Life after Loss and Improving Bereavement Care

About a month ago I did a talk on my experiences for a group of paediatric registrars. This is my talk.

LAL

Thank you. My name is Shona Johnston and I am a post-CCT clinical fellow in paediatric haematology/oncology.

We will discuss two things today:

1) With my mummy hat on, I am going to share my own story with you, what happened to me, and a little about Grief.

2) With my doctor hat on, discuss some aspects of bereavement care and some quotes and points of view from other bereaved parents.

Then hopefully if there is time a discussion on the barriers to really listening to patients, and how you can really listen to them.

I just want to add a trigger warning here that people may find some of my story upsetting. Its ok if you get upset, but please try to bear with me, and I am happy to chat through any issues with anyone afterwards and point you to other support if needed. I want you to learn from my story.

gail

So I told you that I’m a paediatric doctor. I am also a mummy to two little girls: Freya who is 5 years old and Gail who was stillborn at full term in June 2016. She died not long before she was born and she was perfect. There was no medical explanation for her death. She looked exactly like her sister except that she had black, black hair.

She was born here, in the women’s centre in this hospital. I went with my husband to MAU on a Saturday morning when I was 40+4 because she had stopped moving. When I was seen she had already died. After some time, we went home to with our older daughter. I went into labour that night and returned to the JR. We were initially on level 7 in the bereavement suite, then after a little delay we were moved down to labour suite when I was in active labour. Not long after I was in second stage and then had a normal delivery. I had a retained placenta so had a manual removal in theatre a few hours later.

Some hours later we went back up to level 7, where we were able to spend two very precious days with Gail. Our care was outstanding. The midwife who cared for us was my community midwife and the continuity was so important to me. Gail was in a cold cot, meaning slower deterioration in her condition. It enabled us time to cuddle her, to read stories to her, to bathe her. The bereavement suite is an en suite, and has a drop down bed my husband could have stayed in had he chosen to, and he was provided with hospital meals. We were given a beautiful memory box and a lot of Sands leaflets detailing all these strange practicalities we would need to go through. The chaplain came to talk to us, and to bless Gail. My paediatric colleague friends and my parents came and went with a blind eye turned to visiting times. We could be in a little bubble away from everything. The staff told me how beautiful she was and they encouraged me to spend time with her, and to cry. I have no regrets of our time with Gail, and the care and my memories of that time has made a significant positive effect on my grieving.

Our care was outstanding, but still improvements in bereavement care can be made – and I’ll share some specific things which could have been better in my case, and some questions for you to think about.

When I was in labour ward and wheeled through to theatre, the ODP asked what I had had. It was obvious she hadn’t known when I had to reply “a girl, but she died.” A simple error in communication which upset me so much.

The midwife continuity was excellent, but I saw a different obstetrician every day, and we had our debrief with a different consultant from the one who had done my MROP (who while I knew him and entirely trusted his opinion, he hadn’t been involved in my care before).

My discharge letter written to my GP only said “IUD” on it. To me, this was such a gross understatement of what I had been through and was continuing to go through. I made an appointment with her just to fill in the blanks.

We were given a contact number for the bereavement midwife but when I texted her some time down the line for support I got no answer. I felt very vulnerable and needed someone to advocate for me so I didn’t try again for about six months. I could have done with some proactive support from her. When I did eventually have the energy to make contact again it was harder than it should have been to make an appointment. If it was difficult for me, as someone who “knows” how the system works, how would it be for someone who doesn’t?

I am a paediatrician – a reasonably good one I like to think! – And I would not have thought about how important some of these things are – both the good and the bad things – before Gail died.

coffin

When your baby dies, you have to make a whole bunch of decisions that you had never thought in a million years you would need to think about. Practicalities that seem ridiculous in the hazy fog. Which funeral director will you use? Do you want your baby buried or cremated? Where? What kind of coffin would you like? Do you want a private or open funeral? Which music? Do you want to buy a plot of ground next to her so you can join her eventually?

In the day between finding out that Gail had died and her birth, it became apparent that we very much wanted to take Gail “home” to Orkney. We live in the South of England now, but we won’t necessarily be here forever. We both have family in Orkney and it is somewhere we will always go back to. So we took her home, and my parents drove her there.

They took the bravest and saddest journey and never left her alone. They stopped on route with my granny and at their own house.

Gail is buried on a beautiful hillside, looking out to the sea. The location couldn’t be more perfect.

hands

I’m going to tell you a little about Grief, by reading from my blog.

You can read this here: The immediate aftermath

freya

Its been a long pathway.

BUT – I want people to know that it is possible to find Joy again. That doesn’t mean that the grief goes away: sadness and joy exist right alongside each other. In fact I now truly believe that it is possible not just to survive, but to live well and be happy in this “new normal”. It’s a different kind of happy; and will always tinged with a wish that Gail was with us. And this is Freya blowing bubbles for her little sister at her grave in Orkney over the summer.

communication

Our care was outstanding, and I do not believe that anyone was to blame for Gail’s death, but still I feel that lessons can and should be learned from every baby death, and that particularly we should learn from bereaved parents about their experiences to improve the care we give. We need to listen – really listen.

