I was given flowers by a patient this week. That doesn’t happen often.
I mean, we do, as hospice staff, receive gifts from time to time but usually chocolates and mostly from grateful relatives after their loved one has died. Over the past 15 years, I can remember just one large bouquet and one miniature potted rose sent to me from families I’d worked closely with over a long period. It’s always gratifying to know that I made a positive difference at such a key time in someone’s life and that the memory of that lives on for the family.
But this is the first time working in palliative care that I’ve received flowers from a living patient. And it was completely unexpected.
I’d simply arranged a couple of practise sessions in one of our powered wheelchairs to boost her confidence for the one she was hoping to be given for home. They had proved to be really enjoyable times for both of us, taking place in our picturesque gardens and chatting casually as we went along in order to remove any sense of pressure.
The wide gently curving paths were perfect for initial practise, gradually moving on to narrower ones, tighter corners, some gentle slopes, and gateways to negotiate as my patient’s confidence and technique improved. Plenty of benches provided rest points, stopping at one to swap places so I could demonstrate the swing of the smaller wheels that needs to be allowed for when switching between going forwards and reversing. Plants and garden features like the Memory Tree provided talking points and distraction from the task in hand, adding to the sense of relaxed normality rather than a learning opportunity or a skills test.
The final piece in the puzzle was trying a different grip on the joystick. Resting it between the base of middle and ring fingers resulted in more precise control. Laughingly, we nicknamed it the ‘Live Long And Prosper Grip’ for its similarity to the Mr Spock’s salute in Star Trek to help her remember it.
It was wonderful to see the change in her over such a short time of only an hour or two, not just in technique and skill but particularly in confidence. Much of my job is spent in the context of deterioration and decline so it was a real highlight to witness such progress and improvement. It was an absolute pleasure of an intervention and put a smile on my face that lasted the rest of the day.
So to be given material gratitude in the form of a beautiful bunch of autumnal coloured roses and berries was unnecessary for me. She’d thanked me verbally at the time; I’d seen the difference in her demeanour; and I’d had the satisfaction of witnessing her improvement in ability. I’d already had my reward and been extremely happy with it.
But it would have been wrong to do anything other than accept the gift graciously. She had spent time and thought in choosing it. And it rebalanced what can be unevenly powerful relationship between patient and therapist. The sessions I’d arranged had benefitted her and her gift blessed me.
We are allowed to accept gifts from patients that can be considered ‘reasonable’ in cost but have to report them to a line manager – to make sure we have not taken advantage and also to acknowledge them as ‘plaudits’. Similarly, we have to pass on any written compliments.
When I went back to mine, we talked about all the detail that had gone into my wheelchair practices. Whilst to me it had been a fairly standard piece of work, there had been a lot of skill gone into the best approach to take and grading of the task in order to build up the complexity incrementally in order to ensure success. My boss pointed out that it was a perfect example of palliative rehabilitation and not just care, and how important it is to acknowledge and recognise our expertise.
It felt good to get this recognition from a manager. And now when I look at the blooms gracing my sideboard (and perfectly matching the décor), I am reminded of the satisfaction I got from a job well done, the significant difference made to a patient, and the appreciation of my boss.
So one unexpected thank you is proving a lasting blessing.