A Christmas Call

   

“ Blessed is the season which engages the whole world in a conspiracy of love.” – Hamilton Wright Mabie 
 
Last Christmas a worker at a NHS health centre for the homeless rushed through the streets of the city centre loaded down with carrier bags. In the bags were Christmas gifts and tins of chocolates. She had hoped her colleague would accompany her but the colleague was drawn away to clinical duties due the demands on the service. 
 
The destination was the local refugee drop-in. The idea was for the refugee children to each receive a small present  – a colouring book and pens – and gifts of chocolates for everyone there. The money was raised, the gifts bought, donated and duly wrapped. The clock was running fast so the worker decided the best bet was to walk across town.  
 
The city centre bustled with people and shoppers. Halfway through the journey the handle on one of the bags burst. Our friend sighed, grabbed the bag by its body and ventured on. She was stressed  – she had so much work on back at the centre and was behind with things too. She arrived at the drop in centre – flustered and out of breath. She was happy to put the bags down. 
 
The refugee drop-in was full – adults and children filled the centre and sat around tables. People who had endured unimaginable experiences a short time before in the war torn areas of Syria were here and were safe. She started to distribute the chocolates on the tables and gave the presents to the children. The children opened the gifts and got down to the colouring and drawing. Colleagues from the local authority arrived with presents too. As our friend stood there she started to fill with emotion and well up with tears. Something was unfolding before her  – something very simple yet incredibly significant. It was an experience that touched her heart. She stayed a short while and then returned to the busy, never ending world of NHS healthcare. 
 
On her way back she reflected on what she had seen. For a short time at the drop in centre, she had stopped her rush-a-day work life and been given a clear message. There were three parts to this. 
 
The first was she recognised in that little church hall what really matters. It’s people who matter. Seeing the joy in the faces of those children was what both Christmas and work was all about. Seeing people with nothing, happy to receive and to find joy in simple gifts. Caring for others and bringing joy to those near and far from us was the most important thing. It is what we do to others that teaches us most about ourselves and what our services should do. 
 
The second reflection was that we are all in this together. The local authority, third sector, shops that gave free chocolates, good hearted individuals who helped and the faith community who hosted the sessions. It said that we work best when we work and learn together. Each bringing their own contribution to make something greater than the individual parts. In that room she saw how cities and services must be in the future – moving from silos to solidarity. Solidarity comes from the French for ‘interdependent, complete, entire’. Solidarity here was a unity for change and care in the heart of a city. 
 
The last reflection that struck our colleague was that we all have a part to play and that a public service ethos is a powerful connector. She had seen it in the busy colleagues who couldn’t attend but who spent time meticulously wrapping the presents; the local Co-Op manager that donated chocolates; the fact that the city was working to support the most marginalised. This wasn’t just a Christmas tale but an everyday one – people in the NHS and with a public service ethos everywhere  – united in a shared purpose to do good and make a difference, whatever your circumstances, wherever you are form. This was an event perpetually happening in so many places. 
 
Public services sometimes get things very wrong. At other times they shine like diamonds. Public service is a deeply held belief and drives people to create the best they can. This is one of the main reasons why we think so many go the extra mile and work outside of hours to try to help. This wish to publicly serve is something to value, cherish and celebrate. It is about making a contribution to build a better world. A world without social workers, therapists, nurses, doctors, support workers, porters, drivers, chaperones, hostel workers, advocates and everyone who chooses to serve people as a public good would be a lesser place. Public service is a commitment to social wellbeing, development and cohesion.  
 
At this time of the year we hear and see the great Christmas tales. Books like ‘A Christmas Carol’, films like ‘Its a Wonderful Life’ and the story of the health worker at the refugee centre remind us what really matters. When it comes down to it, it’s all about people – like you, like us and everyone else who makes a difference to those we care about. The writers would like to wish everyone a great Christmas and happy 2017. We hope it will be a time of great joy for you and yours. We dedicate this blog to all those – families, patients, carers, staff and volunteers and people out there who every day show us what true humanity and care is all about – thank you – you inspire us to keep on hoping and going. 
 
Rob Webster
John Walsh

THE FOUR HORSEMEN

‘The Nazgul were…the Enemy’s most terrible servants ; darkness went with them’- J R Tolkein

 

In the Lord of the Rings there are the Nazgul. These are former kings who fell through a set of rings given to them. The rings enslaved them to the Lord of the Rings – the wicked Lord Sauron. Now they ride the country as ring wraiths – looking for the master ring which has been lost. They seek it for Sauron their master. They ride on black horses and wear steel armour. They rampage seeking what possesses them – the ring. In the last book of the Christian Bible there is the reference to the Four Horsemen of the Apocalypse. They appear in different colours symbolising their character. They are war, conquest, famine and death. Like the Nazgul they ride bringing their deadly wares with them.

