I have developed lots of lovely and intellectually productive work relationships as a consequence of my external engagement role in Cardiff Business School.\u00a0 One of which is with Diana Reynolds from the Sustainable Futures Division of Welsh Government.\u00a0 Diana is one of the most passionate people I know about the importance of learning and about the importance of the right environment for human beings to thrive and grow. \u00a0She teaches me curiosity and thoughtfulness and I\u2019m grateful to know her.<\/p>\n
In one of our recent meetings I told her about some of my frustrations with my Dad\u2019s recent experience in a hospital. He\u2019s been very unwell unfortunately, but is now, hopefully, on the mend.\u00a0 He contracted a nasty chest infection alongside all of the other medical issues that he was dealing with and one evening, when we were visiting, he was really struggling for breath.\u00a0 He was noticeably uncomfortable, breathing extremely rapidly and it was exceptionally painful to watch.\u00a0 My lovely Dad lying there, desperate for air, and me, powerless to do anything about it.<\/p>\n
Such was the critical nature of his illness, he was hooked up to multiple monitors and devices, all doing their job of informing those around him of his status, bleeping intermittently to alert people of the need for some form of intervention.<\/p>\n
I watched his oxygen saturation number glowing yellow.\u00a0 (I am now good at reading these monitors fyi they obsessed my thoughts over the first 2 weeks of his care) 89% oxygen saturation. It had been 98-96-94 previously.\u00a0 A global covid 19 pandemic had also made me become intimately acquainted with an Amazon acquired pulse oximeter and I knew what levels constitute \u2018good\u2019 and what are \u2018not so good\u2019.<\/p>\n
I asked the nurse whether she could give him some oxygen to help him.\u00a0 He was, surrounded by at least 2 different oxygen options such was the nature of his critical care.<\/p>\n
\u201cI can\u2019t give him any at the moment.\u00a0 The Doctor has assigned his tolerance level as between 92 \u2013 88\u201d.\u00a0 Perplexed, I, imagine sharply, retorted \u201cLet\u2019s wait until it gets to 87% and then give to him shall we?\u201d!<\/p>\n
Dear reader, his levels did of course then reach 88.. 87.. 86\u2026 and then Oxygen was duly administered which instantly helped his O2 level to increase.<\/p>\n
You know that I love common sense and practical, employee empowered, approaches to problems and I just couldn\u2019t quite believe that that nurse didn\u2019t help my Dad when, from what I could see at least, he quite obviously needed it.<\/p>\n
I relayed my frustrations to Diana and we discussed how litigious healthcare is, and that there had probably been many different interventions designed to establish protocols, and staff adherence to protocols, specifically to protect<\/strong> patients. We discussed how difficult such environments are to get the balance right between patient centricity and process compliance. \u00a0Diana then went on to explain:<\/p>\n \u201cYou see there are two types of knowing.\u00a0 There\u2019s the regurgitating information knowing, and the knowing where you truly recognise, connect and understand. Welsh has two different words for the two different types – Gwybod and Nabod. Gwybod is to know a fact and Nabod is to truly KNOW a person or a place. \u00a0There is recognition and emotion that comes alongside that knowledge of that person and place. They are different things\u201d.<\/p>\n (Interestingly, this is the SECOND blog I\u2019ve written about the power of the Welsh language! The first was about the power of combining \u2018to learn\u2019 and \u2018to teach\u2019 in the same word \u2013 \u201cDysgu<\/a>\u201d. John Parry-Jones<\/a> will be proud of me).<\/p>\n The nurse that day was applying Gwybod.\u00a0 Looking at the patient file and what was an acceptable oxygen level before intervention was required, looking at his monitor to tell her what the oxygen saturation level was and whether it was within this tolerance. She was not employing Nabod<\/a>.\u00a0 To know the person. To use her eyes and intuition about the patient in front of her, listen to the family members that knew him, and act on instinct, emotion and connection as to what was required.<\/p>\n You could argue of what difference the hour without the oxygen actually made …. probably absolutely nothing in the scheme of things …. but what mattered to me was the doubt laid in my mind as to whether people were able to make healthcare decisions that were in the genuine interest of my Dad. Could care only be provided if it had been written down (illegibly) in a file by someone else \u201cmore qualified\u201d? \u00a0We had another incident where he had a headache and no one was able to give him paracetamol because someone had inexplicably crossed paracetamol off his drug chart.<\/p>\n Donald T. would probably be pleased.<\/p>\n So yes, how to get the balance right between Gwybod and Nabod? My Aunt, Dad\u2019s sister, was a senior nurse all her life, trained in the old school nursing tradition of capes with crossbody ribbons and upside-down nurses watches, said that one of the most powerful things that she had seen in her career was when a Ward Sister had insisted that above each patient\u2019s bed, should be a recent photograph of that person, happy and well, to remind everyone who they were caring for, of who they were trying to return back to their loved ones. \u00a0A Nabod connection device.<\/p>\n Delicately navigating the difference between Gwybod and Nabod should be something that we think about deeply within our design of our public services.<\/p>\n We need services to be both full of expertise AND empathy.\u00a0 Both should have equal power and weight.<\/p>\n <\/p>\n