No Smoking Guns at the NET/NEP Conference, but plenty to inform the Shape of Nursing Care

I see the British Medical Association last week declared that anyone born after 2000 should be banned from smoking. Hmm, I wish them well with that one - just how they think this might be enforced will be interesting to hear. It’s not that I disagree with the intention behind the suggestion; it’s just not a very practical idea to implement. The UK Government already advises drivers not to smoke in their car while driving, and yet a driver smoking is a common sight. As are drivers using their mobile phone- and it’s been against the law to use a mobile phone while driving since 2002.

Research has shown that using a mobile phone while driving is equally as dangerous as drink driving – albeit for slightly different reasons – while the evidence reveals you’re 4 times more likely to crash, a staggering 68% of the population who use their mobile phone while driving do so because they believe they won’t get caught. Sadly, the BMA proposed smoking ban for anyone born after 2000 seems just as unenforceable.

What is enforceable is the hunting of ducks in Holland. 0.2% of the Dutch population are into hunting – and if any readers of this blog object to hunting, please contact Koninklijke Nederlanse Jagers Vereniging who have responsibility for the control and management of wildlife and as such, hunting, and not to me. Why am I mentioning this? Well last week I was at the Nurse Education Today  / Nurse Education in Practice conference which was held in Noordwijkerhout, which I thought was a quiet suburb of Amsterdam. How wrong could I have been!

At 04.00 every morning the local duck population started what was non-stop quacking. This penetrating sound was inescapable as I had to sleep with the bedroom windows wide open due to their being no air conditioning. The ducks quacking started off the seagulls screeching and for 2 hours it was impossible to get away from the noise. Unfortunately for me and fortunately for the ducks and seagulls, as I travel light, I hadn't taken my Holland & Holland to Holland.

Ducks and seagulls aside, the venue was wonderful, there were many familiar faces, and many more new contributors. The conference was a great success. There were over 400 delegates attending the conference, hailing from 44 different countries. I was presenting 2 papers there. One paper was with 2 of my award winning colleagues Wendy Sinclair and Moira McLoughlin. They created great interest with their presentation of the work they are leading on in using social media in nurse education.

As I said in last week’s post, I was also there to present a paper with my colleague and friend Karen Holland on our work with colleagues from 7 different EU countries. However, 4 other colleagues, Angela Darvill, Elaine Ball, Martin Johnson, and Patric Devitt, also each presented a paper on their work on enhancing nurse education.

Having this opportunity to present the work we are doing in the School across our programmes, but in particular the nursing programmes is important, not least because there is yet another review of nurse education in England. The Shape of Caring Review, commissioned by Health Education England, and chaired by the brilliant and enigmatic Lord Willis of Knaresborough. What is likely to make this review different however, is that the focus is going to be on the learning that goes on in clinical practice placements, and just importantly, the continuing education needs of qualified nurses. Our papers showed just what is possible in both these areas.

Long Days, University Day, Tommy on Tour Day, a Double Dutch Day and those Woolly WMD

Yesterday was the longest day of the year, or as it is sometimes referred to – the Summer Solstice. The day marks the start of summer in the Northern Hemisphere, and the start of winter in the Southern Hemisphere. It was celebrated here in the UK in many different ways, the most famous of these possibly being the gathering at Stonehenge where people celebrate the suns rising (yesterday it was at 04.43). There were precisely 17:01:10 hours of daylight yesterday. Seeing and being part of this annual spectacle is definitely one of the things on my 'bucket list'.

There were lots of other things to celebrate last week. My Social Work colleague Gabi Hesk won the inaugural Harold Riley Award for Community Engagement at our first University Day celebrations. Gabi’s work with refugee communities is inspiring and it was fabulous to see her leadership of a committed team justifiably acknowledged and rewarded.

Likewise 3 of my Nurse colleagues won the Vice Chancellors Distinguished Teaching Award for their work with Social Media. In a University that leads the way in its use of social media, Moira McLoughlin, Wendy Sinclair and Neil Withnell have shown the rest of the University what is possible. Congratulations to our prize winners, and all those that were short-listed but, who on this occasion, didn't win – all your contributions represent a great deal of creativity and commitment to enhancing our student’s experience.

Wednesday we had Tommy on Tour visit the School. Tommy Whitelaw had looked after his Mother Joan for 5 years. Joan had developed vascular dementia and Tommy became her willing carer. It was our students who campaigned to bring him to the School, and they were able to hear of Tommys continuing work in campaigning for better services for those living with dementia . It was good to see so many of our students making their pledges to making a difference. Tommy lives in my adopted country of Scotland, but if you want to see what is going on more locally look here.

Thursday I was at the University of Nottingham for a PhD viva. This experience was equally worth celebrating. The student's study was on the 'presentation of self' in graduate entry student nurses. She got through with flying colours, and it was a very enjoyable and very conversational viva examination. The student's study connected me with my colleague and friend Karen Holland whose work from 1999 was used as part the student’s context setting.

