When Jim Blair, The Nurse Consultant responsible for the care of everyone with a Learning Disability at Great Ormond Street Hospital asked me What Would I Wish For, this is what I said. The one single element of hospital care that would have made all the difference. We once met a wonderful Paediatric Consultant who I will never forget.
Sunday, 30 August 2015
Hospital Care - What I would Wish For
Thursday, 27 August 2015
Coke Floats & Chemo: Serendipity and Social Media as an NHS Change-Make...
Coke Floats & Chemo: Serendipity and Social Media as an NHS Change-Make...: Serendipity Don't you just love a bit of serendipity? A string of random events which position themselves around each other to have a...
Wednesday, 26 August 2015
Serendipity and Social Media as an NHS Change-Maker
Serendipity
Don't you just love a bit of serendipity? A string of random events which position themselves around each other to have a huge collective impact. For me it's been a hospital appointment, a book I've read, some workshops, a totally unexpected invitation and some great Twitter conversations. Together they've pushed me out of my comfort zone and made me think about everything a little bit differently - and I'm loving it.
A World Gone SocialThe book was startling in the effect it's had on me. It's a long time since I've picked up a non-fiction book that was so good I could barely put it down, and every time I turned a page there were yet more light-bulb moments and flashes of inspiration waiting for me. Please read it if you get a chance, and I'd love to know what you think. It's called "A World Gone Social" by Ted Coine and Mark Babbitt, and their take on the way the world is changing has given me a new perspective on so many aspects of life.
It's about how huge an impact social media is having on society, even though social media is new. No one knows quite where it's taking us as a society, but it's definitely here to stay. It's breaking down barriers and changing the way we communicate. It's giving ordinary people unprecedented direct access to the movers and shakers right at the top of every organisation in the world. It's giving a sense of power and control back to individuals as never before - it's loosening the structured formality of society, which is taking democracy to a whole new level.
Some of us love it. We can find like-minded people, people we'd never have med 10 years ago, people we can share ideas and visions with. Partnerships are being formed with people who otherwise would never have met. Career opportunities are being created and all sorts of projects are being initiated which would never before have got off the ground. We can build support networks with invaluable peer support, something that has been a godsend for me. I'm part of two online communities now, one comprised of other parents of special needs children and the other of other women who also have breast cancer.
No more Hype and Spin
However, social media is bigger than that - it's reflecting a
whole shift in the way people think, and what we want from life. We have
evolved as a society. We are all heartily sick of hype and spin. We've had
decades of the wool being pulled over our eyes with glossy marketing campaigns
and clever advertising. We can see through it all, and we want transparency,
accountability and honesty.
Twitter and Facebook have an authenticity which has been the missing piece of a jigsaw for many of us. There is an honesty and authenticity about how people come across on social media - there's a shared vulnerability that facilitates seeing each other's true character in a way that sometimes takes much longer in real life. There's a simplicity about it, a shared purpose, and a real community where trust easily turns into friendship.
Don't you just love a bit of serendipity? A string of random events which position themselves around each other to have a huge collective impact. For me it's been a hospital appointment, a book I've read, some workshops, a totally unexpected invitation and some great Twitter conversations. Together they've pushed me out of my comfort zone and made me think about everything a little bit differently - and I'm loving it.
A World Gone SocialThe book was startling in the effect it's had on me. It's a long time since I've picked up a non-fiction book that was so good I could barely put it down, and every time I turned a page there were yet more light-bulb moments and flashes of inspiration waiting for me. Please read it if you get a chance, and I'd love to know what you think. It's called "A World Gone Social" by Ted Coine and Mark Babbitt, and their take on the way the world is changing has given me a new perspective on so many aspects of life.
It's about how huge an impact social media is having on society, even though social media is new. No one knows quite where it's taking us as a society, but it's definitely here to stay. It's breaking down barriers and changing the way we communicate. It's giving ordinary people unprecedented direct access to the movers and shakers right at the top of every organisation in the world. It's giving a sense of power and control back to individuals as never before - it's loosening the structured formality of society, which is taking democracy to a whole new level.
Some of us love it. We can find like-minded people, people we'd never have med 10 years ago, people we can share ideas and visions with. Partnerships are being formed with people who otherwise would never have met. Career opportunities are being created and all sorts of projects are being initiated which would never before have got off the ground. We can build support networks with invaluable peer support, something that has been a godsend for me. I'm part of two online communities now, one comprised of other parents of special needs children and the other of other women who also have breast cancer.
