An old fashioned concept for a new start, and the Magic of Oxford

The past few weeks have been very busy ones. However, last week’s busy-ness was not down to having to travel so much as having to deal with some big issues and to do so in a tight time frame. Tuesday morning, in a meeting faintly reminiscent of Brief Encounters (in that a somewhat illicit meeting was held in the Coffee shop opposite M&S on the Mezzanine floor of Piccadilly Station) the Deans and Heads of School (Health Care) from across the North West gathered to go through the options available to make the required savings shortfall from the agreed 15% cuts in the Non Medical Education Training budget. The sum required was nearly £5 million over three years, so coming up with options was a challenge.

The subsequent meeting with colleagues from the SHA was a good one, and by lunch time an agreement in principle had been reached. Whilst the cut and thrust of the negotiations debate was interesting, it was also a little wearying. On returning to the University, I had time to meet with all the new students who this week, had started journey of becoming nurse or a midwife, before returning to the station and traveling down to Oxford.

This was the second session I had with the students this week, and both were the highlights of my week. It is a great privilege to meet all these new students and have the opportunity to talk about the relationship we (that is my colleagues and I in the School) want to develop with each student over the next three years. It is also an opportunity to describe what I think is involved in becoming an effective nurse or midwife, and where I think the nursing and midwifery professions are headed in the brave new world we find ourselves in.

One of the thoughts I wanted the new students to take away and reflect upon comes from an old but, in my view important idea. This idea is concerned with ensuring as we become nurses or midwives we find ways to nurture what Carl Rogers described as an unconditional positive regard for others. This is an approach based upon the acceptance of a person whatever that person says or does. It is accepting that people might behave in a particular way, and often for reasons not known to us. To be judgmental in such situations is likely to result in poor relationships and ineffective care and recovery. My belief is that developing such unconditional positive regard for others first requires us to understand something more about our self. This can be a difficult and uncomfortable experience – but an important one.

Although Carl Rogers is the person most associated with the concept, in his book On Becoming a Person he acknowledges that it was his fellow PhD student, Stanley Standal who first developed the term. Stanley was a complex person but someone who was said to have excited and challenged all those he came into contact with. His and Carl Rogers development of the concept of unconditional positive regard became a popular framework for understanding of the interpersonal relationships dynamics involved in therapeutic relationships. For me it is a concept and an approach that allows for nurses and midwives to understand the interrelationship between the being and doing of nursing.

Stanley was diagnosed with Alzheimer’s in the mid 1990's. He moved to the Philippines with his wife Ophelia where lived out his last days. For our students, these are the first days of their new life and journey on becoming a nurse and or a midwife. I wish them all the very best. Many thanks to all those new students who have taken the time to say they enjoyed the two sessions I was privileged to share with them at the beginning of the week. Please remember that I always welcome comments and feedback from all students, it is an important way for my colleagues and I to ensure we constantly find ways of making your experience the best it can be.

And Oxford, well it was my last conference of this academic year and the last opportunity for me to present my work to others. The conference participants were mental health nurses from all over the world and in the surprising sunshine of late September, it was lovely to enjoy the discussion, debate, and exchange of ideas. The venue for the conference, Wadham College, had a magical feel to it, part Morse and part Hogwarts, it was lovely.

Good bye Burt Bacharach, Sitting at the Rectors Table, and the NMC Standards, Transformed

Since writing last week’s blog I have travelled some 1941 miles on University business (Helsinki –Tallin-Helsinki-Copanhagen-Manchester-London-Manchester-Manchester-Newcastle- Manchester). It has been a week where trains, boats and planes have lost their appeal. And for me, Burt Bacharach never had any appeal. However, as they say, it was worth it.

As part of this week’s travels, I went to the Imperial College London. I was there to support one of my colleagues, Denise Megson, who was presenting her work as part of the Stellar HE Leadership Programme. This is a strategic executive development programme for Diverse Leaders (BME) in Higher Education. It has been designed specifically to develop and implement leadership strategies that reflect the unique challenges and experiences of black and minority ethnic academic and professional staff across the whole of the University sector. Stellar HE is a unique leadership development programme that draws on 21st century leadership approaches and thinking to further leverage the effectiveness of Diverse Leaders. The programme aims to address issues of institutional race discrimination, level the career playing field, and provide equal access to promotion, professional development, and increased retention of talented staff. Denise was there presenting their work alongside academics from eight other Universities – Greenwich, Imperial College, Leeds Metropolitan, Loughborough, Oxford,  Bradford, Cardiff and Glasgow. Denise presented her work well and was a great ambassador for the School.

