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The Person-centred Podcast - stories from nurses and midwives
In this podcast we offer nurses and midwives a space to share their stories to support professional learning, identity, wellbeing and the creation of healthful workplace cultures.
The Person-centred Podcast - stories from nurses and midwives
The Person-centred Podcast - Moments of connection
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This month our guest Kirsten speaks to us about how person-centredness runs throughout the care she provides.
Kirsten touches on empathy, respect, and taking the time to be there during someone's most difficult moments.
This podcast is brought to you by The Foundation of Nursing Studies and Listen Up Storytelling.
Hello and welcome to the Person-Centred Podcast, Stories from Nurses and Midwives. I'm Sheila McGovern from the Foundation of Nursing Studies.
CarolineAnd I'm Caroline Dickson from Listen Up Storytelling.
SheilaIn 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.
CarolineIn this first mini-series, Stories That Shape Us, we'll share experiences of person-centred moments and practice from nurses and midwives across the UK and reflect on how these experiences nurture and shape us and those we care for. So today we're very excited to welcome our guest, Kirsten. Hello, Kirsten.
KirstenHi there. Hi.
SheilaHi Kirsten. Just before we start, Kirsten, before we hear your story, we would just like to highlight to listeners that in keeping with the NMC Code and the Storyteller Bill of Rights, we will avoid using any identifiers of people or place. S
Sheilao it's great to have you here, Kirsten. We usually start off our podcast with a question about if you could tell us a little bit about your journey into nursing. How does that feel for you?
KirstenThat sounds great. Yes, absolutely. Thank you. I suppose many, many years ago when I was at school, I always kind of wanted to be a nurse. Um however, my academic results and guidance, I suppose, at school just didn't steer me in that direction. Didn't feel supported probably at school either to go in that direction.
KirstenSo I I left school, worked in sort of admin jobs, which was kind of what was expected at that time once I left. And whilst I enjoyed all these different jobs that I had, I still hankered wanting to do nursing, but was probably at that point scared to move on because I'd started earning money and had a security of a job.
KirstenOne of my main jobs was working for the police, which I loved. And in the end, I ended up working there for 20 years as an emergency call handler and operations controller. During that time, I also got married, had two children, and my dream of nursing seemed like it probably would never happen. However, I ended up moving jobs into another job in the police due to childcare mainly, but I wasn't enjoying the new role, which was sort of less exciting and felt quite bored in that job.
KirstenSo I again looked into nursing, uh, I managed to get some support through Napier University. I had to undertake a couple of modules because I didn't have the right academic qualifications and I managed to get on the course. I also at that time managed to keep on my job part-time in the police while studying.
KirstenI'm not going to lie, it wasn't easy. It was it was a very difficult time, and I suppose many times I felt like throwing the towel in, but I did get through it and I was I was really proud of myself to get through it because academic work was always quite difficult for me growing up. Um, but yeah, so that was me. So I I I ended up doing my management placement in the community, which I loved, but again, at that time you couldn't really go straight from being a student into a community post.
KirstenSo I got a job in a hospital on one of the wards, which I really enjoyed and I learned a great deal. But my heart was really working in the community, that's where I wanted to work. So I eventually applied and got a job, and that was me. And even now, when I look back at how I was so scared of academic work, I completed sort of like many sort of postgrad modules. I did the graduate certificate in integrated community nursing, uh, and I've recently just completed the specialist qualification in district nursing, which I've just graduated from.
CarolineOh, congratulations.
SheilaCongratulations.
KirstenThank you. Long haul.
CarolineWhat a story.
SheilaThat's amazing, Kirsten. Well done.
KirstenThank you. Thank you. Yeah, I'm quite chuffed.
CarolineWhat what do you to the community in particular?
KirstenUh I just know for me, I suppose it was just uh I enjoy I enjoy the connection with the patients, being in their own homes, finding out how they live, seeing how their conditions affect them. You know, I really do feel that you you get a one-to-one experience with patients in the community.
KirstenSo for me, I suppose it was really it was that it was the the varied um aspects of the job. There's a saying about being in community or district nursing. I can't remember off the top of my head what it is, but it's basically, you know, the the variety of the different roles that you have to play in in district nursing is quite quite overwhelming at times and it's becoming more and more uh because we're we deal with more acute things in the community now.
SheilaThinking about when you're with that person in their house and making that connection, what does that feel like?
KirstenI suppose um it's the the getting to know that person for them to be able to trust you in their care. I suppose the the the connection for me is that mainly the the trust aspect that you know you're going into a patient's home, they put their care in your hands, and it's not just about you know respecting the patient, it's about respecting their family's needs as well. So it's the it's the whole household that has to be included in that.
