I understand what you have said, and I like the metaphor of the immune system,
but it still has to adapt as a virus or antigens change. I think that
repeatability and replicability are essential, and I expect my use of creative
doesn't necessarily apply to this aspect of care across the sifferent ways of
providing this. Rather I see the creativity in the care and therapeutic
relationship which occurs during the repeated interventions.
Repeatability and replicability do create safety, and equitability but also
risk lack of critical reflection when the intervention becomes tacitly driven.
The edge of chaos and complexity can become bounded without enough give in the
system for change. The people I interviewed in my previous work talked about
the mechanistic approach to care like being on a conveyor belt within the NHS
compared to the personalised approach in palliative care. Some of the
interventions were the same, it was just how they were carried out. I suspect
there needs to be a more pronounced balance in the drive for efficiency and
modernisation but with enough room for natural change.
Quoting No Name <[log in to unmask]>:
> In a message dated 25/05/2004 11:07:21 GMT Daylight Time,
> [log in to unmask] writes:
>
> >
> > I don't know, these are just my thoughts at the moment, and I have lurked
> > specifically because I am not sure how much sense I would make here!
> >
>
> No apologies for lurking are needed!
>
> Your thoughts are very welcome.
>
> There may not be a conflict between regularity and creativity, just a matter
> of relationship and balance.
>
> Can I suggest that we only need to be creative in certain circumstances, not
> all. Improving regularity in a system could increase the time available for
> creative activity elsewhere in a system. One of the examples regularly quoted
> of
> a complex adaptive system is the immune system. The creative part -
> identifying the structure of a new antibody - is essential, but once
> identified the
> antibody is produced with a 'ruthless efficiency' to aid survival of the
> host.
> Each individual antibody molecule does not have to go through the same
> creative
> process.
>
> Yes, It's only a metaphor, and one which can easily be stretched too far.
> But
> even artists have to rely on a certain level of repeatability, reliability
> or
> "safety." The properties of canvas and paint, the sound of instruments in
> practised hands, the firing of clay, are but some artistic examples.
>
> My suggestion is that the totality of Care is no different. Improving the
> reliability, or safety, in one area opens up the possibility for more
> creativity,
> whatever the knowledge base, (even by mixing knowledge paradigms),
> elsewhere.
>
>
> Ceri
>
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