If you’ve read a few of my previous blog posts, it should come as no surprise that I’m prone to a bit of thinking and reflection. My main outlets for this are this blog and a reflective learn set that I’m part of. Over the past months, however, I’ve been finding it increasingly difficult to make time and space for that reflection (hence the 3 month hiatus between blog posts!). The irony of someone who works in a university saying that they don’t have time to think isn’t lost on me.
Of course, this problem of having the time to think isn’t limited to us academics. It’s pretty endemic in our world in general. And there are many reasons why as a society we find it increasingly difficult to find the time and space to think. But in this post I’m want to muse on three things about thinking. The first is the value of thinking and reflecting, especially for staff working in action-oriented settings like health and social care. The second is the difficulty of stopping to think in these settings. And the third is what we, as knowledge mobilisers, can to do help. I’m going to wrap all of these up into 3 short stories, based on my experiences over recent months. Obviously all names and locations have been changed!
The first story dates back to around 2014 when I’d was designing a project to gather feedback from people about the health and social care they were receiving. On the day in question, I’d gone along to a 2 hour meeting where Helen, an older person who was involved in the project, was going to give the feedback to a community health and social care team. The team’s job was to reflect on the feedback, using a specially designed guide, and work out if there was anything they could do differently. My role was to watch what happened.
Helen’s feedback to the team was that some people struggled to know who to get in touch with when they needed help or advice about an aspect of their care. Helen left when she had given her feedback, leaving the team to talk about what they had heard. Straight away they started talking about the ‘green folder’. This was a folder left in every patients home that contained details about their package of care and in which team members would write about what they had done during each home visit. A couple of the nurses started talking about how they put stickers with their contact details in the green folders. They suggested that everyone who visited someone did the same. Much to my surprise, that was the end of the discussion. Someone wrote down what they had decided to do and the meeting ended. After the meeting I told Helen what had happened. Helen knew all about the green folders, having previously worked in an organisation which provided support and advice to older people. She explained that everyone she talked to knew that the green folders contained too much information and that older people struggled to make sense of them.
For me, this was one of the earliest indications that staff working on the front-line of health and social care might need some help to stop and think. The team’s rush to a solution seemed perilously hasty. What if, I wondered, they had taken a bit more time to think about the feedback they had been given and explore their options? What if more people had been able to share their thoughts and ideas? Might they have come up with a solution that didn’t involve giving yet more information to people who were already overloaded with it?
The second story is more recent, and is an example of something that happened more than once as I tried to actively help staff from community health and social care teams to share knowledge with each other. I was sitting in a meeting where team members were talking about some of the people they were looking after. Ramona, one of the nurses, was talking about one of her patients who she had been worried about for quite some time. As she talked, I was struck by the way that she had been saying the same things to her colleagues for several weeks and just didn’t seem to be making any headway. I decided to intervene and see whether asking a question might prompt a bit more knowledge sharing and enable them to move forward. “What do you need to know to move forward?” I asked. Straight away, Ramona reeled off a long list of everyone who had been involved so far and what they had done to try and help. A couple of people suggested the names of other people who might be able to do things and Ramona made a note to follow these up. They then moved on to talking about the next patient on the list.
When I reflected on this after the meeting, I realised that even though I had been asking a question about what Ramona needed to know, her response only dealt with what she or others needed to do. No one seemed to hear the knowledge part of the question. Once again, the imperative to act (or ask others to act) seemed much stronger than my invitation to stop and think.
The final story is about something that happened just the other week. I was talking to Pete, who had been involved in helping to set up a new network for leaders in a local health organisation. The network had started off with a series of meetings where members would be told about recent developments and news from across the organisation. Pete told me that as time went on people were finding these meetings increasingly frustrating, and wanted more of an open space for reflecting on and thinking about some of the issues they were facing in their day to day work. He told me about several conversations where people had said that they desperately wanted the time and space to think. So the meetings were changed and became a space for small group conversations. Unfortunately, Pete had found that this hadn’t really worked either. The conversations had become very stilted and people seemed to spend most of their time sitting and looking at one another. As we reflected on what was going on, Pete told me “the trouble is that people spend all of their time doing, so when you give them the time and space to think they just don’t know what to do with it”.
Taken together, these stories have helped me to think again about my role as a knowledge mobiliser. For me, this isn’t just about helping groups of people to access, share and develop knowledge. A really important part of my role involves helping them to learn and practise the art of stopping and thinking. Because it’s only when people take the time and space to think together that they are able to come up with truly transformative and innovative actions.
I hope that these short stories (and very long blog post!) have illustrated my thinking and provided you with some food for thought. As always, if you’ve got any musings or thoughts of your own, please add them to the comments section below.