Who Cares?

We had a great day in Rotherham. Fifty staff plus a bunch of great actors from Dead Earnest and some patients - all exploring just how hard it can be to care amidst the pressures of ward and home life. (Take a look at the monologues to get an idea of the kind of stuff we discussed).   For Patient Opinion we wanted to explore ways to extend the impact of the event. How can we use the site to gently nudge busy staff into actually changing the way they care? So at the end of the day we asked everyone to make a Promise to Self – something that they wanted to do for themselves, a change in their practice that came from their professional heart, not from targets, or performance management or anything that was externally motivated. And we’ll be posting these up on the site over the next week or so. All this made me think about what ‘caring’ means. The best definition that I’ve ever found is from Val Isles: caring is always about acts of work or courage. No work or courage, then no ‘care’. So if what you’re doing is routine, or humdrum, or going through the motions, if it does not connect and challenge your professional heart to think and act, then it isn’t caring. Of course this is a particular definition of ‘work’ but its useful because only the person doing the caring can judge whether they really have been working (in this sense) or whether they have been called out of their comfort zone and acted with courage – or not. From a management perspective this is useless of course – a definition with no external measures, and entirely subjective. From the professional’s point of view seing  care as acts of work and courage is a home coming, a return to that place where the best professional practice has always existed, an internal demand to do justice to the suffering, needs and healing of another. This professional side of the story has been underplayed over the last 15 years as health service have rightly concentrated on getting the systematic aspects of care right. But ask any patient – or read hundreds of postings on the site – and you’ll soon find that in addition to providing care that is great in a systematic way (evidence-based, best practice), what people long to give and get, is ‘care’ – acts of work and courage that connect with the heart and cannot be faked.

Finding ways to combine these two aspects of great health care, the highly personal and the highly systematic, is the task of health professionals in the 21st century.

Click here if you want to see an example of a story brim full with acts fo work and courage - or here for one that fails on almost every count.