I want to share some experiences from other bereaved parents, who have all given me permission to share these quotes. I asked them “what do you want paediatric professionals to know about child bereavement and life after loss?”

[I am not going to share these quotes here on my blog, but the general themes were: acknowledge the death of the child kindly and humanly – and continue to do so for many years afterwards; give parents and families choice where it is possible to do so; explain legal processes and why there has to be police presence after a sudden and unexpected death; allow time with the child after death; know that grief is not proportional to gestation or age at death; understand that pregnancy and parenting after loss are difficult and stressful; and most importantly – use the child’s name.]

lets talk about elephants

So we’re going to talk about elephants – elephants in the room, that is:

elephants

I had a recent visit to MAU (maternity assessment unit) where I saw a number of midwives and obstetricians. On my maternity notes I have a butterfly sticker (the trust’s way of recognising previous pregnancy loss) AND a Kick’s Count sticker saying “I’ve had a previous stillbirth.” Everyone I saw had clocked that I’m a paediatrician – not one of them mentioned Gail.

It left me somewhat confused – did they not know about my previous obstetric history even though its all over my notes? (highly relevant both to why I was there and why I was so worried) Or did they know and just didn’t want to mention it for fear of upsetting me? As it was it meant that I had to keep telling the professionals that I had had a previous term stillbirth. Bereaved families love talking about their children – they hate going through their story again and again with medical and nursing staff.

[I’ll just add as an aside that I was very happy with my medical care, everything was fine and I went home later that day.]

barriers

 I then invited the audience to discuss the barriers to listening to parents and talking about the death of a baby or child, particularly if they are presenting with another child sometime down the line.

Themes that came up were “I don’t know what to say”, “I don’t want to upset them”, “I don’t want to upset their children if they are in the room”, “I might not have time in a busy A&E department to discuss it.”

I then discussed that the vast majority of parents are more likely to be upset and confused if you DON’T talk about their child; nothing makes me smile more than hearing Gail’s name. What to say: something simple, heartfelt and human. Something like: “I heard from the nurse that your baby [use baby’s name] died. I’m so sorry to hear that. Do you want to talk about him/her?” or just “I’m so sorry to hear about [baby’s name’s] death.”

It doesn’t take much but can mean the world.

I spoke about Freya and how she is is very open and matter of fact about death – “My sister Gail died and she’s under the ground.” Children don’t pay attention to elephants in the room – so why should we?

I understand time pressures in a busy department – however I suggest that, just occasionally, if you take an extra two minutes to listen in the first place, it can save many more minutes further down the line.

resources

These are a few useful resources that are either useful for health professionals or leaflets that can be given to parents; in particular – the new National Bereavement Care Pathway which has just been published, an e-learning course that is aimed at GPs but open to anyone who registers with the RCGP website, Child Bereavement UK info sheets (particularly useful for siblings), the Sands support leaflets [which I was also fortunate to be able to give out at the session thanks to Oxfordshire Sands], leaflets form the Lullaby Trust, a leaflet for families of children dying from cancer, and a couple of government resources on legal and financial aspects of child death.

[There are hundred more resources out there, I just picked a few of my favourites.]

bereavement care

This is how I’d like to see bereavement care and support – like a hug around the family.

Hopefully the diagram is self explanatory but these are the elements I’d like to see; these are all part of the National Bereavement Care Pathway:

Well trained staff who are confident in dealing with child death and bereaved families.

Family input into service development.

A homely (ie non clinical) bereavement suite or area where families can spend time with their child, making memories to last a lifetime.

Family-led care, so they are able to make their own choices.

Ongoing family support after discharge from hospital.

And finally, staff support. Dealing with child death is not easy for anyone and staff need to be appropriately supported so they are able to support bereaved families.

 

final thougts

So, these are the three things I’d like you to remember:

  1. Don’t be afraid to talk about elephants.
  2. Always, always, use the baby or child’s name.
  3. This is my daughter Gail, and she was beautiful.

Thank you.

 

With a big thanks to Oxfordshire Sands for providing Family Support Packs and other information for the doctors to read.

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A Small Announcement

So I have a small announcement to make…..

This is how I told Facebook about my two previous pregnancies, so why break with tradition?

I am pregnant. 15weeks and 2 days.

This isn’t a surprise to many people. Lots of close friends, family and colleagues have known for weeks. And I know that people are really, really happy for us. Which is lovely, and I’m very grateful for that. It’s just that this announcement is more tempered than the last two. More cautious. Because what if tomorrow, or the next day, I have to write another announcement? The one that no one wants to write.

I’ve decided to “announce” partly in the interests of breaking taboo, and, hopefully, it might start to get more obvious in photos anyway!

Today I have been to the midwife, and heard our baby’s heart beat. So today, at the moment, I am pregnant.

Happy Birthday Gail

Happy Second Birthday Gail. I love you little one.

