HPH Ospedali per la promozione della Salute Rete Italiana 8

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HPH Ospedali per la promozione della SaluteRete
Italiana 8 Conferenza Nazionale HPH
24 25 Settembre 2004

• The feelings narration of workers in sanitary
  area as a professional instrument in sanitary
  work in neonatology and pediatrics
• N. Vinsani - Caposala Pediatria, M. C. Menozzi
  - Inf. Prof. Pediatria, A. Lupi - Caposala
  Neonatologia, P. Cristofori- Inf. Prof.
  Neonatologia,
• P. Fagandini- Psicologa Dipartimento
  Materno-Infantile (Direttore G. Banchini) Azienda
  Ospedaliera S. Maria Nuova Reggio Emilia
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• " There are two events in the cosmos history that
  are absolutely unpredictable the first one is
  the life's origin, the second one is the mind's
  origin
• J.C.Eccles ( neuroscientist)
• The psychoanalytic theory defines the mind as a
  unique human capacity of giving a personal
  meaning to the own experience of the world. Mind
  creates metaphors on worlds experience, it tries
  to understand events building on them unconscious
  fantasies, dreams, stories, games. Mind lives on
  the variety and on the richness of its own
  symbolic constructions. If there is not symbolic
  development or if symbols dont cope with effects
  that generate them, the mind dies.
• If there is a symbolic activity, it is possible
  to overdraw every trauma.

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If there is a symbolic activity, it is possible
to overdraw every trauma
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The way of logic and rationality is still
preferred by sanitary, social and educative
professions. Even if they have interpersonal
relationships as professional instruments that
imply choices and responsibilities, they base
their proficiency on neutrality and on the
avoidance of personal involvement. The manner of
taking care is not enough considered.
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Education and training as concern sanitary
profession are still based on objectivity,
procedures, operability.Feelings and personal
meanings are considered in contrast with
professionalism. For this reason they are not
considered into standard training paths and they
are left to personal choice, training experience,
that dont have any institutional accreditation.

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Professionals dont have training actions
concerning how to handle emotions, further more
they are asked to neglect them in name of
professionalism. Because of the difficulty of
accepting their emotions they feel as defending
themselves from them. Such intensive feelings
leading in such emotional stressful situations,
as it happens in an hospital, in social
professions and even in voluntary world ended to
be an unsaid. Unsaid or neglected, hidden or
repressed nevertheless existing, feelings take
different shapes and sometimes they appear in a
distorted way and they can be dangerous both for
professionals (the known burn out) and for
patients and their families.
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We have to consider and sustain feelings as a
source rather than a problem, and we have to
implement them through the training actions to
make out of them an essential wealth in taking
care contests. Further we have to give to
professionals training and managing instruments
to help them to identify their and other people
feelings. Professionals have to learn to name and
mediate their emotions, and educate them to not
rise up disorderly but to be an instruments to
humanize professional contests. It is important
supporting an emotional dimension in professional
contests and carry on a new concept of social,
health and educative services where taking care
relations are precious.
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The beginning of this project was 1993 in
neonatology and 2000 in pediatrics and its still
carried on. The main project aim is to build an
experimental training path to make health
professionals able to implement the following
issues to manage stress and relation conflicts.
To give support and counseling as concern
emotional handling of pain, traumas, and
mourning.It has been used two
methodological-qualitative instruments-Focus
groups since 2000 pediatrics nursing staff
meets monthly to discuss about the most
problematic cases of the ward.-Since 1993 in the
neonatology ward theres a monthly meeting group
with doctors and nurses leaded by psychologist
to discuss cases according to Bion model.
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We learnt to consider the parents not as patients
but as persons that are in a very problematic and
traumatic situation and so they need support for
themselves, for the couple and to build the
relation with their child.Therefore we dont
consider these situations in term of
psychopathology, but as an inevitable mental pain
that can became psychopathology if its not
receipted, shared and controlled.
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We use the monthly discussing group as a training
and working instrument, to allow the neonatology
emotions world to exist.
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NarrationPoetry saved the group not really
consciously, not planning it, we started reading,
in the group, letters, notes written by ward
parents or to their children. Still
unconsciously papers written by nurses became,
sometimes, poetries, stories, dreams. In 2002
doctors started to write their thoughts, letters,
dreams too. Suddenly we understood that in
Pediatrics and in Neonatology not everything can
be explained inside the group by relations and
psychological interpretations. Sometimes it is
necessary that the group is able to listen and
receive what can be just felt, recounted, unsaid
feeling and emotion not always understandable,
not always acceptable. This is important also and
primarily for professionals tell about
themselves can be therapeutic also for them. It
is important to accept the limit to be able to
find a new way, like poetry, to keep on working,
try to understand, meet children, parents,
colleagues.
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Emotions of professionals in Neonatology and
Pediatrics. Every day our effort, as sanitary
workers in neonatology and pediatrics wards,
opened to parents, is to keep on feeling and
thinking what happens to kids, parents and
professionals.
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In death of AndreaLooking at you is difficultI
see in you the life that, still and
motionless,Waits.I see cries, smiles,
cuddles,Short runsOpen armsLoving
kissesFrozen, suspendedOn the web woven by
destinyBound to the thread of hopeAs a time in
brackets.Yet I have to look at you, little
essenceFragment of universe. Paola C.,
nurse
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To a motherI have knownA kind of loveThat
bounds a little soulWith a tiny bodyAnd holds
it on this Hearth I have seen The soul growing
up fedBy little caressesIntense sightsI have
heardsweet musical Wisp earsthat reach the
heartand talk about unconditional loveI have
heard The strength of this loveThat bounds
heartsAnd fills them with impalpableEnergy.Is
there a stronger medicine? Patty B., Nurse

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