The gift of Presence and Mindfulness – hospice care

“Paying attention on purpose, in the present moment, non-judgmentally, with compassion, curiosity and acceptance”

I am a health care professional my main background being in midwifery. Becoming a midwife enabled me to support women and babies. To be present and be an enabler at one of life’s greatest miracles- the arrival of a new human life. Midwifery involved me in the miracle of life, and being able to be present to help and support women and their families was a wonder in itself. I felt in awe with the moment. 

Before becoming a midwife, I trained as a general nurse and have always had an interest in palliative care. My father died of motor neuron disease in a hospice, I had always wanted to work in the hospice environment, to give back – to offer something to help – after the experience of care I had encountered with my father.

After taking retirement for my substantive position as a Professional Midwifery Advocate, I applied to the local hospice as a volunteer, I was accepted to teach and share the practice of mindfulness to hospice day patients.

Mindfulness is all about the gift of presence. It is not about emptying the mind but rather becoming present to what is. It’s an openness to presence and the discovery of what is all around us and inside us.

I am trained in Mindfulness but have not worked in hospice settings. I drew inspiration from Trish Bartley’s work. I had the support from the psychologist, a Buddhist Chaplain and a volunteer. 

The course for the day patients was delivered in the middle of the pandemic and via zoom and was facilitated by myself, the Chaplain and a volunteer. The aims of the course were to help these patients to learn and cultivate mindfulness and meditation practices over six weeks. This was through exercises, and reflective enquiry, to enable the patients to come back to the present moment in a loving and kind way. 

During the six weeks there was variety of exercises and homework to do. It was advised that the patients start the journey by keeping a journal that is only for them to see. 

Our internal reactions to illness can cause a great deal of extra suffering and a huge impact on our ongoing wellbeing. 

While we may not be able to change our physical situation, there is the possibility through Mindfulness of developing the internal habit to compassionately respond, rather than habitually react. Through practice, our experiences of shock, anxiety, fear and loss can be held in a different way leading to a better sense of wellbeing. By definition, pure awareness of the present moment can free us from been permanently locked in both the past and the future. By repeatedly accessing this present moment, it helps to create internal space and fosters our sense of ‘being OK’ in that moment. 

Mindfulness is not a miracle cure but can help us find and work from a better inward place.

Patients described insomnia, stress and in one case “dark thoughts”.    

Mindfulness helps us to develop self-compassion. Compassion is sometimes called the “trembling of the heart”. Christina Feldman writes about, 

“Mindfulness is not a magic wand or an end in itself, but a platform where understanding begins – where healing of that which is broken is possible… Transformation begins with having empathy for our own struggles – our heart trembles in the face of difficulty rather than moving into judgment – which we do so fast”.

 Mindfulness is essentially making friends with oneself. It can be a powerful anchor and brings about the possibility of being kind towards oneself, developing a different perspective of oneself in a positive and more curious gentle way towards one self. 

The six-week course was a journey of self-discovery and connection. For me this journey was very humbling, to share the mindfulness resources/information with the patients, some of which were still undergoing treatment and yet came back to the sessions.

Teaching hospice patients widened my perspective in how I viewed life and potential death. At a time when things may seem out of control (and indeed may be) the little things are important and I saw their power in our sessions. 

Part of the six-week course was on how we work with challenge and difficulty.

The meditation exercise and information for this was explained in a safe way for the patients and created dialogue within the group exploring how we can work best with difficulty. 

The feedback from the participants was positive and demonstrated that mindfulness has a real place in care across our services and systems. 

In writing this I have reflected a lot personally on giving and presence. There is a close connection between the two. The best gifts are those which comes from the heart. They are wrapped in love and kindness and care. Giving a gift whether it be time or energy or a material object at its highest enables a presence to appear – something that connects us with what is best in us and others.

When I think of my own journey from general nursing to midwifery to seeing how the hospice cared for my father, from there to offering Mindfulness training to hospice day patients, I can see how important gifts and presence are.

Denise Cohen 

(Thanks to John Walsh for help with this writing)

My journey through the lens of mindfulness

 

‘The Universe is made up of stories, not atoms’ – Muriel Rukeyser

 

I entered the NHS in 1983 at the age of 18 to undertake my nurse training. After qualifying and working on a medical ward for six months I undertook my midwifery training and qualified in 1988. I had always had a quiet mind until I became anxious or stressed and then the chatter would begin.  I would feed into the chatter and allowed it to become part of me. These periods did not always last and the quietness would return.

