A Yellow Wood by Gill Stanyard

Gill St 1

The 1st June 2018 was my  last day as a  Non-Executive Director for NHS Dumfries and Galloway.  After four years of a potential eight year appointment from Scottish Government, I decided to  leave. I felt I had reached a good and fulfilling end and to stay on for another four year term would have been signing up to endure.  I made a decision I wanted to enjoy. So, I felt happy with my decision to end my time, made when swimming in a shimmering blue sea one early morning, whilst in Greece.

I made a decision. ‘Decision.’ The Latin origin of this word  literally means, “to cut off.” Making a decision is about “cutting off” choices – cutting you off from some other course of action. Now that may sound a little severe and limiting, it’s not. It is liberating. Decisions, they take us onto the next stepping stone, sometimes called  ‘The End’  – two words which tell us a story is over.

Gill St 2

My friend made the final and shocking decision to end his life at the weekend. A fact I am still struggling to comprehend. Our last communication was a fortnight ago, with me texting him about all the different gins (24 to be exact) that were on the menu at my leaving ‘do.’  He texted me back with a  joke about Rhubarb gin. Then nothing. I didn’t think too much of it, life gets in the way. And then I received ‘The News.’  Yet I have forgotten a couple of times since then, and have gone to text him. Then, with a strange physical ‘flipflop’ stomach feeling,  I have remembered ‘The End,’ which is accompanied by much hurt and sorrow and  strangely, lines from one of my favourite poem’s. – ‘ The Road Not Taken.’ by Robert Frost:

 

Two roads diverged in a yellow wood,

And sorry I could not travel both

And be one traveler, long I stood

And looked down one as far as I could

To where it bent in the undergrowth;

 

Then took the other, as just as fair,

And having perhaps the better claim,

Because it was grassy and wanted wear;

Though as for that the passing there

Had worn them really about the same,

 

And both that morning equally lay

In leaves no step had trodden black.

Oh, I kept the first for another day!

Yet knowing how way leads on to way,

I doubted if I should ever come back.

 

I shall be telling this with a sigh

Somewhere ages and ages hence:

Two roads diverged in a wood, and I—

I took the one less traveled by,

And that has made all the difference.

Gill St 3

 A single decision can transform a life. I always assumed Frost wrote this poem about himself, yet I recently read Hollis’s  biography of Welsh poet Edward Thomas, and discovered that Frost and Thomas were ‘besties.’  Frost had written the lines as a joke about Thomas’s depression induced indecision, which showed up on their long ‘walk and talk’ days together, with Thomas never being able to decide whether to take the path on the right or the left. When Frost sent the poem to Thomas, Thomas initially failed to realize that the poem was (mockingly) about him. Instead, he believed it was a serious reflection on the need for decisive action. At the age of 36, after much wrestling, Thomas felt compelled to enlist as a soldier in the Great War.

Gill St 4

 

He wrote of his decision to his friend Robert Frost  “Last week I had screwed myself up to the point of believing I should come out to America & lecture if anyone wanted me to. But I have altered my mind. I am going to enlist on Wednesday if the doctor will pass me.”  On the first day of the battle at Arras, Easter Monday, 9 April 1917, Thomas was killed by a shell blast.  His poem ‘Adlestrop’ was published in the New Statesman three weeks after his death and has since become a classical favourite of British poetry.

 

Adlestrop

Yes, I remember Adlestrop —

The name, because one afternoon

Of heat the express-train drew up there

Unwontedly. It was late June.

 

The steam hissed. Someone cleared his throat.

No one left and no one came

On the bare platform. What I saw

Was Adlestrop — only the name

 

And willows, willow-herb, and grass,

And meadowsweet, and haycocks dry,

No whit less still and lonely fair

Than the high cloudlets in the sky.

 

And for that minute a blackbird sang

Close by, and round him, mistier,

Farther and farther, all the birds

Of Oxfordshire and Gloucestershire

Life sometimes makes decisions for us. I don’t mean to get all Dead Poet’s Society here, yet I think T.S Eliot had something when he wrote “What we call the beginning is often the end. And to make an end is to make a beginning. The end is where we start from.” (Four Quarters) We get ill and have to take time to rest and get well, and sometimes we don’t always recover, we have accidents,  we don’t get chosen for that job or by that person and we lose people and animals we love and care for.

