Life in the NHS

People still visit this place

2007-09-14T20:22:00.000+01:00

Maybe I will start to use blogger again and post different kinds of things here. I will give it some thought over the weekend!

New Home

2006-09-12T07:10:00.000+01:00

For some time I have been thinking about moving my blog, at times blogger can be something of a challenge to manage and at others a down right pain.

Over the next few days I will be moving all my links etc to my new home at word press. I have already moved my archives and some links (just struggling a little with some of the differences Word Press has).

You can find Life in the NHS here from now on.

Hope to see you there!

5 years ago today

2006-09-11T07:01:00.000+01:00

I was visiting a patient who was having a flare of her rheumatoid arthritis, so rather than her struggling to clinic I went to her. On the way over there (it was only a matter of crossing town and it was around 1.45pm so traffic was light) it became apparent from that something was happening in New York, but when you turn on the radio in the middle of something confusing, it remains just that, confusing. The patient though had the TV on and while I was at her house, administering a gold injection, I witnessed a plane crash into one of the twin towers. Later back at the hospital many people stood around a ward TV and saw the towers crash to the ground one after the other. Our team secretary was frantically phoning her son, on a years work experience in New York to find out if he was alright (he was thankfully) and we wandered around in shock. The distance to New York became nothing, this might as well have been happening in London, as we all felt the impact, as the shock reverberated around the world.

9/11 was a defining moment in our lives. Much that has happened since in terms of politics, war and world evens has happened in the way it has due to the events of that day. Wars have started, other terrorist events have taken place and we have lost some of the last remaining innocence we perhaps had at that time. Last July when terrorism arrived in London we were shocked and saddened but nothing that happens again will ever have quite the global impact of that day.

For those who lost loved ones, and for those who were there, life was never the same again. The direct fall out on others is much greater than I had realised though. Yesterday I read about young workers who spent 3 years or so of their life clearing up, dismantling the buildings and now are doomed to die and die quite soon of chronic lung disease caused by the dust present in the buildings. Ultimately then the fall out from 9/11 will be felt for a very long time and not just in terms of the families of those who died that day or those who continue to die in war zones, but closer to home.

Those of you who read my blog regularly will have noticed that once, 5 years ago I really did work as a proper nurse. I am wondering about that whole thing, should I go back. My next post is going to be about my career and what I should do next.

Any ideas

2006-09-10T16:34:00.000+01:00

Why my Blog doesn't seem to be loading properly? It seems to fail to load on Firefox and has things in odd places on IE, any ideas?

Might be time for a new host? A break from Blogger - comments welcome.

Ok, it is official

2006-09-09T09:31:00.000+01:00

I am a rubbish blogger. In the last week I have posted once, well less than once, seeing it is more than a week since I last posted. So what is wrong with me? Good question, and in my defense I will point to the 5000 word essay that I submitted on Tuesday morning and the subsequent fatigue with typing into a computer. Also on Wednesday there was the England match, and Thursday my night out to a Chinese restaurant to stuff my face, and Friday an evening of wine and TV. It is hardly surprising that the weight loss programme has slightly stumbled!

I have in effect been having a bit of a life, not much of one, just a bit! That is not to say that my life outside of blog land is all that interesting or exciting, but it is just carrying on doing usual stuff. Perhaps then that is where my problems lie, my life doesn't feel thrilling enough to write about right now. Having said that, sometimes it is the more mundane things that seem to be more interesting to write about than things that on the surface seem exciting.

Teen son has returned to school, he has started year 11, the last compulsory year of education. Now where did all of that time go to? He also had a sleep over at friends last night, and returned at 8.30am as he couldn't sleep there! In my experience that has always been the problem with staying with friends, it is great to have fun, to chat and generally do stuff together, but at some point sleep is needed, and it is usually in short supply during a sleep over!

So time to get off and shop, clean, wash and iron - no change there, and to yet again make a pack to post something interesting soon!

A sign of age?

2006-09-01T07:14:00.000+01:00

I must be getting old, because the months and years seem to be whizzing by. Suddenly it is September, now where did almost 3 quarters of this year disappear off to? What is worse is that I look at my 15 and a half year old, 6 foot tall son and am slightly puzzled as to where my little boy with cute blond hair go? When I look in the mirror I see someone who is looking distinctly middle aged; already I am fed up with dying my hair, yet it is so grey that I feel I have little choice.

On the other hand I am filled with energy (mostly), I have a thirst for knowledge and study, I want to and (mostly) do exercise, I seem to be pretty healthy. So actually what does it matter? People live to a very old age these days and who says I won't be one of them. No my problem with the speed that time passes is less to do with getting old than a feeling that I am not necessarily making the most of the time that does pass. We rush around without experiencing the world around us. One of the things I have noticed is that people overtake more and jump traffic lights more. It is almost like people cannot bear to be held up, they don't want to be at the front of the queue of traffic at the lights, they would rather keep going and jump not just the amber but the red too! Further up the road you catch them up and wonder why? What are they frightened of and how much quicker will they get where they are going?

On Monday we did something that we don't often do on a bank holiday and that is go out somewhere for the day. My hubby is usually obsessed that bad traffic will hold him up as we return and he won't be prepared for the next day at work. I am not sure where the obsession to worry about something that probably won't happen came from, nor to always think ahead to tomorrow. But my parents asked us if we would like to have a day out, teen son came too and we set off to the beautiful cathedral city of Ely. We took time to wander round, to eat a leisurely lunch and would have wandered much more but for the rain complete with thunder and lightening that emerged during the afternoon. We took time to think about the history of the place (Oliver Cromwell lived there) and to imagine life during those times. It didn't make Monday come any quicker than it would have anyway and what's more we had a great time. To hubby's relief the traffic he had imagined wasn't there and anyway he slept in the car on the way home.

I am going to post this now, and later when I have uploaded my photos will put one or two here!

Its is getting crazy

2006-08-30T21:51:00.000+01:00

Getting an new job in normal times takes ages. There are advertisements, applications, shortlisting, interviews, various checks, references, that kind of thing. In 2006 in the NHS though, suddenly people get moved around at the drop of a hat. People are leaving, lots of people, it is the uncertainty you know and sometimes those people have been the only one in their organisation who has a particular qualification or does that job. So people can come back from holiday on one day and on the next they are 'asked' if they mind moving to a new department, new job and even a new NHS trust. Yes really. When I say ask, I mean ask in the loosest terms. It is really quite crazy.

Today, I lost my manager, she has a new job starting next week. She is happy as it is closer to home. I am kind of shocked.

Life is really crazy!

Blogging anniversary!

2006-08-26T08:50:00.000+01:00

So tomorrow is the first anniversary of my life as a blogger! On Saturday 27th August 2005 I joined blogger and made my first tentative entry. Little did I know what a complete compulsion the whole thing would become or that I was entering such an amazingly diverse world. When I started and called my blog 'Life in the NHS', I thought it would be great fun to write about my work, and my life in general. I thought it would be most amazing if anyone actually read the stuff I wrote, though never really thought they would.

I think this is where my biggest challenge lies. Most bloggers are writing for an audience, not just for themselves, otherwise you might as well just write a personal diary and lock it away (I wasn't very good at those as a teenager). But when you write about work (particularly) there is a slight dichotomy between wanting to be noticed and fearing that you might be noticed only too well. This was highlighted for me this week, I really want to write about the disciplinary hearing I had to present the management case at this week, but actually I can't. The chances are that no one I know will ever read it, but actually I can't take that chance.

As I reach my anniversary then, I am seeking to re-evaluate what I want to do here and think of where my blog might take me in the future. As far as work is concerned, I am about to go through a process which will probably see me having to reapply for my own job. Well I can't see why I won't be able to write about that. There are changes happening and new leadership emerging I might not be able to be very candid about but we will have to see. There is my MSc in Strategic leadership, I am half way though and should right now be writing good and profound words in an assignment (I will shortly honest)! I guess as I approach the climax of the course with the dissertation there will be plenty to write about here. Lastly there is the life I call home. In a way I would like to write exclusively about that, but I guess the fun of this whole thing is that you can be different people in different posts. You can have fun, you can be serious and somewhere somehow someone flits past your site and reads some of it.

I think I am trying to say that I am not finished with this whole blogging thing yet, I have plenty more to say, so here is to my second year of blogging. Thanks for reading and thanks for commenting. Please come back and visit me soon!

It all feels surreal

2006-08-24T18:43:00.000+01:00

There is an air of end of term at work at the moment. We have only one month left before things begin to change and the prospect of some of the less inspiring senior managers getting the top jobs is part of the feared reality. This is making life in my part of the NHS a little hysterical, or at least it was today. How I managed to get any work done today (and I did just about) is some kind of miracle!

Two of the most interesting events of the week, in terms of grizzly entertainment value as people dig big holes for themselves and then jump in them cannot be discussed. If I was found out I had written about them, I would be sacked for sure, which is a shame because the two things I have in mind would make your hair curl and have you in fits of laughter at the same time.

The bank holiday weekend is almost upon us, so an extra day off and for me that will mean 3 days to get properly stuck into the essay. I have been reading lots about the development of leaders and about adult learning theory so am just about ready to use my laptop for something more productive than blogging! Remind me to start the next assignment a little earlier than this!!

The photo above is of a castle in France we visited - a long and tricky climb, but worth it for the brilliant views. Something I am not getting from my office window right now!

The 5 week month

2006-08-21T22:32:00.000+01:00

Unexpectedly I am experiencing the thing that those who are paid monthly and are not rich dread, the 5 week (that is 5 Thursdays) month. This is unexpected, because about a month ago we were all told that because of the installation and testing of a new payroll system, we would all be getting paid a week early. In anticipation of my trip abroad this was music to my ears. Today, I have a quarter of a tank of petrol, Â£4 in my purse and enough money in the bank for the cheque already written, the bill I need to pay in the next day or two plus a bit of petrol. So I was not best pleased to receive an email telling me it has all been a mistake and payday is in fact on Thursday 31st!!

My current employer ceases to exist on 30th September, and on 1st October I will be part of a whole new world of Primary Care Trusts circa 2006. A world of uncertainty awaits, but mean time we carry on regardless (as Beautiful South once sang). I am planning training, though we still have no budget for it (one day before the end of March someone will tell me how much is available), and we await our fate. This is likely to involve thereorganizationn of departments by new (orreorganizedd) directors and the need to reapply for our own jobs. If I were in charge I would abolish the 5 week month.

For the person who visits via the picture I once posted of a pink ford ka, I saw it again today. It is a lovely car, but it does clash with mine which is orange!

Yes it is Friday!

2006-08-18T07:54:00.000+01:00

Thirteen Things about going back to work after a holiday!

Emails, lots and lots of them.
People who can't wait to help you lose your holiday feeling, well hard luck, I am keeping it this week!
I stood in our local M&S looking at the healthy food to buy, but it just wasn't doing anything for me. I will have to get back to the regime next week I think.
People telling you how well you look - is that the sun tan or are you just looking fatter?
It is amazing how tiring going back to work is even after just a couple of weeks off. By 4pm yesterday I was feeling quite spaced out.
At least it is the school holidays still, and traffic is relatively light.
Changes in the NHS - well surprise surprise they still seem to carry on even in my absence. Our new Chief Executive has been appointed and there is the possibility of a move to a new base (that will be 3 this year!)
It is difficult to do any meaningful work on day one. Which is why it is lucky really that I had 140 emails and a meeting to go to!
Going back on a Thursday was definately a good thing, after all it is now Friday. Trouble is I am confused as to why it isn't Monday!
People have noticed my return. Is this because they have missed me (I work very hard you know) or is it because it has been very quiet (it is that loud voice you know!)
Sitting at your desk it is quite easy to imagine yourself back on the beach or strolling along a harbour. Hubby says he does this alot!
At least with the hot weather passed they are now switching the lights on in the building now. Before I went away it was like some kind of twighlight zone.
The best thing about returning to work is beginning to plan where you might go next. Not sure where it will be yet, but will be thinking along those lines soon!

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Remembering Barcelona and France

2006-08-16T21:16:00.000+01:00

Tonight my brother and sister in law have been over to collect my nephew who has been with us for the last 2 weeks and tomorrow it is back to work. Why is it that you spend so much time waiting for that holiday to come and all of a sudden it is gone and over with? Thank goodness then for our ability to remember, to talk about those great things that have happened, to keep memories close to us. Barcelona was all that I could have wanted and more. It was a fantastic city, full of wonderful, if at times bizarre architecture for instance a cathedral still in construction though another steeped in history and an amazing place to walk round and onto the roof of! Yes, I took this photo from the roof of the cathedral!
The open top bus trip around the city allowed us to see so much of the area in one go, and to identify places we would like to return to in the ensuing few days. It also allowed us to visit the home of Catalan football, the Campnou, where Barcelona FC the current European Cup holders (unfortunately) call home. It was the most amazing stadium and we spent a good couple of hours walking around the stadium and museum. Even teen son (an Arsenal fan, the team who are current European cup runners up) was suitably impressed.

Our hotel, the Barcelona Princess, was close to the beach, so on our second full day we took a day off and relaxed on the beach and swam in the Mediterranean, before resuming the sightseeing that night, with a trip by metro into the city centre and dinner and a stroll through the Ramblas. I partook of a particularly potent Cava Sangria which was also extremely pleasant.
Luckily, I had two young men on hand to escort me back to the hotel!

More of this tomorrow!

My blog is 'in space'!

2006-08-15T10:51:00.000+01:00

Back - more tomorrow

2006-08-14T21:02:00.000+01:00

The worst thing about a holiday is coming home; though generally your own bed is better than any another you might sleep in no matter how big or how good the view from your window is. So while we we were away, some British Muslim people planned to blow up themselves and the planes they were travelling in mid Atlantic on the way to the USA. This has caused the British Government to implement draconian measures in relation to airport security, luckily when you fly into the country you are still allowed hand luggage including mobile phones, ipods and any liquid you choose.

Barcelona was fantastic, France was sublime, the weather was hot though the Mediterranean was colder than in previous years. As far as I know I still have a job and the NHS still exists. More of all of that stuff, with photos tomorrow. Meantime I will be catching up with everyone else's blog, what's more, I promise to be a better blogger now I am rested, though I still have 5,000 words to write.

The countdown continues

2006-07-29T07:41:00.000+01:00

I am keeping busy with all that a busy working mother, also studying for a MSc degree needs to do as their annual summer holiday approaches. With little more than a month before submission of assignment 3 (5000 words on leadership development) I met with some of my fellow students yesterday for coffee, discussion and inspiration. I was pleased to find that we were all feeling as confused as each other about the whole thing. Not least because none of us had been expecting to have to write such a thing during July and August!. Our session together was really constructive though, coffee and discussion about leadership, education, experiential learning, and how different people experience their learning in different ways took place in cafe Nero before we moved on to the university library to get books (no really they have books there).

For some reason the library has no air conditioning so we each got some suitable volumes and escaped for an al fresco lunch before going our separate ways. I have got lots of ideas now, I am just not going to do much with them till I return from holiday and then will get down to some intense academia.

The rest of the afternoon was meant to have been about doing some work; I have my annual report to finish off, but I found I wasn't really in the mood and had lots of other stuff to do. Did some internet, telephone and real banking, went to town to buy Euros and also a few items for holiday including some new cropped trousers and a tee shirt, birthday cards and a present for my nephew.

Today I need to do a general shop, plus all the sun cream and toiletries we need, also need to do some housework including the dreaded ironing. Which makes me wonder why I don't get on with it!

Thursday Thirteen - 27 July 2006

2006-07-27T18:27:00.000+01:00

Thirteen Things I hope to do before my next Thursday Thirteen

Sort this car out, yesterday when I threatened to cancel, they asked for another 24 hours. That will be up when I finish doing this!
Finish my last two days at work for over two weeks. I have been a bit demob happy all week, but who can blame me. Roll on Monday at 5pm
Shop for some shorts for teen son. He has grown so much taller in the last year they are all just too short even though he wears them low on the hips (don't they all?)
Buy other stuff that is yet to be put onto a list (things like sun cream, toiletries etc)
Get myself some Euros
Fly in a plane to Barcelona in Spain
Stay in a lovely hotel (heres hoping it is as good as it looks)
Eat lots of Spanish food and drink Sangria, Cava and Wine
See the sights of Barcelona
Travel by car to France (see number 1, and the post below for more details)
Watch people go by from the balcony of my apartment
Engage myself in French holiday life
Read books that have nothing to do with leadership, relax on the beach and swim in the Mediterranean

Links to other Thursday Thirteens!

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Sometimes blogger is annoying (but then so are car hire companies)

2006-07-25T07:32:00.000+01:00

Yesterday I produced a slight rant only to find that there was some kind of technical error going on with Blogger. I have to admit I was in full Mrs Angry flow, and getting it all off my chest was proving slightly satisfying, not being able to post it was to say the least frustrating. So rewriting will likely be a more balanced approach.

We have booked our car hire for Barcelona through a company called Holiday Autos, we have deliberately booked a reasonably large and comfortable car at no small cost (teen son and his cousin are both 6 feet tall), which has been taken from hubby's credit card about 3 weeks ago. Yesterday the company ring to say the car we had ordered is no longer available. When I spoke to them, I had no idea how easy it might be to rebook with someone else, so at the moment they are checking whether they have a slightly smaller car available at about Â£80 less. Whatever happens, a complaint will take place. I think the problem with these companies is that they are too big, they are essentially run through call centres and internet bookings and I am not sure they care if they lose a booking because someone else doing a google search will find them and book a car in a few minutes time. This means that while the individual call centre man I spoke to was sympathetic to my plight he really couldn't have cared less whether I get a car to drive the 2.5 hours from Barcelona to our apartment in France or not. This really is not good enough in my book, and now having seen that other suitable options still exist with other companies, I won't hesitate to take my business elsewhere!
By the way, did you know that spellcheck here doesn't recognise the word 'blogger'!

Thursday Thirteen - 20 July 2006

2006-07-20T21:22:00.000+01:00

Thirteen Things I am up to right now

Exercise - Keeping the diet fitness thing going, yesterday though I had to go out at 6.30am to find a coolish time.
The diet regime - Cheating less and only drinking at the weekend has got to be part of the recipe for success, weigh in on Saturday well tell me if I am doing enough.
Getting to work more quickly - the schools have been gradually breaking up for the holidays, by next week more people should be off on holiday too.
Thinking about my essay - even reading and making a few notes, but still not made a great deal of progress. I need to take myself in hand on this!
Watering the garden with a watering can - we have a hose pipe ban, it is a real pain!
Reading up on my guide book to Barcelona, less than 2 weeks to go!
Getting my daily fix of Big Brother - mad I know, but what can you do?
Buying my vegetables and salad stuff from a local farmers market - I must admit that I had forgotten what vegetables could taste like.
Buying my meat from the butcher - Time the supermarket got less money from me, and we had better quality food. Plus a lot of it is cheaper too.
Putting off the housework due to the heat - but I guess it will have to be done soon, or else we will be living in a health hazard!
Putting off the weeding (as above) - will need to do something at the weekend.
Not blogging - have been bad lately, still 2 postings in 2 days isn't too bad.
Trying not to think about the mess that is happening at work- another chief executive briefing next week; lets hope for good news for once!

