I have been out of internet contact for a few days over the Christmas period, while enjoying some time with our family. As usual we have travelled round visiting everyone; infact today is our first day at home since Christmas eve, but that is quite normal for us I have to admit. Teen son wasn’t disappointed by his presents and pretty much received everything he had asked for. There were no family arguments, save mine and hubbies bickering which is nothing unusual and never really quite turns into a fight (well not in public anyway).

Not having spent nearly enough money in the run up to Christmas we have today been to a couple of shops to look around the sale and I have bought a new microwave oven with grill and convection for £149 down from £199. I needed this because the old one had stopped working on microwave setting and was getting to be a slight pain. We have also been looking at new beds for teen son, but as he wasn’t with us we left it for today.

We have had a dusting of snow (just a couple of days too late for that white Christmas experience), and more is predicted for later today; I wonder if I will be able to get into work tomorrow?

I think he failed to take holiday all year on purpose so he could taunt me with it this week. Mind you he has been amazingly busy today, and to prove it has provided me with a list which puts my own day to shame! Mine you of course it may have something to do with the bowling and Curry night he has now gone off on with his mates. I am a little worried that I am a bit scary; well people at work often tell me I have scary tendencies and if he has written a list of activities then I am worse than I thought. Perhaps that needs to be on my new years resolution list behind lose 2 stone in weight (after all the embarrassment of being turned down for health care due to obesity would be too much to bear; not that I am ill).

So back to the list:

• Went to Sainsbury’s (A supermarket also selling petrol, not sure what he bought there)
• Took Matt to Barbers (After nearly 15 years he has taken teen son for a hair cut and paid for it, mind you he waited in the car apparently)
• Put garden chairs away and covered BBQ (The nagging paid off at last!)
• Swept Patio (and I didn’t even ask for that one)
• Took decoration box upstairs (I left it in the hall for 2 weeks and am glad I no longer need to step over it)
• Had lunch (bless, he actually had time for food!)
• Watched darts (obviously no good films on)
• Had a kip (his words not mine, obviously due to boring darts)
• Changed outside light bulb
• Went into town, nightmare parking! (not surprised, it is Christmas week)
• Went into Specsavers about new lenses (he sprayed one of his pairs of glasses with some kind of chemical by accident which has left a film over them. Apparently thinking about the cost)
• Cleaned inside of car ready for a car wash on Thursday (I wonder if I leave him my car on Friday he will do mine?)
• Had a shower and shave (too much information)
• Plucked eyebrows (does he really do this?)
• Washed up (not sure why he didn’t just load dishwasher, but impressive none the less)
• Went to corner shop to buy Matt a calendar (not sure he is old enough for that kind of calendar!)

I am exhausted just typing it up, so I guess he deserves his night out. Me, well lets just say I am doing this to avoid a big pile of ironing!

For the picture, I did a google search on: Making a list and checking it twice, and this is what I chose:

You Are Socks!

Cozy and warm… but easily lost.You make a good puppet.

What Crappy Christmas Gift Are You?

Who is Jive Bunny I hear you cry, well he or perhaps they produced a number of cover songs in a kind of mixed together way a few years ago. Hubby thought that it would get us into the Christmas spirit (if that is needed) by buying Jive Bunny and the Master Mixers Ultimate Christmas Party from Amazon, or it might have been Virgin; online anyway. It arrived today and combined with a glass of sherry (sad I know) has sent me into a slightly manic mood.

Well I say sent, infact I have been in it all week. I am hardly able to do much in the way of serious work, though am trying hard to appear normal to those around me. I am even more talkative than usual and I am afraid that is alot. In essence I am increasingly confused, though manic with what is happening around me in work. After all some people get depressed and some people are like me!

Yesterday I attended a very good local conference about the NHS changes and how they might affect the workforce and how it is developed. Trouble is that though in some ways it helped to clear the fog a little about the government’s direction of travel (did I write that department of health jargon?), in other ways I feel more confused than ever. So people who may know anything about the NHS, don’t look to me for clarity. I am up to Have yourself a merry little Christmas, and debating a second sherry or a glass of red wine. At this rate I’ll be certifiable by 8pm.

What is even more scary is that we have also bought a karaoke DVD of 80’s songs. Now that really is sad!

