The power of storytelling as a force for transformational change

Good morning, everyone It is 9:30, and I think we are going to make a start, so I would like to give everyone a warm welcome

This is the first of our expert sessions since we ran the school back in January Wherever you are in the world, or where ever you are in the country, in the UK, or in England, can you just pop in the chat box where you are dialling in from, where you are joining us from That would be great This is the Power of Storytelling as a Force for Transformational change, and our lead presenter today, or facilitator, is going to be Pip Hardy And I will introduce you to her in just a moment

But really, the whole purpose of our Expert in the Room sessions are about making our community of people that we have been connecting with through the school, and through the Edge, through Change Day, through all our communities, and the people that have become this really big community of people who are relating to each other, learning from each other It is about making that stronger The Power of Storytelling is our theme for today, and we will go to the next slide Thank you So, if you are joining in from England or beyond, here are some things that are going to make our session run smoothly and help you to be able to connect with us

We are asking you, if you could use the chat box to contribute throughout the whole of the session, and if you want to raise your hand, just have a look at your participant panel You will see a little hand If you press the hand, Paul will be able to see you if you are actually dialled in on the WebEx, and he will be able to un-mute you At the moment, everyone is muted at the moment We will use Twitter throughout the whole session

We would like you to use some of the hash tags that you can see on the screen It is #SHCR School for Healthcare Radicals, and the handle is @school4radicals And the other handle that we are using is @theedgenhs If you could use all of those when you are tweeting, and we will be able to pick them up on the feed

You can also join our Facebook page, and the group we have got and the page is School for Health and Care Radicals We will summarise each module using Pinterest It brings all the key things together in an easy and digestible way to look at all the things that have come throughout the whole session We have a tweet chat each Wednesday between 4 PM and 5 PM, GMT If you use the School for Health and Care Radicals, #HSCR, you can join in on that, and anybody is welcome to that

So, the next slide So, the team we have got today, my name is Jackie Lynton I am part of the Horizons group at NHS IQ And you have got everybody's Twitter handle on here as well, so I am just going to be doing the introduction now, and then our key presenter today is Pip Hardy We have also got some Twitter monitors, and we have got two

We have got Kate Pound, who is going to be one of our key Twitter people We have also got Carol Read as well You can find them on Twitter as well They have both been central to the Edge, and also to the School for Health and Care Radicals We are also going to be joined by Bev Rodgers during Pip's presentation, who is going to share a case study with us today as well, so we really welcome Bev

So, my last slide, then, is really just to introduce to you Pip Hardy And Pip is the co-founder of the Patient Voices programme And the programme is now one of the largest and longest running digital storytelling projects in the world And Pip was telling me earlier, some of the stuff that she has been sharing right across the world, in terms of the power of storytelling, and how that can transform our whole change process, and transform people's lives in terms of how we share and how we connect through the power of storytelling So without further ado, I really just want to hand you over now to Pip Hardy

I hope you have been able to read the little CV on there, which I probably haven't done justice to But a very, very, you know, compelling, kind of, person, and believer in what she does, so over to you, Pip PIP HARDY: It was really nice to be joined by so many of you I would like to just start by going through a brief plan for the day, what I would like to be doing First of all, I will give you a bit about about the program, and why stories are so important, and get your thoughts about what makes a good story and to give us all an opportunity to think about the kinds of stories that we like to hear, and the stories we like to tell

Think about how you can use stories and we have three case studies, and I am pleased that Bev is joining us to talk about some of the storytelling work we have done with her team And finally, I would like to give you a chance to do a bit of storytelling of your own We will give some thought to finding your own story and how you might actually use some of the, hopefully, inspiration from today, to actually shape your own stories of change and aspiration I know you have been writing in the chat box about where you are, but I thought it would be lovely to have a bit of a visual representation for where people are, so I think Paul is going to make it possible for you to use some arrows, and if you could just pop an arrow where you are coming from on the map, Paul is showing you how to do it I guess we will have quite a few people from the UK, but I know we have also got some people from elsewhere

Mary, lovely to see you joining us from Australia I am not sure what time it is there for you, but I guess it must be Friday evening I think we have got some people from Qatar, and Denmark somewhere New Zealand it looks like Warwick, welcome

Hana from Qatar, welcome Arrows from Bangladesh, well, anyway We have someone from Vancouver, Deanne And somebody from Russia OK, it is lovely to see so many of you

We may not quite wait for all of you to put your arrows in, but it is fantastic to have so many people here More arrows coming now I think we will move on, but welcome to all of you Just moving on to talk a little bit about the background of Patient Voices We chose the name because we actually wanted to hear stories from all of the people waiting patiently to be heard, with respect to the experiences of health care

Really, that is all of us Whether we are clinicians or managers, or improvement people, or change agents, almost all of us, at some point in our lives, will have some experience of health care, either somebody receiving care or as someone looking after someone who is receiving care The idea was it was intended to be a play on words, which sometimes comes back to bite us a little bit, but I wanted to explain that to you, and to say that we have had very many stories from staff clinicians across the interprofessional range, as well as students, and of course many patients, and many carers And it feels really important for us to be able to listen to all of their stories, so that we can all learn from one another We set up the Patient Voices programme in 2003, really, as a way of offering a different kind of reflective opportunity, particularly in the early days of eLearning

We wanted people to think about the why of doing things, not just the how and the what In that time, we have recorded nearly 1000 stories, told by all kinds of different people Many of the stories have been released, sometimes people feel that they are not quite able to release their stories All of the stories on our website are freely viewable and freely usable by people involved in healthcare education and service improvement We get quite a lot of hits on the website every year

