Week 22: Closure, catharsis and crimping

• A team meeting threw up a fascinating insight last week. As a charity helping people through difficult situations at the end of life, we don’t always hear back from people about how things ended. It’s not that we need to know… but I just thought it’s an interesting thing to ponder. Would we improve staff welfare and satisfaction if we got more ‘closure’ from our work? Would we be able to develop a better service if we knew more of what advice worked vs didn’t work?

• We started a round of user research with service users this week. As a reminder we’re doing a content discovery on the topic of best interests decision making and up until now we’ve only talked to subject matter experts. Barristers, academics, experts in the field. I think we have a good picture of what should be happening. This week we started finding out what people are experiencing in the real-world. We’re only just starting to analyse (read my colleague Jen’s weeknote for how). My first impression? It is messy. Very very messy. Another one of those areas where there seems to be a gulf between policy and practice. More research to be done though.

• One thing someone mentioned during a user interview which we’ve heard many times before… “it’s cathartic”…

• As a user researcher, it’s easy to (and you should) be very mindful of talking to people about sensitive and potentially traumatic experiences. But in my experience, I don’t think you should assume people don’t want to talk about it. With the sorts of issues and experiences we are dealing with, often the trauma is between that person and the medical profession. It’s an experience for which they maybe haven’t had closure. An outlet to vent informally to family or friends (because who wants to talk about grim medical experiences at the dinner table) or formally via a complaint to the NHS. So when we come to speak to people about their experience it may be the first time they’ve been able to really talk about their experience in any sort of depth.

• Whilst we’re user researchers, not therapists — it’s nice to hear that some people find the process cathartic. If it means they are more comfortable in the session, and are better able to share their experience, how they feel about what happened and to share openly all the better for it.

• I do wonder how much medical practice could improve and learn from patient experience and trauma. So many of the people we speak to who’ve had poor experiences say things like “I just want them to learn” or “I don’t want others to go through what we did”