The Bigger PictureShalini SinhaLast February I was asked to deliver an inspirational keynote address for the annual nurses and midwives conference in Galway (organised by the National Council for the Professional Development of Nursing and Midwifery, the Nursing and Midwifery Practice Development Units and the HSE).
I received a tremendously positive response to it from those who were in the audience. Given the struggle that nurses and midwives are facing, I thought I would share it with you here:
Healthcare is something that affects everyone, intimately and profoundly. It has a real impact on our lives, including, at times, whether we live or die. When such deeply personal aspects of our lives become intertwined with public policies and decision-
making, the personal becomes political. Where, at its most basic, you are workers with a skill to contribute in healing, your job is a matter of public debate and concern. How are you to survive this? How are you to emerge from this as a relaxed, empowered, individual, functioning at the height of your potential - a level needed to bring satisfaction to both yourself and those around you in your work?
You have little say in how this area is structured and delivered, you have little control over the processes of change being implemented, and you receive few enough resources - including emotional resources - to do the job in the first place.
What are the resources required for a human being to heal? In my experience, the single greatest resource that a human being needs to heal is attention. And, a certain kind of attention: relaxed, pleased, loving attention. Try it here.
When was the last time someone gave you the message they were pleased with you? (Laughter from the audience.) This morning when you arrived at this conference? Last week? Last month? (More laughter.) Did you arrive here believing you were welcome and others were pleased with you? Does it make a difference?
Close your eyes. Notice the current state of your body. Notice the areas of tension and stress, some of which you may have carried around with you for months or years. Now, imagine everyone here is pleased with you. (Laughter.)
If that's too big a leap, imagine I'm pleased with you, because I am. I'm pleased with you for the work you do and the specific contribution you make in the world. Let yourself really believe in it. Does it make a difference?
Notice tension come out of your body, your mood improve, your attitude change and possibilities open up in your mind. Before we even begin to treat anything else, relaxed, pleased, loving attention is a profoundly powerful resource affecting mental and physical health.
Our healthcare system has access to and requires many resources. However, the one resource it lacks most in its structure is attention. Because it is so dominant (and we have made it dominant through our policies), we often lose sight of the fact that it is a specific system with a specific philosophy, and so it has limits in what it can achieve and how it has developed.
Our modern healthcare system is based on allopathic medicine, which holds at its foundation the idea that foreign invaders cause sickness and that healing involves intervention.
As a result, it is very dependent on technologies and has developed a strong, hierarchical structure. As is normal for such structures, an oppression has set in. The question is, does this structure serve us in our struggle for health?
You know what I am talking about. You feel it. And nurses and midwives are among those at the bottom of that structure. That doesn't mean your work lives are the most difficult, it means there is a particular quality to the difficulty you face.
The irony about oppressive structures is that those with access to resources (including privileges) in the system tend to be denied access to resources in human terms. On the other hand, those denied resources in the system are able to maintain access to resources in human terms.
Thus, it is no accident that while nurses and midwives have little structural power within our healthcare system, they are the most able within their jobs to provide care and attention - human resources an individual needs to be empowered in their own healing when they feel most vulnerable. You are key in healing.
Still, it is not possible for a human being to provide a resource unless they also receive it. How can you love if you don't receive love? How can you support others if you are not supported?
I would like you to think of yourselves as leaders in healing. In order to do this from the bottom of the pile, it is important you set up structures to support each other in your jobs. In the absence of anything better, take charge of providing the resources you need, for yourselves. Individually you may be too disempowered in the system, but together you can recover your voice and have a real impact on bringing humanity back into healthcare.
ssinha@irish-times.ie
Shalini Sinha provides life coaching and the Bowen technique.