Thinking Nurse

The Power of Prayer

2005-07-15T09:13:00.000+01:00

Here's an interesting study which backs up previous research on the therapeutic effectiveness of prayer: Prayer and Heart Patients

Who is your greatest philosopher of all time?

2005-07-04T11:32:00.000+01:00

BBC Radio 4 are conducting a reader poll for the public's view of the greatest philosopher of all time.

The rumour is that Karl Marx is currently in the lead, and as a result 'The Economist' magazine has urged its readers to vote for anybody but Karl Marx!

Some very interesting profiles of the various philosophers, so have a look and cast your vote.

If you want to say who you voted for and why, please feel free to do so below...

Person Centred Planning and Strategic Service Planning

2005-06-28T15:03:00.000+01:00

A new pack from the Foundation for People With Learning Disabilities offers an interesting set of tools and techniques to bring together the information and ideas being generated by the Person Centred Planning process currently being rolled out across the country.

It has been shown that where Person Centred Planning is implemented properly, and it's objectives taken seriously by services, it can lead to major improvements in the quality of life of people with learning disabilities (For example see Greig 2005 'The Story So Far').

Now the Foundation has put together a way that service leaders can bring together the information being generated by these plans as a source of data and ideas for the long term and strategic planning of their services, hopefully leading to further improvements in the support and care offered to people with learning disabilities.

The pack is available here: Shaping the Future Together

There will be a one day conference in London on 30th June on issues around Person Centred Planning, called Making It Work Speakers will include Rob Greig of the Valuing People Support Team, Eric Emerson from the Institute of Health Research at Lancaster University, and Barbara McIntosh from the Foundation for People With Learning Disabilities.

Restraints - The Nursing Debate

2005-06-27T14:15:00.000+01:00

JenSN has started an interesting discussion about restraints, that goes to the root of nursing's values, its' relationship with the patient/client, and it's relationship with other professions.
Her post is here:Restraints - Who Decides? She asks the question, who decides when to begin using restraint, and who decides when restraint should end?

I made my own little contribution to this debate too, I was a little concerned about the emphasis of one of the contributions, which did not seem to me to consider the rights of the patient...

Royal Society Of Medicine Forum For Intellectual Disability Student Prize 2005

2005-06-26T23:37:00.000+01:00

'Thinking Nurse" would like to be the first to congratulate Jadwiga Irska of Manchester University and Salford University on winning the Royal Society of Medicine Forum for Intellecutual Disability Student Prize.

Jadwiga won the prize for an innovative and interesting health promotion project in a forensic institution for people with learning disabilities.

In particular she looked at sexual health promotion issues, around preventing testicular cancer, in a population that included people who had committed sexual offences.

Irska took on the ethical and other issues involved in a courageous and innovative way, and fully deserves the prize awarded by the RSM.

Jadwiga Irska is a student of learning disability nursing and social work at Manchester and Salford Universities

A night with the backpackers

2005-06-24T15:49:00.000+01:00

I've just arrived back from a rather cool night spent in Central London.

I went down for a very interesting meeting, followed by an excellent dinner, then back to my 'hotel' - actually a backpackers hostel near Russell Square.

I dont think I could have chosen a better place to stay - the facilities were admittedly basic - I had to share a room with 2 backpackers, but this did not seem like an inconvenience given the friendly relaxed atmosphere.

I met some really interesting people, from every part of the world, who were only too happy to chat, and made full use of the 3am bar, I think at one point I even had a dance. I even met a woman who works as a 'Applied Behavioural Analyst' (whatever that is) with children with autism in Missouri USA, so we had plenty to chat about.

I am sure that had I stopped a more expensive, and more stuffy establishment, I would have retired quietly to my room, and missed out on a mind-broadening experience, and on meeting some rather cool people.

Comprehensive Nursing Blog Links

2005-06-23T13:04:00.000+01:00

I've tried to keep my own links list up to date with the finest examples of nurse blogging, (as well as many other links that might be useful or interesting to people interested in learning disabilities, nursing, philosophy and politics). My approach has been rather wide and eclectic, rather than focussed and specific, so when it comes to a full grasp of one particular area, my lists fall down.

I have to take my hat off to Mediblogopathy, a blog that has managed to compile what must be THE most comprehensive list of nursing blogs, and which I will be treating as the authoritative source for such information, unless anyone can show me a better one!

In the meantime, I will persevere with my own quirky, eclectic (and unfortunately partial) method of compiling my linklist. Hope you find something in there to provoke, stimulate, inform and entertain!

Socialism and Excellence: Reply to Smirnoff

2005-06-12T00:38:00.000+01:00

'Bloggers of the Left Unite think it is funny to parody the language and activities of scoialists. Sometimes they do it very successfully, once I almost laughed.

Their most recent post, and their link to The People's Cube got me thinking however.

There is a common myth that socialists want to make everyone 'the same', that socialism would stifle creativity and excellence, making people into mindless clones, all singing from a little red hymnsheet.

Socialists would counter that it is capitalism that encourages mindless conformity, even packaging 'rebellion' into a neatly wrapped commodity for sale at profit.

Here is the reply I posted to 'Comrade Smirnoff':

The 'People's Cube' has nothing in common with socialism. Those who accuse socialists of wishing to create a society where there is no intellectual challenge, no opportunity for excellence are simply projecting the mushy braindead capitalist MTV culture onto socialism.

Karl Marx defined socialism as 'From each according to their ability, to each according to their needs'.

What are the blindingly obivous implications of this statement?

1. That Marx understood that human beings have different abilities and needs.
2. People with high abilities would be encouraged to express these to the full in a socialist society.
3. People with lower abilities should also contribute to society, we xhould find ways to enable them to do this, rather than rejecting, segregating or impoverishing such people.
4. Socialism does not try to make people the same. It recognises and celebrates their differences, emphasising unity and solidarity NOT homogeneity.

Regurgitating anti-socialist propaganda may be mildly funny, but you seem intelligent enough to recognise when such propaganda is groundless. Is it worth maligning the people who are struggling to create a better world, simply for the sake of a chuckle?

Socialism and Excellence: Reply to Smirnoff

2005-06-12T00:15:00.000+01:00

The People's Cube got me thinking however.

There is a common myth that socialists want to make everyone 'the same', that socialism would stifle creativity and excellence, making people into mindless clones, all singing from a little red hymnsheet.

Socialists would counter that it is capitalism that encourages mindless conformity, even packaging 'rebellion' into a neatly wrapped commodity for sale at profit.

Here is the reply I posted to 'Comrade Smirnoff':

The 'People's Cube' has nothing in common with socialism. Those who accuse socialists of wishing to create a society where there is no intellectual challenge, no opportunity for excellence are simply projecting the mushy braindead capitalist MTV culture onto socialism.

Karl Marx defined socialism as 'From each according to their ability, to each according to their needs'.

What are the blindingly obivous implications of this statement?

1. That Marx understood that human beings have different abilities and needs.
2. People with high abilities would be encouraged to express these to the full in a socialist society.
3. People with lower abilities should also contribute to society, we xhould find ways to enable them to do this, rather than rejecting, segregating or impoverishing such people.
4. Socialism does not try to make people the same. It recognises and celebrates their differences, emphasising unity and solidarity NOT homogeneity.

Regurgitating anti-socialist propaganda may be mildly funny, but you seem intelligent enough to recognise when such propaganda is groundless. Is it worth maligning the people who are struggling to create a better world, simply for the sake of a chuckle?

Learning Disability Week In Oxford

2005-06-11T22:27:00.000+01:00

'Learning Disability Week' is nearly here, a week dedicated to raising the profile of people with learning disabilities, people with rights to independence, to make choices, and to be included as an integral part of society.

I got this over email about some events scheduled to celebrate Learning Disability Week in Oxford. Pop along if you are in the area.

Anyone with information on other events for Learning Disability week can either post it below, or email it to me at thinkingnurseATcoolgooseDOTcom

As part of Learning Disability Week (18-25 June) the School of Health and Social Care at Oxford Brookes University, the Oxfordshire Learning Disability Trust and the Oxfordshire Learning Disability Partnership Board are jointly organising two Open Days.

Why?

These days form part of other activities that will take place in the School during the week to promote and highlight Learning Disability issues, and links with similar events throughout the UK under the auspices of Mencap.

When?

Wednesday 22nd June 10 am to 4 pm
Thursday 23rd June 10 am to 4 pm

Where?

