Alistair Hewison, Yvonne Sawbridge and Laura Tooley
The purpose of this study was to explore compassionate leadership with those involved in leading system-wide end-of-life care. Its purpose was to: define compassionate leadership…
Abstract
Purpose
The purpose of this study was to explore compassionate leadership with those involved in leading system-wide end-of-life care. Its purpose was to: define compassionate leadership in the context of palliative and end-of-life care; collect accounts of compassionate leadership activity from key stakeholders in end-of-life and palliative care; and identify examples of compassionate leadership in practice.
Design/methodology/approach
Four focus groups involving staff from a range of healthcare organisations including hospitals, hospices and community teams were conducted to access the accounts of staff leading palliative and end-of-life care. The data were analysed thematically.
Findings
The themes that emerged from the data included: the importance of leadership as role modelling and nurturing; how stories were used to explain approaches to leading end-of-life care; the nature of leadership as challenging existing practice; and a requirement for leaders to manage boundaries effectively. Rich and detailed examples of leadership in action were shared.
Research limitations/implications
The findings indicate that a relational approach to leadership was enacted in a range of palliative and end-of-life care settings.
Practical implications
Context-specific action learning may be a means of further developing compassionate leadership capability in palliative and end-of-life care and more widely in healthcare settings.
Originality/value
This paper presents data indicating how compassionate leadership, as a form of activity, is envisaged and enacted by staff in healthcare.
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Pamela O’Callaghan, Maureen P. M. Hall, Laura N. Cobb and Melanie Jacobson
US citizens who attend international medical schools (US IMGs) are more likely to be of Hispanic, Black American, or Asian descent compared to US medical students. As physicians…
Abstract
US citizens who attend international medical schools (US IMGs) are more likely to be of Hispanic, Black American, or Asian descent compared to US medical students. As physicians, US IMGs contribute diversity to the health-care workforce; their experiences and perspectives have improved the health outcomes for populations typically underserved. To become a competent medical professional is a challenging experience, especially for IMGs who may have entered medical school with less than optimal academic histories. During this journey, some students develop academic and clinical deficiencies. Addressing these deficits through remediation interventions are critical to the student’s performance as a physician. This study measured the resiliency, self-efficacy, and self-compassion of IMGs who completed remediation while in medical school. Results indicate older students experienced failure more often and were found to have significantly higher levels of self-compassion compared to younger students. Males were assigned significantly more remedial interventions compared to the female participants. Finally, strong positive correlations suggested that the more remediation interventions students were provided, the more likely they were satisfied with their overall remediation experience. These findings indicate that by varying support strategies and encouraging student’s orientation to resiliency, self-efficacy, and self-compassion may assist them in overcoming their deficits.
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Clive Bingley, Edwin Fleming and Sarah Lawson
IT WAS in the mid‐1970s when, having been in the habit for a year or so previously of commenting on public library authorities' annual reports in a partially analytical manner, I…
Abstract
IT WAS in the mid‐1970s when, having been in the habit for a year or so previously of commenting on public library authorities' annual reports in a partially analytical manner, I observed a decline in the arrival of the same in my post. A decline which has been maintained, I may add, and which has led me to the conclusion that, while it is OK on the sender's part if I remark how splendid has his service been, he would nevertheless be happier if the ammunition was withheld for me to observe that his annual loans cost x‐pence more each than those of such‐and‐such an authority!
