Blog: Red and yellow will never make green

A benefit of having counselling and psychology training before you go through watching someone you love die and feeling that opportunities may have been missed (as I had), is that you have tools to unpick some of the complex emotions evoked and reactions experienced.

You ask questions of not only the facts, but the reactions of the individuals involved, the organisation, culture and indeed of your own reactions.  Whilst obscured for a time by shock and grief, a strong sense of empathy and my own emotional development, as is imperative within psychological therapy training, enabled me to slowly see both the world of the medical team and indeed the Trust.

I needed to understand their hospitals reactions, despite how wrong it all felt and knowing the need to still challenge them. This in turn, enabled me, to understand what barriers might be preventing, what felt like the most important thing in the world…honesty and compassion.

However, skills of empathy toward me were missing greatly from the staff and organisation at large, which appeared, unable to look after my well-being in any way, let alone giving me any confidence that they cared enough about what happened to investigate well.

As a consequence, conflict, anger and distrust manifested itself, and further far reaching damage prevailed.  Preventing psychological harm to me and my family, was not, it appeared on anyone’s radar, apart from mine, and as we hear over and over again, is still not a priority in practice.

At its most basic level, the Trust not wishing to hear the basic facts that I witnessed, demonstrated no empathy to me for what had happened, what I had seen and what I was left handling. Compromising not only my well-being but any chance of ‘lessons learnt’

The Role of Empathy in Conflict Resolution

The world of complaints, the NHS being no exception, is often synonymous with conflict, this being almost an expectation from both sides, even if not desired. So often however, the emotional motivation of the complaint is given little or no credence or understanding, yet nowhere is this more imperative and needed than in medical organisations, or where harm has already occurred and the subject matter is rooted firmly in human emotion.

The example above validates this as what could be more emotionally charged than watching a young person you have nurtured for years, slowly die.Conflict resolution however, seems to overlook the human requirement of empathy and the vital insight and protection it can provide to all involved.

Carrie Menkel-Meadow, Professor of Law and Political Science, University of California Irvine Law School, describes in her book, Peace and Justice: Notes on the Evolution and Purpose of Legal Processes, (2006) Georgetown Law Journal, 94(2), 663, p28, the theory of “process pluralism” which is the idea that those with often opposing views needing to be able to ‘pay attention to different systematic values’. Menkle-Meadow states that…

“Modern science and legal life needs to get beyond the binary, adversarial idea that there are only two sides to an argument or the ‘truth”, she adds. (p. 554, 2006). Therefore, empathy is necessary not only for emotional literacy at a personal level, but to be able to understand, feel, engage and act when in situations of conflict with others”.

Procedures and policies

Procedures and policies are altered and tightened up, but emotional development of staff and their own emotions and needs, in turn empowering their empathic ability is not invested in. This leads to missing vital opportunities to understand what is motivating conflict and to prevent prolonged psychological harm. The same ‘colours’ (components), are continually added to the mix, yet a different end ‘colour’ (result) is constantly expected and surprised declared when it is not.

Last month (March 2016) Jeremy Hunt, again, stated that……..

“But to blame failures in care on doctors and nurses trying to do their best is to miss the point that bad mistakes can be made by good people. What is often overlooked is proper study of the environment and systems in which mistakes happen and to understand what went wrong and encouragement to spread any lessons learned. Accountability to future patients as well as to the person sitting in front of you.

The rush to blame may look decisive. It may seem like professionals are being held accountable. In fact, the opposite can happen. By pinning the blame on individuals, we sometimes duck the bigger challenge of identifying the problems that often lurk in complex systems and which are often the true cause of avoidable harm.”

What ever your feelings and views on a political spectrum, whichever government is in or Minister in charge, we, as human beings, remain emotionally driven beings. This is the one constant.

Jeremy Hunt went on to say…..

“Organisational leadership is vital if we are to change this – and we can see world class organisations inside and outside healthcare have a very different approach. They have the boldness to probe more deeply, thus learning precious lessons.

Which is why we need a new mindset to permeate the entire ethos of the NHS, where blame is never the default option. Justice must never be denied if a professional is malevolent or grossly negligent. But the driving force must be the desire to improve care and reduce harm – fired by an insatiable curiosity to pursue improvement in every sphere of activity. This is what I mean by the world’s largest learning organisation.

And when we give patients an honest account of what happened alongside an apology, what is the impact? Countless academic studies have shown there is less litigation, less money spent on lawyers and more rapid closure, even when there have been the most terrible tragedies.”

Adding blue and reducing the cost

I agree that leadership is crucial: A change of colour needs to filter down from the top, with the need for leaders to develop an environment where empathy and emotional development can prevail for staff training and not just for complaints. Then understanding of the conflict on emotional terms and the process of psychological care can be viewed as just as important as the resolution itself.

But the driving force, as Jeremy Hunt states must be more than “the desire to improve care and reduce harm – fired by an insatiable curiosity to pursue improvement in every sphere of activity” It must be validating the experiences and lives of those damaged. On a human level, the cost is emotional too, not just financial.

Repetitive statements are often announced on an individual, organisational and government level over learning, changing and working in an ethical and humane way. Yet in reality, the colours of the complaints system and learning from mistakes, fail to change. If we imagine yellow as procedure and policy and red as fear and apathy (often unconscious), these are the components that will colour the outcome. Until different colours are added to the mix, the end product will remain unchanged.  Yellow and red will never make green, only when you start to add some blue and acknowledge the red to dilute it, will you achieve green. Policy and apathy alone, will never feel caring.

Daniel Goleman, author of Social Intelligence: A New Science of Human Relations, (2006) States that…..

‘What distinguishes leaders in medicine, goes far beyond [medical knowledge and technical skills] into interpersonal skills like empathy, conflict resolution and people development. Compassionate medicine needs caring leaders who themselves can give their staff a safe emotional base to work from.’

By – Carolyn Cleveland







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