There will never be a shortage of reasons for gratitude in our world of healthcare.
That’s not turning a blind eye to genuine mistakes, mess-ups, even abuses and cover-ups. They all need timely attention at the least, lessons learned, new practices implemented, holes blocked up and serious intentions of “never again”.
Unfortunately, bad news sells, and when things go wrong, we seem to pay more attention. The headlines in the mainstream and social media may suggest that more things go wrong than right, but that’s a very long way from the whole story.
Most of us who find ourselves in the care of the NHS and its supportive structures could tell a different story. The bad stuff, horrible enough when it happens, only accounts for a minority of experiences. Most of what happens is at least good, or very good. Some of it is, by any definition, excellent.
We’re so trained to spot what’s wrong rather than what’s right that we may walk past the good and the better, and even the excellent, without comment, even taking it for granted. And when we do say thank you, however fully and eloquently we manage it, it may be received with a wave of the hand and “Thank you, but we’re only doing our job.” What then? Perhaps a card, a letter to the ward. Will it be seen by those we thank? What if it were, and could be appreciated and taken to heart?
Adrian Plunkett is a consultant in the Paediatric Intensive Care Unit (PICU) at Birmingham Children’s Hospital. After reflecting on his own experiences as a patient, he set up Learning from Excellence, encouraging staff to recognise and report when things go well. It’s a way of saying thank you that gets logged, and triggers a note of appreciation for the staff member. It provides a way of learning from when things work well – asking not only what was good, but why it was good and what difference it made. Saying thank you, expressing gratitude, and being appreciative of team members is also powerful food for morale and resilience. ( Learning from Excellence )
We weren’t surprised to see such a thing start in Birmingham Children’s Hospital. Live Loudly Donate Proudly blogs are littered with thanks for years of incredible care for its founder, Lucia, her family, and for many others. Learning from what works well should keep them all busy for a long time, there’s plenty of it…
This day four years ago it was another team, in King’s College Hospital, London, that showed us their excellence. Actually, we didn’t see most of it as it happened inside the Liver Transplant Theatre, and through most of the night. Lucia had walked along the corridor and into the care of the theatre team for a fourth liver transplant. Through her hugs and smiles, her hope shone. “Well, see you next year! You’ll see me before then, but I won’t wake up until then.”
The transplant coordinator spoke with us a few times through the night, then, at 3.30am, “They are still working. It’s not going very well. They are doing all they can.”
A long hour later, the lead surgeon came into our waiting room. “Better,” he said. “Not good, but better.” There was immense, intense relief in hearing that simple word. Better. Even though what followed set its limits.
Later, we began to hear the story of that night’s operation. It’s for another place and time, but we heard enough over the next days and weeks to understand something of the excellence that had been given to Lucia in the theatre. More, we heard of Lucia’s own incredible strength and resilience as, time and again, the team thought they had reached the limits. “The anaesthetist assured us, ‘Lucia is still responding.’ So we carried on. Lucia led us through. Her name means Light, you know? She was our light in there,” they told us.
In the continuing quality care that followed, one after another of that team told Lucia, and the rest of us, how much that experience meant to them, how astonished they were by Lucia, and that lessons were learned, not from something that went wrong, but from something that, against all odds, seemed to go right.
Months later, the story turned. Now we write these blogs in Lucia’s place. But in all the entangled emotions, thoughts and memories that this day brings, there shines a thread of gratitude, for excellence. In the hospital theatre, in those teams and, always, in Lucia.
Saying thank you will not wear out, and there is still so much to learn…