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Now. Okay. So thank you for taking time to come and listen to and participate in this on demand session. My name's Michaela Nuttall and I'm a nurse would see three collaborating for health. Now see three. Collaborating for health is a charity whose mission is to help people to be able to live healthier lives and to be, to be able to prevent non communicable diseases. I'm joined today by Helen Helen. Do you want to say a little about you? Thank you Michaela. And yes. So I'm Helen Donovan and I'm another nurse associate working with C three and I've been working with Michaela on this uh specific project that we've been doing, which is called Winning Hearts and Minds. And this is a joint collaboration between C three and the Boudette Charity who've given us some funding towards this towards cardiovascular disease prevention, which is obviously one of the key drivers within see three as a non communicable, a non preventable uh non communicable disease, preventable disease. And what we know is that certainly for people with severe mental illness, they are significantly more likely. And now that a conservative estimate puts it at 40% of people with mental health problems will be smokers. And that is in comparison to 14% of the overall uh UK population. So, you know, people with mental health problems have got a significantly more likelihood of suffering from cardiovascular disease as well as other diseases that are triggered by smoking. So this project winning hearts and minds is about looking after your heart, but also working with people who've got mental health problems as well. So that's where the project comes from. And Michaela, we've been working, haven't we on a series of tools that we want to sort of really support people, particularly people working in men in mental health, mental health nurses and how they can support people to stop smoking. And I think one of the things for me is it's almost sort of part of the sort of culture, isn't it within mental health units for a lot of the time to be uh a smoking but smoking to support clients, this sort of therapeutic um part of the work to have a cigarette with the client. Uh Do you want to sort of expand on that tour, Michaela? Yeah, absolutely. So, thank you, Helen. So that actually came across a lot during the interviews that we did. So at the very beginning of this initiative, I spent some time talking to a variety of mental health nurses across the country really exploring around exactly that the attitudes and the perceptions and, and the current practice of what happens. And we, I, I saw a lot where people were saying that that conversation could help defuse the situation. It enabled a conversation to happen and you could say, come on, let's go outside for a smoke and it would just move everything a little bit easier. And I think that was a real insight and learning for me. It's been a long time as a, as a, as a non mental health nurse. It's been a long time since I've been on a mental health board. And, and certainly there was a lot of smoking back in my day. You know, that's in the early nineties, back in my day. But, but it, but it hasn't gone, it's still there. And I think there is a very big culture around smoking. Uh not so much on the wards anymore. Although we did hear that lots of nurses disagreed with the smoking ban. We saw that through the survey and the quiz that we ran and also through the focus for the interviews that some nurses absolutely disagree with it because of the extra pressure it was going to create. And actually allowing people to continue smoking on the walls was the lesser of two evils is the way it was, was being described to me. So I think that there is that really big culture, but Helen, I'm going to ask you a little something. Now we have a so people hopefully watching this and they think. Okay, that might be how it is now for me or we know that's what's there, what, what have we got for them that people can, can get involved with watching or participating in? What have we, what have we got? Well, so we've got a series of different resources that I think people can dip into to support them. And one of the, I've gone off. Can you still hear me? I can still hear and see you. Uh my screen went blank. Sorry about that. So we've got a series of different resources that are designed for people to sort of have these conversations and, and to know sort of what to do. And one of the things that triggered me when you were talking was the round table discussion. And so we were um you know, with some very sort of senior nurses working in mental health, but working in an area to sort of prevent tobacco use. And one of the things that they said that came through that round table discussion was, you know, we need other tools. If that's what our tool to diffuse situations, we've got the wrong tools. So that was, that was quite an insightful moment for me. I don't know about you, but what I'm going to just sort of list some of the things and then we can maybe talk about them. So we had the round table discussion and people can listen into that and just see what was said. We also realize that, you know, despite the fact that it's there on the packet of cigarettes that cigarettes will harm you. And these horrendous pictures, people are still, you know, almost reluctant to take any notice of that. So what we thought we would do is to do some a webinar which you yourself did Michaela and really interesting about what, what does a cigarette due to your body? Um, and that's quite, and that came out again in the roundtable. Um, Mary was talking about how having carbon monoxide meth meters, you know, you as a nurse, you take people's BP but actually recording people's carbon monoxide and actually showing people what it's doing. So I think that's quite useful and then the other thing was, well, okay, nicotine replacement, you know, all over the media, certainly in the last few months is where, you know, is there a danger, is it something that we should be doing? And I think Louise's webinar that she did was really good in sort of putting some of those myths to test and, you know, vapes are regulated. They are, you know, certainly safer than cigarettes. And, you know, we should be sort of confident as nurses to be able to support people to move from cigarettes to vapes. So those were two things then. Of course, we have, um, I myself did a session on behavior change. Well, you know, it's all very well and good. But how do you get people to, to actually make those changes? So, again, some a session on behavior change. So what we hope is that people are going to be able to use those tools to info form their practice so that they feel a bit more confident. Um So I don't know about you. Do you want to pick out any of those tools? Yeah, absolutely. So they are all available on demand. And I think one of the, if I go, if I loop it back to that again, we didn't just pick these ideas out of fresh air. This was based on feedback from, from the steering group from the nurses that we've interviewed and even the survey that we had helped inform the content. And one of the things that one of the nurses said was give me something that is quick, something bite size, that's quick that I can add into my day. I can add into a