Experience as your guide

primary_care_training_easter

I missed Easter, travelling between time zones... very confusing. Anyway, it's done for another year. Now, to summer. You'll need to look at the date on your computer, not the sky, or your wardrobe. This year's a cold, grey blur.

Easter may be about new beginnings but the day-to-day of management will be just as untidy, unpredictable and disorderly as it was before!

The liturgical calendar includes two periods of 'ordinary-time'. One after Easter. 'Ordinary-time' doesn't mean ordinary. It's from the Latin, ordinalis. To you and me; ordered, organised... gettin' on with stuff.

It's is also when the church preaches about Christ's first miracle; turning water into wine.

For managers, the normal miracles of turning one pound into two; turning five nurses and two doctors into enough bodies to fill five thousand rota gaps; to say nothing of walking on water and raising the morale of the dead team!

I've never thought of the Bible as a management book but it's all there because management is about human nature. Understanding human nature; cruel-kind, happy-sad, leading-following, asking-telling, success and failure.

A curious book came to mind.

If you were thinking of some holiday reading, I tentatively suggest Henri Nouwen's 'Wounded Healer'. Not for everyone but you should dip into it on the Kindle.

Nouwen speaks of Christian leaders;

'... our service will not be perceived as authentic, unless it comes from a heart wounded by the suffering about which we speak... nothing can be written about ministry without a deeper understanding of the ways in which ministers can make their own wounds available as a source of healing."

The Wounded Healer is from a Greek Myth about Chiron, a Centaur (half human, half horse). Most were savage, but Chiron suffered from a wound that never healed that gave him compassion and healing powers.

Later, Carl Jung said; 

 "The doctor is effective only when he himself is affected. Only the wounded physician heals...'

Indeed, there is even a condition known as mirror-touch synaesthesia, where a clinician feels the pain of the patient.

The Wounded Healer speaks to managers, too.

An example; The Aldershot Centre for Health is in a place that is difficult to get to with a disparate collection of services. For someone, like me, familiar with the NHS and won't take no for an answer, it's tricky to deal with.

For a nervous, anxious patient or relative it must be a horrible experience.

Transport is arranged by a call-centre. Treatment, needing special arrangements, arranged by a different telephone operator. As transport, access, mobility and acuity are interconnected it makes no sense to separate-out services.

If the treatment operator (who uses NHS numbers) worked, for a week, in the services... seeing how they work, they'd know what's involved in making a transfer between a wheel chair and an examination table and their questions less crass.

If the travel-call-handler (who uses NI numbers) had spent a few days working in the services... they'd know how long a radiological examination takes and wouldn't ask the patient and make them feel stupid for not knowing.

If the job was done by one person with a full understanding of the services-pathway, life would be a lot easier.

The Wounded Healer has a practical message about personally experiencing the consequences of our decisions, in our case service planning.

People delivering care-pathways, have to understand and experience the pathway. We, all, should start with the patient and work backwards.

That's why one stop cancer examinations are a good idea. Amazingly, they were invented in the mid-90's in Leicester and have taken this long to surface.

Even if each component of a service for treatment is done well, it is not enough. For the patient experience to work, it has to work as a whole.

Management is more than the ritual of organising but can become a celebration of success when we are able to name the spaces, step over the gaps, feel the interfaces and know where success and failure touch each other.

It is our job to build a rock solid understanding of what we are doing based on the foundation of our experience, knowledge and having been there.

We can't make everything perfect for everyone but we can offer our own experience as a guide.

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 Contact Roy - please use this e-address

roy.lilley@nhsmanagers.net 

Know something I don't - email me in confidence.

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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.