Friday, 31 January 2014

To nurture wisdom

The approach to Windsor castle

St George's Chapel

In recent years my January has been elevated by an annual trip to Windsor. I notice that I always prioritise it in my diary. Even on the Sunday evening as i set off in the cold my shivers are of anticipation. My first invitation was flattering and even though I am now in some ways an old timer, I still go through the thoughts about how did I slip through the net to get the chance to come here! The point the biographies come out is generally another such moment and its hard to be in the presence of such history and indeed historic power not to feel awed.
The Windsor leadership dialogue takes place within St Georges House within the castle grounds. The purpose of St George's House is to nurture wisdom and what an honour it is to be there. As well as a rich and stimulating dialogue we heard of the history of the Chapel, saw graves of monarchs ancient and modern and learned of the Order of the Garter, founded around 1344. The dialogue itself is confidential but its suffice to say, wisdom was nurtured, assumptions were challenged and I left stimulated and humbled and pondering on love and power. Next year is in the diary already.
And January closing means its a year since I left Breakthrough Breast Cancer and I look back on the year with a sense of awe as well. Every change has its gains and losses, time and energy is needed to move through the transition and this has been no different. I have grieved at times and felt joyful at times too.Thanks to all of you who have been there on the roller coaster with me. I wouldn't have missed this opportunity to work independently as a coach and consultant but the joy has come from all of you who have shared the journey with me. Last year at this time I was finalising my brand image below-what a difference a year makes!
Reasons to be cheerful:
I'm looking forward to this next year, working with so many great people and projects. The Windsor Dialogue has really inspired me again. I'm even thinking of writing a book...there I've said it. Wish me luck.

Saturday, 25 January 2014

For a' that

January 25th is a special day in Scotland. Even as a wee girl I understood this. It is Burns birthday- our national bard. At school we practised his poetry ( the ones fit for young ears!), we had competitions, we wrote our own in our version of Scots, we celebrated.
As 2014 has begun I have had a sense of real awakening about what a referendum on independence might mean for us in Scotland. I have noticed more people are speaking about it, a sense of shifting sands. Naturally as we approach Burns night here we see a drive to link the two. Understandably the claims of what Burns would vote has invited  some counter positions and cries of stuff and nonsense. 
I can't see how we can claim what he would have voted some 300 years later but we can however perhaps understand the kind of society he would have called for. Burns was no role model for monogamy but his songs from the heart were not just about romantic love  but also about appealing to our better selves, to our sense of nationhood, how we relate to others personally and perhaps nationally.
We can use his words to test out our own values, the nation we want to see, how we relate to others not just in the UK but across the world. Do we want a society based on social justice and human rights, do we want to be an inclusive society, do we want to build good citizens of the future, do we want to support communities to flourish, do we want to be measured by our approach to health and social care. Will we be able to look our grandchildren in the eye and say I did my best for your future on this planet?
So I leave you with,not a guess of how he would vote,  but a hope that when we make our choice this year we make it with knowledge of the future we each want and the information to know what choice offers that.

Here's what Burns had to say on the world he wanted....

A Man's a man for a' that

Is there for honest Poverty 
That hings his head, an' a' that; 
The coward slave-we pass him by, 
We dare be poor for a' that! 
For a' that, an' a' that. 
Our toils obscure an' a' that, 
The rank is but the guinea's stamp, 
The Man's the gowd for a' that. 

What though on hamely fare we dine, 
Wear hoddin grey, an' a that; 
Gie fools their silks, and knaves their wine; 
A Man's a Man for a' that: 
For a' that, and a' that, 
Their tinsel show, an' a' that; 
The honest man, tho' e'er sae poor, 
Is king o' men for a' that. 

Ye see yon birkie, ca'd a lord, 
Wha struts, an' stares, an' a' that; 
Tho' hundreds worship at his word, 
He's but a coof for a' that: 
For a' that, an' a' that, 
His ribband, star, an' a' that: 
The man o' independent mind 
He looks an' laughs at a' that. 

A prince can mak a belted knight, 
A marquis, duke, an' a' that; 
But an honest man's abon his might, 
Gude faith, he maunna fa' that! 
For a' that, an' a' that, 
Their dignities an' a' that; 
The pith o' sense, an' pride o' worth, 
Are higher rank than a' that. 

