Last Sunday, team “Nurses Matter Too,” born during the NYC OpenIDEO session the Monday before, met for its second ideation session in a Midtown office space secured for our purposes by our organizer, Lee Kim. We sat around a conference room table with chocolates, juice, and piles of materials pulled from recycling bins. Lee played the audio transcript of her recent meeting with one of the nurses she interviewed. Since this nurse prefers to remain anonymous, she's referred in this post as Jean, a pseudonym.
Jean has been a hospice care for nine years. She cares deeply for her patients and loves her job. Lee asked probing questions during the interview, and Jean opened up to her easily. Jean proved to be an exceptionally candid and self-reflective interviewee. As the five of us sat and listened, we pulled out her most memorable and significant comments and noted them on post-its. A portrait of a true giver emerged. We learned how constantly giving to the dying has the potential to emotionally drain and depress caregivers. Jean had struggled with her personal demons, and learned to handle them in a way that made her a deeply empathetic caregiver for the dying. After years of feeling guilty for needing to invest in her own self-care in order to thrive in her workplace, Jean spoke of how she learned to give herself permission to care for herself first - through meditation, yoga, and a range of other spiritual practices. Caring for the dying now seems an extension of her spiritual practice.
Next, Lee drew an empathy map and divided the white board into four categories: FEEL, DO, THINK, and SAY. We discussed our impressions of Jean’s journey, and assigned each post-it to its best-fitting category.
We then used gigantic sticky notes to map out our thinking. Then we wrote down what we were “amazed to realize.” For Jean, the ordinariness of life has the potential to be extraordinary; this insight has the potential to be powerfully liberating for people nearing the end of their lives. Jean shared that she had cried just a few days ago while caring for an elderly man as he passed away - a man who felt truly at peace with his own death. He felt he had lived fully and had no regrets, and she wished this for all her patients.
We were amazed by Jean’s capacity to find beauty in dying, and to help her patient fully inhabit this state of grace. We were amazed by her willingness to be vulnerable to herself by tackling her own struggles with depression and anxiety so courageously, and amazed by how this hard-won growth and self-understanding empowered her to be radically present to her dying patients. This kindly, raw humanness enriches the death experience for Jean’s patients immeasurably - and enriches her as a caregiver and person.
We were amazed by what happened when Jean dropped the boundary between work and life. Work became an extension of her best possible life; something that had the capacity to fortify her as much sweatily facing her demons on a yoga mat - but only when paired with her dedicated self-care practice outside of work.
In short, we intuited from the data and from knowledge of our cultural context that medical care providers are trained to be competitive, to be the best, to sacrifice sleep, to give everything. They learn to treat themselves as candles. Eventually the wax pillar supporting the wick melts away, and the wick burns down to nothing. Providers know this, and cut themselves off from patients emotionally in order to preserve their wicks and get the job done. Some fully depleted providers spend time giving care with no wick at all, just a flame trying to stay alive against a metal base in a pool of fast-evaporating melted-off wax. We wondered what might be possible if we moved away from the candle model. Or, at the very least, what could become possible if we taught providers they are worthy of taking personal time to extend the length of their wicks, to heighten the sturdy wax of their pillar-trunks?
Next, we each named the wildest, most impractical suggestion we could dream up. Suggestions ranged from using fashion to visually “encode” providers’ level of emotional well-being in order to foster community support, to including empathy work for self and others as part of medical school curriculums, to creating a context for providers and patients to practice yoga and meditation together with a seasoned spiritual guide.
All in all, it was a highly creative and productive session. We are in great shape for the upcoming round of prototyping!
June 23, 2016 - By Page Whitmore