The meeting was held at the impressive 170 Queen's Gate (the Imperial College Rectors House). This magnificent building was designed and built in 1889 by Norman Shaw, one of the most important English architects of the 19th century. His work is characterised by an ingenious approach to creating an open plan feel to his buildings. Although he worked mainly on big projects, the country house, and commercial buildings, his designs were adopted on a more modest style, in the mass produced housing of London and Leeds at the start of the 1900s.

On Thursday I was at Northumbria University, in that very privileged role of external examiner at a PhD viva. Whilst the surroundings were not as impressive as those at Imperial, the scale of scholarly work and endeavour was. These opportunities always touch me. Hearing a fellow academic defend their work (and often this is done with such passion), is a special experience, and not one to be undertaken lightly.

At the end of the week we had a School Development Day. Part of the day was a brilliant presentation from my colleague Margaret McAllister, Professor of Nursing, from the University of the Sunshine Coast (what a wonderful place name). She had travelled some 10235 miles since last Sunday to get to Salford. For me it was worth it. Margaret shared with colleagues her experiences in developing transformational learning approaches with and for her pre-registration nursing students. Drawing on some very creative examples from practice, Margaret provided us all with a powerful learning experience.

The timing was spot on as finally, the NMC published the standards and guidance for the new pre-registration nurse education this week. Some 5,000 individuals and organisations across the UK contributed to the development of these long awaited standards. It is these standards, which will provide the foundation for future pre-registration nursing programmes. In our School, Jane Jenkins and Karen Holland have over the last 12 month, led colleagues in developing a framework for our new programme, which we will launch in September 2011. This programme will reflect the new standards. Part of what we heard from Margaret in her presentation, was the importance of developing a ‘language of possibilities’ for our students – whilst we already know of some of the words, it is now up to us to write this particular dictionary.

Bears on the Square, Northern Lights and Giraffes on the Balcony.

It is 06.30 in the morning (04.30 if you are living in the UK). For much of this week I have been in Helsinki as part of the Nordic Mental Health Nursing Conference. I have enjoyed a long and productive relationship with colleagues living and working in Finland, and have been coming here for many years on joint projects, conferences and teaching. It always feels a little like coming home. I was here with some of my colleagues from our mental health directorate, and between us we presented 13 papers and two posters on our research and scholarly activities in the School, more of which later.

I had a chance to look around the city on the afternoon before the conference. There were two experiences that stuck in my mind. The first was sitting in the beautiful Temppeliaukio Church. This is a church whose interior was excavated and built into the rock, but is bathed in natural light entering through the glazed dome. Just sitting there in this natural light listening to soft organ music and feeling the stillness was a wonderful experience and one I will treasure for a while.

The other experience that struck a chord was coming into Senate Square and finding the world tour exhibition of the United Buddy Bears – The Art of Tolerance had arrived in Finland. The bears have been on the road since 2004, and Helsinki is their 20th stop. There are 142 individually painted bear sculptures, each just over two metres tall. Each of them represents a nation recognised by the UN and have been painted by an artist from that nation.

The United Buddy Bears project was initiated by Eva and Klaus Herlitz of Berlin. They wanted to raise thoughts about cultural diversity in the world and tolerance between peoples. That I was able to see this exhibition and become part of the work seemed important given the stories of the pastor in the US threatening to burn another religions sacred text on the anniversary of 9/11. Thankfully a more tolerant position was finally adopted, and the burning did not take place. Coincidently, I was in Finland on the day of the 9/11 attack.

Tolerance was also an unintentional theme to emerge from the collective works presented by my colleagues and me. For example, tolerance in terms of the aging process, sexuality, perceived societal risk, self harm, embracing the non professional voice in providing care, recognising the rights of young people. These presentations connected well with others who discussed developments in primary care and mental health and well being.

Indeed, two colleagues stood tall and proud with heads raised right above the parapet in presenting their work on making mental health promotion everyone’s business. Two flawless presentations cogently set out the arguments and a possible way forward in improving our educational preparation of students in this area and possibilities of working more closely with non professional organisations.

