Sunday, 25 March 2012

Oh mon dieu, a Touch of [Business] Class, şi abilitarea

One ambition for our School is to become internationally recognised for the quality of the educational provision that effectively prepares individuals for nursing, midwifery, social work and counselling practice. We have many colleagues in the School who are actively engaged in taking this aim forward. Collectively we are engaged with a range of international projects that address preparing health and social care professionals in providing more person centred end of life care, adult social and health work for older people, particularly those who are vulnerable, primary health care in developing nations, and what it is we might learn from the ancient Greek notion of doula in terms of promoting safe child birth.   

And this week I was able to do my bit. Yesterday I returned from spending a couple of days in Lasi (pronounced lashy), the second largest city in Romania. It was a tortuous process to get to and from Lasi. The journeys involved early morning dashes to airports, terminal commuting and 3 flights on each days travel. However this somewhat arduous sounding trek was still a much easier journey than the one colleagues from Hungary made to get to the workshops. They travelled from Budapest by car. This was a journey of some 800 km, which took them over the Carpathian Mountains (which at this time of the year are still covered in snow) and on a trip that took the best part of 2 days to complete (each way!). It was cheaper for the 3 of them to do this, and stay overnight enroute, than it was to purchase an airline ticket for just 1 of them. I think it showed fantastic commitment to the project and what we are trying to achieve.

However, I think it is a cost saving idea that possibly I won’t mention to our university Finance Director, although I am sure she would be delighted with the possibilities for making such savings. I of course, as per University policy, travelled economy rather than business class with Air France. But môn dieu, it was not the great experience I had been expecting. Almost unbelievably, Air France ran out of White Wine (Château Ducla) some 30 minutes out of Paris airport. That Air France could do this was for me completely extraordinary. However, I had to applaud their compensation strategy, which came in the form of a couple of glasses of champagne.  

The reason for the travel was to attend the 4th workshop in series of workshops that form part of the EmpNurs Project. This is a project involving 7 EU countries who are working at empowering nurses through high quality mentorship programmes. We have reached the half way point and the workshop in Lasi was aimed at capturing progress to date. It was a great success, and the project is well on target, all objectives being achieved so far.

The meeting was also an opportunity to visit the local health care system. We were able to speak with qualified nurses, nurse managers, students and those involved in promoting the profession of nursing. We met in the main hospital in Lasi. All the Head Nurses came, and a large group of students also attended. Indeed, there were many more people wanting to come and talk about their experiences than there was room for in the lecture theatre. Interestingly, whilst the hospital facilities were different from those familiar to us in the UK, the issues of concern were the same.

What was good to be part of was the way in which the students and qualified staff alike were happy to engage in a vigorous debate of the issues. It was a forthright and honest debate of the way in which nurses need to think differently about how they are educated and prepared for contemporary practice. It was clearly empowerment in action!

And many thanks to Camelia and Ileana for making our stay in Lasi such a productive one. It’s tough to achieve what you achieved, so well done in making such a great contribution to the project. 

Sunday, 18 March 2012

Mothering Sunday, Young Peoples Mental Health and Maternal Deprivation Reassessed

Today is Mothering Sunday, and not Mothers Day (which is an American invention that celebrates motherhood and apple pie on the second Sunday in May). In the UK, Mothering Sunday is said to have its roots in an annual tradition that saw people return to their home or ‘mother church’ once a year in the middle of Lent. Inevitably this pilgrimage became an occasion for family reunions when children who were working away returned home. It's thought that this return to the mother church led to the tradition of children, particularly those working as domestic servants, or as apprentices, being given the day off to visit their Mother and the rest of their family.

In some places Mothering Sunday was also referred to as Simnel Sunday after the practice of baking Simnel cakes to celebrate the reuniting of families during the austerity of Lent. Traditionally there was a relaxation of Lenten vows on this particular Sunday in celebration of the fellowship of family and church. These days Simnel cakes are baked at Easter time to mark the end of Lent. Typically the cake has a layer of marzipan or almond pastes baked in the middle, and is decorated with 11 marzipan balls placed around the edge. These represented the apostles, with Judas being excluded for obvious reasons.

