I have been teaching on a leadership course this week, plus I have worked on another programme which prepares NHS staff for working at executive level. The thing about these courses is that while you observe the actions and behaviours of others you learn so much about your self. It is really easy to get caught up in the rat race of work, wherever it is and, head down not to notice the things that are important in life, or how the things you might do or say affect others.

Like pretty much everyone in this country I am pretty disturbed about the whole MP expenses scandal. I am not entirely surprised by the idea that people who can claim for expenses associated with having to say live in two different places, do a demanding job, employ staff or entertain people, might actually stretch things a bit. What I am surprised about is some of the things you can claim for and what is more, that there seem to have been no proper checks on the way this is done.

Claiming travel and other expenses as I do often finds me not quite being able to remember what I spent, when I travelled or parked (sometimes the receipt gets lost) and I would imagine that over the years the NHS has done better out of me than I have out of it. We are of course however talking of much smaller amounts of work, plus my moral values tell me that in the grand sceme of things a £3.00 car parking bill is not worth losing sleep over. What about claiming mortgage payments back as an expense and then suddenly remembering you have paid that mortgage off and you have just been supplementing your income? I am not sure I can trust this kind of person, I am not sure he has the personal value set appropriate for public office and what is more it is down right dishonest.

People working in the NHS have at times lost their jobs for misclaiming their travel and unsocial hour working expenses, quite rightly so. What though do you do with people like this, and how does the system of politics rebuild the trust of people like me.

My son has just turned 18. In a couple of weeks he can vote for the very first time. These elections are pretty small fry, though I would say important for local and european elections. Not surprisingly he is taking some notice in the whole scandal. His response right now is that the main parties are not for him right now and for the moment he might choose Green. I would say this is fine, but what if he leant more towards a right wing approach and chose instead BNP? Where on earth might that lead us?

Once again I have proved to be rubbish at this blogging lark, having posted nothing since 18 June. As the NHS celebrates its 60th birthday this week, I am going to turn over some kind of leaf and get back into blogging. I also intend to try to blog daily during July.

The last couple of weeks have been busy in different ways, but I haven’t been to work for just over a week, as I have been on leave. I have been for a great weekend to Barcelona (more about that later) and have had a few days generally chilling out at home, shopping for clothes in the sales and doing as little as possible.

So if anyone still calls by this blog to see if I have written anything, I promise to apply myself to blogging much more in the coming days. For today though, I have one last day off, a cat to get jabbed and a son to buy some summer clothes for.

I wrote recently about the issue of dignity and respect in the NHS and how the way we treat our patients may be linked to the general way in which we treat each other and are treated. Over the last week or two a couple of things have increased my view that we have a problem in this country with the way we speak and treat people that ultimately affects people when they come into contact with people in the public sector. We appear not to understand how to do customer service, so much so that even when we are customers in the purest sense some of those who should be part of the service don’t seem to recognise or care about that fact.

One day last week I arrived home to discover the telephone was not working, you could not ring in or out though the internet was working (strange I guess). I got onto my work provided mobile phone (having got the teenager of the house to find the phone number of the telephone company on the internet as I am quite useless at keeping numbers like that handy). The automated voice asked me to key in my phone number, then said it didn’t recognise it. I then had to wait for a very abrupt and verging on rude person. The company first asked me to clear various security hurdles before I could report my phone missing (luckily I do know my own address, post code and the bank my account is paid through) I was then placed on hold. 20 minutes later I hung up, I could hear various sounds going on in the call centre, but no one ever came back to me. The phone was however fixed at the end of all this, so I can hardly complain, well yes actually I was pretty miffed and used my hubby as a means of getting this off my chest.

