Who inspires you?

When the year of the nurse blogging challenge started in 2020 we had no idea of what was ahead of us. Goodness how the world has changed. In January if I’m honest I’d never heard of Wuhan and ‘Coronavirus’ was just the small print on the back of a Dettol spray that I’d never taken more than a passing glance at, this summary from the BBC is a helpful overview of recent weeks

Now with everything focused on COVID 19, caring for those who need it most and vitally keeping staff safe who are providing that care, EVERYTHING has been reprioritised, not only personally but globally.

So the challenge at the beginning of the year was to identify who inspired us, well in recent weeks I’ve been blown away by staff who’ve asked ‘what can I do’ ‘how do I learn the skills that are going to be needed’, along with comments including ‘we can do this’. Team NHS with other essential services, those who make sure we have water, electricity, gas supplies, along with food and the provision of other household essentials (loo rolls!), people who continue to ‘do the doing’ that’s required whilst recognising that for the vast majority of people, the action #Stayathome to reduce the spread of the virus 🦠 is mission critical.

Those of us in Children’s Health care, thankfully have not been overwhelmed in the same way as our adult colleagues. Yet there have been significant issues that have evolved during this pandemic including delayed presentations to hospital of sick children, Tessa, Giles and local GPs of East London compiled helpful information for families to help guide them in decision making.

Challenges have also included training staff to care for older patients, working with reduced staffing ratios, moving to virtual clinics across primary, secondary and tertiary care, pausing elective surgery, whilst making sure that the vital stuff in child health continues, immunisations, safeguarding, emergency care and excellent care for those that need inpatient care such as our neonates and those with complex medical conditions.

Many of the things we’re learning as we progress on this ultra marathon journey will stay with us forever, we’ll change how we do things, make processes slicker, more efficient and effective, but it has been and will continue to be at a phenomenal cost to individuals, families, communities and society.

In amongst all of this are the memories we create for and with children, what will they tell their children and their grandchildren about this time? Certainly the rainbows on windows have inspired me each morning from children offering hope through looking to the future and encouraging that ‘we’ll get through this’.

The poster resources @MonkeyWellbeing has created have ensured we’re providing child friendly information in challenging times, they can be downloaded here https://www.monkeywellbeing.com/resources/posters-leaflets/, wonderful @beciward has a range of colouring challenges too http://beciward.com/category/news/ and @DrKathrynHolden of Sheffield Children’s has developed a great children’s wellbeing resource https://www.sheffieldchildrens.nhs.uk/download/766/coronavirus-resources/9747/self-care-kit-covid-19.pdf

So to return to who inspires me, whilst there are amazing leaders who are doing a brilliant job in the most challenging of times. It’s our health care support workers, our students and junior staff nurses, our newly appointed ward leaders who inspire me most. They’ve been the ones who’ve completed the online learning, done shadowing shifts in unfamiliar environments with new colleagues, who’ve wobbled openly and then got on and done the doing….

Thank you all….

Wonky days …. and joy at work

I was listening to Zoe Ball’s cheery voice on BBC Radio 2’s breakfast show this week when she asked what sort of day we’re having, she encouraged that if we’re having a ‘wonky day’, hang on in there.

It got me thinking that we all have ‘wonky days’ those days when things get out of sorts for a host of reasons and things get really challenging.

We focused a bit more on this at our Children’s Clinical Board meeting this week. Our clinical board brings nursing, medical and AHP colleagues along with the management team who provide care to CYP and their families/carers together from across all sites, we share best practices, address inequities and encourage each other as we all work to provide outstanding care to the CYP and families/carers we serve. Dr Susie Minson shared the work that along with a fab multi disciplinary team she’s been leading to create ‘joy at work’. There’s more information about the IHI ‘Joy at Work’ approach here ‘Joy in Work | IHI – Institute for Healthcare Improvement’ Some of the things that have been introduced following coproduction and collaboration with staff, have included a monthly divisional shared lunch, improved break areas, starting handover with a reflection on what’s gone well in a shift, small welcome gifts for new starters, thank you notes on one year of service, and adopting the ‘you’ve been mugged’ approach (a lovely mug is filled up with goodies and left for someone to show how much they are appreciated). All approaches have all made a difference in enhancing the community that we all work in. It’s been significant to staff wellbeing and recognises the contribution of staff in providing great care day in day out.

