What’s your story?

27/10/19

Do you recall the Monty Python sketch ‘What have the Romans ever done for us?’ https://www.youtube.com/watch?v=Y7tvauOJMHo&feature=share Save the Children did a take on this when the UK was considering its commitment to international aid, if you haven’t seen it please do watch, it conveys a powerful message really creatively https://youtu.be/pMy8rBxRC6I

The ‘what have you ever done for us ‘ was a challenge used at a meeting I was at this week as we reflected on the importance of sharing team stories to try and ‘close the loop’ on the difference that’s made as we collaborate. So much of our work time is spent at meetings (admittedly some more productive than others) it’s useful to reflect on the difference that’s being made, and to capture and share impact. Yet I wonder if this is easier said than done? Are outcomes and impact always so clear? I’m passionate about the benefits of working together to achieve a shared purpose, I’ve seen repeatedly the value of coming together with others to share ideas, work and as a result is encourages and challenges us to think differently and creatively, uncovering shared solutions. Yet changes don’t happen immediately, they can take time.

The organisation that I’m currently working in has ‘clinical boards’, bringing together senior clinical and managerial leaders from across the Trust. For us this means focusing on Children and Young People’s services offered across 3 hospital sites and community services for one of our local boroughs, we have responsibility for making sure that standards are consistent across all our sites and services, setting strategic direction, guiding research and advising on many other areas such as education, role redesign and staff development. We’re currently working on creating ‘our children’s health clinical board story’ and excitingly we’re working across our STP on our shared Children & Young People’s Health and Care Local System story.

I had the pleasure of listening to Dr Nagina Evans ‪@NavinaEvans‬ CEO of East London Foundation Trust (ELFT) who shared her leadership story. She explored the huge benefits and contribution of clinical leadership and the power of us all working together to improving experiences for importantly patients, carers and families, yet along for staff too.

So as I reflect on the week that’s gone, the power of story telling radiates, whether we’re working to improve care, services or experiences let’s keep sharing, tweeting and blogging along with more traditional approaches, it all counts.

My Cavell Nurses Trust #10kforNurses story comes to a close this weekend, Cavell is a charity I connect strongly with. Throughout my career my ‘nursing family’ has meant so much, yet I know many struggle, and often things that go on outside work aren’t shared … that’s why the charity’s logo ‘here for nurses’ means so much to me, like an invisible cloak of support, they are an organisation that envelops nurses and midwives. Its been a joy to run for them in October, I’ve secured quite a medal collection and wonderfully we’ve raised lots for them https://www.justgiving.com/Kath-Evans9 thank you to everyone who’s donated so generously! The awesome ‘We Communities’ have led the way (as always) in mobilising so many of us to play a part in this story.

A busy week!.. the power of people…

Goodness last week seemed to whizz by, there was so much happening from starting with a catch up with lovely ‪@BevMatthewsRN‬ from @NHShorizons as we considered how to keep promoting the NHS to young people and grow opportunities for engagement.

Then there was hearing from fabulous @nancywhiskin our Head of volunteering talk about her commitment to ensure meaningful and fulfilling volunteering opportunities in the NHS.

It was also Baby Loss Awareness week and the fabulous ‪@Rosamund1010‬ has been leading a wonderful team touring the sites to promote resources and to signpost the public and staff to help and support when it’s needed.

We also had visits from students and also our local council lead for Children Danny Hassell, ‪@dannyhassell‬ thanks to Neil ‪@nellyfletch71‬ and Angela ‪@angy_wangy1 ‬our Clinical Nurse Specialists for teenagers and young adults, funded by the Marvellous Ronald Dahl Children’s Charity ‪@RoaldDahlFund‬.

There were catch ups about young people entangled in youth violence thanks to Michael Carvers leadership @ldnvrn‬, ongoing work in meeting NICE Guidance in end of life care, strengthening opportunities for our students and future Children’s Nurses to benefit from our incredibly experienced and knowledgeable Clinical Nurse Specialists was also on the agenda. Along with a visit to St George’s to share the good stuff that’s happening across organisations and to plot opportunities for collaboration.

We also continued to think about workforce development and finalise our our response to ‘accidentally dropped babies in hospitals’ Patient Safety Alert https://improvement.nhs.uk/news-alerts/assessment-and-management-of-babies-who-are-accidentally-dropped-in-hospital/

Yet it was Friday afternoon that offered a moment to pause with women of the Ascend NHS Leadership Academy that allowed some personal time for reflection about priorities and this was really valued, as we met at Mile End it was a lovely reason to treat ourselves to Cronuts which were delicious!

