Category: nhs

At work the pressures to get people seen, assessed and home as quickly (and safely) as possible continues.  All week there were reminders of just how busy we were.  Emails, crisis meetings, phone calls from managers.  Even the TV offered no chance of respite – The NHS ‘crisis’ was making headline news almost every day.

Yes, the war of rhetoric versus reality seemed never ending.

It would be exhausting if it weren’t for the glimmers of light that insisted on shining through.  It’s been a really weird week in that respect.  Without particularly looking for them they appeared.  This is what I want to get into this week – inspirational people.

Throughout my life I have looked to others to inspire me with confidence, a sense of belonging and a sense of possibility.  Watching Barack Obama’s farewell speech this week however, got me thinking about not just how some are able to inspire, but why is it that we seem to need these people?  Why can’t we inspire ourselves?  Bear with me as I realise that may sound a bit conceited or even arrogant.

When Joe Biden was awarded the Presidential Medal of Freedom with distinction, he spoke about ‘getting credit he didn’t deserve’.  In fact his whole speech was incredibly humble and yet to many he is an inspiration.

I think we want to mirror aspects of our own character in other people whilst recognising that we are all a bit flawed.

So coming back to reality how do we do this?  Moreover, how do we do this at this particular time in the NHS’s history?

We are all trained to put the needs of our patients above anything else.  We need to remind ourselves though that we are as important as our patients. The system continues to limp on but if we as a workforce become sick who is going to take care of us?

How we do this is a matter of style (or taste). To quote Leslie Knope from Parks and Recreation ‘one person’s annoying is another person’s heroic and inspirational’

I am a fairly social creature so will look to bring people together with coffee, cake or a simple ‘how’s it going?’

That said, I do think we need to come back to the idea that we can and should inspire ourselves.  We need to tell ourselves ‘You’ve got this! You are amazing, cut yourself some slack.’ Easier said than done when all hell is breaking loose but if I may, can I suggest that you write down some inspirational phrases or quotes.  Put them on your desk so when you’re in the midst of chaos and cannot see, they will make you smile, they will reassure, they will offer hope.

Who knows they may even creep into your subconscious so that…

‘….every time it rains

You’re here in my head

Like the sun coming out

…..I just know that something good is going to happen

… I don’t know when

But just saying it could even make it happen’

Day one. New Years Day.  I volunteered to work the early shift as we were short. My most favourite day of the year is New Years day. It is literally the quietest day of the year.  The silence of the morning is amazing!  Not even the sheep or the cows are making much noise.  Its like having the whole world to yourself.

The noise was of course shattered by the hullabaloo of the acute receiving unit.  It’s about this time that beds become scarce.  Xmas isn’t too bad.  Not that illness is any less prevalent.  I think many people have this idea that they should ‘hang on’ over Xmas so by the time New Year comes they are usually pretty sick.

The only new year resolution you hear about is trying to get through the day without writing last year’s date in the notes.

Another thing you’ll hear people say is “When can we get back to normal?”.  Normal in the NHS is usually defined as a fully functioning multi-disciplinary team and various other departments working ‘normal’ hours e.g. social work, pharmacy etc.

To be honest I’m not sure there is a normal anymore.  When you have the head of the Red Cross talking about ‘responding to the humanitarian crisis in our hospital and ambulance services across the country’  it is not surprising that people may feel like they are working in a war zone.

Add in the changing language that some in management use (we don’t board, we transition care…) and it also has the feel of that scene in Titanic when the string quartet played as the ship sank.

So when I came across this book the other day I thought ‘You know what, yes! This is a book I need to read and apply in my working life’

I even showed it to colleagues and suggested we use it as a template for future job planning sessions.  Much hilarity!

However predictably I started to find it less funny.  In fact I was a little worried.  Not that I had any time to mull on it – work, work, work…….

Periodically that sense of unease would work itself to the surface.  I’d try to latch on for a closer look but some other issue would divert my attention.  It was only when a comment about the ‘prickliness’ of work colleagues came back in my mind did I really stop and think.

We were desensitising.

Now most of us are already desensitised to the minus X bed emails and phone calls (people are usually referred to as beds before ‘transitioning’ to patients).  No, my worry is we are desensitising to each other and that we’re too busy to notice or care.

So with this in mind one of my aims for the coming months is to try to bring people together again.  I’ll be honest, I’m not sure how successful I’ll be but I think its worth the effort.  If history tells us anything then we owe it to our NHS and the people it cares for.  That it includes the people working within it…..

I’m always in a reflective mood at this time of year.  For me Xmas brings a sense of renewed hope and possibility.  So it’s in this frame of mind that I am casting a backwards look over my shoulder to the year that has been.

I started in Forth Valley just over a year ago and it has gone by crazy fast!

The challenge of starting somewhere new can be quite daunting.  A friend of mine cautioned me ahead of the move that I would no longer have a ‘support network’ to lean on.  At least not to begin with. Grateful for the advice I set about putting on a metaphorical life jacket prior to getting on the boat.

My first year in Forth Valley has been more like trying to navigate a boat in choppy seas.  Sure there have been periods of calm and work is plain sailing.  However all too often though the sea has been littered with icebergs.  I think it would also be fair to say that on occasion, I have sailed directly towards the icebergs in order to force hidden issues to come to the surface.

Sometimes this approach has worked very well.  What could be described as ‘confrontations’ have produced some of my best working relationships.  There are some collisions that have not ended as well.

I am trying to go with the ebb and flow of this new working life. Those who have worked with me in the past will testify this is not a change that has come easily to me.  That said there is still work to be done and my focus will always be on what is best for patient care.  How I personally go about working with others will not always be a perfect.  As I was reminded recently I am only human.  I will make mistakes.

So my thoughts turned once more to our Chief Medical Officers report on ‘Realistic Medicine’ in particular these points:

• How can we reduce unwarranted variation in clinical practice to achieve optimal outcomes for patients?

• How can people (as patients) and professionals combine their expertise to share clinical decisions that focus on outcomes that matter to individuals?

How can you standardise the machine of human nature when the two most commonly heard phrases I have come across this year are; ‘that’s not how we do things here’ and ‘that’s a job planning issue’. It is like being up against a proverbial brick wall.  I should stress as well that this is something that you will hear across many NHS organisations.

Now I am not suggesting we become totally altruistic in our pursuit of person centred healthcare. We do need though to somehow strike a balance between what matters to us as healthcare professionals and what is best for the service and ultimately the patients.

Do I have a solution that will see this brick wall come tumbling down?  No I don’t.  To be honest I worry more about the other side of the wall these days.  The sledgehammer approach takes a lot of energy.  Energy that is needed to guide people through a new landscape when the wall eventually cracks.

So back in my boat it is less full steam ahead and more of a steady flow. I will continue to look out for ice bergs and carefully navigate round them.  Keep my eyes on the horizon.  Looking behind will only serve to give me a crick in the neck….

Merry Xmas everyone!