I haven’t had much to say about the NHS or live within it lately. I guess this is because for the first time in my working life, I am struggling to work out exactly where or if I fit in the old dinosaur. As a nurse I always believed that I would have a job of some kind for life, that my work would always involve caring for others and of course I could always return to my roots and back to the bedside. The trouble is, I am not sure that is really where I belong or want to be any more. I am deeply troubled by the state of the NHS and the kind of nursing care that can be provided by nurses within it and am not sure I really want to be part of that whole movement. There seem to be too many nurses who just don’t appear to care and one of my biggest fears was always that I too would become so disillusioned that I too would become like them. I am not sure that would really happen, but equally I am not sure a return to the bedside is what I need right now.

Instead I am increasingly beginning to believe that 2007 (or possibly 200 will see me leaving the NHS to continue some of the leadership and other work I have begun over the last couple of years in other areas of the public and private sector. I already have some opportunities in the pipeline which I know I need to follow up. The problem then of course will be firstly earning a reasonable amount of money (so the mortgage can be paid) and then my registration to be a nurse. In an odd twist of fate I might have to get a part time nursing job to stay registered (because I am not ready to give that up yet).

I should finish my MSc in the coming year, if I actually get my finger out and get on with the assignment due in on 8th January! This course has helped to give me the knowledge and indeed the confidence I am going to need in the future to work outside the NHS.

For the first time in many years I can publicly state that I have less debt today than a year ago. In the summer I took the decision to stop using credit, to cut up the cards and to face my debts. This led to many sleepless nights and also to many phone calls from people demanding money. Now though I have made arrangements with all my creditors and by taking this action have prevented any possibility of losing our house or of ending up bankrupt (I am not joking here). I now owe about £5000 less than I did in the summer, and am well on the way to being completely solvent again. For the first time in many years, our Christmas was fully funded by money we actually had in our bank accounts rather than on credit cards and I feel really proud of that. For the first time in a long time too we are beginning to save for holidays and next Christmas.

The last few weeks have been quite difficult, but when I look backwards and indeed forwards, I can see that there is a lot to be positive about and that is the stance I am taking as we stand on the verge of the new year. So I raise a virtual glass of champagne (the real one will be raised later) to all the bloggers of the world who stop by and read my words. Happy New Year!

The latest edition of Change of Shift can be found over at NeoNurseChic. As usual there are some great posts to read and Carrie has done a great job (and over the holiday season too).

All that shopping and preparation, and in two short days Christmas is gone for another year. Over all though it was pretty good. We spent time together as a family, with my parents staying over and my brother coming for the day yesterday with his. For me, apart from wanting to keep in mind the real meaning of Christmas (and I don’t mean the presents) the main thing I love is being with my family. This includes a boy of nearly 16 still being excited on Christmas morning, and wanting to play silly games with his grandparents, of the smell of turkey cooking when you are still eating breakfast and of the karaoke event with the whole family singing along (I really do pity the neighbours, our singing never seems to improve!)

Ok so I have spent too much money, I have seriously over catered on food (not so much the turkey as everything else) but I enjoy eating trifle at breakfast time (as I have just now). So onto the new year,  and time to spend with more family as we are going to stay with my other brother. I will be posting some of my thoughts on the year and hopes for the new year in the next day or two. Mean time, a very belated Merry Christmas!

I don’t just need more sleep but I need better quality sleep and for some reason I am not getting enough of either. As a young nurse I grew used to grabbing my sleep when I could get it, between shifts and social activities and of course I slept like the young innocent person with little responsibilities that I was. I felt sorry for the poor junior doctors who were completely sleep deprived, though they often didn’t seem to help themselves as they partied when not working too. They also were young though and their only responsibilities lay in the hospital, away from it they were single and ready for a good time.

During that period, as long as I could get my room darkish and was allowed some quiet at the point I wanted to sleep then I could get a good few hours quality shut eye before gettting up, eating and going back to work. Sometimes, during the winter, you could do a week of nights and never go outside, thanks to a tunnel running between the nurses home and the hospital.

As a young mother I came to appreciate the value of sleep much more. It was less about the number of hours you were in your bed and more about the type of sleep you had. My darling son seemed to need much less sleep than me, and loved to get up and play at 5am! Thankfully he is now a teenager and now needs more than he did at 2 years old (apparently).