They were a perfect element to the carb loading for the Yorkshire Marathon which was my 31st. Team #NHS1000miles and #10kforNurses for @CavellTrust came together and sustained the fund raising for Nurses and Midwives facing hardship. It was a

weekend that certainly demonstrated Twitter at its very best! We were all brought together by a passion to make a difference.

Here are some of us along with a very tired #CharlieDog at the end of the Yorkshire Marathon on Sunday afternoon. It was certainly a weekend of fun and friendship!

So as I head into the week ahead, I’m wondering if there was a theme, a golden thread that ran throughout last week? Perhaps it’s the impact of people… people doing their thing, going above and beyond, stretching themselves to do more to support each other and reach across organisational and geographical bounties to keep making things better for others?

#Disruptyourfeed…. valuing cognitive diversity

12/10/19

Have you followed 4 new people on social media this week? @thefemale_lead an education charity, highlighted the impact of positive disruption on our social media feeds. Whilst it specifically looked at the influence this can have on young women I think there are lessons for us all, suggesting diversification of our social media activity can encourage us to think differently by offering new perspectives. This short you-tube clip gives an overview https://youtu.be/ptr-VoXDMQ8 and there’s more information too at Transform your feed with new and inspiring profiles – The Female Lead.

The value of diverse perspectives is also the theme of @MatthewSyed’s book ‘Rebel ideas, the power of diverse thinking’ which has brightened my commute this week. Matthew suggests that all too often we’re blinkered by the #echochambers and #informationbubbles which support our opinions. Whilst these are comfortable, it can also be dangerous, as numerous situations in healthcare have proved to us over the years. Seeking and valuing objective perspectives from teams who come from a variety of backgrounds, are clearly significant assets in growing ‘cognitive diversity’, providing I’d suggest, there’s a culture that encourages people to speak up, and vitally supporting people when they do so.

I know I need to repeatedly remind myself to ‘lean into’ diverse thinking, to seek it out, encourage it and take action….

happy weekending 😉

PS for some diverse thinking why not follow…

‪@MatthewSyedTeam‬

‪@matthewsyed‬

‪@the_female_lead ‬

‪@TerriApter‬

‘Play for all’ and it’s not just about Children, us adults are playing for Cavell Nurses Trust this Oct #10kforNurses 😉

It’s National Play in Hospital Week from Monday 7th–12th October (more info at http://www.starlight.org.uk/npihw), organised by the National Association of Health Play Specialists (@NAHPS) and supported by Starlight Children’s Foundation (@starlight_uk) a national charity which provides play and distraction services in hospitals and hospices across the UK.

The week of putting play in the spotlight gives us all an opportunity to celebrate the difference play makes in healthcare. Across the country there’ll be play related activities, Twitter will no doubt be alive with pictures! Make sure you share what you are up to on social media and use #Playinhospitalweek #PIHW and tweet @starlight_uk @nahpsofficial too! Why not tag @NHSEngland @NHSImprovement and your local Executives and CCGs?

This year there’s a focus on ensuring play is fully inclusive and that children who have additional needs perhaps related to learning or physical needs, are included too, hence this year’s title ‘Play for all’.

It was the famous ‘John Bowlby’ who said ‘Play is the business of childhood’ and we all know and accept universally now that from the earliest age, play helps children to learn, to make friends and develop relationships, and to have fun. With nearly 49,000 children and young people in the UK living with a life-limiting or life-threatening condition and 5,500 new diagnoses each year, the need for play and entertainment services for children in hospitals and healthcare has never been greater.

Research has highlighted the importance of play in hospital, both in preparing children for treatment, providing ways for them to work through anxieties, fears and importantly deal with their experiences. When children and young people are admitted to hospital they are often at their most vulnerable. Play helps them to adjust to a potentially stressful situation, it helps children & young people to understand why they are in hospital and what will happen; cope with illness and treatment; regain confidence, grow independence and self-esteem; express their feelings and recovery more quickly. Play also creates an environment where stress and anxiety are reduced; it encourages family involvement and it can aid in assessment and diagnosis. It’s a bit of a wonder drug really!

