Tagged: person-centred care
Recovery quilts – collaborations of caring
I have a colleague and friend who is unwell at the moment. It is an awful feeling when someone you know is really very sick – and finding ways to help, and showing you care makes all the world of difference…to them and you!
This blog aims to highlight one way to draw together the social capital among small groups of friends, colleagues, family… whoever… for the purpose of collaborating in the development of a quilt gift to give to a person who is recovering. Bringing together a group of people to collaborate in building a quilt as a gift, is one way in which it is possible to develop a tangible expression of care, concern and hopefulness for recovery. Quilts convey both a physical and an emotional warm, a closeness and some comfort, and the expression of these elements in a gift of a quilt can carry with it some positive affect to enhance recovery. I have written a paper about how this has been done in the past – you can read more about some research about recovery quilting here.
Wabi-Sabi – imperfect is beautiful!
A collaborative quilt doesn’t need a great deal of sewing skill or expertise, and creating a project that non-sewers can be included in is possible. The quilt doesn’t need to be stitch-perfect. In Japanese culture there is a concept of Wabi-Sabi – imperfectly beautiful! I think collaborative care expressed in a quilt is an ideal match to the wabi-sabi concept. A little bit of guidance and some inspiration – everyone can have a go and contribute something, without the expectation of being perfect. A relaxed and inclusive way for everyone to work together. I have contributed to a few collaborative quilts – and in my experience, the beauty really is in the varied interpretations and inspirations of each contributor. The meaningfulness that is sewn into each block is a great way to ensure variety. And, with this level of flexibility – it works!
What is needed:
- Someone that can lead the sewing and guide beginners (someone needs to have little bit of knowhow… but, you can manage with just a ‘little’!)
- Fabric for the top – avid quilters will have a stash! (they can’t help themselves!) Ask them to contribute some… or use some reclaimed/ vintage fabrics from an op-shop. Or – buy a ‘jelly roll’ (cut strips of fabric) from a patchwork or fabric shop. What ever you do to collect your fabric – you will need to give it to your quilting collaborators in a ready made/cut blocks. A block will be easiest to work with if it is a square shape. The size doesn’t matter – but do make sure that all of the blocks are exactly the same size. Here is a free pattern if you need one! And some youtube guidance if that helps!
- Middle – batting. Go to a quilt/ fabric shop and buy the quantity you need. You don’t have to have batting… you might prefer to use a cosy backing instead (eg fleece or chenille). The batting is best new – choose a wash and wear type. I prefer bamboo or cotton.
- Backing – can be a reclaimed sheet, tablecloth, curtain or bed spread (op-shop again!) Or – you can buy some plain fabric for the back.
- Distribute the blocks to the collaborators and encourage people to have a go! The more that contribute – the more beautiful the diversity!
What to do with your block:
Here is a list of my favourite ideas about what to put on your block…. it is only a sample of ideas shared (and borrowed) to stimulate your own creativity! Pinterest is a great source of inspiration and has lots of tutorials and patterns to get you started if you need some! Remember to leave 1 1/2cm border around the edge so the blocks can be sewn together.
- Doilies are a great and simple edition to a block. They can be easily hand sewn onto a block.
- Buttons sewn in a corner or in a shape, eg bird or heart.
- Crochet a mandala or a granny square and sew it on your block.
- Crochet a button!
- Use a simple stitch to make a monogram or to stitch a shape design – eg a heart, star, or just straight or spiral lines.
- Applique – a fancy word that means sewing one layer of fabric over another. You can use fusible iron-on webbing to stick the fabric together and then blanket stitch around the edge of your shape, but you don’t have to.
- Use floss/ embroidery thread to embroider some stitches…. as fancy or as simple as you like. A cross stitch animal, tree, or design in a corner of your block for example.
- Use some yarn or ribbon to make a design on your block and then ‘stab’ stitch it in place to stabilise your design.
- Cut some felt flowers and sew a button in their centres to stabilise the flower on the block. Leave the petals free or blanket stitch them in place. Or make some felt birds!
- Cut a range of various sized circles of fabric or felt and layer them to look like flower petals – secure with a centre button or bead.
- highlight some features in the block fabric with coloured stitches or buttons or ric-rac
- Select a variety of stitch techniques
- Make some tiny pom-poms – or buy pom-pom ribbon – cut, arrange and sew in place as a bunch of balloons in a design.