Links to other Thursday Thirteens!

Get the Thursday Thirteen code here!

The purpose of the meme is to get to know everyone who participates a little bit better every Thursday. Visiting fellow Thirteeners is encouraged! If you participate, leave the link to your Thirteen in others comments. ItÂs easy, and fun! Be sure to update your Thirteen with links that are left for you, as well! I will link to everyone who participates and leaves a link to their 13 things. Trackbacks, pings, comment links accepted!

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If we are getting global warming........

2006-07-19T22:45:00.000+01:00

Perhaps we all need to get air conditioning in the UK, because there is definitely a lack of it. I guess that for most of the time the weather is neither hot nor particularly cold and you don't need air conditioning for that. But when the temperature hits the 90s well that is hot for us poor old Brits! I know that this is nothing for some of you people from across the pond who don't even melt when faced with proper hot weather, but I don't seem designed for this unless I am sitting on a sun bed under an umbrella sipping a cool drink and reading a book. Only 2 weeks till that can happen and counting.

So how is the good old NHS? Well it seems to be hanging on just about. When they announced the possibility of redundancies, people began queuing for pension forecasts to get early retirement. That has really freaked out the powers that be. After all, they go on about the demographic time bomb. You know where half of the staff are so old they will retire within 5 years or something (might be more as writing this off the top of my head). Plus if they suddenly decide they need more staff, who exactly is going to do this stuff? Having said that, there is some really great work going on with clinical service redesign, I am just not sure what is driving it. Is it the wants and needs of patients or the need to save money? We wait to find out!

In our place, the directors are beginning the process of applying for jobs. Well they don't actually know what jobs they can apply for yet, but they can apply to find out if they are fit to be directors. I could save some people the bother of the application, but sadly it isn't up to me!! I am toying with the idea of an NHS board game, kind of along the lines of Going for Broke (a game I had as a child, where you have to lose as much money as possible). I might be good at that; lets just say the director of finance is unaware of the state of my personal finances.

Speaking of which, I am making some progress. I am learning how to live within my (what should be ample) means, not to use credit and I have sold things. A book on Amazon and a freeview thing on e-bay. I could get good at this stuff, perhaps in the future I could be selling the board game to the unsuspecting customer of online trading companies. Seems like the heat tends to melt the brain, I am becoming deluded again!

This week I have been a bad blogger

2006-07-13T21:33:00.000+01:00

Two posts in a week is real rubbish and pretty much my worse week since I started blogging. There have been a few reasons for this, firstly as my last post said I have been a bit under the weather, not sure if it was the prawn sandwich I ate for Saturday lunch or something else, but the whole thing really knocked me for six. I went back to work on Tuesday despite feeling rough still because we had the launch of our new Journey Planner appraisal documentation. I got to meet a real live Lord for the first time, and he was really nice if slightly bordering on the mad side!

I have been short on things to write about, I guess it is inevitable that their won't be really exciting, gripping things to say every day whether it is about home or work. But actually I don't think writing went to work, came home, ate dinner, watched TV, went to bed is interesting to write let alone read (hey did I really just write that?) Also I am slightly weary in the run up to my holiday on 2nd August (yipee, can't wait).

So to the stuff that is going on right now. This is not a Thursday Thirteen but I am going to do a bit of a list:

Have lost 8lb now on the GI diet, haven't done any exercise since Saturday due to the aforementioned illness, but will get back to that asap
Have made a start on the required reading for the assignment due in at the beginning of September, but I am struggling to feel in the mood for it - it is summer for heavens sake!
Have got to fill in a massive questionnaire thing for my agenda for change appeal (JAQ) because they apparently couldn't match my job at the appeal. Those reading this who know what I am on about hopefully will sympathise!
Completed my first ever disciplinary style investigation and presented findings today. It will sadly result in a nurse having to appear at a disciplinary hearing and will give me a new challenge as I will have to present the case there. Good experience I guess, but sad as it may end the career of a nurse.
Teen son is doing really well on the Roaccutaine and is pleased with the effect so far. I am a little worried about his unwillingness to protect his face from the son by wearing a hat, as one of the side effects is that it makes you more susceptible to the effects of the sun. He is off to a theme park tomorrow and I would like him to wear a hat there, but what can you do with a 15 year old?

So that is me and my life this week. More before too long I promise!

Not so good at the illness lark

2006-07-10T15:54:00.000+01:00

Today I took the first day off sick I can remember taking in years. Not sure if it is something I ate, or just a bug, but sufficient to say that I have spent a good deal of time in close proximity to the toilet in the last 36 hours or so. Usually I might have battled my way to work, but this morning it was as much as I could do to drag myself to an iron and press teen son's school uniform (yes I know, at 15 he could do it). I then spent till lunchtime (not that lunch was on the menu) in bed while the immodium kicked in. I am now feeling much more like my normal self, so am expecting semi normality to return tomorrow.

Got some semi good news at a meeting on Friday; there is still money for education in the NHS, just much less than we have enjoyed in previous years. Still though it looks as if we can begin to spend, even if I don't know who will be left to spend it on. Having said that, the redundancy threat has subsided a little, as someone somewhere has realised it is not a major money saving option in the short term and is more a long term measure.

As can be seen here, life is a little slow around here right now, this might be because I am under the weather, or it could be because I am counting down to my holiday in 3 weeks and 2 days!!!

Remembering

2006-07-07T21:52:00.000+01:00

At midday today I was at Kings Cross Station, where the first of last years July 7 bombs was detonated below the ground on a tube train. Standing in the middle of the station, having just got off my train alongside many other people was quite a moving experience. In fact despite the heat of the summers day, I felt goosebumps on my arms. I discovered that 2 minutes actually feels like quite a long time when you are stood silently amongst strangers, but it does us no harm to reflect in this way. A year ago, the station would have been packed with commuters on their way to work when the bombers set off their devices in the tube and on a bus just after 9.45am. For anyone who has ever travelled in this way, and who has thought little at the time about who they are traveling with then it is a wake up call and a scary one at that.

At two minutes past 12 I was on my way to the underground and the University Library to look for books for my impending assignment. Noticeably there were a lot of police and London Transport workers both within the station area and on the platform. In my carriage was a man collecting rubbish, now I have never seen that before. The presence of these people was reassuring, as I guess it was designed to be as well as showing the need to be vigilant today of all days.

Four heavy books later, I walked along Great Cavendish Street and into Cavendish Square where people sat in light rain, mixed with a hot and humid day, eating lunch. I had cause to think that only in England and London at that would people sit in the rain eating lunch! Interesting day.

Thursday Thirteen - 06 July 2006

2006-07-06T07:08:00.000+01:00

Thirteen Things about Julie's week

I am now in the swing of my GI diet (has only taken all year to get motivated!). I have lost 6lb in the last 3 weeks or so by following a programme on e -diets diet and fitness programme. So far so good.
I hate to admit it, but I actually prefer the new office to the old one. It is bigger, gives more opportunity to see people I need to work with and is very handy (some would say too handy) for the shops.
Traffic problems have been a feature for all this week. On Tuesday a road closure caused hubbies journey home to be 3 hours long instead of just over 1. He was not a happy bunny!
Both Tuesday and Wednesday evenings have featured world cup semi final matches which we have been able to watch in a relaxed and chilled manner, rather than the stressful time that is watching the England football team.
On which subject, why is Wayne Rooney being treated as some kind of poor wounded animal. He got himself sent off, no one else made him stand on the other player and by doing so the writing was pretty much on the wall!
The glorious, though hot and humit weather has briefly broken. Good thing is though, rain is very good for my garden. Still pretty warm though and hopefully we will see the sun again one day soon!
Teen son is counting down the days to the end of term (2 weeks and one day and counting). I am looking forward to it for different reasons, better traffic for one thing!
I have an essay to write for the beginning of September, I haven't yet done so much as a literature search for it. I really must get on with it (plea to self!)
Work remains ever so slightly depressing. Yesterdays news was that our current chief executive wasn't shortlisted for the job in the new PCT. Gloomy times! The new person will be announced in early August. Wonder if it will be the person we have in the interim setting up the new organisation, many fear a conspiracy!
The Roaccutane teen son started taking last week for his acne is already having an effect I am pleased to say. So far the only side effect is him being more thirsty and having drier skin. He has discovered moisturiser for the first time!
We have been arranging our hire car for the second part of our holiday which takes place in 4 weeks time - yipee! I have also bought a book about Barcelona (part one of the trip), which has made me pretty excited about the whole thing!
We are off to see my brother and sister in law at the weekend to try to extract the money for their son's holiday from them. Wish me luck!
As you can see, it has been a relatively quiet week. That is pretty much how I like it right now.

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The thing about hot weather is............

2006-07-04T18:46:00.000+01:00

It is better spent relaxing at home or at the beach or somewhere. Being stuck in an office with no air conditioning and windows that open no more than an inch is not enjoyable. Much as I love warm sunny days, I never seem to be quite ready for the sheer humidity we get. It just seems to wear you out and today it has made me generally tired, achy and irritable.

My new office is right in the middle of a large town, and is seriously close to the shopping centre. This is good for getting lunch if you haven't brought any with you, or for those retail therapy disasters, but it is terrible if you are trying to stop yourself spending money. Still it will be good for my personal resolve and self control (that's the intention anyway).

At work we are preparing to hold workshops to help people identify their transferable skills and apply for new jobs. People who perhaps didn't expect their jobs would be at risk are finding that perhaps they will be. This is challenging for all, for those affected and also the effect the news has on others around them. Last week I caught the sharp end of a department secretary's tongue as she pretty much told me she couldn't see any need for our department (training) when they are facing cuts to theirs. The thing she doesn't know is how safe exactly my job is, and meanwhile how much work I have to do to help people cope with this uncertainty.

On the plus side, it is only 4 weeks until my holiday: roll on August 1st when I finish work for two whole weeks!

The menfolk are now depressed

2006-07-02T22:32:00.000+01:00

It might be hard for people to understand just how important your average English man considers success in the world cup to be. Even faced with the evidence that the manager has sent the wrong team and told them to play in the wrong formation and in the wrong way, they still consider that winning the whole tournament is pretty much inevitable. Trouble is, reality is different, so when the team lose on penalties in the quarter finals, your average English man sinks into a deep depression. Today hubby has suggested he might move to a darkened room and stay in bed. Of course he didn't quite do that. But he has spent the whole day moaning that if you are paid £100,000 a week then you should be able to score a simple penalty during a penalty shoot out. He definitely has a point and no doubt if he were paid such a salary he would be able to do such a thing. If he were paid that amount, I would of course be out with my personal trainer, or shopping or something and likely miss the event.

So it is all over for another 4 years, hubby and teen son are now supporting France, perhaps because we are going there in a few weeks or perhaps because they have Arsenal and Chelsea players in the team (or some other similar reason). This is the last week of the tournament, so normal TV will be resumed byMonday week; yipee!

That was the week that was.....

2006-06-30T06:41:00.000+01:00

As the topical satirical programme of the 1960s was called (no I am not old enough to remember, I just saw a programme about it recently).

No Thursday Thirteen for me this week, as I didn't have any good ideas or sufficient time to think of any this Thursday, and now suddenly it is Friday! I hardly know where the week has gone, but am pretty glad that it is nearly at an end as I am quite weary. Yesterday I went up to London to meet up with a work colleague and someone who does some work for us on a freelance basis. Both are therapists of the systemic school (there I am sounding like I know what I am talking about, well only vaguely actually), what is interesting is that this leads to a whole different language being spoken over dinner. They are also really enthusiastic people, and that kind of thing tends to rub off, so you come away feeling quite uplifted, though exhausted at the same time because it is like having to translate a foreign language constantly.

Covent Garden, where I met my colleague was heaving with people. Walking around, watching the street entertainers, shopping, sitting outside the many bars and restaurants eating, drinking and generally having a great time. I was a bit early, I had planned a visit to one of my university campuses to go to the library, but discovered that they are closed at 5pm at this time of year. So I sat with my bottle of water and my book for a while till it was time to go back to the tube station to meet Ana. While standing there, a man well into his 50's approached me and asked me if I was Denise! I replied no, because that is not my name, I was then both amazed and amused when Denise turned out to be at least a foot shorter than me, slightly wider with a silver grey bob haircut. I would suggest that if you are going on a blind date, you check out what she looks like in advance!

Anyway, we walked into china town and a place called Blacks (which happens to be there but isn't in any way Chinese). This seems to be a private kind of bar / restaurant club and quite an eccentric British kind of place at that. Not sure how you come to belong to it, but it was pretty full of people, young and middle aged and people who seem to visit there frequently. Not sure if such a place could exist in other cities in the world! The food was pretty good though.

All in all, an educational evening and one that didn't end until I arrived home at midnight. Sadly hubby appears not to have grasped the basics of dishwasher loading, so I have that piece of work to complete this morning. Still it is Friday, and nothing seems too bad on a Friday!

How much information do people really want?

2006-06-28T22:57:00.000+01:00

Because if you ask them, they would say, a lot please. There is a general feeling that people at work are not getting enough of the information they think they should have access to. They think that people are holding back on them, keeping them in the dark, rather than there perhaps being a lack of real hard information. Trouble is, when someone comes along and lays the cards on the table, they don't like it.

Earlier this week we were told the extent of the financial situation our 2 PCTs find themselves in, and what needs to be done to resolve this. Essentially it means that a very large sum of money must be saved and that will mean services and the jobs that go with them will be lost. How many we don't know, but head count must be reduced and nearly £20 million pounds saved.

People are now more depressed than ever and some are saying perhaps it is better not to know. Classic head in the sand behaviour if you ask me.

Patient services will be affected. People will be prevented from going to hospital, whether they want it or not, and I am afraid that people will get looked after by a bunch of nurses, even nurse practitioners instead of them being under the care of a hospital medical team. Some of this will be good, but some of this willdefinitelyy be bad. People will complain, people may even die for all I know. But never again will people who work in the NHS think they have a job for life.

Thanks to NPS saves lives for the warning sign link, you can make your own here

Nostalgia at its best

2006-06-26T18:24:00.000+01:00

Sometimes things affect you in a way you don't quite expect, and I guess our trip to see Sinatra in London on Saturday night was a bit like that. The show was extremely cleverly put together and choreographed, the big band orchestra and dancers were fabulous. But the main thing for me was seeing the old footage of Frank Sinatra and hearing him sing. Because it brought back extremely fond memories of my own grand parents.

My Grandad fancied himself as a bit of an old romantic and loved to sing songs by both Frank Sinatra and Bing Crosby, particularly to my nan and especially when he had drunk a few beers, though he sang at all times of the day and night. Grandad was also a very slim man for his whole life, and as my hubby said he wore the same kind of clothes that Frank wore when on stage for our family gatherings. Hubby and I were both sat thinking the same thing which was slightly spooky but great. I think the effect was helped by us being in the London Palladium a wonderful historical building.

The whole day was great, we headed off on the train in the early afternoon and once we got to the west end, hubby suggested we go to the champagne bar in Selfridges which was extremely pleasant not to mention romantic. Sitting drinking a very nice glass of pink champagne while watching people spend their money! Then we went on to have a meal before wandering around the Oxford Street / Regents street area and then heading off to the Palladium.

Of course hubby is now complaining that he spent too much money, and is mighty glad our anniversary is only once a year. But then if it wasn't such a trip would hardly feel special.

Doing the right thing

2006-06-24T08:20:00.000+01:00

Our PCT and all the NHS trusts around us are in the red and have been so to a greater or lesser degree for some time. At the beginning there was something called the NHS bank, and there was a degree of leniency, after all we were incredibly target driven and meeting targets needs people to do stuff; lots of people. Now the plug has been pulled on credit, a bit like reaching your over draft limit at the bank and the manager saying no more. This means that across the health economy cuts are being put into place. For about 9 months we have had a vacancy freeze and we have all been charged with finding ways of saving money, but now things are about to get more serious, more drastic. So drastic that I and my team, along with the Human Resources department are about to get training on how to career coach people.

In the midst of all this, we have been working on some new documentation to help people through each year up to their appraisal. We have called it the Journey Planner. A hell of a lot of work has gone in to it, and it is pretty good (even if I say so myself and I do). It allows the employee to record their interactions with their manager, reflections on learning, more formal education including mandatory training and finally documents the appraisal. We want to launch this document, after all, people need to have appraisals, and it is a really good piece of work. A colleague knows a real English Lord, she has asked him to come help us launch, he is really happy to do so. The chief exectutive and my own director have agreed to this, but that was before the redundancies which have yet to be announced to those who they will affect were decided upon.

It was suggested to me yesterday that we cannot launch our Journey Planner, we cannot do anything that suggests we are ignoring peoples feelings, that seems as if we are not in touch with reality. When I told this person that we were going to provide a light lunch at the launch (only one hours duration at lunch time) she nearly collapsed in apoplexy. I told her I wasn't prepared to waste the hours of work we have put into this as this was wasting the trusts money if nothing else was, she said she too had had to shelve things that she had done too. Well that's ok then!

I am not sure if we will go ahead, I will discuss this with my manager on Monday, but if I am going to be responsible for creating bad feeling, then I want no part of the whole thing. In fact it again makes me wonder just what my place in this mad and crazy system is!

On a happier note, yesterday was my wedding anniversary, we have made it to 22 years and tonight are off to see Sinatra at the London Palladium. More about that in the next day or two.

Thursday Thirteen - 22 June 2006

2006-06-22T17:36:00.000+01:00

Thirteen Concerts Julie has been to

This kind of follows on from yesterday's blog when I mentioned the group Madness in passing, so I thought lets go for Thirteen concerts I have been to. I won't know till I get to the end if I have 13 to mention; this is not planned in advance!

