HCA training: Knock, knock, knocking on the political domain's door

INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL

individual

emotional care	physical care
social care	FRANCIS - a year on:  How much training do healthcare assistants have before their first shift on a ward? 25% = none

group - population

Although that 25% sits nicely in the POLITICAL domain, what is the impact of this finding across the domains overall? Whether or not the impact is equally shared across the interpersonal, sciences and social domain, upon which domain will it end up knocking?

Calkin, S. (2014) Francis impacts on culture and patient safety, HSJ, 7 February. 124, 6376, 4-5.

6Cs Live! Story of the Month - Competition

Dear Peter,

We wanted to let you know about our new and exciting Story of the Month competition, in partnership with Nursing Times online.

This is your chance to really shout about the great work that you or your team is doing that underpins the values of the 6Cs – and what’s more, if you win you will be featured in Nursing Times online and 6Cs Live! Communications Hub.

So please take the time to fill in the short entry form on the 6Cs! Live Communication Hub – it’s not too long and time consuming we promise. 

Click here to find out more and access all the information you need.

Each month the entries will be reviewed by four judges, Matthew Hodson (COPD Nurse Consultant at the Homerton University Hospital, London), Sam Sherrington (Head of Nursing and Midwifery Strategy at NHS England), Jenni Middleton (editor of Nursing Times) and Matt King who is a lawyer, professional speaker, charity campaigner and 6Cs Live! Patient Champion.

The deadline for August entries is Friday 2^nd August so you’ve still got a chance to be our first winner of ‘Story of the Month’.

We look forward to hearing from you and good luck!

If you have any questions please email us.

6Cs Live! Team

Don't forget to make your 6Cs Live! pledge: www.6cs.england.nhs.uk

Listening to Jay-Z

Listen to Jay-Z's Magna Carta Holy Grail:

- but if it is care fundamentals you seek ...

International Nurses' Day 2013: "The drama of it All"

There is a new nursing drama series starting on BBC TV next week - Frankie:

District nurse Frankie Maddox is a saint. At least she would be if it weren’t for her fondness for red wine, loud music, ghastly singing and fast cars.

Whether it’s an elderly man with dementia, a pregnant woman whose husband is on duty in Afghanistan or a sickly young child who’s never at school, nothing is too much trouble for this caring, smiley character. “Why do you always insist there’s something we can do, when sometimes there isn’t?” snaps Dr Evans (Jemma Redgrave). Because “the world is my patient,” Frankie explains, although she has the grace to grimace after delivering such a clunking line (from Radio Times).

That line may be clunking as a piece of dramatic prose, but there is a need to make some noise that extends beyond nursing's one-to-one encounters.

We are well aware of the challenges that the NHS faces, the themes are well known and read like a script that is increasingly played out on wards, the media and in parliament. The latest playwright is Francis. This is the drama we cannot ignore locally.

What of nursing globally on IND 2013?

The nursing communities within the various nations must also listen to the world. We can make a difference as individuals by challenging our often parochial perspectives; by trying to travel, seeking to engage with others electronically and learn what global nursing organizations are doing on our behalf.

Best wishes to nurses everywhere.

International Council of Nursing

Global Alliance for Nursing and Midwifery Communities of Practice (GANM)

Global Health Network

HIFA2015 ‘Healthcare Information For All by 2015

Global Health Workforce Alliance

'Nursing the Nation' poem Molly Case at RCN Congress 2013

The past fortnight has been quite intense in terms of conferences and the focus upon nursing education; plus as was pointed out to me I travelled from Jordan to Jordanstown. The conference in Jordan began with a beautiful prayer and I heard of this poem while away:

2013 Year of Piri Reis & Navigating the world of nursing care - in Jordan

The conference in Jordan is over it has been an intense and excellent two days, with a free day tomorrow. It has been a brilliant opportunity to share and learn not just about nursing, but travel, culture and some of the people that make up the global nursing community.

I am truly grateful to the Jordanian Nursing Council for accepting my abstract. The welcome and hospitality has been truly amazing.

In the flight magazine on the way here there was an article about Piri Reis, which reminded me of Paul Cunliffe's book about Pytheas.