Are there four horsemen of organisations? The authors think there are many horsemen that ride through our organisations and services. These horsemen of the organisational apocalypse stream through business and service systems creating immense harm. In this blog we will name four particular horsemen and ask what we can do.

The first horseman is fear. Fear dominates many organisations and teams particularly in a time of austerity and cuts.  Fear of the future – fear of restructurings and job loss – fear of what will happen. The phenomena of anxiety through uncertainty is very present. Then there is another fear. The fear caused by bullying and unfair treatment. The recent Guardian poll found a shocking response. The online survey of more than 1,500 doctors, nurses and other health workers in hospitals, primary care and community settings, found that 81% had experienced bullying and for almost half of them (44%), it is still ongoing. Fear is something that effects health, sleep, wellbeing and performance. Fear distorts reality and can freeze true innovation. We often don’t talk about this particular factor. Yet it is so present and moving in many places.

The second horseman is not recognising power. There are power differentials in all organisations and with power can come tremendous influence. Power is not a bad thing in itself. The problem comes when we don’t see it and take account of it. Discussions about change, engagement and improvement can take place without this awareness or recognition. Power is an elephant in the room that we should not ignore. We need to see it and find ways to work with it.

The third horseman is poor culture. Culture defines and decides so much. So many good wishes and words and policies will fall on poor cultures and not be heard and quietly dissolve into nothingness. Culture is the container for everything. It decides to a large extent how what will happen to what lands in the team or service. Yet often discussions and plans will take place without reference to culture as if there was no existent culture at all. Another form of this is where we talk about culture and never unpack what we mean by culture or explore how culture happens or operates. Culture is and can be a wonderful thing. It can also an awful block on any progress or care. When we get it wrong, culture is a horseman making the best words and wishes void and enshrining the worst as the norm.

The last horseman we name is mist. Some might remember those old black and white films where London was filled with fog or smog. Someone recalled how you couldn’t see the house on the other side of the street and even walked past your own house as the smog was so thick. This mist we have has different forms. There is the fact that one can get lost in systems and lose sight of our passions, dreams and goals. A mist coms down and we end up running around, not looking after ourselves and forgetting our visions and hopes. Then there is the mist where we miss the obvious and don’t hear the essential – often the voices of patients, staff and carers. Another shape of mist are sometimes expensive programmes that promise so much and deliver so little. Mist tends to be visible but lacks real substance. These mists can tend to cloud the mind and obscure judgement. There has never been a greater need and time for clarity and clear thinking in these things.

These horsemen ride through our organisations and we believe in a real need to see and name them. What can we do? There are some things which we will not easily change such as power structures and embedded poor cultures. There are three things the authors think are essential and that we can do. They are to look out, look in and look around. ‘Looking out’ means to, in extremely challenging times, work to ensure that those who come through our doors ( whoever we are – NHS, local authority, third sector, business ) get the best service we can offer. This looking out is a commitment to put those who use and need our services at the heart of what we do. ‘Looking in’ means to look at what we each need to keep safe through this turbulent times. We have a duty of self care and self kindness. We need to focus on this. Then there is ‘Looking around’. This is where we see how and where our staff and team colleagues are. We have people and teams under great pressure. We can be support and kind help to them. There is a lovely saying of Rumi the Persian poet. It says ‘ Be a lamp. lifeboat or a ladder. Help someone’s soul heal’  In this difficult times we can be conduits of kindness to others and to ourselves.

In Tolkien’s works it seems that humility and kindness find a special place. In the great battle at the end of the Lord of the Rings it isn’t the great or powerful who strike the decisive blows but the hobbits – the little people, the unrecognised. This echoes Joanne Macy the systems scholar in that it is in ordinary people that the future lies. It is our hope and faith too. It is in local people and communities that we have our focus and locus. In ‘The Hobbit’ Gandalf the wizard and one of the great figures of the Lord of the Rings speaks of kindness. He says his acquaintance,  ‘believes it is only great power that can hold evil in check, but that is not what I have found. I found it is the small everyday deeds of ordinary folk that keep the darkness at bay. Small acts of kindness and love.’ Perhaps as horseman ride through our services the greatest call is to build these networks of self care and kindness for each other. They are spaces of care, love and listening. They are micro communities of connection and learning. Tolkien’s work is all about what we can do together in solidarity and relatedness. It calls us to humble and sow seeds of kind co-working. We believe it is these forces that our future lies for it is them that we find the real energies of life and movement.

Nicki Haywood

John Walsh

 

 

 

 

 

WHAT IS COACHING ?

”The biggest gift you can give is to be absolutely present, and when you’re worrying about whether you’re hopeful or hopeless or pessimistic or optimistic, who cares? The main thing is that you’re showing up, that you’re here and that you’re finding ever more capacity to love this world because it will not be healed without that. That was what is going to unleash our intelligence and our ingenuity and our solidarity for the healing of our world.” ― Joanna Macy

 

 

 

Its usual business at the health practice where Pauline works as a health professional. The workload, demands and pressures are there as always. Her colleagues feel them too and do their best to cope with them. It’s the start of another week for Pauline. She has been a health professional for 12 years. She still has her passion and enthusiasm. As she looks around the centre everything is so familiar – the rooms, the colour of the walls, the leaflets in the racks and  the busy hum that sounds through the building. Yet something is different.

