Sunday, 24 February 2013

Powerful Women, Media and Radar: the next Generation

For lots of different reasons, women were on my mind last week. It started with a conversation about women in powerful and influential positions in the University. It’s true to say that in different parts of the University there are many more men in positions of power than women. Only 3 of the 9 Heads of School are female, and of the 5 Pro-Vice Chancellors, only 1 is a woman.

Our School has a slightly different profile. 80% of the 200 academic staff are female, as are the students, 4 of the 6 Directors, and 3 of the 4 Associate Heads of School are women. We have a large School Executive and 12 of the 15 positions are held by women. However, while these are examples of women in powerful organisational positions, in the School Professoriate, the group providing academic leadership for our research and teaching activities, only 3 of our 9 professors are women.  

And it seems we are not alone in trying to get the gender inequality more balanced. Last week, the Women's Media Centre released their annual report on the status of women in the media for 2012. Although this is a US centric study, I think that some of the rather depressing findings are universally recognisable. Not unexpectedly thee are only 17 women working in media and technology companies to be found on Fortune’s 50 Most Powerful Women in Business list. Men are far more likely to be quoted than women in newspapers, television and public radio, even on programmes that cover such subjects as abortion, birth control, planned parenthood and women’s rights! Talk radio and sports talk radio hosts are overwhelmingly male.

There were other examples of inequality evident in all areas of media: 47% of gamers are women, but 88% of video games developers are male. Story framing and descriptions of women still too often fall into familiar stereotypes, from coverage of the Olympics to the resignation of the director of the CIA over the revelation of an extramarital relationship. Female characters are stereotyped and sexualised in media popular with youth. Indeed girls as young as age 6 are starting to see themselves as sex objects, based on a combination of media influence, parenting and religion.

The study also found that women outnumber men on social media sites, but are also more on guard about privacy and managing friends and contacts. This is not always the case. 2 of our students found themselves in front of Fitness for Professional Panels last week because of the way they chose to use social media sites.

On a much more positive note, last Thursday I was invited to the EU RADAR course dinner.  The EU RADAR (Recognition of the Acutely Deteriorating Patient with Appropriate Response) course is a unique and innovative programme of study developed by a group of colleagues in the School, led by one of the most creative people I have come across – Melanie Stephens. Student nurses from across Europe and the US participate in lectures, seminars and role play with clinical scenarios (informed by patients and families). A systematic approach to early recognition and response to acutely deteriorating patients is taught in a safe environment without risk or harm to real patients. Students also further develop their communication skills hopefully also broaden their cultural awareness and understanding of difference.

It was a buoyant and fun filled end to the 10 day course. This picture shows the incredulity on the faces of some of the students as they watched the tutors perform a dance routine to the music of Staying Alive. The prize-giving recognised the efforts the students and tutors had put in to course, their development of new friendships and acquisition of new knowledge. There was a special kind of energy and confidence to the celebrations. These are the next generation of practitioners, leaders, researchers, and teachers. The evening did much to fill me with confidence that we are helping to prepare nurses who will be able to influence and shape and deliver high quality health care services of the future and to be able to do this so well. 

Friday, 15 February 2013

A Few More F Words...

More than one of my blog readers has questioned whether the posting time of my blogs is in real time or the product of some kind of automatic posting programme. Well I can reassure them that my blog is written live on Sunday mornings, and when completed, it is immediately posted. The more sharp eyed of readers will see that this week’s blog has been posted on a Friday night. The reason being is that this weekend I am back up in my favourite part of the UK, Scotland. There is no internet access, hence the earlier posting.

Well there are nearly 400 pages, 3 volumes and 290 recommendations in the Francis Inquiry into the catastrophic and tragic events at the Mid Staffordshire NHS Trust.  Unsurprisingly, the first recommendation is that patients must come first, with care delivered by caring, committed and compassionate staff working within a common culture. According to Francis the Mid-Staff's Trust Board was weak and chose not listen to patients and staff or ensure that concerns were adequately addressed. It did not tackle the tolerance of poor standards and the disengagement of senior clinical staff from managerial and leadership responsibilities. The Board were too focused on reaching targets, achieving financial balance and seeking Foundation Trust status at the expense of acceptable standards of care.

