One of the pursuits I have found
myself in since retiring from my career as a physician is that of an advisor
for the Richmond Mental Health and Addictions Services. This came out of my
having signed on as a volunteer advisor for the Vancouver Coastal Health
Community Engagement Advisory Network, which is a broader body of advisors.
Part of the work in Richmond at the present time was being introduced to a
recent initiative for the service, Patient and Family Centered Care. This was
being presented to the Department of Psychiatry, Richmond Hospital, in their
Grand Rounds this morning. I attended to see how the presentation was going to
go and to see if I could learn anything about how it was received from my
former colleagues.
Interestingly, the first to
arrive were a number of members of our advisory committee. I had not known of
the plans for the morning in detail but realized later that two of them were
there to present their own stories, one personal and one with respect to a
family member. All told, counting myself and our coordinator, I think there
were seven members of our committee there. I was told later that there had been
seven members from The Department of Psychiatry. I did also recognize a couple
of mental health team members and at least one family practitioner.
In terms of the reception of the
message being brought, I was not surprised at the turnout. The department of
psychiatry itself probably has more than 20 members. You could double or triple
that if you wanted to look at how many members of the mental health and addictions
team there are. So, you can see that the interest was not that high. I should say,
in all fairness, that members of the mental health teams and outpatient
department might not have attended because I believe the initiative has been
presented to them in their own meetings already, as well as to the inpatient
team.
As I commented to the speaker and
our coordinator after the hour-long meeting was over, I also benefited somewhat
from the presentation. It reminded me of some of the lessons I learned in my
career and some of the principles that can be drawn from that.
The speaker talked about the
issue of safety in healthcare, and
from whose perspective. She placed that at one end of the spectrum of managing risk, with quality of care at the other end. A key
statement that she made was that we should be thinking about care with our patients/clients, and not
care provided to them. The former approach helps create a mutual sense of
ownership of recognized goals and subsequent plans of action, and therefore places
some onus of responsibility on everyone involved, not just the alleged care
providers.
She also spoke about how all of
this depends on trust and the
importance of beginning with cultivating that. Another concept she spoke of was
resilience, which she defined as the
ability of a person or system to achieve goals in spite of both expected and
unexpected adversity.
The speaker did talk about the
importance of listening, as did the two committee members who shared their
stories. This reminded me of a previous blog I have written here about being in
the moment in terms of paying full attention to the person with whom you are
sitting in a care-providing setting (see "Remember - In the ER").
It wasn't so much stated in the
proceedings of the morning, but much of this points to the importance of the relationship between the individual or
family/unit requiring care and those who are supposed to have the ability to
provide it. Of course, a satisfactory relationship depends on trust, and one
way of obtaining trust is to pay attention and listen.
As I told the speaker and
coordinator after, this reminded me of something I realized when still in
practice. There are many schools of therapy and one can try to learn the
approaches that one encounters and that interest one. However, none of them are
going to be really effective without that relationship and trust. At the same
time, I found that when you have developed a trusting relationship, that goes a
long way in providing healing, regardless of school of therapy, technique or
strategy. Of course, this is a lesson that all wiser healers and caregivers
understand as being pivotal to the success of our endeavors. We also know that
our ability to trust and form relationships is something that has its roots in
our earliest life experiences, which is something I am paying considerable
attention to in a number of other blog entries relating to child development,
which one can read here.
I could also tie this in with my
faith. As one who believes in God and the work of Jesus, as presented in the
Bible, through history, study and experience, both others' and personal, we
understand that, however our existence came to be, God's will for us is that we
be in a mutually satisfying relationship with him, with ourselves, with one
another and with our world. We were made to be in relationship, something
Science has only relatively recently “discovered.”
