Oxygen

I quite often listen to Radio 2 as I go about my day to day life, it’s on in the car, the kitchen and even the office, I like the mix of music and chat … this week Chris Evans was discussing some rather interesting stuff that really resonated with me.  The section was all about worry and stress and whilst I mostly don’t get too stressed I am a worrier so the conversation was one that I stopped and listened to. Chris and the person he was chatting to (apologies I didn’t catch his name) were talking about how we can cope with stress and worry and the phrase “put your own oxygen mask on before helping others” This was something that I had not heard in this context before and it certainly made me wonder … do we do this in nursing?

Entirely by coincidence last week I ran a series of Twitter Polls through WeNurses asking nurses if they had taken their break that day.  I ran it for 3 days … and here are the results:

Whilst the polls themselves reveal some concerning results the comments made in reply to the polls were perhaps the most interesting part:

 

Not taking a break means that we don’t get to rest, eat or drink.   Hydration amongst doctors and nurses on call (El-Shakawry 2016) is a study that looked at the scale and impact of dehydration on doctors and nurses.  The study found  ”Thirty-six percent of participants were dehydrated at the start of the shift and 45% were dehydrated at the end of their shift” and “Single number and five-letter Sternberg short-term memory tests were significantly impaired in dehydrated participants” This doesn’t even take into account hunger or tiredness … and what about the long term effects on mental health and wellbeing and morale? Not taking a break is a serious problem in nursing and you might argue one that affects the care we deliver, yet from the comments not having a break seems so … well … normal … and .. acceptable!

I wonder if we were to view our breaks as oxygen masks would we think differently about the importance of them? I am not being flippant here, I honestly think that we need to take this approach.  We have to take care of ourselves before we can take care of others – how can we make important care decisions if we are have not rested, eaten or drunk throughout the course of our shift?

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At this point I feel I must confess that I have often been on a clinical shift where I have not taken a break and recently I have been reflecting of why this has happened.  Sometimes the shift has been very busy and there just doesn’t seem to have been time for me to step off the floor .. so given the now established fact that breaks are akin to oxygen masks would I do this differently? Yes I think I will – no matter how busy the shift working tired, hungry and thirsty is counter productive and we need to recognise this.  If I were on a plane and attended to someone else’s oxygen mask before my own I would soon be on the floor gasping for air and we would both be in trouble ! By taking a break this means I can return to my work refreshed and able to care more effectively.

Although taking breaks whilst on duty takes a change in individual mindset I also think that we have to support colleagues to take breaks to … ask them if they have had a break, do that urgent thing for them whilst they go off the floor, reassure them that you will care for that really unwell person and tell them that in order to care effectively they must take care of themselves.  We also need to address organisational culture – is it normal in your work environment that people take breaks? How can we make this a good thing to do? How can we check that people have had a break? How can we support people to take breaks?

The choice is simple – we can either care until we drop, leading to unwell nurses and poor care … or we can take a break and breathe in the oxygen that enables us to provide the very best of care.

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The problem with resilience

I think that’s it’s time to open up the debate on the term resilience – I have a problem with resilience, I know its en-vogue currently for nurses to be resilient, and in theory I get why, but in reality I am not so sure.

How about we start this with a definition …. The internet says resilience is:

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I think this is where my problem with resilience starts – recovering quickly, bouncing back and toughness are concepts I find hard to reconcile as a nurse.  Here’s the rub .. I don’t think that I am resilient.  When things upset me I often take them to heart, I can find it hard to recover quickly and spring back and I am not sure that I need to.  I feel what I need are good support networks and self-care so that I can reflect and grow from experiences.  When something adverse happens, I don’t want to be resilient, I want to be human, but I want someone to ask me if I am OK … in the same way that I would ask them.