Where possible, make a decision and choose your ending and make a new beginning, whether it be the end of an unhappy relationship and the start of a happier one with yourself,  saying No to working for extra hours, when you could be saying Yes to spending more time with your family, or your dog or your garden, standing up to a bully and choosing to start being assertive and courageous, speaking out against something which you see is wrong and thus ending corruption or collusion, stopping trying to do everything by yourself and start asking for help -(getting a mentor through NES really helped me with this)  and putting a stop to being taken for granted and drawing new boundaries that put your needs first.

Gill St 5

I have taken a Non-Executive decision to be more accountable to myself in my life, to spend more time outside, to stop watching tv and read more poetry,  to save up to live in a place where I can have two donkeys, chickens and  another rescue dog and to track down some Rhubarb gin.

Gill St 6

Sorry if I did not see you to say Goodbye. I wish you well in your decision making and hope that your sigh is a happy and fulfilled one.

 

 

 

 

 

 

I

Summer of Celebrations Part 1 by the SPSP Team

SPSP 1

Reflections from Improvement Advisor, Paul Sammons

As an improvement advisor with no clinical background, I work closely with people who want to change things for the better, and who know their teams and roles well, but who don’t always have the skills to structure improvement work.  They may not have the capability to use the ‘model for improvement’ – a proven methodology that helps focus aims, identify change ideas and to measure what difference if any, a change actually makes.  Having completed the Scottish Improvement Leader programme (ScIL) in 2015/16 I do have that capability which, when brought together with practitioners who have a will and an urgency to change things for the better, can be very powerful.   I enjoy the privilege of working alongside, enabling, and learning from some fantastic individuals and teams who strive to improve services of their patients and service users.

Some of these moments will be with me forever – I recall working with Dr. Grecy Bell to motivate and enthuse a group of primary care staff about Medicines Reconciliation – not the most lively of topics, but Grecy created the ‘med rec fairy’ concept – a local champion in each GP practice who would carry the ‘wand’ to ensure their team saw med rec as a vital part of their work.

SPSP 2

Another great memory for me was working alongside Dr. Mark Colwell – we teamed up to lead a local dental improvement collaborative, creating a structure around better decision making and treatment planning for patients on high risk medication.  Mark showed me how ceding power to his team enabled a flat hierarchy where all team members were able to critically observe each other’s practices, and contribute towards a more collaborative approach to patient care.   With the practices involved we improved much – starting even before patients arrived for their appointments – maximising the use of text messaging, moving through the patient’s journey. The work involved reception staff to engage with patients to obtain highest quality patient histories, and enabling dental nurses to observe and to prompt their bosses into even better patient conversations.

SPSP 3

I have observed people in health and social care who once invigorated with a little QI magic, will stop at nothing to deliver better care, and who seem to have the energy to drive improvement forward in the most unlikely circumstances.  I spend time with Julia Hutchison in DG Smile dental practice, and I leave with a real spring in my step.  What is it about these people and all of the others that I get to support that is courageous, different and special?  I do reflect on a wee video that helps me answer that question.  You might like it too.  It is available on YouTube and can be viewed here.

I believe that attention to QI capability and capacity is key to improving services, and that we will see this develop through our local ever-expanding network of QI capable practitioners.  In the near future we will expand our practitioner level QI education and training – to ensure managers and leaders are well equipped to support, coach and supervise improvement projects.  In 2018/19 I plan to focus improvement efforts into the Women’s and Children’s teams as they settle into their new DGRI home.  I contribute to the improvement force field that is growing stronger across Dumfries and Galloway in health care and in social care.  I work as part of a small but wonderful team of hand-picked curious and quirky individuals – who quietly and tirelessly support each other, creating a synergy of support to our customers.  Perhaps you are close to that growing network of improvers – perhaps you feel the force like I do?  Well I do, and as I work with a widening spectrum of fabulous people I can honestly say that there is much joy in my work.  Long may it continue…

SPSP 4

 

What Matters by Ken Donaldson & Alastair McAlpine

I recognise that it is a bit cheeky of me to put my name to this as I haven’t written any of it. A few months back I was scrolling through Twitter and came upon this thread that really moved me. The messages are simple yet immensely powerful. I have therefore simply taken some screenshots from Twitter and published them here. As you can see this is by a Doctor called Alastair McAlpine who is a Palliative Paediatrician in Cape Town, South Africa. Read on…..

