By Carolyn Fox (Director of Nursing, Midwifery and Patient Services at Northampton General Hospital)
and Natalie Green (Associate Director of Nursing and DAISY Lead, Northampton General Hospital)

Compassion in nursing - I recall vividly discovering the TED talk in which Yvonne Sawbridge talks about compassion in nursing and emotional labour. I remember sitting transfixed on my sofa as almost every word resonated with me not only as a nurse but also as a Nurse Director.

A few months earlier I had cemented my commitment to recognising and celebrating nursing and midwifery in our Nursing and Midwifery Strategy. Yet, in the blink of an eye or the time it takes to watch a TED Talk the significance of our plans to launch the DAISY Award for nurses and midwives here at Northampton General Hospital (NGH) were remarkably clear. Not only would this international recognition scheme celebrate great practice but it would “top up the emotional bank accounts” of our nursing and midwifery workforce. Now it would be fair to say that Yvonne had the same impact on my nurses and midwives as she had on me when she presented “the emotional labour of nursing” at our conference in June 2017. You could not hear a pin drop, they were spell bound. What a great platform to launch the DAISY Award from and not many dry eyes in the house when the Barnes family talked about Patrick’s death and the overwhelming desire to say thank you to not only the nurses who cared for him but to say thank you to nurses and midwives all over the world. So the DAISY Award was born at NGH, and how did we hear about this international recognition scheme, well it all began in 2016.

2016 was the year when members of the senior nursing team attended a Pathway to Excellence® conference, which was where we first heard about the DAISY award. Immediately we knew we wanted to take this back to the UK with us because we believe that staff recognition is important to raise morale, increase positivity, improves team pride and working plus strategically it informs stakeholders externally that the organisation is one that values its staff, is a good place to work and thus aids recruitment and retention.

The timing wasn’t quite right at NGH in 2016 as a senior team we first needed to define the Nursing and Midwifery strategy from what the frontline teams told us they wanted in it. This being said one vital section was on ‘recognition’ and what better way of doing this – implement DAISY for year one of the new strategy.

DAISY has at its heart a concept that resonates with staff because the nomination comes from the patient and family themselves. Getting this recognition from the very people we are here for carries such importance. What we had perhaps not prepared ourselves for was the impact that the DAISY Award had on those receiving it, on those colleagues that the recipients work with every day and the families who return to present the award alongside me to say Thank You to their nurse or midwife. The DAISY Award is so much more than the honourees. We had a sense of this and it was put into words by one of our practice Development Nurses:

“I have to say being at one of the actual presentations was so moving. I loved that from a tragic event the family could display such positivity and praise. I am so proud to be part of a Trust which participates in this award. I must say it was heart rendering and moving and made me speechless and I didn’t even receive an award. Well I hope my comment has helped others now understand the power of these ceremonies and that they do boost morale. Thank you so much for honouring my friend and her amazing achievement.” (Ashley Gayton, PDN NGH)

What we found as a senior team was that the initial planning of how the DAISY award was going to be implemented and communicated was crucial. The British public are not renowned for overt displays of gratitude let alone putting into words why someone should be recognised for an award. We had to demonstrate that DAISY is about those ‘special’ staff who have gone ‘above and beyond’ in their compassionate care, we needed to inspire the patient and/or family to pick up a pen and tell their story.

With the assistance of the communication team we planned our campaign, utilising local media, social media, staff forums and the hospital intranet the message started to gain momentum. We commenced in the June 2017 with a target for the first celebration and launch in August 2017. Perhaps one surprise that we hadn’t anticipated was how it affected the other staff in the hospital – our Estates team loved the concept so much when we were talking about a DAISY cart to deliver the award they took our design and built it. On the day when we surprise the honouree with their award the Estates team are with us eager to put up the banner there and then. Our volunteers are DAISY champions when they are out and about they have the leaflets and wear the ‘ask me about DAISY’ badges with pride.

At NGH we designed our own DAISY campaign with motif, trifold nomination leaflets on the website and display boards. The display boards were placed in key strategic positions around the hospital – chosen because they have the highest footfall from the public. The senior team also decided upon the criteria by which the honourees would be selected. The nominations are collated via our PA and anonymised, the senior nursing team then select the honourees based on the hospitals values and against criteria we chose against an acronym of COMPASSION.

This is one of the best meetings that the senior team attend – such a feel good factor, reading how our nurses and midwives have made such a difference to the people they’ve cared for. It gives you that sense of humility, pride and ‘oh my goodness moment’ a reinforcement of why we became nurses and/or midwives. At NGH the awards are presented on a quarterly basis – 3 at a time (equivalent to one per month). Eventually and as the concept gains momentum this may be changed to every month but whilst the nominations are relatively low (the hospital in the US that our ADN visited receives an average of 230 per month). So far there have been 7 recipients at NGH of the DAISY award – on each occasion the positive effect, has been tangible on the staff member, the nominator, their team and the senior team. Yvonne Sawbridge’s work on topping up ‘your emotional bank account’ is never more evident than on these days. When the nominator’s story is read out to the honouree there is not a dry eye to be had.

“I received the Daisy award, after being nominated by a lady I looked after 12 months previous, who was admitted into A&E suffering from sepsis. I had been told about the Daisy award beforehand and knew it held such high esteem; however I never imagined I myself would have the honour of receiving one. When I heard about the award I remember being proud just at the thought of a patient remembering the care you gave, and this thought has been with me ever since.

I was completely humbled on receiving the award that I was able to make such a difference in this patient’s life. In what was, I can only imagine, an incredibly stressful time, I was able to make a positive difference and help her in more ways than medically managing her symptoms. Meeting her again was lovely, and it was great to have her alongside me when I was presented the award.

I was read a statement out, which the patient had written for the nomination, which is something which I will remember forever. Hearing such wonderful things about the care which I gave, and the members of the team I work with give on a daily basis give, is huge. It has given the whole department a lift and has really helped us to remember the impact we have on people, even on their worst days.” (Lucy Mann, Junior Sister in ED)

“It is safe to say that being nominated for the DAISY award was a total shock but at the same time an amazing surprise. The surprise element makes it all the more special especially when you realise your whole team knew all about it but you remain oblivious!

I had no clue what was going on and for the first time in my life was left speechless; when I saw the sea of lilac uniforms the whole of the practice development department and the photographer. I stood as I listened to Carolyn (DoN) read what the DAISY award was all about. As Carolyn read I glanced over and saw the family who had nominated me and then remembered exactly who I had cared for. I did not initially want to look at them as I felt myself tearing up but of course I did. I have never felt so proud to be a nurse as I did at that moment but at the same time, all that was in my mind was ‘this is what we do’.

If it was my friends or family I would want that person that takes a bit of time and shows a bit of compassion. I am glad I was able to make the process of dying a little easier for the family.

I will always treasure the award and wear the badge with pride.” (Fiona Fulthorpe, Senior Staff Nurse, Creaton Ward)

It will very soon be a year since we first launched DAISY to recognise the amazing, compassionate care our nurses and midwives deliver every day. The positive impact that it has has been recognised throughout the hospital and as such we have designed something along similar lines for other clinical and non-clinical staff that go ‘above and beyond’.