It has come as something as a shock to me that I am suddenly struggling to sleep. Now don’t get me wrong, if I am tired I can fall asleep fine, the trouble is that the slightest sound and I am wide awake and with my mind suddenly in over drive I just cannot get back to sleep again. Most mornings this is around 5am when my husband goes out to work (and I tell myself that if this amount of sleep is enough for him then it should be for me) but last night it was 1.30am as I lay there wide awake reliving every minute of the last few weeks at work and I am kind of fed up with it. I don’t want to start resorting to chemicals to induce sleep so perhaps need to learn some relaxation techniques because having my sleep interrupted at night is definitely affecting me during the day in a way I have never experienced before.

Yes I know it is Friday, but what is 24 hours between friends. So my first Thursday Thirteen is about the things I still have to do before Christmas! With only 3 days days to go, and work now over the countdown begins:

1. Cleaning - this morning the bedrooms, I have my parents staying and they will be sleeping in our room, some work is needed there!
2. Shopping for the presents hubby and I will exchange - we have everything else pretty much bought and wrapped but tomorrow we will go shopping for each others presents.
3. Shopping for food - I have my turkey etc ordered and due to arrive tomorrow, I have had my organic fruit and vegetable delivery which arrived yesterday, but everything else needs to be bough, probably tomorrow.
4. Deliver Christmas cards to neighbours - I have been very slack but have at least written them!
5. Encourage hubby and teen son to finish the downstairs toilet which they have been decorating with my dad’s help.
6. Buy a carpet for the downstairs loo and fit that myself on Christmas eve.
7. Visit my in-laws tomorrow as we will not be seeing them over the Christmas day / Boxing day period.
8. Clean the kitchen, including the fridge in preparation for all of that cooking and food storage.
9. Try and sleep later than 6.30 am one day soon, with all the problems at work I have been struggling to get enough sleep.
10. Ironing - I can’t have that hanging around when I have guests.
11. Wash up - sadly my dishwasher can’t be fixed till after Christmas as a new part has had to be ordered. (Also encourage others to wash up for me).
12. Feel glad that I am not flying anywhere in the next day or two (fog at airports does not help you to get on holiday / to your loved ones quickly).
13. Relax -it is time I put my feet up and actually began to unwind - here’s to the opportunity to do that!

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One of the unexpected but great things about the events of this week is the reactions of colleagues at work. People have come up to me in the office and hugged me, they have told me how much they appreciate the work I have done and that they cannot understand the decisions that have been made. Others have sent me the most wonderful text messages and emails, others have rung to check I am feeling ok. These little gestures of friendship have made me feel that I am valued by the people who really matter.

Today as the day has gone on I have felt my mood lift. I arrived at work feeling quite low, but today I have been able to laugh, to chat with colleagues to have a one to one with a member of my team and to go to a meeting where people value my contribution and tonight I am feeling quite positive. The fact that tomorrow is my last working day until 2nd January helps of course, but I really feel I have turned a corner. Something good workwise will come my way in the new year, a new challenge. When it arrives I know I will be ready for it.

Meantime there is cleaning to do in preparation for my Christmas visitors, there is food to be bought and I am intending to get myself to church on Sunday and sing some Christmas carols. I will be with my family, the people who care for me most. This year it can’t come too soon. I might not post about nursing and the NHS again until the new year, but then I might, you never know!

I joined the NHS as a student nurse in October 1980 and for pretty much every day since then (I once left a job and went back within the month) I have worked for some NHS organisation or other. I have had managers who have reapplied (successfully) for their jobs, but I have to admit I never appreciated the stresses involved in the process, I also assumed in the past that only people who are inept, incompetent and inefficient didn’t get reappointed. Now don’t get me wrong, I am not without insight, but I do know the difference between people who are effective and those who are not.

Today was an insight into life as someone no one wanted to employ. I am of course not alone, and all over the county managers are suffering in the same way. Healthcare provision appears to be in crisis, clinical staff are the but of many people’s criticism and morale is rock bottom. Managers are often rightly blamed for the problems that occur within the NHS, but has anyone ever thought about whether poor healthcare delivery and low morale are linked? Everyone, like it or not, needs a manager. An effective worker is a better worker because of their manager, the support and guidance you receive is vital to the way you do your job, like it or not. But sadly people only notice if a manager is poor, and if that is the case then workers will struggle to perform.

My team are understandably devastated by what has happened with my job, as am I. But because I care about them, my main priority is to help them through the process and to prepare them for the changes ahead. My own future is uncertain, I have no actual job today, but that does not mean that I will leave them to it (as others have left me).

I finish on Thursday for Christmas, and it can’t come a day too soon. I need some time to rest and to reflect. More posts about my feelings on this process are on the way, plus I still have an assignment for my MSc to write!

