Responding to Damian Roland blog – ‘Bringing Two Worlds Together’
Damian wrote here
I sometimes feel I live between worlds. There is a the clinical world I inhabit; being physically present on the “shop-floor’ of a busy Children’s Emergency Department or as part of a clinical leadership team improving the quality of care we provide. I try to be constantly aware of the effect my emotions and biases have on other staff, parents and especially the children and young people I meet. Simply put: it’s not easy.
Thank you for being present in the childrens emergency department, I am deeply grateful for your skillful care and attention in the lives of children and their families, this is precious work which is part of what defines us as a society. One of my favorite insights from the wisdom of yoda is ‘there is no try’. Being constantly aware of effect of emotions on others sounds unattainable. I wonder if cultivating a more gentle forgiving self awareness might feel more within reach – we have little control over the emotional and behavioral realities which others inhabit – but we can be intentional in ‘getting our own house in order’. The research from the Westminster Centre for Resilience feels relevant here as it is informed by the latest neuro science on managing our state…..so what helps us to keep showing up moment by moment in a state of compassion?
- Skilful breathing
- Mindful embodiment (how am I ‘carrying myself’)
- Positive emotions (what am I noticing? Am I savoring what is good?)
We now teach these three elements now on all of our programmes and people report back that they feel (and are) ‘more centered and available’.
While#hellomynameis is a reflex, other aspects of compassionate care sometimes aren’t. It’s not simple to challenge others behaviours when you have witnessed a professional interaction that is not acceptable. Maintaining persistent empathetic engagement with families can be one of the most draining aspects of my job. Do I sometimes resent it. Yes, I’ll be honest I do. I don’t think that makes my unprofessional, callous or dispassionate. I hope it makes me aware of when I do need to take a break, re-group and re-energise.
The other world is the network of individuals and groups I belong to who are championing change, within and outside of the health service. Generally via social media, but also through conferences, projects and campaigns. There is a steady flow of what some might call ‘positive energy’ but others see as mis-informed and ill-placed conjecture and eulogising. My efforts with #nhschangeday are on the public record. As it reaches its 3rd year I am proud to have been part of a movement which I do feel has engaged people in understanding how and why change can occur in any health or social care setting. The networks I have developed from this and other initiatives are supportive, inspiring and positive. I have developed insights and skills which clearly have benefited me and hopefully the patients I treat.
Some questions come up for me here:-
Is there a shared understanding of what a ‘professional interaction’ with a patient looks, sounds and feels like?
Are there safe structures in place for growing a sense of team work and shared meaning and purpose?
Are the leadership and management roles sufficiently clear and helpful to all involved in patient care?
Can people openly disagree with each other – and maintain respect for differences?
Is NHS Change Day successful in striking the difficult balance between inspiring and enabling?
In my experience there are fundamental structural aspects to operating within the medical model at a time of rapid social change which require deeper contemplation – without time to think through our place in the world, too many people are becoming stressed and burnt out or addicted to the feel good moments which pop up on our portable devices – neither position is healthy or balanced and it is a real challenge to find what is whole and helpful. My sense is that we need to evolve into conscious kindness for ourselves and each other – and that awareness will help to enable us to make wiser judgments on how we direct our energy and use our time.
On Friday 6 very different people sat together in central London for a ‘story of care’ supper (one of our group hosted and two of our group cooked together) – perhaps more of these suppers would help to keep us connected and safe. I am reminded of The Healers Art movement in the US – the antidote to the de-humanising nature of medical education and the social anxiety we carry in part as a result of our fear of pain and death (not to mention being asked to operate in a paradigm driven by the forces of competition and regulation)
And yet despite this latter point it feels sometimes as if these worlds are in contradiction with each other. If you watch Andy’s videos you think – why isn’t every clinical encounter like this? Why is it that the energy I can have from one phone call on developing a new social movement can be utterly deflated during a clinical meeting a mere hour later. Idealism often crushed by the reality of some of the things that need to be overcome. So how would I like our future health and happiness to look like? For me it would be to live in just one world. One in which there doesn’t need to be a jump from what we think we should be doing to what we are doing. But I appreciate that mostly starts with me. It’s my mindset and my beliefs that predict the energy and compassion reserves I possess. I encapsulated this a while back without realising it:
And while I realise the very thought of this matrix will turn off many, I hope one day to create in both worlds the possibility that: “Today can always be a good day”
My thought on the matrix is that it is profoundly valuable because it demonstrates reflection, wisdom and deep intention to be consistently compassionate – thank you.
I am intrigued by the way we use language that tends towards the cognitive…
Perhaps we will evolve into….
Heartless (noticing we already have that one!)
Damian – we do live in one world….you are making such a brave and consistent contribution to help us all to realise that.
Look forward to creating space to ponder together