 

 

Pauline has been on a course introducing health professionals to coaching. Coaching probably has a number of different definitions. One could be it is how we create conversations where people see their own potency and find in that exchange ways forward to problems. Perhaps, ways which they didn’t see before. It is based on a number of therapeutic disciplines. It has started to be more employed in services. In Leeds the city has brought Health Coaching into the city. The three health trusts and the local authority are working together to see how we can support the emergence of coaching as a dynamic for change and engagement with people. Coaching is also being recognised nationally as an approach that can transform the care and the relationships between people, patients and staff.

 

 

During the training Pauline had a light bulb experience. She had suddenly seen something which made her practice new and potentially exciting. It isn’t easy to describe what she saw. She would say words probably don’t hit the mark.  She saw that coaching wasn’t fundamentally about techniques and models. Neither was it about theory. This doesn’t means that these things aren’t there or aren’t important. They are. Pauline saw what she believed to be the essence of what coaching was.

 

 

Pauline saw that coaching had a number of underlying assumptions which were both visionary and liberating approaches. These philosophical assumptions when linked to living practice formed a mindset –  a new way of seeing the world and a new way of responding to it.

 

 

Pauline saw these assumptions as the heart and centre of the coaching approach. They were –

 

 

 

    * people have great potential yet we often don’t use or aren’t given opportunities.

 

 

 

    * together is better – all bring something to the work – partnership is not telling people what to do.

 

 

 

    * listening and empathy are the arms which welcome.

 

 

 

    * we don’t have the answers – but in the conversations we start to discover them.

 

 

 

    * we should start where the person is – what are their ideas, experiences and priorities?

    

 

 

This is a humanistic vista and values each person. Pauline realised she had done these in her practice but not in any coherent joined up way. Further there was and had been another philosophy written invisibly and visibly into everything. It was that the health professional had all the answers. This reflected historically very hierarchial structures and practice. This philosophy focused on tasks and saw patients as  passive recipients not active partners in their own health. This other philosophy flowed through so much these new coaching approaches excited Pauline. They excited her as she saw how they expressed what patient centred care is all about. She also saw that best practice was about connecting partnerships and  great conversations which supported people to see possibilities. 

 

 

Joanna Macy the environmental activist and scholar of systems theory calls for a Great Turning – to move from industry growth models to a Life Sustaining model of how things can be. This is  a call for services that aren’t primarily there to produce a product but listen and engage people in kind change. Fundamental here for Joanna is a’ fundamental shift’ in worldview and values’ as ‘the  most basic dimension of the Great Turning.’ This is about how we see things in new ways to create things anew. Joanna’s language conjures images of us turning in deep ways to create the future. For Pauline it is how she does the same work in a different overarching vision and practice . Of course when this happens the work while working in the old forms can be transmuted into something different. We believe this offers a possible escape from that cast  iron law of organisations – that if we keep doing things in the same old way we will get the  same old results. Pauline has started to make this connection too. What would our services look like and be if a mindshift to a new mindset  could happen?

 

 

Pauline talks of how coaching conversations and the basic assumptions she sees have to permeate organisations and cultures. Her work today involves coaching approaches with those who use her service. It also has started to seep into the conversations with colleagues and family members too. Coaching approaches for health and care professionals offer so much. It leads us to what the Joanna Macy quote at the beginning of this article describes so beautifully.  Our services will be transformed when we support the emergence of the gifts, passions and energies of us all – patients, staff,  carers, families and communities. That’s the power and energy we need. The call to be absolutely present, to create spaces for creativity and healing and to have conversations that value and include others is the future or we won’t have any future we can truly call inclusive and person centred. The authors are fortunate to see the effects of this work and its value in their own work. They also realise how far we have to go yet. Yet the very fact that this call is been heard, the work is happening and statutory bodies are seriously committing themselves to this coaching approach are to us a sign of hope. Coaching tells us that we have a tremendous power in our conversations and words to support others to find their answers. In a world and culture where people don’t often feel or own their power this can be a hope filled message of what we can do and be.

Josephine Johnson   @Josephi13351788

John Walsh   @johnwalsh88

OPEN SPACE

“If you want to know the secrets of the universe, think in terms of energy, frequency and vibration.” – Nikola Tesla.

