Connecting, learning and reflecting through COVID-19 – Catherine Middleton

Catherine Middleton


One of my first memories of mental health was an older lady who was a friend of my family, and we heard the news that she had passed away. On exploring the cause, I was told that this lady “just never recovered.” I felt sad and I thought, “What could have helped her?” This question still resonates with me to this day. For this reason, I pursued mental health nursing and this is where I am today.

I am now qualified five years and I am based in Holywell Hospital in Carrick 4, a rehabilitation ward. Rehabilitation carries the ethos of recovery, meaning people can recover from the functional deficits of a serious mental illness. Rehabilitation is “a whole systems approach…that maximises an individual’s quality of life and social inclusion by encouraging their skills, promoting independence and autonomy…to give them hope for the future and leads to successful community living.” (Joint Commissioning Panel for Mental Health).

I am driven and inspired by the fact that I can help empower people to live satisfying and meaningful lives. The recovery process is supported by a ‘strengths encouraged, weaknesses supported’ process with the drive to instil hope and insight, while empowering people to take control over their decisions to optimise every opportunity to live rather than to exist in the community.

I was nominated for the Nightingale Challenge because I am passionate about rehabilitation and recovery. I strive for quality improvement and love to seek out new ideas to add to what we do. I want people to live their best lives. Let’s empower people to live, let’s be the voice that promotes living, and let’s be the voice that says ‘I’m listening!

When I was nominated for the Northern Nightingale Programme I thought, ‘Oh they are going to teach me how to become a leader!’ But in fact, this programme has challenged me to become more self-aware and reflect on my own leadership style and skills. There is a leader already within me, but the Nightingale Challenge programme will give me the tools and knowledge to develop that by connecting with and observing other leaders. It has given me confidence to raise my voice to ask questions, to discuss ideas and to ultimately understand what rehabilitation and recovery is and the resonating question ‘what can we do to help?’

2020 The Year of the Nurse and the Midwife looked set to be an exciting year and I was really looking forward to the Northern Trust Nightingale Challenge Programme of Events. One of the first events I attended was the Northern Nightingale’s Collective Leadership Workshop, where leadership was presented in an exciting and in an invigorating, person centred way. Then we attended a ‘Disaster Day’ at the Ulster University and this event put you as a leader into the midst of a disaster. It was frightening being in the midst of a scenario where there were distractions, critical decisions to be made while directing and managing colleagues in a scenario that was unfamiliar. On reflection, I thought about the unfamiliar world that I stepped into and yes it was frightening. Relating this to our service users who stepped inside a mental health building for treatment to be told there is a pandemic and the outside world has changed. This creates an understanding of the uncertainty of unfamiliarity.

When COVID19 struck, I quickly learnt like all of us, that the world around us had changed. The pandemic showed me what I was missing all the time, right in front me, that things can and often do go ‘not as planned’ for us all.

For a person whose mental health is already challenged, processing the news and hearing of new restrictions in place, it felt like a huge blow to their rehabilitation and recovery programme. Staff gowned in masks and other protective clothing, visiting was restricted and programmes halted. When I think back on it now, it sounds like a Hollywood movie.

When some of the building blocks for Rehabilitation and Recovery began to fall, I saw opportunities to connect and to link in with other services. Firstly however, I connected with the service users by chairing weekly patient meetings, providing a space and opportunities for service users to be informed and to ask questions about the ever changing government and hospital policies in relation to COVID19. Through connecting and liaising with dual diagnosis and the recovery college, we continued to follow the ethos of recovery and of hope for the future. I identified and engaged with other professionals who had the shared vision that we can still achieve success and could normalise, educate and support adaption on the ‘new normal.’ As for reflection, I thought I was going to learn how to lead at the beginning of this programme, to now realizing how I did lead without being taught.

Thankfully, Covid-19 did not stop the Northern Trust Nightingale Challenge Programme! We certainly had a brief pause, but our Assistant Director Elizabeth Graham and Trust Lead Orla Mathews and the Northern Nightingales themselves were really keen to continue and stay connected. Thanks to technology, we were able to continue our events via zoom and it was good. We stayed connected and used zoom as our platform to discuss how Covid has impacted us in our workplace. We used zoom for a bespoke Schwartz Round – this proved to be an exceptional way to release issues that we found personal to us. It was a ‘beautiful release’ of emotions in a controlled environment where we related to each other, empathized with each other and connected. I’m also really looking forward to the Northern Nightingale bespoke IQI Level 2 training in October. Quality Improvement is a passion of mine, and I have so many ideas to explore and develop so it’s fantastic that our Trust’s strong support of Quality Improvement, our IQI Lead Gill Smith and through the Nightingale Challenge programme, that I am able to learn more about this this and put it into practice.

Sometimes it is the ‘little things in life’ that we overlook and underestimate, as we want measured outcomes. Through COVID19, I have learnt that ‘little things’ means everything! I was having the same conversations with friends that service users were having with me. Compassion is key, listening, understanding and getting through each day, keeping hope high in our spirits, keeping family contact albeit via zoom or a phone call was priority.

If I really expose my true pre COVID19 self, I can say that I was driven by outcomes, and as long as all the boxes were ticked and indicators met, then I felt as if we were winning. Rehabilitation and Recovery is much more than this. It is holistic, it may be slow some days and it will have ups and downs. We may go off track, but we need to strive and work towards, never looking back.

Being part of the Nightingale Challenge during an unprecedented year has helped me to fulfil my potential of leadership and learn from my experiences. I hope I influenced and ignited a vision for the service users that when things don’t go as planned, to connect with someone who can help support them. I also hope through engaging with the nursing and the wider multi-disciplinary team through COVID 19, that we can use the positives to improve how we continue working in the future.

Catherine Middleton, Rehabilitation in Mental Health, Holywell Hospital, Antrim

Catherine is one of the Northern Trust nurses and midwives taking part in the Nightingale Challenge launched by Nursing Now – a programme of the Burdett Trust for Nursing to improve health globally in collaboration with the International Council of Nursing and the World Health Organisation.  The campaign encourages healthcare employers to support at least 20 nurses and midwives to develop their leadership skills during the 2020 International Year of the Nurse and Midwife.

@nhsctrust #NorthernNightingales
@NursingNow2020 #NursingNowNI #NightingaleChallenge

Other Northern Trust Nightingale Blogs

Gemma McClean, Hospital Diversion Nursing Sister
Judith Shevlin, Community Mental Health Nurse
Denise O’Donnell, Acting Ward Manager, Covid-19 assessment ward
Eleni McCrea, Community Midwife, Whiteabbey Hospital
Stacey Barclay, Midwife, C2, Antrim Area Hospital
Vanessa Best, Community Mental Health Nurse, Oakview House
Kirsty Wallace, Staff Nurse, Antrim Area Hospital
Christine Beare, Staff Nurse, Neonatal, Antrim Area Hospital
Laura Smith, Midwife, Causeway Hospital, Coleraine
Mandy Young, Deputy Sister, Laurel House Chemotherapy Unit, Antrim
Nerell Browne, Practice Development Nurse, REaCH Team, Northern Trust
Chantelle Crowe, Deputy Ward Manager, Causeway Hospital
Michelle Angelone, Community Learning Disability Nurse

Northern Nightingales

2020 International Year of the Nurse and the Midwife logo

16th September 2020

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