And of course play isn’t just for children as Alison Tonkin (@TonkinAlison) a wonderful play champion reminds me regularly. Us adults like playing too! October provides us with perfect excuse as we play at doing 10k hikes, runs, cycles, bake sales etc and raising money for Cavell Nurses Trust (@CavellTrust). Edith Cavell was a Nurse who cared for soldiers involved in 1st world war, she was tried for treason as she cared for those on both sides and was horrifically shot. The charity established in her name supports nurses, midwives and healthcare assistants when hardship strikes. Nurses too face poverty, ill health and complex social circumstances such as domestic violence. The charity can be a lifeline, providing a listening ear when perhaps it’s difficult to talk to managers about circumstances outside work. The support from Cavell also means that nurses and midwives can get back to work more quickly too, which can be helpful for everyone.

So each October the Cavell Nurses Trust with the fabulous ‘We communities’ run #10kforNurses to raise awareness about their awesome work, raise some funds and (the bit I enjoy the most) have fun in what ever way suits by playing! Do get involved if you can https://www.cavellnursestrust.org/fundraise/ or just feel free to donate the cost of a cup of coffee to encourage me to bank those miles for nurses https://www.justgiving.com/fundraising/kath-evans9?utm_campaign=pfp-share&utm_content=Kath-Evans9&utm_medium=fundraisingpage&utm_source=Facebook

Hearing from bereaved families

How we care for babies, children and young people at death, and the care we provide for families remains etched in memories forever. Parents including Chezelle Craig @whatsinakiss, Adam Bojelian’s @4AdsthePoet parents and Joanne Hughes @Mothers_Inst_UK, amongst many others have taught me so much over the years and I am so grateful to them all.

Seeking out parent insights is important in making care as good as it can be in such awful circumstances. Leigh @leighakendall mum to Hugo repeatedly reminds me that families want to help improve things for others.

Back in 2017 Jane @JbereavementUK a bereavement midwife at Imperial and Donna Ockenden @DOckendenLtd led work with SANDs and the London Maternity Network to compile the Maternity Bereavement Experience Measure (MBEM) here’s a blog about the work we did https://www.england.nhs.uk/blog/we-must-listen-to-parents-after-their-darkest-hour/ the resource can be found here http://www.londonscn.nhs.uk/wp-content/uploads/2017/06/mat-bereavement-mbem-062017.pdf

It was Ronny Chenug @CheungRonny a Paediatrician who rightly challenged us and said that if we had a suite of agreed sensitively tested questions to use when bereavement happens in maternity care, it would be helpful to have a suite of agreed questions for parents who experienced child bereavement too. SANDs once again supported the work and this week saw the publication of the Child Bereavement Experience Measure by the Healthy London Partnership Team @HealthyLDN, it can be found here https://www.healthylondon.org/our-work/children-young-people/child-death-review-programme/gathering-feedback-from-bereaved-families-and-carers/

Importantly families, healthcare professionals, the voluntary sector and staff working in roles supporting continuous improvement, have all worked collaboratively to compile these resources for us to use flexibly to gather feedback and use it in commissioning and delivery of services.

Complementing this work this week’s commutes have whizzed by as I’ve listened to Dr Matt Morgan’s @dr_mattmorgan welsh accent reading his reflections of working with people, ‘Critical’ https://www.audible.co.uk/pd/Critical-Audiobook/1471180417.

Lots of his reflections, including the long corridors and respiratory wards of Llandough Hospital resonated as it’s where I did my training back in the late 1980s. Yet it was Matt’s reflection on the work of Rhian Mannings @2wishupon http://www.2wishuponastar.org/ to create environments in hospitals where life changing news can be shared, that made my ears tune in even more intently. Rhian shared that her world changed in 2012 when her 1 year old baby son, George died, followed by the death of her husband Paul, 5 days later. When her son died Rhian paced the corridors looking for a quiet office to spend quiet time with her son who had died, there was no room allocated/created for this. Rhian’s charity now creates undisturbed spaces in hospitals for news to be shared and for families to absorb what’s ahead, in some shape or form.

I had the privilege of meeting Rhian as NHS England worked to improve Child Death processes https://www.gov.uk/government/publications/child-death-review-statutory-and-operational-guidance-england. Rhian’s strength and determination that her work would make a difference for other families infected us all that day. Her presence was unforgettable, please do follow and support the work of her charity.

The work at NHS England with the Department for Health and Social care restructuring Child Death processes, led to the Lullably Trust @LullabyTrust creating an information resource for families when a child dies http://https//www.lullabytrust.org.uk/bereavement-support/when-a-baby-dies/

The final words this week though goes to thanking the team at Child Bereavement UK as they celebrate 25years of rebuilding lives when awful things happen. It’s clear that it’s only when we all work together families, professionals, the public and the voluntary sector that we can really make a difference in people’s lives.

