Three years ago, Kim,  the queen of nursing blogs (as she has become know to us)came up with the most wonderful of ideas. Why not share blog posts written by nurses and others involved in healthcare across the world? As the world becomes an ever smaller place it has become apparent that while our health systems are different, many of the issues we face as nurses are very similar. Those similarities aren’t just that our patients have the same kind of problems, or that they concern us, irritate us and amuse us in the same way, but also that the professional issues we face are often similar. We all face an aging population of not just patients, but also nurses. We all have to consider the extent to which nursing boundaries can be pushed, the extent to which we celebrate the meaning of nursing and the kind of care we can and should provide to patients. We also seek to extend our knowledge and to gain academic and professional qualifications which we hope will contribute to our credibility as professionals of nursing.

I have hosted Change of Shift twice, and found this both challenging and one of the most enjoyable things you can do in the world of nursing blogs if not blogging as a whole. Of course over that 3 years my own work seems to have taken me further from nursing than I would have imagined. However I am still a nurse, still consider myself passionate about nursing and the difference nurses can make to people across the world.

So Kim, thank you for the last 3 years, good luck for the coming year, change of shift’s fourth, long may this wonderful carnival of nursing blogs continue. This week’s anniversary post is over at Emergiblog now!

Julie visits her own blog.

It is true. Not only haven’t I posted for about a month and a half, but I don’t seem to have even dropped by. I have got lazy, I have been on holiday, I have visited facebook, I might even have twittered, but why haven’t I been by my trusty blog?

It is complex in truth. I have to change it’s name. I still work for the NHS but to be honest I can’t write about that whole thing, except in general terms. As I have said before, I am there doing a job not done by anyone else in the county and that makes it just too risky. I am however lazy and I am short on ideas. I will try, but if I can’t sort myself out soon, I might need to kiss goodbye to Life in the NHS.

Maybe, I should get myself reborn?

In my absence though what has been learned?

Today I have seen that in death, Michael Jackson is portrayed as a genius, when in life people called him wacko and showed no respect. People who don’t seem ‘normal’ to us might actually have led lives that damage them.

MPs have become the estate agents and bankers of 2009. No one likes them, or trusts them. Yet next year in the election people will declare that they cannot be bothered to vote, it makes no difference. When everyone says that, the wrong people get into power and people will be sorry.

Nice in France is a lovely place. It is however very expensive and only the rich and famous can afford to go there.

I should write more blog posts…. now isn’t that where I came in?

Time for a bit of a makeover; this is called girl in green or something like that. I’ll try it out for a few days, but don’t be surprised if I decide to try a few new looks! Its a girls perogative to try out everything in the wardrobe before she goes out on the town!!

WordPress is pretty good at weeding out the rubbish that hits any blog, indeed improved filtering and detection programmes have meant that the amount of spam appearing here is much reduced. It is in effect pretty dull, though irritating stuff. If I wanted Viagra, a loan or to buy a specific item I am not sure an advert on someone’s blog would point me to where I would buy it. The spam that arrives in emails is also pretty much filtered out, it has also reduced markedly in recent months. I guess some people are persuaded to send thousands of pounds to Nigeria, or to release their banking passwords to complete strangers in an email but they would have to be pretty stupid.

What is really irritating me right now though is the spam hitting a forum website on which I have remained a moderator along with Terri, other wise known as  Mother Jones. This kind of spam involves registering on the forum, and posting large quantities of either highly dull, foreign character (maybe Russian or Greek) or more unpleasantly parts of peoples bodies I don’t want to see on a nursing website. These people are seriously getting on my nerves.

A quick look on Wikipedia told me this:

Most forum spam consists of links to external sites, with the dual goals of increasing search engine visibility in highly competitive areas such as weight loss, pharmaceuticals, gambling, pornography, real estate or loans, and generating more traffic for these commercial websites. Some of these links contain code to track the spambot’s identity if a sale goes through, when the spammer behind the spambot works on commission.

Spam posts may contain anything from a single link, to dozens of links. Text content is minimal, usually innocuous and unrelated to the forum’s topic. Such text is included to prevent the post being caught by automated spam filters that prevent posts which consist solely of external links from being submitted. Full banner advertisements have also been reported.

Alternately, the spam links are posted in the user’s signature, in which case the spambot will never post. The link sits quietly in the signature field, where it is more likely to be harvested by search engine spiders than discovered by forum administrators and moderators.

