From stress to support: an ethnographic journey of a staff-led wellbeing intervention in maternity services

Addressing occupational distress in maternal services is imperative to ensuring staff retention and patient safety. Interventions to promote wellbeing among healthcare staff are urgently needed. However, little is known about the implementation of such interventions in hospital maternity services. This study aimed to explore the workplace demands and stressors experienced by healthcare staff in hospital maternity services and identify how these demands and stressors affect engagement in workplace wellbeing activities.

This qualitative study employed an ethnographic approach in maternity services in regional Australia. Data were collected through observations over a 12-week period before and during the implementation of a wellbeing program called SEED. Participants included healthcare staff and leaders employed in maternity services. Key themes and insights from the observational data were identified through reflexive thematic analysis. The study followed COREQ guidelines to report key aspects of the research team, methods, context, findings, and analysis.

Six themes were identified, depicting both the challenges and opportunities for implementing workplace wellbeing activities in maternity services. The first three themes highlighted pre-existing challenges that affected staff engagement in wellbeing activities: (1) Disconnection Across the Service; (2) Balancing Role Expectations and Wellbeing at Work; and (3) Leaders Trusting in Wellbeing but Staff not Trusting in Leaders. The subsequent three themes described opportunities for engagement: (4) Staff are the Experts of Their Own Wellbeing and Work Environment; (5) Fostering Connection through Conversations; and (6) Cultivating Camaraderie within the Service.

By identifying challenges such as disconnection and lack of trust, alongside opportunities like collaboration and camaraderie, the findings provide actionable insights for designing effective wellbeing activities. Gaining leaders' trust and commitment, followed by engaging staff in collaborative decision-making, is crucial for successful implementation. This research contributes to the global clinical community by providing a nuanced understanding of workplace wellbeing implementation in maternity services, offering a blueprint for similar interventions in healthcare settings worldwide.