Zero tolerance should be the new standard. And it appears the Knight in Shining Armour charged with ensuring this is the case is one Donald Berwick. He has an impressive pedigree. Obama appointed him as an advisor on health care in the US, and he has held many senior jobs in health care related industries, including Medicare and Medicaid in the US. If you want to see Donald speak about his experience he is speaking at a conference London, 16-19 April 2013, for a knock down price of just £1500. Nice work if you can get it – I am sure he is worth every penny.

Berwick studied the management of health care systems, with emphasis on using scientific methods and evidence based medicine and comparative effectiveness research to improve the tensions involved in balancing quality, safety and costs. Interestingly back in the 1920s, it was Frederick Winslow Taylor who originally devised a system he called scientific management and approach in which he tried to apply science to organisational management. However in doing so, he forgot that organisations are actually made up of people and  his ideas fell  out of favour by the 1960s – well at least until now that is.

Wythenshawe Hospital in South Manchester know about how to look after and protect people. This week they put up the following Fox Alert notice in the main entrance of their maternity unit: The unit has received reports of a fox in the main maternity entrance area which should not be approached. Please do not feed the fox. Please report any incidents to ward staff. A hospital spokesman said humane traps were being set to catch the fox.

And maternity care was the subject of much celebration here last week. Our Midwives celebrated a number of achievements, gaining the UNICEF Baby Friendly award and further additions to our Birth Rites Art Collection. The winner of the Art of Midwifery competition was Just Five More Minutes (see above) – but I also liked Waterbirth for its evocative lines and colours. 

Finally, I was with a large group of family, friends and former colleagues gathered at Walton Lee Crematorium today to pay our respects and say goodbye to Dave. As one of my friends said, we were wishing him a speedy motor bike ride to his next destination. The eulogies were warm, touching, funny, and captured so perfectly the wonderful contribution he made to the lives of so many people. Dave, you will be missed. 

Sunday, 10 February 2013

No F words and Thank you David

Last week I heard some sad news. It wasn't the publication of the Francis report which was sad and I will write about this in another blog. No the sad news for me last week was hearing that my friend, mentor, former colleague, supervisor and boss, died unexpectedly last weekend. They probably broke the mold when they made Dave Skidmore. He was a giant of a man who was never happier than when he could help you. A keen motorcyclist, Dave had an interesting background, policeman, Olympic standard fencer, nurse, researcher and educator. He was well read and loved telling stories. His wit and good humour were legendary.

Although I had been aware of Dave for a large number of years, (as a mental health nurse in the 1970s it was hard not to have heard of him, such was his influence) it was 1995 when I first met Dave. At the time I was working for one of the largest NHS mental health services in the UK, and was growing desperately unhappy with my role. I was doing some work with a colleague on developing a distance learning leadership programme for nurses, and the programme was to be facilitated and approved through Manchester Metropolitan University. Dave was Head of the School of Nursing there.

That first meeting was life changing. Within 6 months I had left the NHS and taken up a post as a Principle Lecturer at MMU, and was as happy as the proverbial pig in muck. Dave introduced me to teaching, which I loved, research which was so exciting, and academic tourism – which he was particularly good at sorting out. Through the opportunities Dave provided I was able to travel the world.

Often he would come with me and together we shared many, many adventures. The first paper I ever presented at a conference was one that Dave basically wrote and very generously allowed me to be second author in 1996. This was at the Slovakian conference I have been supporting ever since. On that first occasion we arrived at the conference venue at 06.00 in the morning having travelled overnight on a train. We looked so cold the conference organisers gave us each a pint glass of  local apple brandy to warm us up.

