Having a growth mindset…

How can we cultivate and nurture a growth mindset in healthcare, one that is always curious, seeking solutions? I firmly believe that everyday provides an opportunity to learn IF we’re in the frame of mind that allows us to do this. Valuing and creating time for systematic self-reflection followed by an opportunity to take action is something I know I need to work at. Having a positive yet realistic outlook is critical in helping us develop personally, as well as professionally.

So I’ve been thinking about what actions I can take to help nurture a ‘growth mindset’?…

1. We all have strong foundations that we need to acknowledge, our upbringing, our training, placements, jobs, people that have had an influence on us, they’ve all created a base from which we grow and flourish. Taking time to acknowledge this can be helpful as we work to build on it.

2. It’s important that we look back on what’s been tough. Reflecting on how we’ve coped with complex situations, means we’re actively using learning opportunities offered to us. Keeping a journal or writing a blog can help us document this learning that can be referred to in the future, as well as providing a record to show just how far we’ve come when times are particularly challenging.

3. Can we do more of thinking big, being ambitious? So often we limit ourselves to what we think is achievable rather than being brave and exploring the potential we could grasp. We’re grappling currently with the vastness of the child health agenda, how do we progress the public health and community offer, whilst sustaining more hospital and specialised care? Realistically it can’t be an either or, we need to be ambitious and grapple with both, articulating why this agenda matters so much to society.

4. Broadening our horizons by seeking out new ideas, inspiration and perspectives can enrich and diversify our approaches, importantly energising us with new solutions, encouraging creativity. With social media offering greater connectivity than ever before, a range of scholarship opportunities available such as Florence Nightingale Fellowships, we don’t have to look too far for opportunities.

5. Asking for and seeking out feedback from others can offer insights and perspectives that can be really constructive, and whilst it can feel uncomfortable, it is so worthwhile and valuable if we can ‘lean in’ and ask for perspectives on what’s going well and ideas on ‘even better if…’

6. It’s impossible to get things right all of the time even though we all love things to always go well, in reality failure teaches us so much – we shouldn’t be afraid of it, supportive colleagues can be incredibly helpful in working through challenges when they arise.

7. Yet it’s important we use all these elements to implement change. Whilst it can seem tedious to jot down action plans, objectives and aims, when we write things down its more likely to get done. I know I need to get better at this!

8. ‘Bite sized chunks’ is a saying I repeat to myself regularly. When the demands ahead seem overwhelming its worth focusing on taking one step at a time…

I’d love to know how you cultivate a growth mindset, ideas and insights welcomed!

So much happening …

29/11/19

Goodness it’s been a busy week! The 20/11 brought an amazing celebration at Barts Health (#CYPBartsHealth) focusing on Children’s Rights thanks to the Youth Empowerment Squad ‘YES’ ‪@YES_BartsHealth‬ and the wonderful Play Specialist team ‪@PlayTeamRLH‬, it got us all talking about how we continue to put a focus on Children’s Rights going forward beyond the 30th Anniversary celebrations of the UNCRC.

I also got to catch up with Starlight ‪@starlight_uk ‬ this week, they were with us at Barts Health earlier this year when Janie our ED Play Specialist won Play Specialist of the year.

Starlight are a wonderful charity that ‘punch well above their weight’ and are known for providing wishes to sick children, providing entertainment in hospitals and wonderful distraction boxes for healthcare environments (amongst other things!). It was this tweet that caught my eye reinforcing that how we engage and support children in healthcare is so much more than what we do in hospitals.

Then on Wednesday our wonderful Roald Dahl Epilepsy Nurse Specialist Lynn @LynnKeen7‬ organised a Children’s party with the marvellous Roald Dahl Charity ‪@RoaldDahlFund‬. A highlight was having a visit from Marvin the crocodile, here we are doing our power poses and having a giggle with him! The charity make such a difference to the lives of sick children and families through their pump priming of specialist nurses, do watch their Christmas campaign video it’s fabulous https://www.roalddahl.com/charity

So whilst this time of year is incredibly busy with our inpatient areas caring for sick children it’s so appreciated when Charities work with the NHS to create fun experiences not only for patients and families but for staff too. This is the stuff that keeps everyone going.