That’s me, not good enough for my own job. I have a sneaking suspicion that politics of the highest order is at work, but can’t prove anything. I only heard this evening at 6.30 after spending all day waiting. For 5 years I have given my all to the job, but I am not surprised it has come to this. The NHS as it stands today doesn’t feel like a good place to be, so I must seriously consider my future. I will have a job, they are obliged to try to find me one and I am too expensive to make redundant. I will write more here over the coming days when my head clears a little! Thanks to everyone who reads my blog for your support, it means a lot!

For the first time since the PCT merger I hesitated several times yesterday before making decisions. A meeting with another manager about the life support training we buy, a new system for foothealth protected CPD, were just two of the things that I wouldn’t have thought twice about being involved in. Maybe I still will be involved, and maybe it is still my business, but I really don’t know. This led me to spend much of the day kind of tidying up, deleting old emails and moving files around (all necessary housekeeping that gets left during busier times). The office had the feeling of anticipation, but not in the end of term hysterical sense that we have had for weeks, more of something quite sombre, morbid even. Many colleagues seemed to have taken the day off, or maybe they were at meetings outside the building (though this is quite doubtful as most are in a similar position to me). For the first time in many weeks I took a whole hour for lunch, and walked around the shopping centre which is so close to our office though only managed to find one present.  Next week will be defining, whatever happens decisions will start to be made about how services will function in the future, then we will have the Christmas period to get ourselves ready for the burst of activity which will surely come during the first week in January. I just hope I am doing the job I want when that time comes.

So to the weekend, we have our tree; I was persuaded by teen son to buy one which is probably too big for the room (and cost more than I have admitted to hubby), but actually it looks pretty good. I just need to cut down the top stalk bit as the poor fairy is leaning somewhat precariously. I have also wrapped what presents I have bought and hope to buy the rest this weekend. Now my attention turns to the food I need to buy, as for once I am the family hostess, I intend to make this a family Christmas to remember!

I can’t decide whether, if I had been interviewing me, I would give me the job. Firstly the questions were pretty standard and in the main I probably answered them well, there were of course one or two that I answered much better as I drove home afterwards. The thing that has surprised me is how much I actually want my own job, after all I have been telling myself that there are lots of opportunities out there for me if things don’t go right. This is of course true, but actually it does matter and the last thing we need in the current climate is having a person who really wanted a different job getting this one!

We actually received notification of some income from the Strategic Health Authority yesterday, but this includes no allocation what so ever for education and training (no real surprise but still I had hoped). With the financial state of the rest of the trust there is a danger that by the new financial year the education and training department might as well just be renamed the mandatory training department as that might be all there is money for. A parliamentary committee report on finance in the NHS has apparently reported (haven’t read it yet so relying on the accuracy of the BBC here) that the Department of Health shouldn’t expect to put the NHS back into the black by cutting back on education and training. In my opinion someone should tell the SHA to give us the money that is rightfully ours (and whats more we have had to spend anyway) but perhaps I am living in some kind of dream world!

I find out on Monday about the job!

Is reading and re-reading some healthcare policy from the Department of Health or planning my answers for tomorrows interview. But instead I am blogging; reading some of the regular blogs I like to keep up to date with and also writing this post. I am in the middle of reviewing the job descriptions for the two jobs I have applied for (one of which I want and the other I don’t) and thinking about the answers I might give to questions on the subjects. However, I wonder if I should be going over board on this. The interviews will be what might be termed ‘quick and dirty’ i.e. half and hour long maximum and with no presentations, tests or anything else to plan for. Secondly my potential boss (following last week’s level 3 interviews (their terminology not mine) ) is someone I have not always got on with. So I will give it my best shot, I will think in a positive way and I know I can do this job. I am going to try not to think of the politics of this process and am going to believe in myself. Thanks for all of the good wishes, I will be back tomorrow with a blow by blow account of the whole thing!

Every day topics have passed through my mind to be included as blog articles, but each evening I find that I am really not in the mood to write about whatever the idea was that morning. Even Dr Crippen is failing to get me worked up enough to respond, even when he posts an email from a nurse practitioner who seems as if she has swallowed a 2006 version of the jargonised phrase book of the NHS. Wait a minute maybe that is the reason, ok so I am passionate about nursing in the NHS, also keen for nurses to develop their skills but even I have my limits. I also wonder why we are all bothering. For the patients you cry!! Of course you are right but I don’t have any patients of my own these days and I left the bedside to make a difference to more people (including patients). I am finding though that managers are hated, and that even in my own PCT no one is particularly valued (might be wrong, check in after Tuesday to find out).

