Sunday 26 May 2019

A lovely week at the Memory Motel (with apologies to the Rolling Stones)


Last week I attended a commemorative service to mark the second anniversary of the Manchester Arena attack. The service was held in St Anne’s church; an Anglican church that was first dedicated in 1712. It is located in St Anne’s Square, which in the immediate aftermath of the attack provided a place that people from all faith, backgrounds and all parts of the North West could come together to show their solidarity, compassion and hope in the face of such a dreadful event. 22 people lost their lives in the attack and many more were injured, both physically and mentally. This year’s service was more intimate; perhaps because the building was much smaller than Manchester Cathedral, where the first commemorative service was held; perhaps because those attending represented a more local and familiar group of people; and perhaps because over the course of time new relationships and friendships had been formed allowing for a more comfortable sense of being amongst so many other families impacted by the attack. 

The hymns and prayers, readings and music created both a solemn atmosphere and yet also underpinned a sense of hope and optimism for the future. It was a privilege to be part of the remembrance service. In fact, it was a week jam-packed with events that sparked memories. Facebook memories showed me a message I had sent out last year at this time. The poppies in my garden had just come into bloom, a fitting reminder that we wouldn’t ever forget those impacted by the Arena attack.

I also heard of the sad death of Judith Kerr. Her book, the ‘Tiger Who Came To Tea’ was a great favourite of many children and mine were no exception and some of my grandchildren are now beginning to discover it too.  51 years after it was published it still has great appeal, and I even heard a rumour that Channel 4 are making an adaptation of the book for Christmas – watch this space.  

And of course, it has been the RHS Chelsea Flower Show week. I’m from the Alan Titchmarsh era of presenters, and apart from Monty and Joe, the new ones leave me feeling a little old and faded. That said I have absolutely loved and been inspired by the gardens this year. The ‘Manchester Garden’ captured the zeitgeist perfectly – water (canals and the industrial revolution) hexagonal stepping stones representing the worker bee, so closely symbolic of Manchester, and of course the wonderful curving representations of graphene and a glimpse into a future of exciting possibilities. 

The CAMFED garden captured the essence of Zimbabwe perfectly. I have not been to Zimbabwe, but I have been to many countries in Africa and seeing the garden brought back so many wonderful memories of the ingenuity of people overcoming obstacles to achieve good health and wellbeing. It was a brilliant advertisement for the important work of CAMFED and the work they do in supporting girls and women in the poorest rural communities across sub-Saharan Africa. It is through this work that women are transforming communities and are proving to be very effective #differencemakers.

My particular favourite garden was the ‘Walkers Forgotten Quarry Garden’ – those who know me will know why this might be the case. However, the Duchess of Cambridge, Kate Middleton’s ‘Back to Nature Garden’ was said to be the most talked about garden at this year’s show. It was lovely to see her children really enjoying the garden and I guess in a very pressured world, such moments of freedom must have been very precious. I liked Kate’s memory of walking through the bluebell woods as a child with her grandmother. The great thing about her garden (designed with Andree Davis and Adam White) is that it will be will be transplanted (literally) to the Dewnans Centre, part of the Devon Partnership NHS Trust, well at least the plants will be. The Dewnans Centre were the winners in a national competition to rehouse the garden, which involved some 23 NHS trusts nationally (I will have to find out next week if @WWL made an application). 

What makes this an especially good thing to discover this week is that the Dewnans Centre is a 60-bed medium secure unit, which provides a service to support the recovery of some of the most socially disenfranchised people who, in a secure unit, have very limited access to natural habits. When I first came to Manchester in 1984 it was to the Gardener Unit, the only NHS service offering forensic care to adolescents with mental health issues. I went there as part of the commissioning nursing team. The experience was the turning point in my life – moving me from being a goat-keeping, chicken-loving nurse onto a pathway of nursing education and research (although chickens are still an important part of my life). The enclosed gardens (whilst not as grand as Kate's) were an important part of life on the unit – and also at one time, we tried to keep a few hens in one of the gardens. Health and Safety issues made this ultimately sadly impossible. 

Finally, in a week of memory joggers came the news from the online journal, the Rolling Stone. Readers of my age might well remember the original newsprint version of this all things music, media and beyond magazine (TBH the digital version is nothing like the radical and of the moment paper version). In any event they reported last week that the Rolling Stones returned the song writing rights for the 40th most popular song of all time, ‘Bitter Sweet Symphony’ to Richard Ashcroft, lead singer of The Verve. For the past 20 years, they have taken 100% of the royalties for the song after a court case decided that the famous string riff in the song was a sample taken from the Rolling Stones song ‘The Last Time’ without their permission. In my lifetime, I have seen the Rolling Stones in concert six times and have always enjoyed their concerts. At the last one Richard Ashcroft was the supporting act and he was superb – so hats off to the Stones, who after 20 years have done the right thing and booked out of the Memory Motel! 

