Just what I needed today

This first appeared on the Point of Care Foundation's website: ://www.pointofcarefoundation.org.uk/blog/just-needed-today-respite-schwartz-rounds/

If you don't yet know about Schwartz Rounds, you should take a look.

I'm in a rush. Not in the mindset I need to be in at all. I've just spent an emotional 2 hours with a family whose son died a few weeks ago. "Some days we're devastated," they told me, "most days it's a thousand times worse than that". They talked about hope and about how small kindnesses made all the difference. 

I steady myself with a cup of tea over the pre-round lunch, I welcome the panellists and check they're ok. This, after all, is my role for the next hour and a half. I tell my co-facilitator he may have to pick up some slack for me today. 

I console myself with the fact that the panel have been well prepared. They are talking about their experiences as patients or relatives; the Round is titled 'From the other side'. 

As I listen to them I am moved by their honesty, their bravery, their ability to share deeply personal stories. And I look out to the audience. They are hanging on every word. No one is fidgeting. There's not a phone in sight. Some are visibly moved. All are rapt. 

There is talk about how the little things create lasting memories: the nurse who spontaneously burst into song; the patient who was able to drink one last espresso because it was delivered on a mouthcare sponge. 

And then it's my turn to speak. I stand and look at the audience. I tell them how moved I am by the panel and that I would love to hear their reflections. And then I wait. 

The initial silence used to worry me. What if no one ever spoke? Now I know that this silence and stillness is important. I am calmed by it, as the audience are. 

"Well, that was a four-tissue event" says a voice near the front. There is a moment of laughter, a release of the tension. Other speakers now, commending the bravery of the panel, reflecting on how "breaking the rules" is often what's needed to make things right for patients. People sharing stories about their own experiences and those of loved ones. Us two facilitators are barely saying a word, it's just working. 

I check the time. The hour is nearly up. And then there is a story about a more negative experience. An example of rules getting in the way of what was right. I don't want to end here. I look across at my co-facilitator. We are a close team. Something in my glance tells him, "not yet". No words are spoken or mouthed but I know he's saying he'll wait. I know this audience will find a positive to end on. I give them a moment and it comes in the form of a new face at Rounds. 

I can feel the moment of tension that filled the room slip away. 

We close. 

I know that this was just what I needed today. And I'm sure I wasn't the only one. I didn't share my experience from the morning, but to be in that safe space and to feel the compassion and support in the room made it better. 

Never work with children or animals?

This is the first time that I’ve started a pre-interview brief with “When the candidates are in the room, you need to keep the bouncy ball in your pocket please”.   But this is the first time I’ve been on an interview panel with a six year old and an eleven year old.  

Honestly, I’m not quite sure what to expect.   I just know this is the right thing.  These are the people who matter most in my world.   If we’re talking about stakeholders, these are the ones who really count.   These two remarkable children are regulars on the ward.  ‘Season ticket holders’,  ‘frequent fliers’, whatever you might call them,  they know the ins and outs of the service and they know the best kind of person to make things right for them when they come in.   We’ll call them Star Wars and Arsenal,  after their respective passions. 

Our fabulous play specialists have helped them to prepare for today.   They’ve spent time thinking about what makes a good nurse and what is important to them.  They understand that they are part of something important and that this is a responsible job.   I had never seen them looking as smart as when they arrived today.  They are clearly taking this seriously.   Nevertheless, the 6 year old’s Arsenal shirt has stayed on!

We have agreed that the children will stay in the room for their questions and then go out for the remainder of the interview.   As the first candidate comes in, we introduce ourselves and I explain the format of the interview.   The knew they were being interviewed by young people as part of the panel today but I can see its an added pressure.

Star Wars, my 11 year old panellist, asks “why do you think its important to keep me informed and how will you do that?”.   He listens to the answer and I nod to let him know to ask his next question: “How will you keep me entertained on the ward?”.   He listens attentively to the answers and passes over to his brother, who has dutifully resisted all temptation to get the bouncy ball out of his pocket.   “I don’t like having the needle in my portacath.   How can you make that better?”.

My colleagues and I listen to each of the candidates in turn, watching how they interact with the children.   Can they listen to them and really answer then questions?   Are they able to modify their approach for each one?   And, most importantly, what do Star Wars and Arsenal think of their answers?

My worry before the interview was that this would be a gimmick,  that I would be able to say we’d had patient representation on the interview panel but it wouldn’t have meant anything.   Yes, I’d had some other lower level niggles about whether the kids would find it too nerve-wracking or boring, or that the candidates would find it awkward,  but this concern about meaningfulness was key.  

I needn’t have worried.  

The ability of these two children to cut to the chase was truly phenomenal.   In that way that children have of really getting to the crux of the matter they gave great insight into how each candidates answers had made them feel.   This added a new dimension to our post-interview discussions and helped with the decision-making.   With their questions, they covered what we would broadly term ‘patient experience’.   They might call it ‘stuff that matters’.  Either way, a job well done, a remarkable experience for me,  and not a bouncy ball in sight.

So what's this all about?

Welcome to my first blog post.

I've been asking myself questions about what this is all about and who it is for.  I suppose the simple answer is that it's for me.  It's a space where I can reflect on my working life as a nurse.

I've given brief information in the introduction section about who I am and what I do. I am passionate about my work.  It's a big part of who I am and I give a lot of myself to it, too much sometimes.  

Having written a few posts for various blogs recently, predominantly for the Schwartz Round community, I discovered that I quite liked it!  This is my opportunity to share my thoughts and feelings about my role as a nurse.  People who know me would probably say that I am always going on about something, so now I can go on about it here!

I hope that you will enjoy my posts, or find them thought-provoking, and maybe even share some of your thoughts with me.  Be gentle please - this is all very new.