From the UNESCO website:

The United Nations Educational, Scientific and Cultural Organization (UNESCO) has agreed to declare 2013 the year of Piri Reis on the occasion of the 500th anniversary of a map he drew up that included seven continents, reported the Anatolia news agency. 

“This map marks a significant event in the history of the country and has enabled its collective knowledge to be transmitted through generations. As a rare world map from the 15th and 16th centuries, Piri Reis World Map is an invaluable piece of the world's documentary heritage as it provides insight on the history of its time. It is therefore part of the Memory of the World and should be made better known,” stated UNESCO.

The world-renowned Ottoman captain and cartographer Reis is best known for world maps and charts collected in his “Kitab-ı Bahriye” (Book of Navigation).

Source: http://www.todayszaman.com/newsDetail_getNewsById.action?newsId=294065

Source: http://en.wikipedia.org/wiki/Piri_Reis_map

I have written before about Hodges' model as a map -

a cognitive periplus 

- for navigation through the complex world(s) of health and social care.

Would a new mariner take to the sea without a clear sky, a compass, map, or satnav? What then of our students?


Additional link: Please see the entry for Iran -

http://www.unesco.org/new/en/unesco/events/prizes-and-celebrations/celebrations/anniversaries-celebrated-by-member-states/2013/

"The Deprofessionals" BBC radio4: nursing, teaching and social work

Driving to Milton Keynes late afternoon for DTMD2013 Mon-Weds, I listened to a BBC radio 4 programme about the political assault on several public professions - The Deprofessionals

What does it mean to be a professional today, at a time when the public services are in a state of turmoil?
Time was when a professional was easily recognised for what he or she did by virtue of their qualifications and experience, when their competence could be measured against ...

It should be available for the next week.

When I think about community mental health nursing since 1985 I can identify with many of the points raised. How the role has changed, the former therapeutic skills focus, the change in skill mix, the advent of Agenda for Change and the existence of staff who may miss being clinically 'banded' altogether.

Inaugural Symposium on Person-centredness in the Curriculum May 2nd - 3rd

Dates
Thursday 2 May and Friday 3 May 2013
(starting at lunch time on 2 May with a full day on 3 May)

Venue
Loughview Suite, Jordanstown campus, University of Ulster, Northern Ireland

The School of Nursing at Ulster has a strong tradition of national and international leadership in the field of person-centred practice. The Institute of Nursing and Health Research at Ulster incorporates the Person-centred Practice Research Centre directed by Professor Brendan McCormack. Against this backdrop the School has been developing a programme of work with a focus on person-centredness in nursing education. It is our contention that in order to achieve maximum effect in practice, person-centredness should be embedded within and across all programmes of education for health care professionals.

This year the School of Nursing at Ulster will host its Inaugural International Symposium on Person-Centredness in Nursing Education. The one and a half day symposium will include presentations and workshops that will appeal to those involved in nursing education in academic and practice settings.

Symposium themes 
The three key themes of the symposium are:

• To explore ways of infusing a culture of person-centredness through effective, contemporary higher education
• To share innovative approaches to the facilitation of person-centredness in practice learning
• To reflect upon how the experiences of teaching teams and service users and to consider how these can shape educational approaches and teaching strategies

Target audience
The symposium will be of interest to colleagues who have an interest in promoting person-centred practice through education in practice or academic settings.

Fee
£70 (includes car parking, lunch and refreshments on both days)

To reserve a place or for further information please contact:
Julie Cummins at the Institute of Nursing and Health Research
Email: j.cummins1 AT ulster.ac.uk Telephone: +44 (0) 28 7012 4094
Web: www.science.ulster.ac.uk/nursing/international-symposium/

-----

I plan to attend this event on a topic central to h2cm.

Manet & the art of nursing - never unresolved: (and The Francis report)

Yesterday I travelled to London for a nurse related meeting and used the opportunity from 8pm - 11pm to take in the Manet exhibition at the Royal Academy of Arts. Brilliant! It is a great event. There really is no comparison apart from the very high resolution close examination that our technology makes possible; but then that is a difference experience, a different purpose.