No more Hype and Spin
However, social media is bigger than that - it's reflecting a whole shift in the way people think, and what we want from life. We have evolved as a society. We are all heartily sick of hype and spin. We've had decades of the wool being pulled over our eyes with glossy marketing campaigns and clever advertising. We can see through it all, and we want transparency, accountability and honesty.
Twitter and Facebook have an authenticity which has been the missing piece of a jigsaw for many of us. There is an honesty and authenticity about how people come across on social media - there's a shared vulnerability that facilitates seeing each other's true character in a way that sometimes takes much longer in real life. There's a simplicity about it, a shared purpose, and a real community where trust easily turns into friendship.
Yes there are trolls lurking who want to cause upset and trouble,
and there have been some pretty high profile incidents of this reported in the
press. However, there are some pretty unpleasant people everywhere, in every walk of life, and
there always have been. Bullying is everywhere, but on social media something
very interesting is often happening when someone is attacked online. People
aren’t tolerating it, they are standing up and being counted, and supporting
the those who are being targeted. They are looking out for each other – a new
solidarity of fairness, kindness and thoughtfulness is emerging – and people
are fighting back in the face of bullying in a way that the same people are
reticent to do in schools, workplaces and on the streets of the real world.
Yes there are trolls lurking who want to cause upset and trouble, and there have been some pretty high profile incidents of this reported in the press. However, there are some pretty unpleasant people everywhere, in every walk of life, and there always have been. Bullying is everywhere, but on social media something very interesting is often happening when someone is attacked online. People aren’t tolerating it, they are standing up and being counted, and supporting the those who are being targeted. They are looking out for each other – a new solidarity of fairness, kindness and thoughtfulness is emerging – and people are fighting back in the face of bullying in a way that the same people are reticent to do in schools, workplaces and on the streets of the real world.
As people, we have spent so long trying to impress each other and
big ourselves up. Yes, there is still a fair amount of that on social media,
but there is also a new spirit of openness and vulnerability which is very
exciting. People are beginning to feel more collaborative and less competitive.
It’s subtle, but it’s happening, and it’s growing.
Changing the shape of Hierarchical Organisations
It’s changing the way companies are working, again it’s only just
beginning, but in the book there are so many examples of real life shifts in
business practice that it feels that there is a very exciting new way of doing
things everywhere that is on its way. These companies which are leading the way
in working differently are becoming flatter in their structure, removing layers
of management roles, and giving staff more autonomy and personal
responsibility. There is trust, and most of all, there is kindness coming back
into the workplace. Rules and regulations are being relaxed – when people are
too micromanaged they become fearful, stressed, and less productive. It’s a
movement, a shift, which is tangible yet still in its infancy – but the signs
are there that this could be big.
In the same way that hype and spin are now out-dated, people are
also sick and tired of policies and procedures and tick-boxes taking precedence
over people and what we, as individuals, need for a sense of well-being.
I read the book in virtually one sitting – barely able to put it
down because it so totally captured my imagination. Then when I finished it the
thinking began. If the future is being led by social media and a more
collaborative approach, then the past is defined by huge corporations with
rigid controls on working practices, where staff are ruled by fear and stress.
The sort of place where bullying can go unchecked because everyone’s too
frightened to whistle-blow. Somewhere like the NHS in fact.
I love the NHS
The NHS workforce is unique. It has huge talent - an army of fiercely intelligent, highly motivated, intensively trained and precision skilled individuals. The vast majority purposefully chose a career in healthcare because they care about people, they are intrinsically kind-hearted.
Many staff, despite years of the frustrations of working with
policies, procedures, pathways, processes, rules and regulation, are still
simply fabulous. Just as in social media, there are some pretty unpleasant
members of the public these people have to deal with on a daily basis, and yet
they still have endless reserves of tolerance, kindness and patience. They know
how frightened we, the patients often are, and they have the capacity to listen
properly as we voice our fears. They offer comfort and inspire our trust in
them.
When Kindness & Thought is Forgotten
I encountered two very difficult moments during my recent hospital
procedure, and being a very experienced patient, neither incident shocked or
surprised me. What warmed my heart was that, of the 7 members of staff
responsible for my well-being that day, 5 of them were wonderful.
