of care programme at the King's Fund and continue to be implemented by the Point of Care Foundation. 

Background

During the pandemic we were trained by the trust and delivered sessions called 'team times' as they were done monthly via Microsoft teams, mainly due to Covid restrictions. However, since we have come back to interacting in person, we have been trained to deliver these sessions in person, these are called Schwartz rounds.

The set up generally includes: Two facilitators (the lead and co-facilitator) and up to three storytellers, who will tell their story for about 5 minutes based on the topic that has been set for the session - examples can include work / life balance, being a carer as well as a professional, trainee doctors' experiences and so on. Sessions are completed within an hour, and the storytellers and facilitators sit at the front of the room like a panel. The audience are the remainder of staff within the trust who are all invited to attend the session.  

Aims and obstacles encountered

The idea behind these sessions is for storytellers to share their experiences on the agreed topic set for that session, and for the audience to reflect on their experiences and not problem solve any issues that may be apparent. This part can at times be overlooked, with professionals feeling the urge to suggest solutions or ways to manage the storyteller's situation as opposed to sit with what's being shared.

It's a skill which can be developed over the course of time, and some are more exposed to it via their professional background and or personal lives compared to others. Having a variety of professionals present in the room where their professional training and / or their cultural background may contribute to their understanding of the intent of such sessions, can sometimes be difficult to manage from a facilitator perspective. 

For example, at a junior doctor's experiences session, senior clinicians as well as empathising with the stories shared were also trying to offer, or at least explore potentially helpful solutions, which is not the remit of these sessions as mentioned earlier. These were helpful ideas / solutions, but this setting wasn't the right place for them. So, trying to manage their expectations and bring them back to reflecting on the stories shared can be challenging for the facilitators at times. 

In summary, as the facilitator, the main obstacle I have experienced so far is when certain staff can step into problem solving mode as mentioned earlier. This can be difficult to manage at times as it's important to validate the staff members' contribution but also to reinforce the aim of these sessions too.

Powerful to reflect together

However, I have enjoyed these sessions so far, especially when observing how powerful the session can be in the room with both the storytellers and the audience reflecting together on their experiences of the chosen topic.

As a facilitator, drawing on themes from the reflections shared can be helpful in reinforcing the strength of what's been shared in the room. It brings staff of all personal and professional backgrounds together in a beautiful and collaborative way. These sessions are there as a source of staff support and their popularity and attendance has gradually increased over time, so they have slowly become an integral part of staff wellbeing within the trust.  

 

Author biography

Dr Sindeep Lehl is a principal counselling psychologist, working within the NHS. She specialises in physical health, especially in cancer & palliative care as well as obesity, and is a member of the BPS, BABCP, SIGOPAC and the EMDR academy. 

Twitter / X @Sindeep1