Embrace those grey areas: they might burst into colour

Resist notions of black-and-white existence.

Lauren Westwood

Lauren writes on faith, community, and anything else that compels her to open the Notes app.

A pile of folded knitted jumpers sit on a grey back ground, one is also grey, the others are red and brown.

Anna Evans on Unsplash.

All too often, the world demands us to be one thing, or to be another. In our responses, our ideologies, our beliefs, we are expected to be this, or to be that. In or out. Yes or no. Red or blue. Black or white. The world likes when we label ourselves with a certainty that makes us easier to market to, to capture in a strategic plan, or to reach in an algorithm.

On a social level, these self-categorising definitions – what I believe, who I vote for, what I consume – can become a filtering system for who gets access to us, and who does not. In a combination of association and assumption, we decide who ‘our people’ are, and who they are not. And it seems straightforward.

That is until you realise two things: most of life occurs not in the confines of black or white certainty, but in the grey, in-between area. And none of us are straightforward.

After living through what was dubbed ‘the largest election year in history’ in a multi-national community, I can appreciate that a person is unlikely to experience uncomplicated commiseration or celebration. In the days following several of these major elections, I witnessed friends express disappointment, relief, uncertainty and acceptance in an exceptionally short span.

We may like to believe that we are clear-cut individuals who hold easily defined, nicely organised ideas and beliefs, but the reality is far messier. Our attitudes, views and feelings are lightly tethered to a spectrum and, almost always, we find ourselves somewhere in the middle.

Think about it. Can you remember the last time you felt sustained unadulterated happiness, without concern for something or someone lingering at the back of your mind? The reverse is true, too. I’ve known people in the trenches of grief to laugh out loud at their favourite Instagram reels. Typically, it doesn’t take much to drag us away from the highs and the lows of life. We are geared to live in the in-between spaces.

Make space for all that occurs within the confines of what the world expects and accepts. To embrace the mess of the in-between.

This pull we feel to the middle is not surprising. One of the early church leaders, Paul, said that ‘if anyone is in Christ, the new creation has come.’ We are new creation beings, surrounded by new creation ideas, in an old creation world. Our social constructs, systems and very lives are built on the premise of being somewhere in between the old and the new, a grey area of partly present and partly future.

Paula Gooder, the New Testament theologian, says of Paul’s writing: ‘With Jesus’s death and resurrection, the new creation lies with the old creation. From time to time, you will see moments of perfection, moments of resurrection, and those are the moments that keep us going in the difficult time … Although you’ve got new creation lying on top, you’ve still got old creation lying underneath. If you want to ask the question of why the world is as awful as it is, it’s because we’re living in old creation.’

In embracing the Kingdom of God in being both now and not yet, we are engaging in an act of resistance against notions of black-and-white existence by living in a grey area that is fit to burst into bright, celestial colour.

On the surface, the story that shapes our origins of existence, the creation narrative of Genesis suggests a God who works in binaries – night and day, land and sea. But we know that there is also the less easily defined twilight, dusk and dawn, marsh and mist. Creation itself indicates that living solely in duality is an impossible feat. After all, we weren’t made for separation, but for unity and reconciliation. All around us, the natural world witnesses to a God who created the things in-between and, like the setting and rising of the sun, he made them to be spectacular and captivating.

In his criticism of Richard Dawkins and the new atheist movement, Terry Eagleton echoes the excitement that dwells in the in-between, writing that Dawkins ‘would seem to divide neatly down the middle between things you can prove beyond all doubt, and blind faith. He fails to see that all the most interesting stuff goes on in neither of these places.’

While certainty has its moment and its merits, I don’t think living in a grey area is a bad thing. In fact, I think we’d all be better off if we could get used to it. If, in compassion, we could assume that our neighbour, too, is occupying space in the grey area, floating somewhere between joy and sorrow, clarity and confusion, relief and pain. If, in humility, we could accept that we don’t always have the answers and grow comfortable with saying ‘I don’t know.’ If, in fairness to ourselves and to others, we could allow for the myriad of feelings between delight and distraught.

In a world that not only expects polarisation but increasingly feeds it for profit of votes or views, this is a counter-cultural way of living. It is radical to acknowledge that our feelings, opinions and even our beliefs can rarely be defined as immovable. We are evolving beings and, as such, the stuff we hold in our minds and hearts today will morph and grow and potentially come to change tomorrow.

Our lives are more than a sum of wins and losses, comedy and tragedy, old and new, black and white. So, as we stand at the beginning of this year, I implore you to make space for all that occurs within the confines of what the world expects and accepts. To embrace the mess of the in-between. To press on in the grey areas of life, only to discover it full, vibrant and glorious in new creation colour.

Join with us - Behind the Seen

Seen & Unseen is free for everyone and is made possible through the generosity of our amazing community of supporters.

If you’re enjoying Seen & Unseen, would you consider making a gift towards our work?

Alongside other benefits (book discounts etc.), you’ll receive an extra fortnightly email from me sharing what I’m reading and my reflections on the ideas that are shaping our times.

Graham Tomlin

Editor-in-Chief

Find out more and sign up

Article

Care

Change

26 July 2024

6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A nurse bends beside a bed and talks to a patient

Marie Curie.

Recently, at a nursing leadership programme in Oxford, attendees focused on the fundamentals of care. Have we forgotten how to care? What can we re-learn from those who pioneered an ordinary yet profound act that affects millions?

