Kathryn:       Hi everybody, today I have Sue Kinsella with me from RedArc Nurses.  Hi Sue!

Sue:            Oh good morning Kathryn and thank you so much for inviting me to talk on your podcast today.

Kathryn:       Oh it’s lovely to have you with us.  We are going to be talking about sort of the common feelings and behaviours of people that have been diagnosed with a medical condition or possibly had a bereavement, how nurses like Sue are able to help and the best practices for advisers and insurers to support people more – well I was going to say better but that’s probably not the best of words is it really?  But this is the Practical Protection podcast.

So Sue, can you tell me a little bit about how things have been for you recently then?  How was your weekend?  And I know you’ve got a very special day coming up on Saturday as well.

Sue:            I have, it’s my grandson’s fourth birthday so we are looking forward to celebrating, being together, socially distancing of course but, you know, after a difficult period of lockdown it will just be so lovely to have a sense of normality.  So I’m looking forward to that, Kathryn.

Kathryn:       Absolutely, I think the thing is that it’s the normality, especially for the kids that’s just so, so important.  The other weekend we managed to take our three to the local sort of like conservation zoo which is Flamingo Land and we usually go really regularly throughout the year and obviously we’ve not been at all this year and it was just nice to get them out in a bit of – somewhere that they know is familiar to show them that things are kind of getting back to normal and safe again.  We stayed away from all the really busy areas because, you know, there was a lot of not social distancing happening between people in queues so we just stayed near the animals and everything.  But it was just really nice and I don’t think as well that I realised just how much I needed that as well, just needed, you know, to see them, you know, really just letting their hair down, just running around giggling and, yeah it was so, so nice.

We have the truth or lie feature from our last podcast and last time I was speaking to Leo Miles from Macmillan Cancer Support and you have to decide if that’s okay whether or not – well which one of us was telling the truth and which one of us was telling the lie.  So Leo had said that she had abseiled down the tallest building in Portsmouth.  I’ve forgotten the name of it but it’s the tallest building in Portsmouth and I said that the weirdest thing that I have ever eaten is crocodile.  So I’m just wondering, who do you think is telling the truth?

Sue:            Ooh, I think it’s you Kathryn.

Kathryn:       You think it’s me?  I’m like the worst person for like lying or – everyone keeps catching me – yes, I am absolutely telling the truth.  Leo has not been down – not been abseiling down that building but yes, Alan is one of those people where I often refer to him as kind of like a bit of a Neanderthal, you know, he will just eat anything and everything, he’ll give it a go.  And I got him this thing for his birthday so quite a while ago where I kept buying like exotic meat hampers and one of them came with crocodile so yes we have eaten crocodile which is unusual but there’s lots of other things like chocolate ants and vodka scorpion lollies, things like that.  Lots of things I think a lot of people will be going, ‘Ugh, now.’  But yes, he’s loved having those.

Sue:            I think I’ll give that a miss, Kathryn.

Kathryn:       Yeah, I think most people would give it a miss, yeah.  There was a few people in our office who were sort of like, ‘Oh we’re not going to try that,’ and I was like, ‘Go on, go on.’  But yeah, I don’t think anybody was very keen on the – I think it was like salt and peppery kind of things and yeah, a bit of I’m a Celebrity theme in the Cura offices for a little while.  So Sue, you work for RedArc Nurses and obviously I’ve had the pleasure of spending a little bit of time with you in your offices last year.  It was wonderful and I had a little break over to Chester Zoo and we managed to pop in and see you guys and it was just lovely to be in that atmosphere and see you guys working.  Can you tell us a bit more about yourself and also about RedArc Nurses as well?

