I’ve been thinking about what has made the most difference to the work we do and the impact it makes. I think it goes back to some words I heard for the first time a year ago….

The wonderfully wise and generous Rev (interfaith minister) Briers offered me these words through his inspiring and illuminating wonder book:-

A Little Book on Finding Your Way: Zen and the Art of Doing Stuff

These words come originally from Howard Thurman

So why have these words made such an impact?

Think about them.

What really makes you come alive, puts a huge grin on your face and fills you with energy and optimism?

Are you being, doing and sharing what makes you come alive?

When we offer our two day compassionate practitioner programme (which is for small groups of committed compassionate foot soldiers who want to lead the way) there is a moment on day two when I ask the ‘what makes you come alive’ question.

I then ask people to think about what the question means in their context – for example dementia care.

Here are the beautiful questions that were designed ‘from the inside out’ at a recent course at Dementia UK:-

Dheeresh – How can we involve others in the development of mindfulness and how it enhances appreciation of life in the work context?

Sally – How can we ensure a compassionate connection with the people we train (outside of these sessions)?

Lisa – How do you think you could bring movement and fluidity to your role?

Rose – How can we ensure our carers get involved and do what makes them alive?

Tina – How can we ensure the people we support spend time with their loved ones?

Ashley – How can we promote community precense and a sense of achievement for our service users and their families?

Hilary – How can I  make sure staff at dementia uk feel alive so that they can realise Dementia UK vision?

Mandy – How can we promote and achieve a sense of balance in the lives of people with learning disabilities?

Lovely!

Threads around family, community, paying attention and balance.

Applying this kind of thinking to each other seems to have a super powered effect – energy, confidence and hope spread and are passed on.

A short story to finish:-

A manager at a care provider organisation in Westminster recieves a call and discovers the CQC inspector has arrived at another site – there are no managers there.

A care giver warmly greets the inspector and quickly sends the word round for her colleagues to join her and the inspector, telling them to ‘bring your certificates’. The care givers have just completed the ‘Compassionate Care Giver’ seminar and they seem to have ‘come alive’ as they tell the inspector:-

Everyone one should do this programme

It makes us proud of what we do

Everyone should be compassionate

They boldly share their ‘certificates of commitment to compassion’ in which they have declared their commitment to taking care of themselves, each other and the people they care for.

The CQC inspector thanks the care givers and says ‘I have never seem such happy care workers’.

As we come alive, we become our true selves and we can give the kind of care that we all long for.

I would love to hear what makes you come alive.

For me it is sharing the gift of compassion.

Wishing you a wonderful day

Andy

Some of the language we use to describe particular functions gives some clues around the pervasive culture which runs the risk of failing to strike the right balance between empowerment and protection and between systems and processes and the important human aspects of care. For example:-

Infection CONTROLLER

Safe GUARD

Risk ASSESSOR

Manual HANDLER

Health and social care may have become so preoccupied with patient and client safety that we are challenged in offering what people say matters most when they are feeling vulnerable; for example:-

Compassion

Empathy

Warmth

Understanding

Patience

Listening

The Compassion habits at the heart of compassionate environments we are developing offer the opportunity to ‘dismantle the furniture of separation’  so that people can rely on each other to be kind and the important functions outlined above do not create a loss of humanity and compassion, but instead form an integrated part of our compassionate practice.

Would love to hear your thoughts on how liberated you are to show compassion to yourself and others

warmest wishes

Andy

Christina has kindly kept in contact with me since I was moved to make contact with her when she first wrote about some of her distressing experience; as a result of the dialogue we have enjoyed Christina was good enough to contact me in the context of her research on nursing to hear more about our own efforts to embed compassion.

It has been quite a start to the year here at Frameworks 4 Change with BBC coverage and The Radicals award, and now this coverage in The Independent. We will redouble our efforts to contribute to a compassionate culture and will be joining forces with a network of wonderful people who imagine a bright future for health and social care.