Anam Cara is an old Gaelic term for ‘soul friend’, a person with whom you can share your innermost self, your mind and your heart. It is a term that Tom Hill, former chief executive at Helen House Hospice in Oxford, used to describe the relationship between his staff and the thousands of children and their families who passed through their ‘big red door’ in its first twenty-five years. The hospice (or ‘loving respice’ as it became known) had been founded by Sister Frances Dominica in 1982.

Other care in this country can also trace its religious roots. Between 1048 and 1070 in Jerusalem, the Order of St. John was founded for the purpose of helping pilgrims (“our Lords, The Sick”) who had become lost, weary, or beset by other difficulties while on their way to the Holy Land. Today, in the United Kingdom, the British Association of the Order has extended care to older people first in almshouses and later in care homes. A trustee for ten years was John Monckton, a man of ‘considerable talent, enormous integrity and deep religious conviction’; his tragic murder in 2004 led to the creation of the John Monckton Memorial Prize, which recognised and rightly celebrated commitment to care by care workers.

Today, across the world, seen and unseen, nurses, carers and families continue to provide compassionate care. “Assisting individuals, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge” is the very essence of nursing, captured by ‘architect of nursing’, researcher and author Virginia Henderson in 1966. Meeting more than basic needs such as breathing, eating, drinking and eliminating bodily waste (which are of essential importance), Henderson recognised the role of the nurse in enabling humans to communicate with others, worship according to their faith, satisfy curiosity and sense accomplishment.

In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care?

An uncomfortable truth brought out in healthcare reports such as the Final Report of the Special Commission of Inquiry (The Garling Report) 2008, and the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (The Francis Report) 2013 is though that this type of nursing is too often done badly or even missed, leading to pressure injury, medication errors, hospital-acquired infection, falls, unplanned readmission, critical incidents and mortality. According to nurse scientist and scholar Professor Debra Jackson, “missed care occurs much more frequently than we might think”. She cites a systematic review in which ‘care left undone’ on the last shift ranged from 75 per cent in England, to 93 per cent in Germany, with an overall estimate of 88 per cent across 12 European countries’.

In one offensively-titled paper, “Shitty nursing - the new normal?” (in which the authors apologise for the title but not the questions raised), real-life pen portraits are drawn of patients lying for hours on hospital trolleys, immobile through infection or injury, ignored by staff. Whilst acknowledging contextual factors for poor care, such as a shortage of nurses and resources, the authors argue that circumstances cannot be the sole cause of missed nursing care.

A report published by the University of Adelaide, School of Nursing, has called for nurses to ‘reclaim and redefine’ the fundamentals of care. It asks whether the cause of the problem (of missed nursing care) lies “deep in the psyche of the nursing profession itself?” “Has something happened to the way modern nursing views and values caring?” it continues. “Indeed, is nursing in danger of losing its claim to care? In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care? Or is this a broader social pattern where individuals are less inclined to show kindness, compassion, and care for others even if it is a necessary requirement of the job?”

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness.

Writing in the British Medical Journal, Professor of critical care medicine Peter Brindley and Consultant in intensive care Matt Morgan wonder whether doctors also “too often default to high-tech and low-touch” when patients are dying – a time “when community and connection matter most”. They powerfully begin with a mother’s comment: “Humans are gardens to tend – not machines to fix.”

Professor Sir Al Aynsley-Green, the first National Clinical Director for Children in Government and former Children’s Commissioner for England, and past president of the British Medical Association, suggests that we as a society need a “momentum for compassion”. Struck by the extremes of compassion witnessed during his wife’s treatment in the last years of her life, Sir Al wants to see a cultural transformation in healthcare: for compassion to be a key operating principle in NHS and care settings, led by the Chief Nurse’s Office; for every organisation to promote the importance of compassion at the professional level; for the views of patients and families to be sought regularly; for much earlier and better focus on compassion in undergraduate and postgraduate teaching programmes for all staff; for compassion to be inspected against by the Care Quality Commission; and for a willingness to encourage staff at all levels to expose poor practice as well as celebrating excellent care.

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. “It’s putting yourself into somebody else’s shoes – and doing something about it.” Recently appointed the UK’s first Visiting Professor in Compassionate Care at Northampton University, at the age of 80, Sir Al certainly is doing something about it. He has made it his new purpose in life to “embed compassion into every aspect of care”.

Like Sir Al, Queen Elizabeth II, the UK’s longest serving monarch, espoused compassion, in word and deed. Living a life of compassionate service, the Queen made clear that her Christian faith was her guiding principle. She speaks of Jesus Christ as ‘an inspiration,’ a ‘role model’ and ‘an anchor’. “Many will have been inspired by Jesus’ simple but powerful teaching,” she said in her Christmas Broadcast, 2000. “Love God and love thy neighbour as thyself – in other words, treat others as you would like them to treat you. His great emphasis was to give spirituality a practical purpose.”

When nurses do unto others as they would have done unto themselves, and act as role model to colleagues, not only do patient experiences of care and their outcomes improve – but so does job satisfaction for nurses: a critical factor in nurse recruitment and retention – the biggest workforce challenge faced by healthcare organisations. Across the UK, there are currently more than 40,000 nursing vacancies, and thousands of burnt-out nurses are leaving the profession early. Whether nurses decide to stay or go is driven in part by their daily experience at work. The late Kate Granger, Consultant in medicine for older people, inspired Compassionate Care Awards in her name, envisioning that such a legacy would drive up standards in care - and surely also help retain nurses, through restoring a sense of pride, achievement and fulfilment to the nursing workforce.