@PaedPDNSRLH shared their gifts to staff on twitter recently ….

There was certainly joy too as I was travelling on the underground this week, the cheeriness of the @TfL staff on the Victoria line made me smile with their fun (slightly bonkers) reminders to keep safe, as weery soggy commuters headed into work. Their unconventional unscripted announcements certainly made me smile and lifted my spirits! It’s often small moments of joy that can make the difference in a challenging day.

So when ‘wonky days’ happen (as they often will!) hang on, look around, seek out a colleague, a smile, and if we’re able to be the provider of that smile, word of encouragement let’s be the ones that offer it, a bit like team TfL and the fab Children’s team at Barts Health 😉

How can we empower nurses?

How can we empower nurses? That’s the February #YearoftheNurseandMidwife blog challenge, it’s a good question that’s got me pondering this week.

Perhaps importantly empowering others starts with ourselves and the actions we can take. I remember last year when Ruth May started as the Chief Nursing Officer of England in January 2019 tweeting about creating #TeamCNO and encouraged others to join in. She set the tone and foundation of a culture aiming to include others, bringing them into the CNO team in an inclusive manner. Such an approach can be highly empowering, it encourages people to play their part and make a contribution to the agenda. Ruth through using twitter and that simple hashtag offered ‘permission’ to join in, to be part of the journey ahead as she works to amplify and celebrate the contribution of nurses and midwives across the NHS and beyond.

Sharing information is another way we can empower nurses. Often I worry about forwarding too much information when people are so busy, but in reality I know people are incredibly adept at filtering information that’s relevant to them. One of the great things about social media is we can share information freely, people can tap into it when it’s convenient to them, using hashtags can help in organising content too. I’m always grateful to colleagues who know which issues matter most to me and tag me in their tweets ensuring I get sight of something they think I’ll be interested in.

Encouraging people to set goals can be helpful too, the fabulous Jane of ‘Quiet the hive’ asks us each week to set our three intentions for the week ahead, sometimes I manage to achieve them, sometimes not, but it’s the thought process, the creation of some time and space that is really helpful. Nurses are busy people, not only in work but at home and in the community too, so we all need a little nudge sometimes to create some reflection space and to create goals or intentions to keep us focused.

Its important we acknowledge we work in highly complex environments, caring for people who are often at their most vulnerable, requiring not only expertise in compassion but also sophisticated technical skills. Sometimes we don’t possess all the knowledge we’d like and we may make mistakes. What’s vital is we share them openly so we can learn and address the issues. I remember as a junior staff nurse working in an incredibly technical environment surrounded by wonderfully competent staff, I constantly gave myself a really hard time about not being the expert I wanted to be and it contributed to me leaving after two years in the role, applying for a more generic post in a less technical environment. Whilst I loved the new job, I do wonder if I’d been kinder to myself and had the recognition from others that whilst I didn’t have their technical expertise, I could bring other things to the team may have made me remain in post longer to acquire the technical expertise others seemingly possessed? Colleagues and teams can be hugely influential in creating empowering environments in which we can flourish.

This week on twitter a great infographic was shared…

It seems to bring some key actions together, having a spirit of optimism, setting out a vision of what ‘best’ looks like, growing collaborations, being ‘human kind’, and having a belief in people’s potential. If we universally and consistently adopted theses approaches I wonder what impact it would have on empowering nurses and midwives?

Pondering on partnerships, dialogue and engagement …

It’s been a busy few weeks, I’m particularly in awe of clinical colleagues who keep delivering direct patient care with compassion and professionalism in the busiest of times.

Sometimes though the activity can seem quite overwhelming, the talented and insightful artist ‪@charliemackesy‬ posted this message on Instagram, encouraging us to just take the next step forward, a simple but important message especially when things can seem overwhelming.

I’ve also been thinking about how we all communicate with each other in organisations and grow dialogue about important complex issues, exploring and understanding challenges is one of the most important elements of our roles. The ever inspiring ‪@Sonia_Sparkles ‬ posted this fabulous graphic about the essentials of understanding problems rather than simply reaching for solutions.