When I stalled with my PhD studies and my supervisor was ill, Dave stepped in and rescued me. And he was like that. Always ready to step in and help, never asked for anything back. 10 years further on when I was ready to leave MMU and take up a role as a professor at the University of Salford, Dave was there supporting my application and providing words of wisdom that I gratefully took on board.

As news of Dave’s untimely death spread across the mental health and nurse education world I have been cheered by the number of people who have emailed me to tell of the way Dave touched their lives. It was a phenomenal response of recognition, respect and acknowledgement. On Friday we say good bye to Dave. His impact and influence on mental health nursing, nurse education and for so many people who knew him is immeasurable. My thoughts are with his family at this very sad time. 

Sunday, 3 February 2013

Gnocchi, Obesity, a Cure and Horse Burgers.

Gastronomically speaking, last week was not a good one for me. It just so happened that on 2 separate occasions in 2 different countries of the UK I got to eat dinner at a Marriot hotel. Well eating dinner is possibly an exaggeration; it was more like pushing food around a plate until I could respectfully say I had eaten enough. The problem was that the Marriot menu in both places only had gnocchi as the vegetarian main dish. To be honest, life is way too short to be eating gnocchi.

The jury seems to be out on whether gnocchi is fattening or not - the majority view seems to think it is. Gnocchi aside, our old friend Anna Soubry (Conservative Minster for Health) had no hesitation last week in determining what she thought was the cause of the UK obesity problem. She declared that is was possible to pick out children from poor families because they tended to be fat. 'a third of our children leave primary school overweight or obese' she said and that the culture of 'TV dinner' had eroded traditional structures of family life and led some homes to dispense with the dining table entirely. Miss Soubry recalled that when she was at school, pupils from deprived backgrounds tended to be 'skinny runts'. she blamed the easy availability of processed and fast foods as the culprit. 

And Mary Creagh, Labour's Shadow Environment Secretary, has recently noted that being able to feed oneself properly is fundamental to everyone, but the evidence suggests that people on lower incomes are buying and consuming less than 5 years ago. Additionally, despite the '5 a day' campaign, fruit and vegetable consumption is falling. The lowest 10% of households by income reduced purchases of fruit and vegetables by 20% between 2007 and 2010 and the real price of fruit, milk, cheese and egg prices have risen by 30% during the same period. The consumption of processed foods however, has also risen 36% since 2007.

It’s estimated that by 2040 50% of adults living in the UK will be obese. Thankfully, as usual the NHS has the answer - Weight Watchers! Over the past 5 years the NHS paid some £4m sending obese people to Weight Watchers. GPs now routinely refer patients to the classes, which cost 'private' visitors around £45 for 3 months. It is estimated that 30,000 are sent on courses paid for by the NHS each year, in an attempt to overcome the UKs obesity crisis.

Research undertaken by the Medical Research Council in 2010 found that patients on a Weight Watchers course lost twice as much weight as those who merely sought advice from their GP. Researchers have also said the courses give patients good habits for life. However, it should also be noted that this and many similar studies have been funded by the company itself, so one may ask if the outcomes may be a little biased. But of course I am sure that is not the case here.

Guaranteed unbiased research outcomes from the UK Department for Environment, Food and Rural Affairs (Defra) suggests that affordability is now the key factor in determining what food and drink we buy. Food prices have risen 12% in real terms over the last five years, taking us back to 1997 in terms of the cost of food relative to other goods. Food prices rose by 32% in the UK between 2007 and 2012 compared to 13% in France and Germany.

Helpfully the food manufacturers and supermarkets have being doing their bit to keep costs down. Unbeknown to consumers (well they didn't tell anyone) they appear to have been selling beef burgers and other processed food that contained horse meat  It was the ‘value’ range of food that was most affected. And yesterday, one of the major fast food chains had to confess to their whopper of claim that their burgers didn't contain horse meat when it was revealed that some burgers did contain horse meet. Maybe gnocchi is not so bad after all.