I hope that you have a very happy birthday, wherever you are.

I have again asked all our friends and family to do a Random Act of Kindness in your memory, as a birthday present. It feels like the right way to celebrate, and to share your love.

This picture is part of your scrapbook – my labour of love in the months after you died.

Today I am minded of the poem which Auntie Tri read out at your funeral:

Into the freedom of wind and sunshine we let you go;

Into the dance of the stars and planets we let you go;

Into the wind’s breath and the hands of the starmaker, we let you go.

We love you, we will always miss you, we want you to be happy and feel you want us to be happy again.

There is certainly plenty of wind where you are! On that bonny hillside just outside Kirkwall. I think of you there and know you are not alone. Not far from Iona, and watched over by Bewsy, Freya, Steven and Auntie Jean. And we’re coming to visit soon.

Until then, Granny and Grandad will be up visiting today. And I’ll carry your heart with me. I’ll carry it in my heart.

I love you Gail. You’re missed beyond measure. You’ll always be with me.

Love, Mummy xx

Anniversaries and “What If’s?”

Today is the second anniversary of the day we found out that Gail had died. A day full of “what if’s?,” of regret, of longing.

What if she’d not died? What if she’d been with us? Two years old tomorrow. Like her sister but with black hair. Its too painful to think about, but sometimes those thoughts just come, unasked for and unabated.

I live my life with Joy, most of the time. I actively look for Joy, in small things. There’s Joy to be found, everywhere. But that doesn’t mean I don’t miss her, always, that it’s not still painful, often. It doesn’t mean that Sadness doesn’t exist right alongside Joy. It doesn’t mean that it’s fair that she died. It’s unutterably, cruelly, NOT fair (I can see a five year old me stomping my foot down as I say that).

I thank Gail for all she’s taught me, and all the good things she’s sent me, all the love she’s shared. All the wonderful people I’ve met, whose babies and children have also died; I wouldn’t know you all if Gail had survived. I’d give up all those things, that friendship, to have Gail here. It’s a very strange thing to say, because they are now some of the most important people to me. But I know they’d say the same.

So today, I have spent some time looking after Gail’s rose (another thing that wouldn’t be here if she was). My husband thinks I’m a bit too precious about it (“it’s not Gail,” he told me yesterday when I was reluctant to cut off some flowers for a friend). Today, Gail’s love needs spreading, so I’ve cut off some blooms for my neighbours.

Today is sad. Tomorrow will be sad too, but I’d also like it to be a celebration for Gail. If you’re reading this, please can you do a Random Act of Kindness in Gail’s memory for a birthday present tomorrow? And let me know what you do.

Happy Mother’s Day

Happy Mother’s Day.

Happy Mother’s Day to all those who are mothers, in all senses of the word. And especially to those who might find today hard, for whatever reason.

To those whose mothers have died. To those whose mothers are far away. To those who are working today and cannot be with their mother or their children, especially those who are looking after other people’s mothers or children.

To those who long to be mothers and can’t, due to infertility or illness.

To those mothers whose children are in hospital, stressed and sleepless with worry.

To those mothers like me, whose child or children have died. Through miscarriage, stillbirth, infant and child death. Who are always missing someone from their family celebrations.

To my mum and my mother-in-law: we are so lucky and grateful to have you. Thank you for being there, for all you do, and for always remembering Gail.

To Freya: thank you for Mother’s Day cuddles, balloons, whatever it is you are “secretly” preparing with Dad right now and for bringing me joy.

To Gail: I love you little one. I’ve pruned your rose this morning to spend a little time just for you. Thank you for sending me courage, kindness and love.

Happy Mother’s Day.

A Year of Acts of Kindness

I have done an act of kindness every single day in 2017 in Gail’s memory. Some have been random, some have been directed. Some are acts of gratefulness. Some are kindnesses to myself. I have learned rather a lot about kindness over the past year! (see previous blog). Here they all are, all 365 acts:

January

1st – a call to action on Facebook, asking friends to join me.

2nd – a knitted headband for my mother in law.

3rd – Grateful for our Christmas and New Year holiday, with family and friends, and being able to visit Gail.

4th – Congratulations letter to a friend who had been awarded an OBE.

5th – Some extra washing up at Mrs Bun’s and reuniting a lost sock with its owner at the swimming pool.

6th – Freshly baked bread for friends.

7th – Donation of pasta to a food bank.

8th – Thankful for my Mum coming to stay.

9th – Parking money for recently bereaved parents in the Lambert Suite at the hospital.

10th – Starting a baby blanket for my expected niece.

11th – A thank you letter with some positive thoughts for a dear friend.

12th – An “Open Me” envelope of positive thoughts left at Cholsey Pavilion.

13th – Kind to myself: taken out for lunch, lobster and prawns for dinner, and so very thankful for Freya’s laughter.

14th – Freshly baked cookies for friends.

15th – Home made soup for a friend.

16th – Thankful for water and electricity, and a letter to another bereaved parent.

17th – Book donation to Helen and Douglas House charity shop.