It can be difficult to present your work at such a large conference. I also received an email telling me about another colleague who had presented this week at the NET conference in Cambridge. This was the first time she had done so, and although finding the experience a little daunting was very proud to have been given the chance to present her work about mentoring at an international conference.

I was in Tallinn, Estonia yesterday, with a group of colleagues from Norway, the Faroe Islands, Ireland, Finland, and Denmark for a brief mental health nurses meeting. This city has a large and almost intact medieval quarter. It was lovely to sit outside and enjoy a peaceful moment in the early autumn afternoon sunshine before returning to Helsinki on the high speed ferry.

And those giraffes, well in the municipal building across the road from my hotel are two life size model giraffes peering down at people passing by. Like my colleagues these two giraffes have been sticking their necks out all week. Unlike the giraffes, I think my colleagues have all made a much bigger impact.

Balancing the Books, more numbers, a 7.30 read and a waste of eggs.

It is that time of the year where every day brings with it uncertainty, angst, hope and relief. I am of course, talking about it being the end of our recruitment activities. Although our student income comes from the NHS rather than HEFCE, we are still subject to the same issues in terms of under or over recruiting. Both ends of the spectrum bring real financial pain. The tolerance level for achieving our commission target is very narrow, partly because we have such a high number of students entering the School every year. Indeed, this week I discovered that we are now the largest School of Nursing and Midwifery in the North West of England.

However, and thanks to the sheer hard work, commitment and conviction (wanted to use ‘faith’ rather than ‘conviction’ but I am not sure the PC police will allow me anymore) of our academic and admin staff we have achieved an almost perfect match of students recruited to commission targets. We just have to hope they all turn up and register in a couple of week’s time.

I am not the only one worried about the recruitment of nurses. I was talking with one of our local Directors of Nursing this week and amongst other topics of conversation we talked about the impact, 4 or 5 years hence of reducing the numbers of nursing commissions as part of the plan to make savings of £20m from the North West NHS Training budget over the next three years. Many of us (with grey hair that is) have been in such boom and bust situations before, and nobody ends up being a winner. The other subject we talked about was what were seen to be poor levels of numeracy found with newly qualified nurses.

Some of our nurses had been given a numeracy test as part of a recent round of job interviews, and many had struggled with these tests. This is not a local phenomenon. In a study published last week, it was revealed that some 55% of students and 45% of nurses failed a simple numeracy test. The study involved some 350 student and qualified nurses. Astoundingly 92% and 89% respectively failed the drug calculation tests (at a pass level of 60%). However, both students and nurses appeared more able to undertake calculations for solids, oral liquids and injections than calculations for drug percentages, drip and infusion rates. Nurses were more able than students to perform basic numerical calculations and calculations for solids, oral liquids and injections.

As a School we have long realised the importance of ensuring our students have the basic mathematical skills required for drug and other calculations. We have put in place initiatives that periodically provide learning opportunities to prevent skill decay. This year we have introduced numeracy and literacy testing as part of the selection process as we have found paper qualifications attesting competence are not always a good indicator of levels of ability.

It was not my in-ability to tell the time that was the reason for me sitting on a bench at the side of a duck pond, outside the Faculty of Health Building at Edge Hill University, at 07.30am on Thursday of last week. It was my desire to avoid the traffic – some Schools have started to go back and the slight lull we have experienced in terms of the numbers of cars and delays over the last few weeks when travelling on the regions roads is rapidly disappearing. So I went early and was able to sit in the early morning sunshine reading a PhD thesis in preparation for a forthcoming examination. I was there to meet with the other Deans and Heads of Schools of Health and Social Care to agree a way to meet the savings target set by the NHS North West commissioners of education and training for a all health care professionals. It was an interesting meeting, but productive too. Our response will go to the Strategic Health Authority next week.

The saddest and dreariest story of the week was the egg throwing in Dublin as Ex PM Blair arrived to promote his latest book. What a waste of eggs. A more effective protest against this dreadful man and his book about his time in politics might have been not to have turned up in the first place. Peacocks only display their feathers when they think there is someone interested in them or someone who might want to admire them.

Of course for me, I also think all egg throwing is a waste. Every egg is a potential chicken. My two little bantam survivors of the fox attack have now started laying eggs. I had an omelette on Friday – it only took 8 tiny eggs to make! Blair allegedly now admits that banning fox hunting was a mistake. I could have told him that many years ago.