How will I shape the year of the nurse and midwife?

It’s New Year’s Day and I’ve seen a challenge to take up. Set by @BloggersNurse as we start the Year of the Nurse and Midwife I am planning on trying to write at least once or twice a month in 2020 on the themes suggested. 

January 1st and I’m thinking about how I will shape the year of the nurse (and midwife, please note I mean to be inclusive). 

It’s 41 years since I entered nurse training; my shape and that of nursing and midwifery have altered. Overall, the two professions have fared better shape-wise than me.

I trained to become a State Registered Nurse (SRN) in England, moving into a profession held in high regard. 

There’s been the transition to degree based learning, and recently apprenticeship programs. All routes opening to a career of varied opportunity. 

What shaping influence can I have? The immediate one as a senior and experienced nurse is as an example of being open, kind and flexible. 

I have to be open about how I work, and be prepared to let others lead where they have ideas and strengths that I don’t possess. Be ready to adapt and adopt fresh thinking and take risks to make gains in service improvement.

I want to be kind and even kinder, to all those in my care. This will be patients as well as my team colleagues, and those in the wider care community in which I work and have a social media presence. In particular it’s those who are exploring the possibility of nursing as a career, or already in training, to whom I should be an example. Showing enjoyment and enthusiasm for our work, and giving such people time will help them be great nurses of the future.

I need to be flexible; my career has had twists and turns; some hoped for and some unexpected. This has helped me appreciate the opportunity of being ready to try something new; to allow me to be trusted by people such as team members when they require some wriggle room - flexible working to allow for family issues for example.

Applying this to shaping the year of Nurse and Midwife? 

Being an example, supporting those I come into contact with and reaching out through social media. 

Embracing and getting involved in events to celebrate nursing, and show the value of nursing work to those who question what nursing is.

Supporting those I work with to look at what we do, and see how the work can be done differently. Getting them to speak up, in person, in blogs and engage in further education so they can be shaping too.

Change happens; being prepared to influence the outcome is a way I can contribute to the year of the nurse and midwife in 2020 and beyond.

Nurses, blogging, and me

Once again I find myself at the keyboard ready to say something more about the day I’ve had as a nurse particularly as I’ve started a new job today and have been prompted by Teresa Chinn to write a contribution to the #70NurseBloggers idea.

My reflection on my day is about the language we use when we’re at work. Whilst in my experience most acronyms are familiar, the localised versions thrown about in meetings can make understanding difficult and slow the flow whilst explanations are given. This is not exclusive to nursing; many clinical and non patient facing parts of the NHS are guilty of this. 

I’d argue that with a little thought, agendas and other documents could contain one example of each expanded title so we can quickly appreciate what it is we’re considering. It would aid transparency from a governance perspective too. My new NHS acute trust role (lead nurse for Palliative and End of Life Care) means I’ll be exposed to more examples of local lingo; it’ll be down to me to ask for clarification and then challenge where it’s used inappropriately. That way I can keep moving and lose the training wheels that Teresa mentions in her blog piece. 

I recognise I’m not a regular blogger; I wait for inspiration and eventually something prompts me to write. As a nurse I find it’s one way for me to express an idea or acknowledge an issue of concern as it arises. It’s a form of public reflection as well as an opportunity to see what others think. As we’re expected to revalidate (having recently done so) ones blog pieces can be used as evidence of reflection. 

So one way to approach starting blogging, or getting going on the one is to try writing a reflection that you can share in the open space of a blog piece. Draft if necessary on a Word or other document and take a little time over it. That way you can be sure to get your thoughts in order, keep your language clear, and make sure you don’t breach any social media guidance such as that from the NMC. Then publish the piece and be ready to get a response, more often than not it’ll be positive and at least appreciative of the time taken. Don’t worry if you’re not generating a huge debate, I think it’s better to speak up anyway and continue to give nursing it’s voice.

