When this work hurts

We have the privilege of sitting beside so many professionals – doctors, nurses, psychologists, AHPs, as they wrestle with the pain inherent in neonatal care. A place of birth, death, and everything in between. Where increasingly vulnerable infants are met every day with the kind of clinical skill and passion and care that most of us have never dreamt was necessary, or possible.

As with much of the NHS, there is so much that looks clear and obvious on the surface – ‘do no harm’, ‘evidence based practice’, ‘be kind (or at least civil)’.

But underneath those messages is often a cloudy, swirling pool of unspoken pain. Of unmet needs and expectations – for babies, from parents, of each other. Of values that are constantly in conflict – what do ‘best outcomes’ look like for this baby and family when prognosis is so unclear? What does ‘evidence based’ mean when two clinicians have heartfelt, values-driven differences on the right course of action? How do we navigate kindness or even civility when every nerve in my body is tired and on edge and there is conflict at every turn?

The challenges in the neonatal and perinatal system have never been greater. Trials, inquiries, and the court of public opinion are regularly animated in telling us what matters, what we need to do, how we need to be. But babies are sicker, resources are stretched, families are frightened and mistrustful. Our teams our tired, conflicted, and often scared. Our leaders are worn thin by the demands of keeping systems safe and holding everyone in them.

And the consequences? We see tears, anger, fear, disappointment, sickness, and the urge to escape. ‘This isn’t how it’s meant to be’.

As clinical psychologists, we wrestle with what can feel like two conflicting positions:

• This is not a failure of individuals. The levels of threat in the system make it impossible not to feel. There is no one more resilient than an NHS clinician.

• And yet, the system is in crisis – and change is hard to come by. How do we support individuals and teams to stay afloat in the swirling pool, help them keep turning towards what is hard and to each other?

‘Wellbeing’ in this context can feel like a vacuous concept that misses the point. Despite the joy and meaning in this work, pain is an integral part of it. Staying ‘well’ is often about making space for the pain and finding ways to ride the current, rather than seeking a mythical state of ‘balance’ where the waters remain calm. It’s about community, and about connection with others, with meaning, and with our own needs.

We know you might be sceptical about psychology. We’re an odd bunch, who relish the messy bits and want to shine a light on feelings rather than turn them off. But believe it or not, we’re humans too, swirling in the same pool. And in our work at The Relational Practice we want to create spaces where you can feel safe, make sense of what’s hard, re-connect with purpose and find ways to keep swimming. If you want a taster of that work please do join us for our webinar series in the autumn.

Thanks for reading!