I have been teaching on a leadership course this week, plus I have worked on another programme which prepares NHS staff for working at executive level. The thing about these courses is that while you observe the actions and behaviours of others you learn so much about your self. It is really easy to get caught up in the rat race of work, wherever it is and, head down not to notice the things that are important in life, or how the things you might do or say affect others.

Like pretty much everyone in this country I am pretty disturbed about the whole MP expenses scandal. I am not entirely surprised by the idea that people who can claim for expenses associated with having to say live in two different places, do a demanding job, employ staff or entertain people, might actually stretch things a bit. What I am surprised about is some of the things you can claim for and what is more, that there seem to have been no proper checks on the way this is done.

Claiming travel and other expenses as I do often finds me not quite being able to remember what I spent, when I travelled or parked (sometimes the receipt gets lost) and I would imagine that over the years the NHS has done better out of me than I have out of it. We are of course however talking of much smaller amounts of work, plus my moral values tell me that in the grand sceme of things a £3.00 car parking bill is not worth losing sleep over. What about claiming mortgage payments back as an expense and then suddenly remembering you have paid that mortgage off and you have just been supplementing your income? I am not sure I can trust this kind of person, I am not sure he has the personal value set appropriate for public office and what is more it is down right dishonest.

People working in the NHS have at times lost their jobs for misclaiming their travel and unsocial hour working expenses, quite rightly so. What though do you do with people like this, and how does the system of politics rebuild the trust of people like me.

My son has just turned 18. In a couple of weeks he can vote for the very first time. These elections are pretty small fry, though I would say important for local and european elections. Not surprisingly he is taking some notice in the whole scandal. His response right now is that the main parties are not for him right now and for the moment he might choose Green. I would say this is fine, but what if he leant more towards a right wing approach and chose instead BNP? Where on earth might that lead us?

I am pretty sure that if I entered a competition, to name a new form of pandemic flu, first prize a trip to Mexico my answer wouldn’t be ‘Swine’. But I guess that I  might not have forseen the involvement of the pig, so what do I know? The media here are loving this. Yes they would deny it, but if you can put on your front page that 750,000 people are likely to die, why be realistic? I travelled today on a train to London, no one wore facemasks, but then no one sneezed. I spent several minutes myself (currently suffering from hay fever) wanting to sneeze, but fearing panic dared not. Even if I had a tissue handy I had no where to wash my hands or dispose of my tissue and what is for sure I don’ t want to be thrown off a speeding train.

I am not trying to make light of this whole thing, since people have died and it is pretty worrying to those directly involved. However, I think the hysteria misleads and detracts from the seriousness of the situation. Plus please don’t let my reintroduction to clinical nursing be at the sharp end of a surgical mask dishing out antivirals!!!

The picure above particularly fits as my day in london was about a commissioning strategy for breastfeeding. Did you know that breast fed babies are more likely to be healthy and less likely to be obese? No? Well thats cos it is less interesting than a flu from Mexico caused by pigs and called Swine!!

We have emerged from winter, it is officially spring and it is also, since last weekend, British Summer Time (which reminds me that I need to reset my blog’s clock)! I seem to have lapsed in many ways during the winter, I have allowed myself to put on weight, and must sort myself out if my new summer clothes are not too small before I even buy them (and no I won’t be buying any kind of bigger size). I have become lazy when it comes to my blog, and haven’t really written anything particualrly interesting about my own life, or the job I do for ages. 3 or 4 posts written over the course of that time have pushed my traffic up massively, but I am not sure anyone would return to read my blog until I buck myself up. I also need to get myself doing more things outside of work, with a son hopefully going to university in the autumn I surely need to get  myself something more interesting to do than sitting on the sofa reading a book or watching TV. I need to get out more, I need to explore the environment more and I need to get more active. I also still wonder if I shouldn’t be looking for a new job, and indeed have one eye on the jobs market. Work though is really busy, commissioning has become quite a lot more interesting because actually we now have to do more in the way of managing performance and in turn we are being performance managed much more by the Strategic Health Authority. Maternity is an interesting area to be working with, since it is pretty high profile, there are targets to meet and those who use the service are not backwards in coming forwards if they are dissatisfied with what is on offer.