Annoyance number two is about banks. I have an account purely used to service a loan. This loan is meant to be paid on 1st of the month. I make sure there is money in there and it is paid. This month I only remembered to do an electronic transfer of the missing £15 needed to pay the loan on the first. Sadly the bank had taken the loan payment on 30 April, and are now charging me £15 for going £15 over drawn (nice work if you could only get it!) I am still to go and have the argument with a human at the local branch but now I am calmer about that one it might go better. I was amused to receive the following as an email at the weekend, apparently recently published in the national press:

A 98 year old woman in the UK wrote this to her bank. The bank manager thought it amusing enough to have it published in the Times

Dear Sir,

I am writing to thank you for bouncing my cheque with which I endeavoured to pay my plumber last month. By my calculations, three nanoseconds must have elapsed between his presenting the cheque and the arrival in my account of the funds needed to honour it. I refer, of course, to the automatic monthly deposit of my Pension, an arrangement, which, I admit, has been in place for only thirty eight years. You are to be commended for seizing that brief window of opportunity, and also for debiting my account £30 by way of penalty for the inconvenience caused to your bank.

My thankfulness springs from the manner in which this incident has caused me to rethink my errant financial ways. I noticed that whereas I personally attend to your telephone calls and letters, when I try to contact you, I am confronted by the impersonal, overcharging, pre-recorded, faceless entity which your bank has become. From now on, I, like you, choose only to deal with a flesh-and-blood person.

My mortgage and loan payments will therefore and hereafter no longer be automatic, but will arrive at your bank by cheque, addressed personally and confidentially to an employee at your bank whom you must nominate. Be aware that it is an offence under the Postal Act for any other person to open such an envelope. Please find attached an Application Contact Status which I require your chosen employee to complete. I am sorry it runs to eight pages, but in order that I know as much about him or her as your bank knows about me, there is no alternative. Please note that all copies of his or her medical history must be countersigned by a Solicitor, and the mandatory details of his/her financial situation (income, debts, assets and liabilities) must be accompanied by documented proof.

In due course, I will issue your employee with PIN number which he/she must quote in dealings with me. I regret that it cannot be shorter than 28 digits but, again, I have modelled it on the number of button presses required of me to access my account balance on your phone bank service. As they say, imitation is the sincerest form of flattery.

Let me level the playing field even further. When you call me, press buttons as follows:

1 To make an appointment to see me.
2 To query a missing payment.
3 To transfer the call to my living room in case I am there.
4 To transfer the call to my bedroom in case I am sleeping.
5 To transfer the call to my toilet in case I am attending to nature.
6 to transfer the call to my mobile phone if I am not at home.
7 To leave a message on my computer (a password to access my computer is required. A password will be communicated to you at a later date to the Authorised Contact)
8 To return to the main menu and to listen to options 1 through to 8.
9 To make a general complaint or inquiry, the contact will then be put on hold, pending the attention of my automated answering service. While this may, on occasion, involve a lengthy wait, uplifting music will play for the duration of the call.

Regrettably, but again following your example, I must also levy an establishment fee to cover the setting up of this new arrangement.

May I wish you a happy, if ever so slightly less prosperous, New Year.

Your Humble Client

Welcome to the May Day edition of Change of Shift where we will be exploring the different origins of this day across the world and what is more linking (sometimes tenuously) to some great nursing (and medical) blogs along the way. Sean from Nurse Sean (dot) com set the bar extremely high in the last edition with his tour around Europe, so lets see if we can go some way to matching his standards (do you sense a competitive edge here?)

There are two distinct themes or origins for May Day which will become clear in the fullness of time, and it gives me the chance to start off with some of the more light hearted and frivolous stories that I have to share with you and then to move onto the more serious and thought provoking.

Did you know that May Day (1^st May) has been celebrated since ancient times to welcome in the end of winter in the northern hemisphere and to rejoice in the first day of summer. May day was traditionally famous for dancing around the maypole and for celebrating the Queen of the May. So let us celebrate this time of year with some great posts from the Blogsphere.

Mother Jones suggests the use of a book she has found called The Joy of Yiddish as a way of managing some of your more difficult patients (and managers for that matter). In her post Yiddish for Nurses she gives us a wonderful sample of the ways in which you can sound as if you are complimenting people when just the opposite is true.