This is how it has been throughout my life. However, looking back over my career I can recognise when the quietness of my mind was a real asset and that was when I was on duty as a midwife. Being with woman was intrinsic for me to provide good care. Through the quietness I could fully be in tune with what was happening to the woman and be astute when changes happened and act accordingly. The concentration, care and sense of a deeply purposeful act brought a quietness and peace to my mind.

I had a number of bereavements within a short space of time including a Head of Midwifery that I had the utmost respect for, and my father. The chatter of the mind took hold for long periods of time and I would become self-critical and spiral quickly into more negativity.

After a number of years, I undertook an energy healing course and started to meditate for the first time. Reflecting back, this was the start of my journey back to wholeness, self-compassion and compassion for others. I attended the local Buddhist Centre and strengthened my meditation techniques, learning to become more mindful.

What does it mean to be mindful? There is an association that being mindful and practicing mindfulness is needed for resilience and that staff should undertake a mindfulness course for this reason.  In my experience this was not what mindfulness is about. Mindfulness is about being fully present and not being preoccupied with the past of future. It is about being in the now.

I was passionate to gain more information about mindfulness and meditation and how it could help. I intuitively knew that I wanted to teach mindfulness and that being present had so much more to offer than being a work help to resilience. I undertook an 8-week mindfulness course based on the Finding Peace in a Frantic World book by Mark Williams and Danny Penman.

With reference to the book it explains exquisitely how we can become the self-critic of our own thoughts which incidentally may or may not be true. Mindfulness is about viewing your thoughts differently – not with harsh judgement but with kindness and curiosity. The course goes further to give you the tools to approaching difficulty instead of avoiding it. This resonated as something which I have done in the past, is to box things up and hope the lid doesn’t come off the box.

For me this was really useful as we may not be able to change the situation, but if we can sit with, and acknowledge the situation, we become more comfortable with it as it is without trying to change it. When I did this, I found usually for me the situation became smaller and I became more accepting. This is just one example of how the tools of mindfulness and meditation have helped me.

Mindfulness to me is not about silencing the mind. It is about viewing the mind chatter differently and encountering it with self-kindness and compassion. The mind body connection is important for healthy living as stress can cause a lot of physical damage.

Mindfulness offers also the ability to be present with another and holding that space for them. This will create that possibility where they will feel fully listened to. This certainly helped me in my previous role as a Professional Midwifery Advocate and holding the space without judgment. Mindfulness helped strengthen my intuition which was an asset clinically. That intuitive knowledge proved invaluable as I was able to address change in a situation in a non-judgemental way.

I retired from my previous role as a PMA in September 2019 and after a period of reflecting over my career which has been challenging at times mindfulness and meditation has helped me to reach a stage in my life where I can turn the  next page with hope and trusting that everything will be ok.

For me life is a story, about balance, healing, kindness for the self and others. It is a story in which mindfulness and meditation have been great help. My mantra comes from a couple of quotes from the Dali Lama

“We are here to help each other, if we can’t, cause no harm “

“Love and compassion are necessities and not luxuries, without these we cannot exist”

My own personal viewpoint after being in the NHS for almost 37 years is that life is complex and we don’t really know what is going on in someone’s life. So we need to be gentle and kind with each other. We are all a bit broken so if we can’t help, we can at least cause no further harm to another. We are all in a continuum of change and how we respond to that is our responsibility. If we can bring and learn skills to help us in a positive way that can only be good.

I am now a mindfulness instructor for the work place. Currently working with a NHS Trust delivering mindfulness sessions to staff #covid19.

If you can be anything be kind, be present and if you can’t help others cause no harm

Denise Cohen   https://mindfulperceptions.co.uk/

John Walsh

New Beginning

So tomorrow I take up my new role of Recreational Support Worker on the unit where I am based supporting people living with dementia, there’s an interesting story behind how the role came about but I’ll save that for another day.

I can see great potential from this role, potential to make a difference to those staying on the ward, potential to engage with family or carers, potential to form partnerships to deliver new and innovative care but most of all potential to bring joy to everyone visiting the unit whether a member of staff, patient or their loved ones.

There is great potential for us as a unit team to come together and consider what we can be doing differently that would benefit the whole patient experience, there was a great example of this recently with one of the Staff Nurses on the male ward organising a Beach Party. The member of staff worked hard to consider what would be appropriate for our client group and secured support from staff within the Trust along with donations from local businesses to ensure that the event was able to provide a wide range of activities that brought back memories of a stroll along the seafront or pier. She was able to draw together a team of staff who supported her in delivering a brilliant event that saw positive feedback from many attending the event and there are many of the patients who are still talking about the event two weeks later.