Then let us pray that come it may, 
(As come it will for a' that,) 
That Sense and Worth, o'er a' the earth, 
Shall bear the gree, an' a' that. 
For a' that, an' a' that, 
It's coming yet for a' that, 
That Man to Man, the world o'er, 
Shall brothers be for a' that.

If you a celebrating Burns birthday, enjoy it, and ponder on the words.

Friday, 24 January 2014

No man is an island-the power of connection.

I did an exercise on values this week and discovered how important a value connection is to me. So perhaps its not surprisingly this week has been all about connection. I have been part of learning environments where it's notable that the deeper we connect the greater is our growth. I also witnessed a moving graduation ceremony where as individuals told their stories of the depth of their learning it was evident that their relationship with others was the key to their journey to understand themselves. The sense of loss of that connection, their formal journey having ended I could relate to and moved all who witnessed it.
Finale with all performers singing Lean on me.

The Concert for Carers was such a wonderful evening, sharing the creative talent of so many but each of the performers linked their work to the carers. Some spoke of their own journey as carers, their own tears shed as they told their personal stories. It connected us differently, no longer audience and performer, more a community enjoying the power of music and song to lift the soul. It's a unique atmosphere generally at Celtic Connections, the joy of the performers infectious in this festival during dark January days but this concert was particularly special, there is no doubt.

Yesterday again I was part of a group, forming deeper partnerships to fuel the PeoplePowered Health and Wellbeing  Project and feeling the connections made not only between agencies and their people but perhaps also with the root motivation of the work- it's all about powerful connections between people, to enable health and also wellbeing. I left feeling part of a community committed to making a difference and excited as well as inspired by our shared passion for this work.

And finally there was a deep sadness fell on our city last week when we heard of a small three year old boy who had gone missing, learning a few days later that his body had been found and a mother was charged with murder. It's hard to even write those words down. But what we also saw was a local community who joined initially to search and then finally to grieve and honour a brief life. A moving display of community connectedness that gives hope in such sad times.

Reasons to be grateful
I connect with so many inspiring and heart warming people in my work and life. And of course the blogging community I'm part of enriches my life and connects across so many parts of the world. Illness can disconnect and isolate people. Blogging I suspect has many roles but I recognise that for me I have loved that it has connected me to a wise and compassionate community who understand this particularly journey so well. Another reminder that what helps us through difficult times will always be our connection to others. 

No man is an island,
Entire of itself,
Every man is a piece of the continent,
A part of the main.
If a clod be washed away by the sea,
Europe is the less.
As well as if a promontory were.
As well as if a manor of thy friend's
Or of thine own were:
Any man's death diminishes me,
Because I am involved in mankind,
And therefore never send to know for whom the bell tolls;
It tolls for thee.

John Donne

Thursday, 16 January 2014

To see oursels as others see us?

This strangely mild January in Edinburgh I have been reflecting on when I worked in a medical practice as a nurse leader, every conference I attended had something on medico legal issues. It was guaranteed to give me at least one sleepless night that week. Here we were in many ways at the leading edge of new practice and any innovation put us at risk according to the advice. I'm surprised we achieved anything new given that- but we did. We worked hard, we looked at the evidence, we consulted with those receiving the service, we planned, we did our best. Any grumbles we learned from and genuinely tried to do better. I was proud of our work, it wasn't perfect but we cared about people and improving the service and it showed. 

So when my own father experienced a poor standard of care it absolutely distressed me. I complained because I knew it could be different and wanted it to be better for others. An unplanned discharge caused him extreme pain ( not least when he fell trying to get to the toilet with metastatic bone cancer-a hasty , uninformed discharge meaning nothing had been put in place to support him even though his mobility was by then very poor) and all the family huge distress and concern. As a family we were well placed to be able to quickly turn it around but what about those who can't? Less than two weeks later he was admitted to the hospice ward which was through double doors from his original ward and culturally was a whole world apart. We were all supported and cared for and my father died peacefully without pain. It's twenty years ago and I remember every detail. That's the impact of poor care and indeed good care. After he died I wrote not only to complain but also to praise the hospice care, employees of the same hospital after all. I never had a response to the praise and my complaint was initially met with defense so I didn't let go-we finally got an apology. At that stage I had recently finished treatment for breast cancer and was at my lowest ebb but it was the final thing I could do for my Dad and I needed to complete it.

