Thursday, October 6, 2016

HSE master class for HSE staff 2016

My lesson from my bed - to you
Master Classes are an excellent idea.
Master Classes means and recognises that changes are needed and experts are invited to network with fellow man to make such shifts.

MY master class is the same.
it is constructed to bring about change but also to understand why it needs to happen.

it is of course in regard providing healthcare
i will look at the 'do's and don'ts' for professionals facing clients.
what is the relationship in the beginning and how it goes wrong
Once your patient client was happy and having some fun
once your patient client was Free Strong and Independent
Your patient had lived a lifetime - just as you have
your patient had lived a life full of achievement - just as may have or will
I will look at the broken client and the professional
what brokenness means to the client and to the professional.
How can one make brokenness whole
the cost effectiveness of an exercise to mend a brokeness

what is the relationship at the end and how it can be so right and move forwards 'onwards and upwards'

Do's and Don'ts


  • the client is sick (they are never going to be well if the professional is a healthcare professional.
  • the client doesn't expect trauma or more trauma or stress or invites this upon them.
  • the client usually is sick and only wants to have a decent life
  • the client wants to be liked and also wants to like the healthcare worker
  • the client is equal for we are all human beings
  • you too could get sick and would expect it as equal, caring and decent life.
  • the balance of professional and power in a sick persons life is not a comfortable one ever
  • the person was a strong and is a strong person but vulnerability has seeped in, therefore sensitivity has to be really 'owned' by the professional, as part of the skill of being professional

  • come into an unknown person's life (who is sick) and expect a perfect relationship
  • be demanding and persuasive because hairs on the back will rise
  • act as if you are mother, father, boss or superior
  • look down on a sick client for any reason whatsoever
  • presume a person is one way unless you get to know them well
  • say you understand their needs when you only speak to them on the end of phone or indeed never even meet them
  • expect to be liked - that has to be earned
  • expect a client or patient to be grateful - they are sick and you are providing a service through your professional career and you get paid.
  • be put out if a sick person withdraws appreciation or is rebellious - they are sick
  • expect it all to be rosy in the camp if you the professional have caused hurt and pain and suffering when the client sick patient was expecting nurture, care, calm and support and healthcare
  • ham up and expect love back
What is the relationship in the beginning and how it goes so wrong

when a person becomes so unwell they need help from healthcare professionals they are walking into a situation that they expect by the nature of the professionals that they will receive care, they also want to be nice and respectful and they strive for a working relationship that initially will be incredibly strange.
if they never had much involvement in healthcare professionals in their home for instance it may be so difficult it is refused at first and it can be very uncomfortable to allow a stranger in and have to let them in over and over.
people who are sick and in such a situation are nervous, doubtful and afraid.
most sick people become physically weaker and not stronger, but if they are screaming and shouting it means they are in pain and upset and distressed and elders who scream and shout are undoubtedly even more so.
rarely by the late ages will a person change so drastically that you cannot determine whether pain and suffering is that or not anger, abusive or even dangerous.

Most sick people want a friendly relationship with a healthcare worker.
it is beneficial to have it so.

When the relationship goes jam side down, bottoms out or explodes to extremely poor connectedness it possibly isnt the sick persons fault.
something has happened to change a dynamic that started off with a shy and fearful patient wishing to engage and wishing for support and friendship.
patients do not create havoc when very sick, they just want to be held in care.

If a professional has made a bad judgement or been silly, idiotically unprofessional or cannot amend a wrong doing or has made a bad situation worse the only way it comes back on track is to view the timeline of wrong and see what went wrong and why.
then you right it, as swiftly as it occured you bring the relationship back to what it once was.
the longer it is left to fester the harder it will mend the relationship.

to defend a wrong doing is about the worst judgement statement any healthcare professional can make.
to label a client with strong words, abusive words and alienate them, is YOUR fault, not theirs.
it is always intrinsically up to the professional to act professionally.
it is not up to the sick person to either understand how to be a professional patient or how to have a relationship with a professional healthcare worker, its an alien relationship for starters but could be a friendly engagment, but its not up to the client to always be the one to stroke a professional and give comfort to the professional when the balance is not equal in status but should be equal in humanity.