Ken 1

Ken 2

Ken 3

Ken 4

ken-5.png

ken-6.png

Ken 7

ken-8.png

Ken 9

Ken 9.1

ken-9-2.png

ken-9-3.png

Ken 9.4

Love Wins by Euan McLeod

Euan M 1Having returned to clinical practice after a number of years away from the NHS (not saying what number) but nonetheless a significant period I attended the corporate inductions week to prepare me for my role in the organisation.

I had thought that much would have changed but although there were a lot of things different it seemed to me that the very essence of what we did as nurses, and indeed as anyone, employed in the NHS had not changed significantly in that we were all part of an organisation there to provide help and support to those in their time of need,

One thing that had developed was the formation of a set of values. The NHS Dumfries and Galloway CORE values

You may recall that the workshop to develop the CORE values was in response to the publication of the Francis enquiry into the Mid Staffs hospital, and that the aim like most health boards up and down the country was to try and create something that would help deliver higher standards of care and stop situations like Mid Staffs happening again.

What was it that went wrong? Did they not love (care/respect) the people they were looking after? Did nobody love their work enough to want to do things well? Were peoples regard for each other such that they became indifferent to their needs?

Love may apply to various kinds of regard towards other people or objects, and this aspect seemed to reflect what had happened at Mid Staffs, a lack of respect or due regard for the people entrusted to their care.

Love – it’s not a word we use often in healthcare but perhaps it’s central and underpins a lot of the other words or values we use to describe how we should be or act in the pursuit of caring for others.  In that sense I wanted to think about that word LOVE and what it might mean in the context of our main activity as deliverers of healthcare.

The title sat in my notes and in my mind for some weeks, I read the board paper on the development of the CORE values and wondered if it might mention love anywhere. Lots of care, compassion, empathy respect, dignity, etc in the body of the document, and hey right at the back in the summary of responses on positive experiences / feelings, there it was the word LOVE-maybe only 1 person had mentioned it but there it was.

Now all this talk of love may be getting some of you kinda twitched as if this was all some soppy, half baked romantic drivel, the kinda thing that people don’t talk openly about, but think just for a moment about how often you might use the word in the context of things, objects and places and not people

What do you mean when you say oh I just love going on holiday to France, Spain, The Bahamas etc or I just love Jaguar cars, or some designer shoes or handbags.

If someone asked you if you loved your job what would you say-Do you love making a difference to people’s lives?

I don’t think anyone would say no to that

Euan M 2

I looked up the Francis report and here’s what it said was the MAIN message

The Francis report is a powerful reminder that we need a renewed focus on hearing and understanding what patients are saying Ruth Thorlby, Senior Fellow, Nuffield Trust

From <https://www.nuffieldtrust.org.uk/resource/the-francis-public-inquiry-report-a-response>

Hearing and understanding what patients say -no problem there then easy and straightforward

The importance of that hearing and understanding aspect was highlighted in the recently published kings fund report

https://www.kingsfund.org.uk/sites/default/files/2017-11/Embedding-culture-QI-Kings-Fund-November-2017.pdf

“Finally, participants noted that a focus on improving patient outcomes and experience was a way to further engage staff in improvement activities:

You have to build that coalition of people who want to make a difference and who want to change and at the centre of it all keep the focus absolutely on patients and never have a conversation that doesn’t involve a patient, because if you do you’re in the wrong place because that’s the only currency, the language, that staff understand. (NHS provider chief executive)”

How can we firstly HEAR what patients say and secondly how can we UNDERSTAND what they are telling us.

Into my in box comes an email from Gaping Void- Everbody’s a patient because evervbody’s a person

Here’s a link if you want to check further https://www.gapingvoid.com/

Gaping void exist to develop the use of culture and art in healthcare settings and the topic that caught my eye was entitled “Everybody’s a patient because everybody’s a person”

There are two underlying truths in patient care:

All patients are, foremost, humans, and one day, we will all be patients.

When designing healthcare experiences, from waiting rooms to waiting times, we have to remember that we’re building for humans — people in pain, people grieving, and people suffering who need to feel loved.

We have to create the experiences that we, as patients, would want to go through. Because, one day, we will.