The story are used in schools of healthcare and medicine throughout the English-speaking world and beyond We published a book last year about a series of case studies about how people are using both the stories and the storytelling process to actually bring around transformation in their particular spheres We have been pretty busy over the last few years We have had the good fortune to work throughout the UK, as you can see, but also in many other places We have been lucky enough to travel to Australia, and Hong Kong, and last year to Tanzania, and we have done a bit of work in North America, and we have colleagues from around the world with whom we share experiences and stories

One of the things that has really struck me really powerfully in our work around the world, and with different people, is that there really is more that unites us than divides us Human beings, people are human beings before they are anything else, before they are patients, carers or clinicians There are two things in particular that I have noticed One is that every group we work with feels they have the monopoly on suffering, whether they are carers, or whether they are somebody that has suffered from a stroke, whether they are overworked junior doctors, or underpaid nurses, pretty much everybody feels that they suffer more than anybody else And the other side of that is that, actually, they want to be treated with kindness and with dignity, and with respect

What we have discovered through the work that we do is that by sharing stories, people also come to a deeper understanding of themselves, and their place in the world And they usually come to realise that, perhaps, they don't have the monopoly on suffering, that there is somebody else that may be worse off or better off than they are I think it is a very, kind of, levelling experience, to be able to share our stories with one another, and realise that we are all human beings in this together, trying to make the world a better place So why do we tell stories? Initially, our goal was actually to use stories in education, so we were very encouraged when we discovered this quote from Pascal, and he said that we tell stories to entertain and to teach I guess, if you have ever had a really great teacher, almost certainly, they will have used stories to illustrate the important point that they wanted to make

And they do that partly through entertaining people, and we all know when we settled down to hear a good story that we, as a sense of anticipation and delight, that we are going to be hearing something that will be instructive, but hopefully also entertaining This is one of the slides that Helen uses, and I think it is a really helpful way to get a start on thinking about why we tell stories People have begun to forget how powerful human stories Many of us, at least, have exchanged our sense of empathy for a fascination with data, networks, patterns, and total information But really, the data is just part of the story

The human stuff is the main stuff, and the data should enrich it Some of you may be familiar with Rene Brown and her work on vulnerability and courage She talked about stories being data with a soul, which is a lovely way to think about stories We need the data, and we also need so was, Tony Sumner summed up the distinction when he talks about statistics telling us the systems experience of the individual, where as stories tell us about the individual's experience of the system Probably, hopefully, you realise from the quote that when an organisation wants to find out what people think about their service, or their product, they ask questions that are important to them

How did you find the cleanliness on a scale of 1-10 question what would you recommend this to your friends and family? But actually, they are always the questions that are important to the organisation, and not necessarily the questions that are important to the individual If we want to find out what matters to individuals, and to gain an insight into their experience, we really need to listen to their stories Robert Francis said that if there is one lesson to be learned, it is that people must always come before numbers It is the individual experiences that lie behind statistics and benchmarks and action plans that really matter, and that is what must never be forgotten when policies are made and implemented Stories are really good way of cultivating empathy

So this is a couple of medical students who are creating digital stories One of the things about empathy is that it helped us to reflect on new knowledge They are important for kinds of reasons, not least that stories are the way we communicate tacit knowledge, and convey the things we know but don't necessarily know that we know So, how to be part of a family, a team, an organisation What we wear at work, what we can and can't say

Stories also help us to acquire different kinds of knowing In healthcare, there's a particular emphasis on empirical knowledge, the facts and figures, the things we need to know in order to treat patients safely But we tend to forget, perhaps, about the other kind of knowledge that can make caring health practitioners We need an appreciation of what is beautiful, and stories, art, paintings, sculpture, music, can help us to acquire and sustain aesthetic knowledge We also need to have a moral kind of knowing

We need to know what is right in order to help us make judgements Often we need to make very quick and hasty judgements in challenging situations So we need to have a really strong sense of morality and what is right and wrong in a particular situation It is very helpful to know ourselves and have personal knowledge Otherwise, we don't know how we fit in

We need to know where something is going to trigger a particular response Stories can help us to do those things By acquiring those different sort of knowing, we can bring an authentic presence into the caring encounter, in whatever way we actually serve people Donald Schön, a guru of reflection, talked about storytelling as the mode of description best suited to transformation in new situations and action I think, as change agents, all of us are trying to bring about transformation

It is helpful to think about the ways that stories can enable us to do that But if we are going to try to transform culture, we need to think a bit about what culture, what we actually mean by culture I have taken a bit of time to look up various definitions of culture The dictionary defines it as the attitudes, feelings, values and behaviours that characterise and informed society as a whole or any social group within it So, whether that's a family or club or a team, and office, whatever it is, all of us belong to many different cultures and different groups

But this is the one that I really like Culture refers to the ways in which human beings overcome their original barbarism and through artifice become fully human I asked a group of people at a conference I was presenting at not long ago, a group of interprofessional students, so they ranged across the groups, from medics to nurses, to different sorts of therapists, all kinds of different people, and I asked them what kind of culture they would like to see in the healthcare of the future as they move from education into practice This was their list I really wasn't sure I could actually add anything to it

I thought this was a pretty good, comprehensive list of the kind of culture that we might be looking for If you have any additional thoughts to the kind of culture we should be thinking of, you might like to put them in the chatbox It would be lovely to see if you have other ideas So, we have learned, healthcare, quite a lot in the aviation industry As it happens, my father was a researcher in a very large research project into investigating why aviation safety was so poor

This was back in the 1980s And they decided to use stories as their main method of gathering data What they discovered was that it was really crucial to have good communication, and that communication needs to go in both directions We often tend to think about communication as a kind of one-way thing, but we also need, if we are going to sustain culture that we are talking about, we need to be able to share our values and a really effective way of doing that is by sharing stories I see that we've been getting some nice comments in the chat box, people are talking about a non-judgemental culture, rather than blame oriented, one that is flourishing, a lovely way to use about the kind of culture that we would like to see

