“We are all diverse” – enabling inclusive Schwartz Rounds
17 October 2024
Anne reflects on a recent Schwartz Round she observed which celebrated neurodiversity in the workplace.
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As a Schwartz facilitator and mentor, I have the great privilege of listening to people who work in health and care open their hearts and talk in a uniquely intimate way about their work and talk about the toll it sometimes takes on them. In Schwartz Rounds, people bravely reveal the hidden wounds and burdens they carry unseen throughout their lives and careers. Often, they find relief and renewed strength from having their stories appreciated and identity affirmed by their colleagues.
Often, as we know, the discussions in Schwartz Rounds remind us, in the memorable words of Jo Cox that, “we have more in common than that which divides us.” Equally, there are times when Schwartz stories provide windows into the minute-by-minute experience of people whose characteristics or life experiences diverge significantly from our own.
Some Schwartz Rounds are deliberately planned for this purpose, such as one I recently observed at the Royal Wolverhampton NHS Trust titled “Being My Whole Self at Work,” which focused on neurodiversity.
Two of the three storytellers self-identified as being neurodivergent. The first was a researcher. She explained that a strength of hers as a person with ADHD, among other characteristics, was an ability to ‘hyperfocus’. But she went on to share how challenging it can be for her to work in a room full of colleagues and be faced with a battery of sensory experiences – sights, noises, smells and touches – that could be overwhelming. On top of this, there was the need to present a conventional social front, to join in the chat and to hold herself continually in check, to ‘mask’ habitual behaviours that gave her comfort. This left her feeling profoundly drained and held her back from pursuing new opportunities.
The second storyteller was a senior consultant who described how the nature of the school exam system had worked against her. Lacking the grades needed for medical school, she initially pursued a career as an Allied Health Professional before finding a medical school that accepted her and a specialism that fitted her strengths But, like the previous speaker, she acknowledged the exhaustion she felt operating in a working world designed for people who were not like her.
The remaining storyteller brought a different take on the topic. This speaker’s story was about the joy he found in using his extroverted, sociable personality to add an extra dimension to his work as a hospital porter. He expressed his empathy with patients who were in pain, or a state of shock at finding themselves in a place far from where they had envisaged at the start of their day. If he could distract a child, or offer words of comfort to a patient, he felt fulfilment in his role.
When the Round was opened up to the room, it was evident each of the stories resonated with the group. One person spoke of the strain of working in a setting in which all forms of communication seemed targeted to people who were ‘neurotypical’. Others gave their own accounts of the exhaustion that came from ‘masking’ their true identity and struggling with the daily experience of sensory overload.
Observing the Round, I was curious that there appeared to be only one facilitator. Questioning this afterwards, I learned that there had in fact been two. Both had worked with the storytellers to help prepare them for the Round but agreed it would reduce stress if one of them provided a single point of focus throughout, while the second facilitator provided a supportive presence by participating from the floor. This slight adaptation of the Schwartz Round model was an example of the thoughtfulness and sensitivity that had clearly gone into the preparation and delivery of this Round.
This slight adaptation of the Schwartz Round model was an example of the thoughtfulness and sensitivity that had clearly gone into the preparation and delivery of this Round.
Schwartz Rounds in this organisation are seen as integral to developing and sustaining a positive staff culture. Challenges faced by neurodivergent staff, highlighted in surveys, led to the creation of plans, guidance, and a dedicated toolkit. This Schwartz Round was included as an integral element of this initiative to host a conversation open to staff across all roles and levels. This brought the topic to life so that people could get a sense of why and how the guidance and toolkit could be helpful, rather than being experienced as something that was imposed from above.
Their overall vision is to build an organisation in which (what one of the facilitators referred to as) the “creativity and rebelliousness” of people who are neurodivergent could be appreciated and harnessed as a strength, alongside the contributions of others, like the porter. Both perspectives are recognised as essential to the diversity and success of the workforce.
As one of the facilitators observed, some neurodivergent traits are invaluable features of certain healthcare roles. In the words of the self-identified autistic Irish anaesthetist Mary Doherty:
“medicine selects for autistic traits … Perfectionism, attention to detail, that dogged determination to stick with an idea until it gets resolved, work ethic, loyalty, honesty.”
Anne will be hosting a workshop on enabling inclusive Rounds for people with protected characteristics and neurodiversity at the Schwartz Community Conferences in November 2024. Find out more here.