Just imagine ... caseloads, payloads and careloads

Just imagine ... no, not like that - really imagine!

You are in a situation. Unsurprisingly, let's say it's in health, or social care. We find ourselves in a care or nursing home, on a ward, or in the individual's home, even if the patient does not currently recognise it as such.

The patient is mobile. That is, and isn't a problem.

Physically, apart from thoughts about a chest, or urine infection, yes they are mobile, but they're also confused - disoriented.

We are concerned about their safety. 

Noisy, increasingly agitated, they are making it clear they want to leave.

Their carer, family, or staff are trying to limit the patient / resident's access to the exits, be that the front, or back door, the spare room, their room, or main entrance. They are not in agreement about where they need to be. Persuasion and distraction aren't working either. They appear to lack the level of mental capacity required to decide for themselves what needs to happen.

It is one thing to have this assessment of the situation running through one's mind; but quite another to 'pick up' a care concept mentally and carry it over the care (knowledge) domains of Hodges' model.

Hodges' Health Career - Care Domains - Model

Try it for yourself ...

Have a think about the following care concepts: mobility, capacity, consent, confusion, mobility, liberty, a locked-door while spouse/partner goes shopping, and safeguarding? 

As we engage in critical thinking, these concepts have a literal payload. They carry varying degrees of informational value, salience that helps us prioritise, what else do we need to factor in, what help is needed, and when; how do we  decide what to do?

As a concept is evaluated against Hodges' model, it changes. It is as if it morphs subtely, or starkly as other concepts, by association, are brought into play.

This process is influenced in so many ways; our training to date, our prior experience, biases and cultural baggage we might also carry, who else is present (this is of course potentially both a positive and negative), past and current role-models, our (team's) preparedness - what to do if .., teamwork, access to leadership (who is 'duty'?), and our confidence in them (Oh no!). And, them in us.*

Vitally, there is the small matter of our understanding, attititude and response to the person in-front of us. 

The delivery of healthcare is often stressed as emotional labour. Whether we use Hodges' model or not, perhaps the labour, the physical and psychological work involved, is experienced through carrying and feeling the careload. A reason too for supervision.

*Do seek help - advice if needed.

Further reading [ please contact me if needed - h2cmng AT yahoo.co.uk ]:

Jones, P. (2025), A Generic Model and Conceptual Framework to Prime Curiosity Across Health and Social Care Disciplines to Facilitate Lifelong Learning. Journal of Evaluation in Clinical Practice, 31: e70252. https://doi.org/10.1111/jep.70252

Jones, P. (2025). A Conceptual Mapping Exercise of Deprivation of Liberty Safeguards in Residential & Community Care Using Hodges' Model and Threshold Concepts. Journal of Evaluation in Clinical Practice, 31: e70085. https://doi.org/10.1111/jep.70085

Diagrams, Visualizations, Intuition and Critical Thinking QED

"The atom of Niels Bohr, a miniature solar system, had become a embarrassingly false image. ... Bohr himself had set the tone. In accepting the Nobel Prize for his atomic model, he said it was time to give up the hope of explanation in terms of analogies with everyday experience. 'We are therefore obliged to be modest in our demands and content ourselves with concepts that are formal in the sense that they do not provide a visual picture of the sort one is accustomed to require. . . .' This progress had not been altogether free of tension. 'The more I reflect on the physical portion of Schrödinger's theory, the more disgusting I find it,' was Heisenberg's 1926 comment to Pauli. 'Just imagine the rotating electron who charge is distributed over the entire space with axes in 4 or 5 dimensions. What Schrödinger writes on the visualizability of his theory . . . I consider trash.' As much as physicists valued the conceptualizing skill they called intuition, as much as they spoke of a difference between physical understanding and formal understanding, they had nevertheless learned to mistrust any picture of subatomic reality that resembled everyday experience. No more baseballs, artillery shells, or planetoids for the quantum theorists; no more idle wheels or wavy lines. Feynman's father had asked him, in the story he told many times: 'I understand that when an atom makes a transition from one state to another, it emits a particle of light called a photon. . . . Is the photon in the atom ahead of time? . . . Well, where does it come from, then? How does it come out?' No one had a mental image for this, the radiation of light, the interaction of matter with the electromagnetic field: the defining event of quantum electrodynamics." p.242.

 Individual
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     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

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GROUP

reflection critical thinking intuition	physics Bohr's atomic model reflection

Gleick, J., (1992) GENIUS - Richard Feynman and modern physics, London: Little Brown and Company, p.242.