Sunday, 30 May 2010

Post Modern Penguins, Performance Management and Palins Fence

Ten new baby penguins have been born at Vienna’s Schönbrunn Zoo since the end of April. This week these delightful creatures have been allowed out and immediately became the centre of attention for visitors at the Zoo. Schönbrunn Zoo is the only zoo in Europe breeding these endangered birds. The baby penguins are clearly doing well, eating up to 20 herrings a day. Three things about the story made me stop and pause:

(1) the baby penguins are not being raised by their parents. Their carers (note not keepers) look after them using new digitally based sound and visual technology

(2) the zoo have re-created the light and climate conditions of the Antarctic at the penguins’ enclosure to create a perfect simulated and stimulating environment for the young ones

(3) our School Administrator has a thing about puffins, and as penguins are a very close substitute I thought she would like the pictures.

Also, it seemed to me that the story, in itself, could act as a metaphor for nurse and midwife pre-registration education and training. For example, increasingly we provide opportunities for our students to learn, develop their knowledge and thinking through the use of new communication technologies. We will continue these approaches through the introduction of the next generation of our virtual learning environment, and approaches such as on-line submission and assessment of students work.

Likewise, we have invested a great deal of time, money and other resources in re-creating experiential and simulated environments in which student nurses and midwives can acquire and practice their clinical skills. Whilst clearly not being the real thing, these environments provide students with very effective learning opportunities and these technological based resources will increasingly play an important part of the students learning experience.

And of course teaching and providing learning opportunities for our students is one part of their experience. Students also benefit hugely from the work of a group of colleagues in the School who not only understand the University and School processes and procedures, but effectively provide a guiding hand and proactive support for the students as they study at every level. They likewise also provide very high standard of support and advice to other colleagues in the School, although often this contribution is hidden from view and sometimes misunderstood.

This latter point is unusual in an environment where so much information is so readily accessible and where our activities are known to so many (and already the baby penguins have their own U-tube site). I had a conversation with a colleague this week where we discussed the fact that these days our work in the School and our contributions as individuals in meeting the School’s objectives are becoming more and more visible to others.

It seems to me that such visibility and access to information about individual performance will increasingly inform judgments about the performance of colleagues. I think in an age of evidence based approaches to everything, moving to this position is long over due and to be welcomed. Others might have different views of course and there will always be a tension between promoting the openness of information, ensuring personal and organisational governance, and enjoying [academic] autonomy and privacy.

This week saw the former Alaskan Governor and Presidential wannabie, Sarah Palin dealing with such tensions. After the exposé author Joe McGinniss moved into the house next door (in order to get close to Palin as he gathers evidence for his next book based on her life) she had a 14 foot tall fence erected between the properties. Satisfyingly symbolic maybe, but in an age where we get to see the most intimate details of baby penguins in a small Zoo in Vienna, ultimately futile!

Sunday, 23 May 2010

Bath, China, Forbidden Words and Chicken Feet

The City of Bath was the venue for this year’s Council of Deans of Health Retreat. It was an inspirational setting. The city was first established as a spa resort with the by the Romans. They built the baths that have made the City famous. The hot springs that fed these baths are the only ones to be found in the UK. The City of Bath became a World Heritage Site in 1987. Although I have been reminded that this is a nursing and midwifery blog and food features too often, so I won’t be saying anything about the food at the CoD Retreat (although the Wild Mushroom Risotto was possibly as good a mine) Bath does have food traditions that are linked to health.

It was Thomas Guidott who in 1668 set up practice in Bath. He was interested in the curative properties of the Bath waters and wrote: A discourse of Bathe, and the hot waters there. Bath has also lent its name to one other distinctive recipe: the Bath Oliver – the dry baked biscuit invented by Dr William Oliver. He was a Doctor at the Mineral Water Hospital and was an early anti-obesity campaigner. He wrote the wonderfully entitled paper: Practical Essay on the Use and Abuse of warm Bathing in Gluty Cases.