Sunday 19 May 2019

‘The problem is not with your body, but with what you think of it, and yourself ‘


It was a funny old week, last week. There was the small matter of celebrating my birthday – and as is the fashion these days, I can say I was 21 again. The rain came and brightened up the garden. I had an interesting conversation about how Wigan Council had used ethnography to better understand the needs of their communities. The shed got painted a delicate shade of purple. Three peafowl eggs were placed in the incubator (something for the neighbours to look forward to if they ever hatch). And the TV aerial man came and fixed the reception problem. You might think this last occurrence was rather banal, but no, it meant two things.

(1)  I got to see Hatari: the bondage inspired, techno-punk, cyber-goth, opera-influenced group from Iceland (their description not mine) perform in this year’s Eurovison show.

(2)   More importantly, I could watch (thank the Lord for catch up TV) the wonderful programmes that marked the 2019 #MentalHealthAwareness week. This year’s theme was ‘Body Image’. Whilst being concerned with how you look, or how your body compares to others is not a mental health problem in itself, it can be a factor in the development of a mental health problem. One of my PhD students completed his study last year which looked at men with an eating disorder. It was clear from his research that for his participants, being unhappy with their body and body image gave rise to mental health distress and a much poorer quality of life.

#MentalHealthAwarenessWeek was ‘hosted’ by the Mental Health Foundation. They conducted an online survey earlier this year that involved over 5,000 adults and young people. The results clearly showed there was a connection between perceptions of body image and mental health problems: just over a third of the respondents had felt anxious and/or depressed because of their body image; one in eight adults had experienced suicidal thoughts or feelings because of concerns over their body image; one in five said that advertising images caused them to worry about their body image and the same was true for images on social media.You can see their survey results and much more here. Their work helped in raising awareness of mental health issues.

The BBC did their bit too. There was some absolutely fantastic programming during the week. You can still catch much of the coverage on iPlayer, and also on the BBC Media Centre, where a wide range of material can be found, including many of the programmes shown. In a week that has seen much in the news about programmes such as the Jeremy Kyle Show and Love Island (both not BBC programmes), I also liked the fact that the BBC as an organisation practise what they preach. Over 900 mental health first aiders have been trained to provide support and advice to any colleague who needs help with a mental health issue. They provide specialist support such as counselling, trauma support and occupational health, and have an organisation wide campaign called ‘Open Up’ which aims to encourage people to start a conversation about mental health at work and the help that is available. 

It will be interesting to see if this approach reaches out to guests of the BBC. Later this morning J will be on the BBC One Sunday Politics (North West) programme talking about the upcoming European Parliament elections. 

It is all good stuff and I’m sure will make a difference. So, against such a positive week, I was a little disheartened to read the story of Kady Lee, who was convicted by a Magistrates’ Court for causing a ‘public nuisance’. Kady had threatened to jump off a bridge over the M602 motorway in Manchester. It was said that almost 1,000 motorists had been inconvenienced by her action (the motorway was closed for 15 mins), and there was a cost of £560 to pay for specially-trained negotiators.  It wasn’t the first time she had threatened to end her life in this way. In fact, on five other occasions, the Police had been called to deal with her during similar incidents. The court heard that she lived with a personality disorder and was grieving the loss of her mother who had died suddenly last year. Earlier this year her grandmother and uncle had also died. She had never been in trouble with the Police before then.

Katy was fined £200 and placed on a 12-month Community Order. This might be the ‘appropriate’ sentence according to the sentencing guidelines for this type of offence, and one of the requirements Magistrates can impose is a requirement to receive mental health help to explore and address any underlying reasons for offending. I was a Magistrate for some 18 years before retiring from the bench. One of the added values that I felt I always brought to my court sittings was my experience of being a mental health worker professional and having an understanding of mental health care services. 

Whilst I wasn’t in court to hear the Magistrates sentence Katy, their reported words made me feel very sad: ‘this [the incident] has caused massive inconvenience to the public and no-one wants to be subject to this sort of inconvenience’; ‘you must move forward with your life. This sort of behaviour doesn’t cause anyone any good, least of all you’; use this [Community Order] well to deal with your bereavement’. These words do sound a bit harsh, but I wasn’t there to hear how these words were spoken. I can only hope they were said with compassion. 

