A story in the news today has troubled me greatly. This was about an 18 year old girl, obviously troubled apparently having had a difficult childhood and having taken drugs and run away from home in the past (so we are told) who has in the last couple of days given birth to a baby. Decisions were taken (without the girl’s knowledge) to remove the baby from her care at birth, but without any kind of court order within hours of the baby’s birth. Once this had happened, the family consulted lawyers and a high court ordered the baby returned to her mother. Sadly this may prove temporary as social services are applying to remove the child once more.I take issues of child protection extremely seriously. I know that social services and us as health professionals have to tread a fine line between supporting a family and protecting the child. There have been more than enough high profile mistakes. However (and of course we don’t know the full details) this strikes me as wrong. What kind of world do we live in where a young woman can give birth and not be allowed to spend even one night (even supervised) with her baby. What kind of world do we live in where a young mother cannot be supported to attempt to bond with her baby and turn her life around? What kind of world do we live in where we want to continue the cycle of difficult childhoods by separating mothers and babies without any effort, without consultation and in our ivory towers.

Maybe there is more to this, maybe I don’t know the facts. But the thought of losing my baby before I had spent even a few hours with him is beyond my comprehension.

To listen to our local paediatricians you might think that money needs to be found for about 5 different types of specialist nurse just so that they can make sure children get a service even worthy of mention. In days gone by, when these decisions were based on what was wanted rather than what was actually needed then about £200k might have been found by the NHS trust on the promise that money would have been saved by better use of resources and throughput. Experience has taught me and those of us working in the side of the NHS that coughs up the money that such savings aren’t always going to happen. The other problem is that what I might call specialist and what they call specialist are two different things. They want a nurse who can be at their beck and call. Who can perform the tasks that they think should be performed and at the same time pacify patients and their families into thinking that what they are getting is something special. They don’t want someone who can think independently, who will challenge practice and who might want that practice changed and improved. What they want is a paediatric nurse with a special interest in say allergy, autism, ADHD, someone they can have control of.

My idea of a specialist nurse is someone who works at the forefront of their speciality, who advocates best practice and most of all works in partnership with the medical consultant. They consultant diagnoses the illness, but the specialist nurse takes part in the process of that diagnosis. He or she also offers the patient and their family the opportunity for a quality of care that they couldn’t otherwise have. This is no cheap option and rather than save money this kind of service might actually cost  more. Quality costs after all.

Our doctors need nurses who have an understanding of the patients under their care, they need to know how to work under supervision and to help free up the doctor to spend time doing things that require a specialist knowledge and skill. What they need are regular paediatric nurses who have been skilled up, who have addditional knowledge and who work at a level above the norm. In my book they are not specialist nurses, unless of course you consider a paediatric nurse a specialist in their field anyway.

Generally I have found wordpress.com to be a pretty good blogging host. It is simple and it is free. It can be very annoying when you want to sign up for particular services elsewhere (like those shoutbox things and one recent site that is meant to drive traffic) only to find that they don’t work here. But generally I am able to cope with those frustrations, after all this is simple and it’s free. But when you write a detailed post with loads of links, when you spend an hour when you should be doing something else deciding what to write and then tapping away on your computer it is very very and even another very frustrating when the post disappears into the ether with just the title of the post to let you know that it ever existed.

For some time I have been wondering about buying myself the domain name associated with this site and instead of using the hosted version of WordPress, going for the other version which is hosted elsewhere. I guess the events of Thursday (when I lost my post) brought this to the fore. The question really is am I prepared to spend money on something that to date has been a free (in terms of money) hobby? To be honest I am undecided. I have been writing this blog for about 18 months firstly on blogger and then here. Generally I have been a regular poster, and a few of my posts have brought pretty healthy levels of traffic. But on an average day about 60 people read my blog, which is fine but not exactly in the realms of changing the world. On the other hand, who am I writing for? Generally I write about the things that interest me, in a way that I feel comfortable. I am careful not to write about things that would too clearly identify myself and this in itself presents a problem. My job is relatively unique. There are few of us, and I cover the area of the whole county in that job. This  means I can’t hide behind the idea that something might have happened to lots of people and therefore will assist in disguising me. What is more, lots of what I do at work is relatively dull, but when something exciting does happen I can’t even talk about it for fear of being discovered.

