My memories of Sunday afternoons as a boy were visiting my gran in a scratchy hand-knitted jumper, Arthur Monford’s sports jackets on Scotsport and the Sunday Post, especially Oor Wullie. 40 years later these memories are still important – I can still taste my gran’s newly made pancakes, I’ve just about grown to appreciate the care my mum took to knit the scratchy jumpers, my kids now think I have the sartorial elegance of Arthur Monford and Oor Wullie remains a role model for being human and staying human…..
I admire Wullie– his sense of fun and mischief , his living life to the full appeal to the wee boy in me but more than that he does what I sometimes find so hard to do….he intentionally regularly takes time out to sit on his bucket….to reflect on the day…..to take stock….to remind himself of what is important in his life…to reconnect with himself. It’s part of the rhythm of his day, its built in….taking time to pause…for himself….it’s not an add on, something he does after all the other things are done and taken care of….it’s a given – a priority.
Working in health and social care we inhabit a world which is dominated by the urgent and immediate – the next patient to be seen, problem to be sorted or deadline to respond to. We work in a culture which values efficiency and throughput – often out of necessity. We can become encultured into pushing ourselves and our colleagues to the full to ensure all the bases are covered and working at a pace that drains us over a period of time. This can leave us with very little energy for ourselves and those we love and value out of work. How often do our family and friends get the ‘fag end’ or grumpy bit of us?
What Wullie reminds me of is the need to pause even for a few moments during the day to recall, in the midst of the urgent and immediate, the important and the significant. Of what matters, of what is important to me, what I value….to hold onto my humanity. And more than that to take time regularly to stock take the events, the joys and the losses of the day or the week, the patterns of my behaviour and my way of living and relating.
In short – to notice and wonder, and maybe…. realise .
In Firth-Cozen’s and Cornwell’s (2009) King’s Fund report– The Point of Care: Enabling Compassionate Care in Acute Hospitals they record the sad realisation of a nurse of her dehumanisation and demoralisation whilst working in acute healthcare.
I went to work on an elderly ward where patients died daily and there were great pressure on beds. At first I did all I could to make the lead up to a death have some meaning and to feel something when one of them died. But gradually the number of deaths and the need to strip down beds and get another patient in as fast as you can got to me and I became numb to the patients; it became just about the rate of turnover, nothing else.
How do we remain human in such a context? Indeed it saddens me that I would even write that sentence. Surely, it’s not enough just to remain human in health and social care but life is too short to be in vocational roles where we cannot enjoy being human and have the energy to share our humanity with patients, relatives and colleagues. As well as having enough, energy, love and compassion for our friends and family and ourselves.
One or two wonderings about how the Oor Wullie model of being human can help us in health and social care :
Firstly, taking metaphorical bucket moments in practice…in the midst of the busyness of the day, during an encounter or a task being intentionally aware of what’s going on inside us, between us and another and what’s going on around us. What is we notice and wonder about…..what do we observe that makes us curious, that we want to explore further in the moment with a patient or a colleague or that we note internally and perhaps reflect on later.
Secondly, taking time to take stock and process the events of the day, the week or the month. The real end of the day sitting on the bucket times. We all do this in different ways – whilst walking the dog, having a coffee or a beer with friends, hitting a golf ball or having a long hot bath. And yet how do we avoid becoming the nurse in the King’s fund report? How and where do we process the human cost of working in health and social care to avoid the accumulation that leads to dehumanisation – acknowledging the daily losses and transitions not just of deaths but people coming and going, dealing with their loss of function, role and identity that illness, injury and trauma brings. To what extent do we prioritise ourselves and our wellbeing?
Thirdly, are we willing as people and professionals, as colleagues and teams and organisations to give ourselves and each other permission to tend to our humanity, to consider the important and the significant not just the urgent and the immediate to enable our greatest resource – our humanity – to thrive not just survive?
These are rhetorical questions.
My mum died 15 years ago yesterday and it took a phone call from another family member at 9 o’clock last night for me to remember. The day, the week had been so busy, so full…but what was really important and significant for me this week?
So thanks for the jumpers mum, lovingly knitted – I’m still scratching as I type!
Ewan Kelly is Spritual Care Lead at NHS Dumfries and Galloway