” If we can be genuinely understanding – listening not only for the words but to the meaning….if I can really be myself…me …that’s helpful. All these things are possible and when they come together that’s creates a very powerful climate for change, for growth, for drawing out potential.’ – Carl Rogers

The Universe is a mysterious and wondrous place. It engages and challenges our thinking and templates. The Nobel Prize winner for physics Niels Bohr says , ‘“If quantum mechanics hasn’t profoundly shocked you, you haven’t understood it yet..’ The Universe offers a plethora of questions and unknowns. Yet we can learn and know some things. Carl Sagan the cosmologist notes how, “We are a way for the cosmos to know itself.” It’s us as human beings possessing conscious awareness and reflection that can make sense of what we are part of. We are a way for conscious understanding of what is.

Scientists tell us everything is energy expressed as form. Everything is moving energy which is creative and has connectivity. If we could see this energy we would be probably be astounded at its flow and power, its potency and manifestation. All the different manifestations all flowing from common sources and form everything from the planets to popcorn. A force including, uniting and yet diversifying all things.

It’s an intriguing point that our organisations and services don’t reflect this dynamic power and energy that flows through all. Rather they often resemble static machines in which the aim is to keep the wheel turning ( or even create more wheels in wheels ). It seems that we have more of a factory understanding than a Universe understanding of that services and people in them can be.

What might a Universe look like? Creativity, new forms, dynamic energy and connectivity? Well we are going to try to create one. At this years NHS Expo we are having an event called ‘Connection Cafe’. Don’t worry – we are not going to try to contact alien life. We are going to do something far greater than that. We are going to try to contact and connect with ourselves.

Work, life and experiences make it very difficult at times for us to be in touch with ourselves and each other. We often live in our heads and stress and pressure drive our minds to dark places. This stops us really experiencing ourselves and other people. Many of us of us hear people but aren’t actually listening. We all probably have the memory of talking to someone and knowing that they are miles away. It may have been us all those miles away. Bodily present but no connection occurring. We are often distracted from the present and the person.

The Connection Cafe is on September 8th from 2pm to 3.30pm. It is part of Expo’s new Patient & Family Fringe (a Fringe that we hope will grow organically year by year, like the Edinburgh Fringe, to be centre stage at Expo)

This will be an open space for people attending Expo to join us – patients, staff, students, families – to talk about what is important to them. There is no agenda, no plans and positions don’t matter. We meet as human beings looking at what matters and what is in our hearts. We hope this will be the first of such events across the NHS and other services to create spaces to be human – to laugh, share, be vulnerable, be open and be kind. It is all about people regardless of status connecting as humans; to learn about each other as humans; to promote compassion and empathy in healthcare. It is a space for everyone to connect as equals; patients, carers, families, clinicians, therapists, nurses or CEOs. It is about breaking down silos and hierarchies; seeing each other as humans not as roles. Listening and learning and taking small steps to improve empathy and understanding in all directions.

Carl Rogers was one of the foremost psychologists of the 20th century. His words at the start tell us that happens when we meet others on the ground of authenticity, openness and real listening. We start to change – actually we start to blossom. Blossom into and as people.

We hope this event will be all about energy, connectivity, flow and being open to new things – as the Universe itself is. The energy for us will be what we intuitively and instinctively so as good human beings, Presence, listening, empathy and congruence.

Our services thrive on this humanity and humane ethics. Without this – everywhere – from cleaner to consultant – from patient to chief executive – we are growing a desert where the human and important cannot grow.

The cafe is an invite to come and be with others and for others. We hope you will join us in Refreshment Area 4 (Next to Camp Expo) 2-3.30pm 8th September at #Expo16NHS #NHSExpoPPF

John Walsh

Zoe Picton-Howell

Tales From A Bus

“Everytime you smile at someone, it is an action of love, a gift to that person, a beautiful thing.” – Mother Teresa

“Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that.” – Martin Luther King

 

On a bus we can see many things. Some are good, some are beautiful and some are neither. Recently the author heard two stories about things that happened on a bus. Perhaps they mark the challenges and possibilities that face us in the months and years ahead. They offer very opposite tales. One is a tale that is frankly horrible. The other is a tale that offers hope and a promise of better ways. I will share them here as we seem to live in such a time of rapid change and uncertainty I believe it is now more imperative than ever for us to stand together for what is decent, kind and supportive.

The first story is from a colleague I sometimes work with. He shared how he got on a bus. At one of the stops a white person turned to a man whose family came from Asia and said to him that it was his country not this man’s. The implication was England is now a country for whites. How must that man must have felt? Another  report said how a bus driver was abused by a passenger. The passenger told the driver to get back to his country. Unfortunately over the last few weeks these reports are heard more and more. We face visibly  deep division and enmity in our society.    

There is another story. A friend of mine gets the bus to work every morning. He often reads. One morning last year a young woman got on and their eyes caught each other and he smiled. She smiled back. From then on they would smile at each other and sometimes wave when the woman got off the bus. After a few months my friend no longer saw the young woman. Early on this year while waiting at a bus stop he saw her walking towards him with a friend. She stopped and they had a very friendly talk. The woman was with a friend. At one point in  the conversation the woman said ‘You know when I got on that bus my head was so full of stuff I was going through.  When you smiled it lifted. I felt different.’ She then turned to her friend and said ‘This is the guy I told you about on the bus.’ Her friend smiled and nodded. 

