Evening clouds

Evening clouds
Sunshine and Clouds

Sunday, 2 September 2018

The NHS and me at 40

The 3rd September has historic resonances that impacted many; the date this year 2018, is a milestone for me. It marks the 40th anniversary of the start of my working in healthcare and specifically the NHS. I entered nurse training in 1978 at Edgware, north London. In those days (older person speak) we were paid so my pension contributions began.
In July I was conscious I’d been part of the UK healthcare system for over half of the life of the NHS. This led to some reflecting on what has happened since my first days as a student nurse.
I became a State Registered Nurse (SRN) under the auspices of the General Nursing Council (GNC) who set a rigorous exam at the end of one's training. Then came the UKCC and now we have the NMC. Now we have a visual printed code, rather than an imprinted culture, and I think we’re better for it. Only a few of those I came across as a student caused concern however it was more difficult to report and remove those who did not uphold good practice.
I found great examples in my training and early years as a staff nurse; they kept me going and enthused. Alongside that the NHS had a ‘local’ feel; we knew who worked in the local ambulance services, the community and often this played to the patients advantage. There was a sense of teamwork, and we rarely saw senior managers. Undoubtedly we faced bastions of tradition, be it a single person or organisation.
In all those years there’s been scandals and times when being part of nursing has not been comfortable. And times too, if being truly honest, that I’ve made mistakes.

My career pathway was set from early on (my first ward placement) even though Palliative Care was not really recognised and hospices were relatively new.
The NHS itself has been through change; the local knowledge, history and relationships altered as decision making has moved away only for it to look like it will need to come back as we strive to do more with what resources we have at our disposal locally.
Clinical practice has changed too. I recall my dad having a cataract removed in the very early seventies and him lying still in bed for days; it’s a day surgery appointment now.
The application of technology has helped clinically, ‘through the keyhole’ is not a TV programme more a way of surgical life. Yet the NHS still struggles to use technology to assist in the day to day running of clinics and sharing information. Yes I can get my GP appointments, test results (service user too) and medications all done online. It helps that I know my way round the systems yet I remain concerned for those who lack the access and have no family to help in an increasingly fragmented system.

To be positive we now have much more access and ability to share what’s good, and what’s not thanks to the internet.
Of recent developments, improving attitudes and access to care for the dying and the impact of social media have made a difference to my working life.
The #WeCommunities website and the @WeNurses links (and there lots of others) have led to new friendships and routes for learning.
This is just a snapshot; so much has been fun and enjoyable with fabulous people, whilst set against times of heartache and loss. Nursing has been a place I’ve thought of as home after trying other careers. I remain thankful for my experiences; I’m still proud to say I’m a nurse and look forward to saying that for some time to come, even if not another 40 years.

Saturday, 2 June 2018

Running in awe

As some may know I tried to be healthier by taking up running again (modest distances) towards the end of last year. What followed in terms of life changes led to real interruption of progress. We’re nearly halfway through 2018 and it’s time to update. I’d begun to run again though that had not felt as positive as it did before. For me it was actually getting outside the house that became an issue. A sense of panic would rise up and I’d not venture into my kit. Isolation seemed to be part of the reason though I wasn’t ready to explore what exactly was behind this.
Meanwhile lots of social media contacts are making many strides (intended pun) in their running. Their obvious achievements are a delight and I remain impressed by what they’ve done.

Another life change has been taking up the new role in an acute trust in the last few weeks; a change of culture and pace that’s been exhilarating. A sense of purpose and excitement pervades the organisation and this is (in a positive non-clinical sense) infectious.
During a recent induction session we were asked ‘what gives us awe?’. Spirituality was the context and I found myself noting the question and day dreaming…
What gives each of us awe, what’s awesome will vary. I expect however aspects of the natural world will feature large. This last week has seen awesome lightning, thunder and rain. Other examples abound, too many to mention here.
Yet I’ve also come across people who give me a sense of awe; they inspire, through their enthusiasm, their willingness to share something of themselves with others, and by their generosity of spirit.

What drove me to write today? Making a promise to run this morning, that I’ve kept. As I ran the note I’d made myself to blog about what gave me awe came into my head. I also had a moment to think about my pre-run panics and what’s been behind them. My conclusion is that it’s been a kind of death fear; my mum has been unwell for some while and whilst making some improvement now I have not acknowledged how close we came to losing her last year. It’s also affected how I’ve viewed my own mortality; getting a little older and perhaps because retirement is higher on the agenda. That feels a plausible conclusion after a 20 min run and getting home felt good. I think too I’ll feel happier going out running again.

And Awe? Those I know who share - in blogs, direct messages, tweet chats, phone calls, letters, and face to face - I’ve decided not to name them as they may be embarrassed; in addition are the many I don’t know in the NHS (and broader UK care systems) who day by day embrace their work, paid and unpaid. In particular my colleagues in our hospital who have been engaged in an enormous change over the last couple of weeks as we moved to electronic patient records. There have been other challenges too that have had the potential to disrupt their work in a big way. That this has not happened is a tribute to them and the team spirit they have. That’s what’s left me running in awe today.