18th – An “Open Me” envelope RAK at the hospital.

19th – A letter and positive thoughts to a friend whose husband was in hospital.

20th – Donation of pasta to the food bank.

21st – Freshly baked bread for a friend.

22nd – An “Open Me” envelope RAK left in a cafe.

23rd – Took my friend to A&E and picked up her daughter from Nursery.

24th – Kind to myself: got my nails done.

25th – Left some Rolos with a RAK note to be found at Brize Norton.

26th – An Aching Arms bear for a friend.

27th – Left a Rolos RAK to be found at The Burn’s Supper.

28th – Grateful to a friend for speaking about Gail with me.

29th – Left An “Open Me” envelope RAK in church, took soup and bolognese sauce to a friend whose wife was in hospital, and Happy Birthday to Sammy (whose family donated our Aching Arms bear).

30th – Picked up my friend’s (who was in hospital) daughter from preschool.

31st – Kind to myself: went on a sourdough bread making course (and got some yummy pizza for lunch).

February

1st – Positive thoughts posters at the hospital, in the foyer and for the sister’s office.

2nd – Posted a TReAT package to someone.

3rd – Nominated a friend for “Teapot of the Year.”

4th – Grateful for the posts: The Swallow, The Owl and The Sandpiper Book from my mum, and the VSO magazine about maternity care in Africa, reflecting how grateful I was for the care I received in hospital when I had both my girls.

5th – Donation to a friend raising money for Cancer Research UK.

6th – Sent the book “No Matter What” by Debbie Gliori to a friend’s boys.

7th – Baked some bread for a friend.

8th – Thank you letter to my midwife, a Positive thought RAK in the hospital and chocolates for the Pafta committee.

9th – An “Open Me” envelope RAK left at Waitrose.

10th – A present of Lego for my husband.

11th – Left a Rolos RAK to be found on a train.

12th – Grateful for Child Bereavement UK, at the snowdrop planting day, for hot soup and cakes to warm up, and left an “Open Me” envelope RAK there.

13th – A letter and the Sandpiper book to the Padre, and a message to a friend whose mum had died.

14th – Kind to myself: Chocolate Fondant treats, and a futureme.org email to myself.

15th – Visited my friend in hospital.

16th – Knitted blankets for SiMBA (Scottish Stillbirth charity).

17th – “Open Me” envelope RAK in Starbucks.

18th – Grateful for Sands Snowdrop teas.

19th – “Open Me” envelope RAK in Pret at the hospital, and visited my friend in hospital.

20th – Kind to myself: attended CBUK counselling session.

21st – Chocolates for some colleagues, Left some chocolates at a friend’s car. So grateful my purse was found.

22nd – Phoned my grannies.

23rd – Thankful for Guides after Thinking Day, with a challenge to Pay it Forward, and so grateful for gas and candles during our power cut.

24th – Washed the car for my parents in law.

25th – A message of thanks to a Sands friend.

26th – “Open Me” envelope RAK in a cafe.

27th – Food donations for the food bank.

28th – Chocolate and cheese gifts for my friend in Freetown.

March

1st – So grateful to be safely in Freetown with my friend.

2nd – Gave bubbles to some children in Freetown.

3rd – Cheese and chocolates and other gifts for friends in Freetown.

4th – Kind to self: a wonderful day at Tokeh Beach.

5th – Left An “Open me” envelope RAK at Tokeh Sands Hotel.

6th – Took my friend out for breakfast and gave bubbles to some kids at Hamilton Beach.

7th – Grateful for an afternoon of chilling out, peacefully reading, and for mosquito nets, antimalarials, running water and NPA (electricity).

8th – Balloons, bubbles and stickers for a friend’s twins.

9th – Donated money for a friend to attend adult learning classes.

10th – So super grateful to be home safely with my family and especially Freya.

11th – Left an “Open Me” envelope RAK at Millet’s farm.

12th – Left an “Open Me” envelope RAK at the STEAM museum in Swindon.

13th – A Thank You and appreciation card for my GP surgery.

14th – Posted a letter for a friend in Freetown and donated the stamp.

15th – Left some chocolate with a RAK note in a cafe.

16th – Knitted booties for a friend’s baby, took in the neighbour’s bins, and grateful to the kind man who bought a coffee for everyone in the hairdressers!

17th – Left An “Open Me” envelope RAK in the village shop.

18th – Left some chocolate with a RAK note to be found in a car park after attending a CBUK event.

19th – Left a chocolate RAK to be found in a cafe, after meeting a wonderful friend.

20th – Kind to self: got my hair cut. Also a shout out thanks to everyone who has done a RAK in Gail’s memory so far, and some money for a homeless busker.

21st – Love and thank you notes for my husband.

22nd – Thank you letter to Will Quince MP (who Co-chairs the All Party Committee on Baby Loss.

23rd – Thankful to the emergency services in London.

24th – Grateful for preschool for hosting a CBUK bake sale.

25th – Sponsored a friend running the marathon.

26th – A Mother’s Day Box for my Mum.