The venue for the open days is the School of Health and Social Care at Oxford Brookes University, Marston Road Campus, Jackstraws Lane, Marston, Oxford OX£ 0FL.

Who might be interested?

The open days are aimed at:

Any member of the public who wants to find out more about learning disability issues

People with a learning disability, their parents, relatives and carers

Those who work in services for people with a learning disability

Anyone interested in working with people with a learning disability and seeking local employment opportunities in a range of different organisations

Individuals of any age who may be interested in studying for a career in health or social care, be it in learning disability nursing or other associated professional courses.

Local people who are interested in discovering the opportunities and facilities that within the School of Health and Social Care

What is on offer?

An exhibition of Art work produced by learning disabled artists

A photography exhibition with Learning Disability as a theme

Non stop video shows of dramas and documentaries that focus on or feature people with a learning disability

Discover a range of sources of information on learning disability in the Internet information centre

Stalls by local organisations, such as the Oxfordshire Learning Disability Partnership Board and Mencap, who represent the interests of people with a learning disability

Information from local organisations who provide services for people with a learning disability, including the Oxfordshire Learning Disability (NHS) Trust, about current and future employment opportunities

Advise on pursuing a career in learning disability nursing and other associated professional courses on offer at Oxford Brookes University

Information on courses that are available locally to obtain vocational (NVQ, LDAF) or professional qualifications in learning disability, such as Nursing, Social Work, Occupational Therapy or Physiotherapy.

Advise on opportunities to get involved as a local volunteer in a range of different activities with VOX

Take a tour of the modern skills laboratories and other facilities at the School of Health and Social Care

Attend a range of skills training demonstrations in e.g. clinical nursing skills, communication skills and methods, massage etc.

A chance to practice some of these skills (taking blood pressure, listening to a heart beat, resuscitation) for yourself in 'Have a Go' sessions

What else?

A half day Learning Disability Nursing Student conference is organised for Thursday 23rd June, 1 - 4.30 pm on the theme of: 'Opening up New Worlds'. The conference is free of charge, but advance booking is required, and it is only open to learning disability nursing students and tutors. Speakers include:

My Life, My Choice - Advocacy Group
Sue Carmichael - National Valuing People Support Team
Yvonne Cox - Chief Executive, Oxfordshire Learning Disability (NHS) Trust
Eddy McDowall - Oxfordshire Learning Disability Partnership Board
Gail Hanrahan - Parent Consultant

'Thinking Nurse' wishes good luck to the organisers of all these events

Would You Agree To Have Your Post Mortem Screened On Live TV?

2005-06-07T15:02:00.000+01:00

Here's a picture of Jeremy Bentham's body - he was the philosopher most associated with the ethical principle of 'utilitarianism'.
In line with his philosophy, he wanted his body to be of some use after his death, so he had it stuffed, mounted in a wooden case and put on display at University College London.

As an atheist, I would have no objection to my body being dissected, particularly for the benefit of science, even though I have heard the rumours about what happens to body parts when medical students get hold of them!

I cannot see what harm it does to have a Post Mortem displayed live on TV for educational purposes, where there is full consent from surviving relatives. In my view, the more people understand about how their bodies work, the more likely they are to look after them.

I'd be interested in what other people feel about this issue.

Carnival of the Un-Capitalists 10

2005-06-07T11:21:00.000+01:00

My recent post on Poverty and Health is featured in the tenth edition of the Carnival of the Uncapitalists. There are some other good posts there too, in what looks a very entertaining, informative and stimulating blog carnival.

Readers interested in issues around the rather disastrous inefficiency of the 'market' as a method of delivering healthcare should look at this old edition of the Carnival, which was specifically devoted to the topic: Carnival of the Uncapitalists: - Markets and Health Edition.

Carnival of the Uncapitalists has become my second favourite blog carnival - after The Nursing Moments Blog Carnival of course!

Infection From Bibles

2005-06-04T21:46:00.000+01:00

Very interested in this story BBC: - MRSA Infection From Holy Scripture?

I can see a few sides to this argument:

Having a Bible at the bedside is a source of comfort to some patients.

It is nice to have something to read to take your mind off the monotony of the ward.

Is there any evidence that someone has caught an MRSA infection from the Bible?

However,

The majority of patients do not read the Bible during their stay in hospital.

Patients who want a Bible could bring their own, or request one from a Chaplain.

Bibles do not have wipe-clean covers and are not magically protected against becoming media for life-threatening infections.

If you were a patient with a compromised immune system, would you be happy to risk touching a Bible that had previously been used by an MRSA-infected patient?

Here is my suggestion to the Gideons
invest in electronic 'talking' bibles that can be easily wiped clean, and would be far more accessible to bed-ridden patients who struggle with small print and thin pages.

Or even

spend the money on providing some hospitals, doctors and nurses in 3rd world countries

Nursing Moments Number Two - Posted at CODEBLOG

2005-06-04T01:18:00.000+01:00

Nursing Moments Two has been keenly anticipated, and now it is here!

As promised it is bigger and better than Nursing Moments Number 1!

Geena has done a great job of tieing it all together. Head over and see what you think.

UK Health and Learning Disability Network Under Threat of Closure

2005-06-03T15:51:00.001+01:00

UK health professionals have grown to value the work of the 'Health and Learning Disability Network', affectionately known as the Janet Cobb Network after the tireless and dedicated woman who currently runs it.

The network is a method by which learning disability workers, nurses, social workers and other professionals can quickly exchange ideas and information about ideas and best practice in this rapidly changing field of health and social care.

But now the network is under threat, at a time when it is probably needed more than ever, as the realities of the size of the challenge of implementing the ambitious aims of the government white paper 'Valuing People' begin to hit home - the aims being to bring into reality the Rights, Independence, Choices and Inclusion of people with Learning Disabilities.

To date, the 'Valuing People Support Team' have funded the network, but this funding ceases in September of this year. Unless new sources of funding can be found, the network will fold.

The Foundation for People With Learning Disabilities is ready to become the host organisation for the network, but will need funding. It has been worked out that a mere £1500 from each of the 28 Strategic Health Authorities would secure the future of this invaluable source of information, and a letter has been sent to each of the SHA's by the Foundation.

So far only one has come up with the cash. Lets hope that the SHA's back this eminently useful and value for money method of disseminating good practice among learning disability professionals, before this valuable resource is lost for good. If it is lost, you can guarantee that it will not be long before much larger amounts of time and money will end up being spent rebuilding something almost identical...

Poverty and Health - Online Resources

2005-06-02T09:25:00.000+01:00

Poverty is the major challenge to human health in the world today.

Thought I would compile a list of links and online resources that provide information on poverty and health outcomes, and ways that nurses can act to challenge poverty and the systems that create it.

This factsheet on poverty and health from the International Council of Nurses is a good starting point:

For those living in poverty the impact reaches far beyond income and monetary matters: the greatest adversities are the lost opportunities to develop essential human capabilities. Poverty is a disease that saps people’s energy, dehumanises them and creates a sense of helplessness and loss of control over one’s life. Illiteracy, ill health, malnourishment, environmental risks and lack of choices contribute to the perpetual cycle of poverty and ill health.

Here is an informative article from Healthlink on Poverty, Disability and Health:

The conditions in which poor people live and work make them and their children more vulnerable to mental and physical impairments and they are less likely to receive the health care they need. The World Health Organization (WHO) estimates that more than 500 million people - between seven and 10 per cent of the world’s population - have impairments that are preventable and treatable. Over 80 per cent of these people live in developing countries.

Ill health and poverty are not confined to developing countries. This PDF from the Public Health Institute of Scotland in 2002 outlines Health Inequalities in the New Scotland

the number of people in the UK living in poverty has increased from 5 million to 14.1 million in the last 20 years. Certain groups of society face the added risk of experiencing exclusion and poverty at sometime during their lifetime. These groups include lone parents, children, young adults, women, the elderly, the disabled, members of ethnic minorities and faith communities, the unemployed and those on low pay.