We don't want culture that is stagnant Thanks for your thoughts in the chat box So, communication, we agree, is really essential One of the findings of this research project that was funded by NASA was that we need to assure the vital flow of information so that the information derived would be helpful to all and harmful to none I think again this diagram is really just intended to reinforce the notion that communication is very much a two-way process

It's not just a one-way delivering of information or delivering of a particular message It needs to be received and understood, and, of course, feedback can really help to improve our communication So, the first case study I wanted to share with you, and unfortunately the person whose case study this really is, Cathy Jaynes, the director of research at the Centre for Medical Transport in the States, is unable to be with us because it would be 4 AM, her time That is not her best time! So she has empowered me to share this with her She has been a flight nurse

Too many helicopters have been crashing over the years They decided to find out why this was happening and try to create a culture of safety so that fewer helicopters would be lost, fewer members of the crew would be lost, and more patients could actually be saved Interestingly, there was a survey posted to nearly 1000 people, and what really emerged was that it was not clear how our culture of safety could be created, because nobody quite knew what that looked like Kathy actually said, well, I do know what safety looks like, having been a flight nurse for many years I actually have a number of stories that illustrate what safety looks like

So I wanted to share one of the stories with you now Hopefully the technology is going to work for us This is Cathy's story (Video plays) CATHY JAYNES: One of the things I loved about being a flight nurse was that my opinion really mattered That wasn't true in every area of my life

Divorce and a walk-through emotional battery had shaken up a lot of my trust in my own voice My own value When I began as a flight nurse, the guy who hired me said, one of my main goals in this job is to leave without knowing anybody who died in an on duty crash 16 years later, that goal, for me, had gone down not once but several times I was leaving to begin my new work as a nurse in faculty

I was thankful that I was leaving safely Just two more weeks until my last duty day The flight began the same way they all did pages beeping, phone is ringing 6 minutes from sound sleep two blades turning as we flew towards a motorcycle crash To describe it as a dark night would be an understatement

The red, blue and yellow of emergency vehicles were the only light guiding us to the scene The pilot switched on the night sun, that huge searchlight on the bottom of the helicopter that would help us find our way God, they are putting us down in a hole, he commented As was the routine, all eyes were focused out the window I was the only one who saw the brief glint of the wires just danger

We had all agreed on a code Go around I had only said those words once before That pilot had doubted me Somehow, we didn't crash

But if this pilot did the same thing, we would all be dead in just a few seconds Go around That was the voice I should have used in so many other situations, with other people The pilot did exactly what was about to happen next No doubt, just trust

A complete stop in midair and then a slow, straight uplift out of danger PIP HARDY: So, we like to think that the best stories are effective, affected and reflective In other words, what does a story make you think about? So, really connecting the head, heart and hands So I wonder whether any of you would actually like to contribute in the chat box and suggest maybe how the story made you feel? How it made you think? And if anybody would like to say anything if you can raise your hand, then Paul can unmute you I would love to hear your thoughts

Any responses to that story? Any thoughts about how it made you feel or think? It sounds as though some people were not able to watch the story OK, so her personal problems resonated How did that make you feel? "Sharing her vulnerability Yeah, that's an insightful comment Thank you Gave you courage; It is great to hear your emotional response to that

I felt a bit shaken; To be honest, I worked with Cathy to make that story and I had to watch it 60 times before I didn't have shivers running down my spine The video is on our website A couple of people asking if they can have access to the video, so, yes, we will be able to send you the link to the story on the Patient Voices website OK, I think we might just move on now So, yes, she has learned from her experiences and pushed herself Simple things that make a big difference

Yeah, OK, so there are some great comments about this story Hopefully you can see that it's not just a story about being a flight nurse The message of the importance of communication and teamwork is actually applicable across any kind of team, particularly, I guess, operating teams, but really we need to have trust within the teams that we work What happened as a result of making a story, Cathy wanted to give a good story about safety that can be used in education and training in their industry And these are some of the comments from other people that have made stories

I think they have made about 50 now They are getting towards their goal, and a lot of the people who have made the stories are now using them in their own training sessions One story at a time, we can leave a lasting impression with those that come behind us, and that is one of the lovely things about the 21st-century that enables us, with digital media, to leave a powerful legacy of our stories and the things that we do, that we can leave behind for others that follow us I felt the stories were so powerful and did a much better job than any other safety lecture of telling the story, because we can hear the voices of the people whose stories they are We need the stories to learn and develop

Cathy summed up some of the research they have been doing by saying that stories are essential in creating a culture where safety and humanity are prized, and the values of intellectual, emotional and spiritual intelligence informed the way that we do things here I would really like to hear your thoughts about what makes a good story We have now looked at a story and thought about how we tell stories And again, if you can use the chat box, and maybe think back to the last novel you read, or the last film you saw, that you really, really enjoyed, and think about what it was that made it so compelling, made you want to watch it again, or recommend it to your friends So yes, do let us know what you think makes a good story

And once again, if you would like to say something, please raise your hand, and Paul can un-mute your microphone and you can chat with us So we are still getting some comments about Cathy's story What makes a good story? The treat A good story needs to be authentic That is a really great point

A catchy novel has a sense of injustice Interesting A sense of reality, something you can identify with Puts us in the role OK, so we can actually stand in somebody else's shoes

Connection with the characters and with the emotions These are great point about what makes a good story Hope, challenging, powerful, emotive, a sense of drama OK, you have got to know what the author wants you to do, think or feel Interesting

