The 6Cs of nursing, Care, Compassion, Competence, Communication, Commitment and Courage. Now what I’m about to write over the next 6 blogs on a basic level is a bit weird for me, because as anyone who knows me will tell you, I’m not someone who really goes in for catchy models or mnemonics. Having worked in the public sector for 15 years I’ve had a bellyful of mnemonic models like the 6C’s – from the ‘5WH’s of offending behaviour’ to the ‘ASPIRE’ of social work (showing my age there) and the SUMO approach to teams. In a nutshell I think they’re usually passé ; few new ideas but a new model to rehash old ones.
So, the 6C’s, yeah. Almost seems like a policy approach to instil personal values in professionalism. An idea to get hearts to attune with minds rather than natural behaviour where thought follows emotion. It’s an odd concept for someone on the ‘outside’ ie non nursing, looking in.
But, and this is a big but, I believe in the concept. If every medical professional that we’ve had contact with in the last 3 and a half years had well developed connection between mind and heart in each of the C’s then our experiences would have been different. I wont say ‘better’ because the statement would read that we weren’t happy with our experiences and as I will always, always, repeat the ones that let the side down are (thankfully) in the minority.
Over the coming weeks i’ll try and tackle the 6C’s one by one and look at what they mean to us as a family, both experientially and our aspirations for Isaac. Can I first state that no offence is meant anywhere by my honesty if it seems critical and i’ll do my best to share the story not the people. We remain incredibly thankful to every single person who has been involved in Isaac’s care.
Well, how is care defined as Isaac’s dad. I guess initially my experiences were of his physical care afforded in NICU and it’s a total and utter transfer of care. As NICU parents what we experienced was a whole, complete and utter transfer of care passing over our little unwell babies to people we’d never met and in Isaac’s case this carried on for over 3 months ; we never ‘cared’ for him in a physical sense. “What about doing his ‘cares’?” I guess some of you nurses may be thinking ; yeah well, from my perspective it felt like a tokenistic name for helping out in the nurses care of him rather than that we were caring for him. I guess the key thing for me is that in order to be ‘caring’ as a parent I think I have to feel like I’ve got responsibility for providing it ; the reality of Isaac’s 3 months is that that responsibility for his care lay with the nurses and doctors looking after him. A nappy change, a mouth swab didn’t really make that feel different for me and I almost resented the way ‘are you coming doing his ‘cares’? was said like we could only offer that bit of support when it fitted in with others routines. So physically, care wasn’t ours to give initially. Now, Isaac’s entire life consists of physical care 24/7 shared between 6 trained people ; me, lynsey, our mums and 2 staff at Rainbow House. Isaac would not live without this 24 hour physical care.
Care though is more than physical and this is where it’s tricky for an NHS initiative to direct thinking. Care is more than ‘taking care of’. It’s about ‘caring about’. If it’s on a job list to ‘take care of’ something then it’s easy to do as it says – I’ve taken care of other people’s kids, I’ve taken care of things at work for people, but there’s no empathic connection let alone an attachment. To ‘care about’ means to invest in the link, to share empathy and even to, god forbid in your professional life, form an attachment. Thankfully, Isaac has experienced, and still does, professionals who ‘care about’ as well as ‘take care of’. It generally comes from ‘taking care of’ for a long enough period that a bond forms (in some ways I wonder if this is how it is with parenting haha!) but I’ve seen nurses, and other health professionals form a bond with Isaac over months and years because they let it happen. Unfortunately there’s a school of thought in some though that to let that bond develop is a negative thing ; that suddenly the professional will become less than professional ; that they’ll become subjective and not be able to remain objective ; that they will ‘change sides’!. This overlooks people’s emotional intelligence ; I know and I mean KNOW, that there are people who have looked after Isaac with very high EI who have been able to show all levels of care ; to empathise, to express their own happiness when he’s happy, to express their own sadness when he’s unhappy but to be able to regulate that within professional parameters. Conversely, Isaac’s had professionals, Doctors more than nurses purely by number, who show little connection or interest and my god how it shows – what do we take from these people as Isaac’s parents? We take it that they don’t care. They haven’t shown the connection we need to see. I mean the people who if they looked through the DSM IV would class us as parents as neurotic or histrionic at different times, see people who express ‘care about’ as having poor emotional regulation and see people who challenge their judgement without hitting them as passive aggressive. You’ve maybe worked with them.
Care is a four letter word. You can throw it about in a professional setting without much consideration I know. But for parents of a child with a disability we want professionals to show both sides of care ; taking care and caring about. If you do the first part without the second it’ll feel hollow and we’ll see it, if you invest in the second part too we’ll see you as being one of the most important people in our child’s life.
This blog is dedicated to the ones that have shown both parts ; the NICU nurses who would rearrange Isaac’s ‘nest’ in his incubator when they themselves were knackered and at the end of a long night shift, the people who look to give him the best play experiences and cuddles when looking after him at nursery, the people who would challenge and act on Isaac’s best interests for us when we’re not there.