Finland Bound: [Going] Back to the Future

Yesterday morning I flew into a grey, wet and windy Manchester. I was amazed that it took just 10 minutes, as we came into land to go from sunshine so bright it makes your eyes hurt to the greyness of the wettest day imaginable. Not that my spirits were dampened on this occasion. I had just spent a couple of days with some incredibly creative and welcoming people, and had a visit from my youngest grandchildren to look forward to later on in the day.

The people I had spent the last couple of days with were from Saimaa University of Applied Sciences, located in Lappeenranta, the 13th largest city in Finland. This was not a trip I had planned. My boss was due to go there and arrangements had been in place for some time. However, she was unfortunately taken ill, and on Tuesday it became clear she would not be able to travel. After a conversation with my VC it was decided that I would go in her place and travel out the following day.

However, Wednesday proved to be a long day. I had a great meeting with colleagues from the pre-registration nurse teams. It was an opportunity to re-affirm my personal pledge to regularly experience every aspect of our Schools activity, from being in a classroom, to practice, and all things student focused. There were also some positive and constructive HR meetings aimed at working towards changes in the School. The last meeting of the day was an extraordinary meeting of the University Senate. This meeting provided an opportunity to discuss our new University Strategy.

Then it was a dash to Manchester Airport to take the 18.30 flight to Helsinki. The flight takes only 2 hours, but as Finland is 2 hours in front of the UK it meant I arrived at 22.30, tired and wanting only to climb into bed and sleep. However, it was a single room with a single bed. I can’t remember the last time I slept in a single bed, and it certainly wasn't last Wednesday!

The following morning it was on a train to Lappeenranta. I travelled with 3 colleagues from Saimaa University. They had been at a meeting in Helsinki. The 2 hour journey passed so quickly and the discussions were rich in content, humour and focus. Once in Lappeenranta it was a quick change before taking a tour of the facilities at the Skinnarila Campus. This is a new purpose built campus, just 2 years old and located right at the shore of Lake Saimaa. It was a fantastic setting, and the facilities were first class.

Dinner that night was an opportunity to discuss potential collaborations between our Universities and in particular, inter-disciplinary teaching and research. We ate at the Restaurant Wanha Makasiini, a great venue, perhaps a tad short of vegetarian options on the menu, but with a wine list that more than compensated this. Later, I spent an hour playing catch up with emails and Twitter conversations, many of which involved colleagues from across the University of Salford interested in being part of any future collaborations.

Friday morning was spent meeting a range of practitioners engaged in putting concepts of integrative care into practice. They had been across to Salford Royal Hospitals to find out how they were doing it. I was impressed with the way they were taking forward integrated health and social care services, particularly in the rural and remote areas of Eastern Finland. I was also treated to a whistle-stop tour of the South Karelia Emergency Health Care service – a different scale to many UK services with just 50,000 attendances a year compared to just fewer than 100,000 patients a year in somewhere like Wigan, Wrighington and Leigh NHS Trust.

The reminder of Friday I was engaged with a series of meetings looking at potential research focused links and opportunities for future collaboration. And by late Friday evening I was back in Helsinki reflecting on what had been a very hectic, but rewarding 2 days. I have been visiting Finland for at least the last 15 years, and I have to say this was one of the best visits ever. I am really looking to going back in the future and developing our relationship with colleagues in Saimaa. 

A TV Snip, Sunrise, Sleep, and a Letter to Father Christmas

Last week was an amazing week, or rather a week of amazing experiences and encounters. Some of which I witnessed from afar. For example, watching Dr Doug Stein perform the first vasectomy live on Australian TV to launch the inaugural World Vasectomy Day. This was said to be the world’s first vasectomy-athon with 184 doctors across 25 countries signed up to perform 1000 vasectomies over a 24 hour period.It was organised as part of a global campaign to address population, freedom of choice, family planning and sustainability of the planet.