Policies that seriously tackled poverty in the UK would have immediate and major effects on improving health. Have a look at these findings by Mitchell, Dorling and Shaw for the Joseph Rowntree Foundation

This is a summary of a few of their major findings:

Annually, some 7,500 deaths amongst people younger than 65 could be prevented if inequalities in wealth narrowed to their 1983 levels.
The majority of lives saved from redistribution would be in the poorer areas of Britain, where 37% of 'excess' deaths would be prevented.
Some 2,500 deaths per year amongst those aged less than 65 would be prevented were full employment to be achieved. Two-thirds of these would be in areas which currently have higher than average levels of mortality, preventing 17% of the 'excess' deaths in these areas.
Some 1,400 lives would be saved per year amongst those under 15 if child poverty were eradicated (using the Government's relative definition of child poverty). This represents 92% of all 'excess' child deaths in areas of higher than average mortality

This map published by the Joseph Rowntree Foundation shows the number of lives that could be saved every year with just a modest redistribution of wealth, back to the levels of 1983, where disparities in income were still vast:

They point out the stark fact that

Your chances of premature death are strongly related to what type of person you are (defined here by your age, sex, social class and employment status).

This page on Poverty Health and Environment contains a list of links to articles that look at environmental effects on human health and poverty.

Here is a rather hard-hitting article on poverty in the USA by the Community Action Board of Santa Cruz County: The War On Poverty

A child is born into poverty every 43 seconds. A child is born without health insurance every minute. Over 40 million Americans are not covered by health insurance of any kind including 9 million children, 90% of whom are living in working families.

Children are hit particularly hard by poverty - they are being punished for the failures of an economic system and circumstances they have had no part in creating

This report by Astrid Guttman highlights child poverty in Canada: Child Poverty, Health and Healthcare Use in Canada

This research clearly points to an inequality in the access of appropriate preventative and specialty health care among the most vulnerable children, and to hospital utilization and morbidity, which may be avoidable.

If you are lucky enough to have access to the British Medical Journal via ATHENS, this regularly updated list of articles on poverty and health is invaluable: BMJ collection; Socioeconomic Determinants of Health

This article by Lovelace Opoku-Agyemang on Nurses Working With The Poor Against Poverty highlights the work of Ghanaian Nurses;

As nurses call for investment in health, education and sound social policies, they equally have a major role to play in reducing poverty. The teaching and care that nurses render their people gives them better health. Nurses must take up the challenge to accept postings to socially deprived areas and respond to the multiple health needs of the poor.

The fact that health workers are themselves poor, leads to absenteeism, lack of motivation, poor quality of services and one of the "push" factor for migration. Health is central to overall human development and poverty reduction. To improve the health of poor people, a pro-poor health approach needs to be adopted and supported. Scaling up financial resources for health should be a priority.

The issue of the 'healthcare skills drain' hinted at in the above quote is considered in this article: BMA - The Healthcare Skills Drain

in countries which already have severe shortages of healthcare workers (fewer than one health worker per 1000 population) further loss of such workers through premature death or migration is very likely to result in loss of health services and loss of life in the countries’ populations.

.

I will also include this debate from my own blog on The question of Human Solidarity in Nursing where I argue:

The question of health itself is inextricably linked to social and economic factors, with people from the most oppressed sections of society experiencing the worst health outcomes. In my own area of nursing, for example, people with learning disabilities are 58 times more likely to die before the age of 50 than the rest of society.

Finally, (for now) I have found this article by Ainna Fawcett-Henesy on Poverty, its reduction and elimination – The contribution of nurses and midwives She points out that:

Even in western European countries, sections of the professions engage in moonlighting so that they can earn a realistic wage. Such pressures on individuals results in tired nurses and midwives who are unlikely to be able to give high-quality care to their patients and clients. In addressing the poverty agenda, WHO and all partners involved in the eradication of poverty in society must pay attention to the needs of the professions in this regard.

These are just a few of the important resources available to nurses on poverty and health. If you find others that can add to this list, please feel free to post them below.

World leaders are to meet soon in Edinburgh for the G8 summit. People from all over the world will be reminding them of the crime against humanity that is world poverty. Nurses and other healthworkers must add their voices to this angry chorus.

Social Class and Healthcare

2005-05-31T11:43:00.000+01:00

Is social class THE most important determinant of healthcare outcomes?

Read This post at 'The Health Care Blog and decide for yourself.

Here is an extract:

social class determines every aspect of each patient’s episode, “from the circumstances of their heart attacks to the emergency care each received...It shaped their understanding of their illness, the support they got...[and] their relationships with their doctors. It helped define their ability to change their lives and shaped their odds of getting better.”

Just within the realm of health care services, the same disparities apply to stroke, cancer, diabetes, chronic viral infections (HIV, hepatitis C) and a raft of other episodes and conditions. Of course, we could examine most of the other issue areas at the core of contemporary life — education, retirement, child care, leisure, on and on — and find in these that social class is also at the root of discrepant life chances and life styles.

Sister In White

2005-05-31T11:15:00.000+01:00

Nurse blogging is getting bigger and better every day.

I love to promote new nursing blogs, and here is another brand new student nurse blog:

Sister In White

Here is an extract from her first post:

i am supposed to be working on several assignements for school but instead i decided to start blogging. me? yes! and i don't even like writing. i know good writing when i see it but i don't consider myself much of a writer. so let's see how long i have patience in trying to keep this blog going...

so ok. this blog is going to be my feeble attempt at journaling my way towards a degree in nursing as well as trying to conceive and carry another baby to term. i am hoping to have the baby before i'm done with school. one can always hope, right? currently i am on sick leave because i've been diagnosed with a burnout. yes, a nursing student with a burnout. haha! i'm already burned and i haven't even graduated!

I think this will be an interesting one to watch!

If you are a nurse or nursing student starting out in blogging, send me a link to your blog - I'd love to give it a plug.

Nursing Moments - The Archive

2005-05-31T10:39:00.000+01:00

Crzegrl has put up a Nursing Moments Carnival Archive so that it is easy to keep track of both past carnivals and posts to Future editions of the Nursing Moments Carnival.

Meanwhile Geena at Codeblog - Tales of A Nurse has put out her last call for submissions to Nursing Moments, so get those submissions in before it is too late!

Oldham Trade Unionist Cleared Of Damaging Fascist Flowers

2005-05-24T21:59:00.000+01:00

I recemt;u reported on how a rather stupid prosecution had been launched against Martin Gleeson, secretary of Oldham TUC, after he protested when the far-right Britich National Party had gatecrashed a wreath laying ceremony to commemorate the victims of the Nazi holocaust. (which include many people with learning disabilities, who were among the first to be killed in the holocaust)

All charges against Martin Gleeson have now been dropped. Here is the press release from Oldham Trades Union Council on this issue:

Oldham TUC Secretary Martin Gleeson Vindicated after Criminal Damage Charge is Dropped

The Crown Prosecution Service has decided it is not in the public interest to proceed with a charge of causing criminal damage to a wreath laid by the BNP on Holocaust Memorial Day against Oldham TUC secretary Martin Gleeson.

The incident occurred on Holocaust Memorial Day (January 27th), when BNP prospective parliamentary candidate Anita Corbett laid a wreath alongside those laid by representatives of Oldham Borough councillors and MP's. This caused considerable upset among the participants in the ceremony, some of whom were of Jewish heritage and lost family members in the Nazi Holocaust. Despite the well-known history of Holocaust denial and anti-Semitic statements from the BNP's most prominent figures in the late 1990's, the BNP representatives seemed oblivious to the significance of their actions, which were cynically designed to raise their "respectable" profile among the civic dignitaries and hence their appeal to the electorate.

The insult was heightened by the failure of Corbett to abide by the clear instructions made by the organisers, which were that organisations other than those specified on the programme should wait until the end of the ceremony before placing their tributes. Corbett effectively gatecrashed the official part of the ceremony, and laid the BNP wreath with its distinctive red, white and blue logo prominently displayed.

Martin Gleeson was present to lay a wreath on behalf of Oldham TUC and community anti-racist group Oldham United Against Racism. He was appalled by the actions of Corbett, and decided to make a protest by placing his wreath on top of the BNP one in such a way as to obscure the BNP logo from public view.

The police officer present - Chief Superintendent Keith Bentley - had made a point of reiterating the instructions of the organisers to the BNP representatives before the start of the ceremony, and yet took no action when Corbett blatantly contravened them. Amazingly, Bentley then responded to a complaint from BNP representative Mick Treacy by arresting Martin Gleeson for alleged criminal damage.