Social Media, my 8 year twitter journey….

If you’re reading this thinking I know nothing about social media, can I signpost you to these great resources on using social media from the ‘We Communities’ thanks to @agencynurse http://wecommunities.org/resources/twitterversity its useful for novices and experts!

I began my social media journey back in December 2011 (massive thanks to @helensadler4 @tallgirlwgc) when I was working at the NHS Institute for Innovation and Improvement. The programme I was seconded to, from my post as Lead Nurse for Children in East and North Hertfordshire was focusing on testing interventions to shift care closer to home, when safe and appropriate to do so. One of the work-streams connected us to education, and meant we worked with children and young people to increase their knowledge of the range of services available including self care, pharmacies, urgent care, GPs, as well as Accident and Emergency Departments. I knew I needed to spread the word about the programme and the evolving co-produced lesson plans so that we could strengthen connections been health and education and aid dissemination and spread. Twitter seemed to provide a free tool without the hassles of formal publication, it was convenient and accessible, and it worked a treat. The secondary school resources (since updated https://www.england.nhs.uk/participation/learning/schools-resources/ ) and ‘Monkey Wellbeing’ primary school packs spread across the country https://www.monkeywellbeing.com/resources/schools-resources/ as part of the improving children and young people’s emergency care programme, shared in these documents https://www.rcem.ac.uk/docs/Paediatric%20EM%20Guidance/CEM7226-Focus-On-Children-Emergency–Urgent-Care-Pathways—March-2010.pdf & https://www.rcem.ac.uk/docs/Paediatric%20EM%20Guidance/11.%20A%20Whole%20System%20Approach%20to%20Improving%20Emergency%20and%20Urgent%20Care%20for%20CYP.pdf

It was also @HelenBevan Chief of Transformation at the NHS Institute who was running a staff gathering at the NHS Institute who gave me a real nudge when she said how great to was to see me tweeting and how much she enjoyed my tweets in front of over 100 members of staff. It was just the sprinkle of fairy dust positivity I needed to encourage me on my online journey.

Another important element was doing some work with @SaveChildrenUK. As a charity they had a public engagement strategy that I’d never encountered in the NHS, back in 2012 they were way ahead of us and they encouraged me to tweet about my trip to Liberia which I did with them, and they also encouraged me to guest blog https://blogs.savethechildren.org.uk/2014/06/newborns-a-promise-kept-a-plan-to-save-babies-agreed/.

The thing that stood out from my early social media experience was having a purpose, I had a reason to tweet, this connection was important.

Another element that’s been important is having a community of like minded people to tweet with. Communities that I’m part of include #EarlyRisersClub the #WeActiveChallenge (did I mention the #NursesActive won in 2019), #NHS1000miles established for #NHS70 http://www.wecommunities.org/blogs/3443 and more recently #CYPBartsHealth. These hashtags are a bit like ‘filing cabinets’ says @spencer_sian capturing tweets around a specific subject. All these communities have have supported connections around the subjects, or issues, that matter most to me.

Yet I do have a health warning ⚠️ once you ‘find your tribe’ don’t forget to reach out and burst your bubble to find diverse opposing views to challenge and grow thinking, follow freely, stay curious, be aware of ‘broadcasters’ (typically CCG accounts that pump out information and don’t engage), social media isn’t called ‘social’ for nothing … you get what you give …

I’d also say life it too short for trolls and pathological negativity, we all have tough days and last thing we need is a dose of doom and gloom from social media, reality and constructive challenge of course, but not nastiness, there’s a ‘block’ and an off button don’t be afraid to use them.

So what are some top tweeting tips? Here are some suggestions from @hepworth_becky 

  • ‘Be engaging  talk to people, talk to different people, make it a rule that you’ll talk to new people each week and ask questions
  • Be reflective – write a blog, comment on someone else’s blog, write a guest blog for someone else
  • Be twitter savvy – use pictures, share links, join in a twitter chat, don’t just retweet
  • Be human – be you, share stuff that interests you
  • Be consistent – whatever you do, do it regularly
  • Be a ‘10 minutes a day’ advocate – 10 quality minutes spent on social media is 10 mins well spent.’