We were delighted to recruit and train 15 wonderful associates just last week to enable us to respond to the growing demand for our compassion programmes.

Here are Christina’s words from The Indpendent on Thursday 12th of April 2012.

“There’s certainly a lot to be said for simplicity, and if the simple measures mentioned in the slogan were adopted on a mass scale, they would surely make a difference. But compassion, and “communicating with compassion”, isn’t always simple. It is, says Andy Bradley, a former care assistant who contacted me after hearing my programme,”demanding” and “requires discipline and practice”. He has, he told me, started an organisation called frameworks4change, which aims to put compassion “at the heart of the nurse/patient relationship”.

Bradley grew up in a care home for people with dementia run by his mother, a “compassionate life-long nurse”. When he got a job as a care assistant himself, working with people with complex disabilities, he was shocked by the attitudes and behaviour of some of his colleagues. Now, he runs courses in “the compassionate practitioner” for people working in care homes, local authorities and NHS trusts.

The courses are proving popular with the staff and, of course, with their patients. “The response from one of my patients,” said one nurse working with dementia patients in Essex, “was that it felt like he was being cared for by a friend rather than just a technician.” Bradley was recently picked by The Observer as one of its “top 50 radicals”, and featured on BBC Breakfast and Radio 4′s The World Tonight. He wants, he says, to change the whole culture of nursing, which is certainly aiming high. But he’s confident he can do it. “As a result of these programmes,” he says, “there are real and lasting changes in the care given. There’s a kind of ripple effect that touches all those in the organisation.”

It takes courage and conviction to move beyond our suffering to take action.

We must ‘be the change we wish to see’.

Your comments, as always are a delight to recieve.

with humility and respect

Andy

Apologies for the poor picture quality – these are the wonderful people who work at Rock House.

I was privileged to spend a day at Rock House care home in Buckinghamshire on the 22nd of February. Being with everyone for the day had a ‘meant to be’ kind of quality as it was the day after the slightly surreal experience of appearing on BBC Breakfast to speak about compassion in nursing and because it felt SO LIKE the care home I spent part of my childhood in (Woodbury, near Hereford run by mum and dad). I was asked to offer two compassion seminars for the team at Rock House and I learnt far more than I taught.

We always ask people to say why they do what they do:-

“I give love to people who may not feel loved at the end of their lives.”

Sue Foster – care giver

In the time between the two seminars the team kindly invited me to lunch. A lady came into the kitchen clearly disoriented and distressed, crying and repeating that she needed help. Sue (quoted above) took the lady in her arms and held her, saying that she was lovely and was doing really well and that all would be fine. She took the ladies hands in her own and comofrted her, without  further words, just giving an affirming presence and kindness.

I spoke about this on the radio a few days after because it is rare for me to see such compassionate care in action. I often witness a catastrophic loss of confidence in care giving as we have become so pre-occupied with resident and patient safety that we may have forgotten that what really keeps us safe is having people in our lives who care deeply about us. It seems to be to be a tragedy when people who work in care giving jobs to show compassion are prevented from doing so.

Compassion is where kindness meets suffering and we are encouraged to flourish. Compassion is nurtured and celebrated at Rock House.

All of health and social care can be consistently compassionate. We just need to make sure that its heart in the right place.

I always love to hear your comments on compassion in care giving.

Thank you for your interest and encouragement

Andy

It was very good to see compassion in nursing feature so heavily on BBC breakfast and to have the chance to take part in a live studio discussion on the issues raised when we think about nurses and the extent to which their compassion is reliably present in their care giving.

Thank you to BBC breakfast and to BBC Radio Wales for picking up the story and inviting me to take part in a compassion specific phone in – more on this here

Thanks to NESTA and The Observer for vision in identifying Britain’s New Radicals – proud to be connected to such innovative and passionate people – more here

Thank you to Charlotte Ashton for her interest and research which has led to these stories and a growing conversation. See BBC on line features on compassion here and on social enterprise here

As I said when asked today I am not sure that we need to teach compassion – my assumption is that nurses want to be kind and want to show the care that (for the vast majority) bought them into the profession. Are leaders creating the conditions for compassion to be expressed so that patient care is continuously improving and staff are full of confidence and energy?