This communication is often badged as ‘staff engagement’ and it’s clear we can never do enough of it between staff delivering direct patient care and those in managerial roles. Dialogue needs to be vertical and horizontal and we can all play a part in growing a culture that reaches out, explores issues together, so that we can discover shared solutions to move things forward.

Yet the reality it in the business and requirement to ‘get stuff done’ to keep on top of things it can be challenging to keep engaging ….. then Charlie posted this….

Perhaps a reminder that every conversation is a step in the right direction 😉

Supporting staff engagement and wellbeing comes through in this ‘quintuple’ model of Population Health Management, which extends the original triple aim model of focusing on best use of resources, improving population health outcomes along with enhancing experiences, along with highlighting the needs to actively address health inequalities, it’s always helpful to have a map as we journey onwards!

Saying goodbye to #REDJanuary2020

So it’s here! Day 31 of #REDJanuary or ‘Run Every Day January’

#REDJanuary is a movement started in 2016 by Hannah Beecham who saw the positive difference physical exercise made to her mum who experienced depression when she encouraged her to be more active. She clearly wanted to encourage others to experience the same benefits. With 1 in 4 of us experiencing mental health issues, suicide being the biggest killer of men under 50 in the UK and research overwhelmingly confirming the benefits of physical exercise on not only our physical health but our emotional wellbeing, putting the spotlight of the impact of being more active is hugely welcomed. Since 2017 the charity MIND have also supported @REDJanuary, encouraging people to fundraise too to help raise awareness of mental health during January often a particularly challenging time of year for people.,

So alongside #NHS1000miles, @REDJanuary provided a focus for getting me out each morning in the darkness of January mornings prior to work for a gentle jog, and my weekends have offered the chance for a bit of @ParkRun tourism, and Sundays have included adventures with the Long Distance Walkers Association @LDWA, a local 10miler, cross country, and a navigational 50k ultra from ‘Cold Christmas to High Easter’. It’s certainly been an active month!

Am I fast? no! Have I had fun, and raised my endorphins regularly to boost my mood during the dark days of January, most definitely!

Thank you Hannah, #REDJanuary has certainly helped me keep a focus on being active this month!

Shaping our nursing story

I had the pleasure last week of meeting a new group of staff beginning their qualified children’s nursing careers, it made me think about how we shape our professional stories? Together we explored our passion for nursing others, the difference we want to make to Child Health by caring for our tiniest babies, to working in special schools supporting children with complex disabilities to flourish and thrive, to working in safeguarding, in ED, Paediatric Assessment units, to working internationally, supporting mental health and working specifically with young people, the list was endless. The opportunities available to Children’s Nurses to make a difference are phenomenal and the enthusiasm to do so displayed by the team was infectious!

So what are tips that can help us fulfil our dreams to improve child health and grow our contribution throughout our careers?

Taking the time and creating the space to think about the future is worth the investment. I love the idea of creating a vision board, drawing or writing down our goals, exploring the path ahead and what will help along the way. Seeking out inspiration, from people, events, visits, books, podcasts etc can all help broaden our horizons to develop this vision. I chatted about the benefits of social media in expanding our professional connections. Continuing to progress growth in our knowledge through pursing masters and PhD programmes are important as we work to enhance nursing practice, all these opportunities are ours to pursue.

Investing in self care through focusing on wellbeing, nutrition, exercise, sleep and having fun, are all important too, so that we focus on creating balance in our stories, we could call it personal social prescribing! Better to do it prophylactically rather than as a reaction when things go wrong. I love running and having just listened to Ian Mortimer’s ‪@IanJamesFM‬ book ‘Why Running Matters’ on @ukaudible, Ian confirms the importance of running, it offers head space to ponder on things, come up with new ideas and importantly work out solutions as well as ensuring we’re physically and mentally fit for our roles.

Life is of course complex, during our careers there’ll be many ups and downs, yet facing our fears, seeking help and giving help to others too, can support us in succeeding, along with plenty of practice and perseverance! No matter what, we are never alone, someone will have always faced similar challenges, we just need to keep reaching out.

So no matter how far we are through our careers together we can keep finding ways to succeed. Continuing to improve children’s health and wellbeing is a important challenge that needs a diverse and talented workforce, Children’s Nurses have an important contribution to make, so let’s continue to step forward, embrace opportunities and shape the future.