It was a very good retreat, if a rather sobering one. Much time and debate was spent on working through the possible implications of the policy changes arising from the recent election of the coalition Government. It is clear that both the HEI and NHS were likely to be affected in a negative way and that both sectors faced some tough times ahead. As health care professionals and particularly Nurses, we caught in the twin headlights of both areas. David Brindle, from the Guardian newspaper provided a very insightful view of the new administration and the likely direction of travel of policy and practice. He didn’t use the phrase Direction of Travel of course, as this is one of some 200 words that have now been forbidden in the lexicon of the new coalition. It appears there are many Civil Servants busy re-writing policy statements in order to erase the use of these words, and some amusement was to be found in the presentations of speakers as these words were highlighted in red.

There was little amusement in the feedback report of the work undertaken to improve the image of nursing. Despite extensive, and one would guess expensive research, little that was new was reported. The solution to our problems appeared to resolve the development of a web site called Colleagues sitting at my table thought it might be misconstrued as the web site for continent nurses, while others thought the research team were taking the p**s. Colleagues from Scotland reminded the speaker that they battle every day with being called the wee nurse and this site would be unlikely to help them win the fight. Given the context of improving the image of nursing, the presentation was paradoxical, ill-informed, and out of touch with new forms of communication. Hopefully the programme will be on the list of those to be cut.

Friday saw our colleagues from China attending the University and School. On a brilliant summers day 30 College Presidents and Senior Academics from across China came to Salford to find out more about what we could do together in the future. The day started with a welcome by our VC followed by a brilliant presentation of our work from me. As always there was a chicken included in the powerpoint. Given the place in Chinese culture of the Rooster I did think about the wisdom of this, but felt there wouldn’t be a problem. China has a population of over 1.3 billion people, and they consume 4.7 billion chickens a year! In Chinese cuisine, chicken feet are often served as an option at restaurants – but this is not a food blog.

Our colleagues were then able to see our facilities and like other visitors, were impressed by the METI men and the possibilities for education and training this resource presented. The China Nurse Fund is keen to facilitate qualified nurses coming to the School to undertake Master levels programmes. We were expecting a small group to start in September this year, but this has now had to be postponed because of changes to visa rules imposed six weeks ago. However, a number of areas for collaborative working and research were identified before the delegation left for the almost must do Manchester United Tour at Old Trafford.

Sunday, 16 May 2010

Election Results, Fresh Asparagus and Robin Hood.

The election is done and the new UK Government installed. The 50 day spending review has started. We know from early announcements that cuts to public sector funding will start this year. I am aware that many of the organisations who make up our educational practice partners have already started to look at how they will deal with what are likely to be large cuts to their funding. For the NHS, this will inevitably involve reconfiguring services, moving services to the independent sector and closing some services altogether. For those of us who have been around the NHS for a little while, this is not an unfamiliar scenario. What perhaps makes things different today is the sheer scale of re-adjustment required. It is scary, and of course any changes made in practice will often have a real impact upon our work in the School.

For example, we have for the last year, had to manage an increasingly turbulent practice placement environment, with more clinical placements being lost to those being created through service reconfigurations. Students from all three Universities providing pre-registration nurse education in the Greater Manchester area have been affected. With the half of the educational experiences being facilitated by learning opportunities in practice, this continues to be a difficult situation to respond to.

Likewise, service reconfigurations often provide opportunities for organisations to re-think the size, shape and compositions of their workforce. Almost inevitably there will be a reduction in the overall numbers required. Managing the long term impact of this situation will also be challenging. I am not sure that the private sector can offer us much help or direction here. This week I noticed a report commissioned by Abbey Legal Protection about how organisations in the private sector are likely to address the severe down turn in the economy. When asked what costs they would be most likely to cut back on in the next year to maintain profitability, 38% of senior management reported they would cut back on staff numbers, 8% opting to slash staff pension contributions, 7% health insurance, 7% IT support and 5% of the managers surveyed declaring they would not touch the client biscuit budget. Perhaps the reports authors had read my blog from last week, and noted the relationship between chocolate and well being.

Nothing quite beats a chocolate covered ginger biscuit – well except perhaps, a dish of fresh English asparagus, served with home made hollandaise sauce, a lightly poached free range egg and hand cut triple fried chips. In a week of birthday celebrations this rather lovely meal was one I really enjoyed!