If you are a professional and make a mistake immediately make amends.
investigate well, with strong investigative intelligence.
never judge before you have really looked at the situation from all angles.

if you make a judgemental remark on the sick persons character or personality you are doing it from a strangers viewpoint, because the professional is a stranger to that person.
you are not a relative, a friend, or a partner.  You are a stranger.  YOu are new in a new dynamic.

if you make mean and horrible remarks and let that fester or embellish it and refuse to mend that dynamic you are going to find it very very hard to win your patient back onto your side.
you are now making an enemy and making one fast and irreversibly so.

You are not their parent, their mother, their father - do not act as if the patients, sick person is a child or an idiot when they are possibly very intelligent and definitely an adult.
a sick person has operated their lives to this time in a certain way, with their own perceptions of their character and personality (they will know their weakness, and will not need more piled up upon them by a stranger), they will absolutely have a routine and certain way about the house, their home and the way they use their environment.
they also will know how their body feels when in pain.  they will know how their mind reacts to he illness.
they will not know how to react to aggressive stances from strangers who are also professionals.
this is way outside the known of a person who is now sick.

they will have a perception of a healthcare professional as being a cross between a saint and a florence nightingale.
they will be in utter shock if this myth is dissolved as like a disprin in water.

crossing boundaries are absolute no-no's.
this includes, crossing the rule that the house and home of the sick person is just that, the house and home of the sick person.
you are not entitled to make character and personality statements unless you have walked the preverbial mile in their mocassins.
you cannot expect a lick, a stroke or a compliment if you go against the truth a person has of themselves, their belief systems and their personal space and environment.
if you violate these, you have in fact just violated a person, you have failed now to hold intact values that are vital to ensure that confidence remains intact and that a relationship of mutual understanding can be embraced for a period of time.
it is never acceptable to break a delicate balance in a person's time when she is sick and vulnerable
i think once it is recognised that harm and damage has been done, the only way to go with this is to mend that.
it is never up to the patient, sick or disabled to patch up a mess another has created.
it will be arse to believe you will have a friend for life if you cock up on the patients patch, metaphorically and physically.
if you act like a lump hammer, you will be told you have in no uncertain terms.
this should be expected.

if you mess up in school or university or in the principals of friendships and make a pigs ear of it, you will be told in no uncertain terms to 'shape up.'

if you are a healthcare professional it doesnt exhonerate you from 'shaping up' and making amends.
in fact part of your training will already have been to care for an individual therefore making a bags of it all will rebound upon your professionalism and to bring it back on track, the whole thing on track amendments must be put in place.

a sick person doesnt have to be grateful to a professional automatically.
gratefullness comes about when its earned.
as is any relationship, trust, honour respect all have to be earned and can be utterly obliterated by constant harrowing experiences from the point of view of the patient.

if the professional is bloody sick of a patient who screams at you for what you are doing to their lives, their comfort, their peace and their home, and if she has a right to scream because you are doing bad things to her life, her comfort and her peace and her home then expect the scream until you change the way you treat a delicate person who now is sick.

if you butcher a person do not expect mercy.  your job was a professional one, and if you treat a person well, you will get this returned in spades.

if you consistently change goal post, renege on promises, withdraw care, abuse, name call, demand and are generally too much in the face of a patient who is not your relative, partner, lover or sister or mother or father than you deserve all you get - the role now has been redefined, by YOU, not by the sick person who had once great expectations and respect and now feels punctured and cruelly suspicous of your real intent.