Manet's work at the RA includes paintings that do appear unfinished. Areas of the canvas being unresolved brings home the relationship and dependency of the artist with the subject, and the artist's approach to portraiture. Manet was quite demanding on his subjects apparently and while not completely averse, he did not routinely rely on the new opportunities that photography afforded. Here are some thoughts from the Art Fund website:

'Summer' or 'The Amazon', by Edouard Manet

Manet was a great risk-taker and critics of day rallied against his inconsistent approach, as you will see many of the works seem 'unresolved' or 'unfinished' but one of Manet's great skills was this ability to stop painting at the right moment, and it is this technique which gives the works a sense of movement and life.

Manet once said to his friend Antonin Proust, 'I must be seen whole. Don't let me go piecemeal into the public collections; I would not be fairly judged.' This exhibition, which brings together the largest selection of works by the artist to be exhibited together in a UK museum, is a great opportunity to judge Manet's extraordinary talent as a 'whole'.

In nursing we are accustomed to impatient patients. Many though have no choice but to 'sit' and 'lie'. They are static, not able to walk or run away.

Unconscious patients - we speak to them: redrawing the outlines. Searching verbally where we cannot go, reaching for the centers of personhood. We sculpt them back to their optimal health. Sometimes the brush strokes are urgent, sometimes we improvise with touch.

All the time an ideal: a portrait of care. No matter how busy we are basic nursing care should never remain unresolved.

That part of the canvas is always completed. The outline is integrated. The horizon, foreground, middle and background may be sketchy in the extreme cases, but the real mission critical bases are covered.

What we should never countenance, collude, or indirectly sanction are the cutting of those bases.

If we do the work of art is not just unfinished: it is corrupt.

The Francis Report

Anagram graphic c/o Wordsmith

Manet's 'The Amazon' from: Reproarte.com

Extrasolar planets, x-phi and The Francis report

I'm sure there is a planet out there - extrasolar - with the physical make-up such that be it an incredible water fall, tidal surge, or rolling polished mega-rocks - the noise, could we hear it, would do far more than make your ears bleed.

Today, here in England there is a legal, health and political media event of very serious import. The ruckus in health and political circles might also make for more than bleeding noses and definitely thousands of continuing broken hearts.

The Francis report will be published today. Further insights and findings will be revealed c/o the Public Inquiry with recommendations on the Mid Staffordshire NHS Foundation Trust health care debacle.

In Philosophy Now Jan/Feb 2013 Tibor Fischer's editorial mentions the need for marketing within philosophy and literature, with the suggestion of placing x-phi on a T-shirt.

'X-phi' of course reads as experimental philosophy.

In health care, nursing and social care evidence counts for everything (and for h2cm too). Evidence based practice that is founded upon research is essential. Experiments are needed that can be reproduced, extended, validated. ...

Today is a profoundly sad day for everyone in the NHS, as many commentators have already predicted. The future constantly beckons, but today reflect we must that in the clamour for evidence based care, does this mean we must don T-shirts?:

x-care

Have we forgotten the principles of what it is to care: compassion - our duty of care?

No, but amid the cacophony of technology, technical care, the targets, statistics, budget cuts, the challenges to morale and nursing's values we need to be ever more vigilant.

We must learn how to x-listen and x-shout in the 21st century health care environment(s).

But experiments in how to listen, how to blow a whistle? Surely not.

Well yes: as clearly here basic care systems did not work they failed terribly: individually, organisationally and across the FIVE care domains of h2cm.

End of Life Care (Pathways), Nursing and Thresholds

There is a controversy (Telegraph) that has been growing for some time, concerning the Liverpool Care Pathway for end of life care. This is a very demanding and yet rewarding aspect of nursing. I have experience of end of life nursing care in a non-specialist capacity, having worked on wards for older adults and being involved with people who have mental health and life-threatening physical health problems.

It pains me greatly not just as a scouser that something with 'Liverpool' in it should become a cause of distress, a center for debate and review. Is the pathway green and shady? Is it comprised of stepping stones, with room for two, and with time granted for your next step? Or is there a danger in some instances the path can become tarmac clad, without the succor of a services stop for basic sustenance? Can a pathway become a motorway? What does that sign say? "DON'T HOG THE MIDDLE LANE!"