I know I’ve said it before, but this time I mean it; During April I am going to post daily. I am going to talk about my struggle with food, because I do struggle not to eat things I shouldn’t. I am going to talk about wine, because I think I like the taste of it too much and sometimes use it as either a reward for things going well or as some kind of treat when things have gone less well. I am going to try and talk about work, though as I have said before this is less easy when you are the only person doing a job in the whole county. But I am going to try. I also have somethings to say about how it feels to be a middle aged mother whose only child is going to leave home this year and who is going to need to learn about being a wife in a home with no children again. So here goes, this is April 1, you are no fool and neither am I!

Time for a bit of a makeover; this is called girl in green or something like that. I’ll try it out for a few days, but don’t be surprised if I decide to try a few new looks! Its a girls perogative to try out everything in the wardrobe before she goes out on the town!!

I expect I will need to read the entire report that the media have taken small elements from today. That abortion clinics will be allowed to advertise on TV and that Adverts for condoms can be shown more widely and earlier than they can now. Our young people are really not all that well educated about sex and while generally most of them don’t have sex before they are 16, a fair number do and when they do it is often fueled by alcohol. Education in school seems to be no better than I received 30 years ago. It is generally about the biological act of sex rather than being about relationships, about love and about how to have those relationships without sex.

Girls and boys need to be able to form relationships of all types with each other and with their families and teachers. They need to know how to trust, and to understand the issues of real life in the 21st century. They need to know that they can get the best possible education, they need to be able to aspire for the best possible exam results, job and life in general. They need to know that we adults will do the best for them, and that we won’t cause them harm.

Teenage pregnancy and the kind of sexual behaviour associated with it is often concentrated in particular town and parts there of. It is associated with poverty, with poor attainment and attendance at school. These are the same children who are hanging around the streets, maybe getting drunk, they may have families who are complex and who themselves are not in work. Teenagers who become pregnant are often the product of a parent who became pregnant themselves before the age of 20.

By all means advertise condoms and where to go if you become pregnant. But lets actually do more to educate our young people, to love and to nurture them, to care for them and to teach them about relationships not just about sex.

Here in the UK we celebrated Mothers Day yesterday. I am not sure but I think that it is celebrated at a different time elsewhere. I am lucky enough to be a mum and also to have a mum, indeed being a mum has probably been one of the best things about being an adult. I am proud of my son and what he has achieved so far, I am pleased that he is turning into a wonderful young man and I do my best not to embarrass him too much (though of course I am bound to do that from time to time).

When I wrote about Jade Goody yesterday, I hadn’t really reflected on how her  mum might feel, losing her daughter on mothers day. Jade’s children are also of course without a mother. Being young, they have little understanding of what mother’s day is about and sadly will probably not really know it in the way my own son does. Of course, because he has his mum he doesn’t necessarily make it a massive deal – a card and small present is enough for us both. Having him around is also important. For my mum too a lot is placed on having family around you.

My relationship with  my mum is complex, often uneasy. There is a lot unsaid between us. She often irritates me and I probably do the same for her. When I was the same age as my son, 18 and right up to my mid twenties, I often said things that I should have bitten my tongue over. This was because when she irritated me, I would tell her. I would let the irritations run over me, until I opened my mouth and stuff came out! I am older now, and generally I try not to be irritated and if I am I try to keep it hidden. Yesterday I found that a very hard thing to achieve. My mum is in less good health than she was; last year she suffered from some strokes. She is less mobile than she was, she struggles more with some of the tasks of living and she also has some trouble concentrating. She is becoming more insular, but then her and my dad’s lives are smaller than they were. But she is selfish. This isn’t something new but I am beginning to notice it more. Assumptions are made and my hackles are raised, I want to say something, but know it might open up wounds that have been plastered over for too long.

I guess this is real and normal life. I am grateful for the fact that I still have a mum, trouble is that often in life we don’t quite appreciate the fullnes of what we have. Perhaps until it is lost. Therefore, I will just carry on, smile when I hurt inside and try not to allow my irritations to show. Next time that I suggest going out for mothers day dinner, and she says that we might as well come to her as she has some meat in the freezer. Next time I say I’ll bring pudding and help with the vegetables. I’ll check that she understands what I mean by the word help, because arriving and then having to prepare everything myself and then cook it is not what I had in mind. Am I just as selfish as her for being irritated by it?