when a broken relationship has been formed and cemented by injustice one upon the other, then a mending process has to be initiated.
Exhaustion through trauma, will never break down a great persons soul - people change so little - if they are composed strong they will remain strong but they also will change viewpoints in face of trauma
if you have a perception of the sick person then see if you are right.  go judge it.
and you can only judge this by meeting your patient regularly and be able to watch and view and shape up what their life is really like for them.
take on board their life style, their pain.  dont butcher it with your definitions, use the skills to view theirs.

you really do have to know your sick patient.
you cannot work in a relationship without knowledge.
you cannot demand over the phone, by email, by letter or by making remarks or withdrawing care.

you are going to feel shit by recieving shit back.
if you create a shit situation for another you should expect shit back, not expect a person to be grateful for abuse and pain.

you are the professional.

when hurt occurs and brokeness occurs a deep added wound has happened to both the psyche and the character and the perception of that person to that person of you as well.
wounded relationship once started with an expectation.
if its broken down you have lost it.
you have caused severe pain and suffering and the person can never expect to view you the same way again.
wounds of this nature are not easy to mend.
dont expect that if you add a little bit of care and do not show full sincerity and show compassion and understanding you will be met with suspicion.
once you show something of compassion and care in a generous dollop of genuine remorse and ownership, you are beginning to win your client back.
A haunted face reflects 'damage'  where deep wounds have been inflicted, this can intrincially never be eradicated
Once your patient client was happy
and having fun -
A wounded soul, and brokeness will bring but only an attempt of a smile, if so broken mending has to be achieved, once inflicted harm may never be eradicated
i doubt if deep wounds have been inflicted you can ever expect to have that person on your side again.
thats why divorce occurs in everyday relationships.
if its broken down so badly, you shouldnt expect to be received in the same light.
what you do is, you mend it to build confidence and allow the service which is caring to be trusted again.
you mend it for your own self respect not to win back respect.
you mend it because its the right thing to do as you hold the power balance.

if you mend it significantly then maybe you will see a shift and a coming together and meeting of minds.

you do this by engagement.
speaking to a person, long and hard getting to know them and understand them.
you apologise, you embrace the need for change and you change the dynamic never to break it again once you change the dynamic back to a healthy one.
you allow a person to be free from the reins of power which has so crushed and damaged them.

if they want that, the way you mend a broken relationship, you give a divorce agree it has broken down and offer the options available.
you work out a plan to start again.

you will win a person back and you will have a healthier relationship if you are honest, hear them speak and try their ways rather than insisting on yours.

cost effectiveness.
the patient who has been very hurt and wounded can only be this through time.
they then build a picture of how they see their care would be delivered to embrace them in care and  give quality of life back to their own selves and their own lives.
dont snuff of the offer of a different way.
it could be cheaper and get you off the hook faster and easier and cheaper.

you have been faced for a long period with a weeping, screaming banshee of a patient who is hurt, harmed damaged and in pain because of what happened in the relationship dynamic that should be equal in treatment of a human being but which has been damaged through power.
you have to 'give'.

there is no option to expect a person to see you, your healthcare systems, and your authority any other way than abusive if they have been on the receiving end of it
it is impossible to deny the damage done as its become -
a lived experience
it is impossible to deny the damage done as its become -
a lived experience
when abusive practise has profound consequences
it is seen in the face of the victim
if you want to turn it around to make it cost effective you work with them.
you mend it.
you save it and mend it for good never going backwards
No, the idea she came home to die through pain and suffering of unimaginable proportions was not something your client sick patient expected
and you admit it, and redress the wrongs built up which has caused a brokeness that the client patient never thought would happen in the first place.

My master class has ended.
the test has been set.
stop speaking
start mending.
you have...such and such a period left to do it....after that you will recieve your marks, either failure, pass or honours.
you chose, after you do the hard work, if you wish to pass a master class with flying colours.

when your hand reaches forth and says in tone, word, action, compassion and care -
"come out, do not be afraid, i will give you care"

This is the day your wounded sick are waiting to hear but also the only real answers are - ACTIONS

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