I have already began the journey of forming partnerships, an opportunity for me to adapt some previous work I completed with my previous Trust (more info here) by forging similar connections locally and there is also potential for me to create a pathway for people following diagnosis providing access to services that will support them in maintaining or improving their wellbeing. I’m excited about what lays ahead, I feel like I have been given a blank canvas with which to paint a picture of compassionate care that focusses on what matters to each person during their stay on the ward. We have an incredible amount of space that I would like to mould into an environment that is warm and welcoming with a focus on social interaction.

The groundwork has already been done as the tool has been developed and the Cubley Care Bundle is finally in print waiting for me to arrive in the morning, an adaptation of the This Is Me from the Alzheimer’s Society. A document that will support us in understanding what matters to each person during their stay and allow us to co-produce the care delivered through engaging with each patient and their significant others. I have attached a copy of the document should you have the desire to take a few moments and cast your eyes upon it.

Since taking up my first Bank Nurse post within mental health I have been very passionate about the benefits of being able to engage people through activity, the opportunity to offer distraction at times of distress, the opportunity to create conversations without the pressure of face to face interviews and the opportunity to connect with a person by walking alongside them in a shared experience. This passion has continued with me throughout my career and as my knowledge expands the more I am drawn to consider what it is that can be important to people staying on our wards.

My mind is a buzz with ideas and I look forward to the weeks ahead as the pages of this first chapter of my new beginning.

The Gap Year

16 days to take up the challenge, procrastinating at the start in the hope of creating the right energy.

30 Day Challenge – July

Well it’s been a long while since I put virtual pen to paper to ramble for a while but there is a good explanation for this, on this occasion it also stretches beyond the usual procrastination that those that have been following this journey have grown used to. They say that moving house is one of the most stressful points in a person’s life and this is one of the many things that I have had to contend with over the past twelve months but that is only the beginning and the move was relatively stress free to if I’m honest.

The change of location brings with it the change of employer and that’s something I’ve not had to contend with in over twelve years which in itself is a world record for me, looks like I may have found a vocation that is right for me.

You’ll be glad to know that since the #BionicCaremaker embarked on this gap year that has brought me here to be writing again, so in a way I think I may have taken that break that many students take before heading off to university to allow them time to find themselves and embrace new experiences.

I am proud to say that there are many new experiences and pleased that my current employer have a taste for creating fast paced change at a ‘local’ campus level, which initially felt a little uncomfortable as I had grown used to the grinding cogs that we have come to expect from change within our health system. I’m interested to see if this same passion is embraced when approaching change at scale across the wider Trust.

There have so many positive developments over the past twelve months which continue to make my head spin when I take a breath and remind myself about them, developing a tool for us to use on the dementia unit where I am based to deliver care that matters to each person during their stay on our wards, becoming our Trust’s first Nursing Ambassador which seemed like a natural development of my #Caremaker  role and I’m looking forward to driving these and other opportunities forward with my future musings and also with the opportunities that are being created through engaging with the Transforming Perceptions platform and the Ambassador role itself.

I think we can safely say that I have accepted that living life on the edge and embracing the fear of stepping outside of your comfort zone is becoming part of professional life and is becoming integral to the work that I am doing especially as I’m about to take up the role of Recreational Support Worker on the unit, taking up the role of Staff Governor is also something that I look forward to and it doesn’t quite fill me with the same dread or create the near heart attack anxiety that overwhelmed me on being listed as one of Health and Social Care’s Standout Stars as part of the #NHS70.

The imposter syndrome is something that’s holding on in there but it is that feeling that I think keeps me grounded and focussed on the task ahead.

Now that the seal on the ink well has been broken once more perhaps I can continue to share stories of the positive differences that are being made and the good practice that is being developed locally in the hope that others see the benefits and adopt into their own environment.

The Journey and the Candle

“From tiny experiences we build cathedrals” —Orhan Pamuk

I worked in nursing for many years and always held to the values of the nursing profession. To me those values were always about putting people at the heart of care; to treat people as individuals and value them. To be empathetic, respectful and treat all with dignity, kindness and open communication. There wasn’t really a work – life divide in my existence. The human being, woman, mother and nurse I aspired to be had these core values at their centre. It was about being me and the best me I could be in a variety of roles and dimensions. The rationale was simple – people deserved this and the old Golden Rule of treating others as we would like to be treated seemed as right, perennial and important as it ever did.