You want to be guided through the story Having a window onto someone else's world, that is a really insightful comment, and making sense of things Standing in someone else's shoes, you can understand the situation Indeed Shared values, and also values foreign

It is lovely to be able to find out about things that may be completely alien to you Stories do that by bridging gaps It needs to be thought-provoking, a structure, a beginning, a middle and end But not necessarily in that order, interestingly OK, I have some ideas that I would like to share with you about what makes a good story, so I think we will perhaps move on

And these are really just some quotes about what can help to make a good story So Mark Twain, in a letter to a friend, said, "I'm sorry to have written you such a long letter, I didn't have time to write a short one Those that have had to write an abstract for a paper or report, would be familiar with this, cramming stuff into enemy a few words It takes a lot of time to write a short story Helen talks about showing not telling

If you can actually illustrate for us the point you are trying to make, it is much more effective than trying to describe it to us Jeanette Winterson says, Stories are always true: it's the fact that mislead; Whatever it is, the details don't really matter What matters is that we actually understand something important about our human state, which is why, for people like me, English literature provides us with a really deep understanding of humanity and history, those of you who are interested in history We can find out so many important things about the human dilemma, and about the world we live in two hearings stories from people in history Finally, Yann Martel, some of you may have seen the movie, the Life of Pi, or read the book

He says;The foundation of a story is an emotional foundation, in other words a good idea that moves; He also goes on to talk about in 'The Life of Pi', when Pi has described this apparently incredible fabrication of being shipwrecked, and the insurance investigators are trying to get from him what they see as the truth And eventually, Pi says, I know what you want, you want the dry actuality That is a helpful way of thinking about stories that are nothing but the fact They can feel very dry We actually need emotions to turn the narrative into a story

Tolstoy talks about the importance of change, he says, All great literature is one of two stories; a man goes on a journey or a stranger comes to town A story must be about to change If there is no change, the story is really boring I think for those of us involved in healthcare, the person going on a journey goes in search of change We begin a journey to find something that may put us in a better place

The stranger coming to town can take on all sorts of different guises, it can come in the form of an accident or unexpected illness Those are the strangers that we need in healthcare, the challenges that we face and he much on a daily basis when we work in healthcare These days, we have so many ways of conveying stories We can convey our stories, obviously, through the written media, but many of us, I am sure, convey stories through PowerPoint, we may make movies, we may create broadcast, we may do a WebEx or a webinar like this, we create a digital stories, some of us may write short stories or poems, we may draw or paint There are many different ways of conveying the message, and it is really important to think about how you can make the best use of whatever the medium is that you are going to use to convey your story

So thinking about the difference, perhaps, between a story and an anecdote, because certainly in health care, I have noticed over the last few years that almost anything that comes out of the mouth of a patient is referred to as a story I am not sure that is necessarily true For me, a story needs to be something else So an anecdote, in contrast, has no contrast, or resolution A story offers a narrative arc, the unification of action, irrevocable change and meaning

You might want to have a little look at this story arc It is a little bit small and hard to read, but it really identifies, visually, the need for crises in our story And the need for some up and down If a story goes completely smoothly, we actually lose interest quite quickly If there are no challenges, no crises, no confrontation, no conflict, there is really no opportunity for us to actually demonstrate our resourcefulness as a human being

We talking the Patient Voices workshops, when we help people to create their stories, we talk about the need for a dragon in a story Flannery O'Connor was a novelist in America, pretty much in the 1950-60s She says, No matter what form the dragon may take, it is of this mysterious passage past him, or into his jaws, that stories of any depth will always be concerned to tell My understanding of that is that the dragon is the challenge Whatever challenge we need to face, in what ever our world is, it allows us to demonstrate our courage, our creativity, our humour, our resourcefulness, our cleverness, our strength, the things that make us most fully human and enable us to demonstrate our prowess I am hoping that Bev has been able to join us

Do we have you on the line anywhere? While we are waiting to see whether we actually have Bev, perhaps you would like to put comments in the chat box in response to that last little section about what makes a good story, and any thoughts you might have about dragons and challenges We would love to see your thoughts in the chat box or on Twitter, and they are trying to work out whether Bev may have joined us Do we know whether we have Bev with us? Hello? SPEAKER: Hi, Pip We are just checking out PIP HARDY: Are all good stories reflective? I wonder what your thoughts are

All good books are alike So yes, it is lovely, if when you finish a book, that everything happened to you That is another great quote from Ernest Hemingway We are going to hold on for a couple of minutes to see whether we have got Bev with us If she doesn't join quickly, I may make a bit of a start

Any other responses or thoughts about what makes a good story? Do any of you have other thoughts or ideas about what helps to make a good story? Any other thoughts? Most stories are messy, I think That is why we have to reflect on them, to try to find the meaning, the meaning in our stories Most stories are improved for a bit of reflection Interesting comment about cultural differences, and how stories may unite us But of course, they can also sometimes divide us, unfortunately

Somebody talking about Ishiguro Yeah, lots of stories are great allegories of journeys Telling stories definitely need courage Thank you, Joan Admitting your problems to others

Strangely, we find that when some people share stories, they realise that many, many other people have similar stories and similar fears Any sign of Bev? BEV RODGERS: Yes, we are here Hello PIP HARDY: Do you want to give us some background to the story? BEV RODGERS: I would love to I can't see the slide in front of me because we are at work, and we have had to find a quiet place, but a bit of background about the ward

I am Bev Rodgers, the senior assistant Sitting next to me is Laura, one of our clinical sisters We are both looking to participate in the storytelling workshop In November 2011, the OD asked me to lead a team in difficulty There were lots of issues, issues around consistent nursing leadership