It was Sophia ‪@SophiaTouzani‬ who shared this position paper from the RCPCH and RCN on winter pressures and the importance of not losing the focus on Children and Young People, particularly regarding community care https://www.rcpch.ac.uk/resources/winter-pressures-childrens-emergency-care-settings It follows tweets from the QNI and Children’s Community Nurse Champion Trudy Ward reinforcing the importance of growing our Children’s Community Nursing workforce to keep care closer to home when it’s safe and appropriate to do so.

And I’m sure all of us have been caught up in politically charged conversations as we head towards the election ‪@mollycasespeaks‬ shares her views on retention of nurses, it’s really worth a read https://www.theguardian.com/commentisfree/2019/nov/26/more-nurses-nhs-50000-frontline-funding

Friday provided an opportunity to say a proper hello to our newly qualified nurses here at Barts Health, our Practice Development Nurses are doing a great job of supporting them as they transition into their new roles across Whipps Cross, Newham and the Royal London Hospitals.

So as all staff providing direct care to children, young people and families continue to work incredibly hard in the weeks ahead I hope you get a moment to have some fun too as the festive season gets underway.

Children’s Rights #UNCRC30

Thirty years ago children were formally recognised as having non-negotiable rights and that active support was required for them to claim their rights. Nearly all Governments have pledged to respect, protect and promote these rights by signing the United Nations Convention on the Rights of the Child ‘UNCRC’ https://www.savethechildren.org.uk/content/dam/gb/reports/humanitarian/uncrc19-child-friendly.pdf.

Notable progress has been achieved globally in the past three decades, through ongoing work to end child poverty along with a focus on increasing school attendance. Yet significant challenges remain in particular for girls, for children with disabilities and for children in disadvantaged and vulnerable situations, and frustratingly children still die from preventable diseases.

Lot of the articles in the UNCRC resonate with us in Healthcare, the right to life and good health care (Articles 6,23 & 24); the right to education, play, to relax and have fun (Articles 28,29 & 31); the right to what is best for children (Article 3); the right to information (Articles 13 & 17); the right to respect (articles 2 & 14); the right for children to have their say (Article 12); the right to consent (articles 5 & 12); the right to privacy and confidentiality (Article 16); the right to be safe (Articles 19, 33, 34 & 36) and the right to a family life (Article 1, 2 & 42). They complement the NHS Constitution https://www.gov.uk/government/publications/the-nhs-constitution-for-england providing the ‘blue print’ for services to achieve.

This is a great poster from young people in Wales that you my want to download, develop and adapt with your local youth forum members http://www.wales.nhs.uk/sitesplus/863/page/91176

This 30th birthday gives us an opportunity to look back on what’s been achieved relating to children’s rights and to look to the future, asking ourselves what more we can do to ensure children and young people who come into contact with our services have a positive experience. Will all children and young people who access our services report feeling that rights are respected, upheld and promoted? Children’s rights are everyone’s business so we all need to take on this challenge across the NHS. 

I wonder if we’re consistently involving children in commissioning decisions? Are CYP involved in the assessment of services by using tools such as the ’15 steps’ https://www.england.nhs.uk/wp-content/uploads/2017/11/15-steps-children-young-people.pdf Are we adopting resources such as ‘We Can Talk’ https://wecantalk.online/ and ‘CYP Me First’ https://www.mefirst.org.uk/ to help us communicate as effectively as possible with CYP so that they are actively involved in decisions about their care? Do we have child friendly complaint processes? https://www.childrenscommissioner.gov.uk/publication/common-principles-for-a-child-friendly-complaints-process/

Are we focusing on mental and physical health and wellbeing, along with good effective preparation for the move into adult services ie transition?

So some asks, will you…

·   Work to involve Children more in your services? https://www.england.nhs.uk/participation/get-involved/how/forums/nhs-youth-forum/

·   Seek out and hear Children’s voices in decisions about their care? https://www.health.org.uk/blogs/ask-three-questions

·   Ensure information about services, treatment and care is accessible and understandable? https://pifonline.org.uk/resources/publications/health-info-for-children-and-young-people/

·   Identify Young Carers and signpost/refer them to ongoing support? https://carers.org/young-carers-awareness-day-2020

Committing to taking on these challenges would be the best birthday present ever! Happy 30th Birthday UNCRC #UNCRC30

#HealthInfo4Children

Some time ago I blogged on the importance of health information for children NHS The Health Literacy Place | Addressing the health literacy needs of children & young people This week the Patient Information Forum ‪@PiFonline‬ held a conference on this subject and it seems like an appropriate time to revisit the issue.