From <http://mailchi.mp/gapingvoid/we-are-all-patients>

If we are able to love people we care for and hold them in a position of high regard then we will be able to hear what they say and perhaps understand, in turn Love may win over the tensions, frustrations and myriad difficulties that are part of delivering health care  and we can be part of creating experiences that are for  people knowing that perhaps one day we may be the patient

Euan M 3

Euan McLeod is a Mental Health Staff Nurse for NHS Dumfries and Galloway

The man With The Tea Trolley by Alison Wren

image1Hello! My name is Alison! I work as a Clinical Psychologist in the Clinical Health Psychology Service; the final member of the team to blog this month as part of our service promotion! Part of my role within this job is to help individuals and their families manage psychological distress caused by or maintained by physical health problems. Of course as a psychologist I do this at a professional level, but do we always need to be a psychologist to provide psychological care to those who need it?

 
This is the story of a man with a tea trolley; an ordinary chap who made a big difference to me at a particular moment in my life when the chips were down. I didn’t know him and he didn’t know me. We only met once and we don’t keep in touch. He probably doesn’t even remember me. He didn’t need to do what he did; it definitely wasn’t in his job remit and he probably bent the hospital rules.

The story starts on a Saturday afternoon several years ago when my husband unfortunately had a heart attack and was admitted to our local coronary care unit. It all came as a bit of a shock as he had none of the typical risk factors. He wasn’t overweight; he didn’t have high cholesterol, and had never smoked. He drank sensibly and walked miles every week. The event itself was fairly low key; just a burning sensation from throat to stomach followed later by an aching jaw. Symptoms so low key that he still image2went off to a football match that afternoon as planned. Twelve hours later after a trip to A&E (“just to be on the safe side”) our worst fears were confirmed. I’m happy to say that after a successful angioplasty he made a great recovery, but at the time we both pretty devastated. I was beside myself with worry. My stomach churned and my thoughts raced out of control “Was he going to die?”, “Would he have another?”

“Would he be able to stay active?”, “Would he still be able to work?”

image3I felt overwhelmed. How would I help my husband to cope if I was struggling myself? I had no one to talk to and could not voice my fears to my husband who needed me to be strong. As a Clinical Psychologist with many years experience working with people who have experienced distressing life events, I knew that my thoughts and feelings were normal but I was at a loss as to how to help myself.

The coronary unit that my husband was admitted to was located in another region in the UK and has now closed. My husband received excellent medical care, but as a worried spouse I felt alone. Nurses and doctors were busy. Visiting hours were limited (I was not permitted to stay longer than an hour). I wanted to be near my husband and to feel that others understood that we were in this together. I wanted reassurance. I wanted information. I wanted someone to ask me if I was alright. I felt that I needed looking after too.

One afternoon with all this weighing heavily on my mind, the man with the tea trolley came into my life. I had seen him before on and off during my visits serving hot drinks and biscuits to the patients. He was always cheerful and took the time to have a chat with people. He bustled passed me as I sat in the visitor’s room. I guess he must have noticed my forlorn expression through the window, because he doubled back and came into the room. What he did next was a small act of kindness that changed my day, and helped me feel a little better.

image4He simply smiled, gave me a cup of tea and said, “It’s hard isn’t it? How are you doing?”

We chatted for a short while about this and that, and he listened to me as I told him what had happened. Of course he couldn’t answer my medical questions, or give me any assurances about the future. He couldn’t really do anything as such, but he was there for me at the right moment and he seemed to understand. He knew I needed a friendly ear. I never saw him again, so I didn’t get chance to thank him. So whoever you are, thank you! That cup of tea made all the difference.

image5Dr Alison Wren is a Clinical Psychologist for the Clinical Health Psychology Team at NHS Dumfries and Galloway

Take Two Bottles Into The Shower? Not me, I’m a Clinical Health Psychologist by Ross Warwick

image1Because you’re worth it

Bang! And the dirt is gone!

Eat fresh

I’ve been thinking a lot about advertising these past few weeks as September is a significant time for my team in Clinical Health Psychology. This month we will be making a concerted effort to promote our service, raise our profile and increase our contact with the people we aim to help.