Mr Gleeson was held for seven hours at Oldham police station, and was eventually charged with causing criminal damage by recklessness to a wreath to the value of £20, belonging to Anita Corbett. At a subsequent hearing at Oldham Magistrates Court, Mr Gleeson entered a plea of not guilty: intending to argue that he had lawful excuse for his actions at the subsequent trial. In his view the BNP's presence and actions had caused alarm and distress to many of the people present, and his visible protest had in fact alleviated that distress.

This incident produced a wave of outrage from trade unions, anti-fascist groups and individuals throughout Europe and even from Canada and the USA. Several union General Secretaries including Derek Simpson of Amicus and TUC General Secretary Brendan Barber gave their full support, and Greater Manchester Police Chief Constable Michael Todd was deluged with protest letters demanding that the charge be dropped.

After initially backing the prosecution, the CPS finally accepted the representations made by Bindman and Partners Solicitors that it was not in the public interest to proceed, and the charge has now been discontinued.

We find it perverse that Chief Superintendent Bentley - the most senior officer in the town - saw fit to take the course of action that he did, incurring many thousands of pounds of legal costs from public funds. Yet he failed to take any action against the instigators of the incident - the representatives of the BNP. This raises serious concerns about Greater Manchester Police's approach to community cohesion.

Oldham TUC and Oldham United Against Racism consider the discontinuance of the charge to be a vindication of Mr Gleeson’s actions, and we take great encouragement from this in our ongoing campaign to heal the divisions in our community.

(Contact us at info@oldhamtuc.org.uk )

www.oldhamtuc.org.uk

Thinking Nurse sends best regards to Mr Gleeson, and hopes that lessons will be learned from this expensive fiasco

The Devil Makes Work For Idle Thumbs

2005-05-24T14:57:00.000+01:00

This BBC News Report caught my attention.

Any suggestions for the titles and themes of the games they might bring out?

What Kind of Blogger Are You?

2005-05-20T15:10:00.000+01:00

You Are a Pundit Blogger!

Your blog is smart, insightful, and always a quality read.
Truly appreciated by many, surpassed by only a few.

What kind of blogger are you?

I am always very sceptical about these blogthings. This one seemed worth posting, or was it simply that my vanity forced me to post it?

Rise of Anti-Recruitment Movement In USA

2005-05-20T14:16:00.000+01:00

This post on Michael Moore's Website might surprise some of us in Britain who tend to believe that the people of the USA are solidly behind the occupation in Iraq.

Just like here in the UK, there is a growing movement opposing the occupation.

Here is an article about the growing counter-recruitment movement that is beginning to build in US high schools, written by a participant in the movement that forced the US army to retreat (at least for one day).

Nurse Blogging

2005-05-20T13:30:00.000+01:00

Seyms has posted an interesting article on the irresistable rise of nurse blogging.

She points out the way that a new community of nurse bloggers is coming together, assisted in no small measure by the 'Nursing Moments' Carnival of Nursing blogs.

She suggests some of the motives for nurse blogging:

Three particular motives for nurse blogging are apparent to me, althought there may well be more. Firstly it is about exchanging ideas, developing reflective practice though an interactive process, talking, thinking, communicating. Secondly it is about advocating for nursing, having a public voice, things to say to the world, "this is what it is like on the other side of the clipboard", "this is what we care about". Finally but perhaps most obviously it is about the humourous and the human side of the profession - the little daily events that are funny or tragic, moments that epitomise human nature; rich pickings are to be found in all aspects of nursing.

Nurse blogging is getting bigger, partly because we are beginning to find each other. At one point I genuinely believed there were only 6 nursing blogs in existence - now I seem to find a new one every day.

Here is a particularly good one: Sonic Nurse.

The site is beautifully laid out, absolutely impeccable taste in the choice of templates. The political commentary is interesting too, particularly for those of us who view US politics from outside, I admire it's rather uncompromising, forthright style. I recommend that you take a look.

Here is another site that does not flinch from it's subject matter: Death Maiden a nurse who cares for people near to death.

Here is a useful site for nurses interested in the use of information technology in their work: Informatics Nurse

The Agony of the Manchester United Fan

2005-05-19T14:47:00.000+01:00

For the first time in my life, I actually feel sorry for Manchester United fans.

Fans of the British football team Manchester United, are faced with confusion and uncertainty as Malcolm Glazer, the American sports tycoon tightens his grip on the premiership club.

From a club that was achieving success and running debt free, Mr Glazer's intervention turns it into a club with huge debt liabilities.

In this BBC News Report former Manchester United director Greg Dyke is quoted as saying that the family will be forced to relinquish it's holding by 2010;

More than a third of Mr Glazer's £790m offer for the club, is debt secured against United's assets, such as its Old Trafford stadium, while a further £275m comes from loans from three US hedge funds.

"I think most of us who have looked at it think he can't conceivably fund that bid," Mr Dyke told BBC Radio Five Live.

"He's clearly bought this on borrowed money and I don't think a club like Manchester United could sustain that."

Fans are rightly questioning how Mr Glazer aims to repay these debts - speculation has included higher ticket prices, and even possible sponsorship deals that would see Old Trafford renamed!

Given this situation many Manchester United fans are aiming to hasten Mr Glazer's departure by refusing to buy Man Utd merchandise, or even to buy match tickets, starving him of the funds he needs to repay the debt.

This must be agonising to fans in two ways, one in not being able to show allegiance to their team, and in having to explain to their children why they cant have the Man Utd wallpaper and bedspreads they have been promised for Christmas.

The other is that in starving Mr Glazer of funds, they are also starving their own team - they see it as analogous to chemotherapy - in aiming to rid the body of a cancer, it is neccessary to cause a certain amount of harm to the body itself.

Who will win? The power of the corporate dollar, or the power of the ordinary fan?

Those of us who do not support Manchester United will watch closely - after all, who is to say that our own teams will not be next

Nursing Moments #2 - Bigger and Better

2005-05-18T12:29:00.000+01:00

Geena at Codeblog, Tales of a Nurse is hosting the next edition of 'Nursing Moments', the exciting new Blog Carnival that relates specifically to Nursing and Nursing Issues.

Geena is aiming to post the carnival in early June, and wants submissions in by 1st June, so please get writing your submissions!

All the signs are that the second Carnival will be even bigger and better than the first, with several submissions already received during the excitement created by the first carnival.

'Nursing Moments' is now the property of a dedicated team of Nursing bloggers who have formed it's editorial board, and, in a sense, it is also the property of everyone who contributes articles, plugs it on their own blog, or simply enjoys reading it.

I think it is fair to say that the launching of 'Nursing Moments' was one of the proudest achievements of the 'Thinking Nurse' blog, and if nothing else survives of my blogging but 'Nursing Moments', all my efforts will have been worthwhile!

Human Solidarity In Nursing - Theory and Practice

2005-05-17T12:15:00.000+01:00

To what extent should social consciousness be a part of nursing theory, and of nursing practice?

I have just received an excellent and aposite reply from 'RNegade' to my post on the need for social consciousness in nursing theory. The reply is so relevant to the serious social questions facing Nurses today that I am reposting it here in full, followed by my reply:

The problem I see with a Theory of Nursing as Human Solidarity is that unless it is grounded in concrete nursing situations, activism becomes something nurses do outside their work. Assuming this would be on the level of the "grand theories," the same sort of inapplicability that kept practicing nurses from using these theories would likely occur.

For many of us, activism is part of our identity as nurses, but in the US it amounts to lobbying efforts and political work outside our roles as nurses. Perhaps it is different in the UK.

The need for social consciouness in nursing has never been greater. For example, who were the nurses at Abu Ghraib and Guantanmo Bay that allowed alterations of records, use of mental health histires as means of determining vulnerabilities to be exploited in interrogation, and concealment of torture injuries, and concealment of homicide through insertion of tubes post-mortem to mimic patient care that was never given?

We ought to rein in our own unethical colleagues, and publically repudiate their actions. At the same time, we must closely examine how structural and discursive elements constrain nurses from preserving human rights.

The social consciousness question hinges on autonomy with accountability in the direct care sphere. To the extent that nurses cannot or will not protect patients from human rights abuses, the door is open for neglect, maltreatment, inadequate treatment, and selective access to services. Nursing education, at least in the US, is geared toward conformity.

Collectively organizing or individually acting in response to a poor care situation is not considered an essential "skill," or a great deal more time would be devoted to it. Social consciousness is needed on the global level as well as in the microcosms of a society that are replicated in the care situation. These include gender, racial, religious, class, and sexual orientation biases.