Learning through Social media

I’m participating in the #AllOurHealth course set up via Public Health England (PHE) and WeCommunities through @WeLearn_.  I decided to join Wave 1 which concentrates on the introduction to Twitter and other social media and its uses in Continuing Professional Development (CPD) for healthcare professionals. Having some experience of Twitter use for a few years I wondered if I was going to find the first level uninformative. In the meanwhile I’ve moved from my hospice role with a view to changing to alternative activity and am preparing to revalidate via the NMC. CPD is therefore uppermost on my mind. 

I’ve been finding the course really helpful; it’s prompted me to rethink my attitude towards the usefulness of social media and Twitter in particular.b In my course reflections I’ve been recording how I need to be rather more disciplined and focused about using Twitter for CPD. I’ve set myself some professional goals using the tools on the #WeCommunities website as well as personal goals that I’ll have to work on myself. 

Meanwhile the #AllOurHealth participants, waves 1 and 2 start on Monday by looking at social media use in promoting good health and the prevent of illness. Lots of great resources have been developed for us to use, and indeed many are already publicly available via Viv Bennett in her blog piece about the AllOurHealth program.

And if you’re wondering about the value of social media and online training for CPD, please give them serious consideration; my experience so far has been a positive revelation, thanks to all those involved in putting the course together. 

The view from behind

A while ago I did one of those Facebook things, something about a motto for life. The answer I was given said essentially I should drop the past, forget it and move on, looking forward. Had I been 20ish, I might not have thought so much about it. 
Of course I shouldn't take that kind of thing literally; it has however given me something to consider that has to be written out loud now.

My concern when that was said was that I was engaged in looking back. First as I begin to consider planning in advance for retirement there's what has work been about and what options are there for the future. Then via a closed group on Facebook (last mention) of friends who went to Southfields School in SW London the idea of a reunion grew into a reality that happened on the 13th May, just gone. If that's not looking back I'm not sure what is. 
Alongside that the fabulous #twitterdisco held once a month has helped me rediscover music and its associated memories. Yes, flared trousers, longish hair and collars and lapels that needed wide load warnings; standing on platform shoes nervously wondering if a girl would like a dance, if only I could attract one away from the lure of the handbag mound mid-floor.

Then there has been my consideration of my performance at work driven partly through the benefit of excellent coaching over the last few months. This led to looking backwards at how I've performed in the past, digging out evidence of 360 degree feedback and repeating the exercise. So there's been lots of ‘rear view mirror’ work.
For me the benefit of ignoring the ‘forget the past, live for now and look forward’ would be to miss out rich sources of information that can help the future.

So when retirement comes I'll have what I've enjoyed doing recreationally to fall back on as well as new things to learn. Friendships that have endured since school will still exist as we plan road trips and travel to see those across the globe. The writing and drawing that sustained me in school are becoming more important now. My love of listening to music will remain strong and be a source of relaxation and inspiration. More immediate is the feedback I've been given in the last week. It shows a lot of reassuring positives as well as identifying things to work on. Even the worst times of early schooling, pre Southfields, have an importance in showing how good the now and future look.
For me then, without looking back I'd have a poorer future, and certainly a very dull present. I therefore recommend looking back on occasion, you may see something afresh just as useful as what's in front of you. 

Challenges for the personal and professional

At the end of February this year my dear friend in nursing @agencynurse Teresa Chinn wrote a blog piece about the WeGetogether2016 event, held on the 29th Feb 2016. As ever Teresa gave a thoughtful account of what happened, the build up to it and considered the consequences. One one aspect Tree asked about was "what happened?" Her response was 'nothing' and that concerned me; so I want to challenge that - gently of course. In one way I guess Tree is right - no great single change or movement emerged that sparked a revolution. 
I began to wonder however if I had missed something because I believe there were myriad outcomes, albeit small ones.

I had traveled to Salford where the University Nursing School hosted us, full of hope and expectation; not to mention carrying banners and freebies including home made cookies. 
When I look back on #WGT16 I think of the developing relationships that were bolstered by meeting in person; the thinking and sharing we were encouraged to do. From my perspective it led to a wider range of contacts and networking that influences me today. So let's remember what we experienced at #WGT16 and think of where we are now. Yes times seem to have become ever more challenging in terms of politics, the economy and the Care sector (I like to think across the health and social fault line). That has not stopped people continuing to challenge both personally and professionally. 