I recall a particularly tough day whilst working as a care home manager a good few years ago now.  I felt really ill, I had a really bad head cold, I had been in work since 5 am, I was dealing with a number of incidents and short staffing.  I had a phone conversation with my manager during which I asked if it was ok if I left early as I wasn’t feeling 100% and had been at work since very early … she told me I had to be more resilient.  I got off the phone and sat and cried.  Whilst I was crying at my desk another of my managers walked in – he asked, “are you ok?” Of course, I wasn’t but he sat and listened. We brainstormed a few things to help with the staffing and the incidents and he told me to go home and rest.  The first manager epitomised everything I hate about the term resilience and the second show cased everything that is right about supporting one another.

woman-1006102_1920Having had a few discussions on Twitter about resilience I can understand that it’s not the term itself but perhaps how we apply it.  With this in mind it is only fair to look at resilience in the context of health (and not just an internet, black and white – definition) Murray (2014) states:

Resilience can be defined as ‘the ability of an individual to cope with and adapt positively to adverse circumstances’. Resilience has been identified as comprising a serious of personality traits such as optimism, self-efficacy and hardiness which enable an individual to cope with increased adversity. Increasingly, resilience is viewed as the combination of internal and external factors, a dynamic process which develops over time and one which can be learned” 

I agree that we need this! I agree that as nurses we need to be able to cope with increased adversity and yes I love that resilience could be a combination of self-care (internal factors) and support (external factors) I do take exception to the word “hardiness” here but let’s set that aside as the definition within the context of health sounds pretty utopian to me and perhaps what we should all be aiming for. To me though this description is not resilience as I have seen it.

This leads me to think that resilience is the wrong word, I think that it does what we are trying to achieve in nursing a huge disservice.  This isn’t about toughness or bounce-back-ability this is about support and self-care. It’s about what we do to take care of ourselves and what our colleagues and organisations do to take care of us.

So what is the way forward? How do we equip the nursing profession with the skills to cope with adversity? I don’t think that anyone has or ever will become more resilient by a colleague telling them that they need to be resilient! The term resilience, when used like this, seems rather like telling the profession to “man up”! This is not healthy or productive.

I rather like what the police are doing…. Have you heard of Oscar Kilo? There is a great link here that explains all > https://oscarkilo.org.uk/about/ The Oscar Kilo website states

 “We need to get the message to our staff that “it’s ok not to be ok””

Oscar Kilo doesn’t talk about resilience it talks about health and wellbeing.  It acknowledges that policing is tough and that people are affected by the things they see and the role they have but it focusses on support, health and wellbeing.

Screenshot 2017-07-03 12.06.36I guess at the heart of this is that I feel that the term “resilience” is a spoiled fruit.  I can see that there are good intentions by encouraging nursing and nurses to be resilient but I don’t think that this term can be used as its synonymous with hardiness, bouncing back, being tough and manning up … and do you know what … it is ok not to be ok!  I think that we should acknowledge that nursing is tough and learn and grow form this, support ourselves and each other … ask that question to yourself and to colleagues … are you ok today?

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Reflecting on a discussion

It’s not long now until I have to revalidate for the first time and I am trying to be super organised.  As my revalidation date is at the start of September I thought it best to get everything sorted this side of the summer.  I have always been an overly organised person – when we go on a long dog walk I’m the person who takes bite cream and plasters just in case! My revalidation is no exception – I have lost count of the amount of times I have logged on to the NMCs revalidation website - to the extent that I apologise to the NMC as its me who is bumping up your visitor figures, which are sure to drop post September!

I now have my portfolio ready.  I opted for a paper version in the end – I can hear you all saying “what?” – however I tried digital but felt that I needed to really see, touch and visualise my portfolio.  I think that this has something to do with the way I learn, I need to use as many senses as possible and my revalidation is no exception.

IMG_2729I have divided the portfolio into colour-coded sections that correspond to each revalidation requirement. I have my feedback and have completed my reflections.  And this week I had my reflective discussion.

IMG_2730I have an unusual role being a self-employed nurse working in social media so I was a little worried about my reflective discussion.  I approached a fellow nurse, Wendy,  who tweets who I respect and who’s opinion I value and she kindly agreed to help.  We live quite far apart from each other so we decided to use Skype.  I emailed her my reflections so that she could read them before hand and we both sat down with a cup of tea and Skyped.

