The Gathering of Kindness is proud to introduce Karin Morrison. Karin is a renowned educator and author, who will be facilitating our discussion on the importance of language in healthcare at Dandenong hospital on November 2nd. I had the pleasure of 'interviewing' Karin by email this week. She has many insights into the necessity for kind communication in health care gleaned through her experiences as both an educator and a patient herself:
Please tell us a little bit about yourself and how you came to be interested in ideas about kindness in healthcare.
My work is and has been primarily in education working with people of all ages, in different positions and organisations, including teaching from preschool to postgraduate, senior executive positions, building local and international collaborations, creating and leading projects. I'm committed to helping individuals and organisations move forward by valuing one another, fostering open-mindedness, the desire to think, learn, explore, understand and take action.
I have seen firsthand the importance of kindness in health care through the serious illness, sometimes leading to death, of my family members and students, as well as my own experience after two extremely serious accidents and a non-life threatening but difficult health care situation. I highly value the positive difference kindness in health care provides.
Can you define what kindness means in healthcare? Is it the same fundamental human quality that we all recognise in others or does it take on a particular quality in the context of healthcare? Why do you think kindness is so very important? Why isn’t mere competence enough?
Kindness does take on a particular quality in the context of healthcare. Competence is very important and great when that is provided. But if what is needed is done very competently but as an automatic process, I think it dehumanises both the person providing what is needed and the patient. People in a healthcare context take on specific roles. They are interdependent roles but one has its responsibilities clearly outlined with skills and tasks repeated continually in familiar settings, though circumstances and responses vary. The patient is usually in a very unfamiliar context, brings with him varying degrees of uncertainty and fear and feels very vulnerable with much beyond his control. Kindness is so important because it shows the recipient that these feelings are understood. A simple smile or a pat on the arm can provide reassurance sorely needed. Kindness to listen to what a person has to say without making judgment and taking seriously questions or requests that may seem irrelevant or trivial to you, but with very limited knowledge of the people you are caring for can mean that you both see the same things very differently. Kindness combined with competence brings the human touch when it is most needed. Today I was volunteering at Very Special Kids (VSK). While internally it is a heart wrenching place to be, the kindness there is so concrete you can feel it, and the children certainly do. So much thought and kindness is put into providing opportunities for children who are dependent on others. You see children smiling and even children that cannot stand are in wheelchairs or hoisted onto an almost vertical frame so they are in a standing position or their beds rolled in to a beautiful child friendly community space where all can participate together in their own ways. Seeing the unlimited kindness all the time at VSK is making such a difference to the quality of these children's lives, however short. Kindness also does an immense amount for their families through the way they are welcomed as active participants in their child's wellbeing (whatever that means in individual cases). For families to see their child /sibling paint with the wheels of his/her wheelchair, and /or creating something with feet or elbows and witnessing active non-verbal communication kindly continued with mute children brings warmth and strength to breaking hearts.
Competence is often critically important with sick people, but it's not an either/or matter looking at competence and kindness. It's the combination that can make very vulnerable people feel they have value regardless of what is happening in their bodies. As a life-long educator, how do you think we can inculcate kindness into medical training and into the organisational fabric of large healthcare institutions?
Imagine you are a person you care for. Think about what would help you best now. Does this give you other insights and perspectives? I believe the training requirements that develop excellent levels of competence are very demanding, but is time built in for reflection? If you were taken from your home for necessary treatment, what else is on your mind? You are the person with the same name, but are you the same person as yesterday? What about tomorrow? Exercises and discussions about identity, similarities and differences, empathy, unpacking complexity and humour all come to my mind.
Can you give an example of how kindness (or unkindness) has affected you as a patient or family member? What was it about that particular act that was so significant and why?
I had an accident that caused very serious injury and coma. Despite my family being given devastating information about my prognosis, from as early as I can remember after regaining consciousness, no member of a very large team of doctors, nurses, therapists and carers ever made me feel that I was not likely to survive or that I would not be able to live an independent life. Their kindness in answering my many questions, never commenting on how much I was repeating myself, or how poor my speech and balance were; always being so positive about small steps I was making and not showing any ridicule at all when I did unexpected things meant that I never doubted making a recovery. While I think it is very important to be told the truth, I don't think I was ever lied to. I believe my questions were answered clearly, I knew so little of what was happening, answers to my questions was what was needed. It was very kind to listen to me and not dodge my questions. Too much information before I was able to process it wouldn't have helped. It could have made me lose hope. Being honest with my family was critical. Over a long period of time my questions changed and even though information was unsettling and sometimes worrying, knowing more was very helpful in ways my rehabilitation was managed by me as well as the team of people helping me. Kindness can take many shapes and forms and being sensitive to the needs of the patient and family takes competence to a new level. Despite some consequences of my accident remaining, kindness was definitely significant in me being able to get on with my life again.
Very different was when I was in the early days of my second pregnancy and heavy bleeding led me to be in hospital. Kindness was absent when I was placed in a maternity ward, could hear babies crying; and occasional comments made that insinuated that perhaps I didn't want this baby hurt like hell. Losing a baby however early in the pregnancy is devastating and coldness and lack of kindness made it even worse.
If one thing could change as a result of the Gathering of Kindness, what would you most like it to be?
For people providing healthcare, despite the challenges I imagine you often face, I would like you to reconnect with why you entered this important field in the first place. Believe in yourselves and know that even when you're under pressure and deservedly tired, the kindness you can give those who rely on you so much can make such a positive difference. Even the smallest gestures, whether a smile as you see a person, a nod of understanding in difficult times, and/or a few kind words consistently given build trust and hope and not only assist the people you care for, you are likely to feel better about yourself too.
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