Where’s the love in critical care? Liz Crowe at #SMACCDUB

 

where is the love in critical care stemlynsWe are into the second month of a new year. Many of us in critical care may have made a resolve to ‘take better care of ourselves this year’. With promises of more exercise and less alcohol and caffeine. So how are those resolutions going?

What if I proposed that another way we can take care of ourselves and our patients better was through the use of self compassion, compassion and love?   Too ‘soft’ for critical care? Not based on research and evidence? What if I could prove t you with science and research that love may be the answer…… Would you take the time to think it over?

If we look at any critical care system there are several components that are required to drive quality, safety and ultimately success.   The greatest driver of success is ultimately the staff. Staff who feel safe, valued and supported will thrive. Staff who have a passion and commitment for the job will be more creative, committed and demonstrate a stronger loyalty to the organisation increasing practice wisdom and skill base. All of these components build successful critical care teams and improve safety and quality of care for patients and their families.

Critical care attracts staff who want challenging work that tests their intellect, a dynamic environment and a competitive drive.   So seriously …LOVE?   Does love have any place in the critical care environment? Should love even be mentioned in the same sentence as Leadership, intellectual endeavour or Patient Care? Medicine is embedded in a culture of evidence and research. The science of love will demonstrate how it is a powerful protective factor to wellbeing, increases retention rates and recruitment possibilities, build pathways to creativity and adaptability and shapes strong leaders and effective teams.

Watch the video from SMACCDub below and the read on to learn more about love and critical care.

 

OUR RELATIONSHIP WITH WORK

Human beings are hard wired for connection and so we naturally bond with others. Yet relationships remain a tricky business. We negotiate our personal relationships all the time with partners, children, siblings, friends and colleagues. Relationships are difficult to sustain and for most of us one of the longest and most successful relationships we will have in our lifetime is our long term relationship we have with our work in critical care.

Like any real relationship our relationship with critical care will be cyclical and have periods of ups and downs. It will hopefully start with great enthusiasm and passion and then overtime it will become habitual and familiar. There will be times when we are still passionate and enthused about work and times when we are bored, disillusioned and may even think of straying to something else.

There is a lot of discussion about the need for work/life balance which is essentially setting us all up for failure. We spend the majority of our time at work, studying and researching for work or thinking about work relationships. Therefore particularly when you consider the shift work of critical care there is NO such thing as work/life balance. It is an annoying to assume that if work is a major part of your life it is a bad thing.   Achieving great harmony with your private and professional life is achievable if you are happy at work. There is no need to only be happy on days off. If days off are the only time you appreciate life you need to review what you are doing for a living, or at least who you are working for. If work brings meaning, pride, community and a sense of purpose than you can be happy at work MOST of the time. You can proudly Love your work and achieve work/life HARMONY.

Our work relationship life any real relationships evolves over time. There will be times when you don’t love work, this is a time for pause and reflection. There will be times when our relationship with work will be difficult and be challenging, and if you love it enough and the factors you love about remain unobstructed your relationship with work will survive. On the whole, for the majority of us, critical care is much more than resuscitation and hero work. It is the daily grind of caring for the vulnerable, the agitated, the elderly and the unglamorous. Days that may seem mundane to us will never be mundane to the individual patients and their families who found themselves in our care.

No love and passion is sustained consistently over the course of time – in any relationship (sorry folks). We have to expect there will be times at work when other specialities look more exciting and enticing. When the thought of something ‘new’ will seem better. However, there are few specialities that offer the diversity and action of critical care. Fight to maintain that passion.

So love is not always hot and spicy. There are times when routine is okay. When work is quiet, or at least sane, use these times to consolidate skills and connect in a meaningful way with our colleagues, to ask people how they are and to focus on education and quality

BE A LOVE AMBASSADOR

Science demonstrates that people and teams thrive in an environment where they feel valued, appreciated and have the opportunity to grow and be innovative. Look at what companies such as Google do for their employees. Staff Specialists and team leaders set the tone for work each day. The literature on emotional contagion demonstrates that negativity spreads through a team faster than passive smoking or a viral infection. Who do you want to be in the team? How do you want your patients and colleagues to remember you at the end of a shift. Be a LOVE AMBASADOR. The person who is safe to confide it. The person that grows others into great clinicians and leaders. We should all be trying to leave the next person bigger and better than who we are.   Share love with a big open heart. Be fun, caring, compassionate. The more you give the more life will be meaningful. Compassion is a protective factor against BURNOUT.   It takes a lot of emotion to contain and control feelings. Giving freely is liberating and so meaningful.

In Edmondson’s fantastic book ‘Teaming’ (2014) she talks about the concept that rarely do people belong to one team today, that we are teaming all the time. The team on the floor, the team in a resus, the team with other subspecialties. Each time we ‘team’ we have to clearly designate leadership, roles and connections in order to keep excelling.

So often we talk about professional boundaries and ways to ‘protect’ ourselves from caring too much about patients. While we should never become friends or connections with patients on social media there are time where human touch and visible human connection are not only warranted …it is the greatest and most powerful medicine of all. We need to teach people how to connect and understand others better. So many people in critical care are exceptionally academically intelligent. All of us need to strive to build our emotional intelligence so that we are stronger communicators, greater colleagues and leaders with skills rather than just seniority.

