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Published 28 December 2018

Thrive: accentuating the positive in the emergency department

Wordmap of words and phrases from the discovery phase; experiences of thriving in the emergency department (Picture: provided)

This doctoral research explores staff wellbeing within an acute medical context. Appreciative inquiry is used to discover the moments of thriving that already exist and to find ways to accentuate, value and promote thriving in the workplace.

The Emergency Department is a melting pot of almost every aspect of humanity. It can be a place of pain, disease, despair, and death. It can be a place of overloaded systems where increasing patient numbers and need can overwhelm available staffing, technological and physical resources. Much of this overshadows other truths about the Emergency Department – that it is also a place of care, compassion, and excellence where many acts of kindness and genuine heroism occur every day. It can be a place of deeply meaningful connection, of achievement and joy in learning and teaching. These positive aspects align with what wellbeing research and philosophy consider living a life beyond merely surviving, one of thriving.

This research project is one of exploring and accentuating the positive aspects within the Emergency Department, to discover, nurture, and value thriving now and into the future. A process called appreciative inquiry, utilising four stages to draw out the best of a system, has been used to incorporate these discoveries into dreams for the future, to design practical and realistic ways of reaching these dreams and to embed these designs within the system. Data were gathered in interviews and workshops that involved many members of the Emergency Department staff, including myself. A hermeneutic phenomenological approach to this data enabled a deeper understanding of our way of thriving, coming to know our ‘being’ as well as our ‘doing’. Eight themes of thriving emerged from our stories. These themes and the dreams they inspired were used to develop recommendations for the department. These included actions to promote thriving and to embed its consideration into ‘the way we do things around here’.

A framework of thriving was developed as a tool to value the often immeasurable aspects of our job that promote thriving. The benefits of thriving, the upward spiral of positive wellbeing, impact almost every aspect of our lives. This enables our own lives to be happier, healthier and more satisfying, as well as better outcomes in terms of the care we give our patients and the efficiency and effectiveness of our healthcare systems. We all reciprocally influence our own and one another’s wellbeing; with effort and awareness perhaps we can do this in a positive way for the benefit of all.

Additional information: Thrive: accentuating the positive in the emergency department