There had been 10 ward managers in 14 years, so no consistency We experienced that medical staff were completely disengaged, there was low morale amongst the nursing team, and not surprisingly, against that background, there were high sickness levels With the underlying team dynamics, a little bit of intimidation, and the staffing levels were really poor We had high numbers of patient complaint and patient safety incidents, including medication errors So there was a lot to do

Against all of this, we asked the staff how they would feel to have their own friends and family nursed on the ward, and the results were really damning 93% of staff reported that they wouldn't be happy to have friends and family nursed on the ward Clearly, there was a major issue and measures needed to be put in place Lots of measures were put in place, which included participating in the storytelling workshop This allowed us to have some time away from work, away from the constant pressures, reflect on the situation and really look at what we could put in place to move on

When Maxine Connor and Pip spoke to me about the digital storytelling, to say I was sceptical was an understatement I really didn't think I had a story to tell If I did have a story, would anybody else find it interesting? And also, I am not someone that bears my soul easily to people that I don't know closely And I didn't really think I would benefit from the exercise So given the negativity that I had, I was then asked to recruit five staff to attend with me

And to say that was difficult is a bit of an understatement Anyway, four days away from work seemed to do the trick in the end Six of us went along to the first workshop And how wrong I was about the value of the storytelling To say that I learned more about my team in the four days that I spend with them in the preceding 12 months, I had absolutely no idea how I felt about award, and the problems we were experiencing

The staff were angry, frustrated, sad, it really was quite overwhelming When the first workshop ended, we were all a bit sad that it ended, and I had to recruit five more staff for the second workshop But by this time, it was easy Word had got out and staff wanted to attend, and after we had done the second workshop, you know, staff would comment to me One of our clinical sisters said, That is my closure now, I want to draw a line under it

And one of our healthcare assistants said that she loved the job before, but loved it even more now I played the presentations and stories quite a lot at different presentations, and even two years later, I find them really emotional, but I am very proud of the team Against that background, I asked the staff about friends and family being nursed on the ward, and it was 90% positive I feel that taking part in the storytelling exercise helps staff to reflect on where they have been, but more importantly what they needed to do to move on Laura participated in the second workshop

I don't know what your thoughts were? LAURA METT: Like you, I felt that group sessions were not for me I felt really nervous As a clinical sister and leader of the team, I felt I should be going rather than I wanted to go On the first morning I felt really nervous I know we all did

We looked like we were going to, I don't know, to our death or something! It was a really nerve wracking morning Pip put us at ease I really didn't think I had a story to tell, either I thought, What am I going to say? I did not think that what had happened on the ward had really affected me that much Obviously, it had

That morning was really quite emotional It felt like we got a lot out of it After we had done our story, and it sort of just flowed, it came natural, I felt relieved I felt valued and value the other members of the team You got the sense of the team by the end of the four days

And friendship, really Not just working relationships, we also have developed a bit of friendship I looked forward to going back to work It made me more positive It was just a really positive experience

I got a lot from it BRENDA ROGERS: I don't know if there is anything else you wanted to add, Pip? PIP HARDY: I am showing the word cloud from the script Laura, do you want to say anything specifically about your story before I show it? LAURA METT: No, I think it speaks for itself, really So, yeah, play PIP HARDY: OK, I will go ahead

Most of you will be able to see this (Video plays) LAURA METT: Morning! I feel happy and full of positive thoughts and ready for the day ahead I would turn back if I were you What an awful shot Oh, and Vicki and Richard have phoned in sick

Trying to stay positive, I look around at the empty seats Phone staff Morning drug round is late Obs to do Oh, and that catheter looks full

The patients in Bed 2, 5, 23 and 25 need feeding But three needs a shave Who is he? What is he feeling? He must miss his family But here is a bed manager Any beds? Bed 16 and 17 are confused, with only one nurse to supervise

Maybe it might not be a good day after all No time for a break A patient to escort to radiotherapy The bed manager is back on the phone Is that bed ready yet? Can you call me back? Bed 5 needs pain relief

Crash! The confused man in Bed 6 is on the floor His cry can be heard by everyone Finally, some help Sorry, I have no staff to spare, but can you stay on for tonight? No help for the man on the floor I just have time to give him some pain relief

The bed manager is back on the phone Is that bed ready yet? That was three years ago Today the staff quickly with a good morning and a smile and I have time to say, Hello, my name is Laura, how you feeling? Now you are Mr Smith and not just a man in bed number five Now I nurse how I should and how the patients deserve PIP HARDY: quotes from the workshop

What the slide has on it is some of the things people said in their valuations Somebody said, it has helped me get a lot off my chest I have put it to bed now I did not realise how sad everyone was Finally, I feel like we have learned a lot about each other's stories

This has brought home of the ward means to everyone Then I have got a lovely picture of the team sitting together, Bev and Laura You are there as well Would you like to say anything else about this? Somebody's asking about what changes have been made to bring about a change in culture on Ward 14? So I suppose whether you think the stories have made a kind of sustainable change to the culture? LAURA METT: The stories were part of it It was important to make sure staff were listened to

I think that previously they did not think their views were heard It was important to make sure they were listened to, looked after and developed, really It is a bit of a hard one, how to put it in a nutshell It is just all those things about treating people as you would expect to be treated yourself, shared goals, objectives It is really that kind of thing

But I really feel the digital storytelling played a part My only disappointment was that we did not get all of the staff through it I think we had 10 staff And, of course, I was somebody who did not have a story to tell but ended up making two stories PIP HARDY: I have got some of the tweets coming through

You said you would like all of the team to experience this BEV RODGERS: I know I felt I did not want to take part But if you just do something out of your comfort zone, sometimes you might surprise yourself completely PIP HARDY: I think that is probably true So somebody is just asking how you work together now? I think that is for you, Bev and Laura? BEV RODGERS: Yes