So there we are:

Should I buy my own domain?

If I buy a domain, should I take the opportunity to change the name of my blog, because sometimes its name is pretty misleading and anyway I don’t want it to be all about working in the NHS?

That folks is my dilemma. As the Picture above says, I love blogging. But it can be pretty frustrating!

Meanwhile, better late than never but if you haven’t already been over there, Change of Shift is up at PixelRN. Take a look at the best of nursing blogs from all over the blogsphere.

It pains me to write this, but for the first time in about 8 years Arsenal have been beaten by Spurs. What is worse is that the defeat has been comprehensively administered. We are not used to this, we don’t get beaten 5-1, but that is the score tonight. Arsenal and spurs are arch rivals and fans of the two teams actually claim to hate each other. I became a fan of Arsenal as a young girl mainly because my dad and brothers supported Spurs who were actually our more local team. I have stayed loyal as have they to their team. Generally I have had a better deal out of this arrangement, Arsenal have won trophies; lots of them, Spurs have rarely done so. We are not used to this kind of humiliation and any minute now I fully expect a text or worse a phone call from my darling younger brother to rub it in.

Losing is one thing, to know your team deserved to lose as they were rubbish is another. Nothing else can be said on the matter!

This is a type of men’s deodorant. To my mind this kind of product, applied by the man following say a shower or a wash at the very least should smell of some kind of pleasant though not overpowering substance. Apparently though the makers of Lynx think women are attracted by the smell of a man’s deodorant, why otherwise would they make it smell of Chocolate? To me chocolate is something to be eaten and enjoyed rather than sniffed, though I guess smelling chocolate on your man is less fattening. Slightly worryingly on seeing an advert for said product hubby thinks it might be nice to try. Should I worry that he is trying to attract the attentions of some chocoholic female at work; after all he has now entered his 50th year and so could be about to have some kind of midlife crisis!

Lynx Chocolate also comes in shower gel. I’ll just buy my chocolate in bars!

A few days ago I wrote about my husband’s granny still being in hospital even though we can’t quite work out why. Yesterday there was a new twist to the tale. Father in law got on the train and travelled into London to visit her only to find a notice on the door of the ward saying it was closed due to Norovirus .

Since Christmas (or just before for all I know) there have been many news stories about the extent to which this diarrhea and vomiting bug has been sweeping the country. Locally hospital wards have been closed as attempts are made to control its spread. People have been told not to go to their doctors surgery or to hospitals if they suspect they have the virus. But obviously that is easier said than done and spread it has.

My questions though are: if you shut a hospital ward to visitors and also there fore prevent the inhabitants from leaving then perhaps you could just inform people so that they don’t embark on a journey to visit their loved ones. FIL travelled home and then got MIL to ring the ward to find out what was happening and that granny was ok. She is fine apparently, but of course she is stuck there and at 96 years old and pretty frail I am worried that if we can’t get her out of there soon, she will be struck with one of these bugs from which she will be unable to recover.

NT is running a major campaign, Time Out For Training (TOFT), to help ensure nurses receive the training they deserve. Over the next six months NT will be encouraging you to get involved in this important campaign. So what’s it all about?

The Nursing Times is running a campaign about what I would probably call post registration education but which they call Training. The online report goes like this:

As exclusively revealed in NT, more than half of nurses who responded to our recent survey believe they are receiving inadequate levels of training (see link to news story).

The situation is so severe that one in ten nurses say they want to quit the profession over the issue, with two-thirds receiving less than ten days training in the last 12 months.

The lack of commitment to post-registration education is a direct result of strategic health authorities using training budgets to balance their books – a trend which began in 2005.

With future career development and patient safety both in jeopardy, TOFT aims to:

• Persuade trusts to guarantee sufficient training time and staff back-fill is set aside to maintain career progression and patient safety
• Put pressure on the government to bring back ring-fencing of training budgets
• Persuade SHAs to guarantee that training funds are spent solely on that purpose

TOFT will run both in NT and on nursingtimes.net, with regular progress updates.