That is the news rotating around the screen during the News this morning. Another message tells us that her family would like to be left in privacy. A reporter is outside her house which was purchased through her place in the media circus she lived and died within. so far they have shown a couple of black cars with darkened windows leave the house, apparently one of them contained the body. We have seen Jade’s mum, giving a brief statement telling us that Jade died at 3.55am.

I can’t quite decide what to make of all of this and of the wall to wall TV and magazine coverage of the last few weeks. On one hand, this is all indicative of the way in which live is lived these days – apparently as if we are all living in a fly on the wall documentary – on the other I know that Jade has raised the profile of Cervical cancer, of smear testing and of getting your daughter the HPV vaccine which might just prevent this kind of thing in the future.

Jade, as I have said before, joined the  Big Brother reality TV show 7 years ago, she struggled to fit in with both her housemates and the public, but eventually people warmed to her. She was poorly educated which then looked like ignorance, eventually though people recognised a certain child like innocence which people embraced. Over the next few years though she was in turn loved and hated in equal measures, culminating with a return to the celebrity version of Big Brother and allegations of racism.

Back in the Big Brother goldfish bowl, this time in India, Jade was told on live TV that she was suffering from cancer. The rest of her life has been played out in glossy magazines and on Living TV. Personally I have not watched the programme nor have I bought OK magazine, it felt somehow voyeuristic in the unpleasant extreme to do so.

But, and this is a big but. If the life and death of Jade Goody encourages the age limit for cervical screening on the NHS to be lowered to 20 (after all young people have sex at an early age and are more promiscuous than we would like),  and if more people come forward for regular screening then some good will have come out of the whole thing. People joining the big brother treadmill (no doubt the series will start again soon) should take note. Big brother might bring you some fame, perhaps some infamy, but no amount of money will ever buy you good health or a long life.

Please note I am not criticising Jade Goody. I am however questioning the way in which we view celebrity life.

Rose was a great lady. She was a wife, a mother, a grandmother and a great grandmother. Rose died yesterday at the age of 97. Imagine, when she was born in 1911 the twentieth century was but a few years old. Most people still remembered the life of Queen Victoria. London, where she lived was a busy but dirty place. It was not uncommon to die at a young age, people were used to horse drawn transport. Life expectancy was 54 and there were only 100 people alive who were 100 years old. 1911 was a time of suffragettes and for the first time unemployment benefit was paid.

Rose married and had one child, a boy, George born in 1935. That little boy was evacuated to Kent during the war and she worked in an ammunitions factory while her husband fought in Europe. Sadly she was widowed at the age of just 50, waking up one morning to find her husband dead from a heart attack next to her.  Rose contined to be an important part of the life of her son and his family.

By the time I came on the scene Rose had been living alone for almost 20 years. She was someone I saw at Christmas and a couple of times in between. We were too busy being young and having our own son. Some years ago, Rose became unable to look after herself and we began to visit her periodically.

I never really knew Rose properly, by the time we began our more regular visits, any meaningfull conversation with her was unlikely. For myself I had my own grandparents, for my hubby he had another more preferred granny. Once they had died Rose was already past her best, she already lived in a limited world. My mother in law blamed her for keeping her son on her apron strings and not encouraging him to expand his opportunities. In the last few years she remembered little of her life, all of those 90 odd years she knew she had lived.

She remembered us all though till the end. For all the small world within which she existed she recognised us. She observed when I had put on weight and said so. It was lovely that she recognised in the last 18 months that I had become slimmer. She recognised that her great grandson Matt had become tall. At times she confused me with my mother in law (I guess she missed her and had things to say to her), at times she thought Matt was Barry. She called George the boss and in the end he was.

Yesterday George, Barry and I were there until the end. It was a privilege to be there. We can only hope that she knew we were there. It brought back memories of my nursing career at the bedside. I do not know what memories it brought for George but I hope  that ultimately they will be good ones.