We have developed a closer bond We have seen what everybody else has gone through Personally, I had no idea that staff were still feeling angry, upset, isolated, despairing, all of those negative emotions So I think just recognising that allows us to work better together I think we are more cohesive as a team

We're definitely in it together and working better together, I would say I don't know was glorious feeling? LAURA METT: I would agree with that Other people recognise it, doctors, people who are not familiar with the war They get a sense of the teamwork It is recognised from the outside and not just ourselves

We recognised it as well We set each other goals were that would never have been before We try to set ourselves targets to achieve things, and have, like, healthy competition with ourselves PIP HARDY: That is lovely to hear In many places, we have observed that telling stories can deepen relationships and provide insights and knowledge of team members

Obviously we think it could be really helpful throughout organisations I think we will probably move on Bev and Laura, you're welcome to stay on and listen even if you can't see I think is so much for joining us BEV RODGERS: We need to leave now, we need to get back to the day job! Goodbye

PIP HARDY: This would be a lovely time to catch up with what is happening on Twitter and chat Kate, what has been happening? KATE POUND: Lots of activity on Twitter People are just enjoying the subject and hearing more about the power of storytelling One of the key things that resonated a lot with people was thinking about the culture and the importance of that The general feeling was that, you know, the storytelling is food for the soul and that we should use storytelling more

Lots of people are saying thanks to the team from Ward 14, sharing their stories So thanks for that PIP HARDY: Carol, what has been happening in the chat box? Are you there? Is Carol with us? CAROL READ: It has been very busy in the chat box and I would say it has been fascinating to see obviously the worldwide contribution that has been going on in a chatbox We have got people wanting to share resources and knowledge Stories are a window to another world

We are looking at the themes you have been talking about Sarah is mentioning being in somebody else's shoes Polly mentioned a good point about giving people time and space to tell the whole story, not just the bit we want to hear So often, stories are modified to protect others, Rachel says People are really reacting to the stories they have heard

They are really wanting to understand and reconstruct the process of storytelling, which I think is fantastic PIP HARDY: Over the years, they have come up with the seven elements of digital storytelling, but actually, the more we have talked about this process and the more we have thought about it, it seems to us that some elements are really pretty relevant to any of the ways that we tell stories and the 21st-century These are the seven, and I am going to go through them point by point, talk a bit about them, and then I will give you a chance to do a bit of storytelling of your own, before we finish So the first element is the point of view, and I think a few people have mentioned in the chat box how important it is to be able to see something through the eyes of another person I thought these two pictures illustrated it quite well, really

It is very common for people that come to our workshops to want to tell a story in the third person, partly because that is the way they are used to writing They even want to write the report or PowerPoint presentation But we really want to experience your world, see how it feels from your perspective So it can be powerful to let your audience, particularly as leaders of change, let them feel what it feels like to be you Let them see the world through your eyes

Secondly, there needs to be a dramatic question, and the dramatic question may or may not be related to the dragon I don't know whether you can see this photograph, but basically this raises the question of why the chicken crossed the road In this case, it is an advert for Audi, he is crossing the road to get to the Audi But we want, we want you to be able to do some of the work when we are listening or watching a story Depending what kind of story it is, what is going to happen here? What will be the outcome? For the hero or heroine of the story managed to accomplish the quest that they have set out on? It is a nice ad! We really want to be thinking, and sometimes you can actually pose the dramatic question right in the very beginning, perhaps in the title of the story

But be thinking about how you can actually get your audience working as your story begins We talk about emotional content in our stories, and I know that is a really difficult term for people You heard Bev and Laura both say that they are not the kind of people that bare their souls People say they don't do emotions, I don't want to open up too much Perhaps an easier way to understand that, we need to think about authenticity

If you tell a story about something that really matters to you, in a way that is authentic to you, it will matter to others of us, and we will connect with what ever the emotion is, whether the emotion is here, sadness, joy, celebration, whatever it happens to be And these two photos, I thought, maybe help to illustrate a for me, the light coming through a stained-glass window onto a stone floor It reminds me that there needs to be both light and darkness in a story We don't appreciate the light unless there are some shadows, unless there is some darkness And the rose is more about authenticity

A rose is just a rose, it is not trying to be anything else It's just there, being a raise So if you let us see the lightness and darkness in your life, we can connect with your story emotionally at some level So obviously for those of us that do presentations, or who may be doing broadcasts or making videos, how we use our voice is really important And many people, find it very difficult to hear the sound of their own voice

In fact, we are pretty much still waiting for someone to come to one of our workshops and say, "I love hearing the sound of my own voice It doesn't happen very often But we have had many people who have really not had a voice, either because they have had a stroke, or because they have had some kind of mental illness, they have a learning disability, something has happened to their voice that makes it very difficult for them to speak, and it is a constant reminder to us about what a gift your voice is, and how unique it is It is one of the things that helps to make your story both unique and universal There is the other way of thinking about voice in terms of having a platform, where you can actually share your vision, your inspiration, your hopes and your dreams

So it can be very difficult to actually have words in your heart that you are not able to utter, but by using your voice and creating a story or a video, other people can actually hear about what really matters to you It can be helpful to add a bit of music, or some kind of a soundtrack, to your story You may like to have a bit of music playing in the background, if you are doing a PowerPoint or doing a video Sometimes a bit of music can help to establish the emotional tone Somebody said earlier in the chat box that they would like to be guided as to how they should feel, and music can be a very helpful way of doing this