Sunday 12 May 2019

Swimming against the malestream: we need more men to become nurses


Today is International Nurses Day2019 - #IND19 – and being a nurse, I of course wanted to add my thoughts on the contribution and impact that Nurses make, not just here in the UK, but across the world. And it’s a formidable impact. The World Health Organisation (WHO) states that there are approximately 29 million Nurses and Midwives in the world. Globally, Nurses remain a critical part of health care and still make up the largest group of all health professionals. Across the world, 70% of the health and social care workforce are women compared to some 41% in all other employment sectors. As such nurses and midwives represent a significant share of the overall female workforce.

Nurses were said to be key to developing the United Nations’ ‘Millennium Development Goals’ and remain key to achieving the UN’s current ‘Sustainable Development Goals’. These are 17 goals and 169 targets that form a ‘to-do list’ aimed at wiping out poverty, reducing inequality, and tackling climate change by the year 2030. The WHO argues that in order for all countries to achieve the Sustainable Development Goal 3 (on health and wellbeing), the world will need an additional 9 million nurses and midwives by 2030. That’s a difficult challenge to meet. However, investing in nurses and midwives is absolutely good value for money! The UN High Level Commission on Health Employment and Economic Growth, which published its five-year action plan in 2016, noted that investments in education and job creation in health and social care, result in a triple return of improved health outcomes, global health security and inclusive economic growth – a win-win outcome and one that reflects this year’s #IND19 theme – Health for All. The 2019 theme is the last in what was a three-year campaign by the International Council of Nurses - Nurses:  A Voice to Lead. It is a campaign aimed at recognising the need for nurses to become more aware and active about health policy development and implementation. 

Closer to home, here in the UK, the National Health Service (NHS) employs some 1.5 million people. There are 82 countries in the world with smaller populations than this number. It is the UK’s biggest employer and one of the largest employers globally.  A UK think tank, the Nuffield Trust, published a report on the NHS workforce last week which notes that across all NHS care settings, there are around 150,000 doctors and over 320,000 nurses and midwives. I found it interesting to read that even when these two groups are combined, they constitute only a third of the total NHS workforce. It’s a reflection perhaps of the multidisciplinary nature of the NHS, and the high degree of interdependency there is across so many different professions in delivering good health care services. 

Within the UK nursing profession, just some 11% of all registered nurses are male. This is congruent with many global health services. Iran is the exception, with nearly a quarter (23%) of its nurses being male. According to a report published by NHS England in February this year, the good news story is that, in the UK, a record-breaking number of male school leavers have applied for nursing programmes this year. This follows the very successful ‘We Are The NHS’ recruitment campaign launched as part of the NHS 70 celebrations last year. There has been a 9% rise in the number of men applying to become nurses since last year. Some 2,650 men have applied. This week’s blog title is an adaptation of the title of a paper I read almost 10 years ago, a paper written by Thomas Harding on why men choose nursing as a career. Interestingly, he found two of the reason’s men might choose to become a nurse were a focus on human caring and the transformational potential nursing provided for personal fulfilment.  

And for hard pressed health service organisations, there is more other good news. The overall number of people applying for nursing programmes rose by nearly 5% on the numbers for 2018, reversing the downward trend seen since 2016. Nearly 31,000 people applied for nursing degrees this year, which whilst not solving the immediate workforce shortages does indicate we might be moving in the right direction in securing a future workforce. What will help in the immediate future is the increase in the number of nurses from outside the EU who are registering to work in the UK. The numbers have doubled in the last year, with 6,157 nurses and midwives registering last year - a rise of 2,790 from the year previously. We have a long way to go, and as the corrosiveness of Brexit continues, we might have to go a long way in finding the necessary numbers of overseas nurses to fill the workforce gaps. 

On International Nurses Day 2019, I wonder what Florence Nightingale might have said about the state of the nursing profession today. And I wanted to end this week’s blog in acknowledging the contribution to health care of another remarkable woman. Her name is Kate Fussell, and she recently celebrated her 90th birthday. She isn’t a nurse but was a surgeon. In 1970, she became the first female surgeon to operate at the Wigan Hospitals (now Wrightington, Wigan and Leigh, an NHS Trust I work with as a Non Executive Director). Indeed, at that time she was one of just six female surgeons in the UK. Over her career, she made a huge contribution to the NHS and health care. She was also a driving force for the Soroptimist International organisation. This is an organisation that I am ashamed to say I have never heard of before. Its aim is to transform the lives of women and girls through education, empowerment and enabling opportunities.  I think that’s an aim we can all work towards achieving, as might be the ambition to get more men to become a nurse.