I mention this fact as last week Dr Ann Hagell published her recent work on the mental health of young people, which showed that young people in the mid 2000’s are twice as likely to frequently feel depressed or anxious as those young people who grew up in the 1980’s. Her research explored a range of social trends that might account for the rise in prevalence rates and she found that most significant of these was the fact that young people are staying in education for longer rather than going out and getting a job. This has led to a longer and less structured period of adolescence being experienced the research found.

She noted that today’s young people remain in educational and training environments populated almost entirely by their peers and not the more mixed social environment of work. Dr Hagell is a charted psychologist with a long standing interest in social policy and adolescent well being. She was the Head of the Nuffield Foundation’s ‘Changing Adolescence Programme’ on which the research is based.

I was also interested to note that the research, published in the form of a book, had a forward written by Professor Sir Michael Rutter. After training in general medicine neurology and paediatrics, he specialized in psychiatry, and was appointed as the first Consultant of Child Psychiatry in the UK. His studies of autism, depression, antisocial behaviour, deprived, and over active children, have been both influential and challenging. One of his most famous works was the book Maternal Deprivation Reassessed which he published in 1972. He argued that it was normal for children to form multiple attachments rather than a selective attachment with just one person (usually the Mother). Michael Rutter is recognized internationally as contributing to the establishment of child psychiatry as both a medical and psychosocial specialty underpinned by a strong scientific evidence base. In 1994 he set up the Social, Genetic and Developmental Unit at the Institute of Psychiatry. The aim of this centre is to bridge the gap between ‘nature’ (genetics) and ‘nuture’ (environment) as they interact in the development of complex human behaviour in children and young people.

And on this day, although I will only be able to see and speak with my Mother through the wonders of modern technology, I will raise a glass of wine to salute her. She is a Mother who I think has very successfully raised her 7 children well, and who actually bakes a wonderful Simnel Cake. However, I was glad when I was able to get a proper job and didn’t have to climb up, and sweep those chimneys every day.

Sunday, 11 March 2012

White Space, VDD, and Thank Goodness for Free Range Eggs

On my return from holiday in Scotland, I had to get some basic essentials yesterday, and so dropped into my local Tesco’s to shop. As it turned out, the few crucial items quickly unraveled into a major shop. By the time I got to the till I could see it was time to pull out that double point’s coupon that had been lingering in my wallet with just such a shop in mind. With the flourish of a seasoned Whist player at the local Derby and Joan Club, (younger readers ask your parents what a Derby and Joan Club was) I triumphantly pulled out the coupon only to be told the ‘computer says no’ and that I would need to ask at Customer Services.

So off I dutifully trotted, by now wishing that I had stuck to the just bread and milk shopping list. Now Customer Services sits beside the Cigarette Kiosk and at first I thought the cigarette kiosk must be closed. The shutters were down and where it was normally possible to see the various brands, these were obscured by white space bearing the legend, Cigarettes Sold Here. I asked the young lady who was dealing with me (the participant observer in me noticing that she had matching painted white nails) what was going on. She told me it was some Government thing to stop young people from smoking.

What I had missed in my reading, was the fact that from the 6th April, all large shops in England will need to hide tobacco products from view in a drive to cut the number of smokers and protect young people, who its said, are often the target of much tobacco promotion.

In the interests of fairness, (and in acknowledging that if like me you are in need of purchasing some basic essentials, there are retailers other than Tesco’s who can meet your needs) it needs to be noted that Sainsbury’s, The Co-operative and Waitrose have already been trialing the ‘White Space’ hidden tobacco display approach. Other shops have until 6th April to cover up their tobacco displays and train their counter staff on the new law.

Our Chief Medical Officer, Professor Dame Sally Davies has noted that ending open cigarette displays will help people trying to quit smoking and help change attitudes and social norms around smoking. And last week she also talked about the dangers of vitamin D deficiency. It appears that up to a quarter of the population has low levels of vitamin D in their blood. In severe cases, vitamin D deficiency can lead to bone problems such as rickets in children and weakness, aches and pains due to osteomalacia in adults.

