Monday, 8 September 2014

Burdens or assets?


Recently I had a reunion with my fellow nursing students from the University of Edinburgh. It was a fabulous weekend connecting with people who were such an important part of my life at one stage. Some have stayed in it of course but how special it was to meet again  and look back at our younger selves as so many memories were awakened. 
How did we feel the course had affected our lives, we wondered? I recalled that a former student had told us, the degree in nursing gave her skills for life. I remember thinking with a youthful arrogance, really, is that all?Of course it was nt all but now I know what a fundamental gift that was. Our Professor was the unique Professor Annie Altschul. She was a mental health nurse by background, an Austrian who had left her homeland when fascism was plowing its devastating furrow. Her special research interest was the therapeutic relationship. We recalled her words to us: that the best tool we had as nurses, was ourselves. An overwhelming thought when you are a raw 18 year old, but now I recognise the deep wisdom she spoke.
Not only are we older, greyer and our lives have had some unpredicted twists and turns but the world we work in too is different. The people we care for now have complex illness, they tend to be older and usually have more than one condition to deal with. In some respects that is a success story as we live longer now, but the reality too is that we live longer with long term conditions.
Its hard to hear this spoken of in healthcare without words like burden and wait for it; multimorbidity  being used. I have been known to introduce myself at such events, as Audrey a walking multi morbidity! Yes it's a joke but its also my way of reminding us that we are people, not burdens, not the blame for pressure on the health system, we are the reason the system exists. I absolutely understand the challenge of caring for people with complex conditions, the primary care system is buckling with that pressure. But we know our medical and nursing education  does not currently prepare people for the reality they face. Undoubtedly we need to change our approach to a person centred one, with people not conditions or systems of the body the focus. An assets based approach where we help people discover their resources to enable their own wellbeing, whatever their health issues. Where we focus on fostering self belief and self management, enabled, not disabled, by our health and care needs. Where health and care workers recognise their role is to enable wellbeing not merely to treat disease or support people safely. And they too as staff are valued, supported and stimulated in their work. A culture that starts with "what matters to you?" is the one which will create the conditions for wellbeing in our selves and our communities. 
The young nurses setting out on their journey as I did so many years ago, will see a health system very different to the one I did. In very many ways it will be better but also wakening up to the fact it needs to change. We need to respond to that call and give those professionals the right tools and conditions to do that. Language is so important so let's stop talking burden and start talking assets, it will start to turn the wheel in the right direction and give us all the starting point for change.
Reasons to be cheerful.
I'm working with a great organisation who have embraced the future with a very personalised form of support. I spent time with the manager, who told me, "since I started this project, I haven't worked a day". A team who love their work because they see the difference it makes. Now that's a great starting point too. 


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