Nurse, manager, wife and mum: In short a busy life!
Over at Fat Doctor, you can find a wonderful collection of nursing blog posts once again. It really is great to read about all the great work nurses are doing out there, and also great to have the event hosted by a doctor. Go on over and have a look!
I guess that I am not alone in the the concept that talking up my own achievements is an alien concept, or is that just a British thing? I am taking most of today off to complete my applications for up to three jobs in the new organisational structure. These are jobs with pretty big portfolios and with the need for a variety of management and leadership (and not to mention other qualities) but this whole thing requires a new mindset. It requires me to talk up rather than down my achievements (I might add that I really have done some good things and have no need to lie here!) and it requires me to write them in a succinct way as each supporting statement can be no more than 750 words.
Reapplying for my own (or something similar to my own) job has been the easy part, but now the challenge begins, hence this blogging break. Because I now have to move on to the jobs I neither necessarily want or think I have a hope in hell of getting but am applying for because they seem my best options in the circumstances. What do I know or want to know about Clinical Governance is my next challenge, I see its importance, I know about its components (risk, audit, education and training, health and safety etc) but am I thrilled about the concept of spending my life worrying about governance and risk. Mind you, perhaps I already do when I find out that nurses don’t appear to know how to keep their records or how to wash their hands properly or how to safely move a patient. I just don’t know if I want to spend my whole life worrying about these issues. How can I use my experiences of managing an education service to promote myself in the governance sense?
I am still finding it hard to comprehend that I am completing an application and wondering what to wear for interview instead of planning a christmas present list and and shopping trip (not that those things won’t be done too). Ah yes my ability to multi task now that is one of my top abilities, now how do I put that into a meaningful sentance?
I wrote earlier this month, about discovering that my job would not be at risk during this round of PCT management restructuring and about my reactions to being put in my place as it were. Yesterday that whole episode came full circle, when just before midday I was phoned at my desk to be told that despite the fact that the consultation had closed 3 days before, and despite my job appearing on no previous list is was actually at risk. The reason given for this was that the new position closest the my present one has been assessed as being on the same agenda for change banding as mine (although this new job covers 4 times the geographical area and about 3 times the number of staff as before).
When the news came, I didn’t act with the extrovert stomping of feet and anger that I had on that previous Friday, instead all I can say is that I was extremely shocked, angry and felt complete disbelief. At that moment I doubt I could have felt worse if I had been told someone had died (extreme but such are our emotions). Colleagues were great, sharing my disbelief at how this whole thing has been handled (not much work was getting done at this point), and sympathy that I technically have 4 days to submit my application (I will get more you will be pleased to know).
I am afraid for the NHS, and my own PCT particularly. Things do not bode well. We know money has to be saved, we know redundancy is expensive and is therefore being avoided, but actually undervaluing the jobs of managers (even if apparently all managers are pen-pushing devils, if I am to believe my own local paper this week) and treating them in this way will not lead to the most effective work being carried out.
I don’t know if I will get my own job, I have to apply for it as lets face it, who can afford not to and I am not about cut off my nose to spite my face (as my mum would say). I wasn’t expecting to be having to read up on local and national politics this side of Christmas, but the implication is pretty much demotion if I don’t play the game here. Regular readers will know that I have been re-evaluating my career in the health service, and let me tell you this is doing nothing to stop my urge to leave the NHS soon. 2007 could be an interesting year.
On a few occasions I a have been approached to discuss elements of my blog and the NHS in general with people from the media (written and TV) and generally I am very nervous and mistrusting of this kind of thing. I really don’t trust that my words won’t be taken out of context and my identity revealed to those who know me in the real world of the NHS. I guess that in the future that might not matter, as I have every intention of beginning to explore a career outside, you might call it being moved to the open prison prior to day release and then full release. But that time has not yet arrived and I intend to keep being as discrete as I can about what and who I blog about.
However the comment left on my blog a few weeks ago by someone from the NPSA was a bit different. This was an invitation to take part in an initiative designed to improve patient safety by using the kinds of media we utilise here on blogs and other such things. I must admit that until yesterday, my knowledge of a Wiki, was wikipedia and I didn’t fully understand how that worked. But apparently I am going to be involved in a pilot scheme of a national wiki for patient safety and that involvement is coming not through my job in the NHS but through this blog (though of course the two are linked).
