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SoWhoCaresAnyway E52 #DoWith: A Way of Being · SoWhoCaresAnyway

• 0:04
  Welcome to So Who Cares Anyway?, a fortnightly podcast exploring stories that shape care, community, and the systems we live in.
• 0:12
  I'm Ruth Germaine, and in each episode I'm joined by my guests, people from behind clinical doors to the North York Moors, whose experiences open a window into how we care for one another.
• 0:24
  Together, we explore care through creativity, connection, and the strengths we already hold.
• 0:31
  Because care isn't small.
• Care isn't soft.
• Care shapes the world.
• So who cares anyway? It's time to talk about it.
• 0:42
  Hi, it's Ruth, and today is another solo reflection in So Who Cares Anyway? And this time I want to talk about do with, and why I've realized that doing with isn't about any particular policy or anything else.
• 0:58
  So this episode is about do with.
• 1:00
  It's something that I've explored before.
• 1:03
  Um, but what I've really started to think is, think about is how do with is a way of being and something that we embrace.
• 1:13
  So why, why now? Well, there's a do with movement growing out there.
• 1:17
  My early conversations on this very podcast were with Adam Lent when he first introduced the idea of doing with as a hashtag and a movement, um, and doing that publicly.
• 1:29
  And many of the conversations that I've had on this podcast are about doing things with people, not to them or for them.
• 1:36
  And we've seen, seen real growth and movement over the last few months, which is brilliant to see.
• And I just wanted to talk about the human side of doing with.
• It's something that I've always thought about, and I think it's something that I've tried to live, and I've been aware of where I've been constrained as well.
• But it's something I've been trying to live and to move beyond for a long time.
• But I didn't have that name of doing with So early in my clinical work, as I say, I would often feel that we were doing to people or for people, and it didn't quite sit right.
• 2:13
  My very early career, actually, we did really get a good momentum going of doing things with people.
• But as my career evolved and I moved into different roles, more and more I felt constrained that I was doing to people.
• 2:28
  And it wasn't just because that's what I wanted.
• 2:30
  I was aware that that was happening, but it was the system and everything around me that would prevent me from doing things with people.
• So I moved a few roles, and then I went into workforce development, and I went there for the very reason that I was told that my role was, and people might have heard me say this before, my job was to get people in and get people out, and that was never why I became a nurse.
• So I moved into workforce development thinking, "How can we make a difference?" And in 2019, I was lucky.
• I was fortunate to obtain a Darzi Fellowship.
• So this was set up by Lord Darzi, and it was about leadership.
• And my project, we all had different projects on that fellowship, was around place-based learning, and I was given a year to explore how learning really happens in practi- in places and how it really makes a difference.
• I feel quite honored and lucky to have had that year to do that, and I know not everybody does, but that's why I think it's really important that I share the things that I learned.
• So what did I do? Well, there was a strong emphasis on co-creation.
• Co-creation, co-production, co-design, people talk about these things.
• But actually, to me, they embody a do-with approach, because what I did there is I brought people together, clinical staff, receptionists, admin, people from across the community and, um, trusts, primary care, hospitals, hospice care, and also people with lived experience.
• And I brought them together in one room.
• 4:03
  Well, it was actually four workshops over a period of time, but each time they were together in one physical room.
• And I didn't present a model of place-based learning or what things should be.
• Instead, I've asked a number of questions, and really, those questions were around what should place-based learning be? What should it look like? And what I saw in that room was people's tacit knowledge just naturally surfacing.
• People started to build a shared understanding together.
• And whilst they were there for me to learn, people were going away saying, "I learned so much.
• I learned so much that was new."
• People actually felt like they were learning, and they built connections And the other thing, it was the thing was that it was the people closest to the work, the people with lived experience, and those who are working on the front line, what you might call the micro level, the people that were actually meeting people to help support them or care for them on a day-to-day basis.
• 5:03
  They held the deepest insights.
• We had sticky notes everywhere, patterns emerging.
• 5:10
  And from that room, or those rooms, new knowledge started to form by bringing people together.
• And there were three values that emerged.
• 5:21
  I've spoken about them on this podcast again, but I'll share them.
• Before rather, but I'll share them again.
• 5:27
  Learning needs to be people-centered.
• The people doing the learning centered around them, and the people that they're learning with and for.
• There needs to be cultures of learning in teams.
• Those two, in a way, were quite obvious when they came through.
• The third one was about the fact of learning being a collective and developing networks for learning together.
• And that's the one that changed everything because when I looked, I couldn't see that in the literature elsewhere, at least not in healthcare and not really in social care.
• And we needed...