And then Teresa has set me thinking again about challenges; this time in her latest blog about professional challenges.  I've found nothing to argue with here; safety and safeguarding are key nursing responsibilities for nurses. It is the anticipated response of others that can block coming forward; I believe that as a senior leader and a manager I have a duty to set an example as a listener and in responding positively when concerns are raised. Likewise I have to be ready to face personal challenges and accept that I have got things wrong. Developing as a leader is about learning about oneself as much as getting to know those around us and that can be a much bigger challenge. 

Thinking about work or not? A connected era conundrum

I'm sitting under this tree in Potchefstroom (or Potch) South Africa.

I'm enjoying a holiday type break whilst my partner works at nearby North West University.
The guesthouse has WiFi; we can post to Facebook and Twitter and monitor emails. In many ways we can conduct life as usual – checking the bank balance, booking a restaurant and ensuring relatives are safe. Much of my social media (SoMe) usage is related to work particularly Twitter. To clarify I mean work in a broad sense encompassing me as a nurse, leader, manager, director, and contributor; these are just part of the whole me and inseparable from who I am. ‘Work me’ is just part of my life and not a completely separable facet.
Through SoMe I have contacts I have never, only once, or infrequently met in person; some I'll see each day at my work place. Nonetheless there's been sharing and an open hearted welcome; I trust I've reflected that to those who've approached me.  Sharing thoughts about aspects of work, favourite foods, what the cat is doing or ideas about music show much about us. Given  technology now available I've been able to consider aspects of work simply by monitoring my SoMe channels. As ever I find much to reflect on and herein lies my dilemma.
Being on holiday – away at least – means social and family related SoMe activity feels ok, a bit like sending postcards. Alongside this are the posts, pictures, diagrams and powerful 140 character pieces that engage the ‘work’ me. Have work and the social become too entwined?
While I've been away recent posts on kindness and curiosity by Sue Spencer @nursingbard and on listening by Tanmay Vora  via Teresa Chinn @agencynurse have positively piqued my interest. 
Perhaps being away is a good time to think about these things? If I'd turned my devices off completely I wonder if I'd reflected in quite the same way? 
Time spent alone is a potent opportunity. Whether using SoMe or just a notebook and pen where this post started, I cannot ignore the influences and opportunities that our connected selves bring. 
Even so  it is good too, to turn devices off completely; enjoy the sun, thunderstorms, breezes and wildlife in places away from home. Even better is meeting the people whose home this town is; in doing so using the kindness, curiosity and listening I've been reminded of makes all the difference to this experience. 

Ten years on

Reflections on a learning experience 

I know I tend to hoard what I'd call resources to do with work, be it books, papers, certificates and bits of card. "It'll all be useful one day" is my internal mantra. I've been cutting down on books by allowing them to be more widely available at work; that in itself has been liberating as in recent times I've gone back to more 'hands on' hard copy reading.

Whilst preparing this week for a session on resilience I went to my cupboard and found amongst other things the workbook from the excellent St Christopher's multi professional week I attended in May 2006. I recall thinking the whole experience had been exciting and stimulating. Do they still do it? Yes, see http://www.stchristophers.org.uk/education/diary and one is coming up soon.

The attendees came from across the world and we were truly multi professional, adding further texture to the week.

The opportunity to learn from David Oliviere, Malcolm Payne, Nigel Sykes, Barbara Monroe, Nigel Hartley, Avril Jackson, amongst other talented colleagues was so invigorating.

I still remember much of what was said and done; from giving instructions on making tea, digital pebbles, spirituality, teamwork and with role play thrown in the international participants were challenged to think, act and learn.