Why is health information so important? In this 30th anniversary year of the UNCRC it’s worth reminding ourselves that children have the right to high quality information and to be active participants in their care. We know that children are thirsty for knowledge, the challenge is meeting this need with engaging information that meets their developmental stage.

When I was a child I used to get lost in a book, Alice in Wonderland was one of my favourites. The quote …

seemed to confirm that even impossible things could be worked out! Creative, engaging narratives teach us so many life lessons, and creativity is a vital component in developing health information resources to convey important messages in fun engaging ways.

It’s also worth highlighting though that we know there are some children who are more vulnerable, those from BAME groups, those with learning disabilities/autism, those from looked after backgrounds, who are likely to need additional support to access health literacy information.

Some time ago PiF produced this really helpful guide https://pifonline.org.uk/download/file/38/

It explores:

1. Why the right information matters

2. How do we involve CYP?

3. What are the best ways to communicate with CYP?

4. How to produce resources

5. And ideas on what can we learn from others.

It’s worth dipping into!

The PiF conference heard from Professor Lucy Bray @LucyBray9 of Edge Hill University who has developed films with children on ‘Coming into Hospital’ https://www.edgehill.ac.uk/news/2019/02/launch-of-new-comic-book-and-animation-to-help-children-feel-less-worried-about-going-to-hospital/

CICRA ‪@CICRAcharity‬ the charity for children and young people with Crohns and Colitis https://www.cicra.org/ shared films young people had made on endoscopies and other tests that are associated with having this disease.

The Evelina Children’s team shared how they have developed great short films on having an EEG for children and families https://www.evelinalondon.nhs.uk/Home.aspx

The Motor Neurone Association ‪@mndassoc‬ shared the work they’ve developed for 4-10 year olds to help them understand what’s happening when an adult is diagnosed with this disease https://www.mndassociation.org/support-and-information/children-and-young-people/children-aged-four-to-ten/

And the Royal London team shared their work on developing a child centred information approach, information and ‘eye club’ with wrap around services for siblings and families when Retinoblastoma happens https://www.nhs.uk/conditions/retinoblastoma/

We also had an interactive session on using social media to engage children, highlighting some of the challenges and the opportunities it offers. What was clear was that when resources have been developed and invested in, sustained promotion is key if the resources are to have maximum impact.

It’s also worth flagging that the NHS Long term plan asks us to work to improve care for children and young people from 0-25years, it moves us as CYP Professionals from focusing on children (those up to 18), to those who are young adults. Research tells us their brain continues to develop until they are 25, therefore child and young person/young adult health information is essential.

Yet the only way we’ll continue to grow health information resources for and with this population group is by involving children and young people and focusing on what matters to them, working with professionals, educators, writers, ‘creatives’, and the voluntary sector.

I had the pleasure of hearing Dr Kelly Harding ‪@HardingKelli‬ a physician and author of ‘The Rabbit Effect’ at an event this week. Whilst talking about the wonderful physiological impact of kindness in healthcare, shared that for every life bio medical science saves, education saves 8, it was just the affirmation I needed that whilst medicine, treatment pathways etc are vital in managing illness, high quality health information is essential to enhance education, its an area we need to do more on in co-production with those that need it most.

Young Adult Experience #YAExp

This week we’ve been reflecting on transition and young people who are cared for in adult services up to the age of 25, it’s really helpful that the NHS Long term plan raised the bar and asks the NHS to work on improving care for those from 0-25 years of age. Previously Children’s services have focused mostly on the care of young people up to 16, sometimes up to 18, the statutory definition of becoming an adult. It’s helpful that research over the past 20 years or so has confirmed that brain development continues until we’re 25, hence the need to support young adults as they continue their journey to independence, particularly those who have long term health needs.

We know how vulnerable young people can be and the impact great, positive, encouraging, support can have, which is why it’s important we continue to work to improve transition and young adult care. It’s vital children’s and adult services work collaboratively and take a ‘system wide approach’ along with primary care, local authorities, the voluntary sector and schools, colleges, universities and employers.

We know than when young people move into adult services, particularly in inpatient care they are often surrounded by much older people. Only last week we had a 19 year old with Sickle Cell Disease being cared for on a ward between two elderly patients which was far from ideal. Young People can feel intimidated by professionals who they haven’t had a life time of getting to know. Sadly we have now have evidence that health outcomes for young people with long term conditions can deteriorate and result in the worst case scenarios of significant long term complications and untimely death as they disengage with services, if they feel we don’t connect with them.

