So we have made it to the end of another year. In 7 and a half hours (GMT) it will be 2008, traditionally at this point in the year we look back at what has been achieved and forward to what we might do in the coming 12 months and beyond. For me this always feels kind of scary and exciting all in one. Often we don’t fulfill our expectations, our goals might just have been a bit ambitious and we are left feeling a little deflated. This year though has been quite challenging, but actually has turned out pretty well. A year ago, I didn’t have a proper job as such (having just failed to secure my own job on 18 Dec), I had just faced up to a large amount of debt and generally I was feeling none to positive about the future. A year on, I have a new job (which ok, is not actually the answer to all long term prayers) which I am am enjoying  and I today received a debt management statement which says I have paid so far paid £16,000 off of  my total debt. Now those two things alone are not to be sniffed at. Mean time we have had 2 wonderful holidays (one paid for by my in laws), our son has grown into the most amazing young man (and passed some GCSEs and looked handsome in his prom pictures) and we still have our wider family around us. Things are not always easy, and only time will tell if we can afford the grand trip to the US that hubby would like for his 50th in October (San Francisco, Las Vegas and Memphis are all in the frame)! I think I might need a part time job, and am now torn between making it something involving nursing or just getting a regular ordinary type part time job to help pay for it. But while I have my health, my family and friends around me, then it can’t be bad.

Happy New Year to all who happen upon this post, because I might tell you some very bizarre phrases bring people here, but that is another topic entirely!!

Hubby’s Christmas holiday has apparently been ruined. The reason for him lying on the sofa watching rubbish TV and James Bond Films this year has apparently changed. This year he is ill. This is not a man who takes time off from work without good reason but his company closes down for christmas so he was never going there this week any way. So there is no way of knowing if he would have gone to work suffering as he does. What is certain though is that in his mind I as a woman could never understand his suffering, after all, what he has now is worse than childbirth; I kid you not he said that just now!!

I do not deny that he is ill, he has a headache (apparently unrelated to the consumption of alcohol that he is still able to manage) he has a very runny nose (he is using lots of tissues) he has a cough and a sore throat for which I have bought him various remedies that he asked for but I am unconvinced that are any better than paracetamol. But if I am ill I generally still cook dinner and generally carry on for the sake of the family. I suffer in moderate silence while he needs to tell me of impending death every 5 minutes.

I am not the most sympathetic of wives (I am slightly better when in mum mode) but then in my nursing career I have looked after properly sick people. Of course according to hubby I might live to regret my attitude since today could be his last. It is lucky then that due to his illness and his nan being in hospital on Christmas Eve (she is still there by the way) I have not yet bought his Christmas present (nor he mine), mind you we were going to get them in the sales and the way things are going they will be over before he is well enough to step outside the door!

I didn’t quite manage to write enough blog posts to get me to Christmas, but December has been pretty good as blogging goes. Now as we reach the dying days of the year, all around people are looking back; over the week, over the year maybe even over the century so far for all I know. This is the time of year when whole TV programmes are devoted to reviewing what has been said and done and maybe over the coming weekend I’ll take a serious look back myself. Today though I am just thinking about the last week; the good and the bad.

Christmas is a time for being with families, actually for me that is the main thing about it (I am not getting into any kind of faith / religious stuff here) rather than what you give or what you receive in terms of presents. Trouble is some of the other people find that whole thing more of a chore or duty type thing. This led in our family to both my sisters in law kind of ‘playing up’ and showing off by having bickering episodes with their husbands and my mum their mother in law. This kind of thing happens every year and actually I just keep out of it, but it does make me long for spending my Christmas lying on an exotic beach miles away from them all.

With my own in laws I experienced a different kind of family Christmas, one spent visiting my husbands 96 year old granny in hospital. She was admitted on 23 December with an apparent urinary infection, much more confused than usual and scratching her carers at any opportunity. By Christmas Eve she had been rehydrated and was a little less confused and was reasonably comfortable (though I think constitpated) and I am pleased to say receiving some reasonable nursing and medical care.  Father in law though was struggling under the weight of responsibility and hubby and I went back to her home to get her some things for her hospital stay and then encouraged him to speak to the doctor and ward sister. Being busy on Christmas Eve unexpectedly like that meant that I had no opportunity to buy things I didn’t need, which was not an altogether bad thing. Hospital wards with sick and elderly people in them are not the most fun places, but as a glutton for fun we were back there on Wednesday (Boxing day in the UK). Granny looked to be on the mend (sitting out of bed and reasonably with it) but for some reason father in law’s only concern was what she had eaten for her Christmas dinner. He seemed unwilling to find out what was happening in terms of her medical condition and didn’t want me to ask either. This had me thinking, even though she is old she is still his mum and if he doesn’t ask there is no hope of getting news he doesn’t want. secondly it had hubby and I wondering if he preferred her in that hospital ward amongst other elderly people under constant supervision rather than in her own care home environment where she isn’t getting all the attention that she needs, though she is well cared for in terms of daily needs. This poor man finds himself at 73 with a son with motor neurone disease for whom he is the main carer, a wife who is increasingly frail though the same age as him and then his mum who he still has to worry about. Christmas is a time for families, but they are not always as they seem. Some of mine thinks they are pretty hard done by, but actually they are not, sadly they are too busy bickering and getting one up on each other to really know that!