Some time ago I was offered an opportunity to work at my trust to work on a model for Nursing and Midwifery Revalidation. It was a tough decision. I was committed to actual nursing yet something strong drew me to this work with staff. It was an inner sense that this was the right thing to do. I decided to make the switch. I joined an internal team at my trust and collaborated with external colleagues and developed an award winning bespoke software solution and model to support nurses and midwives through revalidation. We now offer this to trusts nationwide for free to support our colleagues within the revalidation process.

When I reflect the idea of being on a journey resonates deeply with me. A journey of discovery. There are many stories of people setting out on journeys to discover the unknown or return home and growing through the process. In the Bible we find Jonah and his journey to Nineveh. We have the epic Odyssey attributed to Homer (the poet not Simpson). The Lord of the Rings and Star Wars enshrine the same narrative. Popular comedies like ‘Planes, Trains and Automobiles’ also sing the same chorus. It’s all about leaving where we are to find where we need to be – the place of our destiny and gifts. It is in the journey that we find often what we are and where we need to be.

The journey carries in it a profound psychological and human truth. It is that we sometimes have to move to grow. To stay where we are is sometimes not growth. Wisdom and discernment are needed in this.  Abraham Maslow the great psychologist noted that  ‘ One can choose to go back toward safety or forward toward growth. Growth must be chosen again and again; fear must be overcome again and again.’  It’s a tough quote and tells us a great truth. That moving away from what is our comfort zone is often the path to grow and become who we are. This was my experience – of walking into a new role, leaving a loved old role, learning things from scratch and feeling at times very unsure. Yet in that uncertainty and new space there started to spring flowers of possibility and connection. I was very proud to find my place in this good team and be part of a work that is supporting nurse colleagues through the revalidation process.

When I look back I realise the journey is all about the outer work and the inner development. There is a flowing dance where one leads and the other follows and vice versa. There is this ongoing interchange of the outer and the inner. This is fundamentally about us as people  – who I am and what I can offer –  what I need to let go of and what I need to connect with . My original nurse human values have remained as strong as ever  – they are the same flowers which are growing now in a different soil.

Recently a friend shared a quote from Thea Bowman. The quote spoke powerfully to me and what I have always hoped to do in my past and present role.  Thea said, ‘ I think one difference between me and some other people is that I’m content to do my little bit.  Sometimes people think they have to do big things in order to make change, but if each one of us would light a candle, we’d have a tremendous light.’  I think my story is about a journey – moving to a new place and finding new gifts and possibilities. I am not saying this is everybody’s path. I think for me the lesson is  – to see our gifts, take them wherever we go and to realise growth means sometimes letting go. Most of all as Thea says it is about lighting those candles everywhere. What a light we would make!

Lisa Sharp

( with assistance from John Walsh )

New Eyes

 “The real voyage of discovery consists not in seeking new landscapes, but in having new eyes.” ―  Marcel Proust

 

 A few years ago a nurse working at a CCG office had a wish. She knew that practice nurses and community nurses didn’t meet or work together in any meaningful way. There  would be referrals and an occasional phone call but no living contact. Yet these good nurses worked in the same communities with the same people. She felt something wasn’t right and decided to act.

 

Our nurse friend wanted to bring the nurses together and support them to know and understand each’s other work.  She created lunchtime meeting where the nurses could meet, bring their lunch and talk. The meetings were open and those who attended owned the space. The nurses started to attend  and share what they did. It was clear the nurses didn’t really know what each other did. From this listening dialogue they started to see what each other did. Through knowing this they started to know each other and laughter, friendliness and understanding started to flow. From this the nurses started to identify five areas of co-work and co-learning. They also owned this as their work and focus. Their organisations were supportive too. This was fundamentally a trust in their wisdom, vision and working together. 

 

This work offers vital lessons to our NHS and other services. We will note three aspects which we believe offer the possibility of fresh energy for our tired systems and approaches.

The first lesson is wisdom. Our CCG nurse friend believed passionately that the wisdom was in those rooms with the nurses themselves and it could only be discovered if we trusted the nurses present  and let them talk and explore together. There are two basic theories of wisdom. One is that gurus have it and we have to go cap in hand to receive their jewels of sapiental knowledge. The other theory is that wisdom lies everywhere and we should always be open to be surprised where she might shine her light. The latter theory means the homeless person or cleaner or coffee barista may be our teacher if only we can be open and listen. This approach was our friend’s. Our services desperately need these kind and open dialogical frameworks to create real alliances where all voices – patients, families, carers, third sector, hospital and local authority colleagues can be truly heard and included. But there is a price. The cost is that we have to really believe in people and believe they have something important to share and offer.   