As I was reflecting on this blog ‪@LeighAKendall‬ shared this via twitter, it serves as a great reminder, keep trying, take one step at a time, importantly know you’re never alone.

Connecting and remarkable people #AdsTalk2020

I’ve been reflecting recently on connecting and networking, New Year meetings often provide an opportunity to step back, refocus and remember the importance of reaching out for new ideas and inspiration.

I often remember Jo Cox, she’s a woman who inspired me and her memory continues to do so, the book written in her memory ‘More in Common’ https://www.amazon.co.uk/dp/1473659183/ref=cm_sw_r_cp_api_i_3SchEb1TXSWHQ is well worth a read. Jo believed in tackling loneliness and isolation, the Jo Cox foundation @JoCoxFoundation continues to champion this agenda.

Whilst we think of loneliness as something that older people experience, in reality it’s something that can affect everyone from across the age continuum from the play ground in school to isolation in the workplace. The NHS Youth Forum speak of loneliness in young people, establishing their peer support campaign to tackle this https://www.byc.org.uk/uk/nhs-youth-forum/peer-support

I’ve often heard people remark how lonely it be can sometimes be when complex decisions and actions are needed, and whilst we all work in teams in NHS, reaching out and networking can decrease loneliness, enhance and develop ideas which ultimately leads to better, richer decisions and outcomes. Spending time connecting and networking is worth the investment, even if the day job can be all consuming!

This week I was able to catch up the ‘wonderful women of ASCEND’ we had a breakfast catch up at Kings Cross. An inspiring colleague Lisa Anderson ‪@lilyand67‬ asked us to describe our 2019’s in one word, mine was ‘muddlesome’ I was slightly more optimistic about 2020 wanting it to be ‘pursposeful’. Part of making 2020 purposeful for me will be about continuing to connect with others.

So I’d like to share an opportunity that’s coming up! The 5th AdsTalk: ‘Shining a light: How patients’ voices can have a positive influence’, (#AdsTalk2020) will be on Mon, 16 March 2020 12:00 – 15:00 GMT at NHS ENgland’s Headquarters, Skipton House, 80 London Road, London, SE1 6LH. This year it will be given by Lucy Watts (@LucyAlexandria) & Amy Frounks (@AmyFrounks) and chaired by Rob Webster (@NHS_RobW).

Lucy Watts MBE is a young adult with a life-limiting condition. A passionate advocate for patients, especially those with complex health needs, life-limiting conditions, needing palliative care and young people in transition, Lucy has proved herself a formidable voice in healthcare. A member of the NHS Assembly, various committees, running patient involvement and advocacy groups and working closely with a number of charities, Lucy was awarded an MBE at the tender age of 22 and was recently voted 9th most influential disabled person in Britain. Lucy aspires always to make a difference and use her experiences constructively to benefit others.

Amy Frounks has been a patient and youth voice advocate since 2013, striving to improve representation of less heard groups, particularly children and young people with disabilities and/or health conditions. Some of her roles in participation have included: CAMHS participation, NHS England Youth Forum, Young CDC, RCPCH & Us. Amy was also a young advisor for Common Room, where she co-facilitated CYP Me First training to a variety of health care professionals.

Rob Webster, Chief Executive of South West Yorkshire Partnership NHS Foundation Trust and Lead Chief Executive West Yorkshire and Harrogate ICS, will chair the event and host a discussion of the issues raised and the opportunity to network.

You can book your free ticket here http://intheblinkofaneyepoemsbyadambojelian.blogspot.com/2019/12/adstalk20-bookings-are-now-open_3.html do come and join us and be inspired by remarkable people!

In the meantime if you fancy a great podcast on networking, download Anchor and take a listen to fabulous Jane Galloway of @quiet_the_hive https://anchor.fm/cats-pajamas/episodes/Cats-Pajamas-Convos-with-Jane-Galloway-e8e6kl

How will I shape the year of the Nurse (and Midwife!) #NurseBloggers

I came across a tweet this week from ‪@BloggersNurse‬ asking … ‘how will you shape the year of the Nurse?’ What a great challenge!