The other two? I was apprehensive, particularly since, for
clinical reasons, I was unable to be sedated, something that is generally
standard practice for this procedure. When I arrived in the room, I heard every
word of a disparaging discussion already underway about me, and one member of
staff was very clearly expressing his irritation that I was going to be
conscious throughout. Turning to me,
this person then said “Oh we’ve decided to be brave today have we? I hope you
know it’s going to hurt”. Not exactly the sensitive, caring approach I’d hoped
for.
Later in recovery, finally a nurse approached me where I was still
lying on a trolley, and closing the
curtains told me I could get up and go home. She then walked away. I have
limited mobility. Sitting up on the trolley without help, particularly since I
was still in pain and disorientated, was a fairly major ordeal, and then when I
swung my legs over the side of the trolley I realised that my feet were nearly
six inches off the ground. I’m not quite five foot tall, and I really didn’t
know how I was going to get off that trolley without falling. Very gingerly I
had to edge forward, and slowly lower myself, lunging at the wall close by to
break my fall as I finally jumped the last couple of inches. It must have been
in my notes that I have bone cancer. A simple gesture of a hand being extended
to hold onto, or a step moved into place that I could have stepped onto, would
have been the work of seconds but would have made an enormous difference to my
struggle.
I obviously took far too long in getting off the trolley. This
person returned a few minutes later and flamboyantly opened the curtains before
checking whether I was still there or not. I was. And half naked.
Why is Kindness Forgotten?
Yet it is kindness that patients remember. That, along with staff
taking the time to listen and to exercise a little thoughtfulness. Has anyone ever stood outside a hospital with
a clipboard asking people, as they leave, a simple question - "Was anyone
unkind to you today?" Not to my knowledge, but they'd learn a lot if they
did.
The NHS is a huge, clunky, unwieldy machine of
an organisation. It has policies, procedures, pathways and processes coming out
of its ears. Central Government is always adding new expectations. Staff are
subject to so many rules and regulations and new guidelines and initiatives
that they are effectively doing their job with their hands tied. The priority
has shifted away from people - both staff and patients - to such a degree that
it's now much more about working for the legal department, covering the
organisation's back in case of future litigation. The amount of paperwork every
member of staff is expected to do has long ago passed the tipping point of
ridiculousness. It's a case of one minute at a bedside now means that nearly 10
minutes is spent writing down every nuance of that bedside conversation. The
complexity of the bureaucracy is suffocating real care. Staff are frightened of
putting a foot wrong. Sadly, less and
less of the things they are doing is about good old-fashioned patient care.
It's more and more about filling out forms, jumping through invisible hoops,
and being too frightened to do their job with any real heart and soul.
As the largest health provider in the world, the NHS has created a pretty unhealthy working environment. Fear breeds distrust, people shut down, staff feel unsafe and vulnerable to being accused of wrong-doing. Worst of all, when people feel unsafe, the perfect conditions are created for bullying to come into its own, and it does, I've seen it.
I know quite a lot about the NHS and I've had far more than my fair share of value from the organisation. For the past 3 years I've had constant on-going intensive treatment for Stage 4 breast cancer. Toby, my middle child,
spent most of his first six years in hospital, with me living alongside him
24/7 throughout every admission. The severity of his disabilities and complex
needs meant that we had countless outpatient appointments, therapy
appointments, community health care teams, carers, nurses working for long
shifts in our home - you name it, I've seen it. I've seen great things happen
but I've also seen everything else too.
So have thousands of other patients and their families. We have so much knowledge, insight, experience and answers between us that could really help heal the NHS and get it back into working order again. Yet nobody asks us what we really think, and it's very difficult to get our thoughts across. The NHS need supportive people working alongside them, critical friends who can highlight simple, cost effective changes.
Kindness costs nothing, and yet it is priceless. That’s the irony
of the situation – good care and bad care don’t cost the same, good care is far
less costly because fewer errors are made and everything works more
efficiently. It isn’t just a patient issue either, it’s a colleague issue too.
A new culture of kindness has to begin with staff working together, being kind
to each other, looking out for one another and extending thoughtfulness in the
workplace. Just like what happens on Twitter.
Co-production
Loosening the Steel Grip of Micromanagement
This steel grip of micromanagement has to be loosened. Not
overnight, but in manageable stages. Of course there must be checks and
balances, of course there must be excellent record keeping, but there has to be
room to innovate and some freedom of thought too. Low morale is endemic right
across the workforce, and staff are stressed and unhappy. Unhappy people
don't work productively. No wonder some of them don’t practice kindness. What
is amazing is that most of them do.