Analysis of cases needs to include the effects of these biases on the health of the patient, and the degree to which the care situation is potentially a context for reinforcement of repression. Foucault describes "discipline" in part as a function of the roles played by police, teachers, nurses, physicians, etc. who create expectations for correct behavior. There is no argument when a nurse tells someone to remove their clothing and put on a patient gown. It is an expectation that does not require a reason, because patients already "know the drill."

Recognition of the subtle, and direct ways that nurses already function to reinforce the powerlessness of patients' predicament in the care situation should come first. We cannot rest on the consensus that the core of nursing is care, and thus we are opposed philosophically to oppressive and dehumanizing conditions.

Nurses perpetuate discourses that conceal abuses, disparities in care, and deferral to profit motives. For too long we have been preoccupied with our constraints as an "oppressed group." We are highly educated, and indispensible to the functioning of any health care system. We are not powerless.The frame for opposition to dehumanization is the hands-on daily work of nursing. It is there that critical examination and exposure of nursing complicity in oppressive practices is most needed, and admittedly, most difficult.

I am making the case for social consciousness in nursing practice. Thus far, in the US, theory has not guided practice, except to some degree at the middle range and situation-specific levels. We have an ethical standpoint in many international nursing documents about human rights, and our support of the right to health and health care. Theory would seem to be a potential bridge to the application of stated values. Practices, however, are the substance of care. To accomplish structural change is more a matter of organizing than theorizing.

Thankyou for your comment RNegade, this is precisely the kind of debate and discussion I hoped to provoke when I started this blog. The questions you raise go directly to the heart of the crucial questions facing Nursing as a Profession in the context of a world society with such a breathtakingly steep gradient of wealth and power between a small elite and the rest of society.

I appreciate the thought you have put in to your comment, and will attempt to reply to your points paragraph by paragraph.

You suggest that a theory of Nursing as Human Solidarity should be grounded in concrete care situations, it is something that should apply to nurses in their work, as well as what they do outside work. I agree. 'Activism' as you term it, can take many different forms, and the form it takes within the workplace would neccessarily be different from that in the nurses 'own' time.

I would argue that simply being in possession of social consciousness would change the practice of many nurses in a way that makes their response to patients, different and more appropriate, their care responding to the person's social situation, rather than to a textbook version of an idealised patient.

People whose health is challenged tend to be disempowered by this very fact - you illustrate yourself the question of the powerlessness of patients when they are expected to wear gowns etc. Ill health and disability are shunned and feared in our society which focuses as you say on productivity and profit.

The question of health itself is inextricably linked to social and economic factors, with people from the most oppressed sections of society experiencing the worst health outcomes. In my own area of nursing, for example, people with learning disabilities are 58 times more likely to die before the age of 50 than the rest of society.

You suggest that a theory of Nursing As Human Solidarity could be as sterile as other 'Grand Theories' of nursing. It couls be that these 'Grand Theories' were so sterile because they confined themselves within the walls of the hospital, excluding the social realities outside,

These social realities disrupted these theories because they exist in the hierarchies of healthcare organisations, in legislation affecting healthcare, in the economics of healthcare and in the life experience of patients and nurses themselves.

Your points about Abu Ghraib and Guantanamo are well made. I have made similar points about the role of nurses and other health staff in the 'euthanasia' by the Nazis of thousands of people with Mental Health problems and Learning Disabilities in 1930s Germany.

These are the dire potential consequences of a lack of social consciousness within the Nursing Profession: By not having an explicitly stated 'Theory of Nursing as Human Solidarity', these nurses at Abu Ghraib and Guantanmo have instead adopted the implicit 'me first' values of western capitalist society, and accepted unquestioningly the existing power structures and the unethical actions that flow from these values and structures.

There is a need for theory here, unless we have an alternative to offer, all that remains are the hegemonic values of the powerful corporate elite.

A theory of Nursing as Human Solidarity would put human rights at the centre of Nursing Practice, making the preservation of human rights a key ethical responsibility of the Nurse. As you state so well "The frame for opposition to dehumanization is the hands-on daily work of nursing." This does require leadership, the willingness to speak out and preparedness to swim against the stream. This can be in big and small ways.

In the UK Nurses have an ethical obligation to challenge poor care practices and inadequate care situations. Legal protections for 'whistleblowers' are in place. Individually nurses still feel very exposed when they do challenge existing practices in this way, and there is a clear need for collective organisation that will back up those who stand up in this way.

You argue that "Practices, however, are the substance of care. To accomplish structural change is more a matter of organizing than theorizing." Theory without practice is indeed sterile, but practice without theory is blind.
There is indeed a 'theory - practice gap' in nursing, but this does not mean we should throw theory out of the window, instead we should be looking at ways to make our theories better and more directly relevant to the situations facing nurses.

The existence of the gap could be because existing theories have neglected to take into account the realities of how the social, economic and power structures of society affect the care situation and care practices.

A theory that directly and accurately addressed some of the unpalatable truths about our society might be more relevant and applicable to the day to day work of Nursing

Radio La Colifata

2005-05-13T15:44:00.000+01:00

This radio station from Buenos Aires is a brilliant example of patient empowerment; people with mental health problems getting together and telling their own stories.

In my article on blog therapy I talked about the 'Pennebaker disclosure effect', a phenomenon whereby talking or writing about your most traumatic experiences causes genuine mental and physical healing.

I think that this must be happening at Radio La Colifata too, but also far more.

Paulo Freire wrote in his brilliant 'Pedagogy of the Oppressed' that in order for a person to change their world, it is neccessary first for them to name it. By attaining a voice for themselves, these sufferers from mental illness have found a way to talk about their worlds, to broadcast their experiences, and to become known by millions of listeners.

I would love to hear a British version of this Radio Station - for once real life and bitter experience breaking through the airw

Hewitt to Continue With Creeping Privatisation of the NHS

2005-05-13T11:03:00.000+01:00

The new British Health Minister, Patricia Hewitt has made it absolutely clear that she intends to increase the role of the private sector in the NHS even further.

In this post, just before the election I warned that

The reality for the NHS (and other public services), is that whatever the result of the general election, there are dark days ahead: Privatisation via PFI and Foundation Hospitals, will be stepped up. Workers will face further casualisation and attacks on their conditions, such as retirement age and pensions.

The future of our public services depends not on which dishonest bunch of politicians comes to power, but on the determination of public service workers, and the British people to defend them from these politicians, and the big business interests they serve.

Looks like my words were only too accurate.

The message for people who wish to keep hold of the NHS, and to stop the government's ideologically driven privatisation drive, is "If you value it, fight for it"

Clarity, Fractals, Uncertainty and The Meaning of Nursing

2005-05-12T14:17:00.000+01:00
I found this 'flight of ideas' scrawled on the back of a photocpied article. I wrote it over a year ago, in response to a discussion on the 'Nursing Philosophy' email discussion group about the concept of 'clarity'.

One or two of my ideas have shifted since then, but I felt it was worth posting the piece, just to see what I was thinking about back in those heady days...

Clarity, fractals, uncertainty and nursing

I have been enjoying the discussion held here about 'clarity', a discussion I found interesting because it coincided with some of my own thoughts about uncertainty.

One contributor pointed out that it is possible to make a statement of apparently absolute clarity, but that to another observer, with another perspective, who demands definition of the terms, the statement can seem to be totally obscure.

The problem arises as words are broken down and their meaning analysed, because the very terms that are used as definitions may themselves be challenged and broken down even further.

Some philosophers (I.e. Frege) have sought to create mathematical models of language and meaning, trying to find a 'binary code', the most basic units of meaning that fit together according to rules of logic to eventually build up into units of communication.

One problem is that if such fundamental units of meaning were to exist, there is no reason why they should obey conventional rules of logic that govern higher-level language, any more than sub-atomic particles are governed by the same laws of physics as bricks and bicycles.

Meaning could be structured in a similar way to the fractal. However closely you look at a fractal, you find ever more deeply nested fractalising patterns, structured in layer upon layer of complexity. (It is worth reading Hofstadter's book 'Godel Escher Bach' for a deeper explanation of this phenomenon).

Fractals are deep expressions of uncertainty, it is impossible to predict whether a particular point at the edge of a fractal pattern will be one colour or another until the equations they are based on have been fully computed.

Similarly in language, no matter how deeply the terms we use are analysed and defined, there must remain areas of uncertainty, that could seem 'larger' and more complex than the seeminlgly simple expression that contains them could ever have suggested.