I have always been interested, as you might expect, in the best care for patients being provided by the best people, and as part of that we as health care professionals must try to ensure that the actions we take do not cause harm to our patients and that the safety of our patients are at the front of our minds. These days my influence in such matters is restricted to things like redesigning the way in which people receive their mandatory (fire, health and safety, infection control, moving and handling) training. But also in looking at incidents with clinicians to see how we can better educate them to prevent problems in the future. If this can be done through the medium of the Internet, and we can begin to get real nurses and doctors and yes even patients to take part then all the better.
There is a major problem with the way IT is perceived and used in the NHS. For one thing there are the hardware problems, in clinical areas the computers tend to be old, slow and in short supply, that is without the Internet speed. If the connection speed in the NHS were a means of transport we would be talking hand cart rather than Ferrari sports car. Also there is a perception that giving staff Internet action will lead to them all downloading stuff they shouldn’t (I am loathed to put the P word on here for fear more of those kinds of links will hit my spam filter). Add to that the low morale, shortage of staff and all of the things some of the clinical staff mentioned yesterday as barriers and we have a job on our hands to get people to talk patient safety online.
However, I am a nurse (all be it in manager capacity right now) and there are other nurse and healthcare bloggers out there, all with stories to tell and experience to share. So perhaps they are on to something, after all apparently the BBC have had a place for staff to share ideas and concerns for years. Increasingly they also encourage official blogs to appear (personally I am a keen reader of Chris Evan’s blog). Euan Semple told us yesterday of the whole process of encouraging people who to date had been rather suspicious of the use of such a medium to share ideas, and how eventually though discussion and a greater understanding of each others view points have been able to formulate policy and even protest about the resignation of the director general.
I really admire what the NPSA are doing here, and wonder if this could be a catalyst for other parts of the NHS and even the Department of Health to begin to show a bit more respect for the people who work within it and the people who receive care and treatment. Don’t forget too, that those of us who provide healthcare also receive it at some time and perhaps it is time for all of us to make sure our voices are heard.
As a by the by, we went out for a great Italian meal on Thursday and I had the opportunity to sit next to and chat with Dave who I have had some great nursing discussions with on various Internet forums over the year and who is behind Busy Nurse (along with his business partner). All in all then a great trip!
That’s me, only the second post this week. In my defence it has been pretty mad and crazy, what with working, eating and sleeping and not to mention a trip to Birmingham which involved a collision of my blogging life with my work one! I intend to write about that in the morning, once I have had the chance for a bit of rest following the nightmare that is the British motorway system on a Friday evening.
For now I think a bath, and a glass of cold white Italian wine might be in order! More tomorrow.
Where it appears incompetence is rewarded or at the very least tolerated in a way that couldn’t happen elsewhere. That seems to me to be the grim reality with which I am faced, much as it pains me to say so. It has always been my opinion that no one gets out of bed in the morning and says, “I think I’ll do a c**p job today”. But what happens when people just bumble along in their own sweet way, never taking the advice they are given, seemingly unable to learn to do things differently and where possible allowing others to cover up for them. Also what happens when their own manager seems unwilling or unable to realise just what a mess the whole situation is and just how incompetent the individual must be to be acting in this way. If the person I am talking about was a nurse then they would likely be considered a risk to the well-being of patients and suspended from work pending an investigation. But when they are a manager and are preventing the nurses in their team from functioning properly and seem to be allowing no end of bizarre and unsafe practices to take place, well then that seems to be OK.
I like to think that when I help people out, write job descriptions for them, help them with their staff development and generally enable them to do their job, perhaps some of that good work will rub off, trouble is I am not convinced anymore and it wouldn’t be so bad if the person in question wasn’t actually paid more than me, but they are!
This has been a busy week, both in and outside the NHS for me, though I have to come clean and admit that the lack of leadership and direction at work is beginning to get me down some what. When we are busy, with meetings, deadlines, things to write, training to plan, people to see then it feels like something of a military campaign and it feels somehow that we are doing a worthwhile job. When little of that is happening and you are doing things because it seems like a good idea and the right thing, but no one of any importance appears to know of care if you are doing it then that is a different matter. Still I keep busy doing something! What is really good though is that I have time to work on my college assginment, which I don’t mind doing in work time seeing as it is about work and the results will hopefully have some bearing on how we evaluate courses in the future.
