Article
Awe and wonder
Change
Community
Time
7 min read

The bells that awaken awe in the new year

We need new rhythms if we are to navigate the world as it is today.

Elizabeth Wainwright is a writer, coach and walking guide. She's a former district councillor and has a background in international development.

Restored church bells lined up in a cathedral, as crowds mill around them.
Notre Dame bells.
Notre Dame de Paris.

The jackdaws flap and caw as they come in to roost. The sun sets behind the bare trees; its fiery farewell doing nothing to warm the cold air. The village church bell rings out 4pm. My young daughter stops what she is doing, says “ding dong”, then carries on. That’s what we all used to do: stop what we were doing and be called to something else, the bell’s rhythmic tolls cutting through our individuality and unifying us for a time. Perhaps we would go to church, or stop to pray, or remember the dead for whom the bell tolled. I have been thinking about that often-quoted poem by John Donne:  

No man is an island, 

Entire of itself. 

Each is a piece of the continent, 

A part of the main. 

If a clod be washed away by the sea, 

Europe is the less. 

As well as if a promontory were. 

As well as if a manor of thine own 

Or of thine friend's were. 

Each man's death diminishes me, 

For I am involved in mankind. 

Therefore, send not to know 

For whom the bell tolls, 

It tolls for thee. 

Now, church bells ring out the hours of the clock, and occasionally still ring out mourning and celebration too. They seem also to ring out a quaintness, a nostalgia, a past that is slipping away. I have been sitting by the old stone church listening to them, wondering what else they might be tolling for, what else might be slipping away. In Donne’s poem, he says the bell tolls not for them, but for us, because we are all connected. Each person’s death diminishes the whole from which they were a part, and so diminishes me. The bells used to remind us of that whole.  

The bell could be melancholy but I notice how it tilts me toward hope, even in this deep winter stillness; an audible distillation of light ringing through the dimness. I think it is the hope of mankind which Donne tells me I am involved in. These old bells seem to ring defiantly despite the many other chimes that ring just for me: digital pings, messages, notifications, news, an algorithm that tried to force me down my own lone path. But echoes of communal life persist. Now, I hear the bell say:  

Ding: listen 

Dong: lift your head 

Ding: look  

Dong: life is a whole  

Ding: face each other  

Dong: this is the only way we will meet the future 

A few days later, my daughter and I step into the village hall. We surface together from evening darkness into the light of song: it is the carol concert, we are late, and the music is about to start. The singers are decked in lights and earthy greens and rusty reds. They are a group from Exmoor who conserve and share traditional and local songs, as well as singing the songs we all recognise. My daughter’s cheeks are pink, her eyes blaze with delight. In a few days, the solstice will be here, and the earth will pause in its movement before turning back to face the light. Here in this old hall, the songs seem to reach towards that coming light: we are here, we are together, and we choose to lift our individual voices as one chorus of community.  

I think about the people in this hall gathering to mark other things — memories, celebrations, vision, care — and I wonder about the more figurative bells that draw them together to do so. What are the bells that keep us together now, when so much encourages us into isolation and individualism? — The bells that remind us we can never be the islands that we are so often encouraged to be: independent, tough, believing consumption will heal us, packaged into a personal brand; everything encouraging us to be seen, not known.  

I try to listen for these bells, to hear how to inhabit time reverently and with reciprocity, not with urgency and isolation. In many places the actual church bells are silent, but I think we still need the bells of communality: bells that call us into share rhythms, reminding us to pause in our individual movement, reminding us to gather, to mourn, to remember things and find the light and the hope in each other, just as the tilting of the earth pauses at the solstice before it turns to face the light.  

Nature’s cycle is one way of doing this: tuning in to the turn of the year that makes new life possible. The solstice and equinox; wassailing in January to bless the apple trees; noticing when migrating birds appear or leave; sharing planting and harvesting days. Liturgical calendars are a way that Christian communities kept and still keep time: advent, Christmas, lent, Easter. These rhythms become familiar, reminding us that time isn’t linear, much as the myth of infinite progress would have us believe otherwise. Time is cyclical, expanding and contracting; old events revisited regularly in new ways.  