The second lesson is learning. These nurses learnt relationally  –  by getting to know each other  – by discovery and connection. All real learning is relational – whether a person or books or nature. Its from our relationships that we learn and grow. These relationships are composed of listening, curiosity, humility and openness. This is where what we need so much (and often look in the wrong places for)  – leadership, creativity, innovation and hope – can be found. This sort of learning is also about ownership. The nurses named and owned the change so it was real and personal. That old saying ‘All teach All learn’ comes to mind. If we were to really believe and practice this we may be surprised at what happens to us personally and organisationally.  

 

The third lesson is about surrender. The future  is not about words although words matter. It’s about devolution. Devolution as a devolving of power and decision making to staff on the ground. This should go hand in hand with devolving power, finances and resources to people, communities and families so we can co-design and create the future together. It’s not an easy thing to break the organisational habits
of a lifetime ( and the fears that keep them locked tightly ) so maybe we have to start small, learn how to get it right and grow from there.  

 

There is a film with Jack Nicholson called ‘About Schmidt’. Its about an American man called Schmidt played by Nicholson. Schmidt retires and reflects on his life. He comes to the conclusion that he is living a hollow existence –  devoid of meaning and hope. He starts to support a charity working with African children and writes to one of the children. After his daughters wedding he comes home in a poor state. Fed up with the clutter and clichés of life he finds a letter waiting. It is from a nun in Africa who works with the young boy. She writes and says the young boy is an orphan and cannot read or write but he wants to send Mr Schmidt his best wishes and that he has sent him a present – a drawing. At this Schmidt opens further the envelope and takes out a folded piece of paper. On it is a child’s drawing – of a man and a child and behind them the sun shining. At this Schmidt starts to weep. There the film ends. Some commentators say that the film is all about discovery. At the end of the film Schmidt discovers what life is all about. Its about connection, care and compassion. A child has taught him what really matters.

Our friends work was all about connection, listening and care. In the mess and stress of our services its these authentic human meetings that are the signs and seeds of hope for us all.

 

Louise Brady

Cath Johnson

Jo Williamson

John Walsh

The Wherewithal

The hurrier I go, the behinder I get.– The White Rabbit, Alice in Wonderland 

Marie is still extremely busy around the maternity ward where she works. Every day is like this. So much to do and her head often buzzing. At the end of each shift she often feels exhausted. Yet something has started to change recently. She has started to feel a lot better inside, calmer and clearer in thought. Marie has been involved in Restorative Clinical Supervision with her professional midwifery advocate.

Restorative Clinical Supervision is a practice in midwifery and health visiting  that focuses on supporting staff emotionally. It involves the creation of thinking spaces to facilitate a physical and psychological ‘slow down’ through a process of discussion, reflective conversation, supportive challenge and open and honest feed-back. It seeks to enable staff to ‘understand and process thoughts which free them to contemplate different perspectives and inform decision making ( Pettit and Stephen, quoted in A-EQUIP a model of clinical midwifery supervision, 2017, NHS England. p.17).   

Marie has found this form of supervision helpful in her midwifery work. She explained that, ‘For me it was that I felt listened to – deeply listened to. I felt better about myself and had more clarity in situations. It was quite cleansing and healing. I felt more positive’.   

A few key aspects strike us here in hearing Marie’s story. The first is that these supervision approaches help when done well. They are deeply human ways of listening and supporting. They cannot by themselves replace culture change work  – although they can compliment, support and drive it. There is a need sometimes to address the culture of our workplaces and support staff to flourish and develop. Culture change work and supervision should weave and assist each other. One without the other radically misses something. There is a need to address what Robert Fritz the American organisational specialist calls the structure of our services – the assumptions. dynamics, relationships and behaviours that exist as the foundation and energy of our organisations. Working for external change and internal support should go hand in hand.    