27th – Self care package for a friend who has recently had a baby.

28th – Book donations to Helen and Douglas House charity shop.

29th – A self care package for a Mum in need of self care at Helen House (a children’s hospice).

30th – Reunited a £10 note with its owner.

31st – Kind to self: wrote a letter to myself on http://www.futureme.org

April

1st – Grateful for a friend’s wisdom.

2nd – Thankful for a family day visiting the place where we had planted bulbs for Gail.

3rd – Left some chocolates under a car windscreen wiper.

4th – Left An “Open Me” envelope RAK at a cafe.

5th – Baked some bread for a friend and some cookies for PICU.

6th – Gave an orchid to my Granny.

7th – Thankful for arriving safely at my parent’s house.

8th – Left An “Open Me” envelope  RAK in a shop.

9th – Grateful for doodlebugs (yummy chocolate crispies which my husband’s cousin makes).

10th – Knitted some booties for a friend’s baby.

11th – Sponsored a friend running a half marathon in aid of Epilepsy Action.

12th – Left An “Open Me” envelope RAK at a cafe and some money at a children’s treasure hunt box.

13th – Thankful for the nostalgia of wedding albums and my wedding dress, and left an “Open Me” envelope RAK at a museum in Moray.

14th – Left an “Open Me” envelope RAK at a restaurant in Glasgow.

15th – Kind to self: pancakes for breakfast.

16th – Grateful for paracetamol and ibuprofen.

17th – Left a chocolate RAK by a playpark.

18th – Knitted some booties for a friend’s baby.

19th – Kind to self: yummy sushi for lunch.

20th – Made some soup and biscuits for friends.

21st – Gave some positive feedback to my GP surgery.

22nd – Left a chocolates RAK to be found on the bus.

23rd – Sponsored a girl running the London marathon in aid of MIND and in memory of her sister Rose.

24th – Kind to self: ordered myself some encouragement cards.

25th – Left a chocolate RAK under a windscreen wiper.

26th – Left some chocolateswith a RAK note in the coffee room at work.

27th – Paid for three people to go over the 5p toll bridge.

28th – Grateful for the anonymous person who sent me a Shetland knitting book (I now know who it is!)

29th – Left a chocolate RAK to be found on the bus.

30th – Knitted some booties for a friend’s baby.

May

1st – A Knitted blanket for my niece.

2nd – Positive thoughts RAK in the coffee room at work.

3rd – Thankful for Sands being here.

4th – Left some Rolos under a car windscreen wiper.

5th – Sent a “Book of Strength” to a friend.

6th – Bought a cappuccino for a random stranger at a coffee shop.

7th – Thankful for a bike ride with my family in the sun, and for my mother in law looking after Gail.

8th – Kind to myself: a massage and facial, a hair cut, and some money for a homeless man.

9th – Sent an encouraging postcard to a friend having a difficult time.

10th – Left An “Open Me” envelope RAK at the Institute of Child Health in London.

11th – Thankful for Freya’s picture of me.

12th – Thankful to Gail and my friend’s son Alex for sending us the first rose this year.

13th – Left a chocolates RAK to be found at a wedding, and complimented the bridesmaid on her beautiful piano playing.

14th – Left some Rolos with a RAK note to be found in a bike basket.

15th – Sent a “new Mum package” to my sister in law.

16th – A bottle of posh gin, tea and crisps for a good friend.

17th – Sent some positive feedback to someone’s boss.

18th – Thankful to a friend for organising a star for Gail, and took the bins in for the neighbours.

19th – Left some chocolates with a RAK note under a windscreen wiper.

20th – Thankful for time for reflection at a “Saying Goodbye” service for baby loss, and lit a candle for Gail and for all my friends’ babies.

21st – Sent a “Hug” card to a friend.

22nd – Sent a special birthday message of memories to a friend.

23rd – Kind to myself: bought myself a gratitude journal.

24th – Thank You card for my work colleagues, for looking out for me.

25th – “Take some love” poster in a hotel in Denmark.

26th – Thankful for a fun filled day in Legoland, and for the Robin who visited us.

27th – “Take what you need” poster in a community centre in Denmark.

28th – Sent a “She is Beautiful” care to someone special.

29th – Thankful to a friend who went to read stories to Gail.

30th – “Take what you need” poster at a hotel in London, and phoned my Granny to wish her a Happy 101st Birthday.

31st – Left Positive notes and thank you notes all over my hotel room for the staff to find.

June

1st – Pasta and sauce donation to the food bank.

2nd – Posted An “Open Me” envelope RAK in a post box.

3rd – Brought lunch to my brother’s family.

4th – Stopped to help at an accident.

5th – Thank You letter to the council for the new playpark.

6th – Sponsored a friend doing an ultramarathon in aid of a children’s hospice.

7th – Left a “Take what you need” poster at a cafe.

8th – Got some calpol for our neighbour’s son when they ran out.

9th – Gave some chocolates to a BA cabin crew with a RAK note.

10th – Forget-me-not seeds and scratchcards for my university reunion.