So what can you do to help us help you? NT will encourage you to sign an online petition and send a letter to your trust asking for a training time guarantee. We will also be encouraging you to share your experiences to expose those making access to post-registration training an impossibility.

Starting with an overview of the current training situation (link to first feature), NT has lined up a series of in-depth features looking at how the situation has hit the profession.

Together we can restore nurse training to a level that ensures safe practice and secure career development.

It is vital for nursing that we do so.

I agree whole heartedly with the spirit of what Nursing Times is trying to do, but my feeling is that they are missing some important tricks here. Firstly the situation is more complex than they mention; The SHA’s really did ’steal’ money which was meant to be ring fenced for the education of non medical practitioners (the money is not just for nurses), but the fact is that many trusts were in dire financial straights and as a direct result applied vacancy freezes. This meant that not only was there less money available but also that there were less people around who could be released for education purposes. This year, there is plenty of money available for courses but it has taken most of this financial year to get staffing back to any kind of normality and so problems do remain.

My second issue relates to the idea that ‘training’ only takes place outside of the workplace, when actually I would like to controversially suggest that it can take place from within and that academic courses don’t necessarily help with the learning of practical skills. Which leads me to ask what NT mean by training? In my mind a dog is trained to walk to heel or to jump through hoops (as per the picture above), and I guess if you are being pedantic a nurse could be trained to for example take blood or give an intravenous drug. This is because both are practical skills requiring some theory but mostly practice with appropriate supervision. If NT mean courses of the kind that add theory and allow application of that theory to practice then I don’t actually call that training, I call that education. The difference in funding terms between training and education is that training should be provided and funded by employers and should continue whatever the level of staffing and financial position because whether there are currently 5 or 25 nurses in a team then they all need to be competent to do their job. Education on the other hand is something that is desirable, and in some cases necessary for the job but requires nurses to be prepared to take some responsibility rather than act as a passive partner. Not everyone can afford to self fund and if SHAs put money aside for education then that is what is should be used for but actually NT does nurses no favour by encouraging the idea that education of this kind is a right, is something to be provided for you and is something that everyone should be able to access whatever the other issues that surround you.

As nurses, at whatever level you work, you need political awareness. You need to be able to recognise the difference between education and training, and sadly you are not going to find that out from the nursing times campaign!

My husband’s granny has been in hospital for a month. She is taking up a bed in an acute hospital during a time of year when there are usually ‘winter pressures’. She went in with some dehydration, constipation and the possibility of a urine infection that never transpired. Within 2 or 3 days she was pretty much her usual moderately confused self. She knows who she is and when she was born. She knows the names of the carers in her elderly care home and she knows who we all are even if we are not there. She doesn’t walk and hasn’t done so for the last few years, she is moved using a hoist at home. She is incontinent and wears Tena or some other make of pads. None of this has changed.

My father in law is an only child. His wife has lupus and seems to be getting a bit forgetful herself and his son for whom he is the main carer has motor neurone disease, he also doesn’t drive so has to go by train to visit her if we cannot take him. The three times a week trip is taking its toll. He is not the kind of man to ask questions or indeed to question exactly what is going on. But even he is puzzled by the hospital’s continued insistence that they are doing ‘tests’. He is even more puzzled that they are trying to get her to walk. As Granny said yesterday “I am 96 and I don’t want to walk”. I think that hubby and I will have to make a visit this weekend so that I can ask some pertinent questions about their discharge plan; hospitals are not the best place for a 96 year old who really doesn’t seem to be ill any more!

There are people who work without being paid. Perhaps they develop an interest and get involved in helping out at a school, an area of health or social care. There are many things people can get involved in perhaps for a few hours a month or more. I myself was on the PTA of my son’s school. I did this partly to help but also as a working mother who didn’t collect her own child from school to get to know other parents and to demonstrate that I cared. I was under no illusions about this, but it didn’t stop me spending evenings planning events or evenings setting up and helping run quiz nights, discos, promises auctions and whole weekends running fetes in varied weather from 90 degree heat to torrential down pours.

There are lots of people in health care who do things to support the statutory work that goes on. People who visit others, who sit with people so their carers can go out, who campaign for better services, who advise and support. They do these things without being paid, and as professionals we should be grateful that they do. After all if people didn’t volunteer then things wouldn’t get done or those extra touches that add the quality wouldn’t be there.