My first ever concert was to see Gary Glitter and the Glitter Band. This was glam rock at its finest, and involved a lot of stomping around the stage and pretty heavy beats. The glitter band were pretty good looking if I remember rightly, Gary was, well Gary with big hair and shirt undone to the waist. Sadly, it turns out Gary was really bald and wearing a wig and also that he was a paedophile. Luckily I never was in love with him, and at 11 never got anywhere near him. The concert was great though!
When I was first going out with my hubby he took me on a youth group trip to see Cliff Richard. I wasn't ever into gospel music in a big way, but I liked Cliff, and so was happy to go along. Hubby still maintains to this day that he only ever went to church so he could go to Friday youth group where table tennis was played. But who knows?
When we were first married we got the chance to go to a Queen concert at Knebworth Park. This was my first trip to such a massive venue, with something like 100,000 people packed in to this stately house grounds. We lived near by and so walked home after! Queen were fantastic, and we also saw Status Quo who hubby was keen on.
On Christmas Eve one year (probably around 1982-3) we saw Toyah Wilcox in concert. I most remember that she ran around in a short skirt and long boots, and had longish straight hair. She spoke (and sang) with a lisp. She does TV now, looks like from the link that she still sings and tours.
Whitney Houston was a fantastic singer in the 80's, a real diva, we saw her at Wembley Arena. It is so sad that she has become such a shadow of her former self. Drugs really do damage lives!
M People with lead singer Heather Small were one of our favorite groups in the 1990's. Heather has a strong and distinctive voice which I really love.
Simply Red (lead singer Mick Hucknell) again at Wembley Arena were one of those groups producing music prolifically throughout the 90s. Mick is not much to look at but he has a great voice.
In 1987 we went to Wembley Stadium to see Madonna. What a performer she was (and probably still is). She was into wearing those weird bra things back then!
The Beautiful South are still one of my favorite bands. We saw them at Brixton Academy which is a small venue and where you can see the group without the need for a big screen!
As mentioned at the top of the list we saw Madness a couple of Christmases ago at a venue similar to Brixton. It was a real fun way to start the festive season with plenty of mad dancing!
3 summers ago we saw Robbie Williams at Knebworth. Hubby decided we should park about 3 miles away, much to the disgust of my sister in law. It was a hot afternoon / evening and was just the most fantastic concert. My favorite song Angels had me feeling all goose bumpy - the best yet.
Dina Carroll was a great female vocalist we saw in around 1994/5. Hubby took me away to Bournemouth for the weekend and we saw her there. It was the first time I had left teen son who was about 3 or 4 for more than one night as we were away for two. Great memories.
Last but by no means least, we saw Leo Sayer at the London Palladium, can't remember when, but it was a long time ago. He was a singer in the 70s and someone I really liked for his great ballads. One of his songs - when I need you - was played at our wedding. He has recently made something of a come back.

Wow made it to 13 after all!!
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Things are a bit mad in the NHS right now!

2006-06-21T18:51:00.000+01:00

Mad and just too busy for words. The move to our head office seems to have affected my stress levels in quite an adverse way. I am not sure if this is because I have got a bit behind with things due to having no proper office for several days last week, because I have loads more work to do, or if it is because I am just too visible and accessible in my new office. I suspect a combination of the three, and perhaps one or two other reasons I haven't yet thought up!

Today I attended the most bizarre of meetings. It was just an hour in duration but I came away feeling completely confused. The person calling the meeting had told the rest of us we were meeting for one reason, but when we arrived her agenda seemed completely different. I thought it was me who was confused and somehow missing the point, but no, afterwards it transpired that others were equally in the dark. So guess what? Before I left today, another meeting had been called to sort out the confusions of the previous one!

Rumours now surround us, we are all in no doubt that several million pounds needs to be saved, and the myths, half truths and perhaps lies surround how this will be done. Perhaps services will be cut, but which ones, perhaps people will be made redundant imminently but perhaps that will cost more than it saves after all a lot of people have given a lot of service and would be expensive to get rid of.

I went out for a walk when I got in from work. This had two purposes, one is that I really am intending to get fitter and slimmer and have taken the bull by the horns as it were and changed my diet and upped the exercise levels. The second and best reason this evening was that it has helped clear my head. Now I can get on with cooking dinner, and this evening plan a teaching session for tomorrow that I haven't had the time to do yet. I just hope tomorrows audience don't notice the joins!

The picture is a British group called Madness, I have seen them live and they are great. Tomorrow's TT might be about concerts I have been to, if I have been to 13. I will have to think about that!

For once, a happy family day

2006-06-19T06:40:00.000+01:00

I always have the feeling that my family is slightly more prone to disagreements, arguments and general falling out with each other than most. I think this is often more to do with what people don't say to each other than what they do, and then when something does need to be said it is often blurted out in what may not be the best way. I have two brothers, both with wives and children, any combination of the siblings and their children is usually fine on its own, but throw in my parents who seem to have varying amounts of respect for their daughters (and son) in laws, appear to favour certain grand children over others (though they claim not) add in a good proportion of alcohol which appears to fuel some of these affairs and you have a cauldron constantly threatening to boil over. I have learnt to keep a reasonably clear head at these occasions by volunteering as driver more often than not and even when I am not driving still keeping the alcohol consumption to a minimum (though some times I have let my guard slip and schemed to the evils of alcohol, resulting in my letting my tongue slip inappropriately)!

So yesterday was Fathers day. This family occasion on a (cloudy but humid) summers day was spent in my parents garden and comprised my younger brothers family, my own husband and son, my parents and finally a cousin (male) visiting from New Zealand who these days is something of a fitness freak having been able to drink for both England and New Zealand last time I saw him when he was about 21. I designated myself driver (hubby is a father after all) and cook ( I like doing BBQ if it is not at my own house where I would have no end of other things to do) and I wanted to give my own dad a break. After a great BBQ, with pleasant family type conversation, most of us then went for a very pleasant late afternoon walk before returning for cheese and pudding and then heading home. Unlike some of my other family encounters, this will go down as one where people didn't feel as is they were avoiding saying the things they wanted to say, although I have to admit we were on good behaviour (with the NZ cousin being there etc). I just wish it could always be like that! Sadly no photos from this occasion (forgot to take camera).

Leaving it to the last minute

2006-06-17T11:34:00.000+01:00

I have to admit this is one of my least good attributes, and it isn't just about doing things just before the deadline, but also allowing myself enough time to get from place to place. I have generally trained myself to try to allow sufficient time to get from place and even arrive early where possible. But sometimes I just try to fit in too much between going onto the next thing. In my defense, yesterday was quite an extraordinary day, and far busier than I could have predicted when I booked my annual contact lens check for 3.05pm. Ok so my working day is to 5pm, but the NHS gets plenty out of me, for example no lunch break, working from home in the evenings and the like, and the optician will only take a couple of annual check bookings per day, making Saturday appointments like gold dust. Getting home early on Friday is just the best thing, not something I always do, in fact it is becoming quite a rare occurrence. But a few weeks ago I booked the appointment, thinking that a 2pm departure wouldn't be difficult to achieve.

Yesterday turned out to be moving day, so it wasn't an ordinary day where little happened. Instead the boxes arrived in the new office at 1pm and I set about doing as much as was physically possible in an hour. Except that by the time I was as straight as I wanted to be it was already 2.20pm and I work at least 45 minutes away from home (or my home town where the appointment was to be). Un perturbed I set off as quickly as I could and as I dared in relation to speed limits and at 3pm I was still a good 10 miles away. In my haste to get away from the office, I left my diary (complete with appropriate numbers) on my desk so had to get a colleague on the phone to see if it was worth my while going. They said unless I arrived by 3.10pm then I would need to rebook, and what with parking etc, that was going to be impossible. All this time, I petrol red light was on telling me I needed to fill up as soon as possible, I had visions of breaking down on the motorway and needing to call out someone with a petrol can! Luckily I made it to fill up, but honestly I must get myself better organised in future!

So another new leaf (along with the financial and dieting ones) will have to be turned over; I must allow myself more time to get to places, and I must fill up my car with fuel before I am likely to run out on the motorway! Still if you like risk, and I have to admit I do, then life would be boring if you never had to rush to get anywhere!

Thirteen things you need to know about the world cup

2006-06-15T07:11:00.000+01:00

Thirteen Things about The world cup as seen here in England

Every day at the moment, there are three football matches to see. Once you get past the first round, the rate of matches will drop off, but the whole thing goes on for about 5 weeks, therefore it is hard to ignore.
Many of the matches at the moment are being shown on the BBC, the anchor person for these programmes is Gary Linekar who is a former England hero of football himself. I think he spends the rest of his time sun bathing, since he is turning a kind of deep orangy brown colour!
If you read English newspapers or watch the sports news here, you could be forgiven for thinking that England only need one player, and will only win any given match if that one player plays. When that player injured himself a few weeks ago, they almost went into mourning as if that one player had died!
At about 10.30 each night both of the terrestrial TV channels with rights to show the world cup have highlights programmes showing exactly the same goals at exactly the same time.
Many people in England have taken to flying several St Georges flags outside their houses (this is not something people do all the time), some either have little flags flying from their car windows. These flags often fly off of the cars and can be found by the sides of the roads (probably for recycling purposes).
Hubby has spent all week wondering what time to finish work today. The match starts at 5pm (England v Trinidad and Tobago) and he wouldn't want to miss it. I on the other hand intend to leave work when the match starts because I think I will be the only one on the road by then and will therefore get home in double quick time. Does this make me unpatriotic?
The wives and girlfriends of footballers are extremely thin, glamorous beings. They are following their menfolk around Germany as of course they should. Tabloid newspapers use up much of the space not taken with the Wayne Rooney (will he play or won't he play) saga to fill with stories of their sunbathing and drinking!
Avid fans of world cup football should have something called a 'world cup wall chart', which they place in a prominent position in their living quarters. This is so a record can be kept of all results and discussions can take place about them. These discussions take place at half time and between matches!
So far, even though Arsenal have signed less new players than Chelsea, the new arsenal signings are playing better and scoring more goals then the Chelsea ones (money isn't everything you know!)
The world cup is now interfering with my viewing of big brother, still I have the feeling I am not missing all that much, especially as the BB highlights shows can be watched again later, usually at the same time as the football highlights, but even hubby doesn't want to watch quite that much football!
One of teen son's friends lives next door to someone displaying 2 very large Brazil flags in their windows. These people are apparently not Brazilian and have probably never been to Brazil. The thing about people from the UK is this, if you come from Scotland or Wales, you very likely will not support England as a team even if you happen to live in England. I guess if I was Scottish and didn't want to support England I would support the favorites: Brazil.
In 1966 England won the World Cup, this is 40 years ago and therefore is too long ago. When we are not having actual matches to watch therefore, all the TV talk is about 1966! I just wish people would get over it, but it seems many of them can't help it!
From all this, you might think I don't actually like football, actually I do but it does the men in my life no harm for me to keep a slightly cynical edge going! When it is all over, we will have the TV silly season (if this isn't it) and then there really will be nothing to watch!

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Confused? I soon will be.

2006-06-13T17:35:00.000+01:00

It seems there is to be no time for a dull moment in my part of the NHS, in fact it is beginning to feel like I am on a roller coaster ride, and a scary one at that. The realities of the financial situation is beginning to hit hard as talk now turns to the decommissioning of services. The very idea that something like a health care service can be considered of no further value, be disbanded and staff made redundant is a new one for us here in the UK. Generally speaking, in the past there has been little of that happening, but I wonder who has decided what is no longer needed? Is it the patients using the service, i.e. are they not using it? Or as I suspect is it the job of a senior manager to say, this is not providing value for money, lets pull the plug.

If this can be done to services providing care to patients, what could it mean to people like me who manage an education and development service? Interesting, but very scary times!

Another part of my own personal roller coaster journey takes place on Friday. Having moved to my current office about 3 months ago, we are now instructed that we are required to move again. The packing cases arrived today and tomorrow I will again pack up my office files. I will do my best to rationalise my belongings again in the hope that I arrive there with less than I currently have. After all, I wouldn't be surprised if another move takes place before the year is out! The new office has advantages and disadvantages, on the plus side, it is large and contains most people I need to liaise and deal with on a daily basis, it has on site parking and it is in the centre of town. On the negative, it is large, noisy at times and gives little opportunity for privacy, the car park gets full up and parking in town is expensive, it is too near some very nice shops which may need to be avoided for the sake of my new leaf which requires me to act like a spend thrift when I would rather be a shopoholic.

The one good thing about being in the head office though will be that with the roller coaster existence that is happening right now, at least I will be there to catch the news and gossip first hand and that cannot be a bad thing!

I don't know why I am surprised

2006-06-12T07:05:00.000+01:00

Because this is essentially a footballing household, and as Chelsea now owns half the world's footballers it is inevitable that we will have to watch a lot of the world cup. But yesterday saw 3 matches on our TV, nicely spaced out through the day, all activities carefully times so not to miss the action. When someone like me complains, the answer is (of course) "but the world cup is only every 4 years". This is true, I cannot argue with this claim, but what about all the qualifying matches, friendlies and then there is the European Cup also every 4 years, but a different 4. The photo is from the Holland match, please note the colour they wear, in my opinion slightly bright, and something that the whole crowd loves to copy. Thank goodness that England wear either all white or red and white!

Don't misunderstand me, I do actually like football, I just find so much of it too much to cope with. Particularly when you are enjoying the best weather of the year so far (and who knows it could peak today and be back to winter tomorrow) you don't necessarily want to spend your waking hours watching quite so much of Mexico playing Iran (I think) or Portugal playing Angola. Still I guess it is taking the pressure off of Wayne Rooney and his broken (or mended) toe!

Each result is lovingly recorded on the world cup wall chart on the back of the dining room door, and if either hubby or teen son are unsure of any of the up and coming delights they can spend 10 minutes or so studying it. I wonder if that is the place to pin up teen son's revision work (he has end of year exams this week).

So another week starts, back to work and as I have been out of the office for 10 days or so, a predicted mountain of emails, another office move to look forward to on Friday and every night we have football to look forward to!

My week

2006-06-10T07:35:00.000+01:00

One of the problems with student life, particularly as you hit the mid way point of a two year course is that you have just too much to do. This week that has meant little time for posting to my blog, compounded by the problems blogger seems to have experienced this week. I wouldn't mind but there was me thinking that it was my lap top / internet connection or something (note to self, get yourself onto a new blog host service soon). This posting therefore will hopefully help anyone remotely interested in what I have been up to, catch up with what has been happening.

Tuesday saw my group of fellow strategic leadership MSc students reconvene at our seat of learning. First thing of note was that there were very few other students there. This made parking simple and meant that moving around campus was great. Apparently all under graduate courses finished for the year a few weeks ago and so there were just post graduate students and staff around. We got down to the craziness which seems to be unique to this course of marking each others work. I was pleased to see that with only one exception we had all improved in quality of essay writing and subsequently in over all marks. Sufficient to say, I was very pleased with my own mark which put me into merit territory. I just need to be less deferential to the authors I use in my work, trouble is that is difficult when you have chosen them because you agree with them!

So just when I thought I would be getting a summer break from studying, they suggest that rather than one 10,000 word assignment by Christmas, we do two 5,000 word pieces, the first of which will be due by 8th September! Bang goes the novel reading I was planning for the summer. The theme we are addressing here is learning and development, and with the course being about leadership, essentially I will need to be looking at leadership development. Luckily this is a subject after my heart and something I am doing a lot of at work.

On Thursday the group had a day out in the metropolis of London (hot and humid in the height of summer, but what can you do?) for visits to Lloyds of London and the Tate Modern. What a contrast, the male dominated insurance capital of the world, to the weird and wacky home of modern art. What views both buildings have of their surroundings, plus we enjoyed a lunch in the Gerkin! Photos will follow!

So on to the weekend and the world cup. Today sees England in their first match, lets hope the hype and expectation of the nation has been worth it and we beat Paraguay today!

Last but by no means least, I have become a contributer at All Blog Stars, a new community blog. It is just a couple of days old so in its infancy but please take a look.

Thursday Thirteen - 8 June 2006

2006-06-08T06:56:00.000+01:00

Thirteen Things that annoy or irritate Julie

I decided to compile this particular list after the man serving me in my local shop spoke to someone on his mobile (cell) phone throughout the whole transaction he had with me. How rude, I thought.
I get very annoyed about people from call centres ringing up, obviously from several thousand miles away, and there being a silence between me picking up the phone and the connection. Last week I even had music played to me as if I was on hold. Well I have news, I am not hanging on the phone on the off chance someone who has rung me to sell me something decides to speak!
On the same topic, they ring you from abroad, proporting to be from your bank or some other fiancial institution and then proceed to ask you personal questions like your date of birth and mothers maiden name. I am desperate to ask for theirs back!
Something I find extremely disgusting not to mention a health risk is people who spit in the street. There really is no need for such behaviour - use a tissue if you must spit!
It is not that I am not interested, or that I don't want England to win the world cup, but newspaper and TV news people please stop being so obsessed by the broken toe of Wayne Rooney. If he is fit to play he will, if he plays well he will, mean time, give us all a break.
Rude people, and particularly children who have not been taught any manners by their parents irritate me. Most of teen son's friends are extremely polite, sometimes painfully so, but occasionally you get a child in your house who comes across as rude. Sadly my own brothers children are borderline in that respect, though they are reasonably good with me (I think I am scary!)
People who complain it is too cold, then that it is too hot when the weather hits 75f for 2 consecutive days annoy me. "Oh it is too humid" or "oh this hot weather is unbearable" they say. No it is not, I spend 9 months of the year waiting for the weather to warm up, stop putting the dampers on it!
Very skinny people who eat all day yet never put on weight are pretty irritating. Why can't I be blessed with that kind of metabolism? I only need to think about eating a cake and the extra 2lb is already there.
On a similar topic, I can't stand it when women of a certain age and weight wear clothes that so obviously do not fit or suit them. If you have rolls of fat, do not let them hang over low rise jeans or a tight skirt and do not wear a short crop type top with it. To wear such clothes you need to be slim and probably look reasonably young. Of course young is a flexible term!
Traffic jams. Any one who has read this drivel before will know that I am not good at sitting in traffic jams edging my way home from work. On the same topic I am irritated by drivers who leave it to the last second before merging into a lane and assume (usually rightly) that you will let them in!
The head of maths of my son's school has annoyed me this week. Having accused teen son of not submitting an important piece of work (in January if you please, why wait till May to say anything?) offered proof that the work was submitted, no apology is offered. I will be going to see this man soon, I can assure you.
Christmas arriving too early is annoying. I don't want to buy Christmas decorations in September or Easter eggs in January for that matter.
Lastly, I have been trying to finish this before I get up for work, just about made it but I am now running late. My last thing is that I hate running late, so please excuse me if I go now!

Please don't get me wrong, I am not some grumpy old woman type. For one I am not old, but I know what I like and I know even more just what annoys me.

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Finances in the NHS (or give us your money)

2006-06-07T07:08:00.000+01:00

Great news this morning; the NHS trusts in debt are going to get into more debt this year, yipee!

Our PCT ended the year several million pounds in the red, this is despite extra investment and by getting staff to save several more million through re-using paper clips and freezing vacant posts (or something like it). We are told we can save another 15 million (I think that is what the CEO said at her briefing), through further thriftiness. All of this means that there is now no such thing as a free lunch in the NHS (or my part of it) or indeed a free biscuit.

Education funding has been cut by 10% for this year, that is what we have been told. This is a centrally funded levy (meaning that it originates by levying individual trusts at source, a bit like income tax) used to fund the lions share of education and training for existing staff and for training new practitioners. 10 years or so ago, there was an apparent shortage of doctors, nurses and therapists, so more were recruited for training, and now some of the new practitioners cannot find appropriate jobs and this year training places are being drastically cut. Does that mean that in another 10 years we will have a shortage again causing the cycle to begin again? I know that something like 40% of nurses are over 50, with a similar demographic across other professions, so there is a bit of a time bomb ticking away there, or will we all work to 80, caring for each other in some kind of nursing home for medics?