Sue:            Okay, well Kathryn it was just lovely to welcome you both – both you and Alan to our lovely office in Chester just to see how we work first-hand.  People who visit us say it really brings our service to life when they, you know, they sit with the nurses, see how we work and everyone comments what a lovely, calm environment that we work in.  I’ve been at RedArc for almost 12 years and prior to this I worked in the NHS for 27 years in a busy, inner city hospital in Liverpool working on a busy acute medical ward.  To be honest, I thought I’d be there until I retired.  I loved being a hands-on nurse but I was becoming more frustrated with not being able to give my patients the time that they needed.  An opportunity arose at RedArc and I thought, ‘If I don’t take this, I will regret this opportunity for the rest of my life.’  And I thought, ‘I’ll give it a go for six months,’ and I’ve never looked back, I’m still here now.  So yeah, so yes it’s one of the best decisions I’ve made in my life.  Now the RedArc Nurses – we come from a variety of settings whether it’s district nurses working in care homes, lots of experience behind everybody and again it’s a really unique setting where we have a wonderful team; both the nurses, the admin –

Kathryn:       Okay, so I think that with the RedArc Nurses, they all come from like – you all come from obviously I’m assuming lots of different specialisms and, you know, bring clearly a deep sort of like breadth of knowledge and experience from – I imagine a lot of people have worked in the NHS so have been able to see how things and sort of like the networking and where all those kinds of systems and processes are kind of set up between maybe different hospitals, GP surgeries – you’ll understand very much the ins and outs of the NHS system and I imagine all of your knowledge can come together and really support that and provide obviously a bit more – like you were saying about the time to be able to give to people.  You can maybe do that a bit more with RedArc?

Sue:            At RedArc we do have different expertise that all brings our RedArc service together because we can draw on each other’s experience and knowledge but I think the key thing for me is that the nurses really care about what they do, about their patients and we also have a wonderful admin team who are experts because they’re the first port of call for when the patients call in.  So we’re very proud of the team as a whole.  We work together really well and complement each other’s’ skills and knowledge.

Kathryn:       So I think a good place for us to start would be for us to chat about what it’s like when someone is diagnosed with a medical condition and I want to be really clear for anybody who’s listening that we’re not going to say anything that is identifiable to anybody in particular.  You know, obviously we are going to be very, very sensitive about that.  I know just from my experiences, I’ll be quite open, I usually am – probably everyone is fed up of me talking about my health but I know for myself, I was particularly ill as a child and, you know, when I was seeing, you know, the specialists and the consultants and everything, it was obviously a scary time not knowing what was going on but I kind of felt like, for me it was a scarier time not knowing what was going on, knowing that I wasn’t, you know, in a sense “normal”, that I couldn’t do the same things as friends and different things like that.  And it just – when I eventually got a name for what was wrong with me – and I say, ‘What’s wrong with me,’ I hope that comes across in the right way – when we got the name for why I was different and I got that diagnosis, it was just – it was kind of part of – it was a big sense of relief, you know, there was an anxiety over, ‘Right okay, yes so it isn’t just in my mind, this is definitely happening,’ but also just that relief of going, ‘So I’ve not been making it up and the people maybe who did doubt me or said that things that were happening to me were impossible,’ different things like that, that they were actually wrong and, you know, here was someone like validating what I’d been experiencing.  And, you know, I think sometimes it can be quite powerful but I mean is that kind of quite a common experience that people have?  It’s kind of like a mixture of anxiety but also relief because then once you’ve got a name you can then plan as to what’s to do going forward.  I mean, what are your experiences?

Sue:            Absolutely Kathryn and thank you for sharing your personal experience and I agree what you have felt we do hear from our patients.  I think the initial feeling people have is shock, disbelief and fear when receiving a diagnosis of a critical illness and at that point, people are unable to listen to the finer details but it’s definitely a sense of relief.  ‘Well actually, I’m not going mad and I know what’s wrong with me.’  But ultimately people need to know what their – this diagnosis means for them and the impact that this may have on them and their family.  A real concern we hear from our patients is telling family, friends, colleagues and children and what they should actually say.  The support we provide can give people extra time to have the opportunity to talk through their concerns and we can actually guide them into having these difficult conversations with those around them but you’re actually, you know, you’re absolutely right with what you say, Kathryn.