Other experiences were a multi-sensory delight. There was the Birthday Cakes in the shape of ice cream cornets baked by a friend for Jacks 2nd birthday, delicious to look at and eat. That sun rise on Wednesday. I was stuck on the M62 on my way to Liverpool and a Council of Deans of Health meeting. I was stuck in traffic feeling fairly miserable when the sky was lit up by the deepest red you had ever seen. Over the next 20 minutes the sky line was transformed into a glorious riot of reds, oranges, and yellows. I tried taking a photo but failed completely to capture the experience.  

Possibly I was feeling a little miserable on that morning, because I had enjoyed sufficient sleep to be completely brain washed. Nancy Schimelpfening (what a delightful name) reported in last Tuesdays Las Vegas Guardian, (to my mind a more interesting paper than the British version) on the paper published in the journal Science on the work of Dr Maiken Nedergaad. He, is the co-Director of the Centre for Translational Neuromedicine, in the US. His study looked at the glymphatic system in the brain which he has discovered, cleanses the brain of toxic molecules while we sleep. The results of the study could have implications for the treatment and prevention of several neurological disorders including some of the dementias.

However, I was probably feeling miserable because I was sitting in my car travelling at a snail’s pace rather than at the speed of light, and such inactivity doesn't suit me. Actually inactivity of any sort is not a good thing for us. Physical inactivity has shown to be the principle cause of a number of health conditions including 13% of Type 2 diabetes, 18% of colon cancer and 17% of breast cancers. Doing something as simple as taking a daily walk could prevent 36,815 people dying prematurely from such diseases. Life changing steps to be taken indeed.

Not taking enough exercise, could be one reason why like me, some people have difficulty getting enough sleep. Other reasons might also include drinking too much alcohol (not one that applies to me), disrupted circadian rhythms, stress and of course, an uncomfortable bed. The most comfortable bed I've ever had was a water bed. As these were all the rage in the late 1960s and early 70’s younger reader may not know what these were. Essentially the bed was one giant mattress filled with heated water that fitted into a wooden frame.

I think they went out of fashion very quickly, but now I have found the modem day version of the ubiquitous water bed. It’s called the Exbury Egg (look here) Exbury Egg, and I so want one for Christmas. There are only 65 days left until Christmas Day. So yesterday I got out pen and paper and wrote my letter to Father Christmas. I told him I had been good all year, and after all, I did stop contributing to the gene pool some 30 odd years ago. 

An Alphabetti type Week spent in almost Parallel Universes

My Outlook Calendar regularly becomes littered with acronyms and abbreviations describing what it is I am to do. For example, the week started with an OMG (Operational Management Group) meeting with the Schools Directors, quickly followed by a EMB (Executive Management Board) strategic planning day. Late afternoon it was agreeing the CRaIC College Research and Innovation agenda, and that was Monday. Tuesday, it was a day of back to back meetings, including  preparing for a FfPP (Fitness for Professional Practice) Appeal and a FfPP Panel hearing to be heard later in the week.

Wednesday I had to make my apologies to the GMW (Greater Manchester West NHS Mental Health Trust) Members meeting as the HCPC (Health and Care Professional Council) and TCSW (The College of Social Work) were starting the first of a 2 day approval visit for what was to be the third SU3 (Step Up – Social Work 3) programme. By Thursday we learnt we were going to be recommended for approval by the HCPC and endorsed by TCSW and we were going to do so on the back of such good feedback from students on their experience, and employers because of the high quality newly qualified Social Workers they were able to employ.

Friday and we had the HENW (Health Education North West) ARM (Annual Review Meeting). The ARM is an occasion to see if the School had met the quality assurance targets set by the HENW for our NHS (National Health Service) commissions - and we had! Again it was wonderful to see and hear the reports from our students who found their lecturers inspirational, motivating, and supportive.

So things were going well. And then I came across the news from the former NHS CMO (Chief Medical Officer - Sir Liam Donaldson) that doctors over the age of 55 are 6 times more likely to give rise to major performance concerns. In fact 6179 doctors had caused concern over the last 10 years according to Donaldson. Male doctors were twice as likely as female doctors, particularly those working obstetrics, gynaecology, and psychiatry, to be referred to the NCAS (National Clinical Assessment Service).