To be honest I don't know the answer to all of this. I suspect there has been a great deal of money wasted in the NHS over the years. Some of it caused by ill thought out central budgets (many of them involving IT) but some of it has been caused by our own complacency. Managers going to posh hotels for away days, the use of outside consultants when there has often been perfectly experienced people to undertake projects from within. For some reason there seems a lack of trust in the assessment of a manager from within, when if the same manager were to leave and become a private consultant and charge £1000 per day then suddenly they become the best judge of whatever the problem is. Mind you, that is if the project reaches fruition, because only too often the project is abandoned and something else embarked on instead.

So mean while at the sharp end the lack of money means things like this: we cannot order any stationery without a directors say so, we cannot give people on a training course more than a cup of coffee all day (though I buy biscuits and chocolates myself often), we have to go through telephone bills with a fine toothcomb, we have to justify to members of the board the need for replacement staff to mention but a few. But given all of this, are we happy? Well I for one am still happy in my job, but at times, it is a challenge and for the wrong reasons!

This week I will mostly be....

2006-06-05T10:29:00.000+01:00

A student. Yes it is back to my post graduate course for the final 'learning burst' of this academic year and tomorrow I will receive the mark for the latest submitted assignment. I have to admit that choosing the subject of leadership to study was an inspired one, because much of the coursework not to mention the topics I have chosen for my assignments have become part of my everyday work. The other useful thing, is the MA Organisational Development course that is being taught alongside, because my role has broadened out this year to be much more about organisational development than strictly being just about how individuals in the workforce are developed.

So today is an annual leave day, and one where there is no teen son hibernating upstairs, what is the appeal of his bedroom that makes him love it so much? He has returned to school, for what is perhaps the most important week of his school career yet. On Thursday he will be taking the first part of his 2 part science GCSE with the other half next year. He says he has been revising, I just hope that he has, after all he has had ample time to do it!

One of the downsides of my course, thought it makes for an interesting time, is that we have to read each others assignments and then feed back to each other about them. This means that today I have three 7000 word essays and two 5000 essays to read but with the weather being so good right now, I wonder if a trip to the local park wouldn't help make the long read easier? More about the student life as the week goes on.
Leadership
Post+graduate
Teenagers

At last........

2006-06-03T09:48:00.000+01:00

We have a warm and sunny weekend, and I have actually switched off my central heating! I can't remember a year when we still needed the warmth of it almost into June. Speaking of which we are now in to my favorite month. I just love the long days of June; last night it didn't get dark until 9.30, and was light, bright and sunny when I first woke early this morning. We were married in June (23rd), which was no accident and given the choice I would go on holiday during this month. With Teen son now 15 it won't be long before we can again go away on a June holiday.

Today is the Derby, a horserace held in Epsom, that hubby makes an annual pilgrimage to along with some ex-workmates and his dad. Usually they go off on an arranged trip on a bus, but for some reason this year that hasn't happened so my brother has taken them and I will be going later to bring them home. I am hoping hubby will be richer on the journey home, but some how doubt that will be the case; I am not keen on gambling, but it is only once a year and it is his own money!

My day will be spent doing more work on the garden, taking teen son for a hair cut and then doing a bit of ironing in front of the final England friendly match before the World Cup starts next week. In all I am hoping for a peaceful relaxing day before I head off to fight my way through the race day traffic!

Thursday Thirteen on Friday!

2006-06-02T09:00:00.000+01:00

Thirteen Things about My day out on Thursday

So this week's Thursday Thirteen comes to you on Friday, becasue yesterday I was busy taking 4 children aged between 8 and 15 out for the day. More below.

I have one son, 2 nephews and 2 neices and over the years I have taken various combinations of them all out for days. The elder of my nephews is the same age as my son so he was the main travel companion in the early days but lately I have taken the younger ones out more frequently. Yesterday the party comprised: Matt 15, Abi 13, James 11 and Laura 8.
When deciding where to take them I was influenced by reading Aginoth's blog after the weekend. We have loved visiting various castles over the years and the weather forecast told me that the weather would be better slightly to the northwest than to the south. So we headed up the M1 to Kenilworth.
My brother didn't arrive with the children till after 11am, so we arrived at the castle with everyone feeling extremely hungry. Luckily I had packed an ample picnic and there was plenty of room to spread out. Luckily also the sun came out and was pretty warm.
After the picnic we wandered around the medieval village which was being re-enacted within the castle grounds. We saw water being heated up over coals to make a cup of tea, a minstrel playing and a lady making shoes from leather amongst other things. The children were suitably impressed with the whole thing, though Laura (8) was most impressed by the sheep and lambs in a small enclosure!
Next to the castle, much of which is ruined so there was lots of climbing up stairs and through small doorways. We sat for a while at the top of one tower area. I was admiring the view but James soon made friends and was busy having a sword fight before rolling down a most massive hill before I could stop him.
Time for a drink at the castle cafe then a decision to drive the few miles to the home of Sheakspeare, somewhere I hadn't visited before and thought it might be nice to go to for a couple of hours before hometime.
In Stratford on Avon, we manage to part reasonably easily and take a stroll towards the stratford canal. The children saw a lady selling icecreams out of a canal barge and made a beeline. Who can blame them, I guess they have an inbuilt device to find icecream. Incidentally it was very nice.
Next we walked along the river bank and spotted people having boat rides, some were rowing and some were driving slowly along in little power boats. I said that I would happily go in a boat but wasn't in the mood for the rowing thing. So we hired a power boat for £10 for half an hour.
All the children had the chance to drive after I had got us going. Matt declined, he is getting just too cool these days! Abi went first and soon got in her stride, though she was a little nervous. James was confident and rightly so, he did really well and drove a second time at the end to bring us into the dock. Laura kept over steering so we tended to go from one side of the river to the other. We had a near miss with another boat under a bridge but no damage was done!
We left Stratford just before 6pm and headed home. Luckily the traffic was good and the weather clear and sunny making for a pleasant journey home. They snacked on some of the picnic remains, so my car is now covered in crumbs!
We stopped off at KFC and Macdonalds (I know I am too soft, and should have made them all have the same) on the way home. James and Laura's mum was waiting to take them all home (Abi is staying with my mum this week). So by 9pm peace was restored.
Just time to clear up the picnic remains and sit down with a nice coffee and watch big brother. Looks like the house mates are now fighting nicely!
Pictures of the day:

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Professional Boundaries

2006-05-30T17:39:00.000+01:00

When you are a nurse, or some other kind of professional person; doctor, teacher, lawyer or whatever there are rules which you must keep to, there are professional boundaries. Part of the theoretical training of a nurse must include professional issues, things like making the needs of your patient paramount to your actions, like conducting yourself in a way that is appropriate for example not stealing from your patients or as it says in our code of conduct even borrowing from your patients. What's more you must not accept gifts if it might be construed that you would offer preferential treatment.

But what about getting emotionally involved with a patient / student / client? How do you identify before it is too late, what is right and what is wrong in this regard? When I was a student and young and naive (approximately 19 years old) and also not bound by a code of conduct I went out with an ex patient. I had never been asked for my phone number by a patient before, and had never thought about offering it to anyone myself. But this patient had been essentially well (surgery to arm following motorcycle accident) and I had been left to cope with a very sick patient in his bay (who nearly bled to death) at night, which had led to my sitting on his bed afterwards chatting that and subsequent nights. Afterwards it transpired that he had asked out half the nurses and physios on the ward and had been out with several. I only went out with him once, decided he was not for me, avoided his calls for a while and off he went.

I was young, hadn't yet learned professional boundaries, and I guess in the end no harm came of the situation. But I am not sure it is something I would go out of my way to repeat, in fact, I would consider myself very sad if such a thing happened now. So it is with sadness that I find that an experienced nurse has let herself get very close to a patient who is dying and who is currently residing at her majesty's pleasure (if you don't know what I mean you will need to google it). To the point that she believed no other nurse would be good enough to deal with the patient and to the extent that many senior members of staff became concerned that this person seemed unaware of appropriate boundaries. I do not know what the outcome will be, but here is a professional who should know better and now has her career on the line.

I have never been involved with this kind of work before, but it is a real eye opener and one I could not be doing without being an experienced nurse myself. As far as I can see I am still using my nursing skills daily and I will challenge anyone who says otherwise.

The bank holiday report

2006-05-29T10:58:00.000+01:00

So no NHS for me today, we are having our second bank holiday for may; aptly called 'spring' formerly also known as Whitsun. With it being the school half term, I am also only working 2 days this week, which can't be bad.

The weather still doesn't realised that this is late may, it hasn't worked out that we need more than 20 minutes of consecutive sun breaking through the clouds and preferably we want more than 2 rain free days in a row. I would also like to request the temperature to be at least 70f (20c), but it looks like someone up there is not listening to my particular requests. Still, yesterday wasn't too bad, and we used the opportunity of a dry and sunnyish day to go to the local plant nursery and buy ourselves some very nice plants. Good progress has been made on my posts and hanging baskets but more work is needed in the area of bedding plants. Trouble was, and I will let you into a secret here, yesterday I had a hang over that should make me give up alcohol for ever. I am not sure what happened on Saturday night, perhaps a fairy threw great quantities of wine down my throat while I wasn't looking, or maybe at age 43 I should just know better. Consequently I felt a little unwell yesterday and this feeling of nausea and indigestion lasted well into the afternoon, it was particularly bad when bending over to dig or plant stuff. So action is needed here, or perhaps inaction because I am fully aware of the joy of abstinence!

Now that I am fully recovered, I am faced with a bank holiday conundrum which is further blogging or ironing? The clothes are ready, the iron and ironing board is ready, but here I am typing this. Now what would you choose? Ok the ironing has it, but I won't be doing the extreme ironing in the picture; I wonder where he plugs in his iron?

Interesting couple of days

2006-05-26T20:47:00.000+01:00

Teen son injured his ankle playing football after school last night. Who can blame him for heading off to the nearest park with his friends on a day that freakishly turned warm and sunny and do you know what? There was no rain. Hubby rang in to tell me he was delayed by a traffic jam on the motorway, so I helped myself to a glass of wine and started to browse through some Thursday thirteen's.

So no sooner am I half way down the glass than the phone begins to ring, it is teen son with the injured ankle. Assessment of said injury makes me doubt a fracture, so I apply ice and administer paracetamol and put him to rest. Hubby arrives home in reasonable spirits despite everything. We watch the England friendly, which is inexplicably lost to some country called Belarus, roll on the world cup!

So this morning, it is obvious that teen son will not be up to school, and it is the last day before half term anyway. So when he proclaims great pain, I begin to doubt my diagnosis, as I am after all only a nurse, a non practicing one at that and no type of quacktitioner! So off we go to Hospital. I have forgotten about the children's Accident and Emergency so we are seen in a room full of toys and a picture of Wallace (of Wallace and grommit) amongst others. The xray confirms my diagnosis so off to work I go (relieved that I can leave him to his playstation without guilt, who said being a mother of a teen was any easier than being the mother of a small child?).

I am interviewing people for an investigation about someone suspended for unprofessional behaviour; a whole can of worms begins to emerge! More next week! Next back to the office, for emails, when one of my team calls in to offer her sudden and unexpected resignation. We haven't always seen eye to eye, but she is a reasonable worker and I am not quite sure how we will cope for the next couple of months. Also not sure we can fill her post, what with vacancy controls (new word now the freeze is off). So seeing that it is 4pm, I decide to call the shortened day to an end and head home. Hubby is off for male bonding, so teen son and I decide to go for pizza which I accompany with a beer.

So here we are at the Big Brother first eviction night, I am not sure what I am doing here as I think I am getting past it. But sad person that I am, it is beginning to grow more interesting by the hour. Obviously there is little hope for me now; bring me coffee and chocolate please!

Thursday Thirteen - 25 May 2006

2006-05-25T07:05:00.000+01:00

Thirteen Things Julie is thinking about this week

The weather: about 2 weeks ago we had a couple of hot, sunny, dry days and we were lured into the idea that summer was pretty much here (even though it is still technically spring). Since then the weather can only be described as DRAB, cloudy, miserable, rainy, just yuk. I need warmth, please.
Traffic: Generally I seem to be spending too much time sitting in traffic jams. A combination of road works around the area and accidents happening at rush hour time have caused me to become only too acquainted with the inside of my car.
Petrol: (gas if you are in the US): If you are not careful you can now spend almost £1.00 per litre on pertrol. Heaven only knows how much that is per gallon. Luckily we have some big petrol companies / supermarkets near work which mean I am currently paying only £0.92 at the moment!
Payday: which is today. I have turned over a new financial leaf and am living to my meansthat'sts the plan), therefore I have little in my purse in the lead up to payday. It has made me take my lunch into work this week, something I should actually be doing every day.
Bank Holiday Weekend: We have one this weekend. We aren't doing anything special but I would like to do some gardening and for that please see number 1. I am also looking forward to staying in bed later for 3 consecutive days!
Moving: with work that is yet again. Looks like we are moving to another office on 14th June, and this is just 3 months since the last move. In my book this is looking like bad organisation on the part of someone in my primary care trust.
Big Brother: I have to admit to being disappointed by the housemates this year. Still, it is early days (1 week in) and I guess there is still time. A weekend to watch some of the live feed might do it. That or turn me off completely.
My Hair: I haven't coloured my hair since new years eve because I wanted to see just how grey it is. For the record it is more grey than I particularly like (and not in a silvery way), so I will be colouring it very soon. I now know the colour of my hair and I don't like it!
Football: The world cup is just two weeks away and we are getting hourly updates on the progress of Wayne Rooney's broken toe. There is an England friendly tonight, so I guess it all begins today.
Holidays: I feel very sorry for my mum and dad today, they were meant to be flying to Romania this morning to stay with dad's cousin who lives their with her Romanian husband. Sadly the cousin's mum who is frail, elderly and in England has become very ill so the holiday is off and Gill has flown to England. I wish Gill's mum well, though I believe she may not recover.
Shopping: Due to number 4, I need to stock up tonight so it is off to the supermarket for me after work today.
Walking: I bought myself a book of fun and interesting walks to do in the area in which I live but since I got it the weather has been rubbish (see number 1). Hoping for the chance of a long walk at the weekend though.
Work: That is where I am off to now!

Its official

2006-05-24T07:16:00.000+01:00

I have to say NO. My manager is concerned that I am over committing myself at work, and what's more, over committing myself to things I shouldn't be doing at all. She is right, and to be honest I find myself feeling a bit like a naughty child who has been found out! Of course this isn't just about my welfare, but about her desire to give me more stuff to do. But I am paid to do a job of work, and I guess I have to pay some attention to that agenda. One of the main things I guess I haven't been doing well, it the education plan, as she said, too much of it is in my head, and the executive team are nervous of something that isn't visible enough. Again, naughty school girl time, as actually yes she is right. I tend to take the information from personal development plans and service plans, and formulate it in one go into a education and training plan. In fact at the end of the last financial year, I actually wrote the education plan retrospectively (this was worryingly for the auditors), and while no one by I knew this had happened, actually I know it is wrong.

So proper education planning is going to take place and to allow me time to do that, I will have to give up the infection control committee (no bad thing in my opinion) and will have to delegate more delivery of education plans to others rather than doing it myself just because I like doing it.

I guess that is the challenge between making work enjoyable and actually getting the job we are paid to do done. Having said that, I actually still enjoy that particular job and feel some how unburdened in being able to do that.

I have also been thinking about how it is that I have moved from being the young nurse who wanted to spend her career at the bedside, to the person I am today, who is unlikely to see a patient even by accident. I know that good nurses are in short supply, but it is apparent to me, that I want to remember being a good nurse, one who really cared about her patients rather than the one I would have become. A nurse who really didn't want to do that any more. While we need nurses at the bedside, we also need nurses who understand healthcare working in areas such as mine. So this is official too, I am proud to call myself a nurse, but I am not about to go and start seeing any patients any days soon and that is how it is going to be.

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The NHS Explained

2006-05-22T18:00:00.000+01:00

Generally speaking, I try not to use too many acronyms on this website. I know how frustrating it is to go to a blog / website and not be able to understand what the heck is going on there. But for us who live in the United Kingdom, the NHS means something, I don't have to explain what it is, because we all experience it to a greater or lesser degree. I have had a couple of comments on various postings asking what the NHS is, so as it is now 9 months since I started this blog with introductions to what the NHS means, I thought I had better take some time to explain myself.

NHS means National Health Service. It means that people living here in the UK have access to a health care system which is centrally directed and is free at the point of its delivery. I say free, but that doesn't mean we don't contribute towards it through taxation and it doesn't mean every part of it is free to access. But essentially if you need to see a general practitioner or attend hospital you can do so, if you need dental or optical treatment then it is subsidised or perhaps free (depending on your personal circumstances). It doesn't mean that you can access all medical care as soon as you think you need it, or in the place you want to access it, or indeed always see the person you think you would like to see. There is a lot of debate about how it is possible to offer the kind of healthcare people think they need when there is no bottomless pit of money from which to buy it. There are issues about whether nurses or doctors should provide certain aspects of care, and there are as I mentioned yesterday, issues about what healthcare should take place in hospital and what should happen in the community.

The NHS is complex, it is a tradition, it is part of our way of life. We are facing some difficult choices about what it will mean in the future. But, even though I sometimes have more than enough to say about working within it, actually I am proud to be part of our national health service.

Having said that, I do wish my own organisation would do something about its IT systems and the people operating them. I have had more problems today and am just a little weary of the whole thing!

What do people want from healthcare?

2006-05-21T15:16:00.000+01:00

In the midst of the water shortage we have rain and plenty of it. Hubby is moaning, there are no opportunities for going out and digging the garden (when does he do that in dry weather?). For me though, it means time to sit and read the Sunday paper. I don't know about anywhere else in the world, but on Sunday the newspapers are big. What I mean by that is that for your £1.60 (or whatever you are paying out) you get a newspaper, a couple of magazines, a sports paper, a review thing, a travel paper (today trips to Germany, something to do with the world cup) and much much more!

The thing that caught my eye today in an NHS / healthcare way, was an article about the whole hospital / community care debate, which is something we have been discussing at work. All the time we are being told of the need to keep people out of hospital (something I mentioned the other day). But who has told the great British Public of the plan that they will be treated for their illnesses either in a place that is not a hospital, or else if they start off in hospital that they will be kicked out double quick to be cared for at home?

I completely agree with the idea that hospitals are for thetrulyy sick. That where possible people should be cared for out of hospital and that includes dying at home. But how will we make sure that the money currently pumped into our large acute hospitals will ever be released into primary care and how will we tell people that it isn't about giving them second rate cheap treatment and instead about giving them the best?