If my back would ache this much right now if I had never been a nurse. So today I have been to work and to the supermarket to spend an amazing amount considering how little of any substance I bought. I have carried the shopping into the house and put everything away and then I have crawled around the floor wrapping presents. The latter might not have been the best way to do that particular task, but then I have never been one to make life easier for myself. My tree now looks lovely, with presents all around it. But I have serious back ache.

Back in the 1980s when I first became a nurse I was taught to lift patients manually. We did two kinds of lifts, both of which are pretty much outlawed now - the kind of drag up the bed lift and the Australian lift which actually was my favorite on account of the fact two of you could lift someone pretty heavy quite a long way up the bed. Both of these lifts are dangerous both for the patient (in terms of being dragged, the possibility of getting their shoulder’s dislocated and other injuries) and for the nurse. I didn’t see a hoist until I was in my second year, and that is only memorable because the patient who it was meant to be used on sat and cut up the sling used to support her with a pair of nail scissors. In the community during the late 80’s and early 90’s hoists appeared in peoples homes more and more and indeed legislation was brought in about how much we were allowed to lift. But in people’s homes they often like to sleep in their own (often double) bed and they bath in a normal bath and then there are leg ulcers and wounds to dress. Even though I had done all the training and knew how to safely move and handle my patients I was young and careless.

Before I left clinical nursing I had constant back pain. I never had time off or reported it to anyone medical but it was a constant. It was one of the indirect reasons I moved into a more office based job. Most of the time I have no problems, but the damage is done. When I go shopping for long periods, do gardening and wrap presents I suffer. It is a legacy of being a nurse in the 1980’s but tomorrow I’ll be fine.

Every year people travel to different countries (or perhaps different parts of the same country) to obtain health treatments they perceive are not available closer to home, are provided by better doctors than those at home or more quickly than they could other wise expect. People who currently do this generally have to pay for that treatment (particularly if they are going outside the country, though not always) but yesterday the media was full of proposed new EU legislation that would mean that patients could travel to different countries for treatment and have it paid for by their home country. Of course the ‘NHS is terrible’ media lobby immediately took the view that this would just mean that British people would want to go to France or Spain for their treatment rather than anyone would actually want to come here. But I wonder how likely that is seeing as most people want to receive good care close to home, are actually not held in waiting lists for the lengths of time they were before (no one seems to know about the 18 week referral to treatment targets we are all working to achieve for next year), and generally receive the care they need when they need it.

Of course there are exceptions, people can’t always get new drugs and there have been a few notable publicly played out examples of people taking their health trusts to court to obtain treatment. But we have to remember that this is the exception rather than the rule and that the line does need to be drawn somewhere (even if that line needs redrawing regularly. The media tends to play into the perception that health care as provided in the UK is poor, when most people’s individual experiences are not as such. They play into the idea that the rest of Europe has services that are cleaner, better, and quicker than we can expect. This might be true in countries such as France (where they are struggling to afford the services they have), Germany and Belguim for example but I am not sure it is true for other countries in Europe.

I have witnessed health tourism from the opposite direction and have cared for people from Greece, the middle east and Africa in the private wing of a London teaching hospital and have also cared for people of various nationalities within NHS facilities , some of whom had been here long enough to receive NHS care but equally others who had not. I am all for choice, and certainly choice in this country might help to improve local services (certainly I spend my working life in just this area) but I am not sure that this legislation will help that cause. I would like to see the media in this country doing something to show what is good rather than what is always bad about health care in this country, but I expect that is something of a very tall order.

What The Holidays Mean to You

For you, the holidays are about emotional connections and bonds. You are happiest being around those you love.You celebrate the holidays in a minimalist style. You are likely to only give one great present and decorate your house with a few special items.During the holidays, you feel magical. You love all of the decorations and how happy people are. You like to sit back and take it all in.You think the holidays should be decadent and indulgent. You never mind gaining a few holiday pounds… it’s worth it! Your favorite holiday memories strongly evoke your senses. You are vividly aware of all the tastes, smells, and sounds of the holidays.