However, the Food Standards Agency may have disapproved of my choice of food. It was reported this week that they are planning to consult on whether ‘fat taxes’ on food would help make people eat more healthily. Food is currently exempt from VAT. One proposal is thought to be adding 17.5% VAT to full fat milk, butter and cheese to encourage a switch to products with less saturated fat. A study carried out by University of Nottingham (2004) suggested a wide-ranging fat tax would raise around £2billion a year.

And of course it would be impossible to mention Nottingham without also mentioning my favourite film seen this week – Ridley Scott’s tremendously good Robin Hood. It is perhaps just as well that the Food Standards Agency didn’t exist in his day.

Sunday, 9 May 2010

Kangaroos, Wise Men and Chocolate

It came as no surprise this week when having missed lunch one of my colleagues offered me some Kangaroo flavoured crisps to keep me going. One of the things that makes us distinctive as a School is we care for each other and can be very passionate about defending what we believe to be right and fair. My colleague hastily assured me that no Kangaroos had been harmed in the production of the crisps. Of course this is a good thing. Kangaroos feature in my memories of a mental health conference held in Alice Springs, where I also took a trip to Ayers Rock, or as the local Pitjantjatjara people call it, Uluru

It was William Gosse who on finding Uluru named it Ayers Rock in honour of  Sir Henry Ayers, who was then Australia’s Prime Minster. Uluru is one of Australia's most recognisable natural icons. The sandstone formation stands 1,142 ft high and is just under six miles in circumference. Apart from the sheer heat encountered in walking around the rock, my most vivid memory of the trip was the bus we travelled in to get there. It was ancient and fitted with largest bull bars I had ever seen. I was informed that this was because of the many camels, cows and kangaroos who wandered 24 hours a day along the road between Alice Springs and Ayers Rock. Whilst a collision with a vehicle is capable of killing a kangaroo, it is also possible for collision to result in severe damage to vehicles and their occupants. At night when these animals could not be seen, the bus would just sweep them aside!

Anyway, I digress; Kangaroo Crisps are just one of several new varieties developed as part of Walkers Crisps contribution to the World Cup. Other flavours include:

Japanese chicken teriyaki
Scottish haggis
Argentinean flame-grilled steak
English roast beef and Yorkshire pudding
German bratwurst sausage
Dutch Edam/Welsh rarebit (and thank you Hilda for the birthday wishes – now my Mother will be confused)
South African sweet chutney
Italian spaghetti Bolognese/ Brazilian salsa
Spanish chicken paella
Irish stew
French garlic baguette
American cheeseburger

I came by this information via Charlie Brooker’s column in the Guardian newspaper (not my normal read). Whilst I am sure this particular Charlie Brooker has his merits, he is not of the same ilk as the real Charlie Brooker, mental health nurse and academic par excellence!

Charlie trained as a mental health nurse at the Maudsley/Bethlem hospitals in the 1970s before going on to advanced clinical training in adult behavioural psychotherapy. He started his academic life at Sheffield Hallam University. He has continued to work at various Universities and has made a huge contribution to our understanding of Community Mental Health Nursing. His contemporaries were an influential group, Ted White, Tony Butterworth, Ian Baguley, Phil Barker, Kevin Gournay and David Skidmore. And it was David Skidmore who offered me my first job at MMU, and mentored me through my early years as an academic working in mental health care.

It was also David that got me started with research, although we never got to do the type of research like the study published last week in the Archives of Internal Medicine. This study showed that people with depression tend to eat more chocolate than those who aren’t. Individuals with the highest levels of depression typically ate almost 12 helpings of chocolate per month while those who were happiest only had five servings. A serving equals one small bar of chocolate.

This study will be of interest to many, but unfortunately it has not resolved the debate about whether depression causes people to eat chocolate or if people take chocolate to relieve low mood. To find this out would require a long-term study that objectively assessed chocolate consumption at the start of the study and follow people to observe how depressive symptoms develop over time. If anyone is interested in developing an RfPB application, just let me know!

Sunday, 2 May 2010

Totems in Turku and the Immaculately Coiffured in Glazebury

I have been on annual leave this week. I decided I would not read any emails until my return to work on the 4th May. So far I am up to 843 work emails since finishing work last Saturday. It will be a busy Tuesday morning! I have of course continued to look at personal emails, one of which, on Thursday, was from my colleague Leena, who lives and works in Finland.

