“I’m just not good at staying in touch”

Rather than make excuses, be honest.

Iona Curtius

Iona is a PhD candidate at the University of Aberdeen, studying how we can understand truth.

A woman holds her phone up in her hands and looks at it in a slightly vexed way.

David Suarez on Unsplash

This is an article about honesty… but we’ll get to that.

I cannot count the number of times I have heard some variation of the phrase “I’m sorry, I’m just not very good at staying in touch” or “I’m just terrible at texting, sorry”. Usually, such apologies are accompanied by a shrug of the shoulders, a helpless smile, sometimes even a hint of smugness. Every time I experience such an interaction, I get a little closer to losing my patience. So, it’s probably safer for everyone if I voice my thoughts in this way, safely tucked away behind a screen.

What’s going on here? I believe it’s quite simple: dishonesty. Now, I don’t wish to unjustly accuse anyone of lying, much less assume ill intent. I’m sure everyone who has ever said that to me has believed it to be true. But, as we will see, that’s part of the problem.

Nobody is naturally ‘good at staying in touch’. Nobody is naturally ‘good’ at texting. These aren’t ‘natural’ forms of communication, or even ‘natural’ relationships. We have the opportunities now to meet and form connections with SO many more people than our forebears did. It is impossible to build, let alone maintain close friendships with everyone we meet. Relationships take work and effort, even with people we see regularly. So, what’s the problem with saying “I’m not very good at texting”? Isn’t it a normal, reasonable thing to say?

The problem is that it is used as an excuse. Just because something is hard or does not come naturally does not mean we can’t do it. We do hard things all the time, if we feel they are important and worth our effort. Doing the dishes doesn’t come naturally to me and I hate doing it. Still, I don’t invite friends over for dinner and then tell them, “Sorry, I’ve made food, but you’ll have to eat it out of the pot because I’m just not very good at doing the dishes”. I value my friends (and my health) so I do the flipping dishes. I’m not as on top of it as other people but I have found ways of helping myself to do a task I ‘naturally’ struggle with.

But back to the matter in hand: I believe that the aforementioned excuses are dishonest because finding texting hard is not actually the reason we don’t stay in touch with some people. What these phrases are hiding is “making the effort to stay in touch with you is not worth my time”. Now, obviously, most of us would never dream of saying anything quite so mean. But if we are honest with ourselves and look at our lives more closely, I do think that’s what it boils down to. Simply putting a nicer sounding lie in front of that does not make it any better.

So how do we get out of this? The answer is simple but not easy: honesty. Be honest. With yourself, above all else. Ask yourself, truly, “Why am I bad at staying in touch?” Are you trying to stay in touch with too many people at once? Is it a time management problem? Is it an attention problem? Do you simply forget someone exists if you don’t see them? It’s ok if that is the case. Just be honest about it. Once you have correctly identified what is making it hard you can decide whether you want to find ways to make those hurdles smaller, or whether you are simply going to be more honest in future. You don’t have to directly tell someone “You aren’t worth my time” (in fact, I’d strongly recommend not doing that). You can say something like “I find that maintaining (close) friendships at distance is particularly hard for me, so I focus on friends who are geographically close to me”. Or something similar. Be honest about the reason you find staying in touch hard.

If you are frustrated with how ‘bad you are at texting’, here are some ideas for how to make it easier on yourself. You might think about adding one or two of these to your routine at the beginning of this new year, perhaps.

If the problem is busyness or object permanence, set reminders and/or have ‘reply-amnesties’ where you reply to the texts from the week/fortnight/month. Some apps allow you to pin chats that are important to the top of your page, so you always see them when you open the app. Or, alternatively, you can archive those you don’t need so there’s less clutter. If the problem is the medium, texting feels impersonal, you don’t like having to be constantly ‘online’, or you live in a cave on a desert island, you can find other ways. Could you arrange (regular) calls? If you’ve recently won the lottery, you could send a letter by snail mail. Whether it’s voice notes, video updates, group calls, online board games, or Netflix watch parties, the possibilities are near endless.

One more thing: set expectations. Rather than simply telling people what you can’t do, tell them what they can expect. “Yes, I would like to stay ‘in touch’, but I prioritise the people who are geographically close to me.” “I won’t frequently reply to texts, but I do a reply amnesty every couple of weeks, so you’ll hear from me then.” If you do want to ‘be better at staying in touch’, let people know how they can help you. Maybe you struggle to initiate conversations but you’re happy to reply. Maybe you’re in a position to be able to say, “You can come visit me any time” or even “I’ll be in touch when I’m in the area and we can get together over a hot beverage or a meal.”

Just BE HONEST. Please.

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Article

Care

Change

26 July 2024

6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen Cowan

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.