information for transformational people

Vital 246What matters to you? – a new vital sign


From a talk by Jason Leitch, National Clinical Director, Scottish Government

We all have vital signs - heart rate, respiratory rate, blood pressure, temperature. However there is a new vital sign about compassion, about care which has proved very effective in health services and is now being used by other institutions both in the UK and globally. Jason Leitch explains:


"I want to talk to you about a new vital sign, a vital sign about compassion, about care. That vital sign is called 'What matters to you?'.

"I'm going to do that by telling you about Don. Don is in his 70s. He collapsed at home on the West Coast of Scotland. He had a life threatening heart rhythm problem. He gets admitted to the local hospital. Victor, his cardiologist decides with him that he requires a defibrillator inserted into his heart. That defibrillator will for the rest of his life shock his heart back into the correct rhythm and he'll live a happy and long life.

"Unfortunately, there's a little bit of a delay for Victor to arrange that defibrillator procedure, and Don decides he wants to leave. He tried to sign himself out of hospital. Victor is called and he goes to see Don. He sits beside him and he has a 'What matters to you?' conversation. It turns out that what mattered to Don were his fuchsias. 

"Victor didn't know what a fuchsia was, so he spend some time getting to know Don and hearing from Don how important his fuchsias were. They were his life. They were what he did. He pruned them and he watered them and he looked after them and he entered competitions with them. They were more important to Don than life itself. So Victor, being slightly more imaginative thought, 'Let's try to bring the fuchsias to Don rather than Don to the fuchsias.' That's exactly what he did.

"He got a van with the pots of Don's fuchsias and he brought them to the hospital and Don could go trim, prune, water the fuchsias in the car park of the hospital. They inserted his defibrillator, he did well. He was discharged and went back.

"You see, the difference between the heart rate measurement, the respiratory rate measurement and the 'What matters to you?'. We have started to spread this around Scotland's hospitals.

"We've also spread it to the care of the elderly units. Geraldine Marsh who is a senior nurse in a unit started to use it for really confused and cognitively impaired adults. One of those adults was a lady called Rose. Rose was in her late 80s. She had dementia. She was very confused, very agitated, got up from the bed a lot, fell over. That's a very complex thing to deal with in a hospital ward. You put the sides of the bed up so you trap a patient in. You put a nurse beside the bed so they have one to one nursing. 

"Rose didn't get many visitors. She didn't have many family alive, but one day a niece came to visit. That niece sat beside her and one of the nurses had a 'What matters to you?' conversation with her. The niece said, 'Well it's a bit of a surprise that she doesn't have her rosary with her because that's what matters to her.' They took the rosary out of the drawer because it had been put in the drawer by the infection control police keeping the place tidy. They give the rosary beads to Rose. Two things happen.

"The first thing that happened was that Rose calmed down. She didn't get up during the night. They could take the sides of the beds down. She wasn't agitated anymore. They could move the nurse who had been one to one beside her. Everything was much, much calmer. She was much happier. The second magic thing that happened was that people started to stop. We put notices now above the beds where it says, 'What matters to me are my rosary beads.' People would stop and sit beside Rose, complete strangers. Other visitors for other families would come and sit and do her rosary with her. She had become a human being. We learned something about Rose rather than about the frail elderly lady with dementia in the bed.

"We can't promise everything, but we'll do our very best. I wonder what your 'What matters to you?' would be? Could you take a moment if you're a health care worker, a teacher, a social worker, an artist, somebody who works with others. Maybe you're an entrepreneur with a company. Could you take a moment to ask somebody, a user, a coworker, somebody who works for you, what matters to them.

"It started in health. We're now spreading it to education, to early years environments, other places. It has begun to spread throughout the world. We now have ten countries taking part in 'What matters to you?' from Brazil to Norway to Canada. 

"Let me take you back to Don. You heard that Don left the hospital, had his defibrillator inserted, did well. The end of the story was that Don entered Scotland's five inch pot fuchsia competition. Who knew there even was one? The wonderful news is that Don won it. If there hadn't been a 'What matters to you?' conversation with Don, he would probably have died.

"That's the importance of the 'What matters to you?' conversation."


Listen to Jason Leitch's 10 minute Tedx talk:



Having compassion on others, Jesus asked several times, "What do you want me to do for you?” (Matthew 20v32, Mark 10v51, Luke 18v41). It also ties in with the Luke 10 model - prayer, fellowship, meeting their needs - all part of getting to know them and then being more authentic in telling them the good news..  See blog here.

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From a talk by Jason Leitch, National Clinical Dir, 16/05/2017

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