11th – Donation to Sands with the change from breakfast out.

12th – Knitted Booties for a friend’s son.

13th – Thankful for my mum and mother in law visiting Gail with pre-birthday flowers.

14th – Kind to myself: sent myself an email on futureme.org

15th – Shared some baking with friends.

16th – Chocolates for participants of a course and for the postgraduate centre staff.

17th – Complimented a girl at the end of Parkrun on her sprint finish.

18th – Handed in a lost toy rabbit in a supermarket.

19th – Gail’s Birthday. A day full of Random Acts of Kindness in her memory: a donation to Sands for my mum’s birthday, a donation to the food bank, birthday cakes for the neighbours.

20th – Forget-me-nots and a congratulations card to Mum’s friend who had been awarded an OBE.

21st – Gave the delivery people a cold bottle of coke on a hot day, left lavender to be found outside school, and donated a refund to Tommy’s.

22nd – Posted Knitted booties to two special brothers, and complimented a lady on her glittery nail polish.

23rd – Left some lavender with a RAK note to be found at a museum.

24th – Thankful for our happy, smiling girl, on her birthday.

25th – Left some lavender with a RAK note to be found at a Starbucks at a motorway services.

26th – Donated tampons and towels to a food bank.

27th – Gave a sprig of lavender to a good friend.

28th – Gave another sprig of lavender to another good friend.

29th – Sent the book “Option B” to a friend.

30th – Donation to Sands for my friend’s mini allotment.

July

1st – Helped two separate people who had dropped things.

2nd – Baked cakes for a work barbecue.

3rd – Kind to self: ordered myself some new clothes.

4th – Sent some fancy chocolates to a team who had helped me at work.

5th – Kind to myself: hair cut treat, having survived my first week back at work.

6th – Kind to myself: relaxing afternoon of headspace, a nap, list-writing and a walk.

7th – Left a scratch card with a RAK note for the paramedics at the Summer Ball.

8th – Left a scratch card with a RAK note under a windscreen wiper.

9th – Grateful for a cup of tea, a Tunnocks tea cake and a sit down.

10th – “Take what you need” poster at work.

11th – Sent a Sewing book to a random person from Tea & Empathy (Facebook group for health professionals).

12th – Looked after my friend’s daughter.

13th – Kind to myself: Date Night with my husband!

14th – Looked after my friend’s daughter, and started up the Bereaved Physicians Mums Group.

15th – A sprig of lavender for a friend.

16th – Thank you email to a senior colleague for taking the time to teach me.

17th – Put up a “Take what you need” poster on a notice board in my village.

18th – Bought some lunch for my boss, and chocolates for other colleagues.

19th – Left an “Open Me” envelope RAK to be found at work.

20th – Sent a “You are very special” book to a friend’s son, and took a special Thank You card to Mrs Bun.

21st – Paid for someone’s tea and cake at Millet’s farm.

22nd – Left an “Open Me”envelope RAK at a restaurant.

23rd – Thankful for the wisdom of Winnie the Pooh, sent a book to a friend, and a message of support to Great Ormond Street Hospital.

24th – Left An “Open Me”envelope RAK under a car windscreen wiper in the car park at work.

25th – Left An “Open Me” envelope RAK to be found at work.

26th – Thankful for Freya drawing a picture of her family.

27th – Left An “Open Me” envelope RAK under a windscreen wiper in our nearest town.

28th – Clothes and book donations to Helen and Douglas House charity shop.

29th – Grateful for a moment of joy, dancing in the kitchen with Freya.

30th – Kind to myself: a nice new dress.

31st – Left An “Open Me” envelope RAK at reception at work.

August

1st – Left An ” Open Me” envelope RAK for the sister’s office at work.

2nd – Grateful to my husband for being such a great dad.

3rd – Left An “Open Me” envelope RAK at a cousin’s wedding.

4th – Sent a letter and a “Book of Strength” package to someone who has been ill.

5th – Helped a woman with a pram.

6th – Left An “Open Me” envelope RAK in a Starbucks.

7th – Kind to myself: a bath and an early night.

8th – Left An “Open Me” envelope RAK in the coffee room at work.

9th – Kind to Myself: asked for Tea & Empathy and was grateful for those words of encouragement.

10th – Left at “Open Me” envelope RAK at Louis’ bench, and took in the neighbour’s bins.

11th – Paid some people over the 5p toll bridge.

12th – Made lavender hearts for a friend’s Rainbow Auction in aid of Sands.

13th – Invested in Lend with Care.

14th – Bought lunch for a medical student.

15th – A “You Matter” poster for work.

16th – A “You Matter” poster for the other bit of work.

17th – Thankful for being in Orkney and spending time with Gail.

18th – Kind to self: a night out with friends, and visited my Granny.

19th – A donation to Street Child, Sierra Leone, after the landslide outside Freetown.

20th A donation at church.

21st – Orkney fudge for my colleagues.

22nd – A Thank You message to the POD parking assistant (who had helped me when my car broke down two days before).