Kathryn:       So, you know, based upon that, you know, that whole thing of we were just saying there about how to try and, you know, speak in a supportive manner, you know, somebody’s possibly – just as you say with a critical illness – just heard something that has caused them to go into shock, you know, they’re in disbelief.  What can we do in a sense as advisers and as people in claims departments to provide the most supportive journey to people that are facing these events?  You know, as an adviser – if somebody comes to me and I’ve arranged that critical illness policy for them, they’re going to be, as you say, you know, they’re going to possibly be in shock, there’s probably going to be a lot of emotion.  They’re not sure obviously what to do and obviously they’re coming to us for support.  I’m wondering if there’s like certain things in regards to the language that we can use, the tone of our voices.  Is there anything that you would say is sort of like – really key things to try and to do our best?

Sue:            Yes, I mean it is a very difficult conversation to have with people because you will have that emotional attachment.  I think it is so important to listen empathetically without judgement and show that you really care.  Give that person the time to talk and listen to what is actually being said rather than what you think you have heard.

Kathryn:       Yeah.

Sue:            And do that by just checking, ‘Is that right that you’ve said that?’ to make sure that you’ve totally understood.

Kathryn:       Yeah.

Sue:            I think having a calm approach with a soft tone of voice is important and if you are seeing people face to face, make sure you make eye contact.

Kathryn:       Yeah.

Sue:            Never interrupt and definitely never look at your watch.

Kathryn:       Yeah.

Sue:            Or say, ‘I know how you feel,’ because no one will know how that person feels but I think the most important thing is to show that you care about that person and I think that will come across.

Kathryn:       Absolutely.  I think, you know, that that’s got to be a thing.  I think we live in such a hectic society now that especially in this kind of situation I think, you know, it would just be incredibly important to make sure that you do give undivided attention and that person knows – because to them, their world is potentially kind of in a complete spin and they possibly feel as if the world’s crumbling in some ways.  And just to make sure that they know that you have, you know, they are getting your absolute undivided attention and they are the complete focus.  It’s got to be, you know, the key thing.

I think that when it comes to these things there’s sort of like – there’s some generally – some good practice for all stages in the insurance journey which is the application, the medical underwriting and the claim.  One thing that I am often saying is that I’m not particularly keen on like mental health questions and how they’re particularly worded and I think this need for being, you know, sort of like a – sensitivity is so important.  I completely get what you say about, you know, obviously don’t ever say that you understand how someone feels and I think that can be really hard sometimes to know the exact wording to use and I’m not saying that I always get it right but one thing that I do is because I have – I’m very open, I’ve had generalised anxiety disorder now for the last 15 years.  I’ve had a couple of bouts of agoraphobia and when I speak to people about mental health and they have had a mental health condition and they’ve come to me for support, one of the things I say to them is, you know, I always say, ‘Please don’t, you know, be concerned about being open because obviously I don’t have the same experiences and maybe the conditions that you have but I do have mental health myself and I had difficulties getting insurance and I know how tough these questions are and how they’re very – some of them can be quite intrusive.’  So I do try and make it in that sense of saying so, you know, ‘I don’t understand what you’re going through or what you have been through but in some ways I can appreciate how a mental health condition can sometimes have an effect on somebody’s life.’  And I try and say it that way.  Hopefully that’s alright?

But yeah, I know when we were talking – just going back to mental health questions – with some applications, you can go straight from saying to somebody, ‘Right can you give me your name, you know, what gender are you?  Are you a smoker, non-smoker?  Can I have your height and weight?’ to immediately going into asking about mental health and probably about three or four questions into that, asking about potential suicide attempts which I think is quite a quick step into going into that kind of questioning.  I think if you’re speaking to obviously an adviser who’s maybe had time to build a rapport and you’ve already gone through these things, we can kind of buffer these questions and how quickly they’re going to be said, but I think there’s going to be times where it maybe catches people off-guard.  Can you think of any way that advisers can kind of ask these and approach these questions sensitively?

Sue:            Yes I agree, Kathryn.  This is a very, very sensitive difficult subject and can cause people distress.  From what you already said, you and your advisers really care about your clients and this will come across and hopefully this will put the client at ease while asking these questions.  I think hopefully if your clients feel at ease that will actually help the advisers.  Again, effective communication is the key here and making sure that your advisers don’t use their own subconscious bias which we all have when asking these questions and making the client feel that they are being treated respectfully without any judgement.  I think the key here is show that you care.

