staff morale that inspired this research project, I had a sense of the human need of the HCPs amongst whom I worked. Asking them, ‘How’re you doing?’ they said they were so grateful for space to talk and their instant relaxation was palpable. From my research project reflective journal, dated immediately prior to data generation I noted from the on-going pilot sessions:
Human connection seems to be the theme of the reflections at the moment. Now have done 2 new sessions on […N…] ward in the face of
131 stress and high level of complaints. Staff said they feel unsupported and un-thanked, feeling all they hear is the dishing out of complaints and pressure from above to improve. In the first session several spoke of a ‘good bit’ over the previous few days was a patient’s mood lifting when, in a distressed moment (one HCP) hugged the patient and another who held a baby! In the 2nd session several celebrated
receiving thanks from a patient and another saying thank you for the joy of a shower as he was improving enough to have one.
In pausing to reflect these staff responded to me identifying the ‘human touch’ that the patients have felt, which was equally two-way in the fulfilment felt by the staff. Journal 11th March 2013
From here, looking back through the pilot study, I had seen this before. It occurred to me that this is the thread, or the baseline, for exploring the need for HCPs to have this very space to re-find their humanity in order to link with the human patient. During the early weeks of the research project data
generation (Apr 2013 – Apr 2014) I began to annotate the field notes, having begun to see this theme emerging. Reflecting on a RPW in June 2013 I had started to make note of the human connection. From the journal, and using the data, I had noted “Recognizing human side” (11th June 2013), seeing their shared human connection and how HCPs had grown more able to see and note the patient’s perspective. They reflected: “Changing view of
people/things when know deeper story” (11th June 2013) including facing the challenge of “when they’re putting you down” (11th June 2013).
From here, I returned to the start of the field notes (April 2013) and annotated the margins with ‘H’ where I could see again this human
connection and continued to do so, whenever it was clearly present at the time. Further analysis subsequently revealed a growing theme. I was seeing
132 their value in having the space to reflect on the human and personal in the face of professional challenges.
The HCPs in this reflective space identified the shared humanity between them and their patients: “Sharing humanity – respecting humanity regardless of circumstances” (23rd April 2013). They acknowledge the shared human need, identifying with them, their patients. There is also the sense of the personal giving, the HCP being human too, also sometimes forgetting or feeling prohibited from being human themselves: “You sometimes forget you’re allowed to be human” (21st August 2013) and “Good for us all to remind us we’re humans” (22nd Aug 2013).
They share a human vulnerability, coping with their own story as well as that of their patients, commenting that it is “easy to forget the illness if that’s all you’ve seen them do” and “that’s not the real person” which also “makes me think I shouldn’t have been short with him” (3rd December 2013). This goes to the heart of their connection with their own lives: “Palliative care patient reminded HCP of father – quite raw – uniform on makes you feel you
shouldn’t show it at the time, but time to be aside from it” (21st August 2013). They also describe caring for a “young patient – change in atmosphere – having child of similar age – kept seeing own child – gave own child a cuddle and felt lucky” (21st October 2013).
The recurrent theme was identifying and exploring the balance between being the professional and the human. This means ‘professional distancing’; the capacity to face daily the suffering of others, which is the inevitable acute human experience of healthcare, without being overwhelmed; by having the capacity to act professionally; and fulfilling one’s professional responsibilities. This was described in nuanced ways such as “Professional distancing versus people who connect” (5th June 2013) and “Happens all the time…something about one of them gets under your skin” (3rd January 2014) where the HCP
133 has felt some link or connection with the patient and their story or situation for some reason. Equally, it can be “Professional distancing versus care for the other” (11th October 2013) and “Discussion re caring for patient and own emotions, professional distancing and being human” (4th Dec 2013)
suggesting genuine care for the other rather than simply professional caring practice but taking care to find a balance.
In whatever way they manage it HCPs are expected to have the ability to care holistically for the human patient, with care and compassion (Francis 2013) and this data shows this, for example, “Seeing them as a whole human being” (23rd July 2013), and “Value of listening to the patient – care of whole person – giving them voice” (21st June 2013), with “Reflection on thinking how patient feels” (10th July 2013). The recognition of the shared human
connection provides the key to offering the compassion for a fellow human being. This balance of professional distancing in order to cope with the job alongside making the human connection, and the need to find it, was evident throughout this research project.
The data revealed the HCPs’ sensitivity to the patient’s situation, how they may be feeling, why the patient’s behaviour or response may not be the real person but the ill health directing their response or coping strategy, such as “People kick out because of being distressed” (5th June 2013).
The HCP sees the patient’s perspective, and their world in this context. They also see the patient and intuitively make the link with their own life: “Care includes professional distancing and ‘this could be my relative’” (2nd May 2013) and “Remind you of someone you know” (29th May 2013). This goes even deeper still with phrases like, “Reminds you how vulnerable you are – connects with own family – our vulnerability” (10th July 13) and with a sense of visceral shock – “Went home, went through it all, close to home, reminds me of things of my own like a whack in the face” (22nd July 2013).
134 Nevertheless, the HCPs see themselves as the patient advocate, giving them voice, protection, wanting best for their patient, observing occasions when “Angry with doctors who see them as just a procedure” (8th July 2013) and “feel like you’ve failed him, here to protect him, make him comfortable” (25th July 2013).
Within all of this is also the evidence of the personal self-giving of the HCP, the giving of their own humanity and limitations, and also a fear that a
connection can go too far. This theme returns to the need to find the balance between professional distancing and making the human connection: “They’re our patients but we’re all human beings” (28th January 2014).
If wellbeing is also holistic, meaning links with the ‘whole person’, then this theme of connecting with the shared humanity of staff and patients is consistent with this wider understanding as expressed in this data source.
III. Value of the reflective space to share (examples from 169 phrases)