Keys to Success in Caring

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.”