What happened on that bus is that two people connected and some burden or load was somehow loosened. We can have an incredible power to support and affect others. This writing is not a call for us to wear painted on smiles like a clown. That wouldn’t be real or authentic. Perhaps my friend had a magic smile because he has a magical heart. A magical heart welcomes  people, values difference, gives and cares and wishes people well. In the time ahead the development of magical hearts might be the best antidote we have to division and discord. There is a famous prayer of St Francis of Assisi in which the saint seeks where there is hatred to sow love, where there is despair hope, where is sadness joy and where there is darkness light.That may well be the manifesto that really matters in the time ahead. To spread these seeds of better tomorrows and invite others to join us in this work  will be our core duty. And if we do we will never know  or realise the good we do and the people we help on their journeys. The good news is there are so many people already doing this work. Of course we may fail at times. I fail every day. Nevertheless, in our kindness lies our future. I really hope you will join us. 

John Walsh

BRIDGES AND RAINBOWS

“Don’t be discouraged. It’s often the last key in the bunch that opens the lock.”—Unknown

 

It’s not a secret that services face tough times. High demand, less money, intense pressure, low morale, service restructures and uncertainty about the future feature in many places. This happens. Yet in the middle are people – patients, staff and carers and families. We need to name issues and ask what we can do to support ourselves and each other in these deeply challenging times.  

In this blog we will try to look at one aspect of this phenomena swirling through our services. We will ask how this pressure affects those inside an organisation. We will also ask what can be done to help us keep afloat in times of change and austerity.

When organisational change occurs there is often fear, uncertainty and stress. Many people find their jobs stressful and demanding. When the organisational landscape starts to move we feel more vulnerable than ever. There is a secret that hardly ever gets spoken. It is when these awful times come organisations often don’t know how to respond and what to do. Often neither do we ! Most of us feel centred as long as we have stability. When the earth starts to move everything can start to shake. Our certainties can start to disappear and anxiety and feeling lost can easily start to appear.   

We think there is need of organisational and personal response. What can organisations and people do? There are obvious things such as honesty, clear communication, preparing people for difficult times and support such as coaching or staff counselling. When difficult times have been experienced to demonstrate that lessons have been learnt and how they will do things differently next time. Learning what we can and cannot control, taking control of that which we can, letting go that which we cannot, influencing where we can.

As we write this we think of the need for healing spaces. These are places where we can feel OK. Work organisations should create them. A nurse said to one of the authors today, ‘You often don’t get many of them in work.’ Yet these spaces are essential. They are what inspire, energise and connect us to what is good about us and others. They are places of exploration – where we try to find that key we need. We need them in work or outside. The real concern is if someone is getting them nowhere. Organisations and people can create these spaces. We all need them. Wouldn’t it be a wonder if these spaces started to blossom in our services? An even greater wonder would be if we they were made up of staff, carers and patients where possible. We need to generate and sustain these circles of care. Twitter is a network of healing spaces for many people.

These spaces are like bridges and rainbows. In Norse mythology there was a rainbow bridge called Bifrost ( meaning ‘shimmering path’ ) connecting Earth and Asgard ( the home of the gods ). It could only be destroyed by the powers of battle, warfare and hatred. These spaces are like bridges because they carry us from where we are to where we need to be. They are like rainbows because rainbows bring colour, connection and a sense of the extraordinary. Across the greyness of work demands and pressures these rainbow bridges should and can span. The good news is that they already exist – we see them on twitter – in some of our workplaces – in our conversations, coffee shop meet ups and common work. Some of the best, most effective and caring are made up of patients, families, carers and staff. We have a real power and possibility here. We can make these bridges and sadly we can also destroy them. Whatever the future of our services we are sure whether we create these spaces for the soul to be heard and healed are key to the people working and lost in services. We owe it to them and the ones they try to serve to build thousands of these networks wherever we go. We may not always to be able to change the outer picture. We can create these bridges and friendships that mean the world.

Lucy Sutton

John Walsh

( A special thank you to Helen Bevan and Val Dez La-Lour from NHS Horizons for connecting us to write this )

The Call of Community Nursing

“Too often we underestimate the power of a touch, a smile, a kind word, a
listening ear, an honest compliment, or the smallest act of caring, all
of which have the potential to turn a life around.” – Leo Buscaglia

In the film ‘What Women Want’ we encounter the story of a male chauvinist advertising executive who finds out that through an accident he can hear what women are thinking. He discovers a lot about people and himself. In our busy cities and towns people swirl around us. We don’t know where they go and what they carry. Sometimes in their faces we get a glimpse – happiness, smiles, sadness and worry seem written there. In so many cases we just can’t guess.

