This blog is based on a presentation given by Clare Cable, QNIS Chief Executive and Nurse Director, at the Leading Excellence in Care Event in Glasgow, March 2024.
Looking at that title, given the challenges in the health and care system, an entirely reasonable response would be ‘Aye Right’
It’s tough just now and it’s been really tough for several years.
We have not yet properly taken time to understand and heal the collective trauma we experienced during pandemic and the current financial and workforce pressures in the system are immense, as highlighted so starkly by the Auditor General recently.
Many of us are exhausted ….. we are here …… we are upright …… but only just ….
So, against this backdrop how do we create realistic hope and workplaces where we can flourish?
In a volatile, uncertain, complex, ambiguous world where so much is way beyond our control, we need to manage what we can … and that is ourselves.
I have tried to distil some of my learning as a leader, coupled with the experience of facilitating the Queen’s Nurse Development Programme for seven years, and summarise them in an acronym – FLOURISH.
F is for Flexibility
We arrive at work with a notion about how a day may pan out and within minutes that has gone to pot. We are constantly bombarded with new issues to address and problems to solve. Staying flexible and maintaining our equanimity is key. We also need to be flexible in the ways we develop our leadership, finding opportunities which connect with our learning style.
The Leading Excellence in Care Framework is a fabulous tool.
It has 10 capabilities and 45 key skills and knowledge.
I did the self-assessment and there was quite a lot of red and amber, so we are all a work in progress! It’s not meant to be a rigid tick list; hold it lightly, use it flexibly to inspire the ways in which you focus your energy.
L is for Listening
The chances are you have done advanced communication skills training, so this is not new. But in the busy-ness, we are inclined to lose sight of that listening, particularly to ourselves. One Queen’s Nurse completed her development programme and wrote ‘I have found myself. I have no idea when I got lost, but I am never going to lose myself again!’
Unless we know how we are, and are aware of the narrative in our own heads we will struggle to be truly present to others and listen deeply. And one of the best ways to do that is mindfulness. If you haven’t tried it, it’s not about being still, but about being aware. Being sufficiently present to know how it feels to be me in this moment.
Mindfulness teaches us to use the breath as an anchor, to help us become present. I used to beat myself up because I couldn’t get past 2 breaths before my head filled with thoughts. But I have come to understand that it’s OK. That’s what minds do, and the practice is about cultivating a greater awareness ……
And that awareness enables us to be with others, more attuned.
I love this quote from the poet Mark Nepo
“To listen is to lean in, softly, with a willingness to be changed by what we hear.”
Our challenge is to listen to understand as opposed to listening to respond, which is our tendency.
Which brings us to the connected concept of
Openness
By cultivating an open mind, open heart, open will, we are enabled to hear what others are saying with equanimity and humility – to hear the voices in the system who are too often marginalised or sidelined, but may be the very people who can see what we can’t.
We suspend the Voice of Judgement and approach our conversations with curiosity.
When we are tired or anxious -red zone, black zone … we are less able to be open .. to the evidence that flies in the face of what we believe, to the voices of those who challenge our assumptions, to the ideas which maybe, just maybe might work, if we were able to hear.
As we step into a greater openness and self awareness we begin to recognise our own lens, and the biases we may bring to what we see and hear.
The invitation is to unmask, which is our next letter– to show up as yourself, truly present. I love this quote from Maya Angelou – I’m sure you’ve heard it before …….
“I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”
And that’s about authenticity. One unmasked human being connecting with another, whether that’s your colleagues, those you care for, or friends and family.
- Are you able to show up as yourself in your workplace?
- What would it take to feel safe to bring your true self to work?
- And if you can and do ‘hooray’ but maybe be thoughtful about those around you who find it hard.
Do you behave in a certain way because you believe that is how others expect you to behave or because it comes from the heart? Sometimes we find ourselves put in boxes by the expectations of others; we assume this is how we need to be because that’s what other people expect of someone in our role.
It’s about being truly connected to our own humanity and that leads us into …..
R for Relationships
Find your tribe. Who are the wise and thoughtful people you know? They are your allies. Do you have people who you can safely debrief and rehearse with?
The digital age has made workplace relationships more complex. We now message people rather than walk down a corridor to find them and speak face to face. We work on different IT systems so sharing information can be tricky and the nuance of a situation hard to convey.
How can we create more real, face to face encounters with colleagues to build our teams?
I is for Intention
Brene Brown has a lot to say about this. How often do we jump onto Teams straight from another meeting or rush along a corridor encountering six people who want to speak to us, but our head is still in the last conversation we had.
How would it be to take time to set your intention for every encounter you have? I sometimes start the day with a visualisation, scanning my diary … seeing each meeting in my mind’s eye. I might be absolutely dreading a conversation, but instead of stressing about it, I consider … How do I want to be with this person? What is my intention for this conversation? How do I wish to leave this person feeling? And in that way, I am able to show up with a sense of openness and welcome.
S is for Self Compassion
There is a growing literature around this concept. You may have come across the work of Paul Gilbert, whose book The Compassionate Mind is fabulous.
Another person whose work you might want to connect with is Kristin Neff who identifies three elements of self-compassion. Self kindness, mindfulness, and humanity.
We are very good at being kind to people we work with but often we have a blind spot when it comes to caring for ourselves. It may be we need to take action around our nutrition, exercise, sleep, stress reduction …. It can be helpful to reflect on the areas we need to look at BUT to do it with a lens of kindness.
The research on menopause, resistance, and strength training is compelling. I genuinely dislike the gym, and it may not feel like an act of self love to drag myself out of bed at 6am to get there but I do it because I realised I needed to get serious about my health and the voice in my head is one of self kindness. If someone else told me I had to do it, I would have packed it in after a month. It is an act of self care and that’s why I have been going at least twice a week for the last three years.
And when we bring together a genuine self-kindness, with common humanity and mindfulness we have the beginnings of a life long journey with self-compassion.
And lastly Humour
Let’s not take ourselves too seriously. We do serious work, we are here to lead excellence in care, but you know what they say … laughter is the best medicine. Let’s lead with warmth and humour and create workplaces where people want to stay.
I hope there have been a few nuggets you have found helpful. The invitation is to take what’s useful and leave the rest. Day at a time, may we all flourish a little more.