- Use ribbons or ric-rac to make a rainbow, garden or decorative lines, curves for designs
- machine embroider a design
- Black thread embroidery – feathers
- Add beads and sequins to your block or sew a trinket, mirror disc or charm in place.
Here are some links to some craft sites that might be sources of creative inspiration for some!
Building and giving a quilt together
Relationships are strengthened, emotions are shared and comfort is provided in undertaking this type of collaborative activity. All are stronger together. Have fun making and giving quilts in collaboration with others – a burden shared is a burden halved! And above all…. wabi-sabi! Imperfect can be beautiful – so enjoy the journey what ever your skills might be! Collaborative caring…
I have a few quilting, embroidery and textile artist brains trust that I turn to for ideas, inspiration, tutorage and rescue when needed. Thank you for your encouragement, generosity and skills! When I grow up – I hope to be as expert and generous as you all are in your quilting, embroidery and textiles! xo
Undergraduate mental health nursing education in Australia: More than Mental Health First Aid
Another paper… this time addressing the very important topic about pre-registration mental health nursing education in Australia.
Mental Health First Aid training is designed to equip people with the skills to help others who may be developing mental health problems or experiencing mental health crises. This training has consistently been shown to increase: (1) the recognition of mental health problems; (2) the extent to which course trainees’ beliefs about treatment align with those of mental health professionals; (3) their intentions to help others; and (4) their confidence in their abilities to assist others. This paper presents a discussion of the potential role of Mental Health First Aid training in undergraduate mental health nursing education. Three databases (CINAHL, Medline, and PsycINFO) were searched to identify literature on Mental Health First Aid. Although Mental Health First Aid training has strong benefits, this first responder level of education is insufficient for nurses, from whom people expect to receive professional care. It is recommended that: (1) Mental Health First Aid training be made a pre-requisite of pre-registration nurse education, (2) registered nurses make a larger contribution to addressing the mental health needs of Australians requiring care, and (3) current registered nurses take responsibility for ensuring that they can provided basic mental health care, including undertaking training to rectify gaps in their knowledge.
Click here for more details… Happell, Wilson, McNamara 2014 MH Nurse Curriculum
…and follow for latest publication: here… https://www.researchgate.net/publication/265127066_Undergraduate_mental_health_nursing_education_in_Australia_More_than_Mental_Health_First_Aid
Nurse on the flipside: a patient-eye-view
Fresh from a stint as patient rather than as nurse – I couldn’t help but reflect on my experiences on the flipside. I was lucky enough to have a great bunch of nurses – I am grateful!
But, my senses were sharpened for the patient experience as well, and I wanted to learn from my patient experience to inform my own nursing. Here are some things that I thought about in relation to the ways that expert nurses care based on my own in-bed experiences:
- “Hello my name is…. I am the registered nurse looking after you today…” I was so pleased to see that most nurses do this. It is SO important to orient the person to who is coordinating their care each shift. Knowing who has your back when the chips are down really helps!
- Patient Care Board In one unit, the health service had implemented a new concept of the Patient Care Board which consisted of a large template on the wall near the bedside which includes a daily update of key information. Name, plan for the day, nurse’s name, and medical officer’s name… etc. I was not convinced about its usefulness. To my mind, the information seemed to condense the person rather superficially into a list of tasks (eg ‘observations and medications’). It is reminiscent of a return to task orientated nursing and amplifies the current trend for excessive lists, forms and processes which detract from actual person-care and transcend into attention to documentation rather than attention to person – amber light on! Another interesting observation was the inconsistency of title for health professionals on the boards. The nurse was identified by a first name only and with no designation, while the doctor was identified by title and surname. It is a small matter, but the lack of consistency may serve to perpetuate the invisibility of nursing generally. Nurses, who are most likely to update these boards, should drive a consistency that promotes even handedness. If titles are used for one health professional, then it is reasonable that the same courtesy should be adopted for nurses as well – eg RN Rhonda Wilson/ Rhonda Wilson RN and the same for the medical officer – Dr Susan Smith (eg). If first names are used for one –they ought to be used for the other as well (and in my view first names should be used J). Patient Care Boards – not a fan yet! If they are useful, they should be used well. Otherwise, they risk becoming another ‘busy’ task that detracts from actual person-centred care, despite appearances. Yellow light on this one from me for now, but I am prepared to be convinced otherwise!