So here goes…

I’m really excited by the potential of celebrating the year of the nurse and midwife in 2020. It offers an opportunity to demonstrate clearly the contribution nursing brings to the health and wellbeing of society at a global level.

It’ll be my 32nd year of being a nurse in 2020. I started my RGN training in October 1988 in Cardiff and ever since I have been challenged and stimulated by being part of an amazing profession that focuses on serving others, through the provision of competent and compassionate care, supporting individuals, families, and communities in achieving optimal health and quality of life.

My buckle (as was the fashion then) which my parents bought for me when I qualified proudly displayed the Welsh 3 feathers ‘ich dien’ ‘I serve’, it’s a motto that has been a golden thread throughout my career.

One of the things I most enjoy as a nurse is being part of a healthcare team, the variety of people we work with to meet needs is vast, porters, domestics, caterers, admin staff, maintenance staff, scientists, AHPs, medics, managers, the list is endless! Its the collaboration and partnerships with others whilst embracing the nursing contribution to meet people’s needs of all ages, their families/carers and communities that 2020, the year of the nurse celebrates.

Whilst I loved general nursing it became clear that Children’s nursing was my real passion and after 2 years on a general paediatric ward at Cardiff Royal Infirmary, I left for London, to study at the Charles West School of Nursing becoming a Registered Sick Children’s Nurse (RSCN). As a result my nursing career has focused on child health.

So in the year of the Nurse I’m really keen that we amplify and celebrate the contribution nurses make to neonates, children, young people and their families/carers, whether in the community as health visitors, School Nurses, Community Children’s Nurses, Continuing Care Services, Children’s Hospice and respite services, or in mental health settings, in hospital settings in EDs, outpatients, theatres, PICUs, on wards. Nurses who focus on the care of children really are everywhere, serving 25% of the population alongside their families/carers. I am always particularly inspired by the range of Clinical Nurse Specialists who focus on expert care provision to neonates, children and young people with complex and ongoing health needs, including those supporting safeguarding and providing nursing leadership to children who are ‘Looked After’ by local authorities.

So along with many others I’ll be amplifying the contribution of nurses in child health in the year ahead. I’m hoping other Nurses working with Children will share their professional journey in 2020 and inspire others with the amazing difference they make to society.

So I’m asking fellow Nurses who work with Children in all areas of practice to write a blog, it doesn’t need to be long, please share the role you do and why you love it, I’m happy to publish it here on my blog site if you’d like 😉.

Running to 2020 and resetting the #NHS1000miles clock…

Back in 2018 we celebrated the 70th birthday of the NHS, a number of us decided that our ‘birthday present’ to the NHS would be a commitment to get a bit more active in anyway we could.

The idea behind #NHS1000miles was that if we personally took responsibility for our physical and mental wellbeing, we’d hopefully reduce our reliance on the NHS, easing pressure where possible so it would see it’s 100th birthday. More walking, running, skipping, swimming, cycling, in fact the challenge included any mileage that contributes to covering 1000 miles in the year. The fab ‘Trail Magazine’ have #Run1000miles which happens every year, so the #NHS1000miles built on this, whilst hopefully making it a bit more inclusive and accessible for individuals or teams who feel running not was for them but wanted a target and to cover the miles in other ways. Here’s the link to the original blog post shared thanks to the awesome Theresa Chinn @AgencyNurse of the ‘We Communities’ http://wecommunities.org/blogs/3338

Well thanks to a core team, including Jackie, Karen, Michalis, Celia, Phil, Flo, Tree, Trudy, Sue, Tricia, Jen, Dionne, Tony, Zoe, Amy, Nick, Marc, Leigh, Cat, Steph, Fiona, Ruth, Nicola, Becky, Sian, Lucy, Anne, Clare, Claire, Rebekah et al, who are all the backbone of the #NHS1000miles challenge, we decided to continue! So on 31/12/18, we reset the clock and continued the challenge into 2019, here was last years blog http://www.wecommunities.org/blogs/3443

So as we bring 2019 to a close let’s reflect on what we’ve achieved in being a bit more active and fulfilling a commitment to a work/life balance that includes regular exercise.

Personally I’ve found ParkRuns really valuable and pals in my local running club have kept me motivated. I find I can’t get home in time on week nights for the club training sessions, but ParkRuns, Cross Country and other local weekend events bring us all together. This is a few of us on our Christmas lights tour recently.