As part of this, Ken has kindly allowed us to take over the blog for a few weeks. I’m kicking things off with an account of what the service does and I thought I would take inspiration from psychological tricks used in the world of advertising to help draw you in and get the message out there.

image2I’ll start, then, with a summary of the service that follows the advice of a Professor of Experimental Consumer Psychology at the University of Wales, Jane Raymond. Prof Raymond advises that rather than bombard the audience with information I should break it into chunks to allow the brain time to process each component:

  • Chunk 1: The Clinical Health Psychology service helps people who have a psychological problem that is caused and maintained by a physical illness.
  • Chunk 2: These problems usually involve unpleasant feelings and unhelpful thoughts about the illness that keep someone from doing things that matter to them.
  • Chunk 3: This can cause distress, affecting overall well-being, medical treatment, self-management and health outcomes

An article in a social psychology journal showed that a wide range of people respond well and are persuaded by stories (Thompson and Haddock, 2012). So to illustrate chunks 1-3 here’s a fictionalised case based on real events:

Jane is a young teacher who has type 1 diabetes. Her condition and the things she must do to keep on top of it are often accompanied by feelings of shame, anger and loneliness. She has frequent thoughts that her condition means she is abnormal and that it must be hidden from others. Because of these unhelpful thoughts and feelings she avoids testing her blood, guesses her insulin levels, is inconsistent with her diet and keeps problems to herself.

She has been absent from work and in and out of the DGRI several times within the past twelve months. Because of this she believes friends, family and colleagues are annoyed with her for not taking proper care of herself and landing them with more responsibility. As a result, she avoids seeing people and has become more and more isolated.”

The next steps for Jane are chunked below:

  • Chunk 4: In therapy we would work with Jane to live well with her condition by addressing her unhelpful thoughts, feelings and avoidant behaviour
  • Chunk 5: As therapy is all about collaboration, Jane’s most likely to have a good outcome if she’s motivated to participate and make changes to her life
  • Chunk 6: Jane can be referred to Clinical Health Psychology by anyone who is involved in her care, be it her GP, Practice Nurse, Dietician, Diabetes Specialist Nurse or Consultant.

In Jane’s story, she’s in and out of DGRI because thoughts and feelings stop her from acting in a way that would help keep her well. So psychological therapy would add value by reducing her distress and unplanned contact with services (and by highlighting that sentence your attention has been focused on a key message about how psychology makes a difference to both the person and the hospital; Pieters and Wedel, 2004).

But would you believe that individual therapy expertly delivered by members of our experienced, compassionate, and, yes, attractive, team is but one feature of our service? In Clinical Health Psychology we also provide training, teaching, supervision and consultation because you don’t need to be a psychologist to provide psychological care (worth mentioning because (a) it’s completely true and (b) according to Goodman and Irmak, 2013, audiences are likely to prefer multi-featured products).

Already the Diabetes and Cardiac Teams are benefitting from increasing their psychological knowledge and skill through participating in Emotion Matters training, and a group of local GPs have recently completed training to introduce CBT techniques into their routine consultations. Recruitment of a second cohort will be underway soon.

Time for pictures of the product:

headshotsBy now thanks to my evidence-based and scientifically informed techniques of persuasion, you will no doubt want to know how you can benefit from working with our wonderful service.

You can contact us by email or by calling us at the psychology department to talk about matters psychological, be it complex cases, potential referrals, or training your department. Find out more about making referrals by consulting our service leaflets which are available absolutely FREE through Beacon by searching for ‘Clinical Psychology’ or looking under ‘Documents’ after following the link below. And as the Patient Information Leaflet can also be found there, you enjoy a 2 for 1 bonus!

http://hippo.citrix.dghealth.scot.nhs.uk/sorce/beacon/?pageid=Sitesearch&searchCriteria=clinical%20health%20psychology

Keep your eyes open for opportunities to attend training events we’re delivering this month and enjoy the blog posts written by the Clinical Health Psychology team over the next few weeks. Finally, to eke this advertising ruse out just a little further, comment below to be part of a Clinical Health Psychology virtual focus group.

Just do it.

Ross Warwick is a Consultant Clinical Health Psychologist and Lead for Clinical Health Psychology at NHS Dumfries and Galloway

Endings…………and new beginnings by Ken Donaldson & Julie White

By Ken Donaldson

For anyone working for NHS D&G it is unlikely that you have failed to recognise that at the end of the year some of us will be moving in to a new hospital. I am aware this will not directly effect those of you who work in the community or services that are not moving across to the new site but it is likely to have some impact. This is an exciting time; the building itself will be quite spectacular and it offers lots of opportunities for change.