There seems to be a general feeling of excitement, fear and anxiety in equal measures over the changes currently going on in PCT land. Everyone knows there are going to be wholesale changes, particularly involving the provider part (proper nursing and therapy) splitting, at least in theory, away from the commissioning / core services and functions (finance, education, Human resources) of primary health care. We have been part way down this road before in the 1990’s when fundholding GPs could purchase services from hospitals, but this is a more serious change which will impact on everyone working in this part of the NHS. I think it would be true to say that no ones job will stay the same, and there are many of us who don’t know if we will have a job at the end of it. On the other hand, as with every big change, this provides new opportunities to many people, and I have to hold my hand up here and say openly that I will be looking for something along those lines myself.

This week it has been announced that people at director and associate director level in provider services will have to reapply for their jobs, and that there will be a couple of extra jobs to apply for. Next the level down (service lead / head of service) will have to do the same, but there will be less of them. I half wish I was working in that area right now, so I could go for an associate director job, but half glad I don’t because at the moment I am safer where I am. One thing is for sure; life in my part of the NHS is not going to be dull in the coming months.

On the home front, Teen son has been causing me much amusement this week. On Thursday he informed us that next time the school asked for updated personal details, he would like to change his religion to Jedi! I was slightly gobsmacked, as so far there is no evidence of him secretly dressing as a Jedi Knight and slipping off to some kind of Star Wars temple of worship! It then transpired that he was jumping onto some kind of bandwagon, apparently in the last census, so many people put Jedi as their religion it has now become an official religion! Then ensued a full blown discussion on his religious beliefs. Teen son went to a church of England primary school, and spent a good deal of time in church, and being taught by various clergy, so much so that on leaving that school he announced he was done with religion thanks very much. He now owns up to believing in god, but doubts the whole virgin birth, Christ is born part. So he told us: “I believe in god, but not Jesus. Well I believe in Jesus as a historical figure, but that is it. I am not Jewish or anything you know”. At this point I could barely speak, after all, as his mother, I would hope I would have some idea if he was Jewish.

No time for a dull life right now then!

The picture is dolly mixtures, sweets from my childhood and meant to tell you that this post is entitled: Mixed Feelings!
NHS
Primary Care
Change Management
Teenagers

Today I received a number of cards, and two of them contained those round robin letters which seem to be an increasingly common custom among families in this country (and perhaps around the world?). I find these, often closely typed, letters quite irritating, and I am really not quite sure. However I am torn between throwing them in the bin unread, reading them intensely and firing one off to all and sundry myself. The thing is if I had seen either of the senders of the letters this year, I probably would have been quite interested in what has been going on in their lives over the last 12 months, but I haven’t and I am not quite sure I need the detail they offer me. I wonder if my life is as boring as theirs seems, or perhaps having said that I love Christmas am I suddenly turning into a female scrooge? I have posted off my cards today so I guess it is too late for me to tell my long distance friends of the stresses of my daily life, the blow by blow accounts of my son’s education and social life and the fact that we spent 2 pleasant weeks sunbathing in Tenerife this year.

Anyway, I am off to get ready for tonight’s meal out; it is my dad’s birthday and we are off to a Chinese restaurant. At this rate I will need to wear a tent by New Year’s Day!

People working in the NHS are getting pretty demoralised at the moment, where ever you go, the talk is of vacancy freezes, financial recovery plans, potential redundancies, disappointment with agenda for change pay bandings not to mention the mass uncertainty caused by the proposed changes to primary health care. For someone like me who is generally a half full, happy person, it is getting harder to keep up the act when inside you are becoming affected by all that is going on around you. That and my credit card bill dropping through the door this morning!

At least the oil depot fire is more or less out, and certainly the plume of smoke which can be seen around town is diminishing. The roads are beginning to re-open and hopefully before too long I will be able to get to work without making a massive detour.

Unlike some of my fellow bloggers, I actually love Christmas, and absolutely love giving presents (see reference to credit card bill above). Even now I get so excited on Christmas eve that I can barely sleep, and that is less about what father Christmas is going to bring me and more about the prospect of seeing family and just having a fun time with everyone. Tonight it feels like the whole Christmas thing it getting started with our team night out, then tomorrow another night out with my parents for my dad’s birthday.

For the next couple of weeks, I may probably steer clear of NHS doom and gloom and write about positive Christmas / family related things because actually I want to forget the problems associated with life in the NHS and be happy!

