Satisfaction, Empathy, and Tweets in the Mary Seacole User and Carers Garden

Last week it felt a little like I was a chess piece being played in a 3D game of chess. I found myself either moving at so many different levels at one time or being moved by others in multiple ways and directions. It was fantastic to be able to put my feet up at the end of Friday evening, somewhat tired but, for lots or reasons, feeling very satisfied!

Satisfaction is a strange concept – the Rolling Stones thought you couldn't get it, Bernard Shaw thought satisfaction was death, and Jarod Kintz (the author) once declared he would eat a mosquito to satisfy his hunger for an itch. Despite the busy-ness of last week there were many things that contributed to my end of Friday evening sense of satisfaction.

Monday, having decided to take the last day of my 2013 annual leave, I was able to wake up in the house in Scotland. The Scottish sea, sunshine and screaming seagulls all contributed to my sense of wellbeing and satisfaction with life. Tuesday I was back down on this side of the Border and spent the day with some wonderful folk from the Wigan, Wrightington and Leigh NHS Foundation Trust.

It was a day spent meeting a range of people, and being able to discuss the many challenges there are in providing health care in a rapidly changing world that in itself was fulfilling and informative. The next day I was sent a link to a recent video they had made on empathy. I had a quick look, played it again and thought these were my kind of people! Have a look and see what you think: http://youtu.be/rbxb3DcaohU everyone should watch it.

I sent the link out via Twitter, and although as yet I don’t have that many ‘followers’ I was confident that as each person saw it and ‘re-tweeted’ the video would soon have a wide audience. And it was using the collective power of Twitter that also contributed to my satisfaction this week. Wednesday morning the first tweet I looked at circa 06.00 pointed me in the direction of a web page on Asdas, online shopping site. There, unbelievably was an advertisement for a halloween costume described as ‘mental health patient’ with a picture showing a ‘straight jacket’ type garment covered in dripping blood and the model holding a bloodied meat cleaver in their hand.

I was truly deeply outraged! I immediately started tweeting to communicate this situation to others and to get people to contact Asda to demand to have it removed. I was not alone thankfully, and the Twitter community picked up on the story and soon the twitter protest had gone viral. Eventually Asda removed the costume from sale as did Tesco, who were also stocking a similar costume, and both pledged to make a substantial donation to mental health charities. It was a triumph for a community gaining a voice and being able to use it.

Interestingly I learnt last week that our University has been ranked 4^th of all Universities in the UK for using social media. Only Oxford, Cambridge and the London School of Economics have a greater number of followers on Twitter, Facebook and Youtube.

Yesterday and today are the first of the new academic seasons open days – 2300 potential students and their families are booked to visit the Schools various programme stands. Colleagues are making a fantastic commitment to the School in giving up their time on what is proving to be a very hot and sunny weekend. Last week I also got to meet some potential future students. These were pupils Irlam & Cadishad College, Buile Hill Visual Arts College, All Hallows RC College and the Oasis Academy at Media City. They had come to the School to build a Service User and Carers Garden in the central courtyard of our building.

The garden themes include plants such as seasonal herbs, leaves, and vegetables, medicinal plants and a selection of wild flowers. Award winning gardener Joan Mulvenna of Garden Design Manchester and the not-for-profit social enterprise Tree Inspired planned and help the young pupils bring the garden to life. The garden was also created as a living memorial for our sadly departed carer colleague Terry Flahety, who was both a tireless campaigner for carer services, and a founder member of the Schools Service User and Carers Group. It was clear to see that at the end of the day, all those involved were very satisfied. 

Ignoring the Hocus Pocus, a Crowded Pub, and some Quiet Contemplation

There are 2 days I really like above all others in our School year. One of these is Graduation, the other is the first day of a new Academic Year, which this year, was last Monday. On Monday, we had 1000 new students starting their studies with us. It was great to be able to welcome them to the School. This year we were able to use the 300 seat G21 auditorium, which I have to say is my favourite ‘stage’ for 'performing' on.  It was a great atmosphere, and such a good start to the week.

Now I don’t see myself as an extrovert, but I do like the opportunity to be with people in this way. Adam Grant, the American organisational psychologist, in a paper published last week caught my attention. He was discussing the ubiquitous personality test the Myers-Briggs Type Indicator test (MBTI). It’s all hocus pocus of course. As Grant notes, when it comes to accuracy, if you were to put a horoscope on one end and heart monitor on the other, the MBTI falls about halfway in between.