Recently, a very destructive forum spam attack has been propagated by inserting into comments redirect domains with an automated posting script like Xrumer. These domains redirect a user to pornographic Websites. If a user clicks on the image or attempts to close the Website an ActiveX codec will be downloaded as a Zlob Trojan^[1].

One of the features of Nursing Voices has been the high level of people who register but never post. In the main these are just ordinary people who register but then don’t have anything to contribute. Indeed I once opened a thread asking peoples opinions on why this was the case. But it seems that there may have been a  more sinister reason, and that hidden in the signature line was something which helped to point back to NV. This morning alone I have deleted at least 15 posts and banned the associated culprit. I do wish each individual registered spammer posted 4 or 5 posts rather than 1 to make my life easier.

My irritation, though isn’t just with the Spammers. MJ and I aren’t the owners of this site, we are just people trying to make sure Nurses play fair when they have discussions with each other. In this case the owner of that site appears to have cut us loose and is doing nothing (or nothing effective to help us). We have served notice that we will leave them to it in the very near future.

But, what if we stop moderating and this site mushrooms into one completly full of spam, much of it pronographic and the title of that forum remains Nursing Voices, what then? Well it then shows nursing in a completely different way to the one we want it to be shown. What a mess!

In my last post I told the world about how wonderful I think the weekend break is. This view has not changed since then, however, it would be true to say that a weekend break, followed by a full and busy week working in the NHS is not to be fully recommended. This essentially is because the employer needs its pound of flesh while all of the things you couldn’t do over the weekend (e.g. ironing and food shopping) because you were away finally catch up with you. This week has been eventful, I would like to share my learning with you. As the title of this post tells you, here are some of the things I learnt this week. I am now becoming the queen of the list!

I become irritated if my dear hubby takes a day off following a weekend in Rome while I am forced to pitch up at work.

You can become the subject of a management tug of love. In my absense last week conversations took place which led to people laying claim upon me within their teams. It is currently not quite clear who thinks they are my boss, who thinks they can give me work to do or who loves me most. Still it is better to be wanted by 2 or more people than no one at all.

It is quite possible for your child’s best school report to come in the months before they leave school for university. If only I had known when he was 6 that all would be well in the end, I wouldn’t have worried when the teachers told me he had some kind of problem with writing and understanding written english. I would like to think that the teachers along the way have helped, but to be honest it may be that the most work has come from within.

It is possible to attend a retirement party for an ex colleague and find that other ex colleagues remain in the same place physically and emotionally that they inhabited over two years ago. It is possible to find that the trauma of applying for your job and not getting it could actually be a blessing in disguise.

If you put the word “Facebook” into the title of a blog post you may well receive lots of hits in one day. Equally the name “Gordon Brown” produces plenty of hits. I recommend it.

If there was ever a weekend that I looked forward to this is it. If ever I was weary, I am now.  But actually I wouldn’t change a thing.

He two-timed me on Facebook. But our divorce will be for real

My husband has a natural distrust of the internet and of sites like friends reunited and facebook in particular. He claims they assist in the break up of marriage, I always tell him that real people break up marriages not the internet. Recently though I have seen a darker side. Nothing to do with marriage break up per say, but more about manipulation of those on the periphery. Over the last couple of months the marriages of both my brothers have fallen apart (is it me I ask?) I am on facebook and so are both sisters in law. I have no axe to grind with either of them. They are the mother’s of  my nephews and neices, they are human beings and I believe it takes two to make both a good relationship and a bad one. But one sister in law in particular has begun to write status reports that seem intentioned to test out whether I support her or my brother and really that is not on.

Then I read this

My mother emailed me last week to tell me she had joined Facebook. We don’t chat on the phone; we email. Soon I expect she will want to poke me, write on my wall and, worse still, tag me in photographs of my wedding last May. Well, not if I can help it, mama. I love you too much to expose you to my online self.

You see, she doesn’t yet know that I, her 24-year-old daughter, am about to divorce. She can’t see my Facebook status, so why would she?

Mummy, how do I tell you I’m a Facebook divorcee? That the son-in-law you try so hard to like cheated on your only daughter using the social networking site you so adore? That your daughter learnt of her imminent divorce via Google Mail’s free chatting facility, Gchat?

It began with a woman he met at a party. But it was within the sticky web of Facebook where they really got to know each other, despite the photos of us and our “married to…” status. I know this because my husband once logged on to Facebook and foolishly left the room. I began to use his Mac, only to find myself blasted into the middle of a sizzling cyber romance.