Now Leena is a special person. She is one member of group that came to be known as the Four Musketeers. Let me explain. In 1998 I visited Finland for only the second time in my life. The first time was to represent MMU at an EU distance learning conference in Helsinki during 1996. The conference was held one month before the IRA bombed Manchester. Following the attack, I was surprised, but pleased to receive emails from the Finnish colleagues I had met at the conference expressing their concern and support during what they saw as being very troubling times.

When two years later I returned to Turku, Finland as part of an ERASMUS exchange, I was disappointed that such colligate empathy wasn’t as apparent. The first 24 hours were puzzling. Then I met Mikko and Leena, in the Old Bank – a pub that was previously a Bank. There are 120 pubs in Turku, half a dozen of which had former purposes – the Old School, the Old Toilet, Old Pharmacy and so on – you get the idea. Mikko and Leena, were nurse educators, and Mikko a former mental health nurse.

This extremely fun evening marked the start of very fruitful and interesting relationship with colleagues who became dear friends. Over the next few days, I was also introduced to Heikki, the original Finnish equivalent of Little John, and the four of us became inseparable. Over the years, we have all been involved in research projects, joint writing and each of us gained our PhDs. We have enjoyed many, many wonderful intellectual and academic debates over the years, often fuelled by fine Finnish beer and the occasional glass of Oban.

The upshot of that first week in Turku was the offer to go and teach their pre-registration nurses whose education and training was carried out mainly in English. Native English teachers were at a premium, so I agreed to teach Medical Sociology and Introduction to Anthropology. Since that time, once, twice or even three times a year I would whiz across to Turku, and spend two weeks working with some of the brightest pre-reg students I have ever encountered. Whilst anthropology as a discipline was a completely new subject area, they willingly embraced many of the fundamental concepts of social anthropology – for example, they had no problem with exploring the concept of Totemism as a relevant metaphor to promote understanding of the contemporary social construction of everyday life! It was Lévi-Strauss drawing on the ideas of Durkheim, Mailinowski and Evans-Pritchard amongst others who originally introduced these ideas, he aligned himself to Evans-Pritchard’s argument that the reason for totems was metaphoric. I returned to this work in 2004 and used these ideas in exploring the use of rhetoric and rituals in multi-professional working

Turku is Finland’s oldest city, it has been there for over 600 years. Much of what one sees today however, was built after the last great city fire in 1827. But it is still possible to see many great examples of the typical Finnish wooden house. Turku also has its own twin tower World Trade Centre.

I was eating lunch with Leena when the first news reports came in about the terrorist attack on the World Trade Centre twin towers in New York. We rushed to a TV to watch the breaking news. I can remember sitting there watching the drama unfolding in real time, thinking this cannot be happening. I had been to the top of the twin towers on many occasions, and found it difficult to comprehend what was happening. It was a humbling experience.

I had a similar experience on a visit to New York two years ago when I had the chance to visit St Pauls Chapel and Trinity Church on Wall Street. This tiny chapel where George Washington worshiped after his inauguration now stands as the most extensive September 11th museum in New York City. The back of the church houses exhibits that tell the story of the role the chapel played in the aftermath of the September 11th attack. For the fire fighters, police officers and other rescuers who toiled for up to 12 hours at a time in the smouldering space where the towers once stood, the small chapel was a sanctuary.

Leena’s email was to say that she was on the brink of permanent retirement. She had semi retired a couple of years ago, but continued working for a couple of days a week with post graduate students. She felt that the time had now come to retire completely and spend more time with her family and grandchildren. Leena, toivotan teille kaikkea hyvää ja toivon, olet todella rentouttavaa eläkkeelle. Kiitos ihana ystävyyden vuosien varrella juhlitaan seuraavan kerran olen Turussa.

Closer to home, I was delighted to bump into the Salford equivalent of Leena, my colleague Mrs J (senior). The last I had heard from her was that she was stuck in Australia because of the Icelandic volcano. So seeing her in Bents the UK’s No1 Garden Centre (2009/10) last week on a wet and windy Friday afternoon was wonderful, and slightly disconcerting.

Both Lenna and Mrs J (senior) have that unnerving ability to always look elegant, and both sport hairstyles that are always immaculate. And so it was on this occasion. I on the other hand, looked like I had been dragged through a hedge backwards – but I was on holiday after all!