D30 #100WorkingDays Dipping my toes in

 Picking up the thread of career choice nursing had been suggested. It was a surprise suggestion that nonetheless intrigued me. Without the internet I needed to find out more. At some point I’d found out there was a NHS careers office on the Edgware Road, near Marble Arch. A tube trip beckoned. 

On arrival a Matron, am sure she was, in full uniform rig, cape and so on was clearly disturbed by my entry. Even worse for her was my albeit vague interest in nursing. Cross questioning on my scholastic achievements followed. Blog readers will know these had not been vast in number. I was proud of being able to cook and run a restaurant I could see these weren’t winning her over. 

Eventually Matron told me there were several paces I couldn’t train as they didn’t take men, and also several that would not want me on account of no ‘A’ levels. A list of alternatives to contact was produced and I recall a swift escort to the door. Matron, I think, was pondering the downfall of nursing when the likes of me were thinking about joining. So began a round of letter writing. Waiting for replies was nearly fruitless. Of the five Nursing Training schools I wrote to, only one replied to offer an interview. They had taken their time though, and I’d started an office job in the meantime. Nursing was having to wait.

D26 #100WorkingDays Banking on Father

The time at catering college was a useful stepping stone to the future though I was not exactly clear what that would be. There was understandable parental anxiety as I looked to be unemployed with no future plan. This was in a time where relationships with one’s bank manager were still quite personal. Dad must have chatted to the manager at his bank about me. They had a catering role in the City of London in an important branch. My name must have been passed on. I wonder who’s fate was sealed in those kind of conversations? 

After applying I started a Monday to Friday lunchtime service role in this branch. It had been a tradition in this particular branch that the branch manager, and the managers of businesses accounts within the City each had a dining room. Here they would entertain customers who wanted to borrow lots of money. Out little team would start early each morning to prepare each room as required, cook the food and serve it. Drinks, and corsages for the ladies, were all part of the deal. Usually finished by 3 p.m., I’d make my way home. After a while though it became a little boring and I was wondering what to do. There was still quite a lot of choice though I was no longer sure the world of catering, and regular commuting, were the future. 

D25 #100WorkingDays Project work

 As expected one task I had to complete at college was a report on an aspect of catering. I’m unclear why I chose hospital food, but I did. I wrote to my local hospital in S London, to Great Ormond Street and a couple of other hospitals. Their catering teams were welcoming, knowledgeable, and helpful, often working in old kitchens that needed at least, refurbishment. 

On a small budget per head of patients they produced food on an industrial scale. They were trying new things too where there was willingness to invest in making efficiencies. I don’t have a copy of the report I wrote in the end but I was left impressed with the efforts made. Even so hospital food had reputation that was reinforced by jokes. 

So here I was visiting various hospitals and never thought much about what else was going on. Hospital catering did not attract me nor did any other profession based there. Why didn’t I recognise what was happening around me? 

D24 #100WorkingDays Cooking something up

Having established a liking for food, cooking and the occasional drink I needed to decide on a post school activity. Having turned 18 overnight as I returned from a first trip to Canada I was met at the airport by dad who greeted me with the news I’d failed my A levels. So a proposed higher level course at catering college transformed into one at a different college level. The course covered running a restaurant, cooking as a chef, along with knowledge of food, drink, especially wines, as well as accounts, and some French. All very enjoyable, our gang was a range of personalities and we all had our quirks. Dressed in whites with the tall hats we were a site to behold. The chefs we trained with were strict and on occasion difficult to please. 

Operating the college restaurant was more fun, dealing with proper customers. A favourite turn was to be the barman with the opportunity for a quick try of something we might not have tasted before. Apart from dealing with people the longest lasting non culinary expertise has been double entry book keeping and reading a balance sheet. Very useful whatever the amounts you’re faced with. As we were based in central London we soon learnt to be ready to pick up casual waiting jobs at big hotels, for a large banquet for example after the college day. Usually cash in hand. The best gig was at BBC television centre where if working late you were given a cab ride home as well as well paid. 