meeting. I can make part of staff learning staff development, maybe something I could just watch while I was on the bus coming to work. So nothing really big and arduous, something I can fit in. But then bills on a series of sessions that will fulfill my knowledge. Now, everybody that takes part, it's all hosted on the same platform that people are looking here. So actually, nurses will still get the opportunity to support their revalidation because they'll be able to collect certificates and participate to relate learning. We also have on the C three website, a downloadable um reflection tools. So it's very similar to the NMC one of course. But actually if you want to get involved with this, then you can watch a session, take part of a session, think about it and maybe use it as part of your reflection. So we've really tried to adapt what is very um has the potential to be very difficult content and those very difficult conversations to have. But we've started to try and unpick and make it a bit easier. I think there's one of the session as well though that we didn't mention. And that is the the smoking and um cardiovascular disease and mental health connection and that was done by Joanne whores another nurse. Um and, and smoking and mental health is a big passion of hers. And it's really this bidirectional effect that cardiovascular disease and mental health have and how they are very interrelated. And she talks quite openly about the research that she's been a part of it was her MSC and also surely quite some shocking statistics about having a heart attack if you are depressed. And what happens if you and how many people develop depression and then ultimately, the deaths that, that will increase, that will, that will lead to. So um across the whole spectrum of mental health thing with this, I think smoking and cardiovascular disease is at the forefront I'd like to think this wasn't the end of what we're doing on this project on this initiative though. I'd love to think that we've still, with that taking part in some of this is stimulated um nurses to want to be able to do more or given them the tools to be able to do more. And we do, of course, have the quiz. Have you taken part in the quiz at all? It was a while ago. I think you did. I did do it. But you know what I'm saying, sort of thinking. I need to do it again and see whether, you know, my learning has, has changed. And the other thing I'm thinking is Michaela is that in the presence in the behavior change tool, we used a case study and we could make that as a template available for people and they could, then they could then use that and they don't have to share it with me with us. But it would, wouldn't that be so lovely if they shared it with us? And we could then sort of carry on the learning and seeing whether how people are using it. Yeah. So we can make that available as a, as a, as a word document that people can download and use in their own practice. Really? Absolutely. Absolutely. I love that idea. And, and that's one of the things I think in the different projects we've done through C three is you know, nurses of everyone's busy but nurses are very busy. So it's don't invent a wheel if there's something out there that can help. And we did that in the. Do you remember the winning, the winning uh winning hearts and minds that this one? Um that way, no initiative. We're the winner and through their nursing you, we has nurses saying give me templates, give me, give me sample emails, give me sample things I can write. Don't, don't please don't ask me to think of it all a fresh. So I'm loving the idea of that. So I wonder that. Yeah, brilliant, brilliant. And that's what I think. I think that's just triggered something else to make me think about that. If anybody does get involved and watches this session or gets involved and looks at any of the other training, let us know, let us know how you've used it because then we can turn that into another case study of how taking part will have maybe helped you think differently, change your practice. And we can then again, um really trying to showcase those extra, those extra miles or dist senses that nurses were, you know, we are expected to do it and we know that nurses probably will participate in a lot of this in their own time. But we are hoping that this will also form part of some sort of shared learning, shared training events that that nurses can participate in. Uh I agree. Yeah, I think we, we, and we want to know that, don't we? And so, yeah, we can, we can take that forward. So I feel like we might have just given ourselves a bit of extra work to do. But I think that's okay and I think, I think we probably should keep this relatively short and sweet and encourage people to go and participate more and join one of the other sessions if they haven't already taken part and do follow us on, on the usual Twitter accounts. Actually, three nursing. I'm at, this is Michaela Helen. You are Helen Don underscore RN. We all make up these names, don't we? That made sense a while ago and it is what it is. But a huge thank you to the podiatrist for nursing because without these guys, we wouldn't be able to do this initiative. And of course, a huge thank to everybody at C three to everybody who's been taking part so far and everyone who is going to take part in the future, Helen, I'll leave it to you to close it. No. Well, I thank you. And I mean, it really has been, I've learned a lot. So I think yes, Michaela is just said, we probably have given ourselves a bit more work, but actually, it's useful to know how these resources are being used, whether there you and how we can expand on it. Maybe so um do keep us in touch keep in touch and let us know. Um And, you know, obviously use, use the tools, you know, dip I/O and, and let us know. So hopefully, we will be able to stop some people smoking, certainly cut people down from smoking, move people from cigarettes to vapes. Um And that's, that ultimately is the aim because that will reduce then their risk of getting cardiovascular disease, which is, you know, the whole premise of this particular project. So thank you again, as Michaela said for taking in, oh, Michaela has got one more thought. I have one more thought and it was something that I just remembered lose saying, so Louise saying on the session on the round table that they're having great success at the moment with NHS workers who are smokers who want to stop through the app. So if you haven't taken part and you want to go to the NHS Stop Smoking app and there's an extra section I think within the app, which is just for NHS staff who want to stop smoking. So, because this isn't just about mental health people with mental health, mental health patient's mental health service users. It's also about the nurses themselves. So um who are, who are smokers to um of which is, there's a lot of, there's a lot of us out there. Well, I'm an ex smoker, but a lot of us out there. Yeah, absolutely. Ok. Well, thank you. And thank you. For inviting me to be part of this project, Michaela. But again, thanks to see three and two, the Burdette Trust. And really thanks to everybody who's listened and joined in because, you know, you're, you're what makes these projects. So let's let's take it further and hopefully we'll see you on.