RIP Rose 7 Sept 1911 – 15 March 2009

The other day I sat next to a senior midwife who told me that none of her fulltime staff is under 45 years of age. The younger midwives find fulltime work too tiring. Another told me that she was at the conference in her own time, and that midwives who want to attend a function I am organising in a couple of weeks will need to do so on their days off. The midwife establishment and staffing levels just don’t allow for much in the way of release for training, sickness or days off. On Thursday I needed to speak to a local Head of Midwifery, her PA told me that she was on annual leave, she had been into the unit that morning till 11am but had gone home now (it was about 1pm at the time). Nurses who blog on the internet also describe a long hours culture, one where people take no breaks and hardly have time for a glass of water or trip to the toilet in 12 hours. Even within the office environment it is considered more important to meet your deadlines than anything else even if meeting that deadline means staying till 6pm or more likely taking the work home and spending your evenings or weekends doing the work.

I am pretty sure that the individuals working long hours in the NHS do so without particuarly being TOLD to stay behind, to work in their own time, but it becomes an unwritten rule it becomes part of the culture. One where if you don’t work in the same way as those around you then you won’t fit in, maybe the opportunities for promotion won’t occur and maybe that promotion would just involve even greater long hours working. What happens if the responsibilities you have outside of the workplace mean you actually need to leave on time? What happens if you have a medical condition that means missing meals or fluid are detrimental to your health?

Yesterday I visited my husband’s elderly granny in a hospital not far from here. The ward was full of elderly ladies, most of whom looked as if they had high levels of dependency. When we arrived her IV had tissued, the nurses came to her speedily, they took her observations, made adjustements to her care and detected that she was becoming hypothermic and acted accordingly. While this was going on, I saw only one other member of nursing staff on the ward. The care seemed to be good but I have to wonder about the pressure the staff are under on that ward. I came away, as I often do, wondering if I shouldn’t get back into clinical practice and do some shifts on a unit like this. Trouble is, my working week is pretty intense as it is. I have deadlines to meet, I can’t take breaks, though because I am desk (or meeting bound) there are opportunities for food and drink to be consumed. When I get home I am tired and sometimes there is work still to be done. Why on earth would I work extra in those kinds of conditions when I could be at home ironing and cleaning?

If the NHS pretty much functions on goodwill, what then will happen if that goodwill runs out?

Taxi rapist may have attacked more than 100 | UK news | The Guardian.

As this article says, this man, a London Black Cab driver was able to continue his awful crimes undetected, partly because of the way in which the police investigated the crimes reported by often young women. As you will see, the Guardian uses the word rape, other news papers use the term ’sexual assault’ and the BBC on its website and in its news bulletins has called these awful crimes ‘assaults’. Personally I think this is a weak representation of what went on here – the drugging of women who got into his cab thinking he was trustworthy and the awful realisation when they awoke that a sex crime had taken place. The police are conducting an investigation into how this man was able to get away with these crimes for so long, I’d like the BBC to take a look at why they say the women were ‘assaulted’.

I am grateful that my son, just turned 18 is soon to leave school.  We live in an area of our county where the schools while ok are nothing special, we have never been able to pay for education and what is more at 11 he was no high fligher. Now though he is doing well. A combination of good teachers and serious commitment since GCSEs mean that he is in sight of a very good University place. The school though will not be so lucky, it will be the victim of over provision despite the fact its results are better than those near by that will survive. This year, when my son has left, there will be no year 7 intake. I wonder how long before the teachers start to look elsewhere? I wonder before changes in local residents mean that it is decided a mistake has been made?

If your school is not the best then you cannot always command the best teachers, this has definitely been the case in certain subjects at certain times. What then if you could attract out of work professionals during a recession and between now and the new school year in September allow them to become teachers? A Post Graduate Certificate in Education, the basic qualification for teaching following first level degree takes a year, but apparently if you have been made redundant from the city and wish to teach maths or science you might soon complete this in 6 months. Today’s teenagers are wise, they are demanding, they are confrontational and that is only the ones who actually see the point in learning. Can you learn how to manage classrooms and their occupants, even with the knowledge of life in 6 months?

Whats next? Qualified nurses after a year, a doctor after 2?

I have never been more glad that I have an 18 year old son and not an 11 year old. I don’t need my child’s education mucked about with on the whim of government ministers trying to sort out the country’s mess.