Putting words, grammar and meaning under a microscope becomes an infinitely frustrating process! - But perhaps we are looking in the wrong place. We are surrounded by a landscape of meanings that has been co-created by communities of human beings over centuries.

Perhaps meaning lies not in the words, but in the intersubjective process of exchanging words and meanings, one human being with another.

Sometimes far more clarity, complexity, meaning and beauty can be expressed in a poem, or in a short dialogue between a nurse and patient, than in reams of precisely written academic literature.

When I work with people with learning disabilities, I try to attend to what they say, and what they mean, and to express myself in ways that lie within their understanding.

This may not really be 'simplifying', but perhaps could be seen as working at a different level of complexity, in the fractalised structure of language, an attempt to relate, despite our different experiences and understandings.

Through such listening, and adjusted communication, somehow the need for connectedness is met, horizons touch and somewhere in this process of inter-relating lies what it means to be a nurse, and what it means to be a human being.

Nursing Moments: Future Editions

2005-05-12T10:32:00.000+01:00
The first edition of 'Nursing Moments' was a great success, and volunteers have been queuing up to host future editions.

So far the schedule is as follows:

Nursing Moments #2 (early June)will be held by Geena at Codeblog; Tales of a Nurse

Nursing Moments #3 (early July) will be held by Jodie at Nurse Ratchett's Alter Ego

and Nursing Moments #4 (early August) will be held by Crzegrl at crzegrl.net

You can send your contributions to me at 'thinkingnurse AT coolgoose DOT com' or to the carnival hosts themselves, the main thing is to GET WRITING NOW!

Blair Vader

2005-05-12T09:49:00.000+01:00
Spotted this on Bloggers of the Left Unite which despite being a socialist website, is actually at times quite funny.

Guantanamo Bay - The Backlash Grows

2005-05-11T11:12:00.000+01:00
Todays events in Afghanistan, where Jalalabad has erupted in rioting bear out the predictions of those who have criticised the strategy and tactics used by the USA in their so-called 'war on terror'.

Angered by reports that during the interrogation of one of the captives at Guantanamo, a copy of the Koran was flushed down a toilet, students took to the streets, buildings linked with the west were torched and troops shot dead three people. This in a country that we are told is 'grateful' to the West for overthrowing the Taliban.

I have always felt that the 'war on terror' would have equal success to the 1980's 'war on drugs' - where at the end of the 'war', many times more peoplw were using illegal drugs than before. Indeed the two seem to be linked - 90% of the heroin used in Britain and the USA is grown in Afghanistan, enriching the warlords that the US invasion helped to put in place.

I cannot say that I share the demonstrator's anger at the flushing of a book down a toilet. I realise that they see it as a blasphemy, but in my eyes far worse blasphemies were inflicted on human beings at Abu Ghraib and at Guantanamo Bay itself. The deaths of thousands at the World Trade Centre and the deaths of hundreds of thousands in Bush and Blair's wars against Afghanistan and Iraq were also blasphemies against humanity.

Guantanamo bay, where people are held without charge, and without the evidence against them being scrutinised by any kind of court is a blasphemy against democracy and justice. Even in the USSR at the height of Stalin's terror, they would hold 'show trials' to justify the incarceration and torture of whoever the Stalinists believed was a threat to the USSR - the political and military apparatchiks in the USA have dispensed with even this gesture toward due legal process.

The way to combat terrorism, would be to tackle it at it's roots. People go down the blind alley of terrorism because of their rage and hopelessness at poverty, injustice and national oppression. They may use the language of religious fanaticism, but this is a symptom rather than a cause of the situation they are in.

A 'war on poverty', an end to imperial adventures and the return of the huge wealth in natural resources to the people unfortunate enough to live above them might begin to repair some of the damage done particularly in the last two decades of Western interference in the Middle East. Until then I fear that the backlash we have seen so far is only a small taste of upheavals yet to come in that region.

Keep Your Eyes On The Road And Your Hands Upon The Wheel

2005-05-10T11:34:00.000+01:00
My big news today is that I am on my way to pick up my first car, having passed my test 3 weeks ago.

I have managed to spend nearly all my life without a car, but with qualification looming, it would be practically impossible for me to get a job in my branch of nursing without one.

I have been preparing myself for becoming a driver by watching 'Top Gear' and learning how to moan about speed cameras, car tax, road humps and other methods of harassing the 'law abiding motorist'. I think I am already getting quite good at it. All I need now is a beaded seat cover and a pair of backless driving gloves.

An Alternative to Anti-Social Behaviour Orders

2005-05-09T12:52:00.000+01:00
In the recent general election, all the main parties focussed on crime, and in particular anti-social behaviour by young people.

Working-class people are the most likely to be the victims of crime and anti-social behaviour and are therefore understandably concerned about them.

But all the evidence shows that the knee-jerk policies of New Labour, Tories and Liberals do nothing to seriously tackle them. ASBOs simply DO NOT WORK.

On the contrary, it is the government's 'anti-social' policies of cuts and privatisation which make the situation worse.

Below I have decided to feature three examples of the alternative approach that three local campaigners have taken to the problems of disaffected youth. (I have taken the examples from an article inThe 'Socialist':

"Community action in Coventry

ST MICHAELS Ward has the highest unemployment in Coventry. Outside the city's main areas investment in community and youth facilities has suffered and issues involving young people and local residents have grown.

Rob Windsor, Coventry

A year ago these problems came to my attention when I was representing St Michaels as a Socialist councillor.

A group of young people were playing ball games and bothering residents including a man with a heart condition.

Local residents were fuming. There was a clear possibility of an "us and them" situation between them and the youth involved.

I helped set up a meeting attended by over 35 local residents. The police and community wardens also came.

The meeting was angry but constructive, partly due to the tone we set that there was a lack of local facilities for young people.

It would have been easy just to demand that the police turned up heavy-handedly but instead we used the local warden service to approach the youth.

They did so and discussed with them - one young lad was excluded from school and had nothing to occupy him.

The wardens helped set up a course for him and helped occupy others.

The police were involved and their presence increased but not in a heavy-handed way. Within a month the problems had dissipated in that area.

There were sporadic problems and news that problems had shifted to other streets but for a good few months the area was quieter.

A heavy-handed approach would not have got this result - it may even have exacerbated it.

Stretched police resources would in any case have made such an approach impossible to sustain.

Whilst New Labour's Anti Social Behaviour Bill had some measures that working-class people would support such as closure of crack houses and measures against fly-tipping, it helped to create a myth that deep rooted social problems can be tackled by bits of paper and bureaucracy.

In reality the prisons are overcrowded and the courts can't cope. And the more ASBOs are used for low-key offences, the more swamped the system to enforce them will become.

But New Labour spinners try to use these issues to grab votes and deflect people's attention away from the real robbers, like the capitalists who run Ford stealing the livelihoods of Coventry workers.

Socialists have to be careful - simply blaming capitalism won't help communities having to cope with the "Do what you like and stuff the others" approach initiated by Thatcher and less hope for a secure future for working-class youth.

The community should be really 'empowered' to deal with these issues by strong residents' and community groups that would seek to help young people as well as deal with problems.

Young people need jobs and facilities

KIDS GET into crime because there are no decent jobs, no facilities, and problems at school. It does feel like there's an increase in petty crime by younger teenagers. Some of the problems come from the collapsing education system. But the other problem is the lack of youth facilities.

Lynn Worthington, Socialist Party election candidate, Wythenshawe and Sale

There are well over 8,000 young people in Wythenshawe and nothing for many of them to do.
A lot of the facilities are unaffordable or only open during the day.

Playing games in the street has been made a crime by the council. Meanwhile, the football pitches are so overpriced they're forcing out local teams.

Newall Green school's all-weather pitch is so expensive only Manchester City FC can afford to use it!

All this leads to nothing to do after school, but hang around the streets. Willow Park housing company in Benchill has found an 'answer' to the problem - ASBO the kids for swearing, and send leaflets to every tenant with the swear-words the kids were using!

When the local community first posed the issue of youth facilities during the housing transfer to Willow Park, the company promised a purpose-built youth facility. Years on and it still hasn't been built! The father of a local young person said to me: "Instead of building more housing, why can't the youth have a place to ride their midi-motors (bikes), why can't they give them a little bit of ground and let them use it? Then the youth won't be annoying people with their bikes."