Each week I look at the Births / Deaths / Marriages section of the local paper. Well death section really as never yet have I found a birth or marriage of anyone known to me. Periodically an ex patient is mentioned, sometimes 2 and once even 3 (a bad week but as we know bad news goes in threes!). This week’s announcement of the death of one of my patients from five years ago when I last held a patient caseload has moved me more than I might have imagined. She was a lady who I knew through her Rheumatoid Arthritis (I was a specialist nurse in rheumatology) but whose illness paled into insignificance in relation to the death of one son from cancer and another to suicide. I spent more time than perhaps I should have considering the treatment for her rheumatoid but who needed people to listen to her story. A story of sadness, of lives unfulfilled, but also of hope as she had a daughter, son in law and grandchildren. Maybe that is the side of nursing I miss, the one where I find myself in a patients home and am drawn into their life. Thing is though, I am not sure too many people get to know their patients quite that well any more in terms of their physical illness or the emotional aspects of that illness and perhaps that is part of the problem. Healthcare, including nursing is becoming much more measurable, it is all about outcomes; good or bad. Listening to a patient’s problems is not necessarily a measurable outcome, but in my book it is something every nurse needs to be able to do. (Vi is the name my patient liked to be known as, this post is for her.

Today saw me delivering a teaching session on this very subject to staff at our headquarters office, the second such event and probably not the last. It is spooky to be doing such a thing just an hour after being invited for an interview to take place next Tuesday 12th December. I have spent the last 2 days worrying, somewhat stupidly that I don’t meet the person specification for the two jobs I have applied for and therefore that I wouldn’t be getting an interview. I must admit to being somewhat relieved that said event is to take place sooner next week than later!

So how am I preparing, well I wouldn’t be a proper woman if I hadn’t used the opportunity for some retail therapy, so I have a new black trouser suit and a new green top. I am toying with the idea of new shoes but have so far resisted. Who knows though, Sunday will be spent Christmas shopping and stranger things have happened! I am also reading stuff I think might be suitable, and thinking about the possible questions. One thing seems pretty sure though, they have so many people to interview that the appointments are only 30 minutes apart. This is a quick and dirty process and I am telling myself that the process will be fair. As I said to the people at my session today; if you don’t go in with that attitude then there is no point and I wouldn’t want the money spent on my suit to be wasted!!

Though at least I have been spending money on things I consider pretty essential, and that I had been wondering how the hell I would afford. This week I am a fan of agenda for pay, this is because I have received some back pay, and obviously have been more of a drain on resources than usual. I have been reading on various blogs and in my own local paper, that much of the money that has been pumped into the NHS in recent times has gone on staff pay, and in pay increases at that. I wonder why I am no longer willing to work for the pittance I expected as a young nurse newly out of nursing school? Could it be that we want a reasonable salary for the work we do, or are we mere mercenaries?

Whatever it is, I have some back pay banked. Gordon Brown has taken a large slice to put back into the coffers and I have been spending a bit. First on the list was the new cooker. I was getting a bit worried about cooking my christmas dinner in the old one, but next Saturday my brand new Zanussi electric cooker arrives. I will also be purchasing new pans. Just got to order the turkey and I will be ready for that part of Christmas.

I have also ordered my first pair of varifocal glasses, and am hoping that things will be clearer soon! The contact situation is manageable particularly if it involves driving or doing some other distance stuff. They are not too good for trying to read academic texts and I have an essay to write. It is shocking though that I am having to spend near on £200 for them, though I have to admit to Monsoon designer frames and the fact that I get a second pair free.

This week I am also aiming to get something smart and kind of classical to wear at my impending interview. You see I really am Mrs sensible in my purchases here, I think it might be time for something a bit more exciting; any ideas?

But still hanging on even if my eyes do look a bit like this! By yesterday, having pretty much completed my applications, plus having had a further conversation with the colleague I am considering working with outside the NHS, I was feeling just a tad more positive. This feeling was, I have to admit helped along a bit by the knowledge that my Agenda For Change back pay was sitting languishing in my bank account. I am no mercenary but there is nothing like the knowledge that you can go shopping if you want to to help keep you going through the day!

So what will I do with this money? Well obviously I will be stashing most of it for a rainy day in a highly sensible way. But unexciting as this sounds, I am today off to Currys to buy myself a new cooker. It is sad to say that last time I did such a thing was in about 1986 when armed with back pay from the nurses clinical grading review I bought myself a lovely new gas cooker. At this rate I will be buying the next one when I retire!

My thoughts this weekend turn to three things. Firstly of course Christmas, it is now December and I really need to get myself into gear. I need to do a bit of present planning, card buying and generally start to get ready. Secondly is my next course assignment, due in on 5th January and I must prepare for the final push to writing the thing up. Finally of course, I need to start to consider my interview which will take place between12th and 14th December. Never had such a fun December to look forward to!