I suspect most leaders in the NHS have other ‘more pressing’ issues at the front of their minds and that they too need support to develop more healthy and reflective cultures.

The twitter response to a day exploring compassion ‘coaching’ has been interesting with responses ranging from the extremely abusive to the completely inspired – the subject has certainly got people talking.

My hope is that the nurses in Essex have been the catalyst for an important debate which will result in some deep changes in nurse education, integrated health and social care practice and the leadership style in the NHS and other care giving environments.

The compassion programme is working in everyday practice – that seems reason enough to feel a sense of urgency to invite more nurses and leaders to join in.  When we feel vulnerable we all need to recieve compassion and kindness. It is a tragedy when nurses lose their way and the care they feel is not shown in the way they behave – for them and the nursing profession but most of all for the patients and their families who are on the receiving end of care that is lacking compassion and can even be cruel and apparently heartless.

I have three full days of travel and compassion training ahead of me and it has been a very long few days so I will sign off now – but not before posing a question that I plan to explore here and elsewhere:-

To what extent will the proposed reforms in health and social care create and sustain consistently compassionate care?

Please feel free to comment or to begin a conversation with us about compassion.

Warm wishes

Andy

]]> http://knowingyoumatter.com/2012/02/21/can-compassion-be-taught/feed/ 2 begethers http://knowingyoumatter.com/2011/10/28/compassion-is-good-for-you/ http://knowingyoumatter.com/2011/10/28/compassion-is-good-for-you/#comments Fri, 28 Oct 2011 20:32:00 +0000 begethers http://knowingyoumatter.com/?p=782 Continue reading →]]> The research is clear - showing compassion boosts your immune system. We are hard wired to be good to each other, to meet suffering with kindness and vulnerability with strength. Compassion is never more that a breath away. Compassion requires a gentle invitation and a warm welcome.

We are inspired by the nurses and healthcare assistants we are privileged to work with – they are accepting the call to compassion and they are allowing their hearts to be involved in their care giving. Suffering is transformed.

Celebrate care giving;  elevate the status of compassionate care – what are we here for, if not to care for each other.

Your thoughts and feelings on compassion matter

warmest heartfelt wishes

Andy

But what of the solution?

Lets start by assuming that nurses are good – that they want to show deep care for patients.

Imagine a moment in future when you are in hospital needing care – and a nurse is walking towards you….what quality do you hope they will have?

How reliably is the quality you thought of present in the care currently given?

The solution is to close the gap. Ask nurses to be the quality they wish to see. Appreciate them when they offer this quality.

Ask them this question:-

What do you think and feel about the care you give?

and then listen. Awareness brings change.

Every nurse and care worker could have a goal for improving their care giving.

That is worth managing and measuring.

And celebrating.

A compassionate health service can be created and sustained – we have just been going about it the wrong way. Compassion can only come from the inside out.

What quality do you want when you need care?

warmest wishes

Andy

The people we saw being abused at Winterbourne View and the perpertrators of the abuse, the people who die lonely and afraid in some of our care homes and hospitals and (some) of the ‘rioters’ have something in common; their lives seem not to matter.

As we have seen and felt this phenomenon is dangerous – if you feel that your life doesnt matter, then nor do your actions – you will choose to withdraw (which many do) or (eventually) you will lash out.

People who are routinely not listened to and who feel that they have nothing to contribute are at great risk of harming themselves and others – it seems to me that alongside the inevitable public outcry and need for punishment we are being given an opportunity to deepen our awareness of the healing power of listening and compassion.

There are people within our midst who live out their days in loneliness, fear, boredom and isolation,  unloved and without hope – some are very young, some are very old.

Our education and health and social care systems would do well to place listening and the cultivation of a more compassionate approach at their heart;  uniting around the practice of giving caring attention to each other may mean that the lives of the  people who have been abused, injured who have lost their livelihoods or even their lives in the recent disturbing events may have a legacy that means something better for all of us.