There is some consensus across many of the world’s cultures that the 5 personality types that consistently emerge are: extroversion, emotional stability, agreeableness, conscientiousness and openness. Some would add honesty as in honesty-humility as perhaps being the crucial 6th type. However, introversion – extroversion, which is the trait that the MBTI is supposed to capture best, remains a contested issue. I have done the test many times during my working life and have often had different outcomes.

Indeed I would place myself on the introversion – extroversion continuum as somewhere in the middle – an ambivert – someone who is comfortable with groups and social interactions, but also relishes time alone, and away from the crowd. So this week, whilst I loved being on the stage, welcoming our new students and the social interaction of Fresher’s week, equally, it was good on Friday, to be able to drive to the quietness and peacefulness of the house in Scotland.

Mind you my local pub, the Anchor was full last night, and far from peaceful when I went there to eat dinner. I had to sit on a table already occupied by people so as to claim my ‘rights’ to it while I waited for them to leave. After a few fraught moments and false conversational starts we started talking and it gradually emerged that we had things in common. They were called John and Pam, and both were retired nurses, who now lived in an apartment in the grounds of what was once the Crichton in Dumfries.

The Crichton was the last and largest psychiatric hospital, built in 1838 as one of Scotland’s flagship asylums. At one time there were 700 patients being treated there. Under the management of its first medical superintendent, William Browne, it became famous for the introduction of both Occupational and Art Therapy, and indeed was famous for many contributions to psychiatric research. One of the Crichton's early patients featured in Charles Darwin 1872 book, the Expressions of Emotions in Man and Animals, as the face of the insane. The original hospital has long gone now and has been replaced by a state of the art modern day mental health unit called Midway, providing care for just 85 people.

Whilst my new found dinner companions appeared fascinated by the fact I was a professor in mental health care I was equally interested in John's new profession as a bass guitarist in a jazz band. They were off to Lockerbie today to play in a concert there. It was the second time he had been to Lockerbie, the first time was for 3 weeks following the bombing and crash of Pam Am Flight 103 in 1988. Then he helped the community deal with the initial physical and emotional trauma of the bombing. After many years, the former Libyan leader Gaddafi finally accepted responsibility for the bombing in which all 259 people on the plane died, along with another 11 people who died when the plane crashed into the town of Lockerbie.

And so it was that in the hurly burly noisy hubbub of the Anchor Pub, with its noisy good humoured crowd laughing, drinking, eating, talking and enjoying themselves, we sat for a moment of quiet contemplation of lives lost and lives changed for ever. I will do the same tomorrow, and in doing so, raise a glass to my little brother Christopher who, 6 years ago was also prematurely taken from his family and friends. However he will shine on for ever in our hearts.  

Breaking Barriers in Iceland; 5 Tomatoes and Toadstools

Last Tuesday after 4 hours work at the University, I once again made my way to Manchester Airport. This time I was Iceland bound to speak at the Nordic Conference of Mental Health Nursing – Breaking Barriers. Getting off the plane at Reykjavik I was almost blown over by the ferocity of the wind, and the torrential rain was coming down sideways. The transfer from the airport took well over an hour and I was very tired by the time I finally got to my bed some 18 hours after I had left the one in my home in the UK.

The following morning the opening ceremony started with a few moments silence in a humanistic remembrance of the tragic events in New York on 11^th September 2001. 

Now I have been to many conference opening ceremonies, but this was one of the best. There was 12 different countries represented and the various languages being spoken around me was fascinating, as were the names – thank goodness they are not graduating from our University. The first welcome talk came from Helga Sif Friðjónsdóttir, the Chair of the Icelandic Psychiatric Association, followed by Vigdís Finnbogadóttir, the former President of Iceland and the Conference Patron. She had been the first woman president in Iceland.

There was music from a duet called Lava Garden, but the best element was two readings from the Icelandic poet and writer Einar Már Guðmundsson. The readings were taken from his book Ancients of the Universe, and were dedicated to his brother. His brother killed himself after living with a mental illness for a number of years. They were very moving, funny and totally appropriate stories to be told.

I was presenting a paper on the notion as to whether compassion could be taught or is it best taught. Other participants were very interested in the 6Cs concept, and there was a great deal of Twitter chat on the subject and I hope Jane Cummings, the Chief Nurse in England would have been pleased to see this. She of course is the 6 Cs champion and a regular user of Twitter.

