The Person-centred Podcast - A warm blanket on a cold night

In this first episode of Stories That Shape Us -  we talk to Lee, a palliative care nurse, and explore what person-centredness means to her, both within her work and her life. 

This podcast is brought to you by The Foundation of Nursing Studies and Listen Up Storytelling.

Transcript

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Sheila 0:11

Hello and welcome to the Person -centred Podcast - Stories from Nurses and Midwives.

Sheila 0:17

I'm Sheila McGovern from the Foundation of Nursing Studies.

Caroline 0:21

And I'm Caroline Dickson from Listen Up Storytelling.

Sheila 0:25

In this podcast, we offer nurses and midwives a space to share their stories to support professional learning, identity, well-being, and the creation of healthful workplace cultures. The podcasts are brought to you by the Foundation of Nursing Studies in collaboration with Listen Up Storytelling and will take the form of different mini-series.

Caroline 0:49

In this first mini-series of six podcasts, stories that shape us, we will share experiences of person-centred moments in practice from nurses and midwives from across the UK and reflect on how these experiences nurture and shape us and those we care for.

Sheila 1:10

We are very excited and grateful to welcome our first guest, Lee. Lee, would you like to introduce yourself, please?

Lee 1:19

Hello, good afternoon. My name is Lee, and I'm a registered nurse working in palliative care.

Caroline 1:25

Welcome. Thank you, Lee. Perhaps just before we hear your story, we would like to just highlight to the listeners that in keeping with the NMC code and the storyteller's bill of rights, we will avoid using any identifiers of people or place.

Sheila 1:44

Thanks, Caroline. So Lee, will we kick off with you telling us a little bit about your journey into nursing?

Lee 1:53

Thank you. I mean, where do I start? I have always wanted to be a nurse all my life. I, I remember in primary school when when everyone's asked, what do you want to be when you grow up? My answer was always a nurse. And I think that just shows that it's just something within me. And you can't, you can't learn that. That's I think it's just something that's innately within me. I can learn the skills, but I can't change who I am.

Lee 2:21

So I went through school always with that in mind. But I think I learnt quite early on that I wanted to get to know people, I wanted to travel, I wanted to meet people from all over the world who had different experiences. So when I was 20, I booked a one-way flight to New Zealand and went solo travelling for two and a half years.

Sheila 2:43

Wow.

Lee 2:44

I worked in lots of different areas in lots of different sectors. And I ended up going to university then as a mature student, because I knew that comparing me to an 18-year-old, for example, it wasn't that I was any better, but I was much better placed than I was at age 18. And I knew that that would make me a better nurse. Understanding people, what makes people tick, how to communicate. And if you understand people when they're well, it's a bit easier to understand people when they're unwell and vulnerable.

Caroline 3:16

Yeah.

Sheila 3:17

Amazing. And that's really brought us nicely to thinking about when you're saying understanding people, thinking about person-centredness. That's what that's making me think of. And person-centredness is something we hear a lot of. But what does it really mean to you, Lee? Like how would you recognize it or what how would you describe it?

Lee 3:39

For me, being person-centred is about being present. It's going into conversations or interactions without an agenda and meeting people where they're at. So understanding people's thoughts, feelings, values, experiences, and what makes them them without any judgment, without any criticism, without any beliefs around what I think is right or wrong, and them being at the centre of that interaction and any decisions made about them. And it's essentially, you know, you've probably heard of making every contact, every contact count, but it really is.

Lee 4:24

These person-centred moments don't have to be these huge grand gestures. It's every interaction being person-centred and listening to understand, but also listening and hearing what isn't said, rather than thinking you know what they want, or thinking because I've met someone who is similar to this or has been in a similar experience or situation that I know what they're going to need in that moment. But actually scrapping all of that away and understanding them for who they are. It's really hard to summarize it, really, isn't it?

Caroline 5:06

I think you've done a fantastic job, Lee. And I really love that sense of it's not actually about what you do, it's you're saying it's who you are, it's that, that way of being. So it's in the way you conduct yourself, in the way you are with people, in the way you respond. And I really love that and the small things. It's the smallest thing.

Speaker 5:30 Speaker 5:30

Do you do you have any examples perhaps of those small things that maybe demonstrate it?

Lee 5:36

I mean, of course, but it's sometimes hard to quantify that because it's in those everyday moments. I do, of course, I have examples. I remember when I was very newly qualified, I was supporting a patient who was getting ready for surgery, and they were Jehovah's Witness, and their beliefs around needing a blood transfusion, they felt in that moment that they hadn't necessarily been heard previously, and they had unfortunately had quite a bad experience in the past, and had heard from other people who had also had bad experiences.

Speaker 6:12 Speaker 6:12

And I just took the time to listen to them without any judgment, listening what their beliefs are, and I sought a consent form that was specific for people with those beliefs. We didn't have one readily available, so I traipsed the hospital to try and find one. And I took it to that patient and you know, I said, this is, this outlines essentially your rights, and this will highlight what your beliefs are and what you do consent to and what you don't. And I also made sure that the surgeon was aware and that this was really important to them.

