Life lessons from the pup

A new arrival reminds Natalie Garrett how to learn much about a life of simplicity and joy.

Natalie Garrett

Natalie produces and narrates The Seen & Unseen Aloud podcast. She's an Anglican minister and a trained actor.

Life coaching can be tiring.

So finally, we caved. We bought the puppy. We had been strong and resolute in our parenting decision to say no in the face of almost daily requests over a period of probably three years. But when we moved out of London recently, we relented and got a puppy.

We have had him for nearly a month now. He’s 98 per cent fluff and utterly glorious. He is taking us back to the early days of having our own human puppies – you mustn’t let him out of your sight for a second or he’ll a) be literally under your feet so you tread on him, b) be eating something disgusting you didn’t know was hiding under the sofa or c) well, you can guess what c) is.

But what I hadn’t reckoned on, when I collected this beautiful ball of snuffliness from his breeder, was that he would turn into my life coach. I have learnt so much about life – and specifically how to live it well – in the last couple of weeks, just by watching the way he lives his life.

For our puppy, everything is an adventure.

“Someone’s opening a door! What excitement awaits on the other side?”

“Oh you’ve leant down to talk to me – maybe if I lie on my back, you will give my tummy a rub?”

And so on.

Occasionally, he expresses sadness because everyone’s left the room and he can’t follow us upstairs. But otherwise, his glass (or bowl) isn’t just half full, it’s brimming over. As long as he’s been fed, he’s warm, he’s been let out to do what a dog’s got to do and (most importantly) he’s been shown love and affection, he’s happy and trusting. And then falls asleep, paws akimbo.

Somewhere, I read that in the Bible there are 365 statements variously translated as “do not worry”, “do not be afraid”, “do not be anxious”. 365. One for every day of the year. And even if that rather neat number isn’t actually accurate (although how amazing if it were true), clearly the Bible has a recurring theme around worry, fear and anxiety. Perhaps this most human of conditions is not such a new phenomenon as we think. God has been addressing issues of mental health for hundreds and thousands of years.

Jesus talked about it a lot. He addressed it head on in one of his most famous teaching sessions:

‘Therefore I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear. Is not life more than food, and the body more than clothes? Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they? Can any one of you by worrying add a single hour to your life?’

In my puppy, I see (mercifully not a bird flying around) a creature who trusts that he’s going to be looked after. He trusts that he will have food and love so he is free to enjoy chasing a ball or chewing a stick. He models to me the very wisdom of Jesus. He doesn’t overcomplicate his life, he just lives it. As people, we seem to experience life as endlessly complicated. And, of course, sometimes it really is. Some of us carry all sorts of responsibilities that are very complicated indeed. Some of us don’t have our most basic needs met and that’s awful. I pray we can find and help those around us in that situation. But for most of us, most of the time, life really isn’t that complicated. If we have enough food, clothes on our back, somewhere warm to shelter and someone to share love with, that’s a good life right there. If we are privileged to have our basic needs provided for then maybe we can worry less and enjoy more. But for some reason, it’s not as easy as it sounds.

Like countless others, I have carried with me the shadow of depression for many years. Through CBT and other therapies, I have had to learn new ways of thinking to keep the light on, as it were, and the darkness at bay. In this battle, Jesus’ words provide powerful ballast against the tidal waves of the depressive storm. He encourages us to choose, by an act of will, to fill our minds with truth and with the evidence of good things: the promise of his faithful provision, thus forcing out the lies of the darkness. As we choose to fill our minds with the knowledge and love of God, there is less room for worry and anxiety and we find rest for our minds. This choice brings freedom and the space for joy to grow. And, as we have come to realise in recent years, this battle is real for all of us, in different ways and to different extents.

Wonderfully, my puppy seems to have excellent mental health. When Winston Churchill spoke of his own “black dog”, I don’t think he was talking about a bouncing ball of fur begging for a tummy rub. But as I fill my mind with thoughts of Jesus and my puppy, I will continue to learn much about a life of simplicity and joy. And I am grateful to my children, wise beyond their years, who were instrumental in bringing this puppy/life coach into our family.

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.