Table 1 Managers’ stories of helping employees manage stress at work

It’s more of a personal nature for this member of staff. She’s going through a very difficult break up of a marriage, got young children too … it’s all blown up and all … really struggling, really having difficulties with it. I’m going out to see her on a fairly regular basis – I’ve been out to see her today, actually. Going out, giving all the support I can, refer her to occupational health, refer her to staff support. It’s a really difficult one because I’m sitting there saying, ‘Yes, yes. I hear that you’re not ready to come back. Yes, I hear what you’re saying to me,’ but on the other side of that is the fact that there’s a service need. She had a caseload of patients that we’ve had to share out with other people now, not everybody wants to go to another therapist. Therapy’s quite individualised and quite thought-provoking, and you’re sharing your soul to the devil, so to speak, aren’t you? That’s how it feels. So that’s difficult because it’s that balance of I hear what you’re saying, you’re in a really horrible place, I can’t imagine anything worse for you, but on the other side of that, I’ve got to get you back into work somehow… I think I’ve had to draw on compassion. I think I’ve had to draw on knowing the policy, knowing what I can and cannot allow her to do. The return to work policy, the phased return, all of that, I’ve had to look on that. I think I’ve had to draw my own personal beliefs and my own personal values, really, and be able to stand up and say, ‘I hear what you’re asking as a Trust. I hear what you’re saying as a Trust but I’m the person that’s in there, I’m the person that’s dealing with this individual, you know, I’ll bring her in to fail and that’s how I feel at the moment. I think she’s too fragile, too vulnerable to come back in at this precise moment but I’m also aware that if I take that to a more senior manager they may say I hear what you’re saying but she needs to get back in. (Manager, M6)

I’ve got a member of staff who is still with me, who, last year was for some time, has been the main carer for her father, and whose become increasingly frail. Last year he was diagnosed with cancer, and was only given a couple of months to live. He subsequently lasted several more months than that. But, obviously, this caused her additional stress because it wasn’t only her work she had to juggle. She had to sort out carers to go in when she was in work, and also when she wasn’t in work … So she had a lot of stress around that … She also had a sister with learning disabilities who, although didn’t live with them, was sort of there in the background, and I think a lot of it was she was thinking how was she going to support her if anything happened to the father. So there were lots of stresses around that.

I think (managing stress) for her it was very much about thinking outside the box [manager describes how she introduced flexible working hours for this employee]. What is it that I could do as a manager to support her as much as I could, to prevent her going off sick, because she would’ve gone off sick… And we were able to prevent that. And I suppose a lot of it for me was being able to empathise with her; having gone through bereavement of a close family member myself. You can think what would’ve been good for me at that time. (Manager, M2)