‘Just be loving’, a member of the Board of Directors of a Dutch hospital wrote on a pile of policy documents. A huge care ethical change program was born: a loving hospital. In a jam-packed conference hall in Utrecht, the Netherlands, I could hear a pin drop when Prof. dr. Andries Baart took us on a care ethical journey to this unique hospital program. On the 4th of November 2015 over 150 attendees listened to his masterclass on the empirically grounded long-lasting pilot on loving care.
All attendees received an impressive publication, edited by Prof. dr. Frans Vosman and Prof. dr. Andries Baart, full of reflections by scholars and students in care ethics and Presence Theory and the result of years of research on loving care in the Elisabeth Hospital in Tilburg. It is not a cookery book with care ethical recipes. It is full of critical insights to inspire organizations with a long breath. It is food for thought and reflection, for educational programs that do not want to train care students as obedient competency-based puppies, but as self-confident caregivers that keep on learning.
The suffering patient
For five years a group of care ethicists mixed with care practitioners and policy makers in the Elisabeth Hospital in Tilburg, working bottom up, from the at first vague notion ‘lovable’ or ‘loving’. The logic the care ethicists followed was: think with, against and reversed, and think from practice on all levels. They became critical friends of the hospital, constantly reflecting on care from the perspective of care, -not from Disney, Wellness or Volvo-, weaving a tapestry of inductive care-knowledge from the guts of the hospital, from daily practice and from the perspective of the suffering patient.
Inn of solicitude
What is the most important notion in a sweet hospital? Solicitude and Hospitableness! Where good care is not about following a list of values, but about what emerges as good. Where care is not approached as a set of evidence based single actions, but as a wise and loving muddling through together.
Working from empirical practice to theory and ethics, and backwards, loving care appears to be political-ethical care, because of its ordering of relationships between care givers and patients.
Communities of Practice
The researchers started establishing Communities of Practice where hospital personal could tell stories, share their experiences and learn from one another. The program is now embedded in the hospital and linked to its policy goals. It passed an audit.
After the masterclass shared themes popped up. The audience expressed a longing for similar programs in their own practice and wondered if this ‘soft’ system would work in ‘hard’ ones. One of the conclusions was not to apply professional loving care as a blueprint from outside of the hospital or top down. Best is to search for energy, ingenuity and creativity within your own organization to create space in often complex systemic realities.
With good vibes, as if I’d been to a world premiere, I left the audience hall, longing for this care ethical gem to grow like a pearl inside many organizations. When will the first asylum center have an indwelling care ethicist and Communities of Practice? When will the book be translated into English to reach a broader audience?
And last but not least: prior to the masterclass the audience was familiarized with the renewed and restyled Ethicsofcare.org-website, ‘Sharing views on good care’, the website you are currently visiting!
The Masterclass of Andries Baart
For questions about the program, please mail to secretariaat@presentie.nl
Andries Baart en Frans Vosman (red.), De patiënt terug van weggeweest. Werken aan menslievende zorg in het ziekenhuis. Amsterdam: SWP 2015