Today, I will be getting on a plane to meet with Karen Holland, coincidently in  Holland. I will be there for the Nurse Education Today, Nurse Education in Practice conference.This is the No 1 international nurse education conference to go too. I will be presenting a paper with Karen about our work around 'empowering nurses', and also a separate paper with Moira and Wendy on our work on 'relevant chatter' in social media. I'm very much looking forward to catching up with folks again.

What made me smile last week– well it has to be the story on Farming Today about the Black Faced Woolly Weapons of Mass Destruction (WMD). This was the story of an experiment in Scotland of using sheep to clear ground of the invasive and deadly Hearacleum mantegazzianum (Giant Hogweed to  you and I).The sap of this plant causes phytophotdermatitis in people, resulting in painful blisters, and if it comes into contact with eyes, blindness. It has been recently discovered that the Black Face sheep can eat it with relish clearing acres of ground with complete impunity, and the hogweed doesn't grow back. Mother nature in balance - wonderful!

Open to new ideas, Containing and Holding, and Celebrating Eileen’s work with Joy and Hugh

Last weekend’s Open Garden event was a huge success! The weather was fantastic, and 180 people walked through the gate (all having paid a £4 entrance fee). The House in Scotland’s Garden was the one to see, the one people described as the most interesting and creative, the one that gave folks the most ideas for their own gardens, and yes most people had a smile or two at what they saw and so I wasn't disappointed.

I took an extra day’s annual leave on the Monday, and as a consequence the remainder of last week was ‘back to back busy-i-ness’. There were, however, some high spots. Wednesday I was in London at the Institute of Psychiatry, who were hosting the 2014 Eileen Skellern Memorial Lecture and Lifetime Achievement Award. The former was presented by Professor Joy Duxbury (University of Central Lancashire), and the later was presented to Professor Hugh McKenna (Ulster University).

Eileen Skellern made a significant contribution to the development of contemporary mental health nursing. She planned the first international psychiatric nursing conference way back in 1980. Following her death there has been a annual memorial lecture to celebrate the work of others in mental health nursing – and this year Joy presented her work on the need to reduce oppression and violence in mental health services. It was a brilliant and passionate presentation, using music and poignant case studies to reveal the sometimes (all too often) dreadful consequences of the use of restraint in today's services.

Her presentation made me think of the work of Bion and Winnicott. Regular readers of this blog will know that I have long drawn on Bions concept of ‘containment’ and Winnicott's concept of ‘holding’ – both these concepts have had a profound influence on the development of the field of modern day psychoanalysis. Up to now I have perhaps thought of and used these concepts as being somewhat interchangeable – but Joys presentation made me think differently.

As did a conversation I had on Friday when I was discussing the presentation with a non-mental health nursing colleague and I was asked to provide an explanation of the concept of containment – which I didn't do well as my colleague perceived ‘containment’ as perhaps being restrictive in a oppressive sense. I got to thinking that ‘holding’ might be a more positive concept- although where this is transposed to the physical holding of others such as in the examples of restraint Joy talked about its likely to be anything but positive.

What was positive was Hugh’s address. Hugh and I share a similar time line in terms of becoming a mental health nurse, educationalist and researcher. He was possibly 6 to 7 years in front of me. His passionate acceptance speech reminded us all of the importance of science and humanity, of reaching out, and of embracing the emotionality of practice, and being there for others. It was a speech of inspiration and of celebration.

And following the Eileen Skellern awards we did celebrate in a small pub with a live jazz band that was just around the corner from Kings College Hospital. I have never been to Kings before, it looked an impressive hospital. It’s been around for over 170 years and over that time its reputation as a world class hospital has been justifiably established. It has prided itself on nurturing a culture of creatively and innovation.

Creativity, enterprise and innovation is something I feel passionately about encouraging in our School. I think it is the way we need to be in taking our ambitions forward. So it was great to be invited to see the work of some of our students on Friday. They had been asked to use art to capture and present their academic thinking and experiences. The pictures they produced were insightful representations of their experience and the experiences of those they cared for. Seeing and sharing their enthusiasm was as good as wining an award any day. 

The Open Gardens: time to grow less cynical amongst the flowers

Today is the Village Open Garden event. Every year people living in the village are asked to open their gardens to the public in order to raise money for charity. I thought this would be great fun and started planning 15 months ago when I bought the house. However, for the last 15 years I've tended a large, traditional and rambling garden, with many mature trees, streams that run through the garden and cascade over waterfalls, 6 lawns, herbaceous borders a plenty and free range chickens. So the 50 shades of a grey gravel strewn tiny space that was the garden here at the House in Scotland was a bit of challenge.