What Do the Holidays Mean to You?

You Are Rudolph

Sweet and shy, you tend to be happiest when you’re making someone else happy.Why You’re Naughty: You sometimes stick that nose where it doesn’t belongWhy You’re Nice: Christmas would be a sad affair without you!

Which of Santa’s Reindeer Are You?

You Are Chardonnay

Fresh, spirited, and classic - you have many facets to your personality. You can be sweet and light. Or deep and complex. You have a little bit of something to offer everyone… no wonder you’re so popular. Approachable and never smug, you are easy to get to know (and love!).Deep down you are: Dependable and modest Your partying style: Understated and polite Your company is enjoyed best with: Cold or wild meat

What Kind of Wine Are You?

So a week to Christmas and this year I have been slow off the mark. Yesterday was the last day for posting second class cards and I managed to post my last few today. There is no way I am going down the first class road when 35 second class stamps cost me £8.40! This post is only 4 lines long and already I am sounding like scrooge. My new frugal self, the person who lives within her means (well tries to) and has no credit cards is taking a staged approach here. What is more, if you don’t buy too much food too soon your family can’t eat everything before Christmas Eve and what is more you have the chance of just one more pound off for the last pre-christmas weigh in (tomorrow).

So here is my count down calendar:

Wednesday  - Slimming world Christmas party. The same two pounds has been gained and lost a few times recently. Which means that since my cruise at the end of October I have only lost 2.5lb. 2008 will be a new year though and actually 18lb since August isn’t so bad. So after the weigh in I am going to enjoy myself with my slimming chums.

Thursday - Pay day. I still have a number of key people to buy for, including my 2 nephews, 2 neices and my parents. Nut actually I know what is to be bought and I intend to pick all of them up on Thursday evening after work.

Friday - Last working day before Christmas. I will be popping out of work at lunch time and buying my last few things. I will also be picking up some nice food and drink. I haven’t yet wrapped even one present and my intention is a nice bottle of wine, some nice nibbles (ones not allowed at slimming world) and present wrapping, perhaps with carols!

Saturday - Hubby and I are planning a late afternoon trip up to London to see the lights. One of the great things at Christmas is to see the decorated shops and the lovely lights adorning all the major shopping streets.

Sunday - A day for chilling perhaps?

Monday - Christmas Eve and last minute shopping, maybe something to wear, maybe just a wander around especially if any of the shops move into early sale mode! Then it is off to my parents during the evening and Christmas will begin.

This post is due to my lack of post ideas for today, lets hope I can do better tomorrow!

Today the whole directorate met away from the usual offices in which we are based for a day of group learning, bonding and team building. Well that was the theory. This concept is relatively new to those of us who work in the health service, well certainly something that I had never experienced before about 4 years ago. I doubt there are too many people who do regular nursing jobs who go on such things, after all there is generally far too much work to be done when you are in clinical practice, and you have to wonder who would look after the wards and do the work if they did. I looked up ‘Awayday’ on Wikipedia to see where the idea came from and found this definition:

An Awayday is the term used in British business for a meeting, often of a whole department, project or sales team, which takes place off-site and away from the participants’ regular office surroundings, usually for a whole day or sometimes a weekend

The intention is to allow the meeting to focus on the particular task at hand without the participants being distracted by the demands which, if the meeting were held in the workplace, would normally be made on their attention by virtue of their positions.

The term derives from the name given to a cheap day return railway ticket (a substantially reduced two-way fare for off-peak travel) after pricing by time of travel was introduced on the British railway network in the 1960s

Our directorate only really came into being at the beginning of this year, and the 3 awaydays that we have had to date have been good in terms of getting to know each other, looking at our objectives  and working out what that means for us individually and in terms of our smaller teams. Because we are in the health service and we do not have money to burn they last a day, take place on work premises and any refreshments (including our lunch out today) are funded by our selves. They are not some kind of perk or freebie but they do involve being away from work and one has to question just how effective they might be in the long run in doing anything really useful other than improving the working relationship you can have with each other because of the fact you know each other better.

Sometimes you come across a story that just makes you wonder how some mistakes actually happen. How comes someone never actually asked if this was a good thing to do?

Names, dates of birth and salary details of nurses from Sefton PCT have been sent out in error to four external organisations.

The blunder saw the personal details sent to organisations bidding to provide sexual health services for the PCT.

In a move which has increased anger among staff, the trust has refused to provide the names of the organisations involved because of commercial confidentiality surrounding the bidding process.