Kathryn:       I know that for myself and many others, we get emotionally invested in the people that we speak to but there is a very thin – sorry, thin line between listening empathetically and becoming a counsellor and I kind of believe that we have to be very careful not to cross that line and it’s for both the other person and for ourselves.  Do you have any tips over how to avoid this?

Sue:            At RedArc, our nurses are very skilled in listening and offering advice however we always make it very clear to people that we speak to we are not counsellors.  Counsellors are trained therapists who have qualifications after comprehensive training.  It’s about being aware of your boundaries and making sure that you actually signpost people to where they can access appropriate support such as their GP but I appreciate it is a fine line but sometimes you do have to step back and make sure that that person actually gets the most appropriate support at that time.  But yes, you can easily get involved in having difficult conversations and it’s about establishing boundaries.  It’s very important that your claim handlers are aware of their boundaries and make sure that they don’t cross that line.

Kathryn:       Yeah.

Sue:            And make sure that person gets the most appropriate help and support.

Kathryn:       So when I visited your offices, I distinctly remember the red flags on your desks that the team can wave if they’re on a call and need support.  I absolutely loved it and it’s something that we’ve integrated into at Cura so that we can quickly step in and support each other and the client if the conversation appears to show some kind of like heightened vulnerability.  What would you say are good actions for people to take if they are speaking with someone and they do become concerned over their safety?

Sue:            Yes the flags are a great idea and I’m glad that you found them helpful in Cura.  It is very worrying when you talk to someone and you are concerned about their safety and you want to make sure that they get the help and support they need to keep them safe in the moment.  The advice I would give is that if you feel someone is at risk, to express concern for their safety and reassure them that they are not alone.  You could say, ‘I’m really concerned about what I’m hearing, I think you should speak to a friend, family member, GP about how you’re feeling so that they can help.’  You could also mention charities like the Samaritans, MIND – I think it’s important as claim handlers to talk to a colleague, manager about the call as it will naturally be distressing.

Kathryn:       Yeah.

Sue:            At RedArc we have registered mental health nurses who have the training to help them deal with people at risk and we have a clear risk policy on what to do and this would include, find out where they are, are they alone?  Safe?  Someone they can call to be with them?  Are they bound to hurt themselves? But if in doubt, we will always – we would contact their GP, crisis team – request a welfare check from the police or even call an ambulance.  But again, I stress that we have registered mental health nurses who have the training to support them in that.

Kathryn:       I think that’s incredibly important to know.  I’m not saying obviously in any way that me and Alan are sort of like anywhere near kind of like the level of a mental health nurse but one of the things that we did last year was we took the mental health first aider course with Mental Health Foundation England and we found that incredibly useful just to sort of like know some of those clear steps really to take in regards to, you know, sort of like how do you identify if there is in a sense a vulnerability?  The specific words to potentially look out for that aren’t necessarily – you wouldn’t necessarily immediately think are red flags but actually could be and then that step of like, right do you try and maybe get the GP involved, do you call an ambulance, do you call the police?  Because it’s very difficult to know where to do that, especially I think as an adviser when you’ve got – for many people, you know, we have no, you know, proper medical training.  We’ve got no training sort of like to identify necessarily vulnerabilities and to sort of know when you should really step in and at what point do you say, ‘Okay, well actually I think I’ve got a point of needing to ring a GP at this moment.’  That’s a very –

Sue:            It’s a huge responsibility, Kathryn.

Kathryn:       Yeah that’s it, that’s it – sorry, thank you.  It’s a huge responsibility as an adviser who doesn’t have training to know whether or not they can do that or not or whether it’s their responsibility to do it – the potential consequences of not doing it.  So I do think that the, you know, there’s definitely – as we are getting to a point where more and more people have things like mental health conditions and maybe as well, not even if somebody has classically had mental health conditions, but as you say, if somebody has had critical illness diagnosis, they could be in shock.  There could be a lot of emotions flying around and there could be sudden marked feelings – I imagine can appear quite quickly regardless of their past and I think it’s just really important for us to all have some kind of maybe training or guidance within our companies as to what to do.  So I know in Cura, we now have a very specific vulnerable customer policy.  Do you have any other points or anything that you feel that you would like to mention to anybody about who RedArc are, about any of the services that you can provide?  I know my colleagues – a couple of my colleagues have used your services and they’re just absolutely blown away with what you guys are able to do.

