Former NHS Nurse and manager now contemplating the NHS from outside

Archive for the ‘Blogging’ Category

2011 in review

The stats helper monkeys prepared a 2011 annual report for this blog.

Here’s an excerpt:

The concert hall at the Sydney Opera House holds 2,700 people. This blog was viewed about 23,000 times in 2011. If it were a concert at Sydney Opera House, it would take about 9 sold-out performances for that many people to see it.

Click here to see the complete report.

It’s my 6th anniversary

It is 6 years ago today that I posted my first blog post, boy time flies! I believe I am sitting in the same place, possibly about the same time of day. It is Saturday morning, hubby is putting in some over time (though these days he is on a salary and doesn’t actually get paid for it, he just love it so much!) and I am sitting in bed, laptop on lap. really I have more than enough to get on with. I have house work; who doesn’t but given my recent laziness an urge to blog should not be ignored at the expense of dusting, hoovering and bathroom cleaning!

One of the reasons I am still quite reticent about posting my thoughts is that the kinds of things I would like to say could get me sacked. It would be enough to say that the passage towards my new position has not been facilitated well by my employer. But good news, following my impending holiday (starts next Friday, yipee!) I will at last be able to start the job secured as a secondment in June.The urge to badmouth ones managers is something that you are always wise to suppress especially since I have been hearing stories of people being disciplined and sacked for doing so.

I am part way through a course to become an RCN Steward and the days spent with fellow trainees have been enlightening particularly when it comes to hearing about some of the things that nurses get up to and what is more say online. Whether it is using work computers to run some kind of raunchy dating agency, browse the kind of information they shouldn’t or else posting derisory information on facebook for the world to see apparently people are out there doing it all. What is more, my steward colleagues are kept busy providing them with support and managers are kept busy taking the errant employees down a disciplinary route. I do not intend to have the same thing happen to me!

Of course there is plenty more to write about, or there most certainly will be when I get stuck into working through the world of quality improvements to cancer care. This much I promise.

Work in progress

As part of my attempt to re-enter the grand world of the blog I am making some changes. New theme is done; hope you like it. Just all the links etc to sort. This will hopefully be completed tomorrow!

Resolutions for 2011

The last day of 2010 and I think that means it must be time for a blog post. I won’t apologise any more for not writing  my blog, nor will I make any promises about blogging more; it is pretty likely I will break any resolution like that before the year is a few days old. All in all I’d say January 1st is a poor time to resolve to do anything, after all many people are either hung over, or sleep deprived or both. Although I have titled this post “Resolutions for 2011″ I think it might be more apt to spell out my “intentions for 2011″ then I can justify my failure when things don’t work out. So here goes:

  1. To continue to have a job throughout the year – 2011 will see the continued NHS changes, with the Health Bill published later in January. The year will be an uncertain one as we don’t know yet just how much of the change will take place; PCTs won’t be abolished until March 2013 but change will be progressive.
  2. To save as much money as possible – Matt plans to study in the US for a year from this autumn and it is going to cost us a pretty penny. Not to mention the fact that we will need to visit too. This year will be a year of austerity for the country and for us.
  3. Having said the above, I intend to take a break somewhere new this year. Florence in Italy would be my current favourite.
  4. To get fitter and slimmer – usual thing but after about 2 years of pretty constant weight, I have slipped up a bit over the last few months and put on a few pounds and what is more haven’t been to Zumba or pranced about infront of my Wii for 3 months. That must change and change as soon as possible.
  5. Linked to the above, both Barry and I have slipped into a bad routine of having a drink when we get in from work. That also must change and alcohol needs to be for weekends and special occasions. This will be better financially, for health and for my weight!
  6. I’ll try not to fall out with any of my relatives (particularly those only related by marriage) but at the same time I am going to try not to allow myself to be walked all over.

So there you have it. I’ll be back at some point to see how these intentions are progressing…..

Meanwhile a Happy New Year to anyone who happens past this Blog!

NHS 2010

What can I say? My latest post proclaiming an imminent return has come and gone. In effect my promises are as empty as those of most of the politicians currently infecting my TV screens. The post at the bottom of the page when I logged in this morning was written and posted last July. I am clearly useless, have little to say. Or else there is another deeper meaning? Well no doubt the reasons are not deep. I am just generally lazy, I spend too much time on the evil facebook (that post still gets me 600 hits some days – why?) and my general disgruntlement with the NHS pretty much disappeared during the last year.