Kevin Coyne, Unite national officer for health, said: ‘It’s disgraceful that an organisation trusted to protect sensitive medical details of patients can expose their staff in such a dangerous way.’

The PCT, which has launched an investigation and apologised to its 1,800 members of staff, claimed that all of the details received by the organisations have been destroyed.

The mind just boggles!  Story from Nursing Times Online.

Yesterday I had a day off during which I took my mum Christmas shopping, bought fruit and veg from a farm shop and then spent the evening having a meal and being entertained by a friend’s daughter who is a singer. What do I find this morning? High drama apparently because during my absence Dr Crippen has been pronounced dead by a troll pretending to be a colleague, and while obituaries were still being prepared all around the blogsphere others have confirmed that the good doctor is actually alive and well, just not taking part in blog activities for the time being and who knows may have turned out to have retired without so much as a good bye.  I found all this out through the 18 rated NHS Exposed blog and no wonder they have that rating when stories of death, deception and general hysteria are being reported.

This saga has all the makings of a Miss Marple mystery. We have a (probably) dashing doctor, who maybe lives in a large house in a sleepy village (though his patients probably live somewhere less salubrious), and we have people from all around the world who hang on the doctor’s every word. For 2 years NHS Blogdoctor has been compulsive reading, he has regaled us with tales of the challenges of working as a GP in the UK. This doctor is an advocate for his patient and all that is good in the world, but at the same time he winds people up by expressing his opinion about the poor state of health care in general, the poor state of government (he was particularly vitriolic about a former health minister), and the miss management and poor leadership of those in charge of the general medical council. what is more he is of the opinion that nurses should nurse rather than worrying their pretty thick heads with any kind of extended scope of practice. Doctors should doctor, ambulance people should collect patients and get them to hospital and nurses should stop being too posh to wash. The sentiments of what Dr Crippen was trying to say was something I tend to agree with, it was the way in which he often said it that made my blood pressure rise and got me biting back in the comments section of his blog. Dr Crippen has upset quite a few people over the last couple of years, more than likely created a few enemies and for that reason, if he had met his maker it wouldn’t have been through natural causes but more likely murder most foul!

The written word as expressed through a blog is open to the interpretation of the reader. You have to trust that the words written are true, that they are written in an open and honest way and that they express the views of the person who wrote them. But you cannot have a proper discussion (as with a spoken conversation) with a blogger. You read them and you make sense of them and from that you judge what you think of them. Over time though, on sucessful and avidly read blogs like NHS blogdoctor people start to think that they know the author rather better than perhaps they do. We all crave success, and hope to have more than 2 men and a dog (and the dog probably can’t read) visiting our websites. We hope upon hope that we are not writing for our own benefit but are actually reaching a wider audience. What happens though when thousands of people visit your blog, and participate in discussions on your site? The pressure to post regularly and with originality must grow, not only that but you must then read the comments to each post and contribute to those, and meanwhile you are busily being a GP, husband, father and general ordinary person. It would perhaps have been better if the person that calls himself Dr Crippen had posted a short note on his site to say that he was taking a break as he did in the summer. He didn’t and this meant that speculation was rife, it still is after all here I am writing a whole post on the subject. It is however a very odd person that writes that another individual is dead when actually they don’t know what has happened. But then the very odd people that inhabit real life are also alive and well in the blogsphere but then again that is what makes blogging a fascinating and slightly obsessive pastime.

Apparently if you are under 13 this blog is not suitable for you.

This is based on the following words appearing in my blog (Lets just hope I didn’t include all of them in one post!):

• dead (4x)
• murder (3x)
• pain (2x)
• hells (1x)

Kim from Emergiblog has some great posts on the blog carnival, change of shift, this week so I suggest you get over there and take a look.

If it is nursing you are interested in or indeed if you are a nurse then you should also go over to Nursing Voices, the great online forum. There are some great discussions going on there! I find it a great place to find out about nursing across the world and of course to join the debate.

The police are not happy. They were offered a 2.5% pay increase, but because of the way this is being applied (i.e. not backdated to when it was awarded) they will get just 1.9%. A similar thing happens to health workers each year. We are offered a pay rise, the health unions argue about it, and finally people get it. Trouble is it is often these days staged, or as this year so complex that you don’t know if you have received your entitlement or not. In the public sector we usually receive something each year in terms of a cost of living rise. In the recent past this has been reasonably close to inflation, this year it is not. I don’t know the headline inflation figure (I am no economist and am writing this before work so have limited time) but my mortgage has gone up significantly as has fuel (domestic and petrol) and food. Added to this the fact I actually have not had a pay rise due to my job being banded lower than my previous one (this is currently being reviewed but will not be back dated either) and me being on protected pay. My husband works in the private sector in manufacturing industry (yes there is some left, just about) and often gets no pay rise during a year, but when he gets one he knows how much it will be and when the end of that month comes he sees it in his pay cheque.