Speaker 6:51

And it's to me that it seems like quite a small, a small interaction, but it meant so much to that patient that they really felt heard and listened to and put their trust in someone and thought actually they weren't quite as afraid of going into surgery as they were previous to that.

Sheila 7:14

Yeah. And you can imagine that relief they must have felt that somebody had heard them rather than, you know, sometimes it's just so easy to judge, isn't it, without really thinking about what's needed behind that, but actually being heard in that moment. And you mentioned earlier about listen, you know, really listening to understand, but not just listening with your ears, it's listening with everything. It's like getting that real sense of being with a person. And I loved, I loved hearing that. Yeah.

Lee 7:47

We do, I think in palliative care, especially, we are really good at person-centred care. I think nobody goes into a healthcare environment as a patient wanting to be there, but particularly in palliative care setting, you almost only have that one shot to get it right. And spending time listening to families, to patients, what matters to them, what are they afraid of, and what do they really want, whether that's goals, bucket list things, it's yeah, it's it's a really special interaction, really.

Lee 8:28

It's quite hard to really how do you how do you put that across in words if people haven't experienced it?

Sheila 8:37

Yeah.

Caroline 8:38

And I was wondering when you experience moments like that, how does that make you feel? What feelings does that conjure in you when you're able to do that for somebody?

Lee 8:50

It's like a warm blanket on a cold night.

Lee 8:54

It's that feeling of fulfillment that I have made that happen for someone. But also rather than the actions, although actions speak louder than words, it's knowing how someone felt in that moment, that someone felt supported and listened to and valued, and that I was able to provide that.

Lee 9:16

But likewise, when I have been in moments where someone has shown that person-centred approach to me, I know being on the receiving end of that is equally as powerful as being on the giving end.

Caroline 9:30

Can you say more about that, Lee?

Lee 9:32

Yeah, I mean, I ran a group once on advanced care planning. And that group, people built psychological safety and shared a lot within within that group on what their fears were around coming to the end of their life, what their fears were around anything from funeral planning to symptom management. And for me to build trust with those in the group, I also needed to participate. I was the facilitator, but I was also a human in that, with my own fears, worries, anxieties, and my own personal experiences with family members.

Lee 10:14

And I think there's that sense of being vulnerable, but it also really helps to build trust and that connection, that human connection. I'm a nurse, but I'm not a robot. And being able to be vulnerable and open and honest allowed them to share what their biggest fears were. And through the eight, ten weeks of this group, we were able to unpick those fears on an individual basis. And at the end, those fears were much less than they were at the start. But only, I think, from me being vulnerable in that in that space as well, allowed that to happen because I wasn't asking something of them that I wasn't prepared or able to give myself.

Lee 11:05

I understand that there needs to be boundaries in some situations, but in that space, I was able to be a human rather than just a nurse.

Sheila 11:18

Yeah. And the the space really being able to be vulnerable with others really does help others then be vulnerable back. It's that building of trust, isn't it? Yeah.

Sheila 11:30

So how has this work that you do and really getting into that place with that in that person-centered moment with people, how has that shaped you, do you think? How what what's changed within you over the years of of doing this amazing work?

Lee 11:51

I think it certainly gets you through the tough days, gets you through the tough moments. It's those experiences that sometimes I lie awake at night thinking about, but in a good way. It changes who you are, I think, at the core, for the better. Because you can't read those experiences in a book. You you can hear about other people's experiences, but unless you've experienced them yourself, and unless you have made that human connection with someone, it's quite a unique bond because every person-centred moment with someone connects you and that person in a way that maybe they haven't connected with anybody else. And it's it's just it's really powerful, isn't it?

Sheila 12:36

Yeah.

Caroline 12:37

I'm wondering, it sounds to me that sense of fulfillment is something that not everybody experiences in in nursing and midwifery, but it sounds like it's the thing that really keeps you in nursing and keeps you being passionate about nursing. Is it absolutely so I'm wondering how then we or how do you influence others so that they can also experience that sense of fulfillment that you have?

Lee 13:10

I think there's this misconception that person-centred care, a person-centred approach takes time and that people are too busy to provide that. But actually, it can start with how do people like to be addressed? And that can be pronouns, what name they would like to be called. And you can then build on that.

Lee 13:29

That can be from the very first time that you meet someone. And then you can build on it to, you know, what are your preferences around personal care? Do you prefer to have a shower in the morning? Do you prefer to have a shower at night? Rather than that one size fits all approach of this is time for a wash, whether you like it or not, type thing.

Lee 13:49

But for me, I think it's probably it's role modelling and leading by example. And I think particularly newer members of staff, or maybe staff who haven't grasped it or encountered it in that way, the only way they will is by seeing it in practice, seeing it in action. And then once people try it, I say try it like it's like it's a method, but once people adopt that approach and they realize actually it's not as hard as I thought it was. And the sense of fulfillment that I get by supporting people in this way, they will then just carry on that that way, that way of working, that way of life. Because there's no other way, really.