I have experienced the worst of the local traffic situation this week, with a journey on Monday that took two and three quarter hours instead of the usual hour and I have received a lovely letter from the local police force because apparently last week I was caught speeding. I was late for a meeting, no excuse I know, and I honestly thought the speed limit was 40, apparently the policeman secreted in his white van with his speed camera caught me doing 44 mph in a 30mph area so that is me banged to rights (fine and points on the way!)
I have had the pleasure of a visit to teen son’s school to discuss A level options (this is the qualifications he will be studying next year after finishing his GCSEs). He is a little confused so we ended up talking to numerous teachers, some of whom were impressive in their encouragement and enthusiasm for their subject and some who were less so. Decision time approaches, but of course he can change his mind depending on exam grades. This is quite scary stuff as I clearly remember being in the 6th form and studying for my A levels while of course having lots of fun; can he really be almost 16?
As if to prove the point, last night was my nephew’s 16th birthday party, there is just 3 months between the two of them and my abiding memory is of 2 babies side by side in their little bouncy chairs and of 2 little boys, one blond and one dark running around and doing everything together! Now they are both over 6 foot tall are increasingly and scarily independent (see picture, taken this summer in Barcelona).
So this afternoon, I am taking a well earned rest from the rat race and from anything energetic, taking a look around the blogsphere, and catching up on some of my favorite blogs. Plus getting myself ready for another fun week in the NHS!
Particularly as people are usually in a hurry to get out of the door by the time they fill them in at the end of the education or training session and also because people seem much more interested in the quality of the biscuits they have been provided with or the difficulty they had parking than worrying about whether they can put what they learned into practice. If indeed they can identify that they have learned anything at all!
This is an area of our departments work that has troubled me for a long time, particularly brought home to me a couple of weeks ago when we provided a sandwich lunch on a course (a rarity these days) and all people could talk about was how wonderful the caterer was. In the department we wondered about going into sandwich making instead, people might not even notice!
My action research project for my course was triggered by these kind of thoughts, particularly given that I ran a leadership course over several weeks and evaluated it in relation to what people actually learned; perhaps for some a novel approach. Getting people to reflect on the days events and then talk about it next time is ok if you are seeing the group over a 6 or 7 week period, but what about those one off day or half day events? How can we know what if any learning has taken place and how if at all it will be put into practice?
According to the evaluation literature I have read so far, the suggestion is that people record what they think the person delivering the course wants to hear, or else what they think their peers are putting. The challenge then has to be how to evaluate education and training in relation to their practice.
My blog is pretty low volume, essentially I am writing for myself and 30 - 40 other people (some of the same people more than once no doubt) a day. It is lovely to know that people read what I write and sometimes comment. Something fantastic has happened this week though, and that of course has been change of shift. I really enjoyed putting it together and did it for the challenge, though as secret part of me was interested to see what the traffic might be afterwards. I was extremely pleasantly shocked as yesterday nearly 500 people visited my site for change of shift and already today over 200 have called by. So if you happen by and chance to read this, perhaps you would do me one additional favour - could you leave me a comment about how you think courses should be evaluated, and about how you know if what you have done on a course will help you to improve your practice. Many thanks!
At the beginning of 2006 I wrote a post about what it means to be a nurse in the UK in 2006. Over the ensuing months there has been much discussion on both sides of the Atlantic about what nursing means, and about what patients should be able to expect from their health care providers. As role boundaries blur and nurses and other health care professionals take on tasks formally the domain of doctors sometimes we need to take a step back and ask what our patients really need from us and how we can make sure we are up to the job of providing that special something that makes us who we are.
My theme then for this week’s edition of Change of Shift is about trying to pin down the key skills of nurses and others who provide care for patients in whichever health care setting, wherever that takes place in the world today. This is not about trying to take on that extra role, about giving the most high tech care (though some of our contributors deal with such technical equipment on a daily basis) but instead it is about identifying what is really important for patents and their relatives and indeed the bit that gives us that feeling we have made a difference when we leave the bedside and head off home to our families.
