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The power of story

Rhiannon Barker 01 August 2014

Rhiannon Barker, our programme manager for Schwartz Rounds, explores how stories are used in healthcare and shares the moving story of Kenneth Schwartz.


At risk of sounding anecdotal I’d like to tell you a story…

My son enjoys nothing better than a good made-up story at bed time. In these stories he likes to play the hero. Best of all he enjoys the stories where he has been selected to take part in some Olympic sporting event, when after a close battle he clutches a gold medal from the jaws of defeat. Or, in a World Cup football match he scores the defining goal from the half way line, 3 minutes into extra time. The formula is simple and the victorious outcome always provides joy.

Recently I attended an event hosted by a marketing agency about how stories can be used in the health sector. One of the central messages, which reminded me of my son’s love of story-telling, was that stories often have the potential to cut through ‘science, fact and logic’ and trigger emotional responses that, in turn, can help to bring about a desired outcome. Such story-telling strategies may be employed for a number of reasons including to change behaviours or to sell products, from pain relief to pressure sore pads. A good story has the potential to manipulate the listener’s emotions and make them more easily persuadable, more susceptible to making a purchase; empirical evidence can be jettisoned in favour of the blurred yet alluring world of creative fantasy. Stories were represented as an entry into a world of make believe, and as having strong and unpredictable powers of persuasion.

The argument put forward by the speakers rehearsed the familiar dichotomy presented in any discussion about the merits of quantitative vs. qualitative data. Quantitative data, on the one hand, represents a reassuring world of numbers, counting and hard measurement, whilst qualitative data is more subjective and, though useful, is feared as having the potential to mislead.

As I left the talk I reflected on the power of story and the varied roles it can play: sometimes enlightening, persuading, entertaining; other times manipulating and deceiving. Often times all of these things at once.

At The Point of Care Foundation stories are common currency in the work we do. Schwartz Rounds involve individual stories told by staff members from all disciplines, and are a forum to share emotional and interpersonal work experiences. The purpose of the Rounds is not to solve problems, but to explore the human and psychosocial aspects of delivering care and the demands that staff face on a daily basis.

A very human story lies behind the conception of the Rounds; Kenneth Schwartz was an American health attorney who died of a pernicious form of lung cancer in his forties.  During his harrowing 10 month ordeal, he realized that what matters most during an illness is the human connection between patients and their caregivers. In A Patient’s Story he writes movingly of how “the smallest acts of kindness” make “the unbearable bearable.” He recognised that one possible way to support staff, through the brutality of some of their everyday experiences, was to give them the space to reflect and talk – to tell stories about things that have happened to them during the course of their work.

Schwartz Rounds, developed by the Schwartz Center after Kenneth Schwartz’s death, were devised to give staff to safe space to share, reflect and support one another. It is not intended that any direct action be taken at the end of a Round – their value instead lies in the process of both the recounting of the story and the act of listening and responding. There is no overt intention to persuade, manipulate or deceive – simply to share the experiences from an openly subjective point of view.

Evaluations of the Rounds show that they have a significant impact on reducing stress, increasing the sense of belonging to a team and therefore indirectly help staff relate to patients with increased care and compassion.

The Point of Care Foundation, jointly with The Kings Fund, will be running a conference on November 5th 2014, focussing on the power of story and experience. The event entitled “Transforming patient and staff experiences: the power of narrative, case histories and numbers” will be an opportunity to explore why experience matters, how it can be understood, and how organisations can harness it to drive positive change. It will be open to all with an interest in patient and staff experience.