Lee 14:32

And I think when we ask people the question, what matters to you? I think we also have to ask that question to ourselves, put ourselves in that situation of what really matters to us. Because if we can identify that in ourselves, we can understand then what it's like to be asked, and also understand that it's not a one size fits all approach. Not everybody's going to say my family, for example. Whereas some people might assume that that would be a standard answer.

Caroline 14:58

Yeah. So values and being able to live your values is really important, isn't it?

Lee 15:06

Absolutely.

Caroline 15:07

And I suppose I'm thinking about a lot of the work around person-centred theory and what makes person-centred different from patient-centred is that is about be what you're describing, but to everybody, isn't it? Every every interaction. So patients, yes, families, yes, but also colleagues.

Caroline 15:31

Can you tell us a little bit more about how you interact with colleagues that helps you influence this way of being?

Lee 15:39

Yeah, I mean, I've I've been fortunate to work in roles before where I have been directly supporting colleagues. That has been the the main reason for my job. That's equally as satisfying because how can we expect people to support people if they're not supported themselves? And instead of firefighting and treating people as numbers and gap fillers and nurses on a sheet with staffing ratios, for example, yeah. It's looking at colleagues for as their, you know, as individuals for their unique contribution that they bring, their experiences, their passions, their interests, and seeing people for a diverse team that they are, supporting people with their well-being needs, with their learning needs, not one learning approach or learning style fits all.

Lee 16:38

So actually being person-centred with the way that we deliver information to colleagues, the way that we support colleagues on award in any in any setting, really. But although there are there are there are things that need to be done, there are patients that need looking after, there are roles and tasks that do need to be done and fulfilled, but there are so many different approaches to doing it. And instead of thinking that this is the way I like it done, and therefore this is the way that everybody needs to do it, it's understanding people for who they are, what makes them tick, what brings them into work every day, and how we can keep that spark alive. Because it's a it is a tough world out there in healthcare.

Sheila 17:26

Yeah. I I love that, and I love what I heard there, and you've come back to it a little bit again about the you know, the tasks, of course, but actually being person-centered is a way of being, it's not a necessarily a task, is it? It's a it's about a way of being.

Caroline 17:44

Fabulous.

Sheila 17:45

Any other questions from you, Caroline?

Caroline 17:48

I was wondering about your inner dialogue when you are doing your best. We hear lots about the context and culture in nursing and how difficult it is to be the nurse or midwife that you want to be. And I'm wondering about is the what's going on inside, you know, is there dialogue, do you have conversations with yourself that help you in and you've mentioned tough times already, haven't you? So I'm wondering about that.

Lee 18:20

It's not so much I think in the moment for me, I think it's the afterwards. I am a very reflective person and I reflect on what's gone well in the day, what could have been done differently. And I don't always get it right. I really don't. But I think when I recognize that, I will then try again the next day. And there's nearly always times to try again and try harder. And people understand that.

Lee 18:54

People are a lot more understanding than sometimes we give them credit for. And that and that goes for colleagues and patients. But I think communication is what's key. And the taking accountability, whether that's apologising, if you know, I apologise if I forgot to make someone a cup of tea and I say I'll I'll be back with it, and then I get called away, and I'll go back and say I'm really sorry. People really recognise like respect that. And I think respect and kindness is the main thing. You can't really go far wrong with respect and kindness.

Caroline 19:29

Yeah. I think what's important is that culture that encourages reflection, encourages curiosity about practice, encourages the questions, and it's not about blaming somebody when they they they forget the cup of tea or what have you. It's about being a little bit compassionate, but about thinking about the why. And earlier you were talking about being person-centred is about making the changes that make something possible. But in that, so you talked about having the the kind of information sheet and consent sheet that would be more appropriate for the person. But you in order to do that, you had to make a change, but you also had to communicate with other members of the team in order to make that happen.

Caroline 20:19

So those spaces to have those that dialogue is something that's I think sometimes we forget how important that is. So spaces for reflection, spaces for dialogue to have a culture where we are we can all be compassionate.

Lee 20:39

Yeah, it's the learning from it, isn't it? And that curiosity, like you say, having the culture where it's you want to explore, you want to delve deeper, you want to listen to people because you want to understand rather than just going through the motions.

Sheila 20:55

And that's that's really I'm just that's making me think of that real definition of compassion, isn't it? Compassion isn't just about all caring, it's also about making the action, it's about doing, it's it's really seeing what somebody needs. Really seeing or hearing and then going to make the action and do something about that.

Caroline 21:17

So thank you very much, Lee.

Sheila 21:19

I think that's a lovely place to

Caroline 21:20

it is a lovely place to stop. Yeah. But perhaps perhaps it's worth highlighting some of the real nuggets that that came through in your story, Lee.

Caroline 21:31

You talked about person-centredness is a way of being, using that way of being into action. And it's about the importance of knowing self and your values, but also knowing others. And I loved when you were talking about it's about the that human connection. And I suppose what hopefully the listeners will get from this is that you said that by being this way, it was like a warm blanket on a cold night. So it's definitely something to strive for, isn't it?

Lee 22:04

Absolutely.

Caroline 22:05

So thank you. Thank you for sharing your story.

Sheila 22:08

Thank you, Lee.

Lee 22:09

Thank you. Thank you so much for having me.