SheilaYeah, yeah. And I I did a little bit of uh community work once, and I remember, and I don't know if you'll resonate with this, but I remember the difference is that you're honouring their power more because they're in a safe place, they're in their home and you're the one going in instead of being in a hospital and them coming in. I don't know if that resonates with you.
KirstenYeah, and I suppose like I mean, every person you see is unique and have has different needs, wants. Some would prefer you weren't coming to see them. Uh so you have to break down those barriers. Um so so yeah, it's it's you have to have a high level of communication skills working in the community to be able to adapt to to different people and their needs.
CarolineAnd I suppose thinking about that assessment, because like you, I was a district nurse, thinking about that holistic assessment, the environmental assessment that you have to do as you walk through the gate, up the stairs, up the close, as we say in in Scotland, that you're constantly looking, listening, feeling, touching, you know, smelling. Uh and that's all forms part of your assessment.
KirstenIt's funny because I suppose um as you're right, as soon as you walk up that garden path, you know, you're noticing things like key safes, um, if there's a handle rail getting into the house, do you know, all these sort of things, you almost become like um an investigator, you're instantly looking for a cast alarm, or do you know it's just to see what's already in place because sometimes the assessment side of things can be very difficult because it really depends on the patient and whether they're able to answer your questions. If there's no one else in present, it's sort of no family member. You have to try and find ways to find that information out so they're safe at home.
CarolineSo person-centredness then is um a concept that is being talked about more and more from policy to uh practice guidance and academia everywhere, person-centeredness. What what does that mean to you?
KirstenUh to me, uh it means seeing an individual before the diagnosis. Every person you visit has their own story, their own values and experiences and goals. And I suppose my role as a district nurse is to understand what matters most to them than simply focusing on their medical needs. Being person-centred means treating people with dignity, compassion, and respect.
KirstenIt's about listening carefully, involving them in decisions about their care and uh supporting them to make informed choices wherever possible. I believe that even small actions such as taking the time to listen and explaining what you're actually doing or what you're visiting for clearly, or respecting a person's routine and preferences can make a significant difference to how they experience the care that we give.
KirstenAlso, I suppose working in people's homes gives me the privilege of seeing them in their own environment where they often feel more comfortable. This allows me to build up trust and relationships, understand wider factors affecting their health and well-being, and also working collaboratively with families and carers and other professionals to provide holistic care.
KirstenBut I do think in my role to understand that some people are living with long-term conditions and frailty or approaching end of life during these times, being person-centred means offering empathy and reassurance and honest communication and supporting people to achieve the best possible quality of life according to their own wishes.
SheilaThank you. And I suppose I'm just thinking back to what you said about that being that detective, you're almost you'll be guided providing person-centred care or your person-centred practice. You're constantly observing the environment and observing what's going on around you, and that will lead into um providing that person-centred care.
SheilaI wonder, I'm thinking about, you know, and thinking about person-centred moments, because sometimes we can go out there with all the will in the world to do absolutely perfect person-centred care, but sometimes it doesn't always feel like we get there because of whatever reasons. But we often notice like person-centred moments in our care when there's like a going back to that lovely word connection, when there's a connection sometimes between us. Can you tell us anything? Um, any give us any examples of those that you've had with the people that you care for?
KirstenI would say there are moments when I, for me anyway, when that happens, a person stops feeling like a patient and simply they feel like themselves. There are moments when someone feels genuinely sort of heard, understood, and respected in their own homes. I always think there's often a sense of calm comes over a situation where they trust and there's that connection, even if the situation itself is very difficult.
KirstenFor me as a district nurse, uh moments happen when I probably slow down enough to truly listen to our patients, when I notice what matters to someone sort of beyond their sort of clinical needs, or when a conversation reveals something that changes how I care for them. It might be sharing a laugh, sitting quietly while someone gathers their thoughts or adapting a care plan because uh I understand what is most important to them.
KirstenI do think these moments they don't always need to take extra time, but they do require presence. Uh they remind me that nursing is about relationships as much as it's about treatment. And I know I have been person-centered when someone feels comfortable enough to be honest, when they feel involved rather than directed, and when they know their voice has uh shaped the care that they receive.
KirstenAnd from I suppose person-centred moments feel deeply human. They're the moments where you can see trust grows, their dignity is protected, and the care becomes something that we do, you know, to the person rather than to them as such. Yeah. Um and those are moments that probably stay with me long after the visit uh because they remind me of why I became a nurse.
