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NT Workforce Summit: Matron urges leaders to tackle 'dangerous silos' in nursing teams

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An award-winning critical care matron has said hospital leaders need to ensure nurses feel welcomed when joining a new team to avoid “dangerous silos” forming in departments.

Gillan Belfon-Johnson was named the Nursing Times Nurse Leader of the Year in 2017 for her success in breaking down cultural barriers to create a cohesive team out of nursing staff from 38 countries at North Middlesex University Hospital’s critical care unit.

“I don’t want to feel I have accomplished because I would stop trying”

Gillan Belfon-Johnson

Ms Belfon-Johnson shared her story and some words of advice with delegates at the first Nursing Times Workforce Summit on 4 October.

She said: “I started working in North Middlesex Hospital in 2015 and I found a very diverse team of nurses which I though was really, really exciting to see because it reflected the community and because of that I felt that if we can speak the language of the community we can support the community.

“In the first six months I found that diversity within my unit did not work – there wasn’t a blend, there wasn’t a team spirit as such and that really worried me because it directly affected the care that we gave patients,” she told delegates.

“It directly affected the support we gave to families, the quality of care, the wellbeing of staff and the retention of staff, and it was really sad for me to see,” said Ms Belfon-Johnson, who also spoke to Nursing Times last year in the wake of her award win.

Speaking at the conference last week, she said the trust did a mass recruitment drive from India, the Philippines and Africa in the early 2000s.

She said the problem occurred when the staff were inducted to the department because they did not feel welcomed by the existing employees.

As a result, nurses ended up splitting in different cliques according to their nationality, religion or culture, said Ms Belfon-Johnson.

“For me I could not allow that to continue, I had to change that immediately,” she said. “I felt it was my responsibility to do it.”

Trinidad-born Ms Belfon-Johnson said she had to use her own ingenuity in trying to address the problem, because she could find no policies or guidance to go on.

“For me I could not allow that to continue, I had to change that immediately”

Gillan Belfon-Johnson

Her action plan included setting up staff study days for the nurses to interact, putting up a sign at the entrance to the unit featuring a flag from the home countries of all staff members and running “diversity days” where the nurses brought a traditional dish from their homeland for others to enjoy.

Ms Belfon-Johnson said once the staff got to know and understand each other and began working as an inclusive team, performance and patient care in the unit improved.

For example, patient discharge sped up and infection control enhanced because staff were able to communicate with and support each other in a way they didn’t previously, she said.

During a question and answer session after her presentation, Ms Belfon-Johnson said this problem was not unique to North Middlesex, adding that she had seen similar silo working in other hospitals.

She stressed the importance of ensuring new staff members joining a unit felt included from the word go. 

“I think we spend a lot of time trying to fill our vacancies and we get excited when we get recruits to come in, but we also need to pay attention to how we prepare our current workforce to support the staff coming in and I think that’s where a lot of hospitals have it wrong,” Ms Belfon-Johnson said.

“We fill our vacancies but I don’t think the staff on the ground embrace the new staff coming in in the same way the managers do,” she said. “That’s something we need to look at when we recruit new staff – that they feel welcomed – because if we don’t we will continue to have these silos in our departments and it’s dangerous.”

“In the first six months I found that diversity within my unit did not work”

Gillan Belfon-Johnson

Asked by a delegate whether any staff members had tried to sabotage her project, Ms Belfon-Johnson said she found that issue difficult to speak about but admitted there was a small group that did not welcome the change.

She said: “In changing the culture I was quite excited because I could see the positive side and the difference it would make to patients, staff and relatives but what I did not see was by changing the culture you are taking away status from some staff members.”

Ms Belfon-Johnson said she persevered regardless and those staff members ended up leaving the unit.

She added that her work was not over and she was hoping to build on her successes so far.

There are currently no white nurses working on the unit and Ms Belfon-Johnson said she was going to see what could be done to encourage staff from these backgrounds to join.

Ms Belfon-Johnson said there was also a “huge” Turkish population in the area but this was not reflected in the workforce.

“I don’t want to feel I have accomplished because I would stop trying, so I think it’s still a working in progress,” she added.

More from the Nursing Times Workforce Summit and Awards:

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Readers' comments (1)

  • what in hell does she mean, "silos?" A silo is a storage tower used for holding a product before sale or use in industrial processing, or a storage bay for nuclear ballistic missiles. If anyone knows, please explain.

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