Boxes

As I head from one busy week into another busy week not only do I find myself looking forward to Christmas and a bit of a rest but I also find myself reflecting on the past week.

This week has been spent mostly with my head buried in my computer but on Thursday my faithful laptop was left at home as I headed off to a day long workshop as part of the NHS Leadership Mary Seacole Programme.  It was a fun day but a day of boxes, of being put into boxes and of being a little rebellious against the boxes.

boxesSome of our pre workshop work was to complete some questionnaires one of which looked at our learning styles.  With my learning style putting me in the “Converging” box meaning I prefer to learn by solving problems and finding solutions, I am very much a “do-er”and that I am apparently happier with the technical issues rather than social issues (being in social media and being a nurse both of which are inherently social I was pretty sure I didn’t agree with this last point at all!)  As the day went on we actually got to stand in our boxes, in a grid marked out on the floor we stood in the box that applied to us and we got see where everyone else in our group was.

box3During the lunch break we sat in smaller groups and I sat with a group of people I didn’t really know and one of them asked about the work I do in social media so I explained.  Everyone was very enthusiastic but as we were going back in to the workshop one person, in a very nice way, suggested that as I was far removed from frontline nursing and how could I really know what it is like and how could I know the challenges front line nurses face. Unfortunately there was no time to explain that actually, I am a nurse, I am still a nurse, not only do I still nurse on the frontline but also even if I didn’t I would still be a nurse.  I have to admit to feeling quite cross as I sat down … it felt like I had been put into another box.

Later on in the day our facilitator was explaining a model to us  –it looked like this:

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box2A BOX !!! The more he explained that if we are in tune to our self (self awareness) in the first box the more this effects the other boxes.  Well I think I must have been boxed out as the more I looked at it the more I didn’t get it … the picture just wasn’t right.  As the facilitator drew to a close he asked everyone how they felt about the model, so I raised my hand and said “This may sound a little odd but the shape of it is making me uncomfortable!” The people in the room laughed a little but by this point I was feeling more than a little rebellious so I carried on and explained that I really had no idea what he was talking about until I realised that actually the model was the wrong shape.  In a model where one action has impact on others a box only serves to confuse people ….. well the facilitator changed the shape of the box to a circle with self awareness in the middle and suddenly it all started to make sense.

Feeling a little braver and having firmly rebelled against boxes I started to look at the rest of the day a little differently and started to apply some social media and nursing thinking to the day.  In social media and nursing the individual is king.  It’s all about the person, it’s all about being centred on one person at one point I time.  Seeing the individual and not the box they are in.  As I looked beyond boxes that afternoon I started to see that leaders come in all shapes and sizes, they come from all backgrounds, they have a variety of skills – some are noisy and forthright and some are quiet and shy but each person has their own qualities to bring.  One of the great things about the NHS Leadership Programme is that it is bringing all of these people together and it’s giving them the tools and support to empower them to lead. It was a great day and I certainly learnt a lot not only about models, theories and frameworks but also about the people in my group.  However I am not so sure about boxes.  I don’t like being put in one at all! I like to keep things simple and just be individually and uniquely me.

A patient focussed #NurseCommunity

magEver since Robert Francis released his reports into the Mid- Staffordshire Foundation trust and the appalling standards of care we have been bandying about the phrase “patient centred culture” We are all tasked with putting our patients needs at the centre of everything we do … and rightly so.  As a nurse I firmly believe that patients need to lead their care, we need to work in partnership with our patients to ensure that we meet their needs with care and compassion, there is no doubt in my mind that this is what nursing starts and ends with .. the people we care for.  However as I embarked on my NHS Leadership Academy programme this week I was somewhat thrown into a flux as I pondered on the question – do we focus enough on the people we care for in our social media spaces? And how can nursing social media interaction be more patient focussed?

careSo lets be clear here – I am not just talking interacting with and caring for patients via social media, (although I know that many people are making great strides and are pioneering fabulous work in this area) I am talking about our interactions, our discussions, how and what we share .. is it patient focussed? Do we take what we share and learn and apply it to enhance the way we care for people? When we discuss a topic do we know what the issues are that are important to the people we care for?