I’ve accepted that I’m never going to speedy but I do love ultra running, I was thrilled to do 52miles in one go this year (an ultra I’ve learnt is a running distance over 26.2 miles). Gathering the 2019 bling together showed me the range of races I’ve embraced and finished this year!

Many of these races have been with NHS 1000miles pals. The Yorkshire Marathon was a particular highlight, even in the rain!

So I’m hoping you’ll join us for the 2020 #NHS1000miles challenge, all miles count, just keep a tally & post updates either at 7.30pm on a Sunday evening or on the #NHS1000miles Facebook page. Everyone’s welcome to join in, come on, what’s stopping you? 😉

Building a workforce for and with children, young people and families/carers…

What do babies, children, young people and families/carers who come from a range of socioeconomic and ethnic backgrounds need from the NHS? As custodians of precious public resources allocated to healthcare its a fundamental question to challenge ourselves with, having a competent and compassionate workforce that can meet these needs now and in the future is essential.

Knowing that children, young people and families want to self care where possible, have access to high quality preventative care, reliable assessment and competent compassionate interventions, receive support locally and at home where possible with specialist support when needed, are key principles to work to. This population group are of course digital natives which is a critical consideration going forward for service planning and workforce development.

Having this clarity of purpose helps us design roles, recruit, educate and retain a workforce that is fit for purpose, across the public health, community/primary, secondary and tertiary care domains. Partnership working across provider NHS organisations in collaboration with users of services, education, the voluntary sector, and social care are also essential requirements as we go forward.

Taking all of these elements into consideration I returned this week to the work of the Children’s Outcomes Forum https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/410561/Theme_Group_report_Workforce.pdf and it helpfully summarises the layers of workforce provision to meet population needs whilst recognising children, young people and families/carers as the most significant assets in meeting their health care needs and achieving better health outcomes.

Since the work of the health outcomes forum new structures/roles have developed, including Primary Care Networks (PCNs), Nursing Associates, Physicians Associates, and Advanced Clinical Practice Roles have evolved. Mental Health needs along with Special Educational Needs and Disability (SEND) have continued to increase, community violence is having a significant impact and the technical care skills continue to demand increasing levels of competence from professionals.

The support by charities such as Roald Dahl and Well Child in creating Specialist Nurse posts have had significant impact in creating better, consistent support for those children, young people and families who need it most.

Yet we are still not in the position of having an adequate number of professionals in the community who have the skills to meet the needs of children and young people. Putting a focus on Community Children’s Nursing, Special School Nursing leadership, School Nursing, Health Visiting and roles in Primary Care including Primary Care Networks (PCNs) that take a lead for CYP is vital if we’re to shift care from secondary and tertiary care centres.

Greater integration between mental and physical health is something we’re making progress on, with programmes such as ‘we can talk’, yet there is more to do in ensuring children’s nurses with mental health skills and mental health nurses with skills in child development, family centred care models work collaboratively to enhance care for CYP experiencing MH distress.

Youth workers are a valued addition to the NHS, we are seeing increasing numbers being appointed to teams and their impact in improving attendance at clinics and in improving outcomes is already having impact. We need to gather publish the impact these roles are having in caring for young people more holistically if we’re to grow this element of the workforce.

Along side increasing skills we also need to ensure we’re widening access into the NHS and creating pathways to employment. Volunteering opportunities and the creation of Nursing Associate role offer routes into securing a professional qualification

Of course whilst I’ve focused on nursing, Allied Health Professionals and Paediatricians are a vital element and this year the RCPCH have run a campaign #ChoosePaediatrics, which you can catch up with here https://www.rcpch.ac.uk/education-careers/careers-campaign

Complementing the people development is of course the opportunity digital developments offer us, the e-red book, digital passports, apps to support better self care, navigation to services. ‘Chat Health’ has offered increasing access to advice from school nurses and ‘Parent Chat’ is having impact too.

So as we head into 2020 keeping our focus on workforce development for this population group is going to be an ongoing priority, along with continued work to actively collaborate with the children, young people and families we serve so that the workforce reflects their needs, after all that’s what we’re all about.