23rd – Happy Anniversary! Thankful to have been married to my husband for nine years.

24th – Left a positive thoughts RAK on the bus.

25th – Left a positive thoughts RAK at the hotel in Luxembourg.

26th – Left a positive thoughts RAK at a bus stop in Luxembourg.

27th – Left a positive thoughts RAK in the hotel room in Luxembourg.

28th – Gave some flowers for our neighbour.

29th – Bought a coffee for the next person in the queue.

30th – Nominated my consultant for “Trainer of the month.”

31st – Thankful for a fun day with Freya.

September

1st – Left a positive thoughts RAK under a car windscreen wiper.

2nd – Thankful for a post-Parkrun treat.

3rdKind to myself: bought myself some new trainers.

4th – Left a positive thoughts RAK in the staff room at work.

5th – Gave some Goodbye chocolates to preschool.

6th – Thankful to my boss for letting me go late to work to take Freya to school on her first day.

7th – Gave some nice chocolates to my counsellor at CBUK.

8th – Kind to myself: Date night!

9th – Sent a Little Star for my friend’s son, Alex, who was stillborn three years ago.

10thSponsored a friend running the Berlin marathon in aid of Sands.

11th – Left a positive thoughts RAK under a car windscreen wiper.

12th – Thank You card for my consultant.

13th – Donation to UNICEF for Hurricaine Irma.

14th – Kind to myself: wrote a letter to myself on http://www.futureme.org

15th – Sent (along with some others) a hamper to a friend whose son was in hospital, and bought another friend some tea and toast.

16th – Thankful for a chilled family day with my brother’s family and our mum.

17th – Visited a friend’s son’s grave and took him some of Gail’s roses.

18th – Kind to myself: a bath and an early night.

19th – Thankful for having a smiling girl greet me when I got home.

20th – Chocolates for the child bereavement study day.

21st – Finally finished knitting my Sands blanket.

22nd – Left a chocolates RAK to be found on a bench in our village.

23rd – Left a chocolates RAK to be found at the swimming pool.

24th – Grateful for K-tape for running a race in our village.

25th – Told the trauma team (including their consultant) to sit down and have tea and some lunch.

26th – Bought some chocolates for my colleagues.

27th – Made a cup of tea and gave a hug to two colleagues who had a difficult day.

28th – Baked cakes with a Freya for a Macmillan coffee morning.

29th – Took the bins in for the neighbours, and left a positive note and chocolate RAK to be found in the village.

30th – Chocolate and positive thoughts RAK for a lady at Cogges farm (Freya gave it directly to her).

October

1st – Knitted a scarf for my mum.

2nd – A Thank You note for work.

3rd – Booties for a friend’s baby.

4th – A “Take what you need” poster in the main reception area at work.

5th – Thankful to my friends, family and colleagues for smashing my target sponsorship.

6th – Kind to myself – a hair cut and a new Kindness book.

7th – Bournemouth Supersonic 10K in aid of Sands.

8th – Left a chocolate RAK in a bike basket.

9th – Bought lunch for a new colleague.

10th – Kind to myself: went out for a coffee (and got myself a new job!)

11th – A “You Matter” poster for work.

12th – Helped a Mum with a pram, and thankful to my friends, family and colleagues for speaking about Gail with me.

13th – Left a chocolate and positive note RAK in our village.

14th – The Capture Your Grief Secret Act of Kindness Day (its a secret!)

15th – Wave of Light, for Gail.

16th – Left a chocolate and positive thought RAK to be found at work.

17th – Left a chocolate and positive thought RAK in the main entrance at work.

18th – Bought a twix for a colleague in need of chocolate.

19th – A letter and positive notes to 52 Lives.

20th – Soooo grateful we are going on holiday tomorrow.

21st – Grateful to my husband for finding such a great holiday house, complete with a hot tub!

22nd – Left a positive thoughts RAK in a cafe in Asti.

23rd – Gave up a seat for a lady on the tram in Turin.

24th – Left a positive thoughts RAK in a cafe in a small Italian village.

25th – Thankful to my university friend for running the Great Scottish Run in aid of Sands and in memory of Gail.

26th – Left a positive thoughts RAK in a cafe in Alba.

27th – Left a positive thoughts RAK in the cinema museum in Turin.

28th – Left a Thank You note to the owners of our self catering house.

29th – Thankful for a yummy roast dinner at the end of a great holiday.

30th – Kind to myself: extra day of annual leave.

31st – 40 Things we love about Dad poster.

November

1st – Thank You cards for my nursing and medical colleagues.

2nd – Sent Christmas Joy wishes to the Option B community.

3rd – Lent a baby wrap to a friend.

4th – Thankful for the opportunity to speak at the Sands conference.

5th – Sent nominations for the paediatric Training awards.

6th – Donated old clothes and shoes to the Bags2School charity in aid of Freya’s school.

7th – Thankful for beautiful flowers from my Mum and Dad.

8th – Kind to myself: enjoyed my treats from my new colleagues, and an early night.

9th – Left a chocolates RAK to be found at work.