There’s some more insight on twittering here in a blog a number of us collaborated on http://www.wecommunities.org/blogs/2307

Using social media has led me to establishing my own blog https://kathevans.com/ and also to using UK Audible, which has increased the volume of my reading significantly https://kathevans.com/2019/07/18/my-favourite-books-of-2019/

Social media has certainly helped me to

1. Challenge myself to think differently

2. Seek out and gather wisdom

3. Receive encouragement

4. Have encouragement to keep going

5. See joy and fun in an issue

6. Seek out inspiration to be and do better

7. See role models in action, and see them survive and flourish when things are tough.

But perhaps the most useful reflection comes from a tweet earlier this week @paularich1977, Paula reinforced that ultimately social media is all about positive human connections, more social, less media, and that’s something we should never forget ….

Black box thinking 🤔 World Patient Safety Day #AskAboutAsthma

My audible book listening this week has been revisiting Matthew Syed’s book ‘Black box thinking’. Black boxes are electronic recording devices found in aircraft and support the investigation of incidents. Something I didn’t know was that they are actually bright orange, rather than being black to aid their recovery. What these boxes contain are clues, insights into what’s happened to ensure learning is extracted from situations and used to make changes to prevent incidents happening again. Whilst we don’t have the luxury of ‘black boxes’ in healthcare, what we do have is access to rich data and insight from a range of sources that, when shared openly, can help us get better at using insight to drive continuous improvement in healthcare.

I desperately want the care given to babies, children and young people to be of the highest quality, and to be consistently safe, appropriate and child centred, the reality is though there are always opportunities to learn and improve on the care we give. Throughout my career in nursing there are many examples where I’ve learnt so much from mistakes, bringing these to light, discussing the issues that contributed, then planning changes to increase learning, vitally help to prevent duplication of incidents.

The culture in which we operate is so influential in creating openness so that incidents are acknowledged, shared and learnt from. Of course nobody wants mistakes to happen, it’s not what we came into healthcare for, our aim is provide the best, most effective care in a timely manner, but we have to be courageous enough to share information and learning, in order to move things on. Supportive, encouraging cultures are vital for this.

Syed reflects on how success happens, he shares important lessons on how to expedite progress through learning and creativity. Practice of our skills is critical, the more we practice, the better we get and the more we learn. Syed challenges us to embrace failure on this journey, linking failure and success inextricably.

Professor Tony Warne @tonywarne in his blog ‘Safety first’ http://tonywarne.blogspot.com/2019/09/safety-first-is-always-good-strategy.html reflects on @NHSImprovement’s recent publication of the ‘The NHS Patient Strategy’ https://improvement.nhs.uk/documents/5472/190708_Patient_Safety_Strategy_for_website_v4.pdf

The foreword talks of achieving a ‘collective intent’ to secure commitment to improve the way we learn, treat staff and involve patients.

The strategy also highlights the importance of working with patient safety partners to drive improvements, the role of children, young people and families can be powerful, as they are such strong and effective advocates and drivers of change.

The other role the strategy proposes is a local patient safety specialist, I think there’s real potential to grow the Children and Young People’s patient safety specialist role and create a network of these post holders to share challenges and solutions.

The 17th September will see Patient Safety highlighted as a global health priority marking the first-ever World Patient Safety Day, led by the World Health Organisation (WHO). They will launch a global campaign to create awareness of patient safety and urge people to show their commitment to making healthcare safer https://www.who.int/campaigns/world-patient-safety-day/2019

So what are the issues we need to focus on in child health? Medicines management? I wonder if we can be using the Medicines for Children Resource https://www.medicinesforchildren.org.uk/ more? Pressure Ulcers? this remains a challenge in neonatal care http://nhs.stopthepressure.co.uk/ Early identification of deteriorating patients? Scotland have led the way on this http://www.clinicalguidelines.scot.nhs.uk/ggc-paediatric-guidelines/ggc-guidelines/surgery/paediatric-early-warning-score-pews/ and work by NHS England will follow. Identification of correct patients for procedures?

Something that’s having a real focus in London is ‘week 38’ the #AskaboutAsthma campaign, being supported by Asthma Nurse Specialists and the Healthy London Partnership Team @HealthyLDN. They are keen to get families and professionals involved in improving the care of children with Asthma, there’s lots of helpful resources that can be used by teams beyond London too https://www.healthylondon.org/our-work/children-young-people/asthma/ Do get involved and support the campaign.

It would be good to know what your priorities are as we all work to make care as consistently safe as possible. Let’s keep learning and sharing together.