Sue:            Oh thank you Kathryn, that’s really, really lovely to hear.  At RedArc, we are all very passionate about our service in helping people when they really need support and make a difficult time a little more manageable.  A diagnosis of a serious illness whether it’s mental or physical affects people in different ways and our support is very much tailored to individual needs and circumstances.  We offer telephone support and in our experience people feel more comfortable to share how they’re feeling with the reassurance that they will be not judged in any way so people can talk to us from their bed, in their pyjamas, without their hair done so, you know, the comfort of their own home.  It’s so important that when dealing with a diagnosis and the effects of a critical illness, that somebody has someone to turn to.  It’s helping people prepare questions they may wish to ask their consultant.  It helps them feel empowered and more in control of their situation.

Kathryn:       But I suppose like you were saying about the, you know, the – being able to ask those questions and you helping them, I think – and you were saying before about, you know, when you were in the inner city, you didn’t feel like you had the time, you know, for people.  I don’t think anybody, you know, I don’t think any of us can really in a sense criticise the NHS at all, you know, it is an amazing, amazing institution but I don’t think any of us can deny that people – the resources are, you know, they’re struggling and they don’t necessarily have time.

Alan was recently in hospital and, you know, apparently he could have  been – he was in for five days and apparently he could have been out within two or three but the problem was, there just wasn’t a doctor there to be able to in a sense sign him out and obviously the nurses weren’t allowed to and the thing is that they couldn’t come in and speak to him enough and, you know to tell him the latest updates and, you know, I think having a service like yours where, you know, you’ve all been there, you’ve been hands-on, you know the questions, you know – it’s kind of like with insurance forms sometimes.  So when I ask people about an insurance form, they tell me about a health condition – I’ll often ask a lot more than what’s on the form because I know from experience all the extra bits I need to know and I imagine that’s very much similar to in a sense you guys in the sense that you know like, ‘Right, you’ve been told this but what you need to know is this, this, this, this, this –’

Sue:            Absolutely.

Kathryn:       ‘And, you know, you can get support over here, here, here and here,’ and I know you do things as well like I know you can send out books as well can’t you to sort of like help explain things to children?

Sue:            Definitely and I think our service is so unique and it’s really tailored to the individual to what their needs are.  Our nurses are really skilled at having a conversation and finding out actually what would help that person and nobody – everybody’s different and everybody – even if you’ve got the same diagnosis, their needs will be different.  They might identify somebody who would benefit from some counselling, somebody else might benefit from some complementary therapies to, you know, to help them relax and sleep so very much depending on the – what the individual would need and the important thing with RedArc is the relationship with the patient and the nurse and the patients trust the nurse which is really, really important.

And again going back to time, you mentioned like time, it’s a rare commodity in the NHS and it’s so important that in these really difficult situations that our patients are given the time and then the support we can give people – we give them the extra time to talk, have the opportunity to talk through their concerns and explore what’s going on for them, what their worries are and the impact this may have in their family.  We can arrange – you mentioned apps for the phone, I’d mention maybe some complementary therapies but there’s – we’ve got a wide range of therapies that we can offer and again it’s down to the nurse to make that judgement call and discuss that with the patient depending on the individual needs.

We also offer a second medical opinion which can be, you know, and there’s many reasons why people might need a second medical opinion.  It might be confirmation of a diagnosis, you’ve undergone treatment but are concerned that the symptoms are continuing and again it’s for someone who has doubts about the information or recommendation from their current consultant but the nurse will beforehand – will help them prepare questions to ask on what to expect and following that consultation they’ll go through them, you know, what was said at that consultation.

