The Relay Race of holistic care

Integrated holistic care of people incorporating a 

‘Bio-Psycho-Social-Spiritual’ 

approach is akin to a relay race,

 not a competitive sprint event!

By Drew Mellor 

 

Half a life-time ago, when I worked as an ED Nurse (Emergency Dept Nurse) I was participating in a multi-discipline  debrief of a tragic incident within our department. Present were medical, nursing, radiology, social work, ED Orderly and chaplaincy personnel, all of whom had key involvement during the “signal 1” response and associated attempt at resuscitation of the young patient. Although the official term was not applied in the 1980’s, the Bio-Psycho-Social-Spiritual approach to integrated holistic care was acknowledged and was certainly the “lived experience” of personnel engaged in the critical care context. 

 

In my role as ‘Resus Nurse’, I facilitated the team debrief, and commenced with an ‘open reflection time’ (focused mainly on what worked well). I introduced the analogy of us as a team, running a relay race, not an individual competitive sprint race, highlighting the unique contribution we each made and the strategic importance of handing the baton to the appropriate ‘leg’ of the relay; and I reminded them that the critical time of team interaction was the “baton change” and the potential for dropping the baton if this critical interaction was not done efficiently and with care. On this occasion, the baton change transitions were effective.  The image was immediately engaged and used to better appreciate the integrated approach that we had witnessed and experienced.  

 

More recently, during deployment as an emergency services Chaplain in the 2019/20 Bushfires, I had opportunity to join an ADF medical team as their ‘Padre’, as they undertook a patrol in a ‘Bushmaster’ to check in on families cut off by fires in a remote part of Victoria. As I got to know various multi-disciplinary team members in the vehicle, I shared with the ADF nurse that I had a background as an ED nurse and that such training significantly equipped me for my role and responsibilities as a Chaplain. During a particular encounter, the commanding officer, after discussions with a family member at the gate of a property, turned and pointed at the ADF Nurse and me, (the chaplain) and said, “you two are up, I’d like you to assess the situation and report back”. Meanwhile the engineers cleared the driveway of felled trees so the Bushmaster had access. 

 

As the nurse and I walked to the house, I commented how much I appreciated the genuine integrated holistic approach that the ADF took toward the care of an individual person and I noted that there is much that we, as Emergency Services Chaplains, can learn from our ADF colleagues, especially in their genuine integrated approach to both planning for holistic engagement and in the way we plan for follow up of critical incidents. There may well be a legitimate place for the image of “stay in your lane”, but multi-disciplinary healthcare of an individual is not one such context.  

 

Meaningful holistic care of a person requires an integrated approach that is genuinely holistic; the latter requires members of such a team to value key ingredients of this approach; 

o A shared view and appreciation of the desired outcome

o Recognition of the skill set and expertise that at times is unique to a particular discipline/practitioner. 

o An understanding of what other disciplines do and bring, coupled with timely referral to appropriate clinicians.

o An interest in the overlay/interplay between disciplines, recognising both points of intersection and importantly ‘when to let go of the baton”.

o A shared primary agenda, focused on the needs of the patient/person/member.

o Sufficient trust within the team to risk what might come from the various ‘baton changes’ that are necessary to help transition the patient/person/member, to the next phase of health. 

o An openness to learn from the shared experience and a commitment to improve capacity and resilience during the various transition phases of the ‘team’s relay race’so that the baton is not dropped. 

o An agreement that the objective is to get the baton to the end of the relay event,without unnecessarily dropping the baton. 

 

 

 

OFFICIAL: Sensitive

 

Owning and processing individual and collective grief.

Vale - Lynette Taylor, Glen Humphris, Kevin King and Josh Prestney - 

your shift is over; rest easy. 

Throughout these past days, expressions of Victorians and Australians, 'standing together' have been readily seen as our community grieves the death of 4 Police members killed in the line of duty.  The iconic Flinders Street Station bathed in blue is one such 'expression'.  It is symbolic of Melbourne and Victoria for many reasons; its the public gateway to the CBD and the place where Police are most often seen and accessed.  It sits at a key intersection of foot, rail, tramway and emergency services traffic; traffic which symbolically provides a 'lifeblood' flow across our community.   

Now, twelve days later, with the private funerals of the fallen officers conducted, we stand together as a community and mourn this tragic loss of life.  In writing this, I am acutely aware of the deep sense of loss and pain that the families of our fallen officers are experiencing, and I will forever be thankful for the generous way in which they have allowed us, as a community, to enter into their 'private space' at such a 'tender' time for them; their allowance of this has helped us 'the blue family' collectively grieve. Grief is part of life because grief is a response to death and loss - and 'loss' happens.  (see the beyond blue article https://resources.beyondblue.org.au/prism/file?token=BL/0390 for a helpful fact sheet which provides useful and practical pointers in processing grief).  Therefore, when death and loss impacts our immediate 'family' grief is experienced and it's crucial that individually and collectively we respond appropriately.

Collective grief is painful because it both precipitates the flow of further grief and it compounds what we experientially feel. The outpouring of grief experienced by members of the Police family is real and deep.  Beyond the Blue line, the general public also experience the grief that comes from knowing that life has been taken in the service of their community; the ultimate sacrifice has indeed be made, as Fr Tom in the Josh Prestney's service today, reminded us.  "Greater love has no one than this; that they lay down their life for their friends." The 'friends' in this case is both the Blue family and the community of Victoria; we, the 'friends' have shared the collective grief because of this sacrificial service provided US.  

Collective grief can also provide a healing impetus because it can birth a heart of true wisdom in individuals seeking healing and integrated wellbeing.  Grief deposits within us a spiritual and emotional appreciation that is not found at the periphery of human existence but at the very centre of what it is to be human, to be alive.  When we open ourselves to the rhythm of sharing what we feel, with a trusted friend or colleague, and allow that person or persons to engage with us, we begin an explorative process of understanding who we are and what we are thinking and valuing.  That process helps us grow in our appreciation for both the one we grieve and our current circumstance within the community of people we call 'family'.  

Each of us will grieve differently; in that sense there is an 'individual' aspect to our grief and it's important that we allow ourselves to process things accordingly.  At the same time, the collective nature of this time of grief indicates the significance of us taking some risk to be vulnerable with trusted friends and family who will help us process the 'collective' aspect of the grief we face as a community. There will be a day when we collectively will be able to honour our fallen officers with a Public Memorial Service befitting the nature and circumstances of their sacrifice but until then, let us enter into appropriate ways of collective grief that moves us toward healing while never forgetting their sacrifice.