Why is this in my mind now? Because there has been much written on the power of complaints recently, the importance of apology, the value of feedback and I found myself back there again. The experience of taking  the time to write a complaint and then having it met with defense was awful. And also my mother had to cope with the aftermath, her distress about my fathers last few weeks lived on, an apology helped her to let go. It's all we wanted, a simple we are sorry ,we should have done better. We will learn from this. The reluctance to do that reduced the power of the apology when it finally came.

I know in many organisations feedback can one of the hardest things to receive as an employee, the NHS is no different. Is it a British thing? Do we squirm in our seats before we give feedback, even if its good job? How hard it must be when the only feedback you get are complaints. Yes a box of chocolates from grateful people is nice but its not feedback. You don't know what you did right, never mind what you did wrong. And how many people like me have been trained in giving feedback as the aptly termed "shit sandwich". Yes really! When all we do then is wait for the shit, the bread long forgotten as the shit lands. How genuine and person centred is that and what is the result?

If we want to get complaints and feedback right, to learn from it, to grow personally and organisationally then it has to permeate the whole culture. No blame culture will result in mature responses to feedback. 

We do have existing mechanisms to help with this; we have the patient opinion website to feedback into the system ( remember the majority of the feedback is positive through patient opinion), we have the opportunity for people powered  healthcare to help improve and  co-produce services, we have volunteers and so called patient leaders in places,  we have complaints procedures-complex as they are. But are they enough in themselves? Only if they are embraced by the whole service in my experience. We need mature systems and leaders who are self aware and responsive, who are willing to learn, to change, to be flexible, to listen. We need a system born of compassion and collaboration , not competition and judgement-responsive to people not only focused on targets.

We aren't there yet everywhere, but I see in my work people who are truly open for this, who recognise the need for change and are actively pursuing it. That gives me real hope...the next stage is to make that the norm, working with the culture rather than in spite of it. I know it's possible and the time is right...

Reasons to be heartful

My work and life gives me the opportunity to work with really inspiring people. To see their efforts despite a grinding schedule and an ever growing need to make a difference in their world. Perhaps sorry still seems to be the hardest word but maybe we can practice getting better at it together as well as celebrating the great care delivered each and every day by carers formal and informal, paid and unpaid. Next week I'm looking forward to a celebration of carers for people with dementia, hosted by Tommy Whitelaw and colleagues from the Health and Social Care Alliance Scotland. Eddie Reader is headlining and I'm hoping as Burns night approaches she might do my favourite Burns song, her beautiful version of Ae fond kiss. It's  going to be a fabulous evening I know and I suspect as a daughter of a mother with dementia, not a little emotional. But with dementia being such a prevalent and growing condition as we age as a society, I won't be alone.

 And that is important not being alone as we all tackle the health and social care needs moving forward , support will be the key to resilience for us all.

Saturday, 4 January 2014

Tower of song

My Mum is staying with us just now and we have noticed her increasing frailty during this stay and that's so hard to witness. But it was seeing her reaction to The Sound of Music that reduced me to tears. Her enjoyment was evident and seeing her sing along quietly to the line "my heart will be blessed with the sound of music" was my undoing. 

The film of course reaches down through my childhood. My first trip across the Forth Road Bridge was to see the film in Edinburgh....a big trip, planned in detail by the community I grew up in. As a child too my grandmother had the LP and I listened to it every Sunday we visited, absolutely word perfect as a result. Even as an adult a trip to the singalong Sound of Music was a wonderful cathartic combination of laughter and singing-with a Glasgow heckle to Maria of "Gaun yersel hen" a hysterical high point! So it was both old memories and fear of the future that brought my grief to the fore. The positive role of music in people with dementia is now well recognised of course and alongside my tears I was thankful for her pleasure too.