SheilaYeah, that's just that's lovely. And I that leads on to a lovely thought I was having, and maybe a question for you, because what's happening for you in those moments then as well? What's what's going on for you when you're having those lovely deep connection moments with yeah, what's going on for you?
KirstenPalliative care, so end of life care at home is always um moments where I think they really touch you at times, you know, the the what that person's going through. There's nothing I can do to change their prognosis. And I suppose my role is not to find the right words or offer false reassurance, just to be present, you know, to sit beside somebody and hold their hand whilst they're experienced, probably, I can't even imagine, the worst prognosis that you could ever be given and allow them sort of space to express their fears without judgment or interruption.
KirstenI've I've certainly learned sitting and being quiet and allowing someone to talk and just to ask gently, do you know, like, you know, how are you today? And maybe sort of being guided as well by sometimes it's when they're on their own that they want to have these conversations. Uh, you know, if another loved one's maybe in the room, they don't always want to share, so it's trying to find these moments where you can properly share um their fears.
CarolineAnd and I was thinking when you were talking, because I was I was kind of in the house with you at times there. Um it sounds like the feedback that you get from patients in that relation. So the depth of relationship means that you are experiencing person-centredness when you get that feedback. It doesn't have to be verbal feedback, I'm imagining it it might be might well be nor non-verbal that you need to engage in that depth of relationship in order to experience that yourself.
KirstenYeah, and I think there's there's certain things I don't think can be taught. I think uh, you know, like a being self-aware of situations of yourself is really important. And there are times when I've I've had to sort of, you know, get advice from colleagues, from my senior sort of nurses. You know, like I think we've all been in situations where you, you know, you've you've not felt conversations have gone particularly well, but it's about being aware of these things and recognising it and being able to open up a forum for to be able to have a conversation about it. And I think being honest and saying, can we have a chat about that? It didn't feel like that went very well. Could we uh could we revisit that?
CarolineSo it sounds like to be a person-centred practitioner, you really need um to be reflective and reflexive.
KirstenYes, very much so. Yeah, I would have to agree with that.
CarolineYeah. Do you can you give us some let us in a little bit more and maybe give us some examples of when you've experienced these person-centred moments and you feel that patients or family members have as well?
KirstenI mean, I've had many encounters with patients who receive an end-of-life care at home. I've noticed that, you know, like there's one particular uh person who they were seemed quieter than usual. And rather than rushing to the next task, I sat with them in silence for a moment and gently asked how they were feeling. And after a pause, they told me that they were frightened. It wasn't the thought of dying itself that scared them most, it was the thought of leaving their family behind.
KirstenSorry, I actually get really emotional about this, I don't know why, but
Sheilait's totally understandable.
KirstenYeah, just that they were worried about how their loved ones would cope and whether they would be okay. I think it makes you reflect on your own life and how that must be s the worst thing that could ever happen to someone. I suppose they were just worried how they would they would cope without them and how they would they were going to miss their family members. But in that that moment, that's probably when I did probably realise that you know there's I I can't do anything to change the prognosis. My role's not to find the right words or offer false reassurance, but simply to be present.
CarolineYeah.
KirstenAnd sitting beside them, holding their hand, and allow them the space to sort of express their fears without judgment or interruption. And sometimes the greatest comfort is comes from knowing that someone is willing to stay with you and their in their vulnerability.
SheilaYeah. Yeah. Yeah.
KirstenIt's certainly I think that encounter reminded me that person -centred care is often found sort of in the simplest acts of human connection. Yeah. So yeah, definitely. So say that these are not things we can fix, but and it it doesn't get any easier. I've been in nursing for many, many years, and these moments still still get me.
SheilaAnd and that's really what I'm thinking, what I'm thinking from that is because we're human, isn't it? It's that human factor, and it's so it could be so easy to make that busy and and and to kind of find something to do or fix. But because sometimes that's what as you know healthcare people who work in healthcare feel that they need to fix. But actually it's not about the fixing there, it's about the being with, and that's what you're talking about. Yeah.
KirstenYes, absolutely.
SheilaYeah. Silence can be difficult uh and uncomfortable for sometimes and for others, but it's it it there's a place for it, isn't there?
KirstenYes, very much so. Yeah, yeah. Yeah.
CarolineBut of course it is a challenge, isn't it? We all know that the health service isn't very stretched. Nurses and midwife are meet themselves coming backwards, aren't they? To make time for these moments must be challenging.
KirstenYes, it it certainly can be. But you know, I have learned that things like being on time for huddles, you know, certain things like that, sometimes you just can't be.
