“We need to think bigger to have the biggest impact”
Professor Linda Worrall, Director of the Centre for Clinical Research Excellence in Aphasia Rehabilitation, Australia speaking at the RCSLT Conference Glasgow, September 2017.
I’ve never been a fan of New Year’s Resolutions even before I became a speech and language therapist and learned about motivational theories of change and neural plasticity. As someone whose natural inclination is Hygge it seems counter intuitive to be munching on lettuce leaves and running the hills at 5am on the coldest, darkest days. The irony of course is that I actually enjoy running and lettucing but I did not come to enjoy them arbitrarily; I had to work really hard at it, try it again and again to really get the bug! Change for me is hard.
I am a creature of habit – I like the safe and secure – I like to know where I am and what I’m doing, what’s expected and when – I like the predictable and above all else I like a list, preferably in 3 different colours, with headings and bullet points. Chaos and shifting sands do not a happy Helen make. And yet in my own way I’m an Innovator, I have an inbuilt passion and drive to see things move forward, always searching for more effective ways to continuously improve – huh go figure! And so there’s something quite seductive about thinking, plotting and planning at this time of year – it’s like buying a new pencil case in August, the lure of being able to start afresh, begin again, do it bigger, better, do it differently, get it right this time… One of the things I am most protective of for my team is sacred space, thinking time, reflection time, space not carved out but fiercely guarded for such purposes. I have learnt to my cost that my weakest times mentally and physically, professionally and personally have been when this has been absent for a sustained period.
Professionally 2017 was an enormous year of change for me, my learning curve more a vertical line. I made the leap from working in physical to mental health. My comfort zone for the past 7 years had been working in the community in Dumfries & Galloway. Oft described by bemused city colleagues as the James Herriot of the SLT world, my caseload include supporting those with progressive neurological and palliative conditions in 4 community hospitals, 7 care homes and at home. As my dysphagia and AAC skills developed so did my ability to clear sheep from the road and converse about the Countryfile Weather forecast. Driving time is thinking time and I was always happiest with ‘a wee project’. I am fortunate to be based in a Service where improvement has always been supported. “Let’s set up a drop in computer club for people with aphasia; How about a self management group for people finishing their Parkinsons’ therapy to embed habits, reduce re-referrals? What does the National Delivery Plan say, how can we measure this, can we get the physios involved???” Some projects worked, some didn’t, but hey even James Dyson created 5,126 versions of his vac before he succeeded! Fail, fail again, fail better etc!
In many ways my new role could not be more different and yet the same, building on established skills, discovering and developing new ones. I am now a member of The IDEAS Team (Interventions for Dementia, Education, Assessment and Support). New to D&G and the first of its kind in the UK, this MDT has an SLT, OT, Clinical Psychologist, Social Worker and Specialist Nurse. Our remit is to reduce stress and distress (previously known as challenging behaviour) for people with dementia and their carers. We carry a caseload of people with highly complex needs whilst offering consultation and education to health and social care staff across the region. This year we have written our Operational Policy; our first Annual report; offered 4 levels of education mapped onto the Promoting Excellence Framework; explored models to embed improvements and foster culture change within our care homes and hospitals; run focus workshops, linking in with other AHPs and professionals both within and without the NHS on a wide range of specialist subjects and consulted with our patients and carers to identify their needs. We know our policy drivers, our legislative pillars, we set Smart goals, measure our outcomes and monitor their impact. It feels in many ways that we are pioneers. We build on what evidence base for non pharmacological interventions we have and aim to accumulate more to support those that come after us.
At the RCSLT Conference in Glasgow in September 2017, Jacqui Lunday Johnstone, Chief Health Professions Office for Scotland urged SLTs to be courageous, visible and accountable. There are less than a handful of SLTs working solely in mental health in Scotland. I am proud to be one of them. As AHPs we have so much to offer, more than is often recognised by other professionals or dare I say it even ourselves. We have so much potential, we need to give ourselves permission to be bigger and bolder, to put ourselves forward in ways that we still are not comfortable in doing.
“Do one thing every day that scares you” Eleanor Roosevelt
2017 has pushed me, tested me in ways in which I could not have imagined. Faced with challenges in a new field, I looked first to AHPs in Scotland, learning to tweet, post and blog to reach English, European, American CENs; then to colleagues in psychology and nursing, moving outwards in ever widening concentric circles to educational theory, change improvement theory, graphic facilitation, seeking and finding creative solutions to the problems I was faced with. The highlights of my professional year have been learning to draw graphics to illustrate my presentations, speaking at the RCSLT Conference and receiving an Innovation in Practice Award from the RCSLT Older Age Psychiatry CEN North. The graphic below was my attempt to define and site my role within its wider context. Be kind I’m still learning!
And 2018? Last year I applied for roles that I’d never previously considered, writing/ sub writing inspection guidelines for the Care Inspectorate and for the RCSLT on the role of SLT in Assessing Capacity & Consent. I’m writing up the new experiential workshops I’ve developed, submitted for the National Dementia Congress in Murrayfield in April. And resolutions? I completed a SWOT chart as below.
From this I have taken Linda Worrall’s advice and written a letter to my future self at www.futureme.org which will ping into my inbox on Christmas Eve 2018. It will congratulate me on what I’ve achieved this year, encourage me to keep going and hold me accountable for the goals I have put stepped targets in place to achieve. That together with the cheerleaders and counsellors I have sought out either in person or online will help keep me on track with the things I plan to do and embracing the things I never dreamed of doing when the opportunities arise. If you’d like to follow our Facebook or Twitter page I’d value your company and opinions too.
I leave you with this quote and dedicate it to all those AHPs who are just getting on with the day job, who would never dream of writing a blog but who always like a ‘wee project’:
“You are braver than you believe, stronger than you seem and smarter than you think.” AA Milne
Helen Moores-Poole, Speech & Language Therapist, IDEAS Team, NHS Dumfries & Galloway.
Helen has written previous blogs for NHS D&G on Health Literacy and Alzheimer Scotland on AHP Post Diagnostic work as below.
Follow me @poole_moores on twitter or find us on Facebook at IDEAS Team NHS and NHS D&G SLT Adult