And once I was in, I was hooked. Their lusty emails touched on bad Beat poetry, but were infused with textspeak, their coy cyberflirts rife with emoticons. It felt like I was stuck in a hyper-reality where Douglas Coupland wrote Danielle Steel novels. “Could this really be happening six months into my marriage?” I wanted to comment on my own Facebook wall.

Read the rest here, it certainly makes you think!

10 days into the new year and getting on for a month since my last offering, I am finally going to offer something to my blog. I really am extremely lax aren’t I? It is not as if I haven’t had the time or really a shortage of ideas (though originality might be an issue) it is just I think that the whole Christmas / New Year period causes extreme laziness. It is all of that rushing round the shops unnecessarily spending money we will need later on in January on things we don’t need, might not eat, shouldn’t eat or give as presents. I am the worlds worst. I start off being really careful in my choices, both in terms of price and appropriateness. But as Christmas approaches I start to feel I should buy more, spend more, give more and indeed hoard more food just incase! Then there are the days after Christmas when things are reduced in price and I go out for milk and return with half price chocolate, party nibbles and other such items we don’t need or really want. Luckily I have been able to resist a third off a dyson and half price toys – I am not that gullible.

The headlines for 2009 from my point of view if you are interested will be:

• A teenage son turning 18 and in all probability going off to university in the autumn (I am already feeling semi empty nest like)
• 2 brothers who appear to be heading towards divorce (I only have 2 brothers and in my opinion doing this whole marriage breakdown thing at the same time is a bit much)
• Seemingly I will have to continue to do a job that has been undervalued in salary terms and like it (don’t get me wrong I do like it, but it grates that I am not really being paid what the job ought to be worth).
• I will continue to attempt weight loss. I weigh less than this time last year, but not by quite as much as I would like. But then if I buy half price chocolates, and import Ghirardelli chocolate from the USA what can be expected?
• A trip to Rome next month – birthday treat for son and nephew. I hope a mortgage won’t be needed to pay for it, but I expect it will be pretty expensive – the pound is just worth nothing these days. Having said that, I secured a bargain last night with an outwood bound flight for £5.00!
• A silver wedding anniversary for hubby and I – Can it really be 25 years since 1984?
• A hope that my mum will have a better year – 2 strokes last year were no fun. She hasn’t quite given up the cigarettes but I have to admit she is making a pretty good attempt at cutting down to the minimum.

So I have taken the plunge. I have posted in 2009. I am not announcing resolutions but I will try to pay more attention to my blog. Happy New Year to all who pass by!

Something quite strange has been happening here on Life in the NHS lately, and that is the popularity of Gordon Brown as a tearch subject. Gordon got off to a slow start that is pretty clear. Accountants are always reckoned to be pretty dull and after 10 years or so as our ‘prudent’ chancellor of the exchequor (kind of the chief accountant of the UK) he slipped into the top job without being elected. I suspect no one really knew who he was and what he was about, what is more he is a less than charasmatic, kind of awkward individual who has been required to learn how to actually relate to ordinary people in the real world away from finance.

Over the last year or so, he has faired badly in a country still booming but disillusioned with the fact we are still at war and has appeared much less of a public statesman than his opposition number David Cameron. Roll forward to 2008 and the financial crisis / crunch or whatever we  must call it and actually we suddenly realise the financial acumen of Gordon Brown is something recognised around the world. I wonder if that is the reason why my one previous post about Gordon Brown is now featuring as top of the searches on my blog. Just shows you that you can’t judge an accountant by their apparent lack of charisma!

The picture above shows a very young version – it puts me in mind of a kind of Oscar Wilde figure, anyone else agree?

We all have baggage. The things that happen to us throughout our lives - for example child hood bullying, our experiences of adolescence or educational systems, personal relationships including marriage and work issues. Stuff happens, and isn’t necessarily properly dealt with. We move on, get on with life, just brushing those issues aside. But and this is a big but, sometimes those poorly dealt with issues, those things we think we have moved on from return to bite. For me it has been about being made (almost two years ago now), to accept a job at a lower grade (with pay protection), a job with less organisational responsibility but which carries less power and authority (something I didn’t know I cared about). The organisation is bigger and less personal, but for the most part I am happy. It is just that sometimes particularly times of stress when I can’t get things done in the way I would like I realise that some of my issues with the process that happened at that times haven’t been dealt with as well as they might. This isn’t a serious issue for me or anyone else, but what if the monkeys on your back did affect the way you lived your life and your interactions with those within it.