It's about time the council started meeting the needs of all the community. We need proper youth and community facilities funded by the council and democratically run by the community.

The key jobs for young people in Wythenshawe used to be Direct Works and the airport, as well as the factories. The engineering works used to do apprenticeships, but it closed down seven years ago. Most of the other factories have gone as well. Direct Works used to offer apprenticeships, but these have gone now it's been privatised.

At the airport, to do any job - even cleaning - you need a driving license! This is impossible for most young people. We need real job creation, decent jobs with decent wages, and public money pumped into Wythenshawe - not just token efforts.

We've been campaigning in Benchill for more and better youth facilities. We've gone petitioning from door-to-door and collected hundreds of signatures. We lobbied the Area Committee (the local meeting of councillors for Wythenshawe).

When I pointed out the need in Benchill for youth facilities at affordable prices, one of the councillors agreed. But they still haven't done anything.

Southampton

United campaign gets results

"IF YOU close this place where are working-class young people supposed to go for sport? This is all there is round here." This was an angry question thrown at the Liberal councillor and chair of Leisure Services during our first public meeting to fight the closure of St Mary's Leisure Centre in Southampton last year.

Nick Chaffey, youth worker

St Mary's is one of the most deprived inner city areas in the country. All the problems of housing, low income, poor health and crime are magnified and make life here very hard.

When the council's intentions to close the local leisure centre were known it caused a lot of anger in the area. The youth project I work for use it regularly for holiday activities and 'Midnight Football'. On Saturdays there is a free session for young people.

The centre is used by hundreds of people every week, for football, weight lifting, climbing, fitness and squash.

There is absolutely no doubt that these facilities offer young people an opportunity to use their time positively and keep them off the streets and out of trouble.

We only had a few weeks to stop the closure going ahead.

After our public meeting, we got as many people involved as possible, collecting signatures on the petition, lobbying councillors, getting in the news and building for our demo.

The support was tremendous, young people, parents, all the different groups of users at the centre, got stuck in.

The demonstration was the highlight of the campaign and one of the biggest local demos for some time. It soon became clear that we had won the argument.

In the days running up to the council budget-setting meeting, the council had a sudden change of heart and announced they were going to keep the centre open.

As socialists we understand that it is the profit system that drives the policies of cuts, privatisation and closures which all the main parties are pursuing.

But this campaign was the music of the future and a lesson to all of us who were involved what a strong and united community can achieve.

Noam Chomsky on US Healthcare

2005-05-09T09:18:00.000+01:00
I picked up a little book called "Doctrines and Visions" (Noam Chomsky, Penguin 2004) for only £1.50.

The book is meant as a foreword/afterword to Chomsky's "Hegemony or Survival" (2003), but it actually stands very well on it's own, and being pamphlet sized, (and cheap) makes it quite accessible to readers who are new to Chomsky.

The book is mainly a rather excellent analysis of the balance of world power, between the two superpowers (that's right - I said two!), one being the US political/military/corporate elite, the other being the world's people.

His analysis is excellent, and has been borne out, almost to the letter by subsequent events in Iraq, and the rest of the world.

Being interested in health issues, I was particularly interested in this paragraph on the problems of Health Care in the USA:
It is no secret that a major domestic problem is the exploding health care costs in the mostly privatized US system, far higher than comparable societies and with relatively poor outcomes, results traceable in large measure to the enormous inefficiencies of privatization and the control of government by the pharmaceutical industry, which tops the profit ranking year after year. As in the past, large majorities favor national health insurance, most regarding it as a 'moral issue'. Eighty percent regard universal health care as 'more important than holding down taxes', and favor legal imports of precription drugs. But if these questions arise at all, the proposals are held to be 'politically impossible', because of 'tangled politics'. That is true: disentangling the politics, we discover that the pharmaceutical industry, insurance companies, and other private powers will not allow it, so the will of the public is out of the political arena.
These are among the many signs of serious erosion of a democratic culture under dedicated multi-pronged assaults.

In Britain we must be vigilant not to allow our own health and education systems to be 'privatised by stealth' through PFI and other Labour schemes, otherwise we will be up the same creek as the American people, without a democratic paddle...

Technical Problems

2005-05-09T09:10:00.000+01:00
My apologies for the technical glitch that meant the same post was published no less than 7 times over on my blog. Hope it didnt make my blogging seem any more repetitive than usual...

I know why it happened, which is halfway to preventing it happening again.

Aftermath of The Stinking Election

2005-05-06T13:13:00.000+01:00
The most stinking election in living memory is at last over.

I dedicate this poem by John Gay to all the participants in the mudfight, whether they won or lost their seats:

'The Politician'

I see him mad and drunk with power
Stand tott'ring on ambition's tower,
Sometimes in speeches vain and proud,
His boasts insult the nether crowd,
Now seized with giddiness and fear,
He trembles lest his fall is near.

One rather scandalous story for an election in 2005 was the problems Stephen Pritchard of Tarleton in Lancashire had in voting. Stephen is a company director of www.accessatlast.com an organisation that arranges accessible travel and accomodation for tourists and business travellers with disabilities.

It was therefore highly ironic that he should arrive at his polling station yesterday morning, only to find that there was no wheelchair access, and that in order to get in to vote, he needed 3 men to lift him up the steps.

To add insult to injury, when he tried to vote, the polling booth collapsed.

Clearly the concept of 'Universal Suffrage' has been lost on the election officials at Tarleton!

Despite all my attempts to get to sleep, and avoid the election coverage, I ended up watching the results coming in.

I was very moved to see Reg Keys get such a large vote in Sedgefield, and to listen to his speech. Reg Keys' son was killed in Iraq, so Reg stood in Tony Blair's constituency as a protest against the war.

Blair stood stony faced, shuffling uncomfortably behind him as Reg suggested that one day Blair might apologise to the people for engaging in the Iraq war, and be able to visit wounded soldiers face to face.

Across the country, Labour suffered the public's anger at the way they have been lied to about Iraq. George Galloway defeated Blairite Oona King, in what could be a highly significant development. I think Galloway could go one of two ways, either using his position in parliament to build a New working class party in oppositon to New Labour and their war, or he could spend all his time trying to get back in to the Labour Party, as Ken Livingstone did in a similar situation, which I feel would be a waste of all the immense efforts his supporters put in against the Labour Party machine to get him elected.

Blair's majority has been significantly reduced. This means that if he wants to carry on with his programme of creeping privatisation in the Health Service and Education, he is likely to find it much more difficult, particularly if all the people who value these public services take action to defend them: If you value it, Stand up for it!

The Ancient Japanese Game of Go

2005-05-05T10:38:00.000+01:00
When I am not learning how to be a Learning Disability Nurse, and not blogging, I like to play a rather fiendish game of strategy known as 'Go'.

The basic principles of the game are very simple. You either have black or white 'stones', and place them alternately onto a grid, at the points where the lines cross.

If you fill all the points around an area of the board, that area becomes your territory. The aim is to surround as much territory as possible, without becoming surrounded yourself.

From such simple rules however, a game of immense depth and complication emerges. Games can last for months. Masters of Go sometimes play full chess amtches against each other to relax in between moves!

A full size GO board is 19X19, leading to an immense number of possible permutations of the game. So far, unlike chess, there is no computer programme that can even come close to beating the best human players.

You can play go online at www.dragongoserver.net the system works well, and there are a good bunch of players there of all levels of ability, so it is easy to get a good game.

I play as 'Mostly Harmless' - here is a link to a discussion on the philosophy of Go.

Another good place to limber up and gain Go skills is Go Problems here you dont actually play an opponent, but try to solve Go puzzles, ranging from basic beginner level, right up to downright impossible.

If you decide to take up Go, the motto is 'lose your first 100 games quickly'. To be a Go player, you need to forget about quick and easy victories. Rather like life, you build up your skill and awareness slowly and incrementally, then still lose anyway!

'Nursing Moments' #1 The Carnival of Nursing Blogs

2005-05-04T10:25:00.000+01:00
This is it! The very first carnival dedicated to the ways of thinking, feeling and acting we call 'nursing', an activity of 'Head and Heart and Hand', the place where science and art meet, clash and fuse in the strange and wonderful synthesis of daily life.