10th – Sent an encouraging card to my mother-in-law.

11th- Left a positive thoughts RAK under a car windscreen at a shopping centre.

12th – Thankful on Remembrance Sunday for those who gave their today.

13th – Kind to myself: visit to the new Westgate shopping centre and lunch out.

14th – Gave some chocolates and pictures with a RAK note to the school teachers.

15th – Put up a “Free Compliments” poster at work.

16th – Offered directions to a man who looked (and was) lost and complimented a lady on her nail varnish.

17th – Thankful for the beautiful frosty cycle to work, and the robin who stopped in my path.

18th – Donation of tampons and sanitary towels to the food bank.

19th – Left a positive note and chocolate RAK in a bike basket in our nearest town.

20th – Wrapped boxes for the school Christmas hamper raffle.

21st – Book and clothes donations to Helen and Douglas House charity shop.

22nd – Left a positive thoughts RAK at the volunteer reception at work.

23rd – Put up a “You are Valued” poster at work.

24th – Kind to myself: a bath and a glass of wine.

25th – Sent an encouraging card to a friend who has had a hard time.

26th – Thankful for the Sands remembrance service.

27th – Book Donation and positive thought/chocolate RAK for Oxfam.

28th – #GivingTuesday Donation to Sands and Child Bereavement UK.

29th – RAK advent calendars for my old wards at work.

30th – RAK Advent calendars for my new ward at work.

December

1st – Kind to myself on my birthday: birthday wine, a bath and an early night.

2nd – Lent my car to a friend so he could escape work at the hospital and come for dinner.

3rd – Left a positive note and chocolate RAK under a car windscreen wiper at the swimming pool.

4th – Made a Kindness Jar for the school tombola.

5th- Posted Christmas tree decorations to someone for an auction in aid of Sands and Tommy’s.

6th – Bought coffee for a stranger.

7th – Finished knitting a cardigan for a friend’s baby.

8th – Thankful to a colleague for taking some time to talk to me about Gail.

9th – Thankful for a wonderful family day.

10th – Thankful we are safe and warm in the snow, and checked in on our elderly neighbours.

11th – Left a positive thought RAK under a windscreen wiper in our village.

12th – Checked in our elderly neighbours.

13th – Helped a pregnant colleague carry a box to her car, and a donation to the food bank.

14th – Grateful for the beautiful picture a friend gave me for our family.

15th – Kind to myself: a nice long hot bath.

16th – Donated a Christmas meal to a homeless person at the Social Bite.

17th – Baked Rocky Road treats for all the teachers.

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18th – Kind to myself: went to see Star Wars.

19th – Arranged some chocolates for the coal men.

20th – A gratitude card to a great colleague.

21st – Christmas self care packages for the mums of children admitted to my ward.

22nd – Another gratitude card for another great colleague.

23rd – Thankful to have arrived safely in Orkney and to see my two girls.

24th – Left a chocolate/positive thought RAK in church.

25th – Thankful for an excited girl on Christmas morning, for bubbles, a sparkly hedgehog, and for family.

26th – Left a chocolate/positive thought RAK outside a shop in Kirkwall.

27th – Knitted wee blankets for SiMBA (Scottish stillbirth charity).

28th – Thankful for bubbles and sand angels.

29th – Donated money towards a camera for a Remember My Baby photographer (volunteer photographers who take beautiful photos of stillborn babies).

30th – Gave a positive note RAK to the cashier in a supermarket.

31st – Thankful for family.

Things I’ve Learned about Kindness this year

I have done an act of kindness every single day of 2017 in Gail’s memory. Some have been random, some directed. Some are acts of gratefulness and some are acts of self kindness. Here are the things I have learned about kindness:

  1. People are kind all the time. You just have to look out for it.
  2. Very many of my friends, family and colleagues go well above and beyond, showing kindness by the bucket load, every single day.
  3. Doing kind things for others in Gail’s memory brings me joy.
  4. Most of my RAKs have been small or simple gestures, they are not extravagant and they sometimes feel a little insignificant.
  5. However, as Aesop said “No act of kindness, no matter how small, is ever wasted”.
  6. Kindness doesn’t need to cost any money, or be terribly extravagant. Many of my RAKs have cost nothing but a bit of time.
  7. For some reason, coffee shop baristas often don’t seem to get it when I tell them I want to buy a coffee for a random stranger (perhaps I need to learn a better way to explain it).
  8. The imagination and motivation for RAKs does not always come easily: at times I have struggled with energy to make RAKs.
  9. However, I have the inspiration of my beautiful daughter, and have always kept Gail in my heart.
  10. Every day may not be good, but there is good in every day.
  11. I started the year think I was very alone in having a difficult time.
  12. I have ended the year knowing there are many people having a difficult time; that you never know what someone else is going through and therefore, the default option should be being kind.
  13. Self care is not selfish, it is necessary – perhaps the hardest, but also most important person to show compassion to, is yourself.

Photo taken from “The Story of the Kindness Elves” by Anna Ranson and Benjamin Byrne