What pains me seriously is that what can be a invaluable, evidenced based palliative care resource can be undermined due to the complexity of the generic and palliative care situation.

If we truly practice person-centered care then there are no care pathways.

Or, to put it another way: there are as many care pathways as there are patients and carers.

Whether you believe in social medicine, or private; whether you are laissez-faire, or leave such matters to a higher power there is no escaping the need for organisation - for order.

The mix and concentration of people, knowledge, resources and time dictates that tasks, roles and processes be delineated and assigned. We need to assure a given level of quality, and to predict things, not everything is as difficult as the weather: or death. Pathways can assist in specific contexts.

Is there scope for personalisation on a pathway? ...

Steps and pace can vary and to the left and right of center. There are many pathways though: some valid - evidenced, award winning; while others might be broad, narrow, twisted - to become a disorientating ethical loop...

Being placed on a pathway denotes a decision point, a threshold. We need to remember in all fields of health and social care practice that there are multiple thresholds to be taken into account, communicated effectively and revisited:

INTERPERSONAL : SCIENCES

SOCIOLOGY : POLITICAL

'me' - existence, resilience, assets, personhood, ethics, personal values, mood, personalised care, understanding of treatment, communication skills, self-expression, loss, orientation, observation, distress, psychological assessment, sedation, beliefs, choices, :theology PURPOSE	'me' - existence, feeding, nutrition, fluids,  evidence base, Liverpool care pathway, quality of life measures, referral thresholds, prediction, resilience, reductive - holistic assessment, medication, distance, where: home-hospital-hospice? pain management, decision locale, specialism, basic nursing care, resilience PROCESS
memories, good-byes, love, compassion, carer under stress, reassurance, counselling skills, meetings with family, empathy and rapport, patient and relative engagement, life history, relative's recognition that loved one is dying, care strategies,  patient experts, patient - carer experience, communities of PRACTICE	consent, advocacy, mental capacity,  integrated working, effectiveness, independent autonomy, service access, bed availability, health & nursing in the media, scope of nursing, scope of medicine, law, medicolegal issues, whistleblowing, complaints, formal review, appeals, organisation, argumentation, professionalism, ageism, POLICY (re-PURPOSED)

The relative position of concepts above does not indicate priority.

"The LCP is not the answer to all our needs for care of the dying but is a step in the right direction."

Marie Curie Palliative Care Institute
Liverpool Care Pathway for the Dying Patient (LCP)

A World Record for Health Care: The 4 minute reflection

Of all the things that can be done within 4 minutes one of the most significant in the history of sport is undoubtedly who would be the first to run a mile in under four minutes:

In health care four minutes is both an age and an instant in someone's health career.

If we took four minutes to reflect upon a person's care across the care domains what difference might that make?

Just one minute per care domain to help deliver - personalised care, self-care, carer support, integration, health promotion and how to stay well. ...

In healthcare we are constantly seeking GOLD.

Wherever you are have an amazing Olympics!

Nurse First Programme Seeks Innovators

Dear Peter,

I hope you don't mind me picking your brains :)

We are currently recruiting for a new cohort for the UK's most intensive innovation and leadership programme for health professionals who work in the community. It is called Nurse First and is a free programme that has been developed with the Queen's Nursing Institute, Bucks New University, the Shaftesbury Partnership and Johnson & Johnson (who are sponsoring it).

What we are particularly looking for are creative and innovative clinical staff who -

• are passionate about improving services;
• have strong personal motivation and are resilient;
• are creative problem-solvers;
• are driven and who can keep going when the going gets tough.

We will help them to identify a significant problem or challenge in their area and develop an innovative solution to this. We will also help them bring in outside funding to get the pilot up and running. Many of the Nurse First projects have brought in between £10,000 and £100,000 of funding for their pilots. Our criteria is that applicants have to still be involved in clinical practice and work outside acute hospitals

If you know any clinicians like this who would benefit from the Nurse First programme, I would be really grateful if you could direct them to our site at www.nursefirst.org.uk and the closing date for applications is 31st May 2011.

