The introduction of a voluntary role within the ward environment.

Recognising a long history of volunteering within the NHS and the potential to develop this to further enhance patient care, the befriending role of Ward Volunteer was devised. The aim was to provide added value to improve patients’ experience in hospital whilst relieving nursing staff of some of their lighter, non-clinical duties - spending time in general conversation with patients, for example, or assisting with the provision of hot and cold drinks, providing a reading and writing service, assisting at mealtimes, running errands to the hospital newspaper stand and shop.

Working within a large acute NHS hospital with a diverse workforce supported by a number of trade unions and a myriad of professional bodies, it was important to set up a project team to represent all views. This team included representatives from the voluntary sector, human resources, finance, nurse management, corporate services, Unison and RCN. The Unison and RCN members were able to refer issues for further clarification back to the Joint Staff Committee as required. The project team was tasked with designing and approving the outline of duties that would define the Ward Volunteer role along with determining the boundaries of the role to protect the work of paid employees and ensure that the volunteer was complementing but never replacing the work of employees. A comprehensive volunteer policy would also follow at a later date.

After a successful three month pilot and independent evaluation a dedicated volunteer manager was appointed to develop and expand the new ward volunteer scheme throughout the acute hospital and into surrounding community hospitals. At this time it became apparent that whilst the staff side representatives and nurse management had been involved from the outset and were ‘on board’ with the project; dissemination of information regarding the project and awareness raising amongst frontline ward staff had been much slower. A lack of understanding (amongst some, not all, ward staff) regarding the reasons that motivate people to volunteer within the NHS, and more importantly regarding the simple ‘added value’ of this well defined role, had contributed to an initial high volunteer turnover. This was a risk to the sustainability of the scheme.

Ward Volunteers were seen by some as ‘mugs’ for doing their role unpaid. Some felt undervalued or ignored at times: ‘Some of the non-nursing staff felt I intruded upon their domain and at times were abusive and rude to me.’

‘Most of the staff appreciate me and acknowledge me but there is a small minority of staff who do not even acknowledge me even though I am there almost every week.’ from ‘Part of the Team’ (see Appendix )

The new volunteer manager spent time on the wards, meeting nursing staff, porters, domestic assistants and health care support workers listening to their views and discussing any concerns about volunteering. In preparation for new volunteers commencing on wards, time was also spent with managers discussing how they would pave the way for volunteers to be introduced; the reasons why they were being introduced and the potential benefits to patients, staff, the organisation and the volunteers themselves.

Any issues raised, new tasks identified or risk assessments required were referred back to the multidisciplinary project team for discussion and reference to the original core values of added value and enhancement of patient care. Any volunteer digression over the role boundaries was met with a swift response to re-train and raise awareness amongst the volunteers and time was given to advise and reassure staff members involved. A volunteers ‘can/cannot’ sheet available on every ward helped staff understand the volunteer role boundaries.

Ward volunteers were empowered through their own training programme to say ‘no’ when asked by staff to perform duties clearly outside of their role description eg. feeding patients and chaperoning patients (both are trained nursing tasks).

A presentation on the Health Board’s staff induction training about volunteering entitled ‘Our Volunteers’ and inclusion in the Bank Nurse handbook greatly assisted in raising the profile of the ward volunteers amongst staff.

With time, dedication and some ‘staying power’ from the early ward volunteers the benefits of involving trained volunteers at the patients’ bedsides became quite apparent. Ward staff were also able to spend more quality time of their own at the bedside and patients greatly appreciated the assistance and social contact of the volunteers. This was evidenced by a volunteering impact assessment, entitled ‘Part of the Team’, conducted jointly between the Health Board and WCVA (see Appendix 1).

Six years on and a number of staff within the hospitals commenced their NHS careers as ward volunteers and amongst the current team of volunteers are members of staff volunteering off duty and many relatives of staff members.

When new volunteer roles are devised by staff, they complete a ‘Volunteer Wish List’ encouraging them to consider a meaningful, rewarding role that benefits all stakeholders. The wish list carries the proviso that volunteers undertake tasks that are purely added value; that compliment the work of paid staff and that do not form part of a vacant or temporary post.

Today a frequent comment heard from ward staff is “when can we have more volunteers?” The ward volunteers themselves are known to attend ward nights out and Christmas events etc. They are missed when they cannot attend a shift (see extracts from ‘Part of the Team’ Appendix 1). The profile of volunteering within the organisation has been raised significantly and a mutual respect exists between staff and volunteers. A minority of staff are still not totally ‘on board’ with the involvement of volunteers within their working environment but they are a small minority and the overwhelming majority support and welcome their involvement. The scheme has been awarded the quality standard Investing in Volunteers.

Betsi Cadwaladr University Health Board

N Wales.

November 2010

Appendix 1

Extracts from ‘Part of the Team’. An impact assessment of the Ward Volunteers (Robins) scheme for the North Wales NHS Trust (Central) now Betsi Cadwaladr University Health Board.

Staff responses:

Part of the team, a great asset

Gives staff more time to provide patient care, takes some of the pressure off staff

They (volunteers) enable staff to complete other jobs; volunteers giving out breakfasts, paid staff feeding patients

They add a cheery attitude to wards when staff morale is low

The Ward Volunteers are so helpful, kind and considerate. They always have time to say hello to staff and visitors

Patient responses:

Like a breath of fresh air; merry and bright; a blessing

Worth their weight in gold

Made life much easier

Volunteer responses:

After my working life I feel part of a team again ……it gives me a sense of ‘being needed’ and I feel I would be missed if I wasn’t there.

Volunteering and working as a Robin made me feel valued and fulfilled…after retiring it filled a gap

Having retired, to find that you are needed and could be part of a team has helped tremendously and I look forward to my time on the ward each week.

WCVA/Wales TUC Charter. Case Study. 2011