This blog post comes from a Labour supporter and the granddaughter of a lifelone Labour supporter from the working class north east of England. Give me strength, I am starting to sound like Doctors Crippen and Jobbing!!

WordPress is pretty good at weeding out the rubbish that hits any blog, indeed improved filtering and detection programmes have meant that the amount of spam appearing here is much reduced. It is in effect pretty dull, though irritating stuff. If I wanted Viagra, a loan or to buy a specific item I am not sure an advert on someone’s blog would point me to where I would buy it. The spam that arrives in emails is also pretty much filtered out, it has also reduced markedly in recent months. I guess some people are persuaded to send thousands of pounds to Nigeria, or to release their banking passwords to complete strangers in an email but they would have to be pretty stupid.

What is really irritating me right now though is the spam hitting a forum website on which I have remained a moderator along with Terri, other wise known as  Mother Jones. This kind of spam involves registering on the forum, and posting large quantities of either highly dull, foreign character (maybe Russian or Greek) or more unpleasantly parts of peoples bodies I don’t want to see on a nursing website. These people are seriously getting on my nerves.

A quick look on Wikipedia told me this:

Most forum spam consists of links to external sites, with the dual goals of increasing search engine visibility in highly competitive areas such as weight loss, pharmaceuticals, gambling, pornography, real estate or loans, and generating more traffic for these commercial websites. Some of these links contain code to track the spambot’s identity if a sale goes through, when the spammer behind the spambot works on commission.

Spam posts may contain anything from a single link, to dozens of links. Text content is minimal, usually innocuous and unrelated to the forum’s topic. Such text is included to prevent the post being caught by automated spam filters that prevent posts which consist solely of external links from being submitted. Full banner advertisements have also been reported.

Alternately, the spam links are posted in the user’s signature, in which case the spambot will never post. The link sits quietly in the signature field, where it is more likely to be harvested by search engine spiders than discovered by forum administrators and moderators.

Recently, a very destructive forum spam attack has been propagated by inserting into comments redirect domains with an automated posting script like Xrumer. These domains redirect a user to pornographic Websites. If a user clicks on the image or attempts to close the Website an ActiveX codec will be downloaded as a Zlob Trojan^[1].

One of the features of Nursing Voices has been the high level of people who register but never post. In the main these are just ordinary people who register but then don’t have anything to contribute. Indeed I once opened a thread asking peoples opinions on why this was the case. But it seems that there may have been a  more sinister reason, and that hidden in the signature line was something which helped to point back to NV. This morning alone I have deleted at least 15 posts and banned the associated culprit. I do wish each individual registered spammer posted 4 or 5 posts rather than 1 to make my life easier.

My irritation, though isn’t just with the Spammers. MJ and I aren’t the owners of this site, we are just people trying to make sure Nurses play fair when they have discussions with each other. In this case the owner of that site appears to have cut us loose and is doing nothing (or nothing effective to help us). We have served notice that we will leave them to it in the very near future.

But, what if we stop moderating and this site mushrooms into one completly full of spam, much of it pronographic and the title of that forum remains Nursing Voices, what then? Well it then shows nursing in a completely different way to the one we want it to be shown. What a mess!

When I entered the world of commissioning I had pretty much no idea what it was all about. Ok, so I am not stupid and what is more, I have been education lead which involved identifying need, looking around for the best kind of educational input, buying it and getting people to do it. Little did I know though that within 2 years I’d be running round like a blue arsed fly in the way that I am now. The most interesting part of the job I’d say is the way in which we have to play the whole good guy / bad guy scenario out with our providers. So in the morning I am working with a bunch of midwives to make sure the particular pathway we are looking at will best meet the needs of the female pregnant population, be affordable, be safe and meet some kind of NICE guideline. In the afternoon I am being hounded by the SHA to submit an action plan from a Trust that is performing badly in some way.

Yesterday I attended a workshop on Teenage Pregnancy which was attended by people from health, the local authority  and the voluntary sector, who provide lots of good interventions to young people either in trying to prevent pregnancy taking place or in helping to pick up the people if it does. I was asked to do a short presentation on commissioning. This I duely did, but the end result was being approached by an endless stream of people with services they wanted more money for, who had a good idea they thought would meet need or who generally thought I could be their friend. What I discovered was that the services we provide are a complete mismash. They are often not properly commissioned or funded. They rely on good will and they often have to be withdrawn because money runs out.

