D92 #100WorkingDays Change and Challenge

 As winter settles in, in the northern hemisphere at least I am thinking about the changes of the past, and the challenges to come. Those two C’s could be swapped in the last sentence.  Change and challenge seem to go hand in hand. Why is it we tend to find change a challenge? There seem to people who can throw themselves into a challenge - as a Strictly Come Dancing fan I really admire the way (most of) the celebrities go for it. It seems then they are changed as the series comes to an end. 

I am perhaps more risk averse than those dancing heroes. Yet the challenge of the blog I set myself has felt risky at times. And there have been times in practice that feel risky when starting conversations with those I’m caring for. By exploring and listening we enter into a process of change where we establish the new reality. There’s an element of control that we can exert over this challenge. There are events though that challenge as they are not in our control or influence directly.

Be it politically led or some kind of natural catastrophe, changes occur. Our news feeds have examples of tragedy and some triumphs that can change our mood and challenge us to action. Whether signing a petition, donating money and time, or taking direct action we act by being challenged in the hope of creating change. So facing a move away from nursing and full time working there will be lots of change and challenge. These have a sense of anticipation, and whilst I’ll be stepping away from a clinically focused role I’ll still be looking to challenge and change working for the better through my Freedom to Speak up work.

Doing things badly can be a good thing?

I have had an interesting week; work has been busy with the team doing good things for patients and each other. All very supportive and a joy that they can be trusted to get on with things.

I’ve had two task this week that needed delivering. One was a business case and the other an opportunity to deliver a 6 minute talk as part of a conference day on human rights in end of Life Care.

The business case would seem straightforward however getting the style right for the (NHS) organisation can be a challenge. Fortunately my boss has plenty of experience in our place of work and whilst I started it not very well I’ve submitted what’s been agreed is a much better version. Anxiety about how it might look and be received is lessened; taking the first step is the worst bit for me.

And that, I’ve just realised, is why blog writing regularly hasn’t been easy either.

So I was interested in reading the article by Olivia Remes that points to the science behind beating anxiety, and why doing something badly is a good idea.

This struck a chord with me; getting started is an act that I can successfully sabotage by myself. So reaching a finishing point (sending the business case for consultation, or posting a blog piece) becomes a cause for internal celebration.

The second task has been longer in development as I’d been invited to contribute to a quick fire afternoon session at the Sue Ryder hosted “Human Rights in End of Life Care” on 27th June. A 6 minute slot was mine, along with three others who are trainers like me. The slides were easy, the content came pretty easily too. It was the prospect of delivery that became a matter of anxiety. There was some rehearsal and having the slides safely loaded in advance were helpful strategies.

The night before was not good in terms of sleep and all that could have gone wrong in terms of travel added an extra layer of worry.

On the day the trip was fine and the venue was easy to find and had a nice auditorium. Even so there were nerves; I’m conscious that a poor presentation does no one any favours. As it happened my little contribution was kindly recorded on my iPad by another speaker. I can see I “immediately” a lot to begin with, and then had some trouble with the slides. I did get a hoped for laugh or two, as well as some serious points made. I could have done better (I believe) though I was told I’d done well.

Olivia is helpful in that she points out that doing something badly (or at least not very well) is a way to combat anxiety. So I’m reminded to be kind to myself; to trust the praise of others and to ignore the internal doubts that will lead to further anxiety.

And maybe there’ll be an increase in the frequency of my blogging?

Be brave, honest, open

Inspired to write today by a blog from Tony Warne (an impressively regular writer) I wanted to reflect on the report from the BBC about the lack of cultural competency in hospices. Based on research conducted by LOROS Hospice and Leicestershire Hospitals I wasn’t surprised (sadly) by the findings and the call to action.

I’m aware that many hospices have been trying to engage with those in their surrounding communities. Offering the opportunity to share information about services, and to learn more about the perceptions their neighbours have about hospices.

We now have a greater understanding of the importance of being able to talk about death and dying, and the difficulties nurses, doctors and others involved in caring for those who’re dying face. How important is it that we reframe hospice and Palliative Care services? In my professional lifetime many cancers have become more of a long term condition though still with notable exceptions such as pancreatic cancer. The focus has shifted to supporting those with longer term conditions to get the best out of their situation as they can. Hospices can, and do, help with that.

Perhaps hospices should move to being a community health hub, where services reach out into people’s homes and tackle loneliness, poor physical environmental conditions, encourage finding ways to improve individual’s health and bringing forward the conversations about death and dying.

As cultural norms shift we have to recognise that some changes have left us afraid to address these issues. Time to be brave, be honest and be open; a call to all who believe that being open about living before dying is important to all those around us.

Challenges for the personal and professional

At the end of February this year my dear friend in nursing @agencynurse Teresa Chinn wrote a blog piece about the WeGetogether2016 event, held on the 29th Feb 2016. As ever Teresa gave a thoughtful account of what happened, the build up to it and considered the consequences. One one aspect Tree asked about was "what happened?" Her response was 'nothing' and that concerned me; so I want to challenge that - gently of course. In one way I guess Tree is right - no great single change or movement emerged that sparked a revolution. 
I began to wonder however if I had missed something because I believe there were myriad outcomes, albeit small ones.

I had traveled to Salford where the University Nursing School hosted us, full of hope and expectation; not to mention carrying banners and freebies including home made cookies. 
When I look back on #WGT16 I think of the developing relationships that were bolstered by meeting in person; the thinking and sharing we were encouraged to do. From my perspective it led to a wider range of contacts and networking that influences me today. So let's remember what we experienced at #WGT16 and think of where we are now. Yes times seem to have become ever more challenging in terms of politics, the economy and the Care sector (I like to think across the health and social fault line). That has not stopped people continuing to challenge both personally and professionally. 

And then Teresa has set me thinking again about challenges; this time in her latest blog about professional challenges.  I've found nothing to argue with here; safety and safeguarding are key nursing responsibilities for nurses. It is the anticipated response of others that can block coming forward; I believe that as a senior leader and a manager I have a duty to set an example as a listener and in responding positively when concerns are raised. Likewise I have to be ready to face personal challenges and accept that I have got things wrong. Developing as a leader is about learning about oneself as much as getting to know those around us and that can be a much bigger challenge.