It’s the relationship of the patient and the nurse which is so crucial and the nurse can keep in touch with the patients as often and as long as they need.  They have their own dedicated nurse and there’s no time limit on the relationship.  I’ve been on the phone from as little as a few minutes if people just have a simple question about their treatment or a lot longer if they just really need someone to talk to.  You can’t underestimate the value of giving somebody the time that they need.  They might not need to talk for a period of time but just knowing that you are there can make such a difference.

Kathryn:       Okay, so it’s just comfort isn’t it?  I know my colleague, Lindsay, she’ll be on the next episode and we’re going to be talking about her – she’s had a number of significant events happening this year and one of the main ones was that she lost her mum earlier this year to cancer and I know she’s been very open about speaking to one of your nurses and she’s just, you know, she’s always saying to me the next time I see her, she’s sort of like saying, ‘Oh I’ve spoken to my RedArc nurse again,’ and just how much comfort that is providing her and also just different things like knowing how to best support her children.  Obviously, you know, very, very close family and, you know, just different things and ways that she can kind of describe things to them and how to process it all and I think, you know, when it comes to these things, especially with the value-added benefits, it’s not just what – say like for any insurances, you know, it’s not just the policyholder that is benefitting, it’s that whole family unit and I think that’s incredibly important to know and it’s a huge advantage as well when an adviser is putting a recommendation together, you know, if you do have a value-added benefit there that is available with the insurer, you know, it’s a very powerful thing to let people know about and it’s really showcasing the value of these insurances, not just at claim but also at any stage and how we can get people this extra support because, you know, life events are happening all the time and we don’t all take the time to sort of stop and process and, you know, do what we need to do because as I say, life’s so hectic now and I think it’s just really important to have people like yourselves just on hand to help guide people through what’s happening.

Sue:            We do hear a lot from our patients, they don’t know what to say to their children, to family members and again we have a wealth of resources within our nurse team, point them in the right direction.  We’ve got some absolutely lovely books that we send out to our patients that people, you know, find absolutely valuable and I think over the years we’ve built up our resources that we know are tried and tested and we obviously get feedback from our patients that, you know, these resources are excellent.

Kathryn:       Yeah, I think – didn’t you say as well that – and I’ve heard this plenty of times before and I’m sure there’s been a number of incidences where you’ve actually had, you know, incredible feedback where people have said that, you know, when they’ve made a claim on these insurances, obviously the money from the claim is obviously very helpful but it is the services and the coping strategies and that support that people like yourselves at RedArc are able to offer – that people say that that just stands out far more than in a sense the money did in actually truly helping them when these things happen.

Sue:            Yes I’ve actually had one of my patients who I helped, she had a diagnosis of breast cancer and she was passed from pillar to post.  She wasn’t getting the answers that she needed and for her, just having the support of a dedicated nurse made such a difference to her life.  She was a single mum with a son – a teenage son, and again she found that really challenging – his behaviour was challenging and anyway I supported her for quite a long period of time through her treatment, following her treatment.  I found it really humbling to hear that our services made such a difference to this lady and she actually said the – our service was worth more to her than the actual pay out itself.

Kathryn:       Yeah, incredibly so and obviously thank you so much for all the work that you guys are doing.  We are coming towards the end of the episode now and so you have the joy of being part of the latest truth or lie feature at the end.  So we’re going to do it this week and I’m going to start it off by saying – we’re going to talk about chocolate bars everybody.  So I’m going to say that my favourite chocolate bar is a Twix.  So Sue, can you let us know what your favourite chocolate bar is?

Sue:            Mars Bar.

Kathryn:       A Mars Bar?  Nice, very nice.  So thank you everybody for listening and thank you so much Sue for joining me.  It’s been lovely to speak with you and to hear about your experiences.  I’m going to be back in two weeks chatting with Lindsay Mason from Cura – she’s my marketing executive and she will be talking about the loss of her mum this year, putting an insurance claim forward and the benefit of speaking to a RedArc nurse.  So thank you very much for joining me, Sue.

Sue:            Thank you Kathryn for giving me the opportunity to speak today and thank you to everyone listening.  I hope you found this interesting and helpful.

Kathryn:       Well thank you very much for joining us, Sue.  Bye.

Sue:            Bye!