So what's brought this all about? I'm still teaching on occasion so a dive into the resources led to me think about the workbook. I was sure there were pearls of wisdom to find and was right (on managing stress and teamwork). So ten years later I can hold the pages and how that itself has changed. Hospice UK can put entire conference abstracts, posters and videos on line - an example of the revolution in the way we communicate and produce materials. I wonder what those who will attend my session will recall of the session next week, and in 10 years time. How will they access our presentation, will a virtual channel have the same physical and intellectual resonance as my purple covered booklet? 

Maybe the physical presence of thoughts, ideas and reflections last longer in the memory? I need an educationalist to confirm that; may be though that the way that week was organised and led has left this influential mark. It's a  been a powerful experience revisiting these materials; reflection and development distilling an enervating week in one afternoon.

Perspiration, inspiration, and poetry

Once again I find myself drawn to other sources of inspiration; social media has provided the contact method, using it has been key. That's what's led to the perspiration on my part, modest though that has been.

Dr Kate Granger with her husband Chris Pointon have through their sharing of Kate's experience of advancing cancer been a source of admiration and great ideas; the ultimate being "#hello my name is..." and I was amongst the audience on the last of the roadshows they did last year spreading the word. Out of that alongside my efforts to be more creative, came a poem about Kate and the "#hello my name is..." project. I am convinced more of us should make time for exploring other avenues of expression and outlets for thoughts. Blogs themselves can be a way to say what we're thinking; as I get older I'm keener to explore creative avenues that were not so well developed when I was at school though that is a whole different story. 

Instead I'd like to leave you with the poem I wrote after meeting Kate and Chris last year. Kate has seen the poem and this was the perspiring moment for me; I know now Kate is okay with what I've written. Not only do I want to share my thoughts through this poem, I hope it may inspire readers to explore other routes of expression for themselves.

Kate’s vision – “#hello my name is …” or The Wakefield Wonder

Standing strong
Staring life in the face,
 going only half the distance
Ambition defying the gravity pull of death.

Beyond the expectations of the 
‘experts’
Her medical skills are for others, yet
So needing others now.

Hello my name is – makes us
smile though that’s not
the whole intent.

Touch and calm,
Pace is mine, and your focus
on the person.

With Messiah like drive you push
onwards, touching lives
touching, us, 
Giving the lie to dying
for living still
You make your mark.

An imprint of a modern making,
a Twitter born legacy
that Must leave us 
better people.

Philip Ball, 
24/06/15 2205 hours

Waiting times and times of waiting

This posting has been under consideration for a while. Those who know me well will know I've been looking for a new role since the redundancy word entered my life. After a varied experience regarding the employment search I am the proud possessor of a job; a quality manager with Sue Ryder only in week two as I post this. The best thing about this situation has been the reaction of my friends near and far, some of whom I've not met in person. Networking gets its detractors; without my contacts I would have found keeping positive very difficult. I've been offered opportunities to develop, to increase my exposure in social media, and generally keep busy. I count myself very fortunate to have been supported so well; thankful for all the messages long and short that have come my way, making the waiting so much easier.

There has also been another set of waiting in recent times. I'm getting older and now well onto my fifties I had to get my prostate checked as I was losing too much sleep. A rising PSA blood test resulted in a two week wait referral. The MRI scan was done promptly and the biopsy eventually took place once my blood pressure was controlled.
Today I know my biopsy results were negative, the MRI ambivalent. So its a watching brief at a sensible pace. My very nearest and dearest have known about this; sharing more widely involved waiting so I could be definite about where I'm at. Why not say anything before? False hopes and false alarms are corrosive to the spirits; in addition there has been just a little embarrassment too. I hope that being upfront now will show why life had been a little harder though not as bad as many others. I'm enjoying the inner celebration, tempered by the knowledge that were the news today different for me I have the most marvellous people who would support me, whether we've met or not. That's a real positive and worth waiting to write about.

The times ahead...