Assessment of our patients needs is in my opinion one of the key areas of the role of all health care workers, and our ability to suss out exactly what is going on for that person is what helps us to be able to plan care and make sure patients get the treatment they need. Nursing Student, DK at Four Year Mission finds out that perhaps there is no such thing as a ‘normal patient’ when it comes to assessment, well that has certainly been his experience so far, but he has already discovered that those patients that might be termed ‘difficult’ are often the ones who need us to advocate for them. Assessing the mental state of patients is the challenge for Beth from Pixel RN who discovers that those who seem calm and co-operative while ventilated can become confused and unhappy afterwards.
The way we communicate with our patients, their relatives and each other is not just a problem for those dealing with people in the intensive care setting, but really is key to the work of us all. As OncRN tells us, some nurses have difficulty in filtering the information they share, where and with whom they share it, she suggests we all need to learn how to filter that information. Susan Palwick, a volunteer hospital chaplain from Rickerty Contrivances of Doing Good says that sometimes the sounds of the ED can be worse than the smells (hard to believe I know), and tells us how massage might be a way of helping to calm the screamers (can’t imagine that happening on the NHS with the current financial problems!)
The problem for Crystal from Aunt Pickle is how to tell her patients the things she needs to communicate with them, and writes a series of letters to try to help them see their perceptions and expectations from her point of view. This is something I have found useful in the past, writing a letter (but not necessarily sending it) to a patient or difficult colleague is a great way of learning how we can better communicate, not to mention getting some things off our chest about our real feelings! The reactions and expectations of people whose relatives have just moved into a nursing home and how we deal with them are a source concern for Patti Green from Nursing Assistants.net, something which had led to some interesting discussions on the site’s discussion board.
It is communication of a different kind that has John Crippen of NHS Blog doc angry (a not uncommon occurrence as regular readers of his blog will know). Manager jargon contained in a letter from an NHS Ambulance Trust appears to be suggesting that patients will be telephone triaged by ‘ambulance clinicians’ (whoever they are) in an attempt to cut down unnecessary Accident and Emergency visits. As John says, patients might be better off calling a taxi than putting their lives in the hands of yet another quacktitioner! Speaking in code is a pet hate of my own and in my own post of that name on Life in the NHS wonder why we do it quite so much. This is not to say that I can not be heard doing it myself, but at least I have insight! Speaking of which, Nurse Ratched points out how many letters people seem to have after their names these days which are pretty much an alphabet soup, with one thing and another it is definately getting complicated for us older nurses!
Knowing what to observe in our patients and how to do it are to Nurse Chic from Code Pink one of the key skills a neonatal nurse can have, she is not alone because she quotes Florence Nightingale “The most important practical lesson that can be given to nurses is to teach them what to observe”. As she told a student who wondered why she wanted to do this kind of work, she loves babies, and that must definitely help as actually liking what you do and who you do it for is key to professional fulfilment. A quick plug too for November as Prematurity Awareness Month, did you know that 1 in 8 of all babies in the US is born prematurely? I have no reason to suspect that statistic is different elsewhere in the western world.
Team working is one of those things that all of us need but some of us try to do without, as we attempt to be that person who is all things to all people. Kim, founder of Change of Shift, from Emergiblog however is grateful that others know better and go that extra mile to care for her as I am sure she does for them. Team working also helps us to develop the commitment that is needed to juggle work and home life. Jo from Coffee and Conversation in a Smoky room tells of her life as a busy medical / surgical nurse which she balances with spending time with her daughter. She tells us that she only works 8 hour shifts when many have to work 12 but her schedule is as busy as any I have seen in a long time and made me worn out just reading it!
For all nurses, providing basic nursing care should be something they feel proud to be able to do, Hannah from Milliner’s Dream is a woman of many hats but tells us how important it is to be able to make a difference. High tech equipment and medications are vital to a patient’s recovery but there is no substitute for basic care. You must however expect the unexpected when it comes to patient care, Jenn from Jenn’s Journal tells us about the first patient in her care to die an unexpected death and the equally unexpected but welcome news of life given to others through organ donation.
Finally, Susan Yox points us to an inspiring post on Medscape by Julie about the battle she has been fighting on the way to hopefully winning her own war with Cancer. As far as I see it, our role is to do everything we can to care for our patients and their families so that they in turn have the will and energy to face the challenge of their illness in whatever way they need to. Maybe that is the essence of Health care in 2006!
Well thats it for this edition of Change of Shift, thanks to Kim for giving me this, my first opportunity to do this job, I really hope you have enjoyed reading the contributions as much as I did. The next edition will be on 30th November over at Fat Doctor.