Our two year course passed quickly and I was awarded a book token as a prize at the end of it. It looked like catering of some kind would be the future.

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. 

70 degrees of separation

Many will be familiar with the idea that there only 6 degrees of separation between ourselves and others; there are only a few connections between us all whether famous or not. I'm talking about two different places I've visited where the temperature has been separated by 70 degrees Celsius.

It was early 1999 when I joined palliative care colleagues in a visit to Kemerovo in Siberia where one day the temperature was a challenging -35 degrees; currently I'm in Potchefstroom South Africa where I've been able to enjoy +35 degrees. The link is once again sharing my experiences in palliative and end of life care, recognizing I've worked in this area of practice for 25 years. 
So why here in Potch? My partner Megan has been invited here to be an Extraordinary Professor at North-West University Potchefstroom campus, in the School of Education. As her term of office begins we came here at the invitation of the Uni team. I was just going to be a hanger-on for the two weeks, reveling in the first two week break from work for some time. The Uni team had other ideas and recognizing I had my own area of expertise, in end of life care put me me in touch with the Education psychology and nursing departments of NWU. The upshot has been an opportunity to visit the local hospital and to deliver a presentation to two groups at NWU about ethics in end of life care as well as having difficult conversations. In between we have been able to share meals and time traveling in the area, visiting schools and a game park. All very interesting, though the game park details will have to wait another day. 
The two visits have taken place in places undergoing significant change, in political, cultural and social senses. In addition the organisation of resources for health and education has changed. For brevities sake I'll focus on our current visit, that's starting about 150km SW of Johannesburg.

We have experienced great generosity - time, food and drink, and travel. I hadn't realised just how big a country South Africa is. Our travels have included 3-4 hour drives and we have covered only a small part of one province. We're flying to Cape Town later; the time it takes would get us to the Mediterranean from southern UK. For many here though travel is a luxury with poor public transport; so travel from rural areas to the nearest healthcare provision is only undertaken when you're very sick. The result means many arrive at the state funded hospitals in towns like Potch (where there is no hospice) with advanced diseases and in need of end of life care. Being HIV+ is very common and so is tuberculosis, often going together. Getting people to understand the importance of maintaining the anti-viral therapies and the long  term TB treatments is an important priority. The message of changing behaviour about sex and HIV transmission is loud and strong yet some feel that the very strength of the message over a long  time is counterproductive.

The opportunities to meet students and colleagues at the university and hospital have been invaluable to help understand the joys and difficulties of life here. That people are trying to improve services is encouraging yet difficult given the differences of resource provision between provinces. This was highlighted in the difference in the number of educational psychologists in the Western Cape area approx 130, and the 4 in the North Western Cape where we are. Seeing the expertise and enterprise of North-West University in making links with Potchefstroom Hospital, to the benefit of patients and psychology students has been great to see. End of life care is a big part of what the hospital does so sharing my expertise and stories has been a pleasure and made this leave from work so much more rewarding. It has also helped me to appreciate the fund of examples and experiences I've had, as well as realise there is lots more for me to learn. I'm immensely grateful for the opportunities my career has thrown up; I never expected these travels. I am very pleased though that there is now far less than 70 degrees of separation between my understanding of what's happening in South Africa and my working life at home.

Connections with times past

In an office or ward are people I've worked with; an obvious statement given the length of my working life so far. What has come to the forefront for me are the connections I have with so many, and the influence I have had.
Two Consultants in Palliative Care I have caught up with recently, I first met as junior doctors. Their remembrance of my practice has stuck positively;  a relief and a vital reminder of how careful one must be each and every day.
This focus came from being asked about the achievement which might be my best. The nurse in me wants to be remembered by those in my care as good at what I do. My initial response though was to say the people who I had helped developed in their career path;  whether going on to train as a nurse or win awards for influencing government policy in their homeland.  It struck me our connections can go a long way and have an influence beyond our own world. We can affect the care of many more than the people we meet directly. So whatever your role in whatever capacity keep in mind how you will be remembered.