Having never experienced a reflective discussion before I’m not sure that I knew what to expect.  I was worried about being put “on the spot” or having to answer tricky questions but it wasn’t like that at all.  Wendy made me feel at ease, she used phrases like “I was really interested to read……” and she related my reflections to her own work and experiences.  We found that there were similarities in situations we had come across, particularly one challenging situation that I had reflected on,  but we had dealt with them differently.  We were able to look at why that was and how we would perhaps deal with similar experiences in the future.  We chatted for almost an hour – and stayed on topic ! I can’t thank Wendy enough for making the reflective discussion a positive and worthwhile experience.

The whole discussion has left me reflecting …. Did the reflective discussion help me to become a better nurse? I think perhaps it has …. It gave me time to stop, articulate thoughts, share experiences and understand the reasons for my actions.  It helped me to reason why I felt the way I did about some things and in turn I feel that this will help me in the future in applying learning and learning from experiences and feedback. I think that it has also given me a bit more confidence, people often say that a problem shared is a problem halved perhaps this is true for reflecting on challenging situations. There is a part of you, when faced with a challenging situation, that thinks “is it me?” By reflecting and discussing it can help with that feeling of being the only person to have experienced this and give confidence to act as needed in the future when faced with similar situations.

I hope that if ever I am asked to have a reflective discussion with someone I can do it to the same excellent standard as Wendy did for me, I certainly have a great role model to follow.

At the end of the discussion Wendy asked if I had someone to act as confirmer – I sheepishly said that I hoped that she would consider doing it and again she kindly agreed.  However my hefty, well organised portfolio is somewhat of a challenge in itself – so we decided this was a great excuse to meet up and catch up in person …… I will be hiring a trailer for my portfolio ;D

 

 

Gathering viewpoints – having & eating cake!

I have been engaged in a few projects recently where we have taken the time to step outside of the expertise in the room and ask people beyond the project their thoughts and ideas.  Now we all know that in theory this is what we should do .. but in reality is it really worthwhile?

I have to admit to being sceptical at times about things we ‘should do’ and often subscribe to the ‘just get on with it’ approach.  Working in social media things are very instant and getting on with just doing it is essential. Social media is fast, we try new things constantly, some work and that’s great and some don’t so we either move on or adjust.  To have to stop, take time, ask people what they think is perhaps a concept that doesn’t sit naturally with social media.

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This all presented a bit of a dilemma for me – do I stay true to my social media roots and just go for it or do I stop, gather opinion and delay? But why can’t we have our cake and eat it? Why can’t we get on with doing things AND gather opinion in a timely manner? The more I thought about it the more I thought … we can !! We have the power … social media !!

Sometimes the solution is staring us in the face and screaming very loudly “look here” Social media is a great way to gather opinion ! So here’s what we did:

The first project we developed a tweetchat, asked for ideas and thoughts and then discussed those ideas and thoughts to develop a concept.  We then developed a blog to share that concept and from that held another tweetchat to discuss the concept.  I can now see this becoming a cyclical thing as the project develops:

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The second project was a little more complex so we felt we needed to actually talk to people.  We posted a blog asking people to help, we then held a webinar and gathered opinion and this then fed into the project.  The process was quick, easy and effective.  We recorded the webinar and captured all the typed comments too so we could refer back.

Was it worthwhile? In both cases I would wholeheartedly say YES!

On both occasions other people saw things that we had missed.  We received constructive feedback that confirmed our thinking in some places and enhanced it in others.  On one occasion the feedback was the polar opposite to the plan so we listened and adjusted .. and thank goodness we did as this was instrumental to the success of the project.

The value of listening to what other people think is beyond measure however I don’t think we have to stop to do it! Social media is a fantastic resource for garnering opinion, you get a wide range of views in a short space of time in formats that are easily captured for future reference or analysis.  My learning here is yes just get on with it and yes listen to others views but the two things are not necessarily exclusive – we can have our cake and eat it!