I joined an academic email group recently, which I naively thought would offer me some insight into the world of those who knew more about action research (my next college assignment). What I got was my inbox filled with emails in what can only be described as a secret code like language; I clearly have a lot to learn if I want to join that particularly world. This is a private group, so I guess if they want to speak to each other in a way no one else can understand, that is fine so long as they speak clearer English to their students and others. Of course it might be that I am just less bright than I thought, but I doubt it somehow.
Last week a colleague, not unlike me a former clinician who complained after a meeting about our District Nursing review, that at times the whole procedure takes place in code. She tends to ask a lot of clarifying questions, which is natural but said that doesn’t like to ask as many questions as she would like. She also wondered if people spoke in DN / Nursing code so others couldn’t understand (don’t think so) or if they actually know they are doing it (I think they do, though not in a really overt way), but it got me thinking.
I am sure every area of work has its own secret language, one that people have to learn before they can properly belong and can begin to understand the culture of that place, that specialty. I can remember being proud to do it and whats more to understand what is going on, but I am also acutely aware that maybe we should be more careful of our language (and I don’t mean we should swear less)! When I read some people’s blogs I find they are quite coded (well to my British, untrained eye), in a way it makes them seem more exciting, but in another way almost indecipherable! Often we write our posts for a small group of people and indeed for ourselves (after all best not to suppose anyone but yourself reads your drivel) but actually anyone on the Internet can read them. I find an increasing number of people are searching my blog to find out things about nurses and nursing. Perhaps we owe it to them to try to at least make our blogs slightly easy to understand, or else do what madrad has done and publish a glossary of terms!
This is true,I am considering spreading my wings a little and looking at how I might do something a little different, something that doesn’t involve me being employed completely and full time by my current employer and indeed by the the NHS. I think I am becoming a little tired of the way in which the current changes are panning out and starting to question what my place is within them. I have always worked full time (well apart from a period of time shortly after I returned to work from maternity leave), whats more, full time for one single employer and perhaps it is time to think about having more than one job and indeed perhaps even working for myself.
The NHS pension is a big consideration, I joined long enough ago to be allowed to retire at 55, though I would need to work until 58 to have the full pension and this is important, as it is still one of the best pensions a UK employee can pay into being part of the public sector. The next generation of healthcare workers won’t enjoy quite the same benefits so it is not to be sniffed at. But I don’t think I can just do a job of work until I retire, my career means so much more to me than that. I still want to be able to make a difference some how and right now I wonder just how much of a difference I can make from inside?
I also have skills that I can use outside of the healthcare field, after all leadership, management, organizational development and other such things are necessary and indeed demanded elsewhere. I also love teaching other adults and would like to think about doing that more seriously. I feel like I am at a bit of a crossroads here, not sure that any of the paths I might travel along are necessarily the right or wrong one, but I feel I need to explore what is available a bit more.
I am going with a colleague who is thinking along similar lines to meet some contacts she has in a couple of weeks, and it feels exciting though not a little scary to be considering doing something different and something outside of the safe place that its the NHS. I am perhaps having something of a midlife event, though definitely not a crisis as I am also evaluating everything that I consider important in my life. To me that sees a good thing, as the idea of reaching old age without ever having done something a little bit different or even thinking of it is even more scary than taking a few risks when I am 44!
I have the privilege of hosting Change of Shift, that carnival of nursing blogs (and of course anything else health related) next Thursday November 16 2006, and this post is going to be about getting a good selection of posts as part of that whole nursing / healthcare carnival.
Since I started blogging a little over a year ago, one of the biggest things has been the amount I have learned about healthcare and how it is delivered, received and perceived all around the world. I have some regular medical blog sites that I regularly visit, I have been angered, cheered by the courage and care of others and often amused. By visiting one healthcare blog you get to visit a whole host more and really get a taste of healthcare around the world. But it is the nursing blogs I find most inspiring, after all I have chosen to leave the bedside and am working in a management role. But it fills me with pride to read the blogs of people like Kim from Emergiblog (who gave us Change of Shift) an experienced ER (or A&E as we would say) nurse, Disappearing John, newly qualified and also working in ER (and the last host) or Nurse Sean who is just finishing his training as a nurse. In the UK I particularly like to read the postings of Mental Nurse (more than one nurse here, title explains itself) and also Dr Crippen who both informs and often winds me up (of course he is not a nurse, but is passionate about nurses who are able to nurse).