As a former district nurse, I have cared for many people at home during the terminal stages of their illness. But the lack of 24 hour care, the inability to offer the kind of support people (including the staff) can receive in hospital, makes it unsurprising that so many people end up dying in hospital. There is a feeling that peoples lives can be saved (no matter what they are suffering from), if your relative is sent home and is cared for by the GP and district nurses, then the message is loud and clear. Perhaps people want to think that they are only a new drug or miracle cure away from being well again. This is not to say that people with terminal illnesses don't value going home to die, but the people who write in the media and those that read it are in the main not those who are ill at the moment. They are those who fear the big C word, or some other incurable illness. People call for a national debate on such things, but who will lead it? Where will it be held? Are we talking about a BBC, Question Time debate introduced by a Dimbleby?

We all know we have to die at some time, but generally this death is in our sleep at age 85 with our family close by. The trouble is, those of us who are not yet 85 want those that are to get the best possible chance of the best possible treatment and we don't think that this will be found at home with a district nurse, even if she does have the title community matron.

IT in the NHS?

2006-05-19T20:32:00.000+01:00

Far be it for me to suggest that IT, its systems and staff are in anyway inferior to other places where computers and those that deal with them exist. But, at times I do wonder. In the 4 years I have worked in PCT land I have been 'migrated' several times. Migrate? What exactly does that mean? In my dreams it means heading to some kind of new promised land, a place of sea, sand, fit men; Australia perhaps. Not a land of lost emails, printers that you can no longer send your 24 page PDF documents to and a computer that tells you that you have no permission to remove your memory stick.

So on Wednesday, I arrive from my 3 meeting mission, with an hour to meeting number 4. I think, yipee, an hour to get emails and 'stuff' done. Wrong. There is a man from IT in my seat, doing migrating.

Yesterday, I am fully migrated, but my emails bounce and the network printer can't be printed from. Today I am not allowed to access the printer folder and I cannot remove my own memory stick. I place a call to the 'Help desk'. A new boy tells me to 'bear with him' approximately 20 times in 5 minutes, he tells me, I have 2 types of problem belonging to 2 departments. As I tell him, that may be the case, but the problems were made by two migration men in identical lilac shirts (IT uniform perhaps?)

Just as I am about to head home when suddenly, without warning, my inbox begins to refill with emails I already received yesterday and today. I hit delete, close down and leave. There's only so much a girl can take!

Thursday Thirteen - 18 May 2006

2006-05-18T06:50:00.000+01:00

Thirteen Things about Julie's week

This was going to be a really happy and fun Thursday Thirteen, but sadly, Arsenal did not win the Champions League final last night. It might have had something to do with our goal keeper being sent off after 17 minutes, it could have been due to some of the other decisions the referee made. Ultimately though, if you score less goals than the other side, you lose.
Teen son was as close to tears as I have seen him in a long time, at 6 foot tall and aged 15 he was slightly reluctant to cuddle his mum, though he clearly wanted to. He did hold my hand though (something he used to do a lot when little).
We have a drought in this area, and are not allowed to use hosepipes to water our gardens. I would have looked weird watering my garden this week - it has rained most days!
Rain makes the country lanes I use to travel to work and back, flooded. Trouble is there seems to be road works on all the more major routes, so flooded roads it is.
The political positioning at work has increased at the news there are to be 2 Primary Care Trusts in the county rather than the one recommended by the Strategic Health Authority. Fun to watch!
We now await the appointment of CEOs. Apparently the existing incumbents have to go to an assessment centre to see if they match up to requirements. Would love to be a fly on the wall with some of them!
A meeting with colleagues from other parts of the country about education initiatives showed we are streets ahead of some in the work we are doing; quite gratifying!
My diary has become extremely busy all of a sudden. I would think it had happened while I wasn't watching, but I seem to have written the appointments in!
Still waiting for teen son's dermatology appointment, apparently he must be seen by the end of June (Tony's rules on waiting times), but that's still a few weeks.
This week someone went to court because they had waited 4 months for a joint replacement before going to France for surgery. How long is it ok to wait for something in pain? A day? A week? A month? We forget that you used to wait 18 months for such surgery, so massive progress has happened. But is it enough?
Big brother starts tonight. I have been dismayed that so much apparent information about housemates has been in the paper in advance. Still looking forward to the launch though!
Next weeks' 13 will probably be a BB special!
I want to see the Da Vinci code, but the critics are saying it is not very good, still might be good to cheer myself up over the weekend?

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Is it me?

2006-05-17T06:56:00.000+01:00

Is the reason I put 4 meetings in my diary for both today and tomorrow because I am rubbish at organising my diary? Perhaps the skill I had been developing which essentially involved the use of the word NO, has recently been lost. Perhaps I am just too nice. Well what ever reason I decided to pack the work in to my day like this, I have set myself one hell of a challenge.

So today I am starting off with a meeting about NVQs. These are qualifications people working in our organisations can do via a portfolio approach, to show they meet certain criteria around their jobs. They are for people in support positions or managers who don't have an alternative qualification. This year we have no allocation of money for this education, therefore we are meeting to discuss where to look for some (money that is). Second I am off to an infection control committee meeting, but just wondering why I go to this, as really I am only there to contribute about training in this area and probably it is not my remit otherwise. The chair is quite scary to challenge though, and was my manager when I started attending. Third, a meeting about equality and diversity training, probably just an hour and probably not a problem. Lastly a team meeting, unavoidable, and I didn't set the date.

I think one of the most important things for any busy manager, or anyone for that matter, is to plan their day and plan it well. So I think some better planning and a re-establishment of the ability to say no has got to be the order of this day for this manager!

Tonight, it is football. Tonight Arsenal meet their destiny in the final of the champions league final. There is only one entry in tonight's diary!

Today has been about Community Matrons

2006-05-15T17:51:00.000+01:00

One of the latest fads being rolled out by our wonderful government as the answer to all ills in community health care today. This morning, I found myself at a 'frequent flyer operational group', catchy title I thought to myself. Frequent flyer for those of you wondering has nothing to do with building up air miles and getting that free trip to Paris (I wish it was), but is about those patients who spend their lives yoyoing between home and hospital as their condition exacerbates and improves. These might be people with heart disease, chronic lung disease, diabetes or perhaps all three and in this picture they are the people at the top of the pyramid. The idea is, that if some souped up district nurse could patrol around the area visiting these people before they get ill enough to fly frequently to Accident and Emergency then the health service will be saved a good deal of money and the world will be a happier place.

Actually I think the idea of skilled district nurses managing the care of people with this kind of long term condition in conjunction with their GPs so that they stay out of hospital is quite a good one. It is just the way in which such a thing is being done in an attempt to save money. I predict that the community matron will discover many patients whose health care needs are not currently being met, but that the people left doing the rest of the work will still be doing just that. There will likely not be more nurses to care for the rest of the caseload, and those that are left behind will be the less skillful, less qualified. Still I am here to be convinced, and if I was still a District Nurse I might fancy this particular job.

This afternoon I went to find out a new post graduate course for the new community matrons, which I must say is as heavy on practice as it is theory so should be pretty good. As far as I see it, if we are going to get people to do this job, then we best skill them up properly for it.

Curry in the chapel

2006-05-13T09:08:00.000+01:00

No, not a reference to a meal taken in church. I have to admit that I am not a frequent visitor for purposes of worship, though that is not to say I don't have religious beliefs. But that is not what this post, number 201, is about. No yesterday the elder of my two brothers moved with his family into a house that has been converted from what was a chapel. I personally think it is a shame that such buildings are being lived in these days, but then it is better than knocking them down I guess. The building is, as you might guess, quite imposing, and the rooms are interestingly shaped and in some cases (e.g. the living room) huge.

So yesterday, having escaped work and discussions of education facilitators in palliative care and wound care training (what fun for a Friday), I collected teen son from school and we headed off to lend a hand with the move. Hubby had gone over earlier in the morning to assist with furniture and box moving. The house can be found across the fenlands of Cambridgeshire / Huntingdonshire . In essence this means rural flat countryside, quite pleasant to the eye. At half past four when we arrived there was still unloading to be done, so teen son got stuck in while I helped with box unpacking. By 7pm everyone had had enough, and given that it was a warm sunny evening and there is a pub about 5 doors along, we headed off to sample the local liquid wears. Back from the pub, and hubby seeming a little more merry than 2 pints should have made him (wonder why that was?) and we ordered a curry.

Teen son, who is most impressed that his cousins have a "den" for their computers, music, perhaps homework (who knows) suggested that he needed to stay over for further more indepth exploration. He also asked me when we were getting a big house like this! I suggested he just stay there more often, I have enough trouble keeping on top of the housework in our house let alone one with 3 floors, 4 bedrooms, 3 bathrooms, dens and study. So hubby and I headed home without him and surprise surprise, hubby slept almost the entire journey, leaving me to sing along to the radio to keep myself awake.

Tomorrow we are going back to collect teen son, will take my camera and get some shots. I tried to look on google for something similar but couldn't find anything, but will post something soon to show what it is like.

So today, housework, shopping, FA cup final; usual fun weekend!

Thursday Thirteen - 11 May 2006

2006-05-11T06:45:00.000+01:00

Thirteen Things about Julie's Blog

This is the 200th entry on my blog
I started on 27 August last year, and have blogged at least 3 or 4 times a week since, sometimes every day
I started off blogging mainly about work and what it was like to work in the NHS (that's why I chose the name, I guess)
At times I have found the technical stuff mystifying, but am slowly getting the hang of it.
I work 25 miles from home, but sometimes it might as well be 100 for the time it takes to get there!
I am firstly a nurse, and even though I have had an office job for nearly 4 years still find some of the office stuff frustrating.
In October I started an MSc in Strategic Leadership, and have blogged quite a bit about the stresses and strains of juggling course, work and home.
One of the greatest things is having people from around the world visit and comment on my site, and for me to have found some great blogs to read. This is a great thing to do when you should be doing something else.
occasionally I do little quizzes and tests and post them here, just because they are fun and I like a bit of fun sometimes
Times like Christmas are brilliant fun, but there is lots to be done. Hubby finished work a few days before me last year, and boy did he let me know how busy he was!
I have blogged a lot this year about the changes to the NHS currently taking place, and my role in helping people come to terms with them, and move towards the brave new world (if that is what it is!)
In January I gave you my first Thursday 13, I have been producing one most Thursdays since.
Since I started this blog over 9200 people have visited my blog. Ok so many of them have glanced in, as I am a glutton for sites that you get reciprocal visits from. But a few people do stop by of their own free will, and I thank you for that. Please keep stopping by!

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How do visitors find your blog?

2006-05-10T18:45:00.000+01:00

I, like most people with blogs, I would suspect, like to know someone reads the rubbish I write. So I do tend to look most days to see who has been mad enough to visit, of course most people stay a relatively short time, and who can blame them. But sometimes I am glad to say people stay and read more. This is my 199th blog entry, so tomorrow when I write my Thursday Thirteen ( I am hooked on that whole thing) I will be reviewing my 200 posts. But for today, I find that my blog has been read by people looking for the following via a google search:

Dart hole wall! Now forgive me, but why? Anyway, some months ago I mentioned that my dear teen son had a dart board in his room and there are rather a lot of holes surrounding said dart board. I hope that the person searching found the post interesting

What is it like being a doctor? Well, I have to come clean and admit that I am not a doctor, have never in my life pretended to be a doctor and what's more, much as I admire those pursuing the medical way of life, I do not want to be one. Therefore who ever it was came to the wrong place. Lets hope he or she went to visit Dr Crippen as he gives a very good account of the life of a doctor.

As far as I know, very few people who actually know me visit my blog. Part of me wants others to read it, but then again that makes it restrictive. I am careful about what I write about the NHS. Sometimes, keeping my own opinions closer to my chest than I would like. Perhaps this is a good thing, as someone from the Health Service Journal recently emailed me about using a quote from my blog. A lot of people I know read the HSJ and while they might not recognise the NHS bits some might know my family bits a bit more and it is those postings that let me blog for real pleasure. I have been blogging since last August though and whatever happens I am hooked to it and am not about to stop now!

Whatever next

2006-05-09T18:03:00.000+01:00

Arsenal's rivals in North London, Tottenham Hotspurs (Spurs) apparently want their match on Sunday replayed!

10 of their players apparently contracted food poisoning from a Lasagne and so couldn't play as well as they should have. Firstly it is the end of the season, secondly West Ham (the winning opponents) have the FA cup final on Saturday. Thirdly, what a bunch of losers!

Sorry, just caught out by the BBC website there. So here we are in post essay euphoria, enjoying a reasonably dry and warm afternoon /evening. What am I doing with my time? Choose from the list below:

Doing the housework that I have left for the last week or two?
Starting to cook dinner (shall we have lasagne?)
Cutting the grass and generally pulling weeds (thats the rain / sun compo for you)
Blogging?

Well, obviously number one is a consideration, I am thinking about it, planning the order of chores, but not underway yet. Dinner? Well yes soon. Grass? Hardly, I have hayfever you know. Blogging, well obviously I have been neglecting my blog duties and need to catch up and get my fix.

Life in the NHS is going fine thanks. I still have a job, haven't spent much of my budget (though it has been cut), haven't seen too many disillusioned folks today, haven't spent all day getting to meetings, haven't been bombarded with emails. So actually not bad.

It is life outside that is occupying me. My car has been to the hospital, last week I knocked a hole in its wing and it has been for repair. I collected it today and all I can say is it is an extreme way of getting a valet on your car, but it is extremely clean! Other key events, well we are waiting for a dermatology appointment for teen son, who has quite severe acne. I can't explain how much I hate to look at the terrible time my beautiful boy is having. Someone said they hardly notice the spots any more, well actually both he and I notice them very much. The antibiotic treatments are not working well enough, but how long should I wait before jumping up and down, and should I ask for a private appointment. Comments from any medical folk who might read this please.

My older brother is moving house on Friday, hubby is taking the day off and we are heading over after school. They have let themselves get into the state that their house is going to be repossessed, but on the plus side, the house they are renting is apparently a really great place, a converted chapel. Will let you know what I think after Friday.

So, normal blogging is back, just need to start dinner and I can pick up that novel I've been reading since Christmas! Long may it take for the next semester to start!

Was that the weekend?

2006-05-08T22:23:00.000+01:00

That flashed past me? I barely noticed, surrounded as I was by books, articles and my laptop. But submission day is here, and it has been sent electronically to the various places it needed to go. I know I had more than enough time, but it didn't stop me working from 7am on Saturday and 8am yesterday. Thankfully though I had done sufficient by yesterday lunchtime to go out for the afternoon.

Teen son and his grandad had tickets for the last ever Arsenal match at Highbury(note photo, slight error on my part in setting the date to 2005!), so we dropped them off at the underground station and headed into the West End. They had wanted to get there early to make the most of their day out, so we had plenty of time to walk around Leicester Square and Covent garden, before having a pasta lunch and heading to a suitable pub to watch the match. We arrived half an hour into the match, it was already 1-1, and we weren't disappointed by the excitement level, which was almost too much to cope with at times. By the time the final whistle came, Arsenal had beaten Wigan 4-2, complete with a Thierry Henry hat trick. What was best was that with Spurs losing their match (apparently due to food poisoning), Arsenal will be able to qualify for the champions league should they not win next week's final.

After the match, they stayed for the various parades and celebrations, before meeting us back at the tube station at nearly 7pm. Back home and I still had my references to finish on the essay.

So that was the weekend, and pretty much the end of the football season, a couple of finals and then about 4 weeks without football to disturb my TV viewing, until of course the start of the world cup and the stressful experience that will be watching England. What I am looking forward to though, is Big Brother, now I can't wait for that!

I might do it!

2006-05-06T22:33:00.000+01:00

This is my word cloud, you can get one here

I've started the conclusion and am up to 6200 words, so there is a chance I might even finish my horrid essay before monday morning. Of course it isn't horrid, it is just that I am quite sick of change and leadership and any thing to do do with either of those words. I have read so many books and academic journal articles about those two topics that I am beginning to dream about them. Next week I am going to pick up a nice novel and read it; can't wait!

Thursday Thirteen - 04 May 2006

2006-05-04T07:02:00.000+01:00

Thirteen Things about Julie's Thoughts of this week

Today we have local elections in England, which is meant to be about electing council members but for those who bother to vote it will be about how well or badly (depending on your view) Tony Blair is doing at running the country, and Tony has not been having the best week.
I have avoided meeting any of our candidates at the door, and will make my own mind up and also vote. My nan always told me that women, and working class people had campaigned hard for the vote, it shouldn't be wasted.
Nurses have been accused of being nasty to Patricia Hewitt in the last week, they jeered and slow hand clapped her. They have been accused along with doctors have taking too much of the increased investment in healthcare into their salaries. Never seen a rich nurse, but I may find one soon!
Nurses who have completed the extended and supplementary prescribing course, can from May 1 prescribe from most of the British National Formulary. I am the lead for prescribing education in our trust and we take deciding who can do the course very seriously, so far we have just 5 people who have this extra qualification. By the way did you know that you have to get 100% in the exam to pass, a higher rate than for doctors (of course many will say it is a simpler exam!)
We are going to be doing some education work on record keeping, because nurses appear not to know how to practice this skill. They seem to know that they are meant to write the date, time, not use abbreviations, write in black ink and sign the thing. But often do not do it to the right standard. Training is therefore needed, more like someone needs to stand over them while they do it - it is a behavioral thing.
As someone already working in the NHS as a care assistant you can enter nurse training and be paid for it. This equates to about Â£15,000 per year, a good amount in my book as you are essentially a student. For some people though, this is a pay cut (for a short time anyway), and they think it shouldn't be. If you want to be a nurse you will be one, you should not need to ask to be paid more than Â£15,000 for the privelidge!
Nurses don't seem to want to be ordinary nurses any longer, as a recruitment fayre for students soon to qualify that I went to about a year ago, at least 3 different people asked how they could become specialist nurses. I told them to go and learn nursing first. Trouble is they have been recruiting people who are that bit older and they don't want to be hanging around the bedbaths, bedpans and other drudgery (as they see it) Dr Crippen eat your heart out, I agree.
I am still a nurse, I hold registration to be a nurse, but I don't want to go back to the bedside. I am all nursed out and whats more, the lifting we were encouraged to do manually in the early 80's has shot my back. I think I can make a difference doing what I do, and I am going to keep doing it.
I am probably defined as a manager in workforce statistics, but I am not over paid, in fact I would be paid the same amount if I were still a district nurse, or a specialist nurse in Rheumatology (my last 2 positions). I am appealing against this decision, because actually I think the job I do now is worth more than that (but I would say that wouldn't !)?
Today we are expecting a short burst of summer, with predicted temperature of 74f around here. I might uncover my garden table for the first time this year and enjoy a bit of sun. I am working from home today to get the essay nearer to completion. It won't be true 'shorts weather', but I bet there will be some pale legs around if I venture out!
I will be venturing to our county town later this morning, because my car needs to go to the garage for repair. I have to admit that I am completely responsible for the argument I had with a metal railing last Thursday and the resulting hole the car has in its front wing.
I hadn't realised that Renault made their cars with plastic wings, but they do and the plastic is quite thin. I guess there is a good reason for that!
Well I still have 3000 words to write (out of 7000) so best get on with it. Today's target is to reach 4500 at least.

