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We spend a lot of our time helping colleagues to manage complexity. Systems thinking, theories of change, emergent leadership, reflection and learning, service design: there are many combinations of tools we deploy. But today I was reminded again that public services continue to fail to pass the simplest challenge of all: how to value and care for people. Staff. Patients. Relatives. Carers. Honestly – it’s not that complicated. Until we empathise, walk in others’ shoes, and do the things that matter and allow people to flourish as human beings, no fancy fixes, reorganisations, contracting-outs or integrations are going to make things right.

My friend Sophie is on a Back to Nursing course. She was a senior nurse practitioner before she had children. Currently she’s in the middle of a 100 hour placement on a 38-bedded medical admissions ward. It’s horrible, on many levels:

“I should stop being saddened by what I see. So, for the unmotivated carers who do more damage than they care to care about, you will not deter me, for I know the truth. You are not my role models and thank God real student nurses don’t come here. It would be a terrible place to put them. It’s a terrible place for me so far, but I’m old enough and wise enough to see through it and see it through. The others might not be so lucky. It’s these environments that lose us nurses. 

It’s almost like you have to lower your expectations to fit in, which I suspect is what the patients do every day. Isn’t that terrible?

And as for the senior sister who shouted at me for taking uniform to wear as I’d been told, and the matron who I asked if I could have a word with at 8am, and I said “no rush I’m here til 3”, but she never bothered to get back to me. And the ward sister who I ask several times for the name of my link teacher, but she couldn’t remember the name … She didn’t think me worthy of a name badge either. I did: I thought it was crucial for all patients to see and staff to wear; hard for me to understand why a simple measure like that wasn’t implemented … it told me that a 100 hours of hard graft on her ward meant nothing at all if I didn’t warrant a name, let alone a thanks at the end of the day or even a good morning when you came in. And her again who never spoke to the relatives of my patient Mr Singh with his locked in syndrome stroke, after I asked her so nicely. Still the day went on, and it was a better day than the other days* … Amongst other things I cared well for several dying patients with no voice and then comforted their relatives in the day room afterwards, and I did it well and I will return. At least I now understand what it is that I need to do to carry on. 

And a glowing report from one set of relatives of how I’ve cared for their mother with dementia in the back my practice book makes up for the empty pages from my mentor who couldn’t be bothered.”

* Her stories from earlier in the week are if anything even worse. No dignity. No care. No time. No information. No hope.