It would be great to see some new names and faces on the next edition of Change of Shift, let us show Kim a bit more about nursing in the UK as well as on her side of the pond (and further if you are out there). Don’t make me come to you and actually ask. After all I am going to write nice stuff about you and link your posts to mine and in due course to many more. Think of your visit statistics; you can’t tell me you never look at those and feel good when you double or treble your traffic. To get involved, email me at lifeinthenhs(at)btinternet(dot)com or fill out the entry form at blog carnival (sadly I can’t put the lovely banner on my site as I can’t use javascript but click here to do it that way. Look forward to sharing your post with the world next Thursday!
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| Thirteen Things about Julie’s week I have been a bit tired this week, could be the continuing stresses of working in a place that is so chaotic or maybe it is something else. Best way then to update you on what I have been up to is to tell you in a Thursday Thirteen. This is my 30th!
Links to other Thursday Thirteens! |
Get the Thursday Thirteen code here!The purpose of the meme is to get to know everyone who participates a little bit better every Thursday. Visiting fellow Thirteeners is encouraged! If you participate, leave the link to your Thirteen in others comments. It’s easy, and fun! Be sure to update your Thirteen with links that are left for you, as well! I will link to everyone who participates and leaves a link to their 13 things. Trackbacks, pings, comment links accepted!
Someone found my site today through the search terms “www. if you could see yourself, which is very apt for me today! On Friday, the horror of finding myself in a position where I couldn’t apply for the job I wanted I kind of ‘acted out’. I had a slight hissy fit, and ranted, I am not the most quiet of people and to be honest I should have just kept my mouth shut at that point.
That is not to know that I didn’t know I was doing it, and certainly as I drove home I thought about how my outburst was going to look to others. I was angry but really that was no excuse, I was self centred and gave no thought to other people going through the knowledge that their jobs had become ‘at risk’.
Today I received some feedback on just that, and thankfully it involved people being worried about me, wondering how I am coping in a world where there is no money for training and no manager around who can be bothered to manage me. I am in general a loud person, people know when I am in the office, and I can be quite entertaining (so I have been told), but at times I must be really very annoying. The problem is, how do do you modify your behaviour and make sure that the stress that is building up right now doesn’t over flow and cause you to do something you might regret. Luckily I have a colleague at work, with whom I can speak relatively openly, we are able to tell each other when we are doing things that might irritate others. I suddenly realised today how much I am missing having a proper manager and how sad I am that the new management of the PCT seems to be completely lacking in good leadership ability. The openness that we had in the old organisation seems to have gone and instead we are expected to recognise that decisions have to be made but that we are not allowed to know why. I feel quite nervous about this whole thing, but hopefully I can act in the way I should. After all I am a nurse, and I know how to be professional, sometimes I just forget!
That is essentially what has happened to me, and I guess is happening to others around me in PCT land. I manage a service, it has been fine to be left to get on with it by those in a senior management position. I am (even if I say so myself) pretty good at my job and I have a wide range of knowledge and an excellent network of colleagues who are equally knowledgeable and efficient. But with the reorganisation comes a realisation that I have now slipped down the hierarchy, so that the consultation paper on the future of the senior management roles essentially excludes me. This means that I am not allowed to apply for the job that I thought I might like to do and means that my new boss will come from a large pool of people whose jobs yesterday became ‘at risk’.
Education is quite a specialist area, and perhaps I have been nieve in thinking that someone who has knowledge and experience of education should be in charge of a county wide service. But does it really matter, after all I came from nursing to this post and have leaned what is involved over the last 5 years. I have to say though at the beginning I was massively out of my depth, I had to learn so much so quickly to I could get the service up and running. Some painful mistakes were made, but that is necessary to the learning process I would suggest. A new manager will have some benefits I didn’t have, for example a team that also knows what they are doing and one that is enthusiastic about development of staff and not afraid of change.
This doesn’t stop me thinking seriously about my future. After all, I want to develop my career not sit and stagnate. I need new challenges not a reduction in my remit. I have been seriously thinking about the other kinds of things I could do, as well or even instead of my NHS job. Perhaps this is the catalyst I need to actually make some contacts and see what I can do about it rather than just thinking. Perhaps I am ready now for something new?
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