Knowing that it is not just me looking at these stars, but people across the world and through time, brings me into a peace, a reverence that can be hard to come by.

And there are other things that can bring us together too: causes, hobbies, interests, protests. These can take on the role of bells perhaps, drawing us together around shared purpose – but shared purpose and shared existence, shared being, are not always the same thing.  

Perhaps we need new rhythms if we are to meet the world as it is today. Imagine if a bell tolled — literally or figuratively — not just for human funerals, but whenever a species went extinct, or a tree cut down. Imagine if neighbourhoods gathered to light candles and share stories and soul and care each week, offering a space that church used to provide to lots of people through the ages. And what if we resurrected old traditions for a new age: ‘beating the bounds’ as a way to mark not just the boundaries of land but the places that need restoring and regenerating now; harvest festivals not just as something for school children and rural churches, but as a way we can better connect with food and farming. What if we looked at old wisdom; the way the church calendar aligned with the farming calendar, asking us to remember that food and the soil it comes from are sacred things.  

Our friends were near the beach in Costa Rica. They noticed that at the end of the day, everyone stopped what they were doing — fishing, fixing, working — and watched the sunset. This moment of beauty seemed to bring people together into synchronicity. In his book Awe: The Transformative Power of Everyday Wonder, scientist Dacher Keltner shows us how experiencing awe can, amongst other things, help us to experience humanity, see patterns in life, and better collaborate with each other. He says: “The last pillar of the default self—striving for competitive advantage, registered in a stinginess toward giving away possessions and time—crumbles during awe. Awe awakens the better angels of our nature.” Perhaps putting ourselves in the way of awe might help us hear the bells — old and new — that ring in this current age, and that might bring us together and love each other well. If love only exists in relationship, and love is what helps us to see and to care, then protecting and restoring relationship seems to be vital work for our time.   

Now, the winter sky is dark and the stars shine brightly above. They shine with a clarity that matches the peal of the bells in the village. They call me beyond myself into something unified, something older, something necessary. They call me into wonder and awe. Knowing that it is not just me looking at these stars, but people across the world and through time, brings me into a peace, a reverence that can be hard to come by. I step back into the house but my mind faces outwards into the world.  

Church bells used to call people together to worship, bringing a sense of shared time and purpose. They still ring, but they can be hard to hear against the noise of individual time. I think they are calling us together again now. And if we can’t hear them, perhaps we need to set new bells ringing. May the bells that ring this New Year’s Day inspire us to do so. 

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Article
Care
Change
6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A nurse bends beside a bed and talks to a patient
Marie Curie.

Recently, at a nursing leadership programme in Oxford, attendees focused on the fundamentals of care.   Have we forgotten how to care? What can we re-learn from those who pioneered an ordinary yet profound act that affects millions? 

Anam Cara is an old Gaelic term for ‘soul friend’, a person with whom you can share your innermost self, your mind and your heart. It is a term that Tom Hill, former chief executive at Helen House Hospice in Oxford, used to describe the relationship between his staff and the thousands of children and their families who passed through their ‘big red door’ in its first twenty-five years. The hospice (or ‘loving respice’ as it became known) had been founded by Sister Frances Dominica in 1982.  

Other care in this country can also trace its religious roots. Between 1048 and 1070 in Jerusalem, the Order of St. John was founded for the purpose of helping pilgrims (“our Lords, The Sick”) who had become lost, weary, or beset by other difficulties while on their way to the Holy Land. Today, in the United Kingdom, the British Association of the Order has extended care to older people first in almshouses and later in care homes. A trustee for ten years was John Monckton, a man of ‘considerable talent, enormous integrity and deep religious conviction’; his tragic murder in 2004 led to the creation of the John Monckton Memorial Prize, which recognised and rightly celebrated commitment to care by care workers. 

Today, across the world, seen and unseen, nurses, carers and families continue to provide compassionate care. “Assisting individuals, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge” is the very essence of nursing, captured by ‘architect of nursing’, researcher and author Virginia Henderson in 1966. Meeting more than basic needs such as breathing, eating, drinking and eliminating bodily waste (which are of essential importance), Henderson recognised the role of the nurse in enabling humans to communicate with others, worship according to their faith, satisfy curiosity and sense accomplishment.  