The resultant garden is a space of stories and hope. It is a garden full of surreal objects as well as plants and trees. The plants in the gardens are partly relocated plants from the Manchester garden and plants bought from surrounding areas here in Scotland. It’s becoming a garden to be at peace in, to relax, but also to spark curiosity. It is not, however, a garden for cynics.

Cynicism has been linked to increased risk of dementia in older people a new Finnish study published last week suggests. Cynical distrust was measured by questionnaires used to test an individual’s tendency to believe that others are mainly motivated by selfish concerns. Such research in the past has shown the link between cynicism and increased risk of heart disease. These new findings suggest that cynicism, along with smoking, high cholesterol and cardiovascular disease could be linked to predisposition to dementia.

The 8 year study involved participants with an average age of 71. Now between 2010 and 2018 an extra 2 million people in the UK will have become 65. 2 years after that the baby boomers generation will also begin retiring. I am a member of the Baby Boomer Cohort Number 1 (those born between 1946 – 1955). During my early life the world saw men walking on the moon for the first time, there was social experimentation, sexual experimentation and often drug experimentation. There was the music of the Beatles, Rolling Stones, Pink Floyd, Jimi Hendrix and the sharing of Glastonbury and Woodstock. We are said to be a group characterised by being experimental, individualistic, free spirited and social cause oriented.  

As this group grow older where they live and how they live is becoming increasingly important. The International Longevity Centre-UK and Age-UK have just published report Making our Communities Ready for Ageing which focuses on 3 themes: being at home, getting out and about; and ensuring communities offer what older people want. The report is full of practical and creative ideas for improving the physical environment, improving transportation, and ensuring better access to community groups. 

However the bit I liked best was: 'if communities are to work for today’s and tomorrow's older population, planners must focus on how we ensure and deliver much more than the basics. There is not enough emphasis on fun and playfulness for older people'. Whatever people think of the new Garden in Scotland today, I will be disappointed if walking around it doesn't make people smile – and a smile is a sure sign of people having fun, whatever their age!

Simon Stevens and Steven Smith: Small and Smart is Beautiful

Last Bank Holiday weekend was Spring Fling, and as a treat I took an extra day off in order to make the most of the open artists' studios, and some complete down time. Down time for me means not turning the computer on to look at emails, and apart from writing last week's blog, that is precisely what I did. No email, no Twitter, no texts. At 04.30 on Wednesday morning I sat outside in the garden at the House in Scotland and felt much better for having enjoyed 5 days communication free days.

Sitting in the car park at the Wigan Royal Albert Edward Infirmary 3 hours later looking at the 100s of emails that had come in during that time, some of that good feeling disappeared. But I was there for this months Trust Board, and as always this proved to be a productive and effective meeting, made so by the quality of the papers considered, the timed chairmanship (something I am adopting with our School Executive meetings) and the amount of positive improvements reported upon across the work of the Trust.

The Wrightington, Wigan and Leigh NHS Trust is exactly the kind of hospital the NHS Chief Executive, Simon Stevens, declared we needed more of – that is hospitals that treat more patients in the local communities. Although it was reported in many newspapers that what was required was more Cottage Hospitals, I don’t think this is what Simon Stevens was describing. Many hospitals in the UK are no longer able to provide effective local services because to many specialist services have been stripped out and centralised.

Indeed this is the underpinning rationale for the so called ‘Healthier Together’ programmes which in Greaert Manchester seeks to provide more effective services to the Greater Manchester population by creating a small number of specialist hospitals (mainly the teaching hospitals) that will provide services for all of Greater Manchester’s population. Greater Manchester’s population stands at just under 3 million, Wigan on the other hand just over 300,000

The risk of greater centralisation is that the remaining hospitals lose so many services that they cease to be financially viable as local healthcare providers – and that’s before any developments in integrated health and social care services are considered. As the proportion of older people in the population grows, such services will increasingly become important. Of course centralising some services has proved to be very successful, stroke services for example, but local communities by and large need local health care services.

Another story last week that caught my eye, and ironically reported in the Telegraph newspaper was the story reporting on what Steven Smith (Vice Chancellor at Exeter University) described as a change in expectations of how students wanted to be communicated. Using emails to communicate was no longer seen to be effective – many if not most students don’t read or access their emails sites, preferring instead some form of social media. Today it is Twitter, tomorrow who knows. What I do know is that thanks to some very enthusiastic and skilled colleagues in our School, we are the leading exponent of social media as a tool for communication, teaching and improving the student’s experiences at the University.

Younger readers of this blog may not see the irony in the Telegraph reporting this story. The electrical telegraph system (with its Morse code, telegrams, ticker tape machines) was, in its day a revolutionary method for people to communicate. It was also like an early version of the internet. Telegraphy was constructed around message routing, social networking services, instant messaging, text coding and abbreviated ‘slang’ language usage. Of course today's social media is much more accessible and affordable –just like our health and social care services should be now and in the future.