Vitamin D is naturally obtained through exposure to sunlight and from foods such as oily fish, eggs, fortified fat spreads and some breakfast cereals. But it’s difficult to get enough from food alone. Given that I eat my own home produced free range eggs every day for breakfast, and having just come back from a week’s holiday where the sun shone every day, I hope the risk of my experiencing osteomalacia are pretty low. So I think the slump in my shoulders and pain in my back is more likely due to the weight of those emails awaiting a response in my post holiday in-box than any Vitamin D deficiency.

Sunday, 4 March 2012

A Post Card from the Coast, Some Compassion, Meeting Urpu and Cello’s new Cat

At the time it felt like a very hectic week last week. However, as I write this I am sitting in bed looking out at the sea, and yes it really is 07.00 am. I'm on holiday, staying in an ultra modern cottage (complete with free Wi-Fi – take note Marriet) in Kippford on Scotland’s Solway Coast. The cottage was once a blot on the landscape (owner’s words!) but not anymore. The exterior was remodeled and inside, the cottage has been transformed into a fantastic white walled, clean, bright space, with a large number of picture windows allowing the sunshine in, and which beautifully frame the views of the sea, hills and the weather.

Whilst coming to such a place for a holiday in March might not be everyone’s cup of tea, it allows me to unwind, relax and re-energize. I love being able to walk on the empty beaches, through woods and hills where often no one else is seen. It’s also lovely to just sit and watch the world slowly drift by.

The local pub (The Anchor) provides good food, real beer and roaring log fires. Even at this time of the year one is guaranteed a warm welcome, laughter and a relaxing evening. Just a short walk down the hill from the cottage, it’s possible to leave the car parked up and have a couple of pints every night – of course making sure that you stay within the recommended weekly sensible drinking limits. Who says Nurses don’t know how to do health promotion?!

And what nurses can or can’t do, or rather how they might do things was on politicians mind this week with discussion on how to provide care with compassion being top of the agenda. The latest idea is to make all applicants thinking of joining nursing or one of the other health professions undertake a psychometric test to judge their ability to demonstrate compassion. My understanding is that the Department of Health has already commissioned a company to develop such a test.

Whilst of course being compassionate is a good thing, it’s a highly contentious idea that there is somehow an inherent predisposition to compassion that might be revealed through a psychometric test. Most pre-qualifying professional programmes last 3 years, and I find it inconceivable that during this time individuals will not be able to learn how to provide care with compassion. Our School has for the last 2 years run a Care and Compassion Conference and we will do so again this year. These are well attended and show case just how colleagues, services users and carer’s experience compassion and care.

And that’s what I also experienced yesterday at the WhiteHouse Gallery in Kirkcudbright. I had been invited to this year’s Gallery opening following the winter shutdown. Music, Chocolate & Bubbles were promised and delivered, and there was a surprise in store as well. I had just purchased another piece of art by my favorite artist and sculptor Urpu Sellar, when there she was in the flesh. Rosie the gallery owner introduced us and I had a fascinating conversation with Urpu. Apart from Urpus art being quirky and unusual, she often draws on ideas arising from hearing the way we use words in our everyday conversations and some of the pieces I have collected over the years are brilliant three dimensional sculptural forms based upon such inspiration.

Customer care played a part in my recent thinking and decision making over changing my car. I have purchased Toyotas for a long time now and have always been happy with them. A couple of weeks ago I was invited and attended what was billed as a VIP weekend, where it was champagne, hot dogs and special deals on new cars that was on offer this time. Unlike my experience at the Whitehouse Gallery, these inducements did not result in a purchase being made. I simply wasn’t sure they really cared one way or the other about meeting my needs, just getting a sale.

So for the first time in 15 years I went elsewhere. And now the old Dr T Toyota Avensis Tourer has gone and the new Dr T XJ has arrived. Cello, who also sees the beaches, woods and hills as one big private play ground, didn’t seem to care about travelling to Scotland in the new car, despite it being named after a big cat. He just curled up and went to sleep for a couple of hours, apparently completely content with his changed surroundings. A bit like me at 05.00 am this morning!