Having had an artificial tree for the last couple of years, we have this year gone for the real thing and yesterday teen son and I decorated it, with hubby offering ‘constructive advice’ along the way. I wasn’t sure about the idea of the shiny brown balls until they were actually on the tree, but I think they look pretty good. I still haven’t so much as written a card yet, but hopefully I will get that done in the next couple of evenings. I also have lots of presents to wrap, as I have pretty much finished my shopping (bar a few things to arrive from Amazon), well there is the problem of teen son’s main present but hopefully I will get that one evening this week when not writing cards.

Picture from itv.com
I am about to blow my cover, if of course I have one to blow. I work in the vicinity of the petrol depot which blew up and caught fire yesterday and it seems pertinent to talk about the way we deal with such events in this country. The emergency, local council and health services emergency action plans were obviously put into place. The press pretty much seem to have arrived on scene at the same time as any fire engine or ambulance, and if you believe everything you hear from them then the whole county is engulfed in acrid smoke. So much so that every school in a 10 mile radius was closed today and most people were unable to get into work.

Imagine my surprise then when I drove past the site on the M1 that although the black smoke looked and smelt pretty awful, it wasn’t covering the entire sky, but the smoke and flames erupting from the tanks looked all the more dramatic because of the way they contrasted against the surrounding blue sky. Disruption in the local area seems to have been much less than we were led to believe and the authorities seem to have closed schools outside the immediate area unnecessarily. This is in no way meant to make light of the obviously frightening experience of local residents who have suffered damage to their houses and who will continue to experience smoke pollution. But I have the feeling that the TV media love nothing more than the drama of a story like this.

Luckily I didn’t really need to go into the office today, but I now know that if I had wanted or needed to I could, and that really is not the message which was portrayed to us by those who are meant to be giving us information rather than scaring us more than necessary.

I find it fascinating to watch the way people behave in different situations, and am slightly more tuned in at the moment on account of the reading I am doing about the culture of organisations in preparation for my first essay.

Yesterday morning, I attended what was described as a “stakeholder day”, where the top management of the NHS organisations within the area I work came together to inform each other of the work taking place to develop health care services. This will involve the building of a new hospital and 3 surgicentres, also the development of high tech diagnostic services, and changes which will be needed to community, intermediate and primary care services. The whole focus of this is really a service where the patient, not the service, or the clinician is central to the NHS; in other words a patient led NHS.

While interesting to listen to, the presentations were not the most dynamic, and the managers, many on serious salary packages, found it difficult to sit still and listen. Being such important people, though mindful of mobile phone protocol, there was a lot of movement in the room. A phone would silently ring (well vibrate I guess), and an individual would get up and leave the room, causing the door to bang slightly as they did so. There was also paper shuffling, the sound of things being dropped and picked up, not to mention whispers as the more cynical amongst them discussed what was being stated with incredulity. As I am the education lead within our trusts, my awareness to all this was heightened, after all if you are the person at the front (which is where I usually am) you notice the behaviour of participants, and it can be disconcerting when people don’t seem to be paying attention.

Sadly I couldn’t stay for the lunch as I had to rush off to meet with my course group in a pub near Trafalgar Square (I never said my life was easy!). I was a bit late and they were already tucking into their lunch and discussing essay stuff; I ordered my lunch and sat down to join in. A couple of hours passed enjoyably, though I will be glad when they ban smoking from areas where you eat as it was extremely smoky. We all left knowing what question we were answering, which is not a bad thing, and arranged to meet again a week before submission.

Back to the train, and this was where the most interesting 20 minutes of the day took place. Any one who has travelled on a British commuter train will know that it is a place where people, some of whom travel together daily, sit in silence, reading their paper / book, staring out of the window (obviously reflecting on the day in prospect or the one they just had), or increasingly, speaking on their mobile phones telling the person on the other end that they are “on the train”. However yesterday 3 people got on, who had obviously (their bags were a give away) been Christmas Shopping. Boy were these people noisy! Not only did they speak in loud voices to each other, but they also spoke to their fellow passengers, and laughed uproariously at every opportunity. As the journey got underway, they began to do a crossword puzzle very loudly, encouraging fellow passengers to join in. The interesting thing though was that the lady sitting next to me found this to be completely outside of the expected culture of the train, and sat huffing and puffing, around me a few people made muttered comments to each other. I in turn was close to laughing at the surreal nature of it all.