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Up Pomphrey!

I have been running for a while now and pretty much just stick some tunes on and plod on all by my lonesome.  Though every Sunday I do a 2k Junior Parkrun with our youngest … apart from that I stick to running by myself …. until now !

In my wisdom I thought I would give our local proper grown up Parkrun a go – “Pomphrey Hill” – I spent some time reading up about it, where it was and the course terrain.  I wasn’t familiar with the park but the blurb said “mostly flat” with “a small hill called Up Pomphrey!” (The exclamation mark at the end of Up Pomphrey! confused me somewhat ) It was 3 laps finishing on a downhill. Sounded perfect ! I’m not too good at uphill, I don’t mind the flat and definitely live for the downhill, so the run sounded ideal.

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Saturday came and off I went.  The venue was easy to find, though I worried slightly as I saw some eager participants running to the run (yes it seems people do that!) and I had a fleeting thought that I would be the only reluctant runner amongst a sea of super fit experts and suddenly regretted going on my own … so I Facebooked a post about being alone at the Parkrun and was fortified by a response from Kath Evans who posted a pic of herself at her local Parkrun.  Feeling empowered by support I headed to where people were gathering.

As we were all herded to the start line I suddenly remembered my headphones … which were on the hall table at home! I hardly ever run without the aid of some cheesy feel good music and waves of panic washed over me again.  I mentally gave myself a stern talking to and got on with joining the pack ready for the start. I headed for the middle of the pack, thinking I didn’t want to be at the front with all the serious folk but also I needed a bit of a head start being the slow runner I am.

mobile-605422_1920The course organisers then proceeded to give us all a talk on the course, stating pretty much what it said on the blurb on the website.  I was a little perplexed when the course organiser got to the “small hill” part and said “Up Pomphrey!” And the whole pack shouted “UP POMPHREY!” But I put it down to being just a local thing and started limbering up for the off.

I started at a slow pace but was happy to see an older lady in front of me and thought perhaps I will just go at the same pace as her.  There was a little incline to start with and I thought that maybe this was “Up Pomphrey!” and was quite pleased with myself for jogging up.  We then headed downhill and I was pretty much keeping pace with everyone, I was missing Bananarama and Joe McEldrey via my earphones but hey … I was doing it… I was running!

Then we turned a corner and I can only describe what was in front of me as a small mountain! I now fully understood the exclamation mark and the “UP POMPHREY!” Oh my dear lord .. how on earth was I going to get up there? And not just once but three, yes three, times.

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Well I made it halfway up the first time and I then slowed to a walk before medical assistance would need to be called for.  The second time I did about 50 yards before my legs turned to jelly, by this point people were starting to lap me! Yes those serious runners at the front were lapping us mere mortals desperately trying to cling to some sort of dignity.  At this point I seriously missed my headphones to the extent that I think I started humming Gloria Gaynors “I will survive” I also seriously questioned my wisdom … what on earth was I doing? This was no way to spend a Saturday morning. By lap three and “Up Pomphey!” three I had lost the older lady, she had run off ahead, I was lapped by a man pushing an infant in a pram, was lapped by two dogs, a small child and Batman …. but I kept going.  I kept putting one foot in front of the other.

I eventually reached the top for the final time and headed downhill to the finish.  As I ran the last 200 yards the volunteers at the finish line were cheering me on, telling me to run all the way …. I did it!

I came a whopping 317th !! I collected my little ticket and headed over to be scanned.  As I did I noticed that there were lots still behind me, I checked my time and I had ran the 5k in 34.11 which isn’t too bad for me. According to the email I received later in the day I came 15th in my age group, which I think sounds quite impressive.

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As I headed to the car I felt exhausted, thirsty and bloomin hot.  I downed a bottle of water and headed home with the aircon on full and feeling quite elated. As I walked through the door my husband said “how was it?” I replied “It was awful, I hate running” to which he asked “so are you going again?” ……. “Yes” I said ;D

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A reluctant runner!