Social media use was much in evidence throughout the conference, and there was as much discussion on-line (Twitterchat) as there was person to person conversations. One of the best presentations was on the development of a app called SmartCare – completely service user designed and developed. It had 3 components, a dictionary of knowledge and hope, self-assessment (being able to use standardised tests that service user could access to assess their own state of well-being); and a prompts and reminders section for medication, appointments and so on.  

I was twitter alerted to a paper published in the British Medical Journal last week by the organisational psychologist Michael West from Lancaster University. His team had published their findings from a major project undertaken into the quality and safety in the NHS. Their paper appears to support was I was saying in my paper at the conference that compassionate nurses need to experience a compassionate organisation. Michael West noted that the NHS needed to move away from the tick box approach to quality assurance and towards a values based organisational culture that demonstrates compassion and patient centeredness. These are organisations which have cultures of positivity, self-belief and compassion rather than being characterised by fear, anxiety, hierarchy and defensiveness.

Tomatoes and Toadstools, not a new addition to the vegetarian menu, but my conference pack contained 5 bright red cherry tomatoes in a little bag, brilliantly different, as were the grass verges by the side of the road, these were strewn with the most wonderful looking fairy-tale toadstools and mushrooms. And if we really are going to break through the barriers to deliver more compassionate mental health care then we are going to have to dare to be different ourselves! 

The Last Night, Bug Bearing Nails, and Goodbyes in Budapest

It was a great 'Last Night' at the Proms this year. Marin Alsop, who was the first female conductor for a Last Night performance, took control yesterday evening, and she was superb, brilliantly humorous and kept the whole audience enthralled throughout. And then just when you thought it couldn't get any better, along came Nigel - Nigel Kennedy, playing as only he can, and for the first time also at the Last Night. Such passion and feeling, it was an absolutely fantastic end to the week, and the prom season as a whole!

Last week had a rather slow start. On Monday I learnt that the Royal College of Nursing found the findings from the latest research from Cardiff University and London’s City University ‘worrying’. The research was reported in a paper published in the American Journal of Infection Control which suggested that infection control was being put at risk by fashion conscious nurses wearing nail extensions. RCNs Tom Sandford, (I am not sure he has ever worn nail extensions), helpfully advises that finger nails should be short and free of nail varnish and absolutely that false nails should not be worn as they harbour bacteria.

Wednesday evening I flew to Budapest and joined my colleagues from the EmpNURS Project. This is a project aimed at empowering the professionalization of nurses through mentorship. The 3 year project was funded by the European Union Lifelong Learning Programme. The project involved 11 partner organisations from the Czech Republic, Finland, Hungary, Lithuania, Romania, the Netherlands and the United Kingdom. It was the last workshop and also a chance to present some of the many outcomes of the project. The tangible outcomes, in the form of a series of training programmes, can be freely accessed at www.empnurs.eu  

The workshop day was a hectic one, jam packed with presentations on different aspects of the work, and an opportunity to reflect on the contributions people had made, the challenges overcome, and the work still to be undertaken. Despite a very full programme, we were still able to visit a local health care service provision. These visits have been an integral element in helping us all better understand the cultural difference and similarities across the partnership.

This visit was to the National Institute for Medical Rehabilitation. It was an absolutely stunning facility, ultra-modern, light, quiet, and bright and the whole place had an atmosphere of calm and confident professionalism. The reasons people were there were not good, and often the consequence of some catastrophic event or illness in their lives. However, the institute provided hope, skilled intervention and above all hugely compassionate care. It was a privilege to be able to glimpse inside this world.

Dinner that night was announced to be a river cruise on the River Danube. Now I am not that keen on water, and I have to confess that memories of the Marchioness disaster passed through my mind. This was a river boat on the River Thames that in 1989, was hit by another boat and sank, killing 51 of the 131 people having evening dinner on board. Thankfully, despite the River Danube being some 1785 miles long and passing through 4 Central European capitals, our boat was firmly moored to the river bank and did not move at all.

Friday we found ourselves in the Great Hall of the Hungarian Ministry of Human Resources for the Projects Closing Seminar. It was a celebratory event attended by students, qualified nurses, policy makers, and nurse educationalists from around Europe. I was fortunate enough to be asked to present my work on empowerment and professionalism, which at a personal level was extremely rewarding. It closed a circle of discussion that had started 4 years ago in a much more modest building in Budapest as the embryonic EmpNURS project team hammered out the application, and the projects aims and objectives.