What nurses probably need in preparation for both their work and for dancing around that may pole are stretching exercises. Revitals.com has some information for us on how you can attend to those personal fitness needs, how we can prevent injury and prevent stress too. It would take more than a bit of stretching to allow me to get into the position shown on the post in question!

Heather Johnson at Student Nurses’ Notes gives us 5 very useful ways to reduce stress. Of course you might be given a May posy, or you may be crowned King or Queen of the May (I’m not holding my breath either) but failing that you will find Heather’s post helpful in managing this problem of our times.

My research into the origins of May Day (don’t worry I didn’t get much further than Wikipedia!) puts me in mind of some of the Urban Legends that are part of any healthcare organisation. Max from It Shouldn’t Happen in Healthcare offers up some examples of the types of things that new staff has allegedly shown their naivety by doing. We have all heard of the student nurse collecting the false teeth of an entire ward for cleaning and then not knowing from which mouth they came, but would any of us ever own up to actually do such a thing?

Nursing Blogs on Nurse Connect offers a post about how nurses can be more environmentally friendly. An important issue for everyone, particularly when it comes to saving energy along with the environment!

Have you ever longed for just one internet site where you can find just about all the information you need about nursing? Well that site is out there, at RN Central.com and what is more it offers 100 really useful websites for nurses. Its one drawback is that Lifeinthenhs is not deemed worthy of inclusion, but I am not bitter, honest.

Kim from Emergiblog tells us why RN to BSN is the way to go. As someone who last year completed a Masters and has a Bachelors in Nursing after many years as a bog standard ordinary (but of course excellent) nurse I completely agree with her sentiments. The knowledge that you gain about the professional and theoretical aspects of nursing are invaluable in making those links which might just make you a better nurse.

It is Kim’s post that I am using here as my link into the other reason why May 1 is considered an important landmark date across the world. This is because May Day is a celebration day for workers, it commemorates the fights that have gone on in the past for rights like the 8 hour working day. I know that not all of us work an 8 hour day, but actually in days gone by it was the norm not the exception to spend most of our waking lives at work. It is true that the communist countries tended to high jack the day for parades of national strength, but with the end of the Cold War, that is hopefully behind us. The USA and Canada no longer celebrate this day on May 1, but many countries particularly around Europe still do. The best bit for me (call me a mercenary) is that we get a day off on the Monday closest to May Day.

May 1 is a day for international celebration of the social and economic achievements of the labor (or labour since I am English) movement. The struggles that our predecessors have had in ensuring that workers are well trained and educated, that we have those holiday / vacation times and that our working conditions are safe and pleasant are remembered. This is not to say that there aren’t challenges out there for us as workers and for us as people who need to advocate for our patients (Julie jumps off her soap box at this point and returns to the point).

I am not sure that the level of violence some nurses come across in their workplace was really part of the deal. Mother Jones, in her second offering for this edition of Change of Shift tells of a harrowing tale of just such violence by a patient against several nurses. Often linked to the issue of violence is that of consumption of alcohol by those who use health services. Braden from 20 out of 10 tells just why he hates alcohol

In a further story depicting our violent society, Jen from RN Again?! tells us about her last EMT clinical which saw the admission of a patient with a self inflicted gunshot wound.

Congestion in and around the ER is a major cause of frustration for patients and professionals alike. Waiting times are something that have challenged hospitals in the UK and trying to ensure that people don’t wait during times of high volume that cause problems around the world. Ian Furst of Wait Time and Delayed Care, examines how EMS crews in Edmonton Canada are being used to treat patients who cannot actually get into the ER. Not surprisingly this leads to delays for patients who subsequently call 911.

Nurses have made great progress in developing their careers and in being recognised as people who with the correct development opportunities can examine patients, diagnose and prescribe. After completing her Nurse Practitioner course and getting herself that dream job, Nurse Practitioner Saves Lives is understandably frustrated by the pharmaceutical companies who imply in their adverts that the only person who can give advice to the public is a doctor. NP Saves lives would like you to sign up to a petition to get that kind of advice changed.