Sharing Times

I have been reading recent news items and blogs all reated to end of life care; a recent blog update from Dr Kate Granger, @GrangerKate and via ehospice profile pieces. Kate Granger is no stranger to many social media users; her open door policy gives an insight into the kind of dialogue an individual can have with the cancer they have. Out of Kate's experience has come the '#hellomynameis...' campaign, encouraging everyone to introduce themselves as they deliver care. Just yesterday, while having a simple ultrasound the technician and consultant introduced themselves and asked a little about me as we got ready; the gel was nicely warmed too. I felt valued, and that my part of the preparation was appreciated making the procedure easier for all.
Reading a piece about the Buddhist approach to the end of life and death; an interesting refresher, I found myself wondering about the reality of mindfulness and meditation when thrust into the milieu of care provision. How far can our minds takes us to places of such self awareness that pain and discomfort are reduced? It was a salutory lesson; I am reminded that there are many people who have experiences very different to me yet our paths will cross because of a diagnosis and care system.
How we treat each other, and the room we give each other to hold our beliefs is critical to our future relationship and the benefit that sharing of our selves brings.

Reflections and Echoes

I have been considering writing again for a while; I suppose this is a kind of 'slow-blog' or 'Slog'.  As ever though, strands of life have combined to make sitting down to this task inevitable. I have a notebook that since given it last Christmas I have used to jot down thoughts and ideas. I can see that in mid-MArch 2013 I was thinking about creativity in nursing.

In response to comments by Prof Don Berwick reported on the BBC on 12/3/13 regarding Mid Staffs I was asking do we stifle creativity in healthcare and particularly in Nursing?
Whilst pondering that on 14/3/13 Roy Lilley said this in the first of his blog pieces that day,

"Nursing has been at the forefront of innovation and nurses use some of the most sophisticated kit the NHS has to offer.... Nurses are the mothers and daughters of invention."
So I am not missing a theme here; once we consider nursing history we find the examples of Florence Nightingale, Mary Seacole and many others who have developed kit and service models since then that have led to improvements in care. In my specialist field of palliative care Dame Cicely Saunders qualified as a nurse, as well as in medicine and social work. Her influence remains profound though I wonder if we have lost some of the energy that went with such creative spirits. Is working under the pressures many nurses describe sapping their energy and ability to see problems as they occur?

The other requisite for creativity is risk taking; when dealing with the lives of others we obviously have to minimise the risks, 'do no harm'. Yet whilst discussing service improvements via a Twitter nurse chat last week, care of WeNurses it was evident there were plenty of ideas yet little evidence that things were easy to change. So if creativity is there, what seems to holding things back? Is the appetite for change difficult to identify amongst the bad taste in nursing's mouth delivered by the hands of the detractors of the NHS? 

In all of this I had decided I ought to try something different in terms of learning. I took advantage of an offer from Martin Shovel to join a cartooning for communicators workshop in Brighton. Martin and Martha his partner led four of us through a journey of discovery through drawing and use of language to communicate in simple direct terms. I hadn't drawn for many years; art was something I have always loved yet lacked the confidence to pursue. The workshop enabled me to connect with the idea of simplicity in drawing; finding the key message and developing from there. I found it quite an emotional day, as echoes of past 'you're useless' school days passed by.

On reflection I now know I can use a simple drawing to convey a message; my style is under development and I try to practice in spare moments. Another side to creativity, yet I am sure it has value in terms of increasing my range of communication styles, as well as my confidence in my messages. It has also reshaped my thinking, making me consider the core messages I want to convey.
All this has come about through social media 'SoMe'; using Twitter I have found a new arena for creativity. The aforementioned chats, blogs and vlogs, all make increased links with greater immediacy. This was brought home to me when a nurse contact made via Twitter looked like they could do with some support. I was happy to offer advice and to listen; and now nearly a year has gone by, the echoes of that time are coming around again. On reflection I have to acknowledge that I know there were some days I thought I could have done differently and been a better support. Even so it appears what I did sufficed for that person, at that time.

Reflections and echoes swirl around; often catching us unawares. For me this 'slow-blog' or 'Slog', has enabled to me look at how I have learnt to innovate with modest personal reputational risk taking, using the opportunities social media have offered to be creative.In my work the benefits are that I can see how important it is to allow all the team to reflect and sense the echoes of learning and opportunities that will allow us to grow and develop; from there we can take innovation forward, personally and professionally.