Did you know I took up running ?? I say this with a smile on my face as I really don’t shut up about it, I have turned into one of those insufferable people who post running times, maps and Fitbit stats on Twitter .. in fact not just Twitter I post them on Facebook too .. nowhere is safe! But I am not sorry, not in the least!

Almost 2 years ago now we ran WeActiveChallenge for the first time.  Encouraging health care professionals to get active and share their activity for 2 weeks in August.  WeActiveChallenge is the brainchild of those fab WeAHPs – namely Naomi McVey (@NaomiMcVey) and Jo Fillingham (@jkfillingham) - an inspiring duo, who I can’t thank and praise enough for getting me moving! My activity levels increased slightly, from nothing to some walking.  We then got a dog (prime excuse to share a picture of Muppet the dog) and my activity levels increased a bit more … still walking but a bit more often.

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A year ago we repeated WeActiveChallenge and the tweets started to have an affect on me …. They made me think.

Both my mum and my brother have had heart bypass surgery, my grandmother died of a stroke and my grandfather died of a heart attack.  In addition to this I was starting to feel “not right” I had periods of anxiety and days when I found it hard to keep going, I felt tearful and generally stressed, I also had physical symptoms – heavier periods, headaches, fatigue and restless legs! I knew my mum had gone through the menopause early so I was genuinely concerned that this was me for the rest of my life!! I went to the doctor and had the blood test and everything came back normal … the doc said I could possibly be pre menopausal .. this did make me laugh, (which was a big relief from the crying) as don’t we spend all our lives being pre menopausal ? I started reading about what would help and taking care of yourself with a good diet and exercise was top of every list.  Whilst this was all going on #WeActiveChallenge was quietly infiltrating my social media streams and my thoughts…. So in late August (the week after WeActiveChallenge finished) I downloaded the Couch to 5k app (free!) and bought some running shoes.

The first thing I learnt was that I hate running! Running makes me feel like my chest is about to explode and I need Ventolin … stat !!! The next thing I learnt was that I needed support in order to keep going … so I tweeted and facebooked about what I was doing, and I was amazed at how many of my friends had done the same.  There was lots of support out there.  It’s been hard and I still dislike running, I still feel like I need an inhaler of some description … I am a reluctant runner and some days I really don’t want to go out.  The app helped in the early days as I wanted to get my ticks for each day. Tweeting my app stars and ticks helped too as the tweets I got back were so positive and encouraging.  The app is a 9 week programme and I kept going to the end … and then I felt a little lost! What now? So I started using my Fitbit, starting tweeting and facebooking maps and stats and personal bests – the encouragement and support was awesome.  My currently goal is to do at least 30 mins of exercise a day and get my green heptagon Fitbit shape at the end of each week.

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So how do I feel … pretty amazing actually ! I am sleeping better, I have dropped two dress sizes, I no longer feel “pre menopausal” and I am definitely less stressed.  I don’t love running but I love the feeling it gives me and I love the social media community that it has given me.

I am really looking forward to #WeActiveChallenge this year, infact I can’t wait to have an excuse to tweet pics. It’s taken time for me to change my behaviour but the positive role models that I was exposed too played a huge part in that change and the support that people gave me (and continue to give me) through Twitter and Facebook has had a huge impact.  Social media certainly affected my behaviour and infact I would say it played an instrumental part.

What is nice now is that I am seeing friends now starting the Couch to 5k and I am trying my hardest to support them as I was supported. My daughter, who is 10, now runs at least once a week and we cycle to and from school. I am going to keep boring people with my running tweets and Facebook posts and I am going to continue to be totally unrepentant.  Social media has changed me, it’s helped make me fitter and healthier, it’s helped me to change my lifestyle. I firmly believe that social media is a brilliant tool for public health and changing our habits and adopting healthy alternatives.  Social media exposes us to and connects us with people and ideas we may not normally encounter, it broadens our horizons and gets us to see that there is a better way … it’s pretty fabulous stuff :D

What makes a good blog?