3367921_a75008e7That change is coming is apparent. In December we will move to the new site and whilst I am quietly terrified at the prospect of this move it is not what this blog is about. Nor do I want to talk about change but its accompanying partner, transition. So what is the difference? Well change is situational, the physical move, how we will get all the equipment, beds and kit across to the shiny new building. Its how we move the patients and ourselves and, then, start to work in the new environment. This may sound like a transition but its not the same thing. Transition is psychological, how we actually deal with this momentous move.

Transition

unknownWe have all been through transition before; starting a new job, moving house, taking a newborn baby home for the first time. And although you may not realise it you have gone through a process during that transition. There are three broad stages to transition. First we ‘let go’ of the old ways then we enter a ‘neutral zone’, where we are neither doing the old or the new, and finally we have a ‘new beginning’. If we take the newborn baby example then we can see that whilst there are so many wonderful aspects of bringing your first baby home there are also many things that we have to let go; a good nights sleep, a significant amount of money and the freedom to just go away for the weekend to name a few. Most people just get on with it and accept the losses but others can struggle. The neutral zone may be brief but still exists, often at 2am! As the dust settles and visitors stop coming so often and reality sinks in. This is it now, no going back. After that the new beginning as we settle in and accept the new way of life. The transition process is different for all of us and for some may happen very quickly, over days. However for others it may take a lot longer. Sometimes just knowing that this is a process can help.

Letting go

This stage can feel akin to bereavement. The emotions we go through are similar and the ‘Transition curve’ is to all intents and purposes identical to the ‘Grieving curve’ or stages of bereavement. When we know change is coming (as we do right now) then we can enter a state of denial which is entirely normal and hopefully doesn’t last too long. This is followed by anger, bargaining, anxiety, depression before being followed by understanding, acceptance and moving on. Not everyone experiences these emotions and some are fleeting but the reality is that they will all be manifest in our teams to varying degrees as the move to the new hospital approaches and ultimately happens. There is not a vast amount that can be done to deal with this process other than recognise it and support each other through it but small gestures can help; we want to remember the ‘old’ hospital so what can we take other than memories? Perhaps you can make up a photograph album for your area or ensure that some memorable artefacts (posters, pictures, the Ward Gonk) are not forgotten and adorn the new environment.

The neutral zone

bridges-3-phases-of-transitionSo this unusually named area, like something out of Superman (okay, that was the Phantom Zone and was in Supergirl; the neutral zone was, apparently, in Star Trek, but I’m no Trekkie) is a bit of a psychological no-mans land. It is the time when the old way has gone but the new way does not feel comfortable yet. It is important to recognise this zone and not try to rush through it prematurely. Its also important not to be frightened of it and try to escape i.e. get a new job. People do this frequently and it is rarely the right thing for them or the organisation. Finally, recognising this area and staying with it is important because it is often the time of real innovation and a chance to revitalise our services. The neutral zone is an area of opportunity, a chance to replace old habits with new ones more suited to the new environment.

A new beginning

July Photo SiteNew beginnings are much more than starts. We will ‘start’ in the new hospital the Monday after the migration when the majority of staff and all patients have moved. And we will get on with it, of that I have no doubt. It is going to be a real challenge coping with the move then a few weeks later the Christmas/New Year double whammy and THEN January! But I suspect the majority of us will still be in a neutral zone just coming to terms with the new environment and will not yet have made the new beginning. Starts involve new situations, beginnings involve new understandings, new values, new attitudes and new identities. This can take time and may take longer as we will be extremely busy just keeping the new hospital functioning but, again, its important we recognise that it has to happen. If we don’t move to the new beginning then we can hold our team back, sound like a stuck record “It wouldn’t have happened like this in the old hospital” etc.

ginThere is no doubt the next 6 months will be hard. There will be increasing visits to the new DGRI and next month the structure will be complete and we will have ‘the keys’. I suspect December will loom ever larger on the horizon as the migration and all that entails becomes a reality. As I said above I am positive that we will just get on with it and things will work out fine, albeit there are bound to be some bumps along the way. But I think it is important that we recognise the psychological impact on all of us involved in the move. It will have a massive impact on our lives and if we understand just a little of why we are feeling the way we most certainly will feel then that may help us all get through it. That and looking out for each other, remembering to be kind and a smidgen of gin.

