Containment or compassion?

It struck me as I lay on the floor in the early hours of a Sunday morning that January was the first month in 19 years that didn’t end with a salary in my bank account. I was lying on the floor because there were no free beds left in the homeless centre, where I’d volunteered as an overnight helper. It wasn’t a ‘fun’ night, but for me it’s just one step on a deliberate ‘cultural journey’.


About a year ago I read a quality systems article in the NSF/DBA Pharma Journal, and inspired by that I went off and bought ‘The Toyota Way’ by Jeffrey Liker. I was struck by the contrast between the  Japanese lean manufacturing methods and the traditional Western industrial approaches; particularly the differences in cooperate philosophy and culture. Since reading the book I’ve become interested in understanding ‘working culture’ it’s influence on people, their wellbeing and productivity, and the quality of their output. I’m convinced that culture is as important (if not more important) than technical knowledge. My ‘cultural journey’ leads me to some unusual places: like the floor of a homeless shelter.

Keeping dangerous stuff safe

I’ve found that different working environments manage dangers and hazards in different ways. My scientific career has seen me both desperate to ‘blow stuff up’ (even to point of having my head set alight) and carefully designing ways of keeping people safe and making sure nothing ‘goes bang’.

A few years ago I helped out at an arts performance, demonstrating some chemistry, and, because the science was an unusual part of an arts performance, we a risk assessment. The arts approach was pretty standard ‘risk assessment’: likelihood, severity and so on. However, the numbers were different from the ones I was used to in the lab: the grid allowed me (albeit at one end of the range) to hospitalise one member of the audience without having to implement control steps. This was just mind boggling to someone from a science environment. But it’s performance art, and a different culture. As one of the artists pointed out, a performance that ended in ambulances and fire engines being called could be seen as a challenging and provocative performance. In art, an impact on the audience is good: that what art is for.

In the lab we are trying desperately to avoid effecting the people around us! We spend a lot of time and effort making sure that it’s only our results, and not the experiments energy (be that chemical, electro-magnetic, radioactive, or physical force) that impacts people.

Caring sectors

But in the caring sectors, impact isn’t ‘results or conclusions’, it’s physical, emotional or therapeutic connection. That bring along risks and hazards that are harder to ‘isolate’. At the homeless centre it’s known that a small number of clients struggle with drug addiction, and so caring and supporting them comes with a risk of needle stick injuries: a risk common to many care settings including hospitals. The needle risk is one the centre team understand and manage well, but manage differently from the lab setting.

People vs chemicals?

Containment or compassion? Source Simon Davis/DFID

My lab approach to managing the risk was engineering control and separation. (I had a mental image of me putting everything – and every one 0 in a isolator until we’d kevlar-gloved and masked up! A bit like the image on the right. But the homeless centre is a different environment, with different goals, and so needs a different approach.

People can’t be stoppered in bottles, or handled with gloves behind screens, the risk of dealing with people can’t be engineered or designed out through barriers or separation strategies: they can’t be quantified, risk assessed or COSHH’ed. Vulnerable people need to be treated with care not caution, but with no barriers in place people need to stay sharp (no pun intended!)

During the night shift I needed to deliberately think with both wisdom and compassion, this kept me connected with the people in my environment to get a sense of the risks and dangers around me. Falling into prejudice or ignorance (easier to do when you’ve had no sleep) would have me exaggerating or minimising the hazards I was exposed to. In a way it could be said that; to effectively care about myself I needed to care for those around me.

Jobless but not homeless.

At the moment I don’t have a salary, but thankfully I still have a roof and four walls (something that is – judging be some of the stories at the centre – surprising easy to loose). My idea of what ‘homelessness’ looks like is is now different, and my ideas of hazards and risks are slowly beginning to evolve.



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