It can also be overdone So with all of these things, there is only encouragement to be discreet and to think carefully about how much you might need, and possibly how little, which leads us on to the next slide A couple of people commented on how they like their stories to be short In order to have a short story that also works, you need to think really carefully about what you are going to leave out, as much as what you are going to put in Do you need the entire car full staff and the roof rack overloaded with different ingredients, different words, different ideas, or can you convey your story in a very economical way with really just the minimum of what is needed to cover story? And finally, think about the pacing of your story, if it is a written story you may need to do something quite dramatic at the beginning to actually grab the attention of your reader, your audience

But you can also change the pace of your story It can be helpful to think about pacing as a little bit like the heartbeat of your story, is it going to be very rapid? Is it going to be very slow and elegiac? Is it going to excite people and get them energised? Or is it something more thoughtful and thought-provoking? These are all, really, things to think about as you are creating stories and sharing your stories with other people <br> I wanted to share with you a really, really short story Some of you may be asking yourself, &quot;It is really difficult to share difficult stories in a few words, but I think it is usually reckoned to be one of the shortest stories in the English language It conveys so much

It is a huge story: For sale Baby shoes Never worn It conveys so much in so few words I want to move onto another brief case study, and think about case studies as cancer mission at different levels We talked about transformation at ward level with Ward 14, and at a much wider level This is a story about transformation We have been working with Manchester Mental Health Trust for many years now

They approached us a few years ago when they had poor patient and staff satisfaction surveys in relation to dignity, respect and communication They thought that stories would be perhaps a helpful way to illuminate what was actually going on behind the survey scores behind the data, and the statistics So over nearly 3 years now, we have run eight storytelling workshops with about 64 people Most of them have created stories; Actually, that is the wrong number of stories I forgot to update that because we keep giving new workshops

I think there are actually now 67 stories and about 60 of those have been released Apologies for that non-updated slide But what actually happens is, people have created friendship and support networks, many of the storytellers have kept in touch with one another, and they meet up the coffee and lunch, and they come back to subsequent workshops They bring their friends, they suggest to their friends that they come along A story is now shown at the beginning of every board meeting, where they actually use the stories to assure themselves that poor care can't happen again, or that good care will become standard practice

The stories are used in recruitment and selection interviews to try and ascertain whether a potential person joining an organisation will share the organisation's values, and have the degree of emotional intelligence that is necessary to work with people who have mental health conditions They are used in induction and staff training, and in public screenings to raise awareness and reduce stigma in relation to mental health issues so they have been showing very publicly in the Manchester Triangle Obviously, it gives a huge amount of strength to the patient and carer voice, and reminds everyone involved in the organisation of the shared humanity of patients, carers and staff involved in Manchester The stories are all different kinds of stories We think of a quote from Jeanette Winterson, and she talks about stories going out as flashes of light, like flashes of light from a lighthouse as markers, guides, comfort and warning

The stories from Manchester and actually all of the stories, it can fall into one of these kinds of categories But one of the things that is so important when we are collecting these stories is that they are created by the storytellers themselves, and particularly where patients, and especially vulnerable patients, the opportunity to create their own video and have complete control over what goes in and what stays out is really important And they then also have complete control as to whether the story is publicly released, whether it is shown any further or whether they need to make that story, take it home and put it on a shelf, putting the story behind them and move on The degree of control by storytellers is really, really critical, and the fact that they do their own creation, and that their stories aren't gathered, taken or collected Lots of things have changed in the organisation

They now have dignity walks Patients are more able to tell their own stories and to become involved in the creation of care plans Patients and carers are definitely recognised as being experts by experience And there is far more engagement with family members of people who are patients in the trust What is really interesting, and for those of you that do like data and statistics, in this time, there has been a really dramatic reduction in complaints, particularly complaints related to care, complaints related to staff issues, and communication

And perhaps even more crucially, our production in clinical negligence claims That results in a huge reduction in management costs and a huge saving in staff time So nowadays, the overall quality of care is considered to be good or excellent, and 95% of the patients who were surveyed would actually recommend the Trust in very direct contrast to what had happened a few years previously So, just a few quotes from storytellers Just watching the comments in the chat box that have been going by, creativity does take courage

It is hard to be creative, hard to share your story, hard to open up and make yourself vulnerable to other people One of the storytellers also said about how it reminded her of how our creativity connects with part of our soul, and how wonderful it is to be part of something that does not have measurable targets or hard matrices This leads to the next slide about personal transformation, it certainly seems to me that while those of us, probably all of us, are engaged in the process of wider change, unless we have transformation at a personal level, we might as well forget about the wider transformation What we notice time and time again is that when people do have the time to share their stories, they reach greater maturity as they find the freedom to be themselves, and to claim, accept and love their own personal story with all its brokenness and its beauty So now I think it is your turn to think about a story that you might like to share, and we are obviously going to have to keep these stories are very short

I'd like you to begin thinking, in the back of your mind, about a decisive moment in your life, one of those moments where your life could have gone one way or another, perhaps a fork in the road moment And I am going to give you a few clues as to how you can do this too much in a short sentence, four sentences, a bit like Hemingway, although we are going to have four With your first sentence, you need to make a connection with your audience So as I am talking, if you can, you might like to just make a note of a sentence that would begin your story about a decisive moment in your life, OK? So, Once upon a time; Maybe Sorry, I have to go

That would be a good start to a story, but I understand that you have to leave I am glad you enjoyed it, Gary With your second sentence, you need to give us enough context to be able to understand where your story is going to go Where are you standing? Are you at the top of a tightrope with a bit of a detour What is happening in your life that will illuminate and help us to understand where you are coming from? In a country far away? That is a nice start to a story