This weeks WeNurses discussion was around pressure ulcers and I tried something a little different – before and during the discussion I tweeted a link to the Francis Report with reference to the section where patients and carers comments about pressure ulcers are and I tweeted a link to a Patient Opinion search about pressure ulcers, where there were many patient and carer comments. It was nice to see that the links I tweeted were retweeted a few times and it was also nice to see that we had some patients taking part in the discussion and sharing their perspective (as we often do with WeNurses discussions) But was the chat patient focussed ? Well some of the key concerns of patients (using both links as an evidence base) were discussed – concerns over pressure ulcers occurring and the relationship between pressure ulcers and quality of care.  But was this purely by chance these were discussed as no one asked what is important to the people we care for in relation to pressure ulcers?  There is a certain part of me that says that as caring, compassionate and in some cases experienced nurses we have an instinct for what is important to the people we care for – but equally there is a part of me that thinks we should always check and should always ask that question.

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My leadership journey this week has led me to many questions:

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  • How can we ensure that what we talk about is important to the people we care for?
  • How can we be sure we are not missing the point?
  • What can we do to make our online social media activity more patient focussed?
  • Is a more patient focussed online nurse community realistic and achievable?
  • What changes can I make to help the online nurse community become more patient focussed?
  • And at the end of all of this how do we prove that nursing interaction via social media does put the people we care for at its heart and makes a difference?

I am not sure I know the answers to all of these questions …… yet …. and I am sure that these questions will invariably lead to more questions and I can see my work load increasing as my thought processes progress … however I feel reassured in the knowledge that there is a strong and dedicated nursing community out there.

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I put men into space

nhsleadeThose of you who are very eagle eyed may have picked up through my tweets that a while ago I applied for and was accepted onto The NHS Leadership Academy’s Mary Secole Programme.  I count myself very lucky to have been successful in my application, as I am not an NHS employee, however I am infinitely passionate about nursing and connecting and supporting nurses to improve patient care through social media, and I am grateful that someone at the NHS Leadership Academy recognised this and gave me a xxxxxxxxxxxxxxxxxxxxxxxxxxxplace on the course.

The Mary Secole Programme is a year long commitment of mostly online study but interspersed with meet up sessions. Yesterday was the first session, a meet up with our tutor and tutor group and our official start point of our course.   I have to say I was really quite nervous.  Those of you who know me know I am not the bravest of people and a little bit of a worrier – well my worries were very much getting the better of me.  My primary concern being that I am not in a traditional leadership role, I lead and organise a group of nurses in social media who I mostly never see or have direct management responsibility for so I was breaking out into a cold sweat about how exactly I would be able to complete the assignments given my role is so different. However despite my fears and anxieties I put one foot in front of the other and off I went to meet my fellow students and tutor.

courageThere were about 20 of us in total and it was clear to see that I was not the only apprehensive one in the room but our tutor was very adept at putting us at ease and soon had us talking about our hopes and fears – of course my fears were something I had thought about A LOT but my hopes – well my hope is that I will learn more about how I can inspire others and how I can adapt as our online communities grow.  Somehow by talking about our hopes we all relaxed and our fears became a little less frightening.

Our tutor organised us into smaller peer groups – groups of people that we would spend the next year being supported by and supporting – my group is a really diverse group with a variety of experience – theres me (obviously!) an estates and facilities director, a surgical staff nurse, a senior PICU staff nurse and a library manager .. of course we all joked about how fortunate we were to have a librarian amongst us and how she was definitely our new best friend but in reality we soon realised that we were excited at the possibilities of having such a diverse peer group.

astOne of the things that struck me throughout the day was the amount of experience but lack of confidence in the room.  The room was full of people who make a huge difference to patients every single working day but in their own eyes they were “just” a nurse or “just” a physio and this is something I have been guilty of myself at times.  Our tutor told a very powerful story of a US presidential visit to NASA where the president (she was unable to recall which one and I have been unable to find out on google, so apologies) spoke to a variety of NASA staff.  The president was also introduced to a cleaner and the president asked the cleaner “What do you do?” and the cleaner replied “I put men into space” This is certainly something that we all need to learn in healthcare as it really does boil down to the fact that no matter what your role is in healthcare, whether you are a cleaner or a chief executive we all do the same thing – we all save people’s lives, and this is something we should be proud of. 

I still have my fears, I am still nervous about how I will complete assignments but I am certainly up for the challenge.  It will be hard work but I have my wonderful peer group for support.  I know I will have to do some creative thinking in some areas of the programme but I now have a little confidence, the recognition of my hopes and the knowledge that even though I am “just” a twittering nurse I too save peoples lives.