Managers of health services say that they see nurses as 'valuable human resources'. These pieces of writing demonstrate that we are more than human resources, we are 'human beings', engaging on a daily basis with other human beings in a way that no other health profession can - people see nurses for the most crucial and intimate of reasons, at all stages of the lifespan, at all times of day and night. Nursing is about life and quality of life, about health and human potential, about the mutual support and solidarity of the human species.

The first contribution, is from EmJC of The Unlikely RN She goes straight to the heart of the issues that affect every nurse:- human bodily fluids in Master of the Urethra "It's funny, people used to (and still do) make fun of my nursing school decision and joke about the poop and pee and puke I'd have to deal with. I would haughtily tell them "Oh ho. The days of bedpans and nurses in caps lifting patients and cleaning up vomit are long
gone - the modern nurse isn't responsible for such things..."
Personally I would rather wade knee deep in the human effluvia that EmJC deals with, than watch another Party Election Broadcast!

Jordan Barab gives us British nurses a warning of the kind of innovation our Health Service DOESN'T need in his account of how a 30 Minute Promise policy brought in by the hospital managers led to him being badly injured at work. As our health service faces creeping privatisation, how long will it be before this kind of scheme crosses over the Atlantic?

Geena gives us a picture of a typical day in her life in Tales from the CCU, while Jodie S. looks at life with people who face death Tumour Board

Krybabynurse is a brand new nursing blog - here is an extract from one of her recent posts: "I 've been in situations where I've thought something was funny, only to be looked at strangely, because apparently what I'm talking about is a serious issue. I know somethings in healthcare are really serious, but there are some things you just can't change (for example, bring somebody's legs back), so why not just have a laugh about it and move on??" Do you agree? You will have to visit her blog, read her full post, and make your own mind up…

EmJC has a second bite at the cherry with this article: Oh Sh*t! dealing with her feelings of mortification at uttering these scatological expletives in the presence of her patient:
"A cardinal rule of the health professions involves never ever using the word "Ooops" or saying "Oh Shit". So I decided to break it on Friday. I was helping a patient perform some perineal-area cleansing which involved fussing with her hospital-issue panties. I was being very gentle and careful and totally forgot the woman had an indwelling catheter and came close to pulling the damned thing out. I went with "Oh Shit" instead of "Ooops""

Finally I offer you a couple of posts from my own blog A Charter for Human Caring In Nursing and my tirade against the Harvard Referencing System the most miserable instrument of mental torture ever inflicted on British Student Nurses.

If you have enjoyed 'Nursing Moments', then you might consider one of the following actions:
1. Submit an article to a future edition
2. Host a future edition.
3. Post a link to this carnival.

Cheers, and Happy Nursing!

Nursing Moments: Last Call For Submissions

2005-04-29T11:42:00.000+01:00
'Nursing Moments' is going to be the first nursing blog carnival in history!

You can be part of this historic moment, a major step into the information age for the entire nursing profession, but only if you submit your article before the deadline!

The deadline for submission of articles is 2nd May 2005.
Nursing Moments #1 will be published on or before 4th May 2005.

We still need a logo.

We need volunteers to host future editions, which will hopefully be published monthly, July is already taken, but June and August are still free.

Rush your contributions now to thinkingnurse AT coolgoose DOT com to be there at the start of something BIG!

General Election 2005 - The Most Stinking Election In Living Memory

2005-04-29T11:01:00.000+01:00
On May 5th 2005, British voters will go to the polls, or more accurately, some British voters will go to the polls. The majority who do make it to the ballot box will be pinching their noses tightly with expressions of disgust as they mark their papers. Why? Because this must be the most stinking election in living memory - and we are faced with a choice between some of the lowest, vilest examples of the ways that the lust for office can distort human values.

I have been trying to avoid watching the election coverage. I knew it would make me angry. I didnt realise how much it would make me seeth with anger at the depths to which British politics have sunk.

The first thing I would like to do, is to ban politicians altogether from NHS premises (unless obviously they are using their services!). The sight of Michael Howard walking round hospitals, no doubt spreading vile bugs as he shook hands with patients without washing in between was bad enough, but the knowledge that the politicians, both Labour and Tory who enter these hospitals know full well that their parties plan to continue the creeping privatisation of the NHS, with more dodgy PFI schemes and more Foundation hospitals, and to raise the age at which health workers can retire, all the time that they are grinning and saying 'the NHS is safe in our hands' is even worse.

You can be sure of one thing - when a politician says 'the NHS is safe in our hands' you can be sure that very soon, there will be big business hands in the NHS safe.

The Tory election campaign has attempted to benefit from deep racial fears, targetting asylum seekers, immigration and Roma/travellers. This is unprecedented in a British General election, in the past politicians have been decent enough in general to avoid playing 'the race card'. This time round neither of the parties has felt such inhibitions as they vy to prove that they are the 'toughest' on immigration, without considering the major benefits that immigration brings to this country, the reality of the dangers that asylum seekers are fleeing from and the dark forces that their racist rhetoric could unleash.

The publication of the Attorney General's guidance on the legality of the Iraq war has led to clear evidence of the way that Blair, just like Thatcher, treats his own cabinet with contempt, using them as a 'rubber stamp' for his decisions (or more accurately the decisions that GW Bush has made for him). Michael Howard pretends he would have acted differently - we dont remember him questioning Thatcher's dictatorial approach to cabinet government. He accuses Tony Blair of being a 'liar' with perfect justification, but is just as vulnerable to the charge himself.

I have friends who are going to vote liberal democrat, but in the councils where they hold office or share power, they have enthusiastically implemented the same cuts and attacks on their workforces as the Labour and Tory administrations.

Other friends say 'I know Tony Blair is a liar and is privatising the NHS and attacking our pensions, but Howard will be worse'. This seems to be the main theme of Labour's election campaign 'we are not the Tories', 'Vote for anyone else, and you will let the Tories in'.

The reality for the NHS (and other public services), is that whatever the result of the general election, there are dark days ahead: Privatisation via PFI and Foundation Hospitals, will be stepped up. Workers will face further casualisation and attacks on their conditions, such as retirement age and pensions.

The future of our public services depends not on which dishonest bunch of politicians comes to power, but on the determination of public service workers, and the British people to defend them from these politicians, and the big business interests they serve.

International Nurses Day 12th May

2005-04-26T14:14:00.000+01:00
May 12th will be 'International Nurses Day'.
The International Council of Nurses honour this day by raising issues that are important to nurses across the world.

This year they are highlighting the scourge of counterfeit medicines.
You can download their 'ICN International Nurses Day Kit' (a pdf file) here.

Last years kit featured their campaign against poverty. I think it is worth having another look at the excellent pack they produced then: Working With The Poor Against Poverty (ICN 2004)

As I have said before, issues like poverty are vital to health, but often swept under the carpet, as it does not suit those in power to highlight the awful health consequences of the economic systems they defend.

Nursing Shortage - RCN

2005-04-25T15:24:00.000+01:00
This article on the flight of nurses from the health service suggests that recruitment of Nursing Students needs to DOUBLE to 66,000 a year if present numbers are to be maintained.

It strikes me that if you are pouring water into a bucket with a hole in the bottom, there are two ways to keep the water level adequate - either increase the rate at which you pour water in, or make the hole in the bottom of the bucket smaller! Rather than focussing on the need to recruit more nursing students, surely it would make more sense to try to address some of the reasons why nurses are leaving in the first place?

There are hundreds of reasons why nurses are leaving the profession. It is a tremendous waste of training, knowledge and experience. In the current general election, I have not heard the politicians speak a single word about this issue.

Health policies have clearly not considered adequately the needs of health staff, particularly where they contradict the needs of PFI companies.

The health service's most valuable resource is it's people - perhaps the government and the commissioners of healthcare need to start thinking about this, unless they plan to waste £millions more on training students who also end up burning out and leaving the profession early...

Thinking Nurse Share Prices Soar

2005-04-25T14:51:00.000+01:00
I dont own any shares myself, and dont go in much for share trading (I have always questioned the value priorities of a society that rewards it's stockbrokers vastly more than it's care staff!).

Nevertheless, I have found it hard to resist taking a sneaky peak at the 'blogshares' rating of this blog. Perhaps this is a sign that to paraphrase Marx, 'in any society, the ideas of the ruling class are the ruling ideas of that society'. Here I have been assessing the success of my blog, not by the quality of writing, or it's contribution of ideas to the blogosphere, but by it's success on a virtual stockmarket. Cultural hegemony has arrived at 