As well as individuals, life saving and life valuing services operate and move across our areas. Within this is the vocation known as community nursing. They are the nurses who go out into communities working with children, the elderly and people in medical need. Recently the authors heard the words of one such nurse. These words were important and sum up what community nursing is all about. The words of this children’s community nurse express the heart, call and essence of community nursing and what we can do and be for the future.

In our discussion three fundamental messages came and shone through the stories and words of the nurse.

The first  message was about circles.  The nurse explained her role and that of her team was to build care and support around the child. It was all about the spinning of care and support around children who were ill. The child had to be at the centre. Lots of our services are actually based on people navigating systems and appointments. In this paradigm the person works through the system. In the words of the community nurse we saw another possibility – that the system circled around the young person and built care from that centre. The message of circles is a vital one for all of us involved in the provision of services.

The second message was commitment. When asked why this child centred approach was the practice the nurse smiled and said that it was all about allowing the child and family to have a normal life as possible. She went on to explain that children facing multiple hospital appointments needed that life with family and loved ones as much as possible. The child centred practice flowed from a commitment to the child and their family and to disrupt that life as little as possible. Hearing these words was a very moving experience. In the face of the nurse one could see that the commitment was inextricably tied to the care the child needed.

The last message was collaboration. The nurse explained about working with the families and other agencies especially the local authority. It was clear that people were moving beyond organisational silos to meet the needs of children. There was real sense of ‘We can’t do this alone and  we don’t want to. We all need each other.’

The question we couldn’t avoid asking the children’s nurse was ‘Why do you do what you do?’ Her answer was immediately forthcoming ‘I do it to try to make a difference. I want to be part of the journey and care of the child and their family.’  These elements sum up what good services should look like – services working around the child, working with and listening to others and wanting to make the life of the child as rich as possible. There is no surprise that it flowed from a vision and heart that wanted to make a difference.

One of the authors took place in a meeting last year with colleagues from health, academic and third sectors. As part of the work we had to break off into two’s and share what we valued from others. One of the participants said to another, ‘You make me believe that – despite everything – change is possible. You keep my hope alive.’ Its a wonderful thing to say and hear. The meeting with the children’s nurse had the same effect. It showed in the most difficult of times we can make a difference. It showed whirling across our cities are good services caring for our people. It also shows that ultimately it is what is on our hearts that will create the best services we can.

The meeting with the community nurse showed the value, power for good and importance of this branch of the nursing family. On July 8th 2016 in Leeds we are holding the Community Nurse conference organised by Leeds Community Healthcare NHS Trust, Leeds Beckett University and Leeds University. Its theme is Community Nursing: Innovation and Transformation. It would be great if you could join us to support and celebrate community nursing. 

Jean Strudwick, Community Nurse, Leeds Community Healthcare NHS Trust

John Walsh, Practice Manager, York Street Health Practice, Leeds Community Healthcare NHS Trust

Calling the Jubilee

“It may well be that we will have to repent in this generation. Not merely for the vitriolic words and the violent actions of the bad people, but for the appalling silence and indifference of the good people who sit around and say, “Wait on time.” – Martin Luther King

Several years ago I sat with my good friend Yvonne Coghill having dinner. We talked about many things. It was night of deep conversation, much laughter and real energy. Yvonne then told me something that shocked me. She explained that across the NHS when you go up the structure people like her – black people and people from minority communities – start to disappear. The top was all white. Yvonne explained all the evidence shows that this occurs all over our health systems. Yvonne also explained there was good work going on to change this. I was deeply disturbed and that night said I wanted to do something to support this change. On the way home my mind reeled with thoughts. ‘Why should people be excluded for their skin?’, ‘Why does a service based on need exclude the talents and gifts of people from minority communities?’ and ‘This is so wrong and yet I had never heard about it anywhere before.’ Over the weeks and months later I shared the picture with others. Some knew  – most did not. People in other statutory services also started to share with me that the picture was identical in their structures too.

Last week NHS England published the WRES ( Workforce Race Equality Standard ) which Yvonne, Roger Kline and other good people had worked so tirelessly on. The WRES looks at NHS services and trusts and records the experiences of people from BME communities. The WRES is a barometer to tell us where we are. I believe there are two fundamental tasks that flow from the WRES.

The first is that we name the shame. In the last few years more and more people have learnt the fact that BME people are often excluded and receive poor treatment. We need to accept and own this shame. We shouldn’t deny it or appeal to the ‘wait for a better time’ that Dr King warned us about. Neither must we use this shame to beat ourselves up but as a light to see and create the future. A torch rather than a whip.

The second is we must change the game.There is something in our systems that is working to perpetuate and sustain these differentials of shame and injustice. I am not sure what they all are. Some are probably deep seated, hidden and self perpetuating. I do know we need to work for alternative dynamics and energies that offer new paradigms for people excluded and feeling excluded. The WRES is a support for these two much needed aspects to emerge and embed.