But sometimes you come across people who insinuates that people who only work as part of their paid employment are in some way  less committed, and therefore less professional than them. Who suggest that doing a paid job and another unpaid one till late at night makes them a better person. While I appreciate everything that that person does, actually I don’t think they are better and the very fact that they try to make others look less caring leads me to question their motives.

Each year hubby’s wider family have a bit of a get together over Christmas. This usually takes place at the weekend sometime between Christmas and New Year. This year though, hubby and and aunt and uncle were all ill, so the event was postponed. Fast forward to 12 January and the gathering was rescheduled. Yesterday afternoon I wrapped the presents something I have never done in January before and demonstrates a lack of organisation before Christmas or else intense laziness (or perhaps both) on my part. Arriving at the in-laws we found that they had kept their tree and a few bits of tinsel up so we placed the presents around said tree and gathered. A few drinks, some buffet food and chat with cousins, aunts and uncles ensued then presents were exchanged. A very pleasant time was had by all, and teen son seems to have accumulated a few very nice extra presents including a poker set. Hubby’s aunt said to me: “I’ve bought Matt a game, its in a box and is heavy, I think it is pontoon”.) He of course at the age of 16 and 11 /12 was pretty happy with that.

The post office also seem to think it is still Christmas, one of hubby’s cousins only received our Christmas card on Friday despite me posting it about a month ago. It is good to know that British industry continues to flourish in its efficient way! I wonder if any of the other people I sent cards too also didn’t receive them in time?

Thank you so much for the letter you sent to me and my NHS colleagues to mark the start of the new year. I know we all appreciate the time you have taken to write to us, though I have to say I would have preferred it to have been personally addressed rather than appearing on an email from our communications department. I would like to take this opportunity to offer my thoughts on the points you raise.

Over the past 10 years we have invested in health services at record levels. There are now 79,000 more nurses, 30,000 more hospital doctors, 6,000 more GPs. Where we have seen opportunities to improve the management of health resources we have sought to carry out the reforms which have made this possible – from new roles for nurses and GPs through to new foundation hospitals with greater freedoms and improved stewardship of the NHS’s resources.

No doubt the above figures are true, but this does not account for the people recruited who have become disgruntled with working in the health service and therefore left, it takes no account of the people who lost their jobs in the recent reorganisation, and it takes no account of the disgruntlement felt generally as your government managed to hack off pretty much all hospital doctors (modernising medical careers), all other staff with your derisory pay deals and just about everyone with your centralised, target driven policies.

And in 2008 the NHS is as relevant as it was in 1948. For sixty years now Britain has shown the way to health care not as a privilege to be paid for but as a fundamental human right. The NHS remains our priority not just because it has been fundamental to our past, but because a renewed NHS will be even more important to our future and that of our children.

The trouble is that you need to explain to people exactly which bits of the NHS you want to be part of their fundamental human rights. Health care in 2008 is significantly different from the way it looked in 1948, after all if you have an operation or a baby for that matter you no longer expect to spent the best part of 2-3 weeks sitting in a bed. The types of investigations and treatments you expect are not only different but significantly more expensive. Only last year there were a number of high profile cases where people demanded what they considered the best drug for their condition no matter the cost or effect that their prescription would have on the rest of the health economy.

You have responded with improved care and a higher standard of service. Over the past ten years waiting times have been sharply reduced. 99.9% of people with suspected cancer are now seen by a specialist within two weeks of being referred by their GP, which is up from 63% in 1997. Over 99% of people with suspected cancer receive their first treatment within a maximum of 31 days of diagnosis. Cancer mortality rates have fallen over the last 10 years, and an estimated 60,000 lives have been saved. Similarly, death rates from cardiovascular disease in people aged under 75 years are down in the last 10 years, saving 175,000 lives.

These are your achievements and I want to thank you for them.

Well it is kind of you to say so, and no doubt these are just the tip of the iceberg. People no longer lie on trolleys in hospital corridors waiting to be taken from the emergency department to a ward, people no longer wait to be seen by a consultant and then subsequently for a hip replacement or whatever for 2 years as they previously did. The things I mention are due directly to the work put in by NHS employees rather than in the main due to better treatments, but as I say it is nice of you to thank us.