Life in the traffic jam

2006-05-03T06:57:00.000+01:00

My journey to work involves a 50 mile round trip, then there are the journeys I make most days of the week to travel from meeting to meeting. Often individual journeys are just a few miles, but increasingly these journeys are becoming tortuous. I have a choice of routes in the morning, essentially via main roads or the country way. The main roads route is less miles, more direct and given a choice the one I prefer for the morning. Trouble is, a key roundabout is being reconstructed causing tailbacks on all approaches adding at least half an hour to the journey. The country roads offer a scenic if longer alternative, but involve traveling past some village schools at child dropping off time. Still the villages are pleasant and I haven't knocked down a meandering child yet! So a 40 minute journey (on a good day) can be as much as an hour and a half in duration (and I am not a happy bunny after that long in my car for little reason).

Then there are the little trips out to meetings etc. Yesterday I embarked on one such adventure, an 8 mile, voyage along a major route and what happens? An hour in the car that is what. So I sit there, nose to tail thinking well, this is an accident for sure. But no as I crawl to the front of the queue, there are roadworks just before a roundabout with a man operating traffic lights manually when he thinks enough cars have gone through. All this to sit in 2 thrilling meetings and to appear from them with more added to my to do list, but such is life.

A new task has appeared among my large portfolio of work; investigating alleged poor professional practice in a nurse. This is the first time I have been asked to take part in such a thing, and actually I think it will be quite interesting, though time consuming. Might look good on the CV for when a job 5 minutes from home crops up?
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Tags:
Traffic
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Essay writing and Tapas

2006-05-02T07:06:00.000+01:00

Progress at last on the essay front, well the pressure of deadline (next Monday) is having the desired effect. Yesterday I completely restructured the thing and am at last feeling relatively pleased with the results. I am up to 4000 (of 7000) and have plenty of ideas about what else to write to fill the still large word gap. I shall be taking as much time as possible this week to get the thing finished so I am not working up to the deadline (you heard it here first, I am not going to be finishing it off next Sunday night!)

After a rainy start, bank holiday Monday turned out pretty ok with a sunny if slightly cool weekend. Fresh air was in order so we went for a lovely walk in a local park before finding ourselves in a very nice Tapas bar for lunch and a couple of glasses of white wine.

Back home, Arsenal were on TV and thankfully beat Sunderland, who sadly are relegated and haven't won all season, to keep the hopes of a 4th place finish alive. Amazingly this is the lowest finish teen son can remember since he began supporting them. Of course I can remember some times that they finished a lot lower than 4th.

So to the short working week, and today is one of meetings (3 of them), then out tonight for an Italian meal to celebrate my sister in law's mums birthday (any excuse). Rumour has it Buddy Holly is the cabaret act tonight - thought he was dead, but you live and learn!

The good news or the bad news?

2006-04-29T09:51:00.000+01:00

So bad news first so I can finish on a high here! This might be my worse year for hayfever for several years which means that despite taking the maximum dose of my tablets it is always there. It makes you feel like you are about to develop flu but just never do, it stops you sleeping properly and means you sneeze at very inappropriate times, like when you are driving. Driving with your eyes closed is not to be recommended!

I wasn't sneezing when my car collided with a metal railing outside our office, though I am not sure what I was doing. All I know is that from a moments carelessness I have a hole in the wing of my car and am very embarrassed that I have done such a stupid thing. I have discovered that the front wing of a Renault Clio is made of plastic and not very strong plastic at that. I am talking about a hole of about 10 inches diameter, and when your car is orange a hole in the front drivers side wing is not un noticeable.

For the two reasons above and because I have realised some hard facts about my financial situation and begun to take steps to rectify the matter, it has not been the best week. Worries about money, hayfever sometimes bordering towards what might be asthma (I don't have asthma, but my chest was incredibly wheezy last night along with a sudden cough) and the dreaded essay have meant I have not been my usual cheery self and people have noticed. I guess I need to be generally less happy, smiley and enthusiastic, because I only have to drop the smile and people are asking each other if Julie is all right. For the record, despite the above, I am fine.

So onto the good. I am up to 3000 words (well almost) on the essay front, so only 4000 or so to go. Even if I do say so myself it is beginning to come together and I have given what I have done to a colleague for some constructive criticism. I will be getting on with it over the long bank holiday weekend though. I also spent some of yesterday with the same colleague putting together our latest leadership / management course which will be for district nurses and Macmillan nurses and will start in June. We also had the time to catch up on gossip, you know who is leaving, who is shagging who (usual stuff). The other good thing yesterday was the efficiency of my insurance company and the garage that will be fixing my car next Thursday. I am suitably impressed.

So onto last night and out for a hen party for one of my colleagues who gets married next month. 12 of us met at a local hotel to give her a good send off into married life. There was good food, plenty of wine and lots and lots of hilarity. Just what we all need as some of us are facing a pretty uncertain future job wise. Have a look at the lovely hotel we went to here. Today I get to go back to collect my car as I got a lift home, so might go for a walk around the beautiful city of St Albans. Oops given away my general location, but never mind.

Now I am off to the land of the essay, and my target of 3500 by lunchtime, hayfever etc permitting!

Thursday Thirteen - 27 April 2006

2006-04-26T21:19:00.000+01:00

Thirteen Things about Things I will be doing on the coming bank holiday weekend

Essay, a large portion of my time will need to be spent writing the remaining 5000 words! Why am I such a last minute person?
Apparently watching Chelsea play Manchester United, Hubby is still reeling from Chelsea's loss last week, lets hope Man U don't beat them!
Dealing with hubby's grumpiness if they lose, and probably even if they don't. He really is becoming a grumpy old man!
Visiting a local garden centre to look at plants for the garden.
Gardening (weather permitting), more weeding and maybe even planting some plants that I might have bought from the garden centre.
Supervising hubby to ensure he properly cuts the lawn.
Housework, how comes I have to do this job every week and then it needs doing again?
Seeing my parents, and if the weather is good enough having a barbecue; first of the year.
Walking, we are really getting into the swing of going for some long walks on Sundays particularly. It is a good way of spending some time together, getting fresh air and exercise.
Probably chilling out watching an old film on bank holiday Monday.
Acting as some kind of taxi service to teen son and his mates - why should this weekend be any different?
Trying to sort out the state of my finances. (More on that at a later date)
Better mention the essay again; 5000 words is quite a lot!

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Like being a spin doctor

2006-04-26T18:06:00.000+01:00

That is what one of my colleagues today said she feels like, and I know exactly what she means. The act of talking up the current NHS changes is challenging and hard work, so is dealing with sad and demoralised staff who are struggling to get on with the job of looking after patients. At the same time we hear and see a constant flow of doom and gloom stories about the state of the NHS as a whole, it's financial situation and whether nurses and others really know how to do their job. What is more, most people I know are definitely not over paid, yet they are constantly being told that they are responsible for the fact that much of the investment into the health services have gone on pay.

Still it makes me feel slightly better to know that Patricia Hewitt has been heckled and slow hand clapped by Nurses at the Royal College of Nursing annual conference. Today at our workshops on the redesign of the intermediate care service people expressed feelings of sadness, demoralisation, anxiety, stress, being undervalued, feeling they are increasingly unable to meet the wants and needs of patients, to mention but a few. On the other hand, these are skilled and committed therapists, nurses, managers and others and they are committed to providing the best services for patients. They know that some of the changes, for example, closer working between disciplines in multiprofessional teams is a step forward, but what is apparent is that the changes are made not to make the care of patients better, but to try to save money.

Having said all the above, I am really enjoying the opportunity I am now getting to spend so much time facilitating groups of clinicians. It is a great way of finding out exactly what is going on out there, keeping in touch with the front line and what's more getting a real idea of the development needs of staff. Something you can't get from receiving a load of personal development plans in the post.
NHS
Change Management

Watching Arsenal is very stressful

2006-04-25T22:16:00.001+01:00

Not a shot on goal, amazing luck as Villarreal couldn't get the ball in the net and a questionable penalty to for Lehman to save. But amazingly they are through to the Champions League final on 17 May. Tonight I have spent much of the evening on the edge of the sofa, barely able to watch the TV, as Arsenal failed to string more than 2 passes together and gave the ball away time after time. Thank goodness for last weeks goal, as they played out a 0-0 draw tonight.

A combination of a staff members appraisal and facilitating an action learning set this afternoon, with some office type stuff in between and I was tired enough even before the match. Tomorrow we have a service redesign day with the new intermediate care service to facilitate. Who said life as a manager in the NHS was easy? I wouldn't mind but I am not even that well paid!

Arsenal

It really is quite depressing

2006-04-24T18:21:00.000+01:00

I’d like to believe the government’s assertions that the NHS is in the best state it has ever been in, but to be honest, even without all the news coverage, I don’t believe it.

Today’s directive from the PCT told me that we are likely to be overspent again this year, despite having a 7% uplift in income. This bodes very badly for jobs once the PCTs start merging, and looks very gloomy for those of us in an area of work that is probably only too dispensable, i.e. education. As I type this, Tony is on the BBC news telling me how wonderful everything is after all, more patients are being treated and they are waiting less time. I predict that the good times will be over soon because less staff mean less treatment and over spent PCTs mean higher waiting times.

My mood is not helped by the acceleration in my hay fever over the last few days. Late spring flowers and blossoms now collide with on time oil seed rape and I am left with itchy eyes, itchy nose, itchy mouth in fact I am just plain itchy. The good thing is that by the time everyone else is sneezing, my itching will be over. Until then I am dosed up on pills and without my trusty contact lenses.

The essay is not going smoothly, I am confused by what to write and where; I know I need to get down to it but to be honest I am not in the mood.

To top everything I now owe the national debt of a small country to the credit card company, I have decided I am not cut out for credit cards and cannot be trusted with them. I would like to cut mine up, but am sorely tempted to go out and buy something to cheer myself up. Well no actually I am not, because I am now much more sensible and need to act my age. Perhaps my destiny lies in the lottery?

Rare day in the office

2006-04-22T07:50:00.000+01:00

A day to actually catch up on things, and a long 'to do' list to get through. As a team we have been working on a few projects which involve organisation, planning and quite a bit of writing up. One of the areas that is beginning to really come together now is the changes we are making to mandatory and statutory training. Because we are a relatively small organisation we buy in some of the more expert areas - fire, moving and handling, infection control - through some service level agreements that were devised 5 years ago. People have been accessing these areas of training separately, going off for an hour here, two hours there a half day there. Not a good use of time, and not cost effective for us who pay the bills or the services. We have now begun to devise whole days of training for clinical and non clinical staff that will enable to meet their statutory and mandatory needs in one go.

There have been challenges, there always are when you try to change things, plus some resistance to something that seems like hard work. I find it tricky to manage people rather than lead them, to me leading is fun, and managing is not. But at times some direct management style has to be adopted and yesterday, when one of my team seemed to be trying to get out of organising moving and handling for clinical staff because it is difficult. I am quite proud that I didn't back down and made it clear that we are going to do this and for very good reasons.

Two of my team need appraisals next week, so I spent a while thinking (and writing a few notes) in preparation. One should be straight forward, the other less so (see paragraph above!)

Over lunch I met with one of the team I have been facilitating through a leadership course, who said she wanted some advice. She has been through an awful 6 months which involved a group of health care assistants taking out an unfounded grievance against her pretty much because she did her job and wanted to know what they were doing and why. Again the issues seem to go back to poor management at a higher level, but she is now wondering whether to come back to this service or move onto another job she has been offered. I am not sure I was able to offer help in her decision making process, but we certainly discussed the pros and cons of both options.

Back to the office and the opportunity to make some essay progress; I am pleased to say that at last something reasonable is coming together. Just got to carry on with it over the weekend. The journey home was again pretty tortuous, I don't know what they are doing out there, but every road, main or country seemed to be clogged up. Still home to a nice glass of rose and a relaxing evening - who can ask for more?

Image from:www.teamfrontline.com/images/fl_cartoon.gif

The Queen is 80

2006-04-21T07:09:00.000+01:00

I am not an out and out royalist, but I have no problem with the Queen and her family. Generally they are reasonably good value for money, and people seem to like to go out and see them and wave a flag or two. It is a sign that I am getting old myself, that the queen who has always seemed pretty young, is suddenly 80 today. I think she looks pretty good on it, and seems, from the pictures on our screens to be enjoying every minute of the celebrations. Apparently she has no intention of abdicating, so poor old Prince Charles looks like he will have to wait till he is 80 before he becomes King!

Back to real life. I received the clearest indication yet, yesterday, that when the reorganisations of the PCTs gets properly underway, I am likely to have to re-apply for my own job. Or at least one similar to it, as I am not sure that any job will be quite the same. I feel slightly nervous about this on one hand, but on the other a little excited at the prospect.

Also yesterday, my journey up to London to meet my student colleagues was nothing short of tortuous. Firstly the venue was changed at the last minute which meant we were meeting in Trafalgar Square rather than in Baker Street, this involved a different Tube line. The journey started with a decision on my part to drive to my home town and get the train from there, this was to enable my journey home to be shorter. The trouble was that my decision to go on the M25 was a slow and obviously wrong one. Next I found the station car park full, and having had to walk further, missed my train. Next, the Piccadilly Line was not working, so I had to make a detour along two tube lines. Finally 45 minutes late, I arrived, luckily, the meeting had been moved to a pub, so I was able to enjoy a rather nice glass of Australian white wine. A bit of essay discussion ensued, along with a bit of tutor slagging (they are not very well organised on our course), then chat. I have to admit, that while it was enjoyable, my time might have been better spent at home actually writing the thing as I still have about 5800 words to write! That will be my weekend accounted for then.

Post Graduate Studies
The Queen

Thursday Thirteen - 20 April 2006

2006-04-20T06:53:00.000+01:00

Thirteen Things about Julies Week

Friday and we were up at 6am, hubby is obsessed about the prospect of traffic jams and likes to leave early to go anywhere. We left home just after 7am and headed off to Brighton. Found a brilliant cafe once we arrived for a hearty breakfast which set us up for the day.
As regular readers will know I am struggling big time to lose weight. This is caused by weak will power, excessive food, a love of wine and probably being 43. We did loads of walking over the weekend though, so much so that on Saturday afternoon my legs ached big time.
It had paid off though because I have lost 4lbs this week, and am determined to stick to the diet exercise thing in the run up to my holiday in August.
On Sunday we had a great day out in a place called Arundel, home of the Duke of Norfolk, leading Catholic in this country. The castle was an amazing combination of ancient and modern, wonderful views from the keep and then the striking castle living quarters which have been updated over the years. Great pizza in Pizza Express in town too!
We were home on Monday by 12.30, having set off from Bognor at 10am. The traffic was pretty light again and so we had the afternoon at home.
We spent Tuesday morning in the garden, weeding, cutting the lawns and generally tidying up out there. I need some new plants now, as things look a little bare now the trees have gone and we have tidied up out there more than in a long time.
My parents and niece and nephew joined us for lunch at our local pub on Tuesday, a kind of ending to the long weekend.
I now have a massive pile of ironing to do, is this the same pile of clothes I had this time last week? More than likely!
Today I am off to meet up with my student colleagues to compare progress on our essays. I am not making great progress myself, and really need to get stuck into it this weekend!
Hubby picks up his new car today, so I guess I will have to go out and say nice things about it later!
The Champions league match last night was extremely nerve racking, 1-0 lead to carry over to next week. Wonder if my nerves will cope with it all!
A week to pay day, I could do with it today - slight over spending last weekend!
Struggling with number 13, just today to get on with!

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Back to work

2006-04-19T17:52:00.000+01:00

I highly recommend the 5 day weekend, not to mention the 3 day working week! Because it had been the Easter break, there were just a few emails in my in box, and so I was able to get on with preparing for this afternoon's teaching session pretty early in the day. Today's session with the group I have been working with was about groups, teams and the leadership there of. I am trying to take a positive stance with this group now, as there is only so many times you can complain about the way you have been led through the current changes and harp on about the past. They have a job of work to do and are beginning to realise that they need to get on with it.

The traffic was awful today, the main route I take is now subject to major roadworks so I think that I will be taking the country route from tomorrow onwards. I am not good at sitting in a car edging forward at half a mile an hour, I like to get where I am going at a reasonable pace.

Teen son struck lucky today, as the school seemed to have some kind of water problem which involved men digging up the street as they arrived. They were all sent home and so his day has involved chilling with his mates, a trip to town and lunch in pizza hut! He will be back to earth with a bump tomorrow I predict.

So we have an evening of football to look forward to, Arsenal have reached the semi final of the Champions League for the first time ever, fingers crossed!

This is Bognor Regis

2006-04-17T20:31:00.000+01:00

So Butlins is not cool, but it is fun! I took this picture of the sea front this morning. As you can see today was the best for weather, and that lasted till about 9am. One of the great things is the lovely sea walks, mind you that is after you have managed to escape through the gate to the high perimeter fence. I don't think they want you leaving In case you spend your money outside!

Highlights of the weekend - the accommodation, well I expected basic (we booked deluxe, but I was worried), and got pretty good. Spacious rooms, a little sitting room, fridge, reasonable bed and nice powerful shower.
Great company - hubbies family and friends were great and really good fun. Entertainment - especially the Freddy Mercury sound alike on Friday and the guy from the 70's group Shalamar last night. Bucks Fizz - not so good. The watersplash pool in Butlins, great fun, slightly scary at times though why the 10am -5pm opening times?

The lowlights - well, the food to be honest. Our best meals were had in Brighton on Friday morning and lunch on Sunday in Arundel. I think I am past poor quality canteen food, and also like to eat in reasonable surroundings. Also, who with a child over 5 eats before 7pm while on holiday? The dining room was only open between 5.30 and 7pm each evening, which led to us eating just pudding one night and soup and pudding on another - I just wasn't hungry.

A great weekend though, and brilliant fun!

Thursday Thirteen - 13 April 2006

2006-04-13T07:02:00.000+01:00

Thirteen Places I have been to on holiday

I decided to list places I have been to on holiday because tomorrow we are off for our Easter weekend trip to Butlins at Bognor Regis. Not quite a holiday (a short break I guess you would call it), but a trip away from home none the less. So here goes.