Anyway, hope you are well,

Kind regards,

Dave
Dave Dawes
Nurse First Project Manager
The Shaftesbury Partnership

e: dave@nursefirst.org.uk
e: dave.dawes@shaftesburypartnership.org
twitter: @davedawes

Locating the Spiritual in Care: (very big) Plantpots vs Green Windows

Last summer, July 13 2011 to be precise, the cover of RCN bulletin #278 declared 'Prioritise spirituality'.

I am not a religious person, but quite a spiritual one (I think). This RCN news item reported Professor in Dignity of Care for Older People at Staffordshire University, Wilf McSherry's views on spirituality. It is central across health and social care, (it is also vital in terms of cultural and spiritual literacy):

The practice of spiritual and religious care is about meeting people at the point of deepest need,' Professor McSherry said. 'It's not just about religious practices but preserving dignity'.

Also in that month, the 30th in The Times (page 19):
'Sacred forests bear witness to religion's unsung role in fostering a rich variety of life'.

This news concerned the extent of religious forests, with a project by scientists in Oxford to create a global map of forests under religious ownership and control. Now under the guardianship (whether intended or not) such forests have assumed importance as examples of biodiversity. Ruth Gledhill writes: From the Garden of Eden to Avatar, sacred groves have been central to religion and myth ... between 8 and 15 per cent of the world's land is regarded as sacred or religious.

With many remaining exceptions places of care have changed remarkably over the past 30-40 years. There remain many residential and nursing homes that prove challenging for health care professionals (I know they have told me over several years), never mind the residents and their carers. Challenging in the spiritual sense of the surroundings. I posted in 2010 about the wail of call systems. Visually though we must ask: how green is that care home?

Count - plants real [3]* : artificial [13]^#
  
This isn't just the colour of walls and use of curves to soften the environment, but access to outside, to grass, to trees and flowers. The benefits of real plants in the office environment are well established.  Being able to see a green vista greatly improves employee productivity and well-being. For those people in care what is the view outside their window, the lounge(s), the dining room? How can it be improved? For those essentially bed-bound can the furniture and bed be moved around periodically to achieve a new perspective?

It is still upsetting to see that those physically less capable of reaching the outdoors are elevated to first and second floors. Even with positive spiritual acuity of staff (the outdoors matters to all) readiness to hand and soul - a sideways glance through a window, the sound of rustling leaves through an open window - can make a huge difference:

Spirituality, dignity and respect. ...

*And in need of water. ^#Five over-watered.

Image source:
http://www.fanpop.com/spots/avatar/images/9492947/title/avatar_promo-screenshot-screencap

"You're a nurse? That's cool. How much do you make?"

Somebody asked:

"You're a nurse? That's cool, I wanted to do that when I was a kid. How much do you make?"

The nurse replied: "HOW MUCH DO I MAKE?" ...

I can make holding your hand seem like the most important thing in the world when you're scared. ...
I can make your child breathe when they stop. ...
I can help your father survive a heart attack. ...
I can make myself get up at 5 a.m. to make sure your mother has the medicine she needs to live. ...
I work all day to save the lives of strangers. ...
I make my family wait for dinner until I know your family member is taken care of. ...
I make myself skip lunch so that I can make sure that everything I did for your wife today is charted. ...
I make myself work weekends and holidays because people don't just get sick Monday thru Friday. ...
Today, I might save your life. ...

How much do I make? All I know is, I make a difference.

Re-post not only if you are a nurse or you love a nurse, but most importantly, re-post this if you respect their work.


My source: Stu Young, Royal College of Nursing Students

States of mind and policy [I]: 25% of hospital beds...

The repeated things that some people say, what does that denote?

The repeated things that other people say, what does that demonstrate?

INTERPERSONAL : SCIENCES

SOCIOLOGY : POLITICAL

In which care domain does the Person living with dementia reside?	1 : 4 - 25% of occupied beds [ diagnosis? ]
... and what of their carers... with their expertise?	there is a strategy - yet more hospital champions are needed and training.

My source:
BBC Radio 4 & RCN Students mail list