Whenever I have visited hospitals, GP surgeries, and health centres across the country people tell me of their huge admiration for our doctors, our nurses and those who work in our health service. The best of NHS care has always depended on its staff for innovation, for commitment and for professionalism and we will continue to draw on your ideas and look for ways to empower you.

With all respect people are hardly going to be allowed to meet you to say that those working in the health service are horrible, unpleasant work shy people. But it is true that the commitment of people who work in health care has been second to none. To a great extent the NHS runs on good will, because while many salaries are now of a reasonable level we are all expected to go ‘that extra mile’ to step in for those who who are not there or not good enough, to carry on working at the end of the shift because you just can’t walk out on people who need you. Change and innovation has become many of our middle names, and many of us spend our working lives trying to persuade those who would rather keep doing the same thing to embrace change.

In 2008 we know that working together there is more to do. The Government’s priorities for the coming year will be to do all we can to support you as you work to bear down on hospital infections and improve access to care. We have committed additional investment to MRSA screening and deep cleaning of our wards in order to help you. Achievement of the 18 weeks target by the end of the year will mean the shortest waiting times since the NHS was established – almost unthinkable just a few years ago.

But you allow the population, generally through the media, to think that MRSA and other ’super bugs’ are due mainly to the inability of health workers to wash their hands. You have bought into the idea that deep cleaning wards will solve everything when these are not the only causes of MRSA in our hospitals. I would imagine the cleanliness of wards and the rise of MRSA are caused by slightly different things. It might not be your government that promoted the tendering of hospital cleaning to external companies for the cheapest price but you cannot pretend that there is no link between that and a lack of cleanliness generally. The 18 week targets do give us the best opportunity to change patient pathways and to improve care and treatment at all stages of the pathway so long as it isn’t just about time scale but quality is promoted too.

But 2008 should be more than this as well. I intend for this also to be the year in which we demonstrate beyond a doubt that the NHS is as vital for our next 60 years as it was for our last – more relevant to our future and the challenges that we face than ever before. That is why one of my first acts as Prime Minister was to ask the eminent surgeon, Professor Ara Darzi, to conduct a fundamental review of the NHS, listening to patients, to staff and to the public and understanding their expectations from a 21st century healthcare service.

Yes and we can barely wait for more significant changes to the way services are delivered and the way our organisations are run. We cannot wait for more re badging, re branding and more control and targets. Remember some of us have only just recovered our nerve from last time, and some of my colleagues remain gibbering shells of their former selves. So beware of the Darzi reviews and the effect any new policy might have on the staff you care about so much.

So over the course of the next year the Department of Health, under Alan Johnson’s leadership, will be setting out how the NHS needs to continue to reform to meet the new challenges of 21st century healthcare and 21st century lives. Reform and change which we will work with you to achieve to create a better NHS.

I don’t deny the need for this, but Alan Johnson is not really showing much in the way of leadership so far, however I am prepared for a sudden burst to come our way!

We will describe how we will achieve our shared ambition of an NHS which is more personal and responsive to individual needs. Personalised not just because patients can get the treatment that they need when and where they want, but because from an early stage we are all given the information and advice to take greater responsibility for our own health.

This is great stuff, but I wonder quite how you balance the agenda where you offer choice with the one where you expect people to take more responsibility. What about if they choose to live unhealthy lives and then expect us to pick up the pieces?

We will talk to you about the changes we need to make together to create an NHS which is as good at prevention and keeping us healthy as it is at the care and the cures we know are there when we need them. An NHS which is able to offer the help and support that we all need to make healthy choices for ourselves and our families.Well yes, because contrary to popular belief this is meant to be the national health service rather than an illness service which is how most seem to treat it.

We will set out how we can give all those patients who want it, or would benefit from it, far greater control and choice over their own health and their own healthcare. We need an NHS that gives all of those with long-term or chronic conditions the choice of greater support, information and advice, allowing them to play a far more active role in managing their own condition in partnership with their clinicians. And even when healthy, we know all of us will benefit from earlier information about potential health risks and advice on how we can keep ourselves fit and well.