              
The ancient Hebrews used to have a practice of Jubilee. Every 49th or 50th year something amazing happened. The year started with a ram’s horn been blown ( the horn is called a shofar ). All debts were cancelled and slaves were freed. If a man in debt sold his land to escape poverty it was returned to him. The idea was that in this year liberty and reversal of misfortune would happen. Maybe the NHS needs a Jubilee of its own. For the bullying of staff to stop, for families and carers to be fully listened to and included, for staff to look after themselves and each other, for care for patients to be primary, to embrace and support social care as our sister, teacher and equal and to build positively with our great third sector colleagues. And for BME staff to be fully included in all levels of our service and not just be included but feel valued. That is why I support the WRES. It is a sign of what we can be – Jubilee people. People who see and act when we view something so wrong. The quote by Martin Luther King is from his work ‘A Testament of Hope.’ Maybe that word ‘hope’ sums up why Yvonne, Roger and so many more are there working and struggling for these shifts for justice and equity. They are people who work for positive change and sow seeds of hope. I am honored to stand with them.

John Walsh

Facing the Future ✨

“Not everything that counts can be counted, and not everything that can be counted counts.” (Sign hanging in Einstein’s office at Princeton)

”Our crowded, overly-consumed, hyper-active, digitally-addicted lifestyle is draining the life out of us. We are desperate to transcend the chaos and find a better way to live.” –  Phileena Heuertz

The reality of life and work for many of us is complex, challenging and changing. If we could name some of the main characteristics or manifestations we might instantly name – constant change, tiredness, stress, increasing demands, people not valued or treated well, illusions, working long hours and not always sure we are making the difference we wish. Some of us feel lost in systems or in a world that no one seems to be controlling or directing. Yet this takes part in a world that offers many of us increased luxuries and opportunities. How can it be that more slavery takes place now than in the 16th, 17th, 18th and 19th centuries combined? And still great kindness and care dance their good way across the globe. Further science is telling us that the cosmos is a reality so mysterious and difficult for many of us to conceive and conceptualize. Carl Sagan the astrophysicist told us there are more stars in the universe than there are grains of sand on the whole earth. Recently NASA recently spoke of the discovery of 1284 new planets. All these big questions and puzzles that can make us feel small, unsure and even afraid. Where do we fit? How can we navigate through this picture in a meaningful way?

We would like to suggest two possible road signs that may help us on the way. They are mystery and wisdom.

Mystery is accepting we don’t have all the answers and that this not knowing all is true learning. It betokens a humility before the awesomeness and mystery of life and the universe. Its just fine not to have all the answers. It is to see a great cosmic picture in which we all feature. Rumi the Persian Sufi writer of the 13th century spoke of how we don’t have to see ourselves as insignificant. We can see ourselves as part of the glorious unfoldment that we may call history or evolution or the universe. He calls us and says, “Stop acting so small. You are the universe in ecstatic motion.” We are part of a dynamic and positive energy that is forever creating the new. Carl Sagan commented, “Every one of us is, in the cosmic perspective, precious. If a human disagrees with you, let him live. In a hundred billion galaxies, you will not find another.”  Sagan referred to us as ‘made of starstuff.’ Perhaps we are not so small and unimportant. As each snow flake and finger print is unique so is each of us. We are all here with our gifts, limitations and contribution to make. In the Hindu tradition there is the concept of Tandavam and Lasya. This is where the whole cosmos is seen as a dance of re-creation, energy and new possibility. It is a dance combining male and feminine. Perhaps in these pictures we can find a sign of re-framing the vastness of the universe and the smallness of our life. We find our meaning in the process not apart from it. We seek to be in solidarity with the dance of life and those we encounter in its movements.  It is a challenge to patriarchy and non collective solutions. Mystery is about seeing our limitations but still dancing. Seeing the bigger picture and writing our own story in it with a caring heart.

Wisdom has many forms and shapes. One thing about wise people we have found is that they are very skilled at focusing their energy. They tend to know where they should concentrate their minds and hearts. They usually don’t waste their time and resources on what can’t be changed. They are too busy changing the things can be changed. Their wisdom sees both givens and givings. The givens are the things that we cannot change. We can often work to push away mountains only to find that in the morning they are still there. We waste money, time and emotional investment and nothing moves. Sometimes our response to this is to keep pushing or to try to push harder. We get caught up in fighting the wrong battles and always losing. One ‘given’ might be the hyper-rush, crowded  world we all work in. Rather than a community we often experience it as a machine in which we all seem caught. The Jewish scriptures spoke of Leviathan and Behemoth. Leviathan was the giant sea monster and Behemoth a fearsome land monster.They dominated their terrain and were not able to be easily controlled. Perhaps there is a parallel with aspects of our modern world. Wisdom asks and seeks what really matters and counts in our lives and experience.

