Midwifery and birth, NHS

Courage butter  

As an NHS CareMaker I’d like to provoke some debate on one of the six 6cS COURAGE . 

We hear phrases like “that must have taken some guts!” , “wow – what a courageous act ,”Speak out” 

But how exactly does courage apply to health care professionals ?  

Here Karen Lynas of the NHS Leadership Academy blogs about courage and talks about why we must not chop the heads off tall poppies . 

Visualise your working day and consider how you approach challenges  or difficult situations within your place of work. Do you feel an air of acceptance to comply because  you are  working for the institution, not the patient/woman/family/service user? 

How we approach others and also how we react to others  can be an identifier of a courageous nature – anger should not be responded to by anger as this is like holding an unlit match against a matchbox. 

If  a certain situation is happening , compassion and safety  should always be foremost in our thoughts – is your response kind ? Is the person in any danger – it is worthwhile to contemplate the long term effects of failing to challenge poor care . Poor or substandard care  may continue  because no one has ever challenged the process but it’s always wise to consider the detrimental effects on the service user. Reflection by the service user might not happen until a few weeks later and the impact could be immense on that persons mental health and well being . It is wise to see hold the thought that ‘we are only human”  but in effect our humanity is instrumental in helping us to differentiate right from wrong. 

On the other hand it is always easy to look back on incidents and ask “How did that happen?” We must not bask in the unpredictable light of complacency but each day question our own selves by asking 

Are my actions kind? 

Are my actions evidence based? 

Would I accept this care for myself or for others that I love?”

And we must also hold this thought

 “I am accountable for my inactions”

Imagine yourself as a  newly qualified health care worker suddenly engulfed by the system – what would give you courage ? Would you learn best practice by sticking with the same preceptor or would you observe and gain a sense of right and wrong by reflecting each day and researching care . Is courage visible or auditory ? Can we teach courage do we see it in our daily lives ? Is courage something we associate with Superheroes / daredevils / mountaineers/ extreme sports people but not health care workers ? 
If you overhear colleagues talking about another member of staff in a cruel manner would you  be able to speak out for that colleague or would you join in ? If you discovered that the person being talked about was you how would you truly feel ? 

How can we raise the profile of courage as an intrinsic and crucial part of the 6cs? Do all health care  workers talk as openly about courage as they do the rest of the 6Cs? Is courage embedded into the curriculum  I believe that love and compassion strengthen ones courage.  Maya Angelou’s quote , 

 “Courage is the most important of all the virtues because without courage you can’t practice any other virtue consistently”

 highlights the fact that first and foremost courage is the core of all our virtues – we  must hold onto it . 

I’m currently reading a book about a man who  displayed immeasurable courage during the Second World War. Louis Zamperini overcame immense suffering through personal courage . What made this man courageous and able to survive ? Was it the discipline of running ? Do health care professionals require an extrnal outlet to help them channel courage in the workplace and is social media one such outlet ?  It is now a proven theory that the  tweeting as a healthcare worker increases ones awareness of compassion . Theresa Chinn MBE (for Theresa’s blog Click Here) has discussed this in her Chapter “Compassion in the Social Era”  in the book Roar Behind the Silence  Click here to be directed to Roar behind the Silence (Why kindness , compassion and respect matter in maternity care) edited by Sheena Byrom and Soo Downed – published by Pinter and Martin 2015. 

On a personal level social media has connected me with a community of real like minded health care professionals that I can reflect with and learn with and from  . Yes it’s totally true I have made real and true tangible friendships through Twitter. There is no hierarchy on Twitter we all have a voice that is heard. Where else would you find a  breastfeeding support worker chatting openly to a Head of Midwifery at 7am in the morning? Tweets from NHS patient experience leads to student nurses ? Someone like me discussing  skin to skin contact with radio DJs as well as rugby players – where else would this happen ?

Recently I sent a tweet out saying I wanted to Spread courage like butter on twitter and slowly the # CourageButter is spreading. Please click the following to read Tweets about Courage Butter Anthony Longstone who is one of #TeamShiny first coined the phrase on Twitter Here . 

I firmly believe that courage can be taught and this teaching knows no hierarchy – a breastfeeding counsellor might teach a student midwife more about courage during one observed consultation with a woman who is breast feeding her newborn than she has seen in her first year of training . It is possible to be quietly courageous or a roar might be needed . 

Remember to use systems to back up your courage – supervision , incident reporting , reflection and record keeping will all help you on your courage journey also use refer to  The new NMC code – click here 

It is crucial that we discuss display and teach courage in order that future generations of health care workers  embrace  it as part their role and more importantly so that the people we care for can continue to receive and expect high quality  care. 

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