We are all capable of being both good and bad.

Your own reflections as always are very welcome

warmest

Andy

Thanks to Alister Scott, my friend and collaborator of One Leadership for first bringing this way of seeing the world to my attention (and thanks to Chris Barez-Brown for the image I just found online – this is VERY strange indeed as Chris was my best friend for a while at school and we haven’t spoken for years).

Anyway, why is this thinking relevant to people who have dementia?

Lets imagine I have dementia, how should you be with me to let me know that I matter?

The answer to this question will of course depend entirely on me as an individual but some clues i think:-

Be with me in the here and now. It may be that my mental (cognitive) energy begins to fail me so i suggest you tune into the other energies….so you might…

Dance with me (physical)

Be with me in nature, noticing and appreciating (spiritual)

Use gentle touch to reassure and validate me (emotional)

When we learn to be with a person with dementia in the here and now, a kind of awareness shift happens and the person with dementia becomes the teacher and we become their student. A student of now. Life always happens now but those of us whose energies are out of balance believe we are our thoughts and so are over cognitive, meaning our four energies will be out of balance.

I’m off to walk the dogs now in the woods. I will listen for the bird song and smile – in this way I find I don’t ‘think too much’!

A comment on your energies and your sense of the here and now would be recieved with joy.

warmest

Andy

The first day of the ‘Everyone Matters’ project at Essex University on the 30th of June bought together 19 compassionate people who were seen as role models in the places where they work for the North Essex Partnership NHS Foundation Trust. Thank you all for an inspiring day.

We started with the question we now always begin with:-

Why?

why do you care, why do you do the job you do, and we all listened to each others stories and passion for figuring out how to give the most consitently compassionate care.

Lindsey – it is personal for me

Julie – it is about the here and now

Lynn – i do care deeply

Kim – customer service, moments of truth,  i love the job

Jill – to observe, has the person lost something?

Beverley – dedicated and compassionate

Russell – a compassionate person, known since school

Lee – listening to families, they are the experts

Denise – youngest of eight, family gave me essence of compassion and compassionate skills

David – always been an OT without knowing; how can i help?

Preerna – a passion for the physical side of people who have mental problems

Simon – a naturally kind mother taught me about a ‘state of acceptance’

Maria – mum made me cut my neighbours toe nails – made me come and now I love it!

Sebastian – i am interested, motivated and open

Olivia – my mum said why don’t you try it – my passion is dementia

Zoe – i want to help, changed me as a person

Carol – it is interesting, rewarding, working with families

Priscilla – elders are inspirational, it is my love and my passion

Sharon – always compassionate and caring, love sport…best of both worlds, the care and the physical

Imagine a moment in the future when you no longer provide the care as you now require it. There is a care worker coming towards you, what quality do you hope they will have? Here is what this amazing group of people said:-

Look at Me; Kindness in Approach; Eye contact and listening; Treat me with respect; Privacy and the least interference; Listening in the moment; Calm, reassuring and inviting body language; Acknowledged; Time; Understanding; A genuine smile; Clear personal explanation; See me; See beyond what i am saying; Caring approach; Ask my permission; A natural smile which shows the person wants to be there.

We thought about power and relationships and the ‘distancing effect’ in which care can be cold, authoriatarian or overprotective. We all want the qualities above which we call SOLIDARITY.

A bit of an aha moment – we must………

NAME IT (the unhelpful way of caring) –  THEN CHANGE IT (to a compassionate way)

How can people change and bring compassion if they are not first made aware?

This was a day to remember. The time by the lake thinking about how we know we matter will stay with me as i witnessed people in pairs listening to each other with a quiet mind and an open heart.

The leaders of this work understand that breaking old habits is complex and takes time and effort;  cultivating new compassionate habits can then begin.

A wonderful start – a wholehearted thank you!

Please add your comments, they always mean a lot.

Andy