The givings are where we give to others and ourselves to build something better. This is where we create or discover wellsprings – places of refreshment and replenishment. These may be in work or coffee shops or in our homes. Where they take place is secondary ( although workplaces cry out for them as trees for water in parched land ). That they happen is the key point. We make them whenever we listen , care and laugh with others. Wherever the human spirit is released and soars those places shine. We are beings who respond to inspiration., stories and hope. We can be lifted up in possibility and new ways to cope and walk. In this arena of awareness and connection we can find fresh energy and encouragement. Further we may even  find answers to  some of the bigger unchangeables. The machine may still run and run but we have found spaces to be human and laugh. Who knows the value and effects of these spaces that humanise against a machine that often dehumanises?

Our world is a wonderful and scary place. It embodies the highest achievements and deepest regrets. It promises much and could offer more. Carl Sagan spoke of how,  “We are a way for the cosmos to know itself.” In these words we are confronted with a conscious role and responsibility. A role and responsibility to be what we need.  We can be conscious of our and others need for compassion and kindness. Sagan saw this. He wrote, “To me, it underscores our responsibility to deal more kindly with one another, and to preserve and cherish the pale blue dot ( the earth ), the only home we’ve ever known.” That’s not a bad call.

Angela Green

John Walsh

JEWELS ALL AROUND

‘The truth must dazzle gradually or else every man be blind’ – Emily Dickinson

 

One of the authors recently visited Mexico. He was struck by the Mayan people. They worked in the hotel – in the restaurants, bars and cleaning. They were so kind, calm and friendly. It was a pleasure to see them every day.  On the last day one of the Mayan people gave the author a big hug. It was a lovely moment. Yet some hotel guests didn’t seem to see what was in front of them. They were demanding, rude and talked to the Mayan people as if they were slaves. There was another paradox. The Mayans seemed to be happy whereas the hotel guests acting this way didn’t. Maybe the guests were carrying heavy burdens themselves. Whatever was going on here, the Mayan attitude was a lesson in humility, kindness and an open spirit. The author’s holiday was brightened by the Mayan people – a people historically oppressed but offering so much.

 

We can have a tendency to judge people, to pre-judge them. Almost to think we know everything about them before we know anything about them at all.  In doing so we do not just do them,but also ourselves a great disservice.  We miss out on opportunities, sometimes daily, to learn from the wise, the really wise, those with real knowledge and experience from which we can learn.  The fellow travellers who dismissed the Mayans caring for them with such dignity and grace, missed the life lessons they could have learnt about the joy and happiness that comes to ones own life when you treat others well.

 

Some people reading this would have been aware of AdsthePoet, on the face of it an unlikely source of wisdom. A child; a severely disabled child and one for the last months of his life confined to a hospital bed. But many people saw beyond this.  They read Adam’s words; his blogs, tweets and poems. They saw the wisdom in his experience. They saw that he could tell them things they themselves would never be able to experience; what life was really like for a severely disabled child in a modern NHS. Like the Mayans, Adam had a wonderful capacity to be happy and to spread that happiness to others through a generosity of spirit.

 

Adam and the Mayans teach us something deep about wisdom. There are two theories of wisdom. One is there are special people who have it. They are gurus. We go to them and get the goods. The other theory sees wisdom everywhere sparkling, awaiting recognition. We adhere to this latter theory. Its not about elites, but in everyone everywhere. It may need to be tapped and released but its there.

 

We may find wisdom in unexpected places if we will only be open and truly listen. Three of the great faith traditions tell of how it is found in a shrub, ( with Moses ) a manger in a stable ( with Jesus ) and under a Tree ( with the Buddha ). A little plant, a stable and a tree are the places where wisdom and energies were found. Wisdom is everywhere. The Jewels are all around. They gleam and we sadly sometimes don’t see them. The Mayans in the hotel, Adam and others are teachers because they tell us what really matters. They remind us again and again what is important.  We need to hear this lesson and inscribe it in our hearts and practice.

 

We need awareness to see and hold these lessons in meaningful ways. Fritz Perls the psychologist talked about people having mini satoris. These are experiences which bring realisation. They are ‘getting it’ moments. Its where the scales fall and we see what really matters. They, if only for a moment, break  through the shell and superficiality of what we often see and hear and take for reality. These mini satoris are seeing with eyes wide open rather than eyes wide shut. These are the gifts we all can bring to each other.

 

There is a flow between the giver and receiver and that flow we call gift. Carl Rogers made a very wise point when he wrote that ‘The degree to which I can create relationships which facilitate the growth of others as separate persons, is a measure of the growth as I have achieved in myself.’ This shows that out of their fullness people like Adam and the Mayan staff could give in ways that enrich others. This seems to point to the need for us all to find and keep those good relationships that help us grow and flourish. In these gifts to us we find ourselves and are able to give back out of our self discovery. We hope this year of 2016 will be a year where we all have many mini satoris. Where we allow ourselves to be dazzled by the goodness and beauty of others. We hope that from this bright dazzling we will discover the wellsprings of our own goodness and beauty. Open yourself to the gifts of others, receiving is as key to compassion and caring as giving.

Zoe Picton-Howell

John Walsh