In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care?

An uncomfortable truth brought out in healthcare reports such as the Final Report of the Special Commission of Inquiry (The Garling Report) 2008, and the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (The Francis Report) 2013 is though that this type of nursing is too often done badly or even missed, leading to pressure injury, medication errors, hospital-acquired  infection, falls, unplanned readmission, critical incidents and mortality. According to nurse scientist and scholar Professor Debra Jackson, “missed care occurs much more frequently than we might think”. She cites a systematic review in which ‘care left undone’ on the last shift ranged from 75 per cent in England, to 93 per cent in Germany, with an overall estimate of 88 per cent across 12 European countries’. 

In one offensively-titled paper, “Shitty nursing - the new normal?” (in which the authors apologise for the title but not the questions raised), real-life pen portraits are drawn of patients lying for hours on hospital trolleys, immobile through infection or injury, ignored by staff. Whilst acknowledging contextual factors for poor care, such as a shortage of nurses and resources, the authors argue that circumstances cannot be the sole cause of missed nursing care. 

A report published by the University of Adelaide, School of Nursing, has called for nurses to ‘reclaim and redefine’ the fundamentals of care. It asks whether the cause of the problem (of missed nursing care) lies “deep in the psyche of the nursing profession itself?” “Has something happened to the way modern nursing views and values caring?” it continues. “Indeed, is nursing in danger of losing its claim to care? In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care? Or is this a broader social pattern where individuals are less inclined to show kindness, compassion, and care for others even if it is a necessary requirement of the job?” 

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. 

Writing in the British Medical Journal, Professor of critical care medicine Peter Brindley and Consultant in intensive care Matt Morgan wonder whether doctors also “too often default to high-tech and low-touch” when patients are dying – a time “when community and connection matter most”. They powerfully begin with a mother’s comment: “Humans are gardens to tend – not machines to fix.” 

Professor Sir Al Aynsley-Green, the first National Clinical Director for Children in Government and former Children’s Commissioner for England, and past president of the British Medical Association, suggests that we as a society need a “momentum for compassion”. Struck by the extremes of compassion witnessed during his wife’s treatment in the last years of her life, Sir Al wants to see a cultural transformation in healthcare: for compassion to be a key operating principle in NHS and care settings, led by the Chief Nurse’s Office; for every organisation to promote the importance of compassion at the professional level; for the views of patients and families to be sought regularly; for much earlier and better focus on compassion in undergraduate and postgraduate teaching programmes for all staff; for compassion to be inspected against by the Care Quality Commission; and for a willingness to encourage staff at all levels to expose poor practice as well as celebrating excellent care.  

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. “It’s putting yourself into somebody else’s shoes – and doing something about it.” Recently appointed the UK’s first Visiting Professor in Compassionate Care at Northampton University, at the age of 80, Sir Al certainly is doing something about it. He has made it his new purpose in life to “embed compassion into every aspect of care”.  

Like Sir Al, Queen Elizabeth II, the UK’s longest serving monarch, espoused compassion, in word and deed. Living a life of compassionate service, the Queen made clear that her Christian faith was her guiding principle. She speaks of Jesus Christ as ‘an inspiration,’ a ‘role model’ and ‘an anchor’. “Many will have been inspired by Jesus’ simple but powerful teaching,” she said in her Christmas Broadcast, 2000. “Love God and love thy neighbour as thyself – in other words, treat others as you would like them to treat you. His great emphasis was to give spirituality a practical purpose.”    

When nurses do unto others as they would have done unto themselves, and act as role model to colleagues, not only do patient experiences of care and their outcomes improve – but so does job satisfaction for nurses: a critical factor in nurse recruitment and retention – the biggest workforce challenge faced by healthcare organisations. Across the UK, there are currently more than 40,000 nursing vacancies, and thousands of burnt-out nurses are leaving the profession early. Whether nurses decide to stay or go is driven in part by their daily experience at work. The late Kate Granger, Consultant in medicine for older people, inspired Compassionate Care Awards in her name, envisioning that such a legacy would drive up standards in care - and surely also help retain nurses, through restoring a sense of pride, achievement and fulfilment to the nursing workforce.