Hospitals are high-pressure, emotionally intense environments. Yet, unlike elite athletes who have coaches and psychologists monitoring their performance, that kind of support isn’t always available in the NHS.
Intensive care and anaesthetic consultant at Royal Papworth Hospital NHS Foundation Trust, Dr Rob Gatherer, is keen to change that to help create a healthier workforce. He's leading a pioneering study exploring how tracking nurses’ stress levels could improve performance, teamwork, and ultimately, patient outcomes.
In 2024, Rob secured £34,443 from the Innovation Fund - a partnership between Royal Papworth Hospital Charity and our research and development department to improve patient care.
The funding enabled him to purchase 14 heart rate variability (HRV) monitors. These devices detect subtle changes in the time between heartbeats, a key measure of stress and autonomic nervous system function.
"Previously, I’ve used video to help teams reflect on their performance,” Rob explains. “This time, we’re giving our critical care nurses who care for complex cardiothoracic surgery patients real-time insight into their stress physiology.
"We think we know when we’re stressed, but it’s often subconscious. By seeing their physiological responses, the aim is that nurses will be able to start to recognise triggers and adapt.”
Each nurse will wear the monitor during 10 baseline shifts, gathering data on their stress responses during typical working days. They’ll then join coaching sessions to explore what drives their stress – whether it’s alarms, workload peaks, emotional encounters, or skipped breaks.
In the next phase, participants will trial targeted strategies such as mindful breathing, adjusting alarm thresholds, or restructuring tasks to reduce cognitive overload. They’ll then wear the devices for five more shifts to see if greater self-awareness translates into lower stress levels.
“This is about helping nurses to recognise stress and take steps to be healthier at work,” says Rob. “It has to be individually tailored – what stresses one person may not affect another.”
Intensive care and anaesthetic consultant, Dr Rob Gatherer
Why is monitoring stress so important?
Stress can cloud judgment and slow decision-making, which are both essential in critical care.
Rob’s hypothesis is simple: reduce stress, improve performance and enhance patient outcomes. Even small improvements such as fewer delays, faster responses and better wellbeing could have powerful ripple effects across critical care teams.
Coaching will be personalised using data-driven tools like SMART goals, mindfulness and structured breaks.
“This isn’t just about creating better individuals,” Rob adds. “It’s about building healthier, more resilient teams.
“And, if we can show that by supporting and coaching staff, we not only reduce their stress but also improve how quickly they respond to patient changes, for example drops in blood pressure or oxygen saturation - that would be truly groundbreaking.”
Health and wellbeing support is available to all Royal Papworth staff, including access to health and wellbeing facilitators and a counsellor. This research will build on current provision by helping to develop an additional tool focused on self-recognition and self-management.
The Innovation Fund is open to all Royal Papworth Hospital staff to support projects / innovations which will have a direct impact on patient care. Rob’s study is a perfect example: proof that innovation doesn’t always start in a lab but often begins by caring for the people who care for others.