These thoughts have been prompted by a series of posts on the Nursing Voices forum on which I remain a forum guide. I say remain because I have continued in this role all be it intermittently since the site changed ownership. For one there is no interaction these days with the site administrator which wasn’t the case when Shane was around. I am a less frequent visitor these days but was prompted to visit at the weekend following the reporting of an abusive post.

What I found was an individual who was taking his anger out on a number of people from both the cyber and real world. People who the person felt were making it their life’s work to cause him irritation and anger. He was upset with his nursing school instructors whose fault it was he was failing his course, he was upset with his student colleagues who were just pretty stupid and he was upset with other forum members who tried to engage with him and discuss his issues on the forum. From the content and tone of the posts it was pretty obvious that the person brought with them a wealth of life experience but whose posts demonstrated a level of unfinished business that made me question whether nursing might be the right profession right now. If colleagues, teachers, managers, and people in the cyber world wind you up quite so much then what will the patients do to you. As we all know patients often don’t listen, don’t follow advice, and often know what is best for them. How we deal with the issues thrown at us is more than learning how to deal with disease processes and how we behave in difficult and stressful circumstances will define us as nurses.

For me this has been food for thought about the way in which previous life events impact on the way in which we portray ourselves to others and how perhaps they might judge us on our behaviours both in real life but also here on the internet.

Yesterday was my brother and his wife’s 16th wedding anniversary. Sadly there were no celebrations, he and his children had spent the night before with us and the marriage is on extremely shaky grounds. Listening to our nearest and dearest pouring out their hearts about such things is difficult and seeing the effect on children is pretty heart wrenching. For them there has been years of arguments, of failing to listen to each other, above all there seems to be a lack of respect. Being in a relationship is tough, it takes work, it takes flexibility and understanding. The trouble is people often don’t realise what they have lost until it is pretty much too late. I really hope they can sort themselves out – for their own sakes and for the sake of the children, but right now the jury is out.

I have been thinking over my non posting weeks about this blog and why it has often been difficult to write even though I am often not short of ideas. I have come to the decision that it is the title of the blog that is wrong. I still work in the NHS, I still believe in the principle of the NHS, but actually my attitude to work has changed. I think I am going to need to change the title and focus of this blog, because work is not something that I want to write about all that much (though sometimes I might). Some changes are afoot – watch this space. Good news though is that I am back to blogging even if I am apparently unworthy due to my carbon footprint (see comment in my previous post). Personally I think that after the year I have had (fighting for the right salary, turned down for two jobs, mum too unwell to come away with me to mention a few things) I am not about to apologise for drinking bacardi in a hot tub that I didn’t heat and that will be heated if I sit in it or not; so there.

That just when you think you are winning, suddenly you are awake at 4.30am drinking hot chocolate and wondering why you aren’t sleeping. Not being a seasoned transatlantic traveller I managed to do a few things wrong. Firstly I let my hubby tell me that his normal window seat would be a good idea for our return 9 hour flight from San Francisco, this meant that I was pinned in the middle between him and a man who spent the entire journey (or would have done had I not woken him twice). Secondly I wasn’t tired at the start of the journey (I was calm and rested following my holiday and not suffering from any sleep deprivation) and so couldn’t sleep) and thirdly I went back to work too soon.

In this ‘back to blog’ post I am reporting my trip kind of from the wrong way round, but the last few days have made it difficult to think straight about the great time I had climbing hills in San Francisco, feezing in Vegas and watching the ocean in Bodega Bay (but if I am serious about the return to blogging then that will come). I guess I should say something about my lack of posts, now down to 1-2 a month. The time has come to either put up (posts that is) or shut up, although recently I have had more visitors in my absence than sometimes called by when I was posting daily! But no, actually I have lots to say, both about my recent experiences across the pond and my thoughts on the current state of play in the NHS. I just needed some time to get my thoughts back together, and back together they are. It is just that before 5am in the morning is not the time I would choose to do this, but I seem to be awake and so here I am.

We returned home on Tuesday morning, and strangely that felt like the middle of the night (we landed about 2am Pacific Time, so I guess that is accurate), ever since then I have struggled to understand why it is light when I would like to be asleep and visa versa. On my first day back (Wednesday was too soon) I lost my car park pass (luckily it was handed in by and honest soul), and I sat at my desk unable to do more than open and close emails and drink coffee. On the second day I realised jet lag was about a splitting headache, a complete inability to sleep at all even though you are extremely sleep deprived but I managed to sit through two meetings without falling asleep and without looking completely idiotic. By day 3, yesterday, I was reasonably normal (well normal for me) but now on Saturday morning I am awake too early (but ever hopeful of another hour before day light).