After months of not blogging rather surprisingly @SarahChapman30 tweeted me asking for some advice on blogging.  Luckily she also copied in @AnnieCoops and @ProfJuneG too – who blog in a slightly more organised and less rambling way than myself. The Twitter thread unravelled some great suggestions and you can read it HERE. The conversation got me thinking …. What makes a good blog? Not just for the reader but also for the writer.  Yes blogs need to be readable but they also need to be manageable.  So this is me writing some top tips down on paper … perhaps more for me than anyone else, that way I might actually manage to successfully resuscitate my blog:

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Find a platform you like and is easy for you to use – it really doesn’t matter which platform you use but its important that you get on with it, the last thing you want to be doing is getting hot and bothered because you can’t figure out how to post your blog online.  I use WordPress but some simple solutions include LinkedIn, Blogger , Tumblr & even the WeCommunities community blog ( and lots more too!)

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Blog regularly – I subscribe to (and often fail) to the theory that if you blog regularly, even if infrequently, then your readers know when to expect a blog.  In theory it makes sense, sometimes the reality is a little different.  It’s perhaps a good idea to decide how often you want to blog and then double that time period so if you think you can manager weekly blog every other week.

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Don’t be hard on yourself – In relation to the above if you don’t manage to blog regularly then don’t be too hard on yourself, the world will keep turning and people will survive

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Blog from the heart – remember this isn’t an academic piece of work, it’s personal, it’s you ! Whatever the subject matter blog about your thoughts, feelings and reflections.

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Keep it short … or not – I always aim to keep my blogs short as it makes them easy to read on a mobile phone and as someone with dyslexia the struggle to read large bodies of text is real! However there are times when more needs to be said … so say it, don’t be confined by word count

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Experiment – Experiments with styles – try reflections, lists, stories, add in tweets, add in pictures or infographics and in addition to this remember blogs don’t have to be written, try video, audio, or even blogshots.

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Tell people you have blogged – ok so I find this bit difficult, it’s self promotion basically and something that a great many of us are uncomfortable with.  I know I don’t promote my blog posts enough – however I liked @anniecoops suggestion in the Twitter thread linked above … promote for 48 hours.  This feels comfortable for me so I may give it a go

bicycle-1533130_1920Have a few blog posts in the bag – this was @ProfJuneG’s suggestion (again please see the linked Twitter thread above) and something that I had never considered, but it seems to make sense.  If you have time and the inspiration then write away whilst you can and save them for a rainy day.

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Make notes – I have a specific note on my phone that is called “Blog ideas” The reason I have this is that I often think  “that will make a good blog” and then totally forget my thought process by the time I get to a laptop.  My phone goes everywhere with me so it’s a good place to jot down thoughts as they come.

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Subject matter matters – when I first started this blog it was going to be all about social media and nursing, however what I have learnt is that it ok not to be specific and fixed in your subject matter.  Blog about what matters to you at that point in time …don’t put your blog in a box, go with the inspiration.

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There are no rules – so having come up with a definitive list of top tips the final point is that these are not rules, more like loose guidelines that are open to interpretation and amendment.  Go with what feels right for you, what you can manage and what fits in with your lifestyle.

So, Dear Reader – here’s hoping that this not only helps you to get blogging but also that it helps me to put pen to paper more often.  I am now off to write 6 more blogs so I have them in the bag and to pimp this blog post for the next 48 hours !!

Thank you @SarahChampman30 @ProfJuneG and @AnnieCoops for spurring me into action :D

That will never work !!

I recently asked a question via a Twitter Poll about nurses use of social media:

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The results didn’t surprise me too much but what did surprise me was some of the tweets i received in response to this poll. What most surprised me were the comments made in relation to using social media to communicate with the people we care for, some people were quite adamant that nurses should absolutely not engage with the people we care fro within social media spaces …. I feel that I need to challenge this thinking and ask “why not?”