The second is that this has worked powerfully because Marie experienced herself in a encounter with another human being. This supervision had become a circle of listening and understanding where Marie experienced being heard. The philosopher Jacob Needleman when asked how we can help others spiritually replied that we can learn what it means to listen to another person. Carl Rogers the great psychologist spoke of the lessons he had learn working with people. One of the fundamental learnings was ‘to permit myself to understand another person’. Marie had received one of the greatest gifts we can ever give to another person  – she had been heard and understood. All the whirling in her head and heart had found a place to be heard, accepted and supported. There can be a tremendous power and potency in this. A healthier NHS would seek and source these spaces for humanity  and learning wherever we were – with patients, families, staff, carers, social workers, third sector colleagues and everyone. These circles offer hope. The walls we build often destroy it.    

The last aspect we mention is that these are slow spaces. Slowness as a practice and way has been mentioned in different spheres including recently in Organisational Development ( OD ). The philosopher Michelle Boulas Walker wrote a key work on Slow Philosophy. Michelle argued for spaces for authentic reflection, internalising and slow learning. This slow philosophy is the immersion in discussion and thought that we need to grow.

The slow space Marie encountered was something clarifying and refreshing.  She described it as cleansing. This resembles the description of water in the Tao Te Ching 

Water will go the low places 

everyone despises

and be content

A home prefers level ground

A heart prefers depth

Relationships prefer kindness

These supervision forms can help us see and touch deep places. They can offer a supportive place to explore how we are and what we might need to go forward. 

We called this piece ‘Wherewithal’. Wherewithal is a not word heard much these days. Its an old word – from the 16th century. It denotes a means to accomplish something. The late English singer songwriter Clifford T Ward wrote a song called ‘Wherewithal’. It wished he had the wherewithal to attract the attention of a person he loved. In our services there is a need to find the wherewithal for so many things. 

Our services are sometimes sadly bereft of clarity, compassion, slow safe spaces and attempts to listen to others. Structures, processes and schemes can’t provide these in any meaningful authentic way. Only human beings committed to each other can. This does not negate structural forms and shapes – it rather defines the one quality that will give them deep meaning, effect and coherence. It is in our need to be human and humane that we can see and support others to see too. It is in this humanity that the future of our services and indeed our own wellness lies.

Denise Cohen 

John Walsh

#TwitterDisco #Afrobeats 20/4/18

This months outing for the #discoteers is brought to you in conjunction with The Caribbean and African Health Network.

CARIBBEAN & AFRICAN HEALTH NETWORK (CAHN)

CAHN GM is a Registered Non-Profit Organisation whose purpose is to empower, enable and equip faith and community organisations with the infrastructure to deliver and shape health and wellbeing services.

Our website – http://cahn.org.uk/

We aim to work collaboratively with commissioners, statutory organisations and voluntary sector organisations with a particular emphasis on sustaining health and wellbeing provision within the Caribbean and African community. The ultimate focus will be to facilitate capacity building in the Caribbean and African voluntary, community sector, ensuring they are commission ready to deliver evidence based, and culturally appropriate health and wellbeing services within a framework of governance.

Our Vision:

To transform the way the Caribbean and African Community access appropriate information and resources that enable them to improve their holistic health and well-being.

Our Mission:

To lead, educate, support, advocate and enhance the work of Caribbean and African organisations so that they are empowered and enabled to improve and sustain the health and wellbeing of our community.

Values:

CAHN GM is committed to working in an inclusive, creative and responsive manner with communities and organisations irrespective of socio-economic status, ethnicity, religion, sexual orientation, gender, age, and physical or mental ability. Our work will be conducted within a framework of respect, integrity, openness, transparency and accountability.

Our Core Objectives:

1. To work collaboratively with Caribbean and African faith and community organisations to strengthen their structures and systems so that they can be responsive to meet the health and wellbeing needs of their community.

2. To build partnerships across the sectors and to be the point of contact between communities, voluntary sector members and commissioning agencies.

3. To improve health inequalities within key areas outlined in Greater Manchester Strategic Plan with creativity and innovation.

4. To engage in continuous consultation, planning and evaluation to provide solutions to persistent health inequalities and act as a direct point of contact with commissioners.

5. To champion the work of the Caribbean and African community and to promote its assets, efficiencies and achievements.

FAYE BRUCE

Faye Bruce, Chair is a Senior Lecturer and Programme leader in Nursing at Manchester Metropolitan University. Faye has several years experience of frontline nurse practitioner roles within acute and community settings. She has a particular expertise and passion within the area of cardiovascular disease and related conditions. Her work in higher education commenced over a decade ago and her achievements largely lend themself to setting up and delivering on programmes allied to nursing. Faye’s MSc In Health Care Management at the University of Birmingham provided her with expert knowledge and practice in health literacy, commissioning and procurement and the opportunity to tailor this knowledge to develop her work in the Caribbean and African Community.