Commissioning for me is opening up more questions than there seem to be answers to. It is enabling me to meet some great people, but I would say beware those who make friends with me, sometimes I have to performance manage you and then you appear not to like me quite so much.

I am trying out the Press This feature on word Press, so here is the link to an article in the Daily Telegraph from a few days ago.

America just doesn’t get this Jade Goody thing :: Tom Leonard.

Well actually I am not sure I get it either. Jade Goody appeared in Big Brother, she was young, from a poor background, she was loud and unfortunately showed herself to be poorly educated. To begin with she struggled for support both inside the house and with the public at large, but gradually people came to like her. She did not win the competition although in terms of earnings since the show in 2002 she has probably earned more money and has certainly covered more square inches of newspaper, news and internet than the rest of the housemates including the winner. Since then Jade has been celebrated and vilified in equal measure, she has had relationships, given birth to 2 children, had a boob job, and in an act that would end most careers appeared with her mother in celebrity big brother and been accused of racism, bigotry and other moral crimes.

When Jade discovered last year that she had cervical cancer she set about managing the concequences of the disease in the public eye. If you had been so inclined you could have followed her treatment on a programme on Living TV while grabbing daily updates on the TV. This has not been without good effects for the wider public, after all the number of people seeking cervical screening has increased dramatically and hopefully it will do no harm to the HPV vaccine for girls (if people can see the links). I admire Jades decision, on learning that the disease was terminal, to marry her boyfriend and sell rights to the wedding to the highest glossy magazine winner. The money will after all go on to help support her young family (you would hope).

Now though I say enough. It is not just death that needs dignity but the process of dying. If you have just weeks to live then you should concentrate your energies on those who are most important to you. Who ever you are there are few certainties in life but you will be born and at some point, hopefully much later you will die. I do not expect to see every moment of that life and death. This would be true if a person were famous because they were great at sport, acting, politics or even if they were a member of some royal family. Jade became famous and perhaps infamous for appearing on a reality show. Reality TV is not real life and people must not be encouraged to think otherwise. We do not actually know people like Jade, and we should not be made to think that we have to be part of her death because somehow she is a part of our lives. I wish Jade a dignified death, I am sorry this has happened to her and to her family, but I don’t want to see any more of this filling my newspaper, TV and the internet. I hope that doesn’t make me feel too hard.

In my last post I told the world about how wonderful I think the weekend break is. This view has not changed since then, however, it would be true to say that a weekend break, followed by a full and busy week working in the NHS is not to be fully recommended. This essentially is because the employer needs its pound of flesh while all of the things you couldn’t do over the weekend (e.g. ironing and food shopping) because you were away finally catch up with you. This week has been eventful, I would like to share my learning with you. As the title of this post tells you, here are some of the things I learnt this week. I am now becoming the queen of the list!

I become irritated if my dear hubby takes a day off following a weekend in Rome while I am forced to pitch up at work.

You can become the subject of a management tug of love. In my absense last week conversations took place which led to people laying claim upon me within their teams. It is currently not quite clear who thinks they are my boss, who thinks they can give me work to do or who loves me most. Still it is better to be wanted by 2 or more people than no one at all.

It is quite possible for your child’s best school report to come in the months before they leave school for university. If only I had known when he was 6 that all would be well in the end, I wouldn’t have worried when the teachers told me he had some kind of problem with writing and understanding written english. I would like to think that the teachers along the way have helped, but to be honest it may be that the most work has come from within.

It is possible to attend a retirement party for an ex colleague and find that other ex colleagues remain in the same place physically and emotionally that they inhabited over two years ago. It is possible to find that the trauma of applying for your job and not getting it could actually be a blessing in disguise.

If you put the word “Facebook” into the title of a blog post you may well receive lots of hits in one day. Equally the name “Gordon Brown” produces plenty of hits. I recommend it.

If there was ever a weekend that I looked forward to this is it. If ever I was weary, I am now.  But actually I wouldn’t change a thing.