You are going to need to help us as health professionals learn how to do that though. We have been brought up to take control and patients generally have fitted into the model where doctor / nurse knows best and they are expected to conform. A new mind set is needed to allow people to take the control back and to enter into more of a partnership relationship with their doctors or nurses. In some cases someone will need to be available to advocate on behalf of patients, particularly those with the kind of conditions that make this difficult to do for themselves. We also have to learn to be open and honest about what can and cannot be done and have debates about the finite resources we have and how we best spend them.

And we will also examine how all these changes can be enshrined in a new constitution of the NHS setting out for the first time the rights and responsibilities associated with an entitlement to NHS care.

I am all for this, but how it is sold and how the media pick it up will be important other wise it will be all about rights rather than anything to do with responsibilities.

I believe these are steps vital to securing the health of the NHS for the next sixty years. They will require a broadening and a deepening of reform to ensure that the NHS as a whole attaches the same priority to a personal and preventative service as many of you already reflect in your own day-to-day decisions. And I believe they will transform the experience of the NHS for millions of people in this country.

Working together I know we can make these changes a reality. I thank you for your continued hard-work, determination and innovation and I look forward to working with you all to make 2008 not just a milestone for the NHS’s past but for its future as well.

I look forward to working with you too Gordon and hope that part of the celebrations for the 60th year of the NHS doesn’t tie me into a pay deal worth about 2% over 3 years because that just won’t be good enough. Meanwhile, thanks for the letter and a happy new year to you too.

This week there have been a number of programmes on TV about the welfare of chickens that are used for eggs or that are eaten for meat in the UK. Chicken has over a period of my lifetime gone from being a relatively expensive commodity that was eaten perhaps once a week to something eaten as a main staple of the British diet because it is so cheap. Supermarkets have helped to drive the price down and with that the quality. Chicken that costs a couple of pounds is generally pretty tasteless and what is more it is much more fatty and less good for you than people might believe. This is due to the way in which chickens are produced by farmers; kept in large numbers in great big sheds for the duration of their short 30 something day lives. It is difficult for the average consumer though, even if they know all of the above. If you are on a low income and struggling to feed your family then the offer of 2 chickens for £5 might be too much to turn down. You can after all cover it in some kind of sauce and ignore the animal welfare arguments, feeding the family is more important than all of that.

Well no, not for me. I prefer my chicken to taste good, I prefer to know that it has been brought up in at last a half decent way and I also would prefer not to discover one day soon that the chicken I eat is full of fat / antibiotics / water / some other unpleasant substance that perhaps might cause cancer. So I have joined the campaign and I am going to continue to buy a better standard of chicken even if I have to buy less of it because it is that bit more expensive.

The year is 9 days old and this is just my third post. I could put it down to being far too busy sticking to new years resolutions and generally getting back into the swing of work, but that wouldn’t really be the truth. For a start I haven’t actually made any resolutions since I am not good at sticking to them and anyway I don’t want to follow the crowd on this. No we are talking laziness and a lack of ideas on the blog post front. But as regular posting helps to keep at least some traffic visiting, and as I have now run out of chocolate which stupefies the brain it is time to get back into the swing of some regular pearls of wisdom from yours truly.The NHS went through something of a lull over the Christmas / New Year period. Only important people went to work; which means generally those who actually contribute something meaningful (i.e. nurses, doctors and the like). Managers and admin staff in the main try to avoid work as far as I can see, though someone has to be seen to be keeping the place going so a skeleton staff remained during the working days. As someone who went to work for one whole day over this period I saw this in action for myself. The truth was though that no one really knew or cared that I was there and so while I got some useful work done I am not sure of its value over all. Still it got me out of the house and away from hubby’s germs.

Speaking of which, he has at last emerged from his sick sofa and gone back to work. I pride myself on knowing quite a bit on illness and recovery from it, so offered much advice on his rehabilitation. For example I suggested that lying on your back watching football for the whole of Sunday was no  preparation for his return to a full days work. He agreed with this but was unable to raise himself to so much as take a ball off the Christmas tree or to take a step outside the house. Consequently he lasted to lunchtime Monday and 4 o’clock on Tuesday which means today he will make it to the same time as everyone else. It pains me to be right so much of the time, but someone has to be.