This issue is not about the amount of money people are awarded, it is not about how often they get it but it is about being open and honest with your workers. Police officers do an increasingly difficult and dangerous job; every night there is a news story about someone being killed or injured at the hands of someone else and for every victim and perpetrator there are several police officers working at the sharp end. Police, Nurses, Ambulance crews, Fire officers are all there doing their job getting on with making the changes to their services as dictated by ever changing government policy. They have become more professional, they have become highly trained, highly specialised and all of these professions attract pretty high caliber people into them. For the government, our employers to pretend to us and the public we are being given a certain amount of money only to secretly take it away is scandalous. I don’t agree with any of us striking but the government has to learn to treat us all with more respect and if there is some kind of work to rule that helps to do that then I am all for it.

If like me you enjoy observing the behaviour of others you would relish the opportunity for a day out where the use of public transport is necessary. Today I went to bond with other commissioning types in London and therefore went by train. This is generally the best mode of transport into the capital from my home town. Travelling by car is really out of the question, firstly because the traffic is likely to be bad, secondly because of the congestion charge, thirdly because you can’t park easily and fourthly because you might want to arrive without wishing to murder someone.

This morning’s journey was interesting because of the girl on the train who was taking up two seats. I saw this as I climbed aboard and walked through the carriage. She was asleep with her feet up on the seat beside her. There were quite a few seats available so I didn’t bother trying to wake her, but within minutes a lady was trying to do just that. Her response on waking was that “I am trying to sleep here”, well yes fine sleep, but what right do you have to take up two seats while others stand. A few others tried to get her to move her feet as the train travelled from station to station but most were told not to “f****** touch me, I am trying to sleep”, so a pleasant girl! The best thing was that as we all got off at the final destination she was still sleeping, lets hope she didn’t wake until the train had returned to her station of origin (but that may be too much to hope for).

On the journey home after an interesting but cold day (the heating in the building we were in seemed to be less than perfect) I managed to get on a train which was travelling to Leeds, with a first stop of my home town. These trains are worth getting onto because you get to your destination more quickly, this proved a blessing. Behind me sat 2 men who had been to a meeting in London and were travelling back to Leeds. On this occasion I was glad that my journey was short, and I can only imagine that one of the two wished his were the same. His companion spent the entire journey that I endured moaning about pretty much every work colleague he had ever come into contact with. Slagging people off and generally gossiping is, if you believe many men, the domain of the woman, but I beg to differ. I would hate to have ever worked with, emailed, phoned or just come into contact with him because he went through the lot before complaining that someone had emailed him to complain that if he though he was so perfect why didn’t he just try running the show himself. I have no idea what line of business he was in, but it is my suspicion that he would love to do just that and whats more could do a much better job than anyone else.

For once I got a seat in both directions, and didn’t need to use the underground as my destination was within walking distance from Kings Cross. A day on a train was fun, but it is back to the car tomorrow after all you don’t want too much of a good thing!

I have followed with amazement the ‘canoegate’ story this week of John Darwin and his wife who appear to have led the authorities and their sons into believing that he had died in a canoe accident 5 years ago when he had in fact been living in his own house, Europe and Panama during that time. I have to admit that when he turned up last week apparently without a memory in the south of england while his wife was in of all places Panama I smelt something of a rat. After all who goes to Panama other than to cruise down the canal? I am intrigued by the idea that he would pretend to be dead because of debt problems, but then that his wife would help them both out by pretending that he was dead, having him declared so and then claiming life assurance policies. How desperate would you need to be do do such a thing?

I have rarely broken the law. Ok so I do break the speed limit on the motorway, but then who doesn’t but other wise I think I’d be a poor law breaker. Once in about 1972 I and a cousin stole some sweets while out shopping but were so ashamed of our behaviour that we couldn’t eat them and instead binned them. I am not sure that I would be any better now at making out I had done know wrong. Once also in about 1982 the police called round to my parents house while they were on holiday and we were holding a fancy dress party. I agreed to turn the music down and did. I also admitted to my own parents that a party had taken place and that the beer cans under the bushes in the garden didn’t just grow there. So you see I could never be the type of person to pretend that her husband was dead when he wasn’t, much less lying to her offspring. The worst thing about the whole episode has been that she has been waiting it out in Miami, selling her story to all journalists who cared, while at home her husband had been arrested and her sons were getting more and more angry at their deception. If I were going to break the law, I doubt it would be pretending my husband were dead and claiming on his life policy!