Twitter Leading NHS Change
Society is changing, and I'm hopeful that it's a good change that is on its way. The NHS needs to embrace these changes and implement them throughout, from the top down and from the bottom up. Hierarchical organisations such as the NHS are going to become out-dated dinosaurs in the next decade or so unless they find significantly different ways of doing things. Change has to come from within, but may have to be kick-started from outside, and with difficult truths being spoken by ordinary people like you and me.
NHS England Leadership
I believe that the NHS has already seen the writing on the wall and is fully committed to changing. I have met several of the NHS England Leaders, and they are a breath of fresh air in their energy, vision and
optimism. They can see how it is and how it needs to change, but it's a huge
task ahead and one that they know needs a complete sea-change in culture.
My New Series of Workshops
Underpinning every workshop is a spirit of kindness, where I will create a safe, supportive space in which participants can be open with each other, listen to each other's experiences and stories, and share their best bits. There are thousands of people who feel like I do, both inside and outside the NHS, wanting positive change, and believing it can happen As I said earlier, I love the NHS, and even if I can only be a tiny drop in the ocean, I want to do everything I can to make it better, to heal it back to health.
Embracing Change
The NHS workforce is unique. It has huge talent - an army of fiercely intelligent, highly motivated, intensively trained and precision skilled individuals. The vast majority purposefully chose a career in healthcare because they care about people, they are intrinsically kind-hearted.
As the largest health provider in the world, the NHS has created a pretty unhealthy working environment. Fear breeds distrust, people shut down, staff feel unsafe and vulnerable to being accused of wrong-doing. Worst of all, when people feel unsafe, the perfect conditions are created for bullying to come into its own, and it does, I've seen it.
I know quite a lot about the NHS and I've had far more than my fair share of value from the organisation. For the past 3 years I've had constant on-going intensive treatment for Stage 4 breast cancer. Toby, my middle child, spent most of his first six years in hospital, with me living alongside him 24/7 throughout every admission. The severity of his disabilities and complex needs meant that we had countless outpatient appointments, therapy appointments, community health care teams, carers, nurses working for long shifts in our home - you name it, I've seen it. I've seen great things happen but I've also seen everything else too.
Loosening the Steel Grip of Micromanagement
Society is changing, and I'm hopeful that it's a good change that is on its way. The NHS needs to embrace these changes and implement them throughout, from the top down and from the bottom up. Hierarchical organisations such as the NHS are going to become out-dated dinosaurs in the next decade or so unless they find significantly different ways of doing things. Change has to come from within, but may have to be kick-started from outside, and with difficult truths being spoken by ordinary people like you and me.
NHS England Leadership
I believe that the NHS has already seen the writing on the wall and is fully committed to changing. I have met several of the NHS England Leaders, and they are a breath of fresh air in their energy, vision and optimism. They can see how it is and how it needs to change, but it's a huge task ahead and one that they know needs a complete sea-change in culture.
Underpinning every workshop is a spirit of kindness, where I will create a safe, supportive space in which participants can be open with each other, listen to each other's experiences and stories, and share their best bits. There are thousands of people who feel like I do, both inside and outside the NHS, wanting positive change, and believing it can happen As I said earlier, I love the NHS, and even if I can only be a tiny drop in the ocean, I want to do everything I can to make it better, to heal it back to health.
Embracing Change
Not everyone is ready to embrace social media, and many large
organisations find it threatening. Yes it is likely to change the status quo,
but in a way that should be beneficial to all of us.
If the NHS is to successfully make the changes that this social
revolution is heralding, it needs its staff to be on board, and for them to
feel comfortable in leading the way. Already there are thousands of NHS
employees on Twitter, and from every sector and seniority level across the
board. They are learning to bring down barriers and to embrace diversity of
opinion and a new spirit of collaboration. As their numbers grow, they will
bring this new-found spirit of openness back into their work stations with
them, and in time it will take hold throughout the whole NHS.
These people are the pioneers, the forward-looking change-makers,
the ones the NHS so badly needs on board.
#We Nurses
Nurses were talking freely, exchanging ideas, supporting each other, pooling their thoughts, pulling together - just how every corner of the NHS could work without the limitations of over-reaching rules, regulations, intimidation and fear. Yet the fear was still there - lurking in the shadows. Nurses felt that many of their colleagues are too frightened to tweet for fear of being accused of saying the wrong thing. There was a lot of discussion of what guidelines should be put in place for nurses to follow, and whether that would give more nurses the confidence to join in the on-line discussions.