It was brilliant working with such a great team over the last 3 years. So a great big thank you to: Erna, Olga, Karen, Ileana, Eva, Andrea (short), Andrea (tall), Mariann, Heini, Nicole, Ildiko, Zdenka, Camelia, Grazwida, and of course my long standing friend, good lad and old rock and roll star, Mikko. I hope it’s not the last goodbye and we soon find the next big idea to work on.

Sadly, I learnt while in Budapest that another of my friends, from Central Europe, Alzbeta Hanzlikova, from Martin in Slovakia, had died after a brief illness. She had invited my former boss David Skidmore and I to what was then a fledgling conference on nurse theory, research and education in 1996. I loved that first experience, and Alzbeta along with her wonderful husband, Vladimir, David and I shared many positive, productive and often humorous experiences together over the years. The conference wasn't held in Martin this year, and so I last saw Alzbeta at the 2011 conference. While we never went on a boat together, we did once watch black bears come and eat the plums from her back garden, to my mind a somewhat safer experience! 

Broken Toes and Nigerian Flu, But it’s not yet So Long Marianne!

I didn't know before last week that 10% of all fractures occur to bones in the foot. Last Sunday I accidentally dropped a boulder (well 2 actually) onto my foot causing extensive bruising, pain, and an inability to walk very far. By last Tuesday the pain and swelling was severe, but according to my colleagues in the School of Health Sciences, who are experts on all things related to the foot, there was nothing broken and nothing needed to be done.  As the week wore on, the swelling and discolouration has indeed reduced and my mobility increased.

That I chose to consult my colleagues in Health Sciences rather than go to Accident and Emergency Department (A+E) was the result of a couple of factors. Like my colleagues and despite the pain and bruising, I didn't think there was anything broken, but the other factor was my perception of the time it takes to be seen these days at your local A+E services. The thought of waiting for hours to be told something I probably already knew, was not motivation enough to attend the emergency department.

My local A+E department is at the Royal Bolton Hospital. This is a NHS Foundation Trust, which it’s fair to say has experienced a number of problems over the past few years, but now appears to be well on the road to recovery. In April 2012 the hospital was seen to be in ‘significant breach’ for failing to meet the 4 hour A+E waiting time. Every foundation Trust in England must meet a target where 95% of patients who go to A+E are assessed and either admitted, discharged or transferred within 4 hours. Last year Bolton only achieved 93%.

This year they were able to celebrate achieving 96.5%, beating the national target by 1.6% - and that was after seeing a 4.8% increase in attendance, some 115,920 patients in the year. This works out to be some 317 patients a day making Bolton the second busiest A+E department in Greater Manchester. The average time each patient spent in the department was 126 minutes, which is remarkable, and colleagues working in the hospital are to be congratulated on this turn around.

The Trust put in place a number of changes to bring about this achievement. There have been more medical staff available at the weekends, establishing a nurse led team to ‘see and treat’ minor injuries and illnesses, and improving community services in an attempt to reduce unnecessary visits to A+E by those who might be better seen at their local GP practice. All of which would have been music to the ears of Prime Minster David Cameron, who earlier in August visited Salford Royal Hospital, NHS Foundation Trust to announce £500m of additional funding over the next 2 years for A+E departments.

Possibly just as importantly, there is a separate £3.8bn fund that will be spent on treating more people in the community, rather than in hospitals and working towards there being 24 hour, 7 days a week social work care available to people. Such developments in the future delivery of health and social care services will need us to review and adapt our educational programmes so as to ensure we most effectively prepare the practitioners of the future.

As my battered and bruised toes started to recover I was struck down mid-week with Nigerian Flu, which is just as bad as Man Flu. I think I got it on the plane back from Nigeria last weekend (and many thanks for all your comments and emails I received about last weeks posting - I will respond!). Like my toes, there was no point seeking help at my local A+E department. However, my personal physician, Dr Moi prescribed that tried and tested old remedy, 20mls of Lagavulin, to be taken as required. Thankfully, the medication regime is beginning to have the desired affect and I started to feel much better yesterday.

So much so, that I was able to go to see Leonard Cohen at the Manchester Arena (not sure what its called now). He was magnificent. Aged 78 years old, he was able to bring the entire arena audience to their feet with his songs of love, longing, desire, and satisfaction. I was mesmerised and any complaints I might have had of my ailments or illness just faded away in sheer enjoyment of his celebration of life through music. It was a truly wonderful experience.