CarolineI was wondering if there was an example you might have drawn on, perhaps when the connection was maybe with somebody who I mean you talked right at the beginning about enabling people to be in their own home. That perhaps to be in their own home required you to help them work out ways to manage in this new new situation in this new world.
KirstenI suppose it it ultimately it it it can often be gauged by um engagement between patients and nurses. You know, we can we can go into an unkempt house and we can see the issues that are ongoing in that house, but that pa that person has chosen to live like that. You know, we we can't fix certain things as long as that person is safe and they're in an environment that whilst it's not how I would want to live, they have chosen to live like that.
KirstenSo it's about having conversations, open conversations, um you know, if there's maybe trip hazards or hoarding or all these things that can go on in the community. It's about you know having conversations um slowly. You can't push these things. You have to gently because you know that that person has chosen that life and it's about putting, you know, like safeguards in place um to make sure they're safe.
SheilaYeah, and it's not I mean I'm here when you say gentle conversations, I'm here in respect as well in that and that kind of non-judgmental that you know it's it's not for us to say because people live different ways for different reasons.
KirstenAbsolutely, yeah. And whilst it's you know, whilst sometimes it can be unsafe to a certain degree for us going in, do you know like because we are we're thinking about things like fire hazards and you know it's mice, oh do you know, there's a lot of things going down that route, you know, like when it's a a hoarding house or um and trying to find space safely to do your to to you know to do your task that you've maybe gone in to do, whether it be legs or boon care.
KirstenSo it's always I've I've always found that um slowly and gently is the best way forward with certain people. You know, it's it's their home, and that's what people and and nurses need to realize, it's their home. We're we're being given the privilege to go into their home to care for them, so we need to respect that.
CarolineWhat what kind of inner Dialogue or self-talk supports you staying compassionate and present.
KirstenInner dialogue that supports me to stay compassionate and present in nursing is the reminder that every person I've I meet is someone with their own story and their own fears and hopes and their own experiences. I'd probably remind myself to see the person, not the task, and to consider what this moment might feel like from their perspective. I always ask myself how I would want someone to look after my loved ones.
KirstenAnd I know the answer would be with compassion, dignity, and respect, and for them to be listened to. And being listened to is so important. I also sort of tell myself that I do not always need to have the answers. Sometimes the most valuable thing I can offer is my time and my attention and my presence. That small acts of kindness, listening, and reassurance can have a lasting impact, particularly during moments when people feel vulnerable.
KirstenAnd as a nurse, I suppose, and now as a specialist practitioner district nurse, I also remind myself to extend that same compassion to my colleagues that I work with. Nursing can be emotionally demanding and draining. And recognising the importance of teamwork, taking breaks and acknowledging the challenges that we face helps me to remain grounded. But ultimately, my inner dialogue probably brings me back to why I chose nursing is to make people feel seen, valued, and supported, even during some of the most difficult moments of their lives.
CarolineIt's always useful, isn't it? And I'm sure for any any profession, any role, reminding yourself in the difficult times why you actually are there, why you wanted to be there in the first place. I think perhaps sometimes that gets lost, doesn't it?
KirstenIt does. And it's hard. Do you know? Let's face it, nursing is hard, but it's also it's an amazing career. It really is.
CarolineSo many opportunities, aren't there?
KirstenYeah, there is so many.
CarolineSo if you so I think what you were talking about there resonates what McCormack and McCant talk about person-centred cultures amongst other people, but their school of thought is the whole point of person-centred practice is to achieve person-centred cultures. Now you've just have you just moved into a new team?
KirstenI actually was very lucky in the fact I've worked with the team um before. I've kind of been all over just because how long I've been in the job. But um, but yeah, so um I'm very lucky that I work with a really wonderful team of relatively young uh nurses, but they're fantastic.
CarolineThat's great. It is it's great. But you're in a different role now, so how do you create that person-centred culture?
KirstenCreating a culture where sort of people, you know, nurses especially feel valued and supported and recognizing the contribution that they make. I always feel nursing we as a team, we need to feel that they're more than their workload, and they need to know that their well-being development and voice matters.
KirstenA positive workplace is built through sort of strong relationships and compassionate leadership and a sense of belonging. It is about creating an environment where colleagues look out for one another, where they feel safe to ask for help and share their concerns and celebrate everyone's successes. Simple things for me, like, and it's something I've been really headstrong about, ensuring that everybody takes their break, you know, having an opportunity to learn how, you know, everyone's getting on in their own personal lives, having a laugh can have a simp a massive impact on morale and resilience.