Faye is a doctoral researcher in Cardiovascular Caribbean and African health and focuses on the factors that impact upon health outcomes to include economic and policy analysis. Faye is currently a key member of the Greater Manchester Health and Social Care Partnership Working Group that seeks to develop a Memorandum of Understanding between the Faith and Health Sector in Greater Manchester.

CHARLES KWAKU-ODOI

Charles Kwaku-Odoi is a Christian Minister co-leading Command Prayer Centre Ministries International and Co-chair of Faith Network for Manchester. He is a keen advocate and passionately participates in Christian ecumenism, interfaith and multifaith initiatives across Greater Manchester; engaging with people of different faiths and none.

Charles specialises in engaging with the Black community in the Diaspora raising awareness of important issues such as democratic participation, Female Genital Mutilation, Domestic Violence, Modern Slavery, Hate Crime, Forced Marriage, etc. Charles closely works with the UK HIV sector lead Terrence Higgins Trust in their delivery of the HIV Prevention England programme by engaging with African faith leaders and organising HIV testing in churches and at community events. Charles is a Management Consultant, an entrepreneur, and volunteers for initiatives aimed at reducing social isolation, poverty and building community resilience. Charles is visionary and has good knowledge of stakeholder engagement, civic engagement, charity governance, policy formulation, systems & process development and change management.

Charles currently serves on boards and management committees of a few organisations including Caribbean and African Health Network, Command Prayer Centre Ministries, Macc, Faith Network for Manchester, Manchester Street Pastors, Manchester City of Sanctuary, Manchester City Centre Street Pastors, HIV Prevention England Steering Committee and Manchester BME Network.

Come and join us for this special #TwitterDisco, Friday 20/4/18 from 9pm with @charleskod

We Matter

‘When your heart is broken, you plant seeds in the cracks and pray for rain’ – Andrea Gibson

  I opened my eyes. 

Life had recently been challenging. Work stress, two recent unsuccessful job interviews and a new bout of an old illness had come back. I felt rubbish.

As daylight touched my eyes I suddenly had a thought. It took me back to work and my office.

The plant on top of my office filing cabinet needed to be watered, needed to be nurtured and loved. I had been nurturing the plant back to full health until I went off sick last Tuesday. I recalled the day I had discovered the plant a few weeks previous. There it was inside the black bin liner in the kitchen bin at the NHS Health Centre where I work. It seemed all discarded and rejected – with no one to care or prize it. It was covered in scraps of food and rubbish. Its soil still clung onto its exposed roots and its dried up leaves were nearly all detached from the plant body.

The sight of the poor plant touched my heart. I had turned around and spoke to a colleague who was making a drink. I said to her ”We don’t give up on humans who are suffering yet someone has given up on this plant”. I dug deep into the bin and lifted out the plant brushing off the food, rubbish and fallen leaves. The plant felt smooth – it still had life in it, I could sense it. I found a pot and watered the plant. I heard it whispering thank you and felt it drinking thirstily wanting to live and thrive.

I thought carefully about where it would like to be and took it into my office near the window. I picked up a YOU MATTER postcard and stood it up leaning against the pot. ”YOU MATTER dear plant I whispered. I hear your pain and I respond with love. I am here and will care for you.”

As I lay in bed thought of the plant.  Recent illness, failure at job interviews and painful childhood memories had stirred within me a deep sense of feeling rejected, useless and unwanted.

As I mused that I was just like the plant inside the bin covered in rubbish, I heard the voice of the plant in an inner dialogue talking to me. 

“You have been through some tough times recently Angela. Let me teach you a lesson – a lesson for the heart and soul?”

”I’m listening” I said hesitantly and hopefully.

”The events you went through are one thing – just like me being thrown away in that kitchen bin. What matters is what comes next – you rescued me. You don’t have to remain in the bin do you?” the plant offered.

I realised there was a lot of truth in this. The illness and events had knocked me massively but I had ended up believing a lie – that I was useless, a failure and someone with nothing to contribute. The lie was keeping me in the bin of self-doubt.   

“You told me I matter Angela. Do you matter then?” the plant inquired.

I was lost for words. The plant was very wise. It had felt my love and heard me. Now it was helping me. I put my hand on my heart and listened.

The plant continued, “Thank you for loving me back to life. To give love, you need to love yourself. You are love and you are loved. The world needs your love. YOU MATTER”.

The inner visual dialogue ended there. I got out of bed (out of the bin) and shock off the rubbish.