My return to normal work has been nothing short of frustrating with people canceling meetings half an hour before they are due to start and when I have just arrived outside the door half an hour early because I got the time wrong! Also I am operating out of two bases at the moment (my normal one which is 27 miles away from home and often where I need to be) and my new base where as previously mentioned people are pretty unfriendly and where I need to spend time to get them responding to me a bit more positively. But my computer remains in my original base and IT have judged the request for its movement as being only category 5 (whatever that means, rest assured not urgent).

Today I return to slimming world. I am ashamed that having worked hard to lose 19lb since last August I managed to put on 7lb in just 2 weeks by eating and drinking whatever I pleased and doing very little useful exercise. But today sees me return to the weight loss programme because actually I like being able to buy smaller clothes and I don’t want to return to the bigger ones. Plus of course I want to have energy, I want to be fit and I don’t want to be a public enemy by being obese.

So that is where I am, and tomorrow (or later if I feel inclined) I shall report on the daily dose of NHS related sound bites that have emerged from the government since the start of the year which started with the lovely and not at all condescending new year message we all received from the Prime minister himself.  I’d do this now but firstly I don’t want to peak too soon in terms of blog posts and secondly I should be heading off to work right now!

Everyone, myself included is often in a rush. We lead busy lives, and are perpetually trying to get from place to place in the shortest possible time. Maybe this is why people often seem so irritated with each other. People risk their lives overtaking one car just to get to their destination slightly more quickly, and if someone holds them up for 2 seconds they are on their hooter giving them what for. A couple of weeks ago, I drove the wrong way around a car park to grab a space I had seen, after all I was irritated by the 5 minutes or so I had spent queuing to get in with all the other Christmas shoppers. But this did not prepare me for the mouthful of abuse I received from a probably otherwise pleasant lady who considered I had stolen her space. If you get called a selfish b****, you could see how someone could get into even more of an argument, which I am pleased to report I didn’t.

Yesterday though I was struck not once but twice just how rude people can be, and without provocation too. The first was while I accompanied hubby to the Dr’s surgery and I witnessed 3 consecutive people being rude and short with a perfectly pleasant and accommodating receptionist. Yet no one was being made to wait, the lady who was at the wrong branch of the surgery was advised that she would ring ahead to tell of the reason for the delay and the lady being asked to complete a survey was only being asked for her opinion on her doctor and his services and being asked nicely at that. Once in the office (not my usual current base but the one I will soon be moving to) I was struck by the way people just chat amongst themselves and carry on with their own lives and do nothing to welcome a stranger, even one who has been turning up reasonably regularly lately and who is cheerful and who says hello and goodbye though doesn’t muscle in on their conversation. Once you have sat in an almost full office being ignored for about 3 hours then it is time to go and that is what I did.

Politeness and friendliness costs nothing, particularly when you haven’t had someone grab ‘your’ car park space, and even then you don’t have to swear!

I have always prided myself on being able to say the right kind of stuff to patients; empathy, sympathy, toughness depending of course on the situation. With members of my own family, I am not always so good. This is partly due, and particularly in relation to hubby’s ‘man flu’ the feeling that sometimes they are trying to make themselves seem more ill than they really are. Trying to perhaps opt out of any household chores, trying to avoid family get togethers and generally slob out. It turns out though that perhaps I was a little harsh. Last night was the 9th of hubby’s illness and over the last few days he has developed a cough particularly at night. This meant that he was unable to get up to return to work on Wednesday morning as planned and last night he was no better. The trouble is, it is not just the poor patient who suffers when one of a married couple coughs all night and I woke up this morning feeling like I had not slept. Action therefore was needed.

Our GP surgery holds back a few appointments each day for ‘urgent’ cases, but to get them you have to get on the phone at 8.30 sharp. On this occasion I was lucky, got straight through and had him round there by 9.10. This was despite his protestations that a) he didn’t know where the surgery is and b) he would be wasting the Dr’s time. Hmmmm well I reasured him that he was no time waster and took him there myself . By 9.30 he was home with some Amoxil (Tracheitis apparently) and I was on my way to work. I probably should have bought some ear plugs while in the chemist, but I am hoping for a quieter night tonight!