The NHS is rule-bound. Twitter is the complete opposite. The NHS needs its staff to lead the way towards a social model of doing things, and staff should be encouraged to take part in online debate without having to abide by petty rules. Nurses are sensible people. They know what they can and can't say in public. One or two may overstep the mark perhaps, but one or two probably do already and say too much when out with friends. You can't restrict the freedom of everyone just because a tiny minority might occasionally step out of line. There has to be trust. There has to be personal responsibility. Rules will curtail freedom, spontaneity and authenticity. Anything they’re “allowed” to say will become meaningless.
Also, who would set these rules for Twitter? At the moment the world is made up of two types of people, those who are embracing social media already, and those who are cautious, skeptical and would like to make it all go away. That's true right across the spectrum, this isn't a specific NHS issue.
However, it’s the skeptics who want rules in place, and they’ll be
the ones to write them. They don’t want the early adopters running wild in this
new-fangled twitter-thing and somehow causing trouble. But how can they write
rules for something they don’t understand? The Twitter nurses and doctors and
their colleagues have to be set free and allowed to explore new ways of doing
things unburdened by bureaucracy. Those who are uncertain of change must be
encouraged to trust their pioneering colleagues to act responsibly, and they
won’t be let down.
The NHS was designed and developed for people. Somehow it’s lost
its way. Everyone, patients and staff alike, have to be placed right back in
the heart of the organisation ahead of all the bureaucracy.
NHS England - Innovation Expo 2015 Conference
Lastly - my exciting invitation? Completely unexpectedly, with thanks to the lovely Gill Phillips of Whose Shoes, I'm off to Manchester next week to be at the NHS Expo Innovation Conference. Who knows? Maybe somebody will ask me what I think about the NHS. Serendipity indeed.
PS! I've just done a short selfie-video vlog on What I would wish for from Hospital Care if you'd like to hear more.
Are you on Facebook? If so, have you seen the
Coke Floats & Chemo Facebook Page, offering support, information, news and hope to anyone coping with cancer, sharing the best relevant posts nearly every day?
I also have another Facebook Page called The Special Parent’s Handbook. It’s full of information, advice and support for families of special needs children
Nurses were talking freely, exchanging ideas, supporting each other, pooling their thoughts, pulling together - just how every corner of the NHS could work without the limitations of over-reaching rules, regulations, intimidation and fear. Yet the fear was still there - lurking in the shadows. Nurses felt that many of their colleagues are too frightened to tweet for fear of being accused of saying the wrong thing. There was a lot of discussion of what guidelines should be put in place for nurses to follow, and whether that would give more nurses the confidence to join in the on-line discussions.
The NHS is rule-bound. Twitter is the complete opposite. The NHS needs its staff to lead the way towards a social model of doing things, and staff should be encouraged to take part in online debate without having to abide by petty rules. Nurses are sensible people. They know what they can and can't say in public. One or two may overstep the mark perhaps, but one or two probably do already and say too much when out with friends. You can't restrict the freedom of everyone just because a tiny minority might occasionally step out of line. There has to be trust. There has to be personal responsibility. Rules will curtail freedom, spontaneity and authenticity. Anything they’re “allowed” to say will become meaningless.
Also, who would set these rules for Twitter? At the moment the world is made up of two types of people, those who are embracing social media already, and those who are cautious, skeptical and would like to make it all go away. That's true right across the spectrum, this isn't a specific NHS issue.
NHS England - Innovation Expo 2015 Conference
Lastly - my exciting invitation? Completely unexpectedly, with thanks to the lovely Gill Phillips of Whose Shoes, I'm off to Manchester next week to be at the NHS Expo Innovation Conference. Who knows? Maybe somebody will ask me what I think about the NHS. Serendipity indeed.
PS! I've just done a short selfie-video vlog on What I would wish for from Hospital Care if you'd like to hear more.
Are you on Facebook? If so, have you seen the
Coke Floats & Chemo Facebook Page, offering support, information, news and hope to anyone coping with cancer, sharing the best relevant posts nearly every day?
I also have another Facebook Page called The Special Parent’s Handbook. It’s full of information, advice and support for families of special needs children
Yvonne Newbold named by HSJ as a Top 50 Inspirational Women in Healthcare 2014
Author of "The Special Parent's Handbook"
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