“I DO MATTER” I said.

I rang my manager to tell her I’ll be back in work tomorrow. I wanted to rejoin my colleagues and also water the plant.

This blog began with the words of the poet Andrea Gibson. Andrea’s words encourage us to plant seeds and seek rain. This is precisely what I did. I believe that love is reciprocity. We give it and receive it. It is a dance that flows and a river that bends and returns on itself. The seeds we sow are the forests of tomorrow. Whenever I see my friend the plant at work I will think of the lessons it taught me:

We are all valuable despite whatever life throws at us.

We all have a contribution to make to ourselves and our world.

WE MATTER.  

(I am in deep gratitude for the wise voice of the plant who I know is there next time I throw myself into the rejection bin.​ With deepest appreciation too for my dear friends Andy Bradley and John Walsh who have helped me to believe in myself once more and thank you Tony for sharing this blog on your webpage.)

Angela Green (with assistance from John Walsh)

                                           

Movement and Change

 The whole is other than the sum of its parts – Kurt Koffka

 You may have heard of the #endPJParalysis work. It’s a work with patients in hospital which encourages their movement from bed to mobility and health. It has been a great success and as a global social movement has touched the UK, New Zealand, Australia, Ireland and Canada and by February 2018 had amassed over 169 million twitter impressions.  #endPJParalysis seeks to raise awareness of deconditioning – where an 80 year old person confined to bed for 10 days or more can lose up to 10 % of their muscle mass.    

 My Trust, North West Anglia NHS Foundation Trust, launched this work locally across our three sites in April 2017 as a 100 day challenge. We worked to share the vision and support the work with wards and staff using pledges, activities for patients, conversation and co-work with patients, loved ones and carers. This was heavily influenced by the work of Professor Brian Dolan about creating cultures permitting clinicians to be innovative and work differently. 

 The gamification exercise finished in July 2017 and some 21,868 patients had benefited from the #EndPJParalysis approach. Gamification fosters an environment of healthy competition and engagement through quality improvement and a form of game playing, in essence bringing fun into the work place. It enhanced autonomy, promoted dignity through movement, supported positive innovation and worked in person centred ways with those in hospital. Engaging with colleagues and patients across the NHS East of England region, another 100 day challenge was cascaded between September and December 2017, had an even wider effect and let to 91,728 patient days of people up, dressed and moving while in hospitals. The tangible benefits in the art of conversation, empathy and meeting patients needs in a different form were but a few. Nationally – well let’s leave that to be skilfully mastered by the #endPJparalysis originator Professor Brian Dolan. For now my journey continues, meeting others like John Walsh who inspire and create, with a like-minded passion.

 There were many ingredients that made #EndPJParalysis a success. If I had to mention three, I would name the following; first, there was new thinking. Sometimes our systems and organisations are caught in old ways of thinking that never change which leads to stultified cultures and a real lack of organisational learning. The #EndPJparalysis work has flowed from new approaches and started to form into new visions and practice around care and health. The second element is new alliances working across our services and hospitals. This is an alliance of care with patients and their loved ones that has focussed on a ‘working with’ approach. This embodies a deep focus on conversation and collaboration between staff and those who use our hospital services. Lastly, the power of compassion. Kindness, listening, caring, smiling and a simple touch have marked the work. They have been its lifeblood. It illustrates once again that values matter because people matter.       

 I have been amazed at how a simple and small idea has created such a mighty ripple effect. At one step at a time, good health has been promoted, hearts and minds have connected and a more open way of working has emerged.  

 The quote at the beginning of this blog, by Gestalt psychologist Kurt Kofffa is, I think, very relevant and is often misquoted. It is often stated as the whole is greater than the sum of its parts. For Koffka, it wasn’t about addition and how a greater entity is made, rather it was how and when different parts and pieces come together dynamically something new and ‘other’ can be created. There is a precious lesson here; often what we need is what we have. It is in the relationship, dynamics and response to what we have that new possibilities and futures emerge and #EndPJParalysis is, perhaps, a good example of this. It is a fresh approach that unites people around a common good has changed practice, experience and outcomes. It is an approach filled with values and care. What has emerged is something truly other. It’s a real honour as a nurse to be a part of this story of change and care.

 Lisa Sharp RN

I would like to thank Professor Brian Dolan, John Walsh and Ciara Moore and many others for their wonderful collaboration. You have all supported me greatly and were always willing to help. Thank you also to Tony Longbone for hosting these words on his blog site.