 

By Julie White

We are now only weeks away from our staff and patients being able to experience the benefits of a modern, state of the art hospital which will enable us to continue to provide the highest possible standards of care to our patients in the 21st Century. However this change means a significant transition for many of us. Transition has been defined as any event, or non-event, that results in changed relationships, routines or roles. (Schlossberg, N 1995) The move to the new hospital will mean changes to routines, working relationships and roles for a large group of our staff. However, we all go through transitions, big and small, as part of our everyday lives. How we deal with these transitions is important……
Right now, for me and my family, we are going through a transition which will be familiar to many. My 11 year old son, Adam, is just about to undergo the transition from primary to secondary school. Whilst the school have worked hard to prepare him for this move, Adam is having to ‘let go’ of the comfort blanket of primary school, being one of the ‘big boys’ and having the security of a well-known routine and the familiar faces of teachers and pupils. I am also having to ‘let go’ and accept that Adam is becoming more independent (even allowing him to walk to the end of the road to catch the bus to Lockerbie!). This transition is huge for both of us, for different reasons.
I recognise, however, that we are entering a new phase and there is no going back now. I have to admit, however, I am far more nervous about the future than Adam is – he has the fantastic ability to see this as an adventure, an opportunity to learn new things and make new friends. He also particularly liked the lunches at the Academy when he visited which is always good news for an 11 year old boy!!!. I am anxious about the move to a much larger school, worried that he will need to make new friends (whom I won’t initially know) and that our very close relationship may change as he nears the teenage years!!. I know, however, that I will do everything I can to make this transition a success as I will do with another major transition in my life – the move to the new hospital.
July Photo SiteIt is less than 4 weeks until we ‘get the keys’ to the new hospital and we can begin our commissioning and migration process. Feedback from staff who have had the opportunity to visit has been overwhelmingly positive. All staff will have the opportunity to visit for orientation sessions between September and the end of November (if you haven’t booked a slot yet please do so!).
Whilst the move to a brand new state of the art hospital will be an exciting prospect for many, it is important to recognise that for some staff, the move will evoke emotions such as fear, loss, anxiety and sadness. We have lots of staff who have spent most of their working lives in DGRI (some of whom have worked in the same ward or clinical area for 20 years or more) and we cannot underestimate the scale of the transition for lots of us. Some staff will also have memories of being a patient (or having friends and family members cared for in the existing hospital) and we have a general attachment to the past, to our history here and to our memories of the good times. I would encourage staff to think of ways of ensuring that you and your teams don’t forget the good times and take photos and memorable artefacts with you. The new build team will also be ensuring that some of the treasured artwork from our existing hospital is incorporated in the new DGRI eg the tree of life. I am sure we will all create new memories and have good times in the new hospital but it’s important not to forget the past.
In order to help with the transition process, we are planning a couple of events to celebrate our new beginning and to recognise the varied emotions that people will experience.. We will hold our annual Winter Service at Crichton Church with a theme of “ new beginnings”. I also hope to hold an event in the Atrium of the new hospital soon after the move to acknowledge the huge amount of work undertaken by staff, celebrate the fact that we have had a safe, successful and smooth move (which I am confident we will achieve by pulling together) and to focus on our future in our new surroundings. If anyone has any ideas about how else we could mark our transition, please get in touch.
I would also like to acknowledge that not everyone in the current hospital will move to the new facility. Some staff will choose to retire or leave but other teams will be moving to Mountainhall Treatment Centre (Cresswell to us all just now!) and I fully appreciate that these teams will experience different emotions when the move to the new DGRI takes place. We will work hard to ensure that we support all staff during this transition and it would be great to hear people’s thoughts about how they can best be supported during this time.

 

Julie White is Chief Operating Officer and Ken Donaldson is Deputy Medical Director Acute Services at NHS Dumfries and Galloway.

References

Bridges, William. Managing Transitions. 3rd ed. Nicholas Brealey Publishing, 2009.

Kubler-Ross, Elizabeth. On Death & Dying. Scribner, 2014.