So what would good transition and young adult experience look like? This model gives us an ambition to aim for…

Young people want honesty and they want us to start preparing them early, they want their GPs to be involved, they want a named point of contact, they want shared care plans with emergency care instructions too. Importantly peers matter, young people want us as health care professionals to connect them with other young people in similar situations.

So at the Trust I’m working at there is wonderful senior leadership on this agenda, the executive team are all supportive of this work. We have 2 fabulous nurse specialists Neil Fletcher and Angela Thompson, funded by the wonderful Roald Dahl Charity who are leading the way, supported by fabulous consultants in Paediatrics and in Adult Medicine. We’re embedding the transition framework ‘Ready, Steady, Go, Hello’ https://www.uhs.nhs.uk/OurServices/Childhealth/TransitiontoadultcareReadySteadyGo/Transitiontoadultcare.aspx (thanks Arvind Nagra ‪@arvnagra‬ & Southampton UHT 😉) where teams don’t have a transition framework in place. The Trust strategy team are helping make this happen. We’re also strengthening our links with primary care, GPS like Helen Jones are testing different models for young people’s clinics. And the numbers of youth workers are growing across the Trust. We’re also been part of the National improvement programme with NHS Improvement/England.

So what do young people from us?

They tell us they want to be welcomed, reached out to, to feel safe and ideally cared for with people of similar ages. They want to be respected and for us to remember it’s scary being a young person using the NHS.

Importantly, we are just as concerned about those young people who ‘crash land’ into adult services as those who transition to adult care from Paediatrics. We need to get it right for all young adults.

Lucy‬ kindly shared her experiences of being a young adult receiving care, please follow her ‪@LucyAlexandria‬ she’s totally inspiring! Huge thanks to all of the amazing young people informing and helping to move this work forward.

Young People’s health is a responsibility of all of us shares the Health Foundation in a recent report https://www.health.org.uk/sites/default/files/upload/publications/2019/HEAJ7109-Young-Peoples-Health-Report-WEB.PDF So we asked our Trust if they’d be allies for and with young people and adults, 220 senior leaders said yes! Will you ask your Trust to do the same? 😉

#WeEatWell19

29/10/19

Dr Zoe tweets as ‪@4AdsthePoet‬ and has challenged us in November to embrace a month of eating well and is encouraging us to share our stories as we join in with #WeEatWell19.

Public Health England has loads of helpful guides to help us with this challenge which can be found here https://www.gov.uk/government/publications/the-eatwell-guide

Healthy eating is also good for the planet https://www.theguardian.com/environment/2019/oct/28/healthy-diet-means-a-healthy-planet-study-shows fruit, vegetables, beans and wholegrains are best for both avoiding disease and protecting the climate and water resources apparently!

Yet in our busy lives it can be hard to be intentional in our healthy eating habits. For me its rather too tempting to reach for a bag of Percy Pigs on my commute home which is something I’m rather partial too! I’m going to try hard to dump this habit! Although it looks like dark chocolate can remain in! https://www.healthline.com/nutrition/7-health-benefits-dark-chocolate thanks @‪KitzingerCelia‬ 😉

So I’m going to dust off my ‘healthy eating’ cook books (I have quite a few, often picked up from various charity shops over the years!) and test some new ideas. I’m also going to try to drink more water, I’m not too good at this so I’ll be adding some slices of lemon 🍋 or a herbal teabag to make it a bit more interesting …. hopefully this will help in reducing my Diet Coke habit too! It will provide an opportunity to put my colourful collection of chilly bottles to good use.

Dr Zoe recognises the challenges of shift working, long commutes, stretched budgets, supporting families, caring for relatives, the list is endless of all the things that mean we revert sometimes to less than healthy choices. Time saving and cost efficient ideas will be valued. I’m going to try to load up a plastic lunch box for the following day each evening too, to reduce the temptation of a mayo laden sarnie when I’m on the move.

So will you join in using the hashtag #WeEatWell19 and post pics of your healthy eating ideas for the month of November? I’m hoping to develop some new habits, pick up some new recipe ideas and dump some old ones!

Oh and did I mention there’s a prize? Dr Zoe is offering a scrummy fruit basket for the best posts over the next 30 days. Bring on Friday 1st November 😉

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.