Now I was totally confused. I thought the report was about the recently formed NCA (National Crime Agency) - the British equivalent of the FBI (Federal Bureau of Investigation). I wondered what on earth they were doing getting involved with the performance of doctors? Well I guess that one explanation might be that as far back as 2000, Dr Richard Smith, the then Editor of the BMJ (British Medical Journal) reported that up to 30,000 people a year in Britain die of medical errors with many more people being injured and suffer other consequences.

The president of the GMC (General Medical Council) at the time, Sir Donald Irvine said it was a complete fallacy to think that doctors should be expected never to make mistakes – and that as medicine is a judgement based discipline, it is inevitable that mistakes will happen. Of course, on this occasion the mistake I made was confusing the NCAS with the NCA (and what is an S between friends?) – however it’s possible to see how such tiny differences in understanding, perception or experience, can lead to at best confusion, and at worse, utter destructiveness.

Last week, in a parallel universe that is my world as Head of School, I experienced a little of this. It wasn't a good place to be. However, taking a step back, I was reminded of my long term desire to show unconditional regard to others by recalling the words of one of my all-time favourite poets T S Eliot – in his book the Cocktail Party, he noted that: ‘half the harm that is done in this world is due to people who want to feel important. They don’t mean to do harm; but the harm does not interest them. Or they do not see it, or they justify it because that are absorbed in the endless struggle to think well of themselves’.  Today, thankfully, marks the start of a new week. And a big thank you to all of you who chose to read my Empathy blog - you have truly helped spread the word in such a magnificent way.

Gareth the Tree Man, Leadership and Not Seeing the Noise

The gardens at the house in Horwich contain a great number of trees, many of which are fairly mature. They look lovely but require a great deal of work in looking after them, and that’s before the leaves fall and need to be swept up and composted. These days I have been banned from climbing trees with chain saw in hand, so every year Gareth the Tree Man comes and gives a number of them a good trim and sorting out. 2 weeks ago he came and worked on the trees in the back gardens.

2 year old Jack, who is fascinated by all things agricultural, botanical and mechanical, insisted on going outside and watching Gareth do the business. He ended the day with 2 new words learnt (‘Gareth’ and ‘trees’) and a new found love for chainsaws and ladders. Last Friday, Gareth returned and started to work in one of my neighbours gardens. Little Jack heard the chainsaw noise, and immediately wanted to go and see Gareth again.

Coat on he kept going to the back door only to be told Gareth wasn't there. Pointing at the door and repeating ‘Gareth’ and ‘tree’ he became increasingly upset. Aged 2, he really didn't understand why it was he could hear the noise but not see what was causing it (Gareth) - because he was looking in the wrong place. Finally he agreed to go the front door as the garden Gareth was working on was in front of the house. As soon as Jack realised where Gareth was, he was back outside and once again in ‘ladder and chainsaw heaven’.

Jacks upset resulted from a simple 2 year old little boy misunderstanding or mis-perception of events, which was both amusing and easily resolved. In an organisational context, sometimes misunderstandings and mis-perceptions of events are not so amusing or so easily resolved. Avoiding such situations and/or dealing with the consequences require effective transcendental leadership, particularly from an organisations senior leadership group. Where such leadership is absent, the result can be catastrophic in terms of developing and maintaining a motivated and committed workforce.

I was reminded of this during the week when I took part in the @WeNurse Twitter chat last Thursday. @WeNurses is a weekly Twitter chat mainly aimed at nurses (but all are welcome) and takes place every Thursday at 20.00 on Twitter using #WeNurses. Last Thursday the focus was on leadership and the chat trended 6^th in the UK with 1500 tweets from over 200 participants. A summary of the chat can be found at http://t.co/4k7Nw3qT9c

The conversation was fast, wide ranging, informed and informative. The fact that it could be shared with so many was truly amazing. I believe that such opportunities can lead to a greater understanding of what makes for an effective leader. And I think there is an important lesson here for anyone in a leadership position. For me, it's critical that before making a judgement about a situation  or a person, their performance or contribution we should ensure we have heard as many sides of the story as possible. If we don't we will end up like Jack,seeing (rather than hearing) the noise as only coming from one direction and that doesn't make for an effective leadership.