I know I have made promises before, but this time I mean it. I have lots to say and share. I have opinions on life in the good old US; somethings I loved, somethings I find slightly odd because I am a brit and somethings I think we could learn (even now). So I promise to return very soon. I leave you with a picture of the view from our rented house across the Pacific ocean, which actually is where I’d like to be right now, and where I’d take a 10 hour flight to, even pinned in the middle of the cabin and even allowing for jet lag!

This blog has lasted much longer than any diary I ever wrote, but it would be true to say that I am struggling. The enthusiasm I had over the last few years seems to have elapsed, but actually I don’t feel inclined to give up just yet. I can’t blame the summer, since we haven’t exactly had one. I can’t blame lack of material, but I suppose that I could blame laziness, a lack of motivation and just really a lack of desire. All through this lean period I have continued to read the blogs of my fellow nurse bloggers and they put me to shame. How is it then that I have plenty of topics I could write about on here, but when it comes down to it I just can’t be bothered?

Or actually should I really worry about the why and just relaunch myself and get back down to business?

Yes………….. that is what I shall do……

The next post follows in ………… 5 minutes

On the first of this month, I said (no actually rather I claimed) that to make up for my lack of blog posts during June I would write something every day. Here we are 15 days later and this is the first time I have written anything. I can’t quite work out what is wrong with me. I don’t entirely have bloggers block, because most days I come up with ideas about the kinds of stuff to post here (as I always have) but by the time I get a spare half an hour to actually do so, I either decide that there isn’t enough to say or else I get waylaid doing something else.

One of the issues I have is that often my stories, thoughts and opinions are driven by annoyance at the health related issues that appear on TV and in the newspapers, rather than by something that has actually happened or affects me. This is all well and good, but if it doesn’t directly impact on me I have to try and find out more about the story to form an opinion which doesn’t look as if I am ranting at the negativity of what is reported rather than anything else.

In the almost 3 years I have been writing this blog, I have studied for a Masters Degree and have gone through a torrid health service reorganisation. I have moved office several times and job probably twice. It is not the NHS itself that is causing me problems right now, it is not my actual job that is of much worry (since I like the day to day business of maternity and children’s commissioning), my pay will apparently be resolved next week (but then I am not holding my breath for either it to be resolved in my favour or for it actually to happen next week). No it is my own PCT and the way in which it just is that gets me wound up right now. The trouble is, having seen what has happened to fellow bloggers who have got too personal with their actual employer and characters within work, I don’t think I can go there. I have applied for a new job, outside of this employer but still in the NHS so that (if I were to get the job) might give me more material.

I would like to make my blog content more general, to move away from just about work and health with the odd post about other things that happen to me in my life or that I have strong feelings about. Therefore, and I have spoken about this before, I think I am heading for a re name and a re focus. Till then, please bear with the erratic nature of my posts.

I seriously doubt it, but the Guardian online has used part of my post on compassion in a round up of blogs as we approach the 60th Anniversary of the NHS. It is interesting, and this happens when I read papers I have written at work in the past as well as some of the academic essays I wrote for my masters, that sometimes you re-read a passage and feel pretty pleased with yourself.

My own organisation is celebrating the great diamond jubilee (I think 60 is diamond) by holding a family fun day. I hope it is successful, though have a good excuse for not going (really I do), because next weekend I will be in Spain. Those who work in the NHS, and my own trust in particular still struggle to feel valued, but I guess events like this one may help. The problem I have with the NHS right now, is wondering how much longer it will be fit for purpose and affordable. The trouble is that we are far more discerning than we were in 1948, we expect more from those who provide services for us, we know more about what we should be able to expect and it is much more expensive. We are often told through the media that there needs to be a public debate on a particular topic, but if there was ever an important subject to be informed about and to get talking to others about this is it. Meanwhile I and my colleagues, clinical people now working in management will continue to try to challenge services to prove to us that what they do is the best value and most appropriate for the needs of the patient. Free this treatment might be but quality and value are what are important. What is more, going back to the compassion debate, we need to value each other and be caring of everyone who comes into contact with us.

J	Judicial
U	Unusual
L	Light
I	Intense
E	Exhausting

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