The job, while not necessarily the best paid has been pretty fulfilling not to mention busy. I also think I have had a reasonable amount of fun on the way. I have been learning to live my life post-child-leaving-for-university. This has involved me doing more than work, cook dinner (anything involving pasta and curry though not together), wash and iron jeans and tee shirts (the clothes of a teenager) and act as a taxi service to a boy who ought to have passed his test by now. No, hubby and I have travelled the country (well been to a few sea side towns and London), stayed in hotels we can’t really afford and eaten in good restaurants. We have also been on a couple of longer trips abroad and generally enjoyed ourselves. Mortgage rates are low, the debts are reducing and some months hubby even has some overtime. Yes life has been good.

Now however we need to get real. It seems that some of us haven’t taken this recession seriously enough. We have enjoyed a period of growth (more money in our pockets and more money in the NHS). Now though all that must end. Firstly the new government (whichever gets into power) will need to tighten the belt (maybe higher VAT or national insurance or both), and the public sector will need to take a hit. The bottom line at work now is this: THERE IS NO MONEY.

This is a depressing message in whatever language you might translate it into. Reading between the lines of: The job of a commissioner is to redesign services to obtain the best value for money tells me that quality is pretty much out and saving money at all costs is in.

A lady interviewed on the London News last week caused a massive chill to move up my back and into my head creating a headache which hasn’t actually left me yet (though the virus keeping me off work today could be responsible for that). This person, a member of the London Assembly I think and who was a Tory said that NHS bureaucrats are dispensable (or something similar), she stated she saw nothing wrong in getting rid of folks like me. This is set in the context of my organisation which has told us it needs to save 30% on management costs (more on that in my next post) and a Tory leadership that would like to freeze public sector jobs as they become vacant.

Over the last few years I have often been critical of the target driven, central control exerted by the Government through the Department of Health. But at the same time there has been progress, and while I  might not think this if I was still nursing at the bedside, I do believe that Commissioners can be a good thing. “She would say that” I hear you cry. Well of course as I am one. But having people out there who ask doctors, nurses, midwives, therapists and other clinicians why they do what they do in the way that they do it can only be healthy. The idea of leaving “front line staff” to get on with what they apparently “know what to do best” is frankly scary. I am now just plain scared that on 7th May I will awake to Dave preparing to move to Downing street. I am scared mainly that this will be followed by a large amount of ‘throwing the commissioning baby out with the bathwater’ to save money.

We do need challenge and we do need people to wonder if services are being provided with the patient rather than the practitioner in mind. We do need to make sure that value for money is being thought about because in my experience not everyone treats public money in the way they would their own. Or maybe on second thoughts they do which is why the country and many individuals are in quite so much debt.

Back to the drawing board…….

On the way back

It’s been a long interlude, but to be honest I needed it. I have often come close to posting, but then stopped myself. There’s so much I’d like to be able to say about work, about the current mess the NHS is once again in, but to be honest it is hard to do that without wanting to get carried away and say things that could be regretted. Having said that, my break means there is a better chance than average of finding a few things to talk about here – both to do with work and home. Bear with me, and I’ll have something to add later!

Managing upwards

buckstopsHaving no team to manage is often a blessing. I have to admit that I have had very few people reporting to me who have been troublesome, and the stories I hear from colleagues about the workshy, the incompetent, the people discovered working while off sick and so on are just that. I have had a few difficult staff; one who tended to cry during our one to ones without good reason, one who appeared to do little work and hated to be challenged about why this was the case and another when I was a district nurse who couldn’t understand why 4 inch heels might not have been a good idea. Dealing with people in these situations can be tricky, and what is more managing poor performance in the NHS doesn’t seem to be easily resolved – there is a balance of power that appears to lean more towards the rights of the individual than those of management or organisation.

What is really difficult though is managing a manager who is less than brilliant at their job and who while working their notice has stopped turning up to do the things they are meant to do. It is difficult when colleagues from other organisations know what is happenening and pass comment. Even worse, more senior colleagues know what is going on, they talk about it, but they do nothing about it. What kind of message does that send out – it is ok to be workshy and bordering on incompetent so long as you have found yourself another job and are going to be leaving soon.

