Little miracles of kindness, compassion and care

Nobody buys new pyjamas because the district nurse is coming round. Community nursing, therapy and health visiting provides a privileged insight into the
lives of people needing care in their own homes. People in our services see how we really live in modern Britain.

Behind closed doors, little miracles are happening every day, lives are being changed or people are persisting with conditions that lead to lives many find beyond comprehension.

This is the world my staff inhabit. Populated by all sectors of society – we treat everyone everywhere. Stoical women living with Parkinson’s , the epitome of Yorkshire grit. Young mums with palliative babies, seeing through short lives to the full. Teenage girls not letting  cerebral palsy get in their way. Refugees, the victims of torture and trafficking. Aged singers reminiscing about life before COPD and reliving mixed race marriages in 1950s Leeds. Young dads, doting on precious bundles, eyes like saucers. The rich, the poor and everyone in between. From head to toe and birth to death.

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I try to spend at least one whole day a month back to the floor and often manage more. Every one of these sessions leaves me with an indelible memory of the people I meet. It often leaves me emotionally drained and carrying a set of concerns about them too. On the back of yesterday’s session with our fantastic Parkinson’s Nurse Specialist, Paddy Harris, I feel exactly the same.

That lead me to thinking about our staff and the weight they carry of all those lives. Every day working close to life, death, joy and many people with persistent, ongoing struggles. How do they cope? Some tell me the love of the job and the difference it makes drives their energy levels. Others say, after a challenging visit,  they readjust in the car before the next one. Regular exercise,  the support of teams, recognition from senior colleagues, a card from a grateful family. Small touches making a lasting difference…..
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Our staff need to be supported to flourish in this reality. Michael West’s work shows how much this matters. Do read his blogs.

Good leaders create a positive climate for staff so that they feel engaged and have the emotional capacity to care for others. There is enough negativity in health service organisations – fear, pain, anxiety, loss, uncertainty – that we must counterbalance it with positivity. This is both fundamental to leadership in the NHS and not widely understood. Expressions to staff of gratitude, appreciation, support and encouragement cost nothing but profoundly impact patient care”

And if the research is not enough for you, listen to Tommy talk about how “the district nurse put her arm around me and told me I was doing OK” . The power of a bit of kindness that
helped him through tough times as a carer for his mum. That nurse’s compassionate approach is something we need all our staff to be able to deliver. I have seen this from band 3 support workers and band 8 community matrons and staff  in between (as well as drivers, therapists, doctors…)  Retaining this valuable asset requires that we look after our staff.

The RCN survey into stress among nurses is a sign we need to do more. If two thirds have considered resigning, then things need to change. In my organisation, as well as back to the floor sessions, I have just finished listening events with community nurses. These have been a necessary part of how we are growing and changing services. In the news we hear about A&E being busy. This is the same for my 24-7 community nursing and therapy services. A boost of over 35 extra nurses in the next month – with support from commissioners – is essential. Nurses tell me of the strain they are under whilst new capacity comes on stream. At each session they have noted the importance of knowing that I know what they face, that the chair and other directors too. Just being there to listen helps… …and I now, more than ever, appreciate that this impacts on the resilience they need to do one of the most fulfilling and important jobs in the world.

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So next time you casually tell someone that nurses or staff in the NHS don’t care, ask yourself when you last spent time with one and what you might be doing instead that will support them to do what they do best. Let’s lead with a positive culture that promotes little miracles of kindness, compassion and care.

Saying Yes to Life, Despite Everything

Grief is the most shocking and visceral experience. I was standing in the hallway of my parents’ house. I felt like someone had forced their arm down my throat and grabbed my heart in their fist and twisted. It was excruciating. Just when I thought the pain was too much to bear, they squeezed harder…..My brother had just committed suicide. He was 32 and this was his first attempt. At his funeral, hundreds gathered from across the country to pay their respects. How could he not see how much he was loved by them? By his kids? By me?

I now believe, after many years, that I know the answer. He had simply lost hope.

When looking at suicide, relationship issues, mental health problems, alcohol and substance abuse, financial pressures are usually at the top of people’s lists of probable causes. But hopelessness and helplessness are the main emotions felt by those attempting suicide according to published research. Without hope, what are we?

One of the inspirational clinical staff in my organisation, John Walsh, quotes Viktor Frankl’s work on the power of hope, as set out in his book “Man’s Search for Meaning”. The original title may be more relevant here – “Saying Yes to Life, Despite Everything”. Frankl survived Auschwitz and lost most of his loved ones in the holocaust. He looked at why people survived the holocaust and the concentration camps. He concluded they were able to find hope in something bigger than themselves – whether religion, family, purpose, love. In brutal conditions in Aushwitz, he discovered:

“A thought transfixed me: for the first time in my life I saw the truth as it is set into song by so many poets, proclaimed as the final wisdom by so many thinkers. The truth – that love is the ultimate and the highest goal to which Man can aspire…..I understood how a man who has nothing left in this world still may know bliss, be it only for a brief moment, in the contemplation of his beloved…..”

There are now many charities and organisations working how to address or mitigate suicidal risks. These often trade on this idea of building hope or finding meaning.  You probably know someone affected – since 13% of 16 year olds have self harmed and suicide remains the biggest killer of young males. If you or someone you know needs help,  get in touch with your GP who can signpost to some brilliant NHS services – trawl on NHS Choices too.

I would also point you in the direction of the fantastic  Campaign Against Living Miserably which is aimed primarily at men

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“All men, at times of need, may not know where to turn or go. CALM gives this freedom to know there is always someone to listen and more importantly help. Suicide is preventable”

And UCanCope a partnership between Connecting with People, the Samaritans and the Royal College of Psychiatrists. The latter has fantastic free resources aimed at:

 ‘Suicide mitigation: a compassionate approach to suicide prevention’ – the desire that health professionals and those people in a therapeutic relationship with someone who has self-harmed realise that ‘every encounter with a suicidal person is an opportunity to intervene to reduce their distress and, potentially, to save a life.

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This short film says a little more http://vimeo.com/48721158

Today, on Phil’s birthday, this blog is a thank you to those people and organisations who work in this arena.

It is also part of my commitment to the pledge I made to the Time to Change campaign about stigma and mental health – that I would talk more about how I have been affected.

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Perhaps if that stigma didn’t exist and if more time was spent talking about mental health and whether young men are OK, I could be wishing him a happy 43rd birthday. Instead, I will feel the fist around my heart, squeezing ever more gently as time goes by.

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