One of the commonest excuses put forward in defence of the practice of treating milk, butter, meat, and other foods with ‘preservative’ drugs no longer possesses even the…
Abstract
One of the commonest excuses put forward in defence of the practice of treating milk, butter, meat, and other foods with ‘preservative’ drugs no longer possesses even the appearance of validity. Several of the large railway companies are adding refrigerator vans in considerable numbers to their rolling‐stock, and this fact should make it no longer possible for defendants to plead that the necessity of sending food‐products a long distance by rail involves the necessity of mixing preservative chemicals with them. Although the excuse referred to will not bear examination, it is a very specious one, and in those instances where evidence has not been brought forward to refute it, it has produced some effect on the minds of magistrates and others. It cannot be too often pointed out that such substances as boracic acid, salicylic acid, and formaldehyde are dangerous drugs, and that their unacknowledged presence in articles of food constitutes a serious danger to the public. Such substances are not foods, and are not natural constituents of any food. In most instances they are purposely introduced into food‐products to avoid the expense attending the proper production, preparation, and distribution of the food, or to conceal the inferior quality of an article by masking the signs of commencing decomposition or incipient putrefaction, and thus to enable a dishonest producer or vendor to palm off as fresh and wholesome an article which may be not only of bad quality, but absolutely dangerous to the consumer. The use of these substances, in any quantity whatsoever, and the sale of articles containing them, without the fullest and clearest disclosure of their presence, is as gross and as dangerous a form of adulteration as any which has at any time been exposed. In no single instance can it be shown that these drugs are, to quote the words of the Act of 1875, matters or ingredients “required for the preparation or production of a food as an article of commerce,” nor, of course, can it be contended that such substances are “extraneous matters with which the food is unavoidably mixed during the process of collection or preparation.” In reality, even under our inadequate and unsatisfactory adulteration laws, through which the proverbial coach‐and‐four can be so easily driven in so many directions, there ought to be no loophole of escape for the deliberate and dishonest drugger of foods. While the presence of preservative chemicals in any quantity whatever in articles of food constitutes adulteration, wherever the quantity is sufficient to allow the production of the specific “preservative” effect of the substance added, that fact alone is enough to make the food so drugged a food which must be regarded as injurious to the health of the consumer—in view of the inhibitory effect which, by its very nature, the antiseptic must produce on the process of digestion. To our knowledge the food market in this country is flooded with all sorts of inferior food‐products which are rarely dealt with under the Adulteration Acts, and which are loaded with so‐called preservatives. There will be no adequate protection for the public against the consumption of this injurious rubbish until the consumer sees the advantage of insisting upon an authoritative and permanent guarantee of quality with his goods, and until manufacturers of the better class at length find it to be a necessity for their continued prosperity that they should supply, apart entirely from their own statements, an independent and powerful guarantee of this kind.
Understanding the concepts of policy and policy-making is far from straightforward. There has now been considerable empirical and theoretical work on the nature of policy…
Abstract
Understanding the concepts of policy and policy-making is far from straightforward. There has now been considerable empirical and theoretical work on the nature of policy development and implementation, and it is abundantly clear that the whole process is far more complex, dynamic, and interactive than any of the traditional linear or staged models suggest. There have been many attempts to describe and analyses this complexity, and the models produced have frequently been highly contested. However, it is evident that policy is not made ‘once and for all’ by people called ‘policy-makers’. Any attempt to make change within the educational system is the result of compromise and circumstance and, even where the change is incorporated in law, the nature of that change that results is often far from clear. This ambiguity and lack of clarity is not necessarily due to poor drafting of the law, but is usually the result of the constraints within which most legislation comes to be agreed.
Michael Clark, Andy Bradley, Laura Simms, Benna Waites, Alister Scott, Charlie Jones, Paul Dodd, Tom Howell and Giles Tinsley
This paper aims to discuss the importance of compassion in health care and experiences of Compassion Circles (CCs) in supporting it, placing this into the national policy context…
Abstract
Purpose
This paper aims to discuss the importance of compassion in health care and experiences of Compassion Circles (CCs) in supporting it, placing this into the national policy context of the National Health Service (NHS), whilst focusing on lessons from using the practice in mental health care.
Design/methodology/approach
This conceptual paper is a discussion of the context of compassion in health care and a description of model and related concepts of CCs. This paper also discusses lessons from implementation of CCs in mental health care.
Findings
CCs were developed from an initial broad concern with the place of compassion and well-being in communities and organisations, particularly in health and social care after a number of scandals about failures of care. Through experience CCs have been refined into a flexible model of supporting staff in mental health care settings. Experience to date suggests they are a valuable method of increasing compassion for self and others, improving relationships between team members and raising issues of organisational support to enable compassionate practice.
Research limitations/implications
This paper is a discussion of CCs and their conceptual underpinnings and of insights and lessons from their adoption to date, and more robust evaluation is required.
Practical implications
As an emergent area of practice CCs have been seen to present a powerful and practical approach to supporting individual members of staff and teams. Organisations and individuals might wish to join the community of practice that exists around CCs to consider the potential of this intervention in their workplaces and add to the growing body of learning about it. It is worth further investigation to examine the impact of CCs on current concerns with maintaining staff well-being and engagement, and, hence, on stress, absence and the sustainability of work environments over time.
Social implications
CCs present a promising means of developing a culture and practice of more compassion in mental health care and other care contexts.
Originality/value
CCs have become supported in national NHS guidance and more support to adopt, evaluate and learn from this model is warranted. This paper is a contribution to developing a better understanding of the CCs model, implementation lessons and early insights into impact.