Personally, as a person (along with others) put in this position, I would rather not be at work either, it would make my life easier. I am no shirker however, I also won’t completely avoid a difficult situation and so I will carry on doing my work, with my head firmly down. All we can hope is the next person to inhabit that job is better at it than the previous encumbant.

On another more positive note, can I draw your attention to the latest installment of the brilliant Blog Carnival Change of Shift, which can be found over at Emergiblog. This week’s edition contains some great nursing posts!


Roundup of events

Ok, so this is a lazy way of blogging, to write one post about everything that is currently going on in your life. But when you don’t have a great deal to say aboutu specific topics then maybe this is the way forward and at least people know you are still alive!

Firstly the blog. I have carried out a bit of maintainance and removed the inactive links from my side bar. I was sorry to see that Disappearing John had well.. disappeared. Sadly he looked up the medical records on his child while they had been a patient – something I’ll bet he isn’t the first to have done, and got found out. This, unsurprisingly, made him extremely nervous of carrying on with his blog. I hope things have improved work wise and that he will return to the blogesphere one day soon. I am now in the process of adding to my blogroll, so if you read this and want adding let me know.

I am still wondering how I might be able to write more candidly about work related stuff myself without risking the sack, but so far I haven’t quite worked through that one. As I have said before, I am the only maternity commissioner in this county and one of not that many in the region which makes things a little tricky. Having said that I do have a few posts in the pipeline about my work.

Tomorrow is a big day in this household – it is results day. It would be true to say that I am displaying greater nerves than the boy whose destiny depends upon those results, but then it is the job of a mother to fret on his behalf. I am hoping that tomorrow I will be posting something exciting and excitable – watch this space.

This month has been a big one in my family – a number of birthdays including my mum’s 70th and my own less special and rounded birthday. We have also had a weekend away in a swanky hotel celebrating my parents’ Golden Wedding – now that is something these days isn’t it? 50 years of married life. What is more it saw all 3 of us siblings present, along with our partners to celebrate that great milestone.

So that is your round up of events in the life of Julie, now I am off to carry out the best job of the week – putting the rubbish (garbage if you are that way inclined) for the bin man. From next month they want us to put food waste and cardboard into our garden waste bin. Not sure about what I think to that, but as with all recycling I’ll give it a go!

Emergiblog – Providing leadership to the Nursing Blogsphere

Just under 4 years ago, during a bank holiday weekend I discovered the existence of weblogs or blogs. I can’t exactly remember how I came to be surfing the web that  morning, but what I do remember was that in browsing through I was struck that there were very few blogs written by nurses or others in the health world, but that those that were there were interesting to read. One of the first I came across was Emergiblog, written by a new and novice blogger called Kim. As a nurse in the UK, I have read about healthcare in the US, I had at the time met nurses who had worked in the US and as a teenager I loved the series of books featuring Sue Barton, but I hadn’t really read any first hand experience by a nurse actually working in the US and what is more working in an ED. What struck me most was the enthusiasm and love that Kim had for her work and for her patients. How despite the frustrations of dealing with the public, working with some of lifes more irritating doctors and having to deal with the bureaucracy of healthcare providers Kim really loved and still loves her job.

The last 4 years has seen Kim begin her studies on a pathway that she believes will lead her to a Doctorate, she has questioned and developed in her practice in a way that we all do as we reflect on our work, read around the subject and then write academically. What is different with Kim is that she then puts those thoughts into her blog posts and creates more debate and more blog posts through the great following she has for her site. I wonder if Kim would have believed just 4 short years ago that she would have spoken at conferences, hosted Grand Rounds several times and devised the wonderful blog carnival that is Change of Shift.

Kim is the envy of the blog world. She writes wonderfully, she has great topics to write about which just flow and flow, and what is more she always finds the most wonderful pictures to accompany her blog posts. Kim is an inspiration to nurses across the world and what is more she is  able to write with the authority of a clinical nurse at the sharp end and as a nurse manager type I can only admire that.

Happy Blog birthday Kim!

Happy Birthday to Change of Shift


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!

At last

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 change

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!!

Spammers – The most irritating people on the internet?

spam-collection-2007-06WordPress 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!

What I learnt this week

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.

Facebook – good or evil?

facebookMy 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

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

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!


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