Discoveries

Well the findings were really interesting and demonstrated that people did a lot of work before, during and after their clinic visits. Their lives were about attempting to fit their condition into their lives but each time they went to the clinic or had an appointment with a health care professional they were reminded that their condition was more in the foreground. Weeks of anxiety and uncertainty became their companion leading up to their appointment, concerns about parking, time away from work, who they might see, results that might show complications developing or poor control that might lead to displeasure and a sense of failure.

I found these experiences very sobering and wondered what to do with them given how much time and effort was being put into making people comply and attend the clinic. None of the messages in the “how to” manuals of care for HCPs encouraged them to consider what was happening for people coming to the clinic. It was all about getting patients to understand more about their condition and be more like professionals.

It deeply bothered me and as I had moved from practice here was very little I could do myself to bridge the gulf between what ought to be happening in practice and what might help people coming to the clinic. For the second stage of the research I interviewed health care professionals and this made me realise that very few of them saw the patients’ perspective as critical to getting the experience right for people.

I guess this sense of powerlessness and lack of purpose was the main reason I didn’t progress my PhD, I found it very difficult to motivate myself to write it up and also I didn’t seem to have a receptive audience for the message ... it wasn’t really compatible with the received wisdom of the time and I couldn’t find any practitioners willing to work with me to help make a difference in practice.

The long lasting impact of this is something I will explore further but for the moment I want to reflect on the lack of interest from practitioners and that 10 years later medicine comes forward with a plan.. it has made me think...

http://www.yearofcare.co.uk/

So why do the research

So what motivated me to undertake my research? The answer to that lies in my experience as a specialist nurse and a long standing ambivalence with the out patients clinic. In my first post I used to use quite a number of delaying tactics in relation to getting to the clinic. I used to find home visits and liaison meetings to book in before I would get to the clinic. It took me a couple of years to get out of a navy uniform as well and the staff at the clinic disliked me and my status. I wasn’t there to help them out with the processing of patients and I would sit out in the waiting area and chat to the patients while they waited for their name to be called. I did not want to sit behind a desk in one of the consulting rooms like the doctors although that was what was expected.

The extent of their dislike for my approach materialised when a patient complained about me and they were able to ventilate to my manager about how disruptive I was in the clinic and how this was not very helpful and a hindrance to their work. Back then I was just very hurt by their response but with the wisdom of 20 years of reflection I now realise what they were trying to protect. Their complaints weren’t about supporting the lady who had complained about me but all about looking after themselves and closing ranks. The lady complained about me because she thought I should have given her special attention at the clinic, for very complicated reasons she had expected me to act very differently.

It was not my greatest moment but I know I didn’t do anything wrong, what I had done was maybe not give her extra special time in the clinic and maybe I should have acknowledged that. I am not sure it would have made any difference but what it did teach me was that I couldn’t fit in to a model of care that expected us all to 'behave' ourselves when at the clinic. There were many unwritten rules about behaviour in the clinic and I had cleanly transgressed many times.

So my research was about understanding people’s experience of the clinic, why did they come, what did they think about before, during and after their appointments. I disliked going to the clinic and felt that there must be better ways of providing advice and support to people.

So I decided to interview people three times over a period of 18 months,

Each time I visited participants for an interview I asked them to tell me their story about their recent experiences of health care and health care professionals.

I always felt that there must be a better way of delivering care for people, instead of the clinic and the model replicated in general practice...



Layers

Start with now

I’ve been thinking a lot about not getting my PhD – think it is because it is 10 years since that dreadful day when my supervisors decided for me that they should put me out of my misery.

The parting advice was to get a PhD via publication, that was it, a severance with no proper ending; not even a suggestion of a MPhil as a consolation.

So I have decided to share my findings on this blog, and then that may start a discussion and help me move forward.

It was an awful time, a real loss and now that I know about proper grief (my Mum) then it was very similar to that. It was harsh, unthinking and I have explored the motives for many years.

There is a deep ambivalence in the nursing profession to clever nurses, we still see in the media today and I experienced it (somewhat paradoxically) in Higher Education. Nurses need to be kept in the place and this is usually instigated by more powerful, high ranking managers who haven’t got the wit or wisdom to go on an intellectual journey themselves.
So I guess it’s important to keep the numbers down and prevent too much influence from thinking, articulate nurses. It can make people feel very uncomfortable and there seems to be a ambition to keep that club very exclusive.

There seems to be a distinct lack of generosity, integrity, authenticity, a wish to see others flourish, a well of skills and knowledge that they share and enable others to reach their potential. I wasn’t in contact with that, at all, probably why I needed to leave my job.

Now I am back in practice I am in a position where I sprinkle generosity, integrity, authenticity and the notion of flourishing rather liberally. It is an approach that many are unaccustomed to and it can make feel people feel very wary. However I know I am uncomfortable if I do things any other way – so I am sticking to my position.

I am hoping that I can develop robust and meaningful links with like minded folk that will help guide me on this journey and I trust that they share those values. I am sure they do, they’ve been talking about and practicing them for a long enough – I think I can trust them and may even dip my toe in the academic water again and consider linking with them in ways of spreading my knowledge.

http://criticalcreativity.org/