Tenerife - One of the canary islands that we travelled to last year with my brother and his family. We stayed in the most wonderful apartment with its own plunge pool. Trouble was it was in the middle of a concrete jungle. We travelled up to mount Teide (highest point on the island), but it was closed due to high winds!
Cyprus - We have travelled to this Mediterranean island several times, most recently for Christmas 2004. It is steeped in history with ancient ruins and mosaics to visit, and is just a lovely place. I would like to return and perhaps stay in one of the less populated areas, I would also like to visit the northern area that is occupied by Turkey.
France - We have been to this particular part of south west France several times as a friend has some property there. My favorite trip was in 2004 when we travelled through France by car. It would have been nice to have taken a bit longer than 2 days as we saw little on the way, but it gave us a taste of the countryside some of it pretty striking. We will be going back there this summer, though not by car this time.
Las Vegas - My only visit to the US and a brilliant though unexpected trip paid for by my inlaws who wanted us to go with them. We packed masses into just a few days including a trip over the Grand Canyon. I am not a gambler, though I enjoyed watching and of course the slot machines. Hubby wants to return for his 50th birthday
Tunisia - I didn't choose to go there but was persuaded by my sister in law that it would be a great holiday, which it was. We stayed in a great hotel on the beach, and did things like camel riding (not recommended, they are very smelly animals!)
Camping in France - We had 2 holidays here when my son was small, and camping was great fun. No actual putting up of tents was involved, so I guess it is kind of cheating. There was also a large fridge and beds with mattresses (well a girl is entitled to her comforts)!
Cornwall - One of my favorite places to travel to in England. It is rugged and at times remote and just a lovely place. We have spent hours trying to get there (the roads once you get into the deep west country are narrow and often crowded), but a couple of years we went by plane. A trip that took just 40 minutes - it took longer to get to the airport!
Norfolk - This is a county in the east of England and is characterised by a sandy coast line and the 'norfork broads' a large waterway. I have been for a holiday on the coast, though I am sad to say it rained every day, but also have been for a trip on the broads over a weekend which was great fun.
Scotland - In our youth (ie pre teen son), we spent 2 weeks traveling around the north Scotland. The countryside was fantastic, and surprisingly the weather and beaches were great. We went to Loch Ness but saw no monster!
Bath - A city we went to as part of our honeymoon. Set in the Somerset countryside it is another extremely historical place (Roman). I have fond memories of both the city and the rolling hills surrounding it and particularly remember Cheddar Gorge.
Calpe in Spain - Another place we visited pre teen son, infact the photos I have from them show me as extremely skinny. This was mostly a beach holiday, and if I ever (god forbid) developed skin cancer, this would be the kind of holiday that was to blame. Low factor sun oil (we though oil would make us browner) applied very infrequently. Also we thought you needed to burn to get that tan. It is a beautiful place though.
Malta - One of those places that is very built up and full of Brits but another place we travelled to in the early years of our relationship (before we were married even). I do remember a striking coast line though and a wonderful day trip to a small island called Gozo.
Portugal - The coastline of Portugal is very much like Cornwall, but it is much hotter there! My main memories are of a morning on the beautiful beaches followed by a lunch of sardines grilled in the open air. Probably my first experience of anything barbecued.

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Don't drop your laptop on your toe

2006-04-12T06:56:00.000+01:00

Take it from me, that is a very painful thing to do, especially if you are bare foot. The laptop bounced and seems undamaged, I was left bouncing around in pain and now have a throbbing right big toe. Limited sympathy was received from hubby who stated that 1) it might be broken 2) you'll probably lose that nail and c) put some ice on it. Thanks for you sympathy I thought as I got my own ice from the fridge.

This was the final chapter of a day that had involved a panic stricken phone call from teen son, to tell me his computer was broken, that there was an error message and where were the windows disks. Sadly he was unable to find the box with these unaided, so it had to wait for my return and then finally we worked out how to fix the thing and set about doing just that. Why though do these things tend to take such a long time. I suggested he find out more about computer fixing and perhaps take it up as a part time job. He briefly thought this was a good idea before he returned to the challenge of discussing football with his online cronies.

So I have just a couple of days before the weekend away and haven't completed the ironing I was going to do last night. Still I am out tonight (a colleague leaving), so perhaps the ironing fairy will come along in my absence. Ah a pig just flew past the window, time to get up!

Busy but not much happening

2006-04-10T22:23:00.000+01:00

That is pretty much the flavour of this week at work, with Easter approaching a lot of people are already taking a break. Sending emails means a few out of office auto replies, but not enough yet to prevent things from getting done. It also means the chance to spend some time in the office, to get things finished off and to get other things started. At home, I have finally made a start to the essay, and have just about made it to the first 1000 words. I am struggling with the structure at the moment, but hopefully that will come in the next week or so.

A reasonably quiet worklife is just as well, because home is pretty hectic, what with our weekend away approaching and all the preparation that involves. I am wondering if I should have taken Thursday off to get everything ready, but with meetings already in the diary that is not possible now. Still I thrive on leading a frantic life which is just as well.

So Butlins to look forward to, and a slight apprehension about the whole thing. Butlins is a name that is part of British history, and with only 3 camps left perhaps a dying type of holiday. This is not the kind of holiday I would go for usually, for a start I am pretty much a hotel type person now, or at the least high standard self catering, and we don't usually choose very touristy places to go to (well certainly not English tourists). Call me a snob, but I don't like my fellow holiday makers to be too, well, common. But I think this will be fun. I have heard varying reports on whether or not I will enjoy it and the standard of things like the accommodation and food. But to be honest it is the company we are going with that appeals. A chance to have some fun with hubby's cousins, their husbands and wives and their friends. Not to mention all the kids of teen son's age and a little younger. Plus a chance to get away from my own mad family, but that is another story I may share tomorrow.

Count down

2006-04-08T07:24:00.000+01:00

I am in effect counting down to two specific events. One is the dreaded assignment, due on May 8th and so far just a couple of hundred words long (I am going to write some more this morning). The other is Easter and our trip with a large number of hubby's family and their friends to Butlins. In the mean time we have a weekend that is as busy as they come. My question to myself is this: when will you get the time to clean the house, wash and iron the clothes and do the shopping? Today's tasks are as follows:

Take teen son for a haircut and arrange own hair appointment sometime before next Thursday night
Go to shops that are suitable for buying a sleeveless pullover for father in law, also cards for him and my brother who both have birthdays on Monday
Do the weekly supermarket shop. We won't be here for dinner tonight or tomorrow, but teen son is not coming with us today, so will need the fridge and cupboards to contain something edible
Put some washing into the machine and preferably clear some of the ironing from last time
Sit for at least an hour and write some of the assignment on Change and Leadership
Go to visit father in law with card and present, as we don't have any other time to do it before Monday
Go to brothers house for his birthday pre show late lunch (see below)
Go to see niece in dancing show, she is 8 and has been doing ballet and tap for 3 or 4 years and modern more recently and apparently will be in 7 of the shows dances
Stay for after show party as tonight is the last night

I am worn out just typing this, and am now off for a sleep before it begins..........

Butlins
Leadership
Family

Thursday Thirteen - 6 April 2006

2006-04-06T17:57:00.000+01:00

Thirteen Things about my week

I am getting used to these short working weeks, a day off last week, one this week and of course Easter to look forward to next week.
The focus of work this week has been change management as we are running a series of workshops on this topic.
This is bringing me into greater contact with nurses and therapists who are actually out there providing the care. It is giving me an amazing insight into some of the short comings of certain managers in our organisation.
As it is the school holidays I have been getting up earlier (no teen son to wait for in the bathroom) and leaving for work earlier. I have been in the office about half an hour earlier too.
Today I ran a change session with a specific team who have been going through a very traumatic change situation. Quite a challenge, and pretty tiring. However I think it went pretty well.
Today was the first day this week that I have spent longer than an hour in the office, hopefully I will get to spend alot longer there tomorrow as the work is building up!
We are going to try to go for a brisk walk at lunchtimes when we are in the office from tomorrow, all I need now is to join weight watchers or something.
Arsenal drew 0-0 last night, and went through to the Champions League semi final on the basis of last weeks result.
We found out that teen son and his grandad are going to Arsenal's last match at Highbury on 7th May. We had to go into some kind of lottery thing to get the tickets.
Hubby has been bowling twice this week, some kind of tournament with a group of friends. This has meant 2 peaceful evenings when I have full control of the remote control.
I have been reading for my assignment (due on 8th May) but really need to begin to write something (only 4 weeks and 7,000 words to go).
It has been another dry week, I really need some rain to fall on my new plants which I planted into my front garden on Sunday. We have a hosepipe ban in the area due to a lack of rain over the last couple of years. Contrary to popular belief it doesn't rain all the time in England.
Bird flu has arrived in the UK, we are not to panic and at the moment I am not about to stop buying free range eggs or chicken. Also in the news today, a nurse has been murdered while taking a break outside her hospital!

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Devalued and Deskilled

2006-04-04T19:08:00.000+01:00

That was the overwhelming message from a group of District Nurses on the second of our managing change days today. Devalued because they perceive that managers don't appear to hold them in any kind of esteem or think that they are necessarily doing a good job. Deskilled because financial cuts mean that they are no longer to assess patients for medical loans items or for Marie Curie nurses to care for their patients over night. There seems little evidence that managers are listening to the concerns of front line staff and at the same time I expect they are being heavily leant on from above in terms of finance, governance and risk.

I wonder how we got into this mess. How did district nursing managers lose the trust of their staff and why don't they trust their nurses to make these kinds of decisions? I guess we have to come to terms with the fact that we are at the mercy of the finance department, but does that mean that we have to assume that a manager who hasn't laid eyes on a patient is best placed to make such as vital assessment.

On the way home, stopping for bread and milk, I saw an amazing thing; a pink Ka with pink fluffy seats with the words babe on board on each. When I came out of the shop the car was being driven by a peroxide blond girl with fake tan and pink dangly earrings. Surreal I thought!

District Nursing
Change Management

A busy few days

2006-04-04T06:46:00.000+01:00

I am not sure what happened to my weekends, but they have become extremely busy. The one that just passed was no exception, compounded by the inability of two teenagers to properly organise their trip to a football match and the discovery at the 11th hour that work on our local train line into London would cause cancelled trains and replacement bus services. The end result was me taking them part of the way into London and them arriving at the football match with 3 minutes to spare. Luckily Arsenal won 5-0 so all was worth it according to teen son!

Sunday we dodged showers to carry on the garden work we started a couple of weeks ago, I have planted some new shrubs and hubby has been doing some spring pruning (or hacking) in the back garden. He spent the time telling me how much more energy you have when you have lost weight (almost 2 stone since Christmas). I on the other hand appear to be the same weight and have only a week or so until Easter by when I wanted to be slimmer! I am not sure what I am doing wrong, but I guess it involves food and possibly wine!

This will not be helped by yesterday's day out to France, we set off at the crack of dawn for the channel tunnel, then waited for 2 hours to cross due to a train stuck in said tunnel. As I said to hubby, rather sitting in Kent than in the middle of a tunnel under the English Channel. We had a fun shopping day though, of course with lunch, wine and a brisk walk around Calais before returning home. Hubby is now set up with beer for the world cup and I have enough wine to last till Christmas if I pretty much give it up so I can actually lose that weight. Maybe I should take drastic measures and put one of those charts that chart progress such as weight loss or time to an important event up on my blog.

So having used up the last of my 2005/6 holiday days it is back to work to face the new financial year. More change management sessions with staff today, and with hubby going out tonight some essay work tonight and maybe some time for a more serious blog entry. My new resolution for April though is not to let myself be wound up by all that is said on other blogs, especially if they relate to the work nurses in the UK do or do not do.

Arsenal
Day trip to france
dieting

Finding the time for study

2006-04-01T07:57:00.000+01:00

A day in London at the University yesterday, essay discussions about change, leadership, strategy, organisational culture etc. It is good to get time out of work to get together with the group (and also the cohort ahead of us on this occasion) to discuss these issues. I also found the time to go to the library and get a few books, mindful that I had to take them on the tube and train, I only picked up a few. Setting aside time to actually read, make notes and then of course write the assignment is a little more tricky, and something we all seem to be struggling with. 3 of the group work in the NHS, and all have busy demanding jobs, I for one struggle to have my brain sufficiently active by the time I have driven home, cooked dinner, loaded the dishwasher etc. I guess that I should cut down on the blogging, but a girl has to have some fun!

Having said that, I am finding the reading about change management, the manager / leader debate and the skills you need to make change successful really interesting. I am increasingly wondering if some of our problems in the NHS might be due to the selection of managers, the fact that we just assume people can lead and manage others, and the fact we expect all managers to just be 'leaders' just by telling them they are leading on something. I also think that the skills we are looking for now, in a time of flux might be different from those we needed even 2 years ago when things were relatively calm. Leadership and management development is our key priority for this year, so maybe we are on the right lines, I wonder though if we shouldn't have been doing that some time ago.

So to the weekend, teen son is off to Highbury to see Arsenal play today, and is doing this with his friend rather than his granddad, his independence is both great to see and scary, but I know I have to let him go off and explore the world. It is now the Easter holidays for him, though he has 3 pieces of GCSE coursework to complete and some revision to begin for his GCSE science exam. My brother and his family (who were meant to come over on Thursday but didn't) will be visiting for dinner, and apparently there is to be some action in the garden by hubby! Tomorrow though should be a quite one, and I am going to be sitting with my books for at least some of it; only 5 weeks to the deadline for my assignment.

As a bit of a post script, part of one of my posts on this blog appeared in the Guardian this week! Sadly I have only seen it online rather than in print, but it filled me with a mixture of elation that my words should have appeared and trepidation that I need to be really careful about what I write. Having said that, my posts are pretty guarded when it comes to work already which is probably why I struggle at times to think of good stuff to put here.

part time post grad leadership
Change Management
Arsenal

65% Satisfied!

2006-03-31T23:43:00.000+01:00

Your Job Dissatisfaction Level is 35%

Your job is not bad, but it's probably not a long term thing.

You're just not happy enough to stick around for too long...

And there's little that can change how you feel.

Start looking around for other options, but only quit for something really good!

Should You Quit Your Job?

A question

2006-03-30T16:45:00.000+01:00

If Agenda for Change meant that all NHS staff (except Doctors, Dentists and Directors) were placed on the same pay system how can the BBC report that nurses are to receive a bigger increase that other NHS staff? Or is the award for all people on Agenda for Change and just not properly reported?

Thursday Thirteen - 30 Mar 2006

2006-03-30T09:17:00.000+01:00

Thirteen Things about my Week

Not sure why and no it is not PMT but I have been getting angry and upset by things that are really not worth it (see previous post).
This has not just been a blogging thing though as last night I had a major go at hubby for going through my bag to help me find my university card, I have nothing to hide and am not sure it was worth me yelling at him.
I have been suffering from hayfever this week, I am allergic to spring (well tree pollen and oil seed rape which thankfully isn't around yet), I have bought some tablets are much nagging by hubby about my sneezing habits.
Tomorrow is my final study day before my assignment needs to be handed in (this will be in May), luckily my life is now dominated by change management and the essay is about......
Teen son has caused some irritation, first he left his mobile phone in a train carriage on Saturday and then yesterday delayed me as he couldn't organise himself enough to remember his school bag when I gave him a lift to his friends house for the great 'walk' to school.
There seems to be problems with the drains in our new office, a man from the estates department has been twice in the time I have been there (about a month) to unblock the toilets.
We are in the process of organising our education and training programme for the new financial year. For the first time we have really got the mandatory thing sorted (hopefully) and I just hope that managers will continue to release people for training (apparently the latest NHS survey shows a reduction in uptake for training).
I discovered yesterday that the head of HR doesn't do her appraisals properly (surprise surprise), when I took possession of the staff file of someone I have inherited from HR.
I successfully used a computer in the PCT head office yesterday without losing my emails (see a recent thursday 13).
I held the third session of my new action learning set this week, one member has left the PCT (nothing to do with me, so she said) and 2 new people have joined. Hopefully we can now get going.
Hubby is buying a new car about 5 days after the insurance policy on his old car runs out, he has left me to sort this complex situation out for him, including changing insurance company.
I have my brother coming over for dinner tonight, wonder what to cook?
Today is payday, we are meant to be getting our backdated pay from agenda for change, sadly at the moment that is about £20 per year for me! roll on my appeal.

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Shock horror

2006-03-28T21:57:00.000+01:00

Dr Crippen of NHS Blog Doctor slags off nurses and moreover specialist nurses again! Actually I agree with some of his sentiments, there does seem to be a lack of nurses who are prepared to do basic nursing care in a basically caring way and there does seem to be rather a lot of nurses who fancy being specialist nurses. I wonder why this might be?

What is the average age of a nurse? At the last reckoning, pretty much over 40 if not over 50, what kind of work would you like to do when over 50? How much do you want to be paid by the time you have given 30 years service? What do you do when you have your diploma and degree in nursing and have spent many years fighting the system, working out that actually you have the skills to do more than wipe the backside of the average patient. Why you decide to get yourself a job where you can have your hard work recognised, where patient's appreciate you and where the doctors you actually work with respect your knowledge and skills. The down side is that other doctors find you threatening, they think you are getting above your station and what's more you are too specialised.

A nurse in the UK in 2006 should earn no more than £20,000 per year, she (and of course it is a she) spends her day running around a nightingale ward from patient to patient, she refers and defers to her superior matron at all times and only matron communicates with the great doctor before telling our cowering nurse what to do next.

There are some very poor nurses around, I have met some of them, there are some poor 'specialist nurses' who really shouldn't be allowed near a patient. But there are equally some extremely poor doctors too, they are not all thorough in their assessment of patients, they are not all accurate in their diagnoses, they are not all blessed with excellent interpersonal skills. Sadly I have worked with some of them.

The good news though is that Arsenal have beaten Juventus and for that I am extremely pleased this Tuesday night!
Nursing

Listening to people

2006-03-28T17:42:00.000+01:00

When it comes to communication skills, a lot of NHS managers seem to be under the impression that they are pretty good with their teams and services. They give out plenty of information, even if they are not sure they are giving the right information, and they make sure they are involving people with the things are going on. The trouble is, that there seems to be relatively little listening going on, and very little checking out that the message they think they are delivering is getting through in an effective way.

Yesterday we held the first of a series of change management / coping with change sessions (one for managers and team leaders and the other for team members) and for me the messages are stark. I would go as far as to say that I am horrified with some of the things my fellow managers are doing in terms of communicating the changes to their staff. It seems ok to send a director to talk to a team of health visitors and for the person concerned not to introduce themselves and not to adapt their talk to make it relevant (of course the health visitors could have been brave and asked who the hell she was, but I can understand why they might not have). It seems ok for a team to find out who their employers will be and where their base will change to 3 days before it is due to happen. It is ok for staff to launch a new service, which thankfully they are committed to doing, but without having any say in the way it is done.

It seems as though in all of the big redesign work going on in our PCT, no one considers that the people out there actually delivering the care to patients actually have anything to offer in terms of knowledge about how the service should look or function. There is an assumption that they will just get on with the work, and while they do it they can just find out that they are to be based in a new office some time this week or next. People need to be treated with more respect than this.

Having said all of the above, actually this is just the kind of work I really enjoy, because actually I can make sure people know what is going on. I left bedside nursing because I felt unable to make enough of a difference to the way things get done. Hopefully now though I can get people to listen and I can make a difference to the way people are treated and what's more that can only have a positive effect on what is happening out their in practice.

The last week of the financial year and my budget is looking like a real budget, and hopefully it isn't over spent nor will it be significantly underspent. I seem to have managed to provide an education service which reasonably met the needs of our staff and within budget. Shame it has happened more by luck than judgment or perhaps I am actually psychic and don't know it!

Communication NHS

I was brought up to believe that..........

