Posted by: ayrshirehealth | September 25, 2013

What motivates me? by @davidthemains

Easter Monday 1996

Easter Monday 1996 should have been a very special day for my wife and I.  She was a few days overdue with our third child – our first son, and as described by her mother, a retired midwife, she was in “good going labour”.  An hour later my mother-in-law phoned because she was alarmed that she hadn’t heard any news from the hospital regarding her grandson’s arrival and I explained that there had been some anxieties with meconium being passed but that the fetal scalp blood test had been reassuring.  This didn’t reassure my mother-in-law and indeed she was quite right.  Another hour later I phoned to tell her that her grandson had been born but unfortunately was in a state of some distress and had died only 15 minutes later.

As a west of Scotland male I am not used to such personal disclosure as this, SANDS D&Gbut when Derek Barron asked me to do this blog I was tempted to say I couldn’t because my wife and I are in the middle of organising a charity ball in Dumfries for SANDS (Stillbirth & Neonatal Death Society) which my wife is the local chair person of and which I have been involved with a little myself.

Speaking to Derek regarding how important it is to understand what motivates people to take on roles such as I have in patient safety, I thought that it may be time to be more explicit about what really does motivate me.

The aftermath                                                                                                                                                           

I am not going to go into the detail of what occurred as I’m sure everyone can imagine the effect such an event has on young parents and their family but also on the staff involved in dealing with what is fortunately a reasonably rare event.  The midwife who had been with us was distraught, as were we.  Instead, I would like to focus on the things that helped us.

SANDS D&G teardropAs stated, we were a relatively young couple and in the immediate aftermath I felt like a lost boy.  Looking back at the distress that we were going through, I recall wanting to just take my wife and leave, but luckily there was a sensible experienced midwife who acted in quite a maternal way and looked after us for the day.  I now realise just how important it was that someone was willing and able to be supportive in this way when we needed it.

Equally, it was important that we were treated as adults too, and that when my son was being attempted to be resuscitated, I was present.  Whether this was something that would normally have happened I am not sure.  The fact that I was a consultant,  albeit fairly recently appointed, may have altered the process,  however it did not seem in any way inappropriate and in fact ultimately it was very helpful that I was present at that point.

Judging when to direct and support patients or relatives and when to include them as equals is something which I consider when I deal with people in distress in my job as a consultant psychiatrist.  Again whether or not it was because I was a consultant psychiatrist or whether this would happen normally, we were given copies of the post mortem.  We had frank and honest discussion with the consultant in the weeks thereafter.  We had really quite detailed descriptions and insight into what was thought to have gone wrong.  Openness and clarity of communication certainly helped me and again it is something which I feel is key in dealing with people who are in distress in dealing with what for them will be the most difficult period of their life.  In my field of practice it is often cases such as a person’ son/daughter /husband/wife being detained in hospital, or the enormous effect of a suicide on a family and a network of people that require such communication.

Patient safety                                                                                                                                                                 

The fact that our son was born and died on a public holiday and the fact that signs that a traditional midwife would take terribly seriously were then given some false reassurance by a blood test result, are two of the aspects of the situation which I know have been reflected upon and are relevant to driving safer services.  SPSPI am not writing this blog to highlight deficiencies in obstetric care.  Instead I would like to explain part of what motivates me.  It  became clear to me that being able to look at all the aspects of a situation when things go wrong;  to do so objectively; and to do so in conjunction with those affected,  in the case of a suicide or other adverse event in mental health,  is a key to improving services.

Challenging what is “accepted”                                                                                                                        

When I was fortunate enough to be able to get involved in the mental health patient safety programme, it wasn’t conscious in my mind that my own experiences of our son’s death was behind part of my passion.   On reflection, even as a west of Scotland male, I have to admit that this has been very clearly part of my reasoning and rationale.  SANDS D&G telephoneIn the years since our son died, as I have indicated, my wife became involved in SANDS and I took on the Treasurer’s role for a while (I can use a calculator and have a rough idea of Excel spreadsheets) but the main effect on me was a desire to treat the people I deal with in as open and honest way as possible.  I was also prompted to challenge what is accepted as part of the job, (eg suicide of in-patients – should that be a ‘never’ event?)  I think that the neonatal death of an otherwise healthy baby following a low risk pregnancy, is something which people would hope should never happen.  In thinking about the safety of the patients that I am responsible for I would like to think that there are some things that we used to accept which will now and in future become ‘never’ events.

Doing things better                                                                                                                                                      

People who know me will have perhaps noticed that I wear a yellow band on my wrist and occasionally people, sometimes patients, ask me what it is and I just say I wear it because of a charity I support.

SANDS never forget wrist bandIt is of course an “always loved – never forgotten” SANDS band.I wear it not necessarily to remind me of what I have lost, but increasingly I think about what I have gained by hopefully using my experience to inform my practice and to be a large part of what motivates me to want things to be better.

This week blog was by @davidthemains (Dr David J Hall) National Clinical Lead Scottish Patient Safety Programme – Mental Health

Further information related to SANDS, in Ayrshire, can be found on the Ayrshire SANDS website www.ayrshiresands.co.uk or via the national SANDS website http://www.uk-sands.org .

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Responses

  1. Well done David. That was moving and inspiring….and can’t have been easy to write. Ken

    • Thanks, Ken.

  2. David, thank you for such a heartfelt and personal blog.

    • Thank you Alice.
      I’m glad it has touched people, and hopefully may help some.
      David

  3. Very moving blog, thank you for sharing this and your motivations.

    • Thank you.
      David

  4. Well said David.It just goes to show we rarely know what our colleagues have lived through.Been reflecting on my own first experience of parenthood as I visited a Mental Health Perinatal Unit recently,seeing how very hard it is for young parents when things don’t go according to plan. Your blog has reminded me how full of risk even apparently straightforwad medical events can be and how especially painful must be for people coping with tragedy in situations more often associated with joy.

    • ThanksTony-it was a bit of a thought to share this but the timing seemed right and I’m pleased it has resonated with others.
      David

  5. Thank you for your openness and honesty in sharing such a personal disclosure.

    • Thanks- I’m really pleased this has touched people and I hope it may help some.
      David

  6. Motivation comes to us in many guises. A very moving, personal blog.
    Thank-you for sharing.

    • Thanks, Gladys. Glad the blog has touched people, and hopefully may have helped some.

  7. Well done David – a real testimony to yours and Alison’s work for Sands in remembrance of your son and how that sad experience has helped others in many ways, Emily

    • Thanks Emily.
      Really appreciate the support this has received.
      David

  8. Thank you for writing about your experience and being honest about such a personal situation, Sally

  9. Thanks Sally- I appreciate your support.
    David

  10. I feel privileged to have read this moving blog. The motivation and inspiration moves us in the deepest most personal and private experiences we face.

    • Thanks, Judy.
      All the support this has received has made me really glad I plucked up the courage to share this.
      David

  11. […] the second must-read post of the week, David Hall revealed a painful personal experience in What motivates me? on the Ayrshirehealth blog that helps drive him as a medical professional to put people at the […]


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