We then need to have some kind of crisis or conflict Again, this is the lighthouse, I don't know if you can see the flashes of light going out from the lighthouse If you were a ship about are found on the rocks, that would be a great crisis for your story But also be thinking about if you find yourself in a crisis, are you going to be building bridges or are you going to be building dams? Finally, in your four sentenced story, we need some closure We need to know what you are saying about this topic at this particular time

It does not need to be the end of the story, it does not need to be a happy ending, but we want to know that you have actually concluded the story Would anybody like to venture a short, four-sentence story in the chat box? Or would anybody like to share a story they have managed to write while I have been talking? We would love to see any contributions Any thoughts? No? Here I was in a psychiatric hospital in South Africa I chose to transform healthcare for those who were most vulnerable a great start

Three years ago I nearly left nursing That is a great start The NHS changed my life We might need more of a crisis there, but it is a lovely, positive story So I think maybe I will leave that with you as a bit of homework, to actually be thinking about the four-sentence story or you might like to tell, and thinking how much you could actually get into that story

I would like to move onto how stories can help us to think about our values and our identity So, there should be, on this slide, OK Values, identity and stories Your values and your identity, for most people, are a bit like the hidden bit of the iceberg We don't necessarily see them in any obvious way apart from through your stories

Your stories are the ways in which we reveal our values and our identities Stories can actually really help to shape our identities Toni Morrison talks about narrative being radical, creating us at the very moment it is created Think about how your story might change the direction of your life, how you might think about yourself As Laura and Bev found, it changed the way they thought about themselves

Stories can also change our lives So, we often think we tell stories but the stories often tell us They tell us to love to hate, to seal to be blind They may sadden us, write us, we pass onward, tell us what to do, and we do it without questioning The task of learning to be free requires learning to hear them, to question them, to pause and hear silence, to name them, and then to become the storyteller

We have done some work over the past few years with students, medical students, nursing students, newly qualified nurses, and it has seemed to us that there are some important things that are not taught in schools of medicine and schools of health care, and these are very important qualities are to do with vulnerability, courage and resilience A few weeks ago we had a fourth-year student come to us and she was quite nervous about the story that she thought she wanted to share In fact, she was really quite hesitant and said, I feel so guilty about this incident that I'm just not sure I should even tell this story But I would like to share her story with you, and then we will pretty much close this presentation But I felt this was a useful story to end on in terms of thinking about how we may need to continue to change culture and how we can help the clinicians and the people of the future, our future, to be the best people they can possibly be and deliver the best care they can possibly give

So this is Emily's story An Education (Video plays) SPEAKER: Beautiful, straight-backed and head held high I guessed her at 70 Her notes told me 93 Hello, my name is Emily

I understand you have had some changes in your bowel habit Are you happy to tell us about it? She told me her story and answered my somewhat personal questions Next door, in the consultation, I stood and watched as this wonderful lady disintegrated into vulnerability The consultant asked her questions He did not listen to her answers

There was none I waited for her to be invited to ask questions But no invitation was made I waited for my colleagues and I to be introduced It never happened

I watched as the consultant prepared to examine her She was frightened and uncertain Exposed to a group of strangers I was stuck in a scene I did not know how to be a part of I wanted to take her shaking hand, explain what was going to happen

I wanted to add some compassion to this scary, sterile encounter But I did nothing Her hand shook and her face winced, but she made no sound She didn't say another word As I watched her shrink away out of the consultation room, I sensed that she would not be asking for help from doctors ever again

I wanted to say sorry I wanted to say that this was a one-off I wanted to tell her how much I admired her All I said was, Thank you, thank you for letting us be here Although, in reality, she had never been allowed the choice

PIP HARDY: So, for those of you that weren't able to hear Emily's story, as a fourth year medical student she was observing a patient who was offered no choice about whether she would have students in the room So really her story, which was creatively done, was about the lack of compassion in many medical encounters So, yes, it is a really powerful and moving story, and just the kind that we need to be hearing from the clinicians of the future And, of course, the feedback from the other people in the group was, please don't even consider leaving the medical profession You are the kind of person that we need for our future

So, I'm seeing in the chat box that people addicted to think it was certainly affective There were lots of comments about it being a powerful story Any other comments on that story? Emily shows great insight I think she shows the opportunity to be really creative, that was one of the really important things about it We don't always make much room for creativity in the health service

We are nearly finished now I would like to leave us with a reminder from Gandhi that the culture of the mind must be subservient to the cult of the heart It is the culture of the heart that we get to through sharing our stories And then, really, if we think about our stories as individual stories, we're kind of missing the point By maintaining our separateness and our individuality, we forget that every single one of our stories is really part of the greater story

Just in case any of you are perhaps feeling a bit hesitant about sharing your own stories, I would just like to end with a short poem, which hopefully will leave you feeling inspired to share your stories and to listen to the stories of other people So, the poem is called 'The Sleepless Ones' What if all the people Who could not sleep At two or three or four In the morning Left their houses And went to the parks What if hundreds, thousands, millions Went in solitude Like a stream And each told their story What if there were Old woman Fearful if they slept They would die And young woman Unable to conceive And husbands, wives Having affairs And children Fearful of falling And fathers, mothers Worried about paying bills And men, women Having business troubles And both unlucky in love And those that were in physical Pain And those who were guilty What if they all left their homes Like a stream And the moon Illuminated their way and They came each one To tell their stories Would these be the more troubled Of humanity Or would these be The more passionate of the world Or those who need to create to live Or would these be The lonely Ones And I ask you If they all came to parks At night And told their stories Would the sun on rising Be radiant and Again I ask you? Would they embrace? Thank you for listening I hope you have enjoyed this webinar I hope to see you at the next expert in the room session

Thank you all so very much for all your comments and suggestions Goodbye

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