Care management


were about to occur. As a child where I accompanied my


grandmother to ‘help’ at the nursing home where she worked, I learned so much. By the time I was 14, the investment in me as a person and as a nurse to be, and dare I say it, the beginning of my leadership journey had been sown. This was person- centred leadership and care in action by my grandma. In the two decades since this moment,


I had seen a type of care that, while clinically efficient, was devoid of love, heart, and soul. I remember being yelled at as a trainee nurse for making a woman a cup of tea after her mother had died, but the bed needed to be carbolised. Or the time that a group of nurses played a horrendous practical joke involving somebody who had died. Disrespectful at the very least, this


was abusive disregard for the value of human life at best. Where was the love? It was still there; it was just harder and more secretive as it no longer had a status deemed important.


Covid hits the heart and soul Covid-19 has seen this dichotomy of person-centeredness being played like Russian roulette. This sad tale has been our lived reality and the dichotomy is more critical than ever. Leaders are resigning in droves,5


unable to care,6


which has become more of a reality since the Covid pandemic, where loneliness, isolation, and a loss of core spirit for people who live in care homes has manifested. The leaders and workers who used to love their job more than anything


40


were ‘losing their family’,7


and this was a


hard reality to live and learn as a human being, let alone trying to lead a team through this. Despite this hardship, the increase of regulatory burden due to lack of government attention to repeated reports indicate a lack of resources, crisis and a pandemic of loneliness and depression. Person-centredness did not appear


to extend to those who were on ‘the front-line’ of dealing with this crisis and expected to respond to constantly changing demands and priorities.8


intensity and severity of ill-being caused by behaviours from colleagues is where the most damaging of impacts can be seen.11,12 This is not unique. Bredemeier and


Miller indicate that the levels of people in leadership experiencing psychiatric conditions, burnout and suicide cannot be ignored.13 The loss of one life from suicide is one


Covid


was a catalyst, but the cause has been deep-rooted for some time within health professions.9


Horizontal violence We have seen people in leadership roles who have had their core spirits crushed. This is clearly a serious and very sad outcome. While this is the extreme end of the spectrum, a study of 200 industry leaders found that 100 per cent of leaders experienced a level of ill-being at some point in their lived experience in a role of leadership.10 There was a shared theme that leadership roles at some point have an experience of reaching their breaking point at work. Furthermore, 24 per cent of the leaders who participated in this study indicated they had suicidal ideations. Sadly, ‘horizontal violence’ is


not limited to a single silo of health professionals, it is pervasive, damaging to wellness, mental health and every aspect of our lived experience and core spirit. Sadly, as some people have progressed into leadership roles, the


too many. Our stories matter, every life matters, leadership matters, so why do evidence-based research studies identify that leadership roles generally result in 54 per cent of individuals having long-term impaired executive function, ultimately leading to higher rates of suicide? When we accept this as the norm, we no longer can see past this experience, and we lose sight of what wellbeing as leaders can look, sound and feel like.14


True leadership For person-centred cultures to be truly effective, palpable, something that you can look, see, feel, and almost touch, we must be person-centred with each other as leaders and as teams. We will never create a true person-centred culture until we can replicate what we purported to be achieving in our policy statements with each other as leaders, workers, and colleagues. This means everyone organisationally. Personally, this is part of my lived


experience. My life almost ended due to the ill-thought belief that I was a failure at leading my team. The fact was that I was ill-prepared, ill-equipped, and unsupported in a role which was a significant step personally.


www.thecarehomeenvironment.com • November 2021


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