 I got a new iPod for Christmas so as i fill it I will  create my own favourite theme tunes that will enhance my life right now...but who knows maybe at some stage in the future they will help me raise my head and make me sing too. My taste in music leans to reflective singer song writers. From my youth (after my Sound of Music days that is!) it would be James Taylor, Joni Mitchell, Leonard Cohen and Carol King  who adorned my music collection. I never owned an Abba record in the 80s but recently downloaded Abba Gold and love it. Its easier to singalong to than Leonard Cohen, lets be honest!Perhaps our sound tracks need to be that eclectic mix of all of the music we have sung to over all the years. My Dads favourite songs to sing would need to be on it ( "You must have been a beautiful Baby", "For Me and my Gal" ) and I'm now realising The Sound of Music should be there too.

In many ways its been a very moving start to the year. Mine is the sandwich generation and on one day this week a good friend called me to let me know her father had died after a long illness. Just a few hours later another friend was in contact to announce the birth of her first grandchild. How poignant  it was to experience the juxtaposition of their news.

Reasons to be cheerful. We had a lovely family time over Christmas and New Year and also welcomed with joy the news of a family engagement. Im so delighted! How fortunate we are. I hope you too find joy and connection this new year. And maybe you could join me in collecting some of your songs that connect you to the past and to what gives you joy....our collective thank you for the music.

Friday, 3 January 2014

This one is for the men who are affected by their partners breast cancer.

This is a different kind of post for me as its a guest one. I don't normally do this but when i was approached I was keen to pursue it as its some tips for men whose wives have been affected by breast cancer. A much needed source of advice from someone who has been through it.
His name is Todd and here are his tips. Do pass them on.The men involved need support too and often are much neglected. Thanks to Todd for his honesty and willingness to share.

Three Goals for Guys
                Soon after my wife was diagnosed with breast cancer I went in search of helpful information and tips that would prepare me for my role as a support partner. This information wasn’t readily available.  There were plenty of books, magazines and web sites devoted to a woman’s needs (and rightly so), but guides designed to help men were fewer and farther between.
                In short order, however, I began receiving helpful counsel from friends and family members who had walked this path with their wives.  There were more breast cancer survivor husbands than I realized.
                Taking away the best of the best, I eventually settled upon three goals that I wanted to achieve as a support partner and husband through my wife’s breast cancer journey.  I pass them along here as key ingredients to your support, and hope you will find them helpful.
                Goal #1:  Be the support—don’t just talk about it.
                This was important on many fronts.  There were many aspects of my wife’s journey that were not conducive to my presence.  I would have rather talked about these, or assigned someone else to “be there.”  For example, spending the night with my wife post-surgery was a draining experience (the cot, the sleeplessness, the discussion with nurses).  But I couldn’t just say I was supportive, I had be there with my wife, by her side, and with every one of the subsequent steps in her healing it became easier to accomplish.  Our love deepened through these fearful and uncomfortable points, and I was glad that I made every effort, cleared my calendar, and took the journey with her.
                Goal #2:  Wear different hats.
                The breast cancer journey will press men to be and do what they didn’t think was possible.  During my wife’s surgery and recovery period I learned how to cook from her recipes, completed my first loads of laundry, changed bed linens, fluffed pillows, made runs to the grocery store, accompanied my children to school activities, and generally ran the household by myself for a short period.  I wouldn’t say I was a single-parent, but close.  All of these varied endeavors taught me much, however.  And I essentially learned that I had a greater capacity for multi-tasking than I realized.  Even work was easier once I returned to the desk.  After breast cancer, the rest of life is gravy and the days seem simpler and less complicated.  Wearing all of those hats increased my life skills and my talents.
                Goal # 3:  Bring our lives back to “normal”.
                Well, what’s normal?  In truth, life never completely returns to the same place after a breast cancer experience.  She is changed.  And he usually is, too.  But this isn’t a bad thing . . . in fact, it can be quite positive.  What I discovered is that we were creating a new “normal” post-recovery.  My wife changed careers (this is more common than you think!) and I was soon talking about these experiences and seeing the carry over to other aspects of our lives (marriage, parenting, careers).  All in all, getting back to normal is simply learning how to help your wife live as a breast cancer survivor.  Time changes things—and most couples discover that the new normal is better than the old.  It’s all in how you look at it.
~Todd Outcalt, author of Husband’s Guide to Breast Cancer (Blue River Books)