• It talked about developing networks, meeting people from other organizations, other places, and our communities, and starting to learn together.
• We talk about integrated care, but this was integrated learning.
• And what it showed me is that co-creation and co-production isn't a technique, it's a way of being.
• By allowing everybody to come together and share, whoever they were, with equal voice and equal agency.
• And that's what I now call, and many people now call, Do With.
• And the reason why we call it Do With is so that we can start to create social awareness and understanding of what this principle is, so that more and more people can start to embrace it So I'd done some work earlier on in this year to- with people to say, "Well, what is do with about? What's its purpose? What's it for? And what does it really mean?" And there were a number of values that came through, and to me, values are important 'cause they're things that we can hold.
• 7:06
  And the first one was do with centers those most impacted.
• So I've just said that those people are the people that hold the most knowledge.
• 7:16
  It's the people who are doing the work on a day-to-day basis that are meeting the people we care for and support that holdest the clearest insight, and it is the people in our communities, the people that we meet just as we walk down the street when we go about our day-to-day lives, that also hold the clearest insight and understanding.
• And it's their knowledge and that are often, that is often unseen, and it's their capabilities and their strengths and their assets that are underused.
• 7:49
  But when they speak, and I've seen this time and again in co-creation and co-production work that I've done since, the room shifts.
• 7:59
  That's when you get something else.
• That's when you get something new.
• That's when you get something that you didn't see before because we are doing with So this includes all sorts of people, staff under pressure, parents and carers trying to manage on a day-to-day basis, autistic people or people with learning disabilities who are really trying to struggle to get the help and support and care they need, that they need, people facing deprivation, marginalized communities, to name but a few.
• And these are people, the, the groups that I've named are probably because they're the people that I've been working with most recently.
• 8:43
  So it includes many people, but we need to make sure that we include these people that are impacted the most.
• The second value of Do-With is that Do-With dissolves the us and them divide.
• 8:59
  So staff and communities are not separate.
• Staff we know are shaped by the conditions that they work in, particularly.
• I learned that early in my ca- career, and I found it really hard, and I've described that already.
• But it wasn't about me, it was about the system.
• So Do-With says there is no us, there is no them, there is only we.
• And we need to really think about how we embrace that when we work with our communities and when we work within our organizations to make sure that we're reaching out to everybody.
• And the third value is that Do-With embraces collective power.
• There's no single role that holds the full picture, the full perspective and understanding.
• 9:48
  There is no single profession or community that understands everything and has all the knowledge.
• But together, clarity emerges.
• And just like in the workshops that I described earlier on, not only does clarity emerge, but the collective knowledge comes out, comes from that connection.
• And quite often, that knowledge is new when everything's brought together.
• 10:17
  One of the things that was said in the workshops when I started to do this Do-With piece of work is that none of us is as smart as all as us, and I like that, and I think that really talks to that point of embracing collective power.
• 10:31
  So why does it matter now? Well, to be quite honest, when I look over my 40-odd year career as a nurse, I would say it's always mattered, but it particularly matters now because systems are stretched.
• 10:46
  We all know that, whether we're working in them or we're trying to access them.
• 10:51
  Staff feel pressured, and they are under increased emotional, um, toll and, um, labor on a day-to-day basis.
• They are also expected to perform and to show that their role makes a difference and that they're having an impact.
• But they also want to go home knowing that the impact that they had was real and what was needed.
• Our communities are disconnected, people feel c- disconnected, and people feel unheard.
• But Do-With offers a human way forward, and I would say it's not just a method, it's a culture, and it's a practice and something that we all need to try and embody, whoever we are, whether we're working or just living our day-to-day lives.
• I spoke recently about how to learn we need to feel safe, and I would say again that Do-With only works when people feel safe, when people feel safe to speak, safe to listen, safe to share power.
• And safety is the bridge between values and our actions.
• So Do-With isn't something we do, it's something we are.
• It's how we meet people, it's how we learn, it's how we build trust, and it's how we create change that lasts So my final invitation, and I will take this for myself too.
• 12:29
  In your next conversation, whether it's at home, at work, in your community, pause, and just ask, "Am I including the people who matter? Am I listening to what they really need? Am I doing things with them, or am I slipping into doing things for them?" Small questions, small moments of reflection create culture change.
• So I'll probably say this in the outro, but as I always say, and I think it's really important for this one, do with, stay caring, stay connected, stay curious, and until next time.
• I hope today's conversation gave you something to think about.
• If it did, please share it with someone.
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• And if you have reflections or ideas, then please leave a rating, or to support my work, head over to my Linktree, which you can find in the show notes.
• But for now, stay caring, stay connected, stay curious.
• Thanks for listening.