- Bedside hand over – not one size for all. The concept of a bedside handover where the person being cared for is included in the conversation and transition of care from one shift to another is a great one – but in a shared bed unit, it is awkward. My lived experience of this was both good and bad… Being included in the discussion and the transfer of knowledge about up to date care is important for people, but personal and intimate information get shared in public spaces too – I just didn’t need to hear about the bowel activities of my neighbours in the in-depth details that I was exposed too. They didn’t need to hear my personal stuff either – and I felt uncomfortable that they could hear that discussion. Bedside handover is an excellent concept –but one size doesn’t fit all. Context, environment and cultural safety are critical factors to consider in a sensitive person-centred and person inclusive model of care transition. The curtains are still thin buffers for voice!
- The linen. Those I have taught over the years will have ringing in their ears – ‘do one more thing’ and ‘make sure the bed is tidy!’, at least I hope they will! A well made bed, and a well maintained bed, matters. I am not talking about mitered hospital corners, but I am looking for more than a compost heap of linen dumped on a person. It takes very little time to straighten the linen, and make it tidy and comfortable. A doubled up blanket tossed under a sheet and precariously balanced on top of a person in a bed just doesn’t cut it for very long! A warm blanket is a kind offer, but a sheet is more comfortable then a blanket for a longer period of time – remember to come back (or hand over) and maintain the comfort level! Remember too that the person is probably sick and not feeling well and they are probably uncomfortable, so don’t add to their woes with omitting to do what you can to increase comfort. Pain relief can be enhanced by ensuring that the person is comfortable in the bed. These are the little invisible things of nursing that make a very real and present difference. The linen – the blankets the bed cover… they matter, they increase comfort, and decrease the experience of pain. Do one more thing – every time! I had some very caring nurses in this regard for most of the time, but there is skill to be recognized in regard to the linen! It takes an investment of caring by the nurse –it is not just a mindless task, and not one that should be overlooked as irrelevant. Expert nurses were the ones that saw the relevance and could carry out nursing care that included acting on their intuition about ensuring that the bed was comfortable for the person – Now THAT IS NURSING!
- Quiet and present nurs-‘ing’ around the bed. Bedside care is nursing territory! It is our space for the delivery of professional health care. How we manage that space is critical to the health of the person in the bed! Nurses are responsible for the bed-based hospital environment and that includes the people who travel in and around the beds to deliver care or related services. Quality nursing is, in part, about managing the micro and little seen or noticed aspects of the health care environment. Privacy, gaps in curtains, the light and noise levels, the smells, hydration and water jugs, accessibility of patient personal items (eg tissues), the conversations in the uni/ward etc… My recent visit as a patient reminded me just how noisy the health care environment is! And, how uncomfortable that noise can be! We talk so LOUD! And we talk LOUDER to be heard over the LOUD! An expert nurse is able to moderate this by practicing in a quiet, present, mindful and listening manner. These are real nursing skills, they are not on any of our fancy flow charts or tick and flick lists to say we have carried out that particular intervention – But, never-the-less, they are extremely important nursing skills – that is practicing quiet and present nursing care. The demeanor of these nurses is noticeable from within the bed – and I am pleased to report that I had the expert care of some especially proficient nurses in this regard. The more of this type of nursing that occurs, the more likely it will mitigate the loud and overly familiar, less sensitive type of care that results in a downward spiral of quality… you might have seen it… the loud abrasive humour, the use of profanity as a frequent descriptor of adverse circumstances, a ‘Darl’ in every bed, and the lazy dropping of the ‘ing’ on words that more properly usually end in ‘ing’. When we let the bar lower to this ordinary type of care, we do nursing a disservice and we do the people we care for a disservice. Nurses are powerfully influential in the bedside environment. Lets lift the bar for our other health sector colleagues – medicine, allied health, administration services and domestic/ hotel services. If we lead by example, and expect a higher standard, other will follow. And, the people we care for will have the optimal environment for recovery. It’s our call.
Nurses – We have extraordinary capacity to do good, and to help people recover. Most of the ways we do this lacks prominence or visibility. I hope I have been able to make some of the invisible a bit more visible today! It is the little things we do that matters and that is how we show that we care.
Here is to my nurses! Thank you for your care extended to me! And thank you for helping me to think more about the importance of what we do to deliver quality nursing care to others.