DOES LOVE HAVE A PLACE WITH LEADERSHIP?

Great leaders don’t lead through aggressive, fear or intimidation. Look at the quiet strength and ability to create change through the quiet love of Mandela, Mother Teresa and Gandhi. The greatest leaders in critical care are loved and respected by staff for being personable, approachable, strong, clear in their communication, had a sense of fun and most importantly protected, enabled and empowered their staff at all times. They did NOT have to always be the hero, the smartest or the scariest.

Great leaders create psychological safety. Great leaders create a climate of trust and intimacy that makes individuals and the team feel emotionally and physically more comfortable and allow for robust conversations and disagreement that does not lead to lasting conflict nor does it impact the team. Great leaders protect their staff from the day to day grind as best they can. They let their staff know that any mistake that is made is human and falls to the system, not the individual. Great leaders love their team, apologise quickly and are consistent in their behaviour.

Our critical care team should feel like a family – with all its culture, eccentricities and love.

LOVE GROWS YOUR BRAIN

When people feel loved and supported their brain capacity grows. It is why there is more and more emphasis on attachment theory not only between a parent and a child but how early attachment history can impact relationships in the future, including the way we react and engage at work. We will never love every single individual we work with – patients or colleagues. We do need to respect and listen to them anyway. Try and find a work spouse, the person in the team that you can safely unpack the day, thrash out problems with and ask “am I wrong?” and know they will answer truthfully. Individuals can be more intelligent, more creative and more innovative when they have less stress and feel safe.

Love builds innovation and creativity. As critical care becomes more governed by fiscal constraints and lean thinking and hospitals are run more like businesses and less like hospitals we will need critical care staff to use all their brain power to solve new problems with new solutions. This can only be achieved in an environment of safety

LOVE AND PATIENTS

We see people in the most vulnerable, frightening and horrific moments of their lives. We will never have the capacity to cure each person we see of every physical and psychological ailment they present with. We do have the opportunity to make a difference in their day through connection. Love , respect, integrity and compassion are gifts we can give to our patients that will never impact budgets or hugely change length of stay. In fact it is proven that when patients feel heard their length of stay is shorter! Start every engagement with patients with a level of compassion and openness, build rapport quickly. You will find that if you are kind to your patients, on the whole, people will be more forgiving of wait times, error, several attempts to get a cannula in, or any other inconvenience either you or the system put them through. Why? Because they will feel valued

Remember that for a very long time medicine was more about caring for people, connection and concern than it was about technology and science.

LOVE OF SELF

Even if you give 150% every day, even if you are and kind and skilled and clever, there will be days when this job sucks. When it is all frustration, tragedy, sadness and pain. These are the days when love is most important. When that love has to be kindness and compassion to self. None of us is perfect. There are days when we may need to be a little more careful with ourselves, a little more forgiving. On these days share your vulnerability with your team and maybe if appropriate your patients. Let them know that life is tougher than usual so that people can cut you some slack or bond with you over the injustice of life.   Nurture yourself like you would a best friend, without the ruminations and self torture. Seek out those who love and know you most. Know that this time to will pass

Remember what brought you to this work. Every day fight to find your ‘IKIGAI’ and you will live a blessed life

https://i2.wp.com/upload.wikimedia.org/wikipedia/commons/e/eb/Ikigai-EN-optimized-PNG.png?w=1130&ssl=1

 

 

IGIKAKI (Japanese term) – environment of blessing

vb

Liz Crowe

 

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5 Comments

  1. lizzie robinson

    too often love, kindness and compassion is seen as a weakness. So thank you for posting.

    Reply
    1. Simon Carley

      I think we are getting better at recognising that it’s far from a weakness, it’s a strength. We still have some way to go, but the words of Liz, SMACC and the St.Emlyn’s team will hopefully help promote the message.

      vb

      S

      Reply
  2. Karen Edwards

    Great article and such an important message in so many ways. I didn’t realise but when I took up medicine I gave up playing the piano. It wasn’t a conscious decision it just sort of happened. I moved so many times during my training and never seemed to have time or space for a piano. I was never a great player but I did used to get completely absorbed in the music sometimes for several hours. It was a great way of switching off but after over 25 years I couldn’t see myself comfortably tickling the old ivories again. However 3 weeks ago I was lent an old digital piano by a friend and plucked up the courage to contact a piano teacher. It’s now coming back, initially faltering and stuttering but after a few lessons, the joy of playing now feels like it never left and I’m loving every single minute.

    Reply
    1. Simon Carley

      Hi Karen, this comment is fantastic. All too often I see colleagues give up something that gives them joy in the pursuit of career, and that’s insane. I’m so pleased that you are enjoying playing again. If you’re lucky enough to have musical training it’s such a fantastic tool to maintain sanity in the busy jobs we have.

      Please keep it up.

      S

      Reply
  3. Robert Foryś

    Love is what keeps us from going insane.

    Reply

Thanks so much for following. Viva la #FOAMed

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