7 reflections from being on shift (and my shift in numbers)

One of the expectations of a Wellbeing Leader, is that they do a shift each month. 

I learned how important this was last year, when I both shadowed and did a few shifts with the people we support in Ashton. Talking to people about knitting, when I was shadowing Mo led to the Knit and Natter group. Becky (our Community Link Worker/social prescriber) started to support the Knitters, and is now actively developing groups and opportunities for people to connect. When Michelle, who was the Wellbeing Leader in Wigan, did shifts, she introduced spa music when she was supporting someone to have a shower, and this led to the teams thinking about how to make every shower a spa experience. On another shift I took nail varnish with me, to see if it was possible to deliver care and have 3 minutes to do nails, or a hand massage. This led to team members carrying ‘pamper packs’ of nail varnishes, hand and foot cream, and we worked with a beauty therapist to learn how to do this well, and give head and shoulder massage. This does not mean that innovation only comes from Wellbeing Leaders, instead it is an opportunity to learn, and test ideas (like taking nail varnish with me). We are seeing innovation from teams, where people are sharing ideas about our ‘Death Café’ next month (with our co-production partners), about wellbeing in the work place, and the person-centred team reviews that happened last week are where teams also set the agenda for innovation, change and development.

This Easter weekend I had to opportunity to support our team in Oxfordshire. I shadowed Gemma on Friday night, and then did two shifts myself. Here is what I learned:

1) Compassion in action

I learned how the team do ‘small things’ that make a big difference. I heard examples of team members:

·     buys Seb’s favourite flowers for him on a regular basis

·     staying later with Shirley after their shift had ended to have a cup of tea and chat

·     taking Easter Chocolates to everyone we support

·     doing a deep clean of Cynthia’s bathroom in their own time

·     putting flowers on the grave of someone we used to support

·     buying food and treats that they know people would like 

I learned that these are done by every team member, not just one of two. These are examples of compassion in action. I was going to write ‘going the extra mile’ but Jackie Le Fevre rightly challenges me on that. It is not doing extra, it is living our values.

2) The power of a hug or a hand massage.

At the end of my last visit to Harry, I asked if I could hug him. Over the four visits on Saturday, I heard about how he and his wife fostered children, his small holding (he scoffed at me having two hens!), his love of steam engines, how he had worked as an engineer and we talked about our favourite whiskey.

Most Professional Boundaries policies discourage or forbid this.

When I asked if I could hug him, Harry said yes, and then said “It has been a long time since anyone has hugged me.”

Older people receive functional touch all day – support to get up, get dressed, have a wash. I want my teams to express compassion and care, and for some people this includes hugs. As a registered manager I know of the appropriate concern about abuse. I trust my team to be thoughtful about this, to raise concerns if they have them, and offer to hug people.

Hand massage is another way to give compassionate touch. My last visit was to support Annie. After supporting her to wash, when she was back in bed, I asked her if she would like a hand massage. She looked surprised, and then said yes. She closed her eyes as I gently massaged her hands. A mindful five minutes for me, and I hope I communicated care and love to her, as I held and massaged her hands.

3) Shift Buddies supporting each other

Louisa and Megan were also on the morning shift. At 7 am, a message came through on Slack (the App that we use to communicate) wishing each other well for the shift, and being there is we needed each other. It gave a sense of camaraderie that the three of us were out supporting people at the same time, and virtual ‘high five’.

4) Life stories

Without exception, and without me asking, everyone I supported over the weekend told me something about their history and their life. From how Annie got her name, to Jenny’s work as a nurse, and Cynthia’s factory work, and John’s work in adoption. We have started to buy a commercially available book to record these stories. We looked at lots of options, including the StoryCorps App, but the one we use has headings that makes it easy to quickly jot down a snapshot of a story. Life story work is embedded in work with people with learning disabilities, and in good dementia care, but not in care at home. In every visit I did there was between 3 – 5 minutes where I could have jotted down an example or story, or looked to see what was already there about Cythia’s factory work and found out more.

Being seen, and being known, rather than someone on a visit list and a set of tasks, is part of the change we need in care at home. I think capturing life stories together – with families where possible, is part of what needs to change about commissioning and delivering care and support at home.

5) Relationships and rotas

Everyone I supported had a personalised rota with who was coming next, and I was on their list and people knew to expect me. This is a physical demonstration of the continuity in relationships that the team have trying to achieve when they do their scheduling.

6) Life worth living?

The last person I supported on Saturday night, Jeannie, whispered to me, as I helped her off her commode. She said, “I wish I was dead.” It was heart breaking to hear this. She is in pain and has morphine to help with this, she has four visits a day, does not go out and has her TV and audio books for company in between visits.

This made me think about two questions:

How can we support people to have purpose and connections? For people in similar situations to Jeannie, what could be possible?

How can we support people to think about plan for their death?

In Wigan, we have a group of people (team members, co-production partners) developing an opportunity to talk about death, during Dying Matters week. I hope this can be the beginning of us thinking more about our role in supporting courageous conversations at end of life.

We have some new funding from June, to contribute to purpose and connections in Abingdon, in a similar way to the role Becky takes in Wigan. I want to keep thinking about Jeannie, and what we could explore with her. 

7) Sharing learning across teams

My final reflection, is how we learn across teams and from different Wellbeing Leaders about what they are noticing and learning during their monthly shift. We meet weekly (via Zoom) for tactical meetings with the national team and with Wellbeing Leaders. I want to suggest a monthly time to share our reflections, and most importantly, how we use this learning.

My shifts in numbers

1x put out washing

8x Commodes emptied

4x Leg bags drained

1x put bird food out

8 x medication given

5 x making meals and snacks

4 x tidying and washing up

3x compliments to the team

1 x reprimand (I had put the dead flowers in the wrong bin - in Stockport garden waste is a green bin, but in Abingdon the garden waste bin in brown!)

12 x making tea or coffee

2 x people cried with me

4 x helping people wash and dress