KirstenI know certainly for me in my new role, I sort of I've got a role in shaping the culture by being visible and approachable and leading by example, uh, supporting learning, encouraging reflection, recognising their strengths. And everybody has different strengths in the team that I'm working in. But it's about creating opportunities for them to grow and help them to feel invested and valued. I think is really important.
SheilaAnd and you've you've definitely mentioned a few things about what you do. But how do we do that? I think let's go a little bit deeper with that. How do we create those spaces that are we as a team can grow, you know, in coming from a person-centred kind of culture. What do we need to do, or what do we how do we go into that? How do we show up?
KirstenThe importance of being listened to. I've I've certainly found in, you know, in certain aspects of my current my job, not being listened to isn't great. It just makes you feel dis dismissed. You know, ensuring that everyone's listened to patients and staff. And promoting an environment where at handovers you can listen to everyone talking compassionately about the people that we care for.
KirstenYou know, it's it's about opening up these conversations and for everyone to sort of sing from the same hymn book. Um, that we don't, you know, it's it's providing sort of that compassionate care and you know, making sure that everybody feels listened to is really important.
CarolineAnd that shared purpose, yeah, just uh say, which is really important. Yeah. Make time to articulate that.
KirstenIt is, yeah. You know, and I think as I say, we no matter how busy we are, we we always and and it's something that I'm really glad that we've managed to and and everyone's very keen to have these sort of handovers because if you don't have them, you know, you you you're not learning patients' needs, their their wants. It's it's just it's very important to get aside that time no matter how busy we are.
CarolineBut you also said person-centredness, connection is so important. So even having these handovers is important for the connection within the team, isn't it?
KirstenYeah, definitely. We use evoke cards as well in our like sort of monthly meetings that you know it's just checking in with everybody just to make sure, you know, pick a card and tell us what you're feeling, what you're thinking. Um, you know, is there if you've got any highlights that we've not managed to like listen to just in our general chit-chat in the office?
KirstenIt's it is very important for for staff to feel at home, you know, um, and to be able to open up these cards. It's amazing how these these cards can open up conversations. Um, you know, it's a bridge, and then all of a sudden this huge conversation opens up that um we all discuss. But again, it's it's given that person that moment to be listened to. It's it's really important.
CarolineYeah, absolutely. And it means as well that you and others are not making assumptions about how people are yes, exactly. When we're busy and don't take time to do that sort of thing, we don't actually know, do we?
KirstenNo, I know.
CarolineExactly.
SheilaI just I just got that lovely image of your team, you know, sitting around in that handover, but and you seeing the compassion within the team, and that was lovely. I I kind of just got a glimpse of that, and it took me back to handovers that I've been in, where you know the team is sitting around and handing over, and there's this care, you know, this care happening um around the conversations about the people that they care for. And it is absolutely beautiful.
SheilaSo thank you so much for taking me to that image because it's just and it's just sitting with me. It's lovely.
KirstenThat's really nice to hear. Thank you. Um it's like that, it's it's uh a nice and even when things are very difficult and very busy and whatever else, we know we've still got each other to to you know hit off, which is what you need, doesn't it?
CarolineBut it does also highlight the importance of leaders and uh leaders creating the conditions for a person -centredness, isn't it?
KirstenYes, it is, yeah, absolutely. I hope uh I hope I never ever forget that.
SheilaYeah.
CarolineI'm sure you won't. I'm sure you won't. Kirsten, thank you so much for sharing your story. It's been wonderful, and a few of the nuggets that you shared with us um was that you experience person-centeredness when you realize that people stop feeling like a patient, feel like a person.
CarolineI love that. You talked a lot about how you achieve that, and that's about human connection. It's about recognizing the uniqueness of people, and again, everyone has their own story. I love that presencing and enables you to demonstrate empathy and and that sense of calm that perhaps is in that encounter is something that is um quite hard to articulate. So thank you for helping us to understand that. But in order to do that, you you did mention that it's important to be self-aware, to be reflective and reflexive and and engage with people.
CarolineSo thinking about how you create that engagement, how you enable that that choice, um whilst ensuring patient safety, because that is so important.
KirstenYeah.
CarolineBut these things are not just about patients. You've talked beautifully about your team, and you can feel the respect, you can hear the respect from your team and the importance of leaders, creating those connected the the culture and person-centredness so that um we can all experience that. So thank you once again, uh Kirsten.
KirstenWell, thank you for having me.
SheilaThanks a million, Kirsten. Thank you. Thank you.