A day in the life of Annette Greenwood, Trauma Response Lead

Annette has worked for St Andrew's for 12 years, and before joining our charity she spent over 25 years with the NHS. She is currently the Chair of the Crisis, Disaster & Trauma (CDT) section of the British Psychological Society (BPS). Here she shares a little about her role at St Andrew’s, and what she is most proud of....

What did you do before joining St Andrew's?

I joined St Andrew’s in 2009, and before that I worked for the NHS for 25 years. I spent over 15 years as a consultant on a neonatal unit; I wrote protocols for end of life care for very poorly babies and supported both staff and parents.  My main role in the NHS was to respond to national serious incidents, and I worked on well-known cases including Beverley Allitt (a nurse who was convicted of murdering four children), the Alder Hey organs scandal and the Madeleine McCann case among others. While working for the NHS, the Royal College of Nursing (RCN) commissioned me to write the Counselling for Staff in Health Service Settings: A Guide for Employers and Managers. I have always have a passion to support nurses and doctors, and wanting them to have professional support when needed.

Why did you move on to St Andrew’s?

I was asked to apply to St Andrew's by one of the psychiatrists at the Charity who knew of my work. Twelve years on, I still wake up every morning excited about my job and wondering what the day will bring. I was originally worried about moving to St Andrew’s as I was well-known in the NHS, but since I came here I have had great opportunities to further develop my career.  In 2011/2012 I was commissioned by the EU to jointly write psychosocial guidelines for debriefing (working in both Berlin and Madrid).  More recently, the Flemish Clinical Psychology Association asked for my expert opinion on the competencies psychologists need to train in trauma support. Sharing knowledge is important to me as it enables understanding and learning.

What qualifications do you need to do our job?

I am a Health and Care Professions Council (HCPC) registered consultant counselling psychologist and have four-psychology degrees.  In my role you have to be able to understand how trauma impacts our staff, and how to help stabilise and normalise their experience of trauma.  Supporting traumatised staff starts after the incident, and includes how managers respond to the injured/threatened – they can have a real impact. Keeping in contact, being supportive and compassionate enables the recovery and helps staff return to work.  It also stops any secondary trauma caused by lack of contact and support.

Describe an average day at St Andrew's…

I cover all three of our hospital sites - Northampton, Birmingham and Essex, so I have to be flexible as you never know what will happen! There's no average day and I do not always know what I will be working on. For example, last year when Covid hit my referrals went through the roof. We lost a number of patients and staff in a short period.  It is extremely difficult to speak on the telephone to relatives following the death of a loved one, especially when that person worked at the charity.

How is your work at St Andrew's different to the NHS?

I have always worked in trauma, but the main difference is that at St Andrew's, trauma is sadly not a one off. I have worked on national serious incidents, which were one-off events. What happens here is staff have to go back to work on the wards after experiencing racist, physical, or verbal abuse or violent assault. This makes it so much more difficult for them and a challenge for their team and myself.

I spent a lot of time when I first joined St Andrew's going round and asking what staff needed from a trauma service. The staff asked for something confidential and responsive to staff needs, and I feel we deliver this. I get emails through the night telling me what has been happening on the wards; managers may contact me for advice, and referrals are a big chunk of my job. I also speak to members of the CEC as needed. To be successful and thrive in trauma you need a good manager and executive team, and I am glad they have my back, and I have their support.

When I first joined the Charity, I was informed patients had a mental health diagnosis and their experiences of life trauma was not so well understood. In the last 3-4 years, trauma informed care is an important part of what we stand for, and I am very proud of that. Interest in the impact of trauma is growing in healthcare settings. The research work of Deborah Morris, Emily Fox and the team has started this process. Understanding the traumas our patients have experienced in their lives has a massive impact on how we formulate their care, and how we educate the staff who are providing that care.

What are you most proud of?

I had an idea about four years ago to bring Compassion Focussed Staff Support (CFSS) training as a form of personal development for our staff. Following a pilot, we are now rolling out this training across the charity.  It has received great feedback. The antidote to trauma is compassion; for example, if a nurse who is traumatised at work (perhaps assaulted by a patient), not only do they have to deal with the trauma of the injury, the may also feel quilt and shame at not being at work and not be able to support their team to care for the patients. The CFSS model helps individuals and teams learn more about their own reactions to threat and trauma, and to be more compassionate to themselves. 

How do you relax and switch off from work?

To unwind I indulge in my big passion of motorcycling. Every year (Covid-permitting!) I go to Europe along mountain passes and to Sardinia on a motorbike with a load of mates.  I look forward to my holidays and to have time with my partner and dog. It is no good saying “I wish I had…” - this is not a rehearsal. Having fun adventures is important, as it balances out my day job!

Any last message for our staff?

Every single person at St Andrew’s will be impacted by the patients in our care, whatever their role - from reception to cleaning, to grounds to security, nurses, doctors and the Exec.  Because of this, everyone is open to trauma, and therefore please make sure you take very good care of yourselves.  Moreover, if needed my door is always open.