The picture at the top has nothing to do with the topic, but is of my cat who likes to sit in a cardboard box, and I guess, why not, after all it is probably a good place for people watching!

When you work for an NHS trust, your contract states that you are employed by that trust to do a particular job, but that you can be deployed to work anywhere suitable within the trust if necessary. This pretty much means that you can be asked to move from one geographical area to another, or to provide your service in a different way if that suits the organisation. One of my colleagues is having some problems with a couple of staff acting in what seems to me a pretty juvenile manner when asked to move to a new area to care for a group of patients 10 miles up the road. What is pretty apparent is that they care little for their client group and are only really worrying about how long it might take to get to their new base. Moving to where the caseload is heavier is somehow infringing their personal rights; Sometimes I wonder what these people think they are actually there for.

I have been troubled for some time, about just how uncaring some nurses are of their colleagues, particularly their managers who they seem to assume make it their personal business to make their lives difficult. Actually they are generally trying as hard as they can to provide the best possible service in extremely difficult circumstances. What thanks do they get for this? Well pretty much none.

I am now going to be doing some work with this team, which starts off with me going to one of their meetings and getting them onboard with a leadership programme which we are putting together for some of the more dynamic and proactive nurses. One of the biggest challenges will be in getting them past the idea that they are there for their own purpose and making them realise that it is the service they provide for their patients, who incidentally are usually terminally ill that matters. I wonder what their patients would think if they could see their ‘wonderful’ nurses’ behaviour with their manager.

NHS
Managing change

That eventually it grows up. Well that is one of the troubles at least. It seems no time at all since I brought my little bundle of joy home from hospital, he looked a bit like a skinned rabbit at the time, but I loved him all the same. His looks improved, he put on weight and in no time was crawling, standing, climbing and walking (in that order). It seems no time at all since he used to say “carol mummy” if he wanted picking up, and his first day at school seems like yesterday.

Yet suddenly (ok so it is not quite that sudden) he is nearly 15, is over 6 feet tall and tonight has gone with his friend to a football match in London without a responsible adult (that is assuming his parents are in any way responsible). I have dropped them at the station, and they are now well on their way into North London to see Arsenal play Ajax. I am sure they are confidently walking the streets on their way to the stadium while I on the other hand am something of a nervous wreck. So much so that I turned down the opportunity to go on a night out tonight so that I can go with his dad to collect him from the tube station later tonight.

It is scary to think that your children have to grow up like this, and of course this is not the end of it. Next will come girls, exams, university…… If I wasn’t driving tonight I’d have a stiff drink at this point. I wonder if it is too late for another baby?

Today I have been wondering about life outside the NHS, and whether, if I were to think of moving jobs I would actually want to work for another NHS or perhaps do something in the private sector or even perhaps do something in terms of consultancy. My Agenda for Change pay banding has hit me harder than I would have imagined; I am feeling pretty devalued. When I look around me and see who has been put onto the same or a higher band than me, then I just wonder what I am doing here. The problem is that it is not about the trust I work for as such it is really about the NHS as a whole, it is about things I don’t understand.

Once, 18 years ago, when I was still quite new to the nursing profession, I applied for a job as a drug rep. I didn’t get the job and at the time, I just applied because it seemed like something different I could do with my nursing qualification; at the time we were more poorly paid than perhaps we are now. I don’t actually think I was serious and that probably came across at the interview, still it was good experience and I still remember it today.

Now though I am in a very different position, and I have much more in the way of transferable skills. Perhaps I would get better recognition for them outside the NHS. Don’t get me wrong, this is not about money, but it is about the fact I have pretty much 25 years before I might want to retire, and even if there was a NHS in 25 years time (which I doubt), I am not sure I would want to be part of it. I feel immensely sad that I feel this way, but to be honest sitting in the middle of a whole host of change for change sake is not somewhere I really want to be. One thing is clear; I have a whole load of thinking to do on this one and perhaps it is time to be brave and do something different. I am sure I will return to this topic in the next few days as it is not about to go away.

