3 thoughts on “Compassion in Healthcare at Torbay Hospital

  1. Hi there

    A few comments – first of all I have always believed that hospitals, clinics and practices are part of a wider community; we seem to have lost this somewhere along the way. They should feel like they belong not just to the staff but the local community. The more I look at the community asset based approaches (thanks to my friend @smclrk ) the more I think that this is right. The librarian was brave though;10 people isn’t many really and its hard when local communities don’t feel able or want to respond. I’ve sat in many public sessions where only a couple of people arrive – how can we do this better?

    Your real questions though relate to compassion and the trouble is I don’t know – I don’t know the answer to the question you pose and I’m going to explain why. Its so individual and unique that it almost defies definition.

    I spent Friday on a ward where mainly elderly people are rehabilitated. I was really upset when I came away because there was a lady who I knew I couldn’t help. I sensed her pain, frustration, anger and even a level of contempt but she couldn’t tell me. I did my very best – I tried to listen (although she couldn’t speak) and tried hard to ‘tune in’ to her feelings. I’m fairly confident she saw hospital as a prison. I was tired when I came home, frustrated too. Perhaps compassion was the issue – I felt it and it was upsetting.

    All of the approaches they described to you are familiar to me. I’ve been an advocate of story telling for a decade or more, feedback and observations from people are also invaluable (15 steps good example – linked to johari window concept) and I think Schwartz rounds are amazing. But I’m not honestly sure there is a silver bullet – more a genuine and sustained endeavour to listen, hear, feel, experience and so on and perhaps – like Schwartz rounds support staff in what is after all emotional work.

    I’m not sure if I’ve answered your question…. But I hope my thoughts help

    Anne

    A couple of links for you x

    http://www.theschwartzcenter.org/

    http://www.institute.nhs.uk/productives/15stepschallenge/15stepschallenge.html

    http://www.patientvoices.org.uk/

    and finally but I think you are connected:

    http://www.frameworks4change.co.uk/#!

    Here is Andy’s TED talk too – worth a watch http://www.youtube.com/watch?v=eMelRxXl3-M

    [sorry if you know all this already 🙂 ]

  2. Thanks Annie and George, your words have got me thinking on a quiet Sunday night.
    Andy Bradley’s TEDxBrighton talk is simple and very effective. “We stand for compassion” is a great motto for any healthcare organisation.

    Schwartz rounds seem to be increasingly used and discussed locally in Devon. St Luke’s Hospice in Plymouth are already using them and finding them helpful. There is talk at the Royal Devon and Exeter about using them in the acute trust, which I wholeheartedly support.
    Using them as fora for reflection across an organisation seems like a great way of spreading the compassion fire.

    I’m also a great believer in clinical supervision for healthcare professionals and have undertaken monthly personal reflection sessions with an external supervisor now since 2000. Sometimes I have stumped up the cash to pay for these vital sessions (I have vowed to myself never to work without them), but mainly they have been funded by organisations I have worked for.

    There is precedence for such clinical supervision sessions in psychology, counselling, psychotherapy, mental health nursing (and doctoring). Balint groups in GP-land perform a similar function. Stopping to think about how one’s own behaviour and responses impacts on the care one is able to give is so important.

    However, it’s not seen as vital in many organisations, and often is the first to go when clinical and time pressures are high. I hear “I’m too busy to go to supervision” not infrequently, and often reflect that it is this “busy-ness” that can act to reduce our ability to be compassionate. We all have many roles, jobs and tasks to do. Time is extremely pressured. Staff shortages and sickness are common. But often it is the simple things (like offering a patient a sip of water if their mouth is dry or making sure they have a drink within reach) that take such a minute fraction of time, but can be so helpful in letting people know they are truly cared for.

    Good quality supervision is fantastic in getting individuals to reflect, learn and grow. However, often it’s seen as an add-on, too expensive or not important enough. It’s often confused with management oversight and the “rods” that are sometimes (I think unfortunately) in place to “improve staff performance”. It will be interesting to see if Schwartz rounds can bring the message of reflection and growth into the mainstream.

    Anyway, probably enough of a ramble for now.

    I wrote an article about clinical supervision for doctors about a decade ago….it never went anywhere, even after 10 drafts. Maybe the climate is now right to fish it out again and stimulate some more discussion.

    It’s been lovely thinking about this with you tonight. Many thanks. Becky.

  3. Dear George, Becky and Anne, I found George’s excellent blog just now, browsing on line having attended Sarah;s PhD transfer at Plymouth Uni yesterday ( she and I are train companions!) ( she passed and is now continuing her PhD on what is compassion in health care). I am passionately interested in the things that George and Anne describe thinking of, and I share Sarah’s interests in compassion and story telling. I am now the facilitator for Schwartz Rounds at RDE ( we are now running them there in partnership there with the mental health Trust Devon Partnership Trust) and doing this is one of the best things I have done in my whole career. It is so moving to enable people as staff to talk safely and openly ( letting down some of their defences) to share their feelings and cameraderie about the tough work we do as health professionals. Providing mutual support and ensuring that staff are well and happy is critical to our being able to work compassionately and effectively in hospitals. Like Becky, I am a great believer in clinical supervision and my profession of clinical psychology I hope has a lot to offer – but we are so small in numbers. the real psychological care is done by doctors, nurses, cleaners, porters, morticians etc and patients themselves with their families and friends. As an educator I am very keen that we do far more in training the next generation through inter-professional learning and patient and family participation in training. Lovely to find fellow spirits on line, and local! ! I am also a member of a southwest women’s Playback Theatre Company, Tarte Noir ( there’s also a mixed group, Mirror Mirror, who are wonderful) – we are all about hearing and sharing our stories to deepen our human connection. Our theme this term is – what frees us, what binds us.” google to look us up on line! Come along to a performance. Thanks , Annie Mitchell

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