Nursing is not the kind of thing you can just learn in a classroom, clinical practice is an important part of nurse education. The trouble is that as part of that process you have to learn about bodily fluids and gases! Our student at Nursing School Insanity: Whats a perineum (you can find out the story behind the title on the site) tells us about Flatus (which is something you wouldn’t think to call it if you hadn’t started that nurse training). ‘Floating’ seems an increasingly common way of redeploying people around different departments. But if you are a ‘float nurse’ then you are continually needing to update your skills, continually feeling like a student. This post called A fish out of water, on Nurse Connect looks this topic which has also been discussed on Nursing Voices, and will I think increasingly be something that worries nurses now that managers seem to seek the most mobile and flexible workforce possible.

The way in which we as nurses communicate with our patients is vital, and with our aging society it is highly likely that many of those patients will be elderly. This Nurse Connect post offers advice on the things we need to consider in communicating with this group of patients. Those elderly patients are just the group of people who have fought hard to achieve the kinds of rights we take for granted today. Dignity and respect are something we all expect, yet only too often some of us don’t seem prepared to offer. My own post about this subject asks whether this is a reflection on society, and wonders why we need to teach this topic, and Nursing Blogs on Nurse connects looks at how we address our patients – would you call any patient ‘honey bunny’? No nor would I!

It is about 18 months since I last hosted Change of Shift. I am heartened to find that the nursing blogsphere remains a healthy place, even if some of the work our colleagues are doing out there is difficult and challenging. We still have our sense of humour, we can still laugh at ourselves and what is more we are true to our origins both in terms of dancing around that may pole and in respecting those who campaigned for the rights we take for granted now.

The next edition of Change of Shift will be on Thursday 15 May at Parallel Universe, when Dr Emer will be our 3rd MD host. You can submit your posts via the blog carnival icon on Kim’s blog at Emergiblog, or by sending directly to Dr Emer: doc(dot)emer(at)gmail.com

Last night, after a long day both working and enjoying myself with friends, I watched the 10 oclock news on the BBC. Generally I treat any health related stories with complete scepticism but on this occasion I was drawn in by the story of a young person whose medical history had been split into two. One part public and the other private and held by a doctor by the name of David Southall. This doctor had today been struck off by the General Medical Council and this boy, who appeared the same age as my son had in front of him records suggesting that he had been abused by his parents. I wanted to write a post to my blog, and despite being tired I did so and as was suggested that post contained sweeping statements on a subject I knew little about but was also perhaps out of context.

I have still not read much about Dr David Southall. I am a working woman who does not have time in her working day to study such evidence on the internet. But I will be doing so over the next few days. However, what I have to say on the subject so far is this. I am pleased that the medical profession is rallying to support Dr Southall, it is something that sadly never happens with us nurses. I accept that the evidence as presented to the General Medical Council may to some extent have been misunderstood, taken out of context and generally not to the letter of their own directives. But we do have here a doctor who to the outsider has been playing god. Not all parents are perfect, not all parents are any way good, but at the same time not all parents abuse their children. If your child dies by hanging, perhaps you do not anticipate being accused of murder, after all there are easier ways of committing that murder. Children in London are going around shooting and stabbing each other and if you were to follow the rules of the case considered by the GMC then you might expect one of the parents of the children who perpetrated those killings this year to be charged any day soon after all they didn’t stop those children accessing guns and knives.

What I saw last night was a ‘that could have been me’ type scenario. Someone who had been in touch with paediatricians found that they had a secret record in which a doctor played god and suggested they had been abused. The person concerned said the accusation was not true, and perhaps there are many other records held where the accusations are true. However secrecy is not the answer. Doctors acting in such a way as to suggest they are god is not the answer. We need doctors to be involved in Safeguarding, but at the same time we need them to work within teams. We do not need them to confront bereaved parents with accusations that they are murderers when they have been called upon to give impartial advice. That is the job of the police and not a doctor who appears to believe that he is in some way special.

The above views are not evidence based. They are based on my own opinion and limited facts. Please do not reproduce this blog post without permission or vilify me. Because I was driven to write as a mother and not a nurse.