Part two of this post is about my day out yesterday, during which we went on a day trip to France. We live about an hour and a half from Dover and from their an hour or so and you are in Calais. This is pretty much a town which has been built up on the back of the fact that prices in England have traditionally been higher here than over there. They cater big time for the brit booze cruiser (English people are obsessed by alcohol, if you believe everything you read in the papers). In years gone by, I have to admit to having been embarrassed by the behaviour of some of my compariots fighting over cheap wine and beer while ignoring the delights of the other delicacies on offer in the wonderful shops in France. That has essentially changed now and there is little that you can get cheaper in France than you can find in a shop like Tesco or Asda, unless you are looking for quality, and then you can make some savings still. It is also still a fun day out to sample a little of French culture close to the English Channel. Washing powder and dishwasher tablets are pretty cheap; perhaps people will soon be fighting over them, somehow though I doubt it!

I bought a couple of presents, some delicious chocolates which may or may not find their way into someone’s stocking, some very nice champagne ( I have standards), some cheese, wine, beer for hubby and dishwasher tablets; well you have got to go with the flow!

NHS
France

You Are Apple Cider

Smooth and comforting. But downright nasty when cold.

What Part of Fall Are You?

Off to France for the day tomorrow, tales of shopping, lunch and french wine on my return!

I got this from sonja at brainxplosion:

W O U L D Y O U R A T H E R . . .
1) Pierce your nose or tongue: nose
2) Be serious or be funny: funny
3) Drink whole or skim milk: neither I prefer semi-skimmed

A R E Y O U . . .
4) Simple or complicated: Complicated, after all who wants to be known as simple?
5) Flowers or angels: flowers
6) Grey or gray: grey of course, I am English
7) Color or black-and-white photos: color, or colour as I prefer to spell it Sunrise or sunset: sunrise
9) M&Ms or Skittles: M&Ms
10) Rap or rock: rock, I hear enough Rap coming from Teen son’s room!
11) Staying up late or waking up early: both depends on day and time of year
12) TV or radio:TV, though for obvious reasons I love the radio in the car
13) Apples or oranges: Oranges

A N S W E R T R U T H F U L L Y . . .

14) Do you have a crush: Not right now
15) Who is it: if I did it would relate to W

D O Y O U P R E F E R . .
16) Being hot or cold: cold
17) Tall or short people: Tall like me
1 Sun or moon: sun
19) Emeralds or rubies: rubies
20) Left or right: left
21) Having ten acquaintances or one best friend?: one best friend
22) Sun or rain: sun
23) Vanilla ice cream or chocolate ice cream: chocolate

M I S C E L L A N E O U S . . .
24) What are your biggest fears in the world: the loss of a loved one
25) Kids or no kids: kids of course
26) Cat or dog: cat though in truth I could live without either
27) Half empty or half full: half full
2 Mustard or ketchup: ketchup
29) Hardcover books or soft cover books: any books
30) Newspaper or magazine?: Newspaper, particularly at the weekend
31) Sandals or sneakers: sandals
32) Wonder or amazement: wonder
33) Red car or white car: red
34) Happy and poor or sad and rich: happy and poor
35) Singing or dancing: singing

A B O U T Y O U . . .
36) What time is it: 6.45pm
37) Number of siblings: 2
3 Birthdate: August 6
39) Height: 5′8
40) Eye color: blue
41) Hair color: brown turning grey
42) Piercing(s): ears

W H A T D O Y O U W A N T . . .
44) How many kids do you want: well, I have 1, would have liked more, but it won’t be happening now!

W H I C H I S B E T T E R . . .
45) Two doors or four (on a car): 2
46) Coffee or ice cream: both together is nice
47) Bridges or tunnels: bridges

F A V O R I T E S . . .
4 Color of socks: black
49) Food: Curry, or a chinese meal
50) Non-alcoholic drink: coffee
51) Alcoholic drink: wine

I A M . . .
52) Wearing: jeans, sweatshirt, socks
53) Listening to: Manchester United versus Portsmouth, which my hubby is watching

C U R R E N T S. . .
54) Hairstyle: short but seriously in need of a trim
55) Annoyance: I will need to think about cooking dinner soon
56) Smell: Roses which were given to me a few days ago
57) Show: Football on now, but will be watching Strictly Come dancing which I am recording soon
5 Book: Steering clear of fiction as I need to write an essay! So books about culture and organisations.
59) Refreshment: Wine, but my glass needs re-filling
60) Thought: Time to finish this, and re-fill my glass!