2006-03-27T23:14:00.000+01:00

Mother's day is a day that involves the mother of the family lounging around, while her children prepare food and her husband plies her with wine. Well that is how mothers day seems to have been for my mum, and yesterday was no exception. I guess that my main mistakes have been firstly to have only one child and secondly to have only a son. Still I have acquired a very nice perennial type plant to put into my newly cleared front garden (though I need to go and buy several more to stop it looking too lonely), when it is planted I will post a picture here so that teen son knows how much I appreciate my gift (and I do actually).

So yesterday I cooked lunch for 9 members of my family, then we all headed off to Roller City for my niece's birthday party. Her parents had booked the whole place for 2 hours, and invited her whole class of 8 year olds, and a few of her brother's 12 year old friends, many arrived with their parents, so the place was pretty busy. I decided that I should join in, but soon came to regret this decision and have the bruises to prove it. There were many minor injuries, and I realised why I never encouraged such dangerous parties for teen son when he was young enough for such things. The main casualty though was my other niece who is 13 today and celebrated it in her local accident and emergency department being xrayed for a fractured humerus!

Teen son announced last night that he is to tone up his apparently long but puny body, this will involve regular (daily perhaps) circuit exercises he has got off the internet (they are always saying that the internet is a dangerous place for the young!) and a healthy diet. I have spent a lot of time trying to encourage healthy eating and suddenly he is going to eat more fruit and less fat of his own free will! A friend asked if a girl is on the scene; well I haven't noticed one, but I guess it is only a matter of time! The up side could be that she might cook me food on mothers day!

Lazy Saturday morning?

2006-03-25T09:23:00.000Z

I am writing this as a delaying tactic for the fact I can't get my posterior into gear this morning. Hubby is at work and teen son still at his friends having had a 'sleep over' last night, the inverted commas are because I wonder just how much sleep took place and what state he will be in when he gets home. I have now had morning coffee in bed, breakfast in bed and now am blogging to the Commonwealth Games in bed. After this I promise to get dressed and clean the house!

Yesterday I had a pretty productive day, I was in the supermarket at 8.15, though I struggled at that hour to know what I actually needed and will need to return tomorrow for extra supplies (I have my parents and brother and his family coming over for lunch). I have read several articles on change management, leadership and other related topics ready for my essay, and am pretty much ready to get going on this. Perhaps if I race round with the dyson and duster I will have time to at least get on with a proper plan before hubby gets in or teen son rings to be collected. After lunch I went out into my newly cleared front garden and dig some digging, now I am in need of plants to fill the spaces created by the tree felling.

This afternoon we are off to London, we are planning a stroll around Harrods looking at things we might buy if our lottery numbers come up. If the sunny weather keeps up we might even have a walk through hyde park. Teen son and his friend are coming with us, but are being permitted to go off on their own for a few hours. Hubby asked me why I asked him if he wanted to do this rather than stay home, and it is for selfish reasons; I need to be in London when he is wandering around with his mate before he asks me if he can go on their own by train. In fact next Saturday Matt and Jordan (he is a boy by the way) are off on their own to Highbury to see Arsenal play.

So enough procrastination, I must get up and on with the day!

Will I still have a job at the end of this?

2006-03-24T10:02:00.000Z

In today's Guardian there is yet another headline about NHS job losses, as they say 4000 have been announced in the last 2 weeks, and there are now predictions of 15000 in total over the next few years. Some of this will be about jobs moving from one area to another, for example jobs which are currently part of the acute sector becoming part primary or intermediate care. Secondly these are posts rather than actual people, as many trusts are now running with high vacancy rates due to the inability to recruit and more recently vacancy freezes. Many jobs have been created since Labour came to power in 1997, to a great extent with the purpose of servicing the centralised targets we have been set. It has been about quantity rather than quality: lets make sure we see patients within a given time, lets make sure no one waits longer than x months for an appointment, lets make sure that x number of people stop smoking. In the process of doing that thousands of staff have been recruited some of them health professionals, some admin staff and some managers.

At the same time organisations have undergone reorganisation, the two PCTs I work for started as part of a community trust, and then split into 4 PCTs, 1 CEO, Finance Director, Director of nursing etc became 4 and each of them and their other fellow directors needed their own teams, no wonder so many jobs were created as a result.

As regular readers will know, I began my career as a nurse. I have carried out various nursing roles during the 26 years since I began as a student nurse, but for the first time I am not sure what my next move might be, and what's more I don't know if there would be a job for me if I were to want one. In our area there is to be a vacancy pool, so that people who find their jobs at risk, or who are made redundant can begin to look for a new one. What jobs will be in this pool? Will this offer an opportunity, because demand will exceed supply, for employers to actually cut pay? Will someone like me who has been working in a management role for the last 4 years, actually be able to go back to clinical work if we want to, and if we do, what kind of job will be available to us? It may be that my job is actually safe, after all it would be nice to think that the education department of any organisation should be felt to be too important to be made redundant, but actually I wouldn't be quite so sure. The other thing of course is, that I might actually want to do something else, I might want to use my increased knowledge and hopefully skills in a new area, but I wonder what there will be left for me to do?

I don't have blue hair but.......

2006-03-23T23:07:00.000Z

You Are Marge Simpson

You're a devoted family member who loves unconditionally.

Sometimes, though, you dream about living a wild secret life!

You will be remembered for: your good cooking and evading the police

Your life philosophy: "You should listen to your heart, and not the voices in your head."

The Simpsons Personality Test

Thirteen things about my week

2006-03-23T17:48:00.000Z

Thirteen Things about Julie's week

Finally managed to get the horrible trees at the front and side of my house chopped down on Saturday. I have a lot of work to do now to make it look less bare, shrubs and plants, but no trees!
Went to visit hubby's 94 year old Granny on Sunday, she was on excellent form and really excited to see her sister who we took for the visit. It is also good to know there are some good care homes with excellent caring people looking after the elderly.
There have been 4 live football matches on since Monday, now that really is overkill! Thank goodness for Grease on Tuesday night!
My emails have been returned to my inbox; I know that a number of people felt my pain on this topic last week!
I have had one to ones with 3 of my staff this week, which of course take up time but are really worth while. A few appraisals coming up next month, so preparation to do for them.
Thankfully the number of meetings I have to attend seems to have dropped to a much more manageable level, and all the meetings I do attend seem to be reasonably worthwhile. Unlike my last manager, this one doesn't insist on us doubling up at everything which is a big relief.
The consultation on the reconfiguration of the PCTs closed yesterday, we should know in May what that will look like. Could be 1 PCT in the whole county could be 2. After that the process of discovering which jobs are likely to be at risk will begin.
Money will be very tight again during next financial year, no surprise there then. Any savings goes to bale out the acute trust!
I have spent the most thrilling day today pouring over the training needs each department has sent in. So few surprises that I could have pretty much written it without consulting with them. Either that or I am a major fountain of knowledge!
Tomorrow I am using up one of my last 3 annual leave days, I also have next Thursday and the following Monday off. Friday next week is a study day.
Tomorrow I need to get my essay planned out properly as I have to submit the plan to the group by email on Monday for discussion on Friday.
It looks like the cold weather might be ending - we will be in double figures (centigrade) tomorrow - yipee!
The fixed rate period on our mortgage ends next month, so we have to put up with a hike in payments, that's the great news I came home to today.

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1. Mama Kelly

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It just gets worse

2006-03-22T21:09:00.000Z

10 days to the end of the financial year, and another finance person to consult with. Some how the fact their department have failed to do what they are paid to do is my fault. I wasn't tough enough with the management accountant! Well in hindsight maybe that is true. Back to the office after that meeting and it seems that someone from the Financial Services Agency has told one of our training providers that she won't be paid just yet because the NHS is in difficulty and hasn't she seen the news. I guess if you provide a service to the NHS you shouldn't expect to be able to pay your own mortgage! Mind you I guess it has got to the stage of her bill or my salary for March, and I have my own mortgage to pay!

A bit of light relief last night Grease is the word! We went out for a meal and Grease tribute act show for my nieceÂs 8th birthday. Laura loves the film, and the songs, and gets us singing to her karaoke DVD whenever we are visiting. She is always Sandy of course, which leaves anyone else to be Danny! The singers were pretty good entertainment, I got the chance to dance to add a few steps to my daily count and had some good Italian food too (mindful of my diet of course). Tonight it is back to an evening of football as Chelsea play Newcastle in the FA cup. Lets hope for a Chelsea win so that my evening is a relatively quiet one.

End of year

2006-03-18T12:19:00.000Z

The financial year ends in just under 2 weeks, and that means (even this year) getting invoices in and sent off for payment and spending our last bit of petty cash. Our budget, which mainly comes through education allocations from the Department of Health through the Strategic Health Authority, must be spent wisely or returned and lets face it we went through enough hoops to find our how much we were getting, and then got most of what we were promised, so I'm not sending it back in a hurry. This year though I am in the middle of a guessing game. I don't like to accuse people of incompetence, and I do know how busy and stressed the finance people are but surely it must be possible to be given an accurate budget statement before year end? They are the only department to be allowed to recruit staff and still I have the impression of unconscious incompetence about many of them.

At the same time we are preparing for the new financial year, a year of promise? Well I doubt it promises anything too wonderful, but we must keep our stiff upper lip we must keep our chins up and we must be positive. I am in the process of compiling the training needs analysis (sounds grand I know) for the organisation and we are also starting to plan our training programme for the coming year. It will pretty much feature mandatory and statutory training, core skills training, stuff on change, management and leadership and little else. With no end in sight to the overall financial crisis (did I say that?) we are in, people will not be able to be released from work on a whim, but there are such fundamental changes happening to some services that there are a lot of training needs and so released they must be. For the first time we are going to be able to do something I have been aiming for since I started this job and that is to have half and whole days of mandatory training so people only need releasing once rather than for an hour here and there. It is taking a lot of organising, but now the team is functioning so much more efficiently we are in a position to do this, and it is what people want.

Next week sees the start of spring, and next weekend the start of British Summer time, I wish someone would tell the weather that it is time to warm up please! I am fed up of wearing winter clothes and a thick coat, I need warmer spring like weather please!

Thirteen things I have recently noticed

2006-03-16T18:02:00.000Z

Thirteen recent observations / discoveries

It is quite possible for a 15 year old boy to come home from school covered with mud after playing football at lunch time.
You can buy the seats from highbury (We have bought one for teen son, it will apparently be delivered in August), his dad is apparently going to connect it to the wall in his room. Lets hope it is more successful than some other DIY efforts.
March can be a very cold month and spring can apparently appear to be suspended.
The journey to work can be reasonably good even during term time, hope I haven't jinxed my journey tomorrow!
It is quite handy to employ an ex-landscape gardener, especially when he is going to bring his chainsaw and a mate to remove some very unsightly trees from your garden at the weekend.
It is good when your administrator arrives back from her holiday in Australia, refreshed, cheerful and ready to get back to work (well seemed it).
Cold sores are really painful - just had one for the first time in about 10 years.
Using a computer in another office could result in your inbox being emptied, as I discovered mine had this morning; very annoying.
It is possible to have successful 1 to 1's with staff members on 2 consecutive days, even with people who you had previously had problems with.
When you arrive to a finance meeting to find the accountant off sick it is very annoying, however the blessing might be to find someone more efficient to sort the problems out (ask me after Tuesday if the other person is actually efficient).
It is possible to put up your step count by going for a lunchtime walk, dancing to top of the pops and jumping up and down while cooking dinner.
My GP still thinks I work at the hospital and can arrange dermatology referrals for my own son!
Some new nursing / medical blogs through Grand Rounds (see links at the side, here, here and here.

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It turns out I am not psychic!

2006-03-15T21:24:00.000Z

I guess I shouldn't be disappointed, though was considering a career as a medium before I did this test, looks like I shouldn't bother!

It is hard to take 10,000 steps

2006-03-14T22:10:00.000Z

When you do a job as sedetary as mine. This is something that has become apparent in the last couple of days. When I was a young nurse, in her 20's working on a medical ward (which happened to have a small coronary care unit), I must have walked miles every day. Up and down the ward, around the beds, up and down the stairs (lifts were for patients and visitors), over to the ward opposite to borrow stuff, to other wards to accompany patients. I was slim, though never realised that I was.

In 1987 I moved to the community, I started to walk a lot less, the only stairs were those in people's houses, or in small blocks of flats which we have quite a few of in our town. I got in an out of the car, walked across car parks but as in those days we still did plenty of manual work (lifting, moving, bending, stretching) I kept fit, and I kept pretty slim. In 1994 (having had a baby, got fat during pregnancy and lost it) I moved back to an acute hospital. I walked much more, though not often up to my 10th floor office (walked down though), I didn't do much of the manual work though and I was happy, contented and sadly fatter.

So I guess it should come as no surprise to find that in moving to an office job, it has become more difficult to stay any way near slim (of course I am also older). It was quite a shock though to realise that I struggled to walk 1000 steps by lunchtime (and 400 of those were before 8am when I got in my car. Therefore I took 20 minutes out of my day and went for a walk, actually it was great to get a breather, even if it was very cold today. When I got home, it was getting dark so I have danced and exercised around the house, and got up to 9000 steps by now (10.20pm). But having to think about this is a good thing, I need to be creative about how I do this, how I get fitter. I know I'll never be that young nurse running up and down those stairs, but I'll have a go at getting back into shape.

Tomorrow I am at the other office, meetings and more meetings, but there are stairs involved which is good. I hope the finance person is a bit more on the ball for our meeting than when we last got together, after all the financial year is nearly over and it would be good to see a proper budget statement before 31st March!

Increasing the exercise

2006-03-12T13:40:00.000Z

If I don't do something soon, I will be the size of a whale by my next birthday in August. I am not a lover of exercise, don't get me wrong, I know what is good for me and know how I should do it, but I just don't actually like it much. Well not the exercise for exercise sake kind, you know running on a machine and getting no where, or even running through the streets and coming back again. Cross country running at school was something you endured and caught up with gossip doing. I guess this would be fine if I ate like a little mouse, actually I have a rather larger appetite, and am not all that good at being hungry or at not eating something which I quite fancy. For that matter I quite like a glass or 3 of wine, and lets face it there are a number of calories in 3 glasses of wine, especially when accompanied by a nice meal and not worked off through exercise.

On Friday I did 30 minutes of swimming, I am not sure how far I swam but it got the heart rate going and got me a bit out of breath, then yesterday I covered 11,000 steps by increasing the amount of places I walked and did half an hour of my Rosemary Conley DVD. Rosemary is someone who is a kind of diet and exercise guru and has got very rich in the process, but I like her regime and like her exercise DVD's. It is only 2pm but already I am well on the way to the 10,000 steps, and because we have to go and collect the inlaws from hubbies aunt's house later intend to have no wine today. The only thing I still have to crack is not putting too much of the wrong food in my mouth, but then you don't want to over exert yourself in these matters do you?

Friday thoughts

2006-03-10T17:10:00.000Z

I was far too busy last night going out enjoying myself to do the Thursday Thirteen thing, so today I present you with my Friday Thoughts:

This week my manager told me she definitely wants to move the team over to the base we were originally meant to move to, but there was no room for us. Apparently now there is room, but I have informed her that as I have just unpacked my boxes I am not moving any week soon! Anyway I really like my new office, and don't feel inclined to be mucked around, I am going to hold out as long as possible on this!

I also checked out with her exactly what my job is meant to be, you may laugh but it seems to be constantly changing. She and I seem to concur that I am meant to be investigating issues within the workforce and facilitating them to learn, develop and change. That of course is on top of managing the team and commissioning education. We finished my Agenda for Change Appeal which will lead to me having to do a Job Assessment Questionnaire, something I should have done in the first place seeing as my job is not exactly run of the mill. I am hopeful of a good result in the end and perhaps it will mean some backdated pay (well a girl can dream).

I have written a paper which reviews and evaluates our leadership and management training, then today I have spent the day with my former manager sorting out exactly what we are going to do around leadership and management in the coming year. More work still to do on this, but it is feeling like we are actually getting somewhere with this.

Last week I bought myself a book called Curries of the World, and tonight, having bought every spice known to man, I am cooking a recipe from it. It's the Weekend!

Watching Arsenal is like........

2006-03-08T22:16:00.000Z

Watching England during the World Cup. This has nothing to do with English players because the only person who was English was David Beckham who plays for Real Madrid(can't believe he has his own magazine!). But it was all very stressful to watch, I had the feeling that at any moment our 1-0 lead could become 1-1 or worse. I guess that the next thing will be a draw against Barcelona who put out hubby's team last night! Kieran on Loopy Librarian has got a little carried away tonight and mentioned me on his blog twice in one day, I wonder what it will be like to be an Arsenal fan in Liverpool tomorrow when the red half wake up to their own loss tonight. What's more we are playing them in the premiership this weekend.

Teen son is pretty excited, he is off to see Arsenal next on 1st April and we have registered for him and his grandad to go to Arsenal's last match at Highbury in May. Lets hope this win tonight is going to mean a better end to the season than we might have expected. Tonight I am a proud Arsenal fan, and very glad that my brothers' support for Spurs led me along this path many years ago!!

Surely this isn't me?

2006-03-07T22:07:00.000Z

Badger

What Is Your Animal Personality?
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Proving you are busy

2006-03-07T06:59:00.000Z

About 15 years ago when I was a wet behind the ear district nurse we spent a period of a couple of weeks writing down everything we did, for whom and how long it took to do it. At this time all records were manual, and there was little official knowledge about how a district nurse spent her (or his day). I seem to remember this led to the Koener (not sure about spelling) report and showed that the average district nurse visit was 30 minutes long and that half of time was actually spent writing up notes, traveling between visits and in the surgery or health centre referring people elsewhere or generally discussing cases with other professionals. We ended up with a computerised system of reporting, which some nurses embraced imputting accurate data regularly and others avoided and treated with the contempt they felt it deserved.

Yesterday I spent time helping to facilitate a meeting between two teams of district nurses who are seeing their staffing establishment eroded by the vacancy freeze and their manager. I don't doubt these dedicated nurses are already operating on good will and are extremely busy with caring for ill (sometimes terminally) patients with a variety of conditions. The trouble is that the latest time and motion study and their computerised records don't support the level of work they say they are doing, and in this day of finance driven healthcare, I am afraid that if you can't prove it happened then it didn't. The trouble is that a time and motion study doesn't show everything about the visit to a patient's home. It shows the time spent, it shows the tasks performed and you can say you offered advice and support but this is only part of the picture. At the same time though (and I am a manager now so have developed a more cynical edge than I had 15 years ago), I am not entirely convinced that they haven't developed a way of working which is to some extent driven by custom and practice. I was tempted to offer my services to a bit of qualitative audit and actually do some practice observation. This may support their argument that they need more staff, but I have a hunch it might just say that the staff they have need to be better organised.

I don't think I am the one to observe this practice, but I do think it will have to be done, and I know that I will need to be around to help pick up the pieces of whatever comes out for the manager and the teams involved.