With more than seven in ten internet users having a social media profile and two thirds of adults, with a profile,  using a social media site more than once a day (OFCOM 2016 ) it could be argued that social media is becoming the default way to communicate.  Particularly when I think of my teenagers social media is such a normal way for them to talk and communicate with others. So why are nurses reticent about using this communication tool to communicate with the people we care for?

The NMC Social Media Guidance does not discount engaging with patients on social media it quite rightly mentions confidentiality and not using social media to build or pursue relationships with patients, which gives us some scope to embrace the power of social media to engage with the people we care for. There are obstacles to overcome – privacy ? – confidentiality ? – do the people we care for want to engage with nurses in this way ? – to name a few … but surely the possibilities are there if we dare to think a little differently? Can we really write off social media as a means of communicating with the people we care for? I’m not sure that we can.

I think that even though there are challenges with communicating in social media spaces as nurses we will overcome them, we will evolve and the technology will evolve to find a way that works… as this is how people want to communicate.

Whilst contemplating this and browsing the internet I came across this rather interesting blog “15 Worst Tech Predictions Of all Time” Documented here are the naysayers, the people who said ‘that won’t work’, and boy did they ever get it wrong … among the worst predictions are:

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1876: “This ‘telephone’ has too many shortcomings to be seriously considered as a means of communication.” – William Orton (President of Western Union) – errrrmmmm the telephone is pretty much the basis for modern communication.  If we look at healthcare alone … how many times do you use the telephone during your working day? What about NHS 111 ? Teleconferencing? Telephone consultations?

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1981: “Cellular phones will absolutely not replace local wire systems.” — Marty Cooper, inventor. - just take two seconds to appreciate the proximity of you mobile phone. I bet it’s within hands reach.  Of course without advances in mobile communication community nursing and mobile working would be so much more challenging!

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1995: “I predict the Internet will soon go spectacularly supernova and in 1996 catastrophically collapse.” — Robert Metcalfe, founder of 3Com. - yep!! someone actually said this!! If i have all the time in the world i bet i couldn’t list what the internet has done for health – online journals, NHS Choices, sharing of information, blogs, videos … ahem … SOCIAL MEDIA!!

So in 10 years time when we are tweeting our virtual GP, Facebooking our midwife or have a Instagram outpatients appointment will we look back and say how daft we were to think that we would never be able to communicate with the people we care for through social media? Well I don’t have a crystal ball so I am not entirely sure … however I do know that without exploring the possibilities we will never realise the potential.

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A challenging week

Challenging practice is perhaps one of the most difficult things that a nurse has to do.  Seeing practice that is harmful or potentially harmful is not only upsetting but also can be very stressful.  Having found myself in a “challenging” situation this week I can testify that it makes you question yourself, your judgement and your motives in all sorts of ways.  Whilst I won’t go in to the in’s and out of my situation it’s suffice to say that I had concerns over some practice and raised them.  It wasn’t easy and took courage and thought .. however I am left reflecting on several things:

The NMC Code clearly states:

“You make sure that patient and public safety is protected. You work within the limits of your competence, exercising your professional ‘duty of candour’ and raising concerns immediately whenever you come across situations that put patients or public safety at risk. You take necessary action to deal with any concerns where appropriate.”

As nurses we must raise concerns immediately whenever we come across situations that put patients at risk and we must take necessary action …. It couldn’t be more easy to understand.  And yet I am not sure that everyone understands that nurses have this professional duty.  Most nurses I have met have an understanding of the code and where their responsibility lies – but the difficultly comes when we work with people who are not nurses.  Do they understand our code as we do? Do they even know what our code contains? Do they understand our professional responsibility? I think the answer to this is, sadly, sometimes no!

Which leaves me with a question …. How do we resolve this?

The fundamental problem is that often until we challenge and raise concerns we are unaware of how others will take this and what their understanding is.  My concerns and challenge to thinking this week was met with shock that anyone would dare to raise concerns and what appeared to be a lack of knowledge that this is what nurses have a duty to do! We have to be that voice that says “what about the safety of the people we care for” we have to stand firm and take the action needed to ensure the care of our patients remains at the heart of all decisions both clinical and financial, but until we actually do this we never know how it will be received.  I understand that it’s human nature that when someone challenges you it can be hard to listen, as it can seem like a criticism, and although we have to take this into account when we challenge, we must not let it confine us.  I think that there is some work to do here in educating others in our code and how it translates into practice and I think that we as nurses should use our code more to help and empower us to do the best by our patients.

Another reflection I have is that what happens when your challenge to practice or approach is taken negatively by the people you challenge? What do you do then? This is when you start to question your own judgement … it’s the “is it just me?” thought process.  This becomes even more difficult if you are challenging upwards, that is to say challenging managers or directors as you can be working against the system.  Raising concerns is not easy.

My last reflective thought is – oh wow its stressful!!! Lots of thoughts spinning through your head, was I right to say something? Am I making a fuss? Why don’t people understand a nurses responsibility? But would I do it differently next time? No I would not.  As someone very wise said to me this week “one day the person you challenged may be sat wishing that they has a nurse to challenge for them” We raise concerns because those in our care can’t – the people we challenge aren’t our primary concern … the people we care for are.

Even though my week has been awful, even though through raising concerns I have put my head well above the parapet I am proud to say that the needs of the people I care for come, and always will come, first.

Has it really been a year since #WGT16 ?

As we hurtle towards the end of February I have been thinking lots about this time last year and how we were busy plotting, planning, organising and doing in preparation for February 29th and WeGetTogether or #WGT16.  And what a day it was! For me it was definitely one of the busiest days of my life …. lots to do, lots of people to connect with, lots to see. lots of cake to eat and lots and lots to talk about.

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The whole day seemed to whiz by in the blink of an eye …. however I remember halfway through the day taking time out to just sit and watch; I went upstairs to the balcony and just sat for ten minutes and observed.  What I saw was pretty overwhelming; I saw people from all different backgrounds, with very different roles and pace in healthcare doing what we do everyday via social media .. connecting and talking.  You might think “why was that overwhelming?” – well it was overwhelming because they were all under one roof …. we did it! We got together and we connected beyond our virtual spaces.  It was overwhelming because I was just one agency nurse and here I was face to face with people I had connected with.  It was overwhelming because here was the proof that we are not alone and we are all working together with a common purpose.

One of the enduring images of the day was this time lapse video that we created … we see people coming and going, hugging and laughing, connecting and celebrating …. it has to be one of my most favourite videos of all time:

There are many things about #WGT16 that I am proud of:

  • We had an amazing team that pulled #WGT16 together
  • We crowdfunded a whole conference
  • We connected the conference to social media & social media to the conference
  • We raised money for two charities
  • We showed that there is another way of doing things
  • We had a jedi, a giant blue bird and feather boas in the same room!
  • We embraced tech like QR codes, Vine, YouTube, Infographics and Blogs
  • We had some fabulous cake
  • We had the most amazing and inspiring student nurse volunteers helping all day
  • We worked together to create something amazing

What would I change about #WGT16 if I had to do it all again ….. there is loads I would change and tweak.  I would be braver in the planning and trust my instinct more, I would think more clearly about how we connect the virtual experience to the real experience and vice versa, and I would take more time to sit back and enjoy the time with the amazing people in the room.  We said we would hold a #WGT every leap year …. so perhaps, if I am fortunate enough I can take these thoughts forward for #WGT20 !

But what came out of #WGT16, what did we achieve ? NOTHING!!! However I am not sure that this is a bad thing.  Social media is living in the moment and what #WGT16 was about was living in that moment, in that space and that time TOGETHER …. and we did that!

I feel that there is a lasting legacy to #WGT16 and that is the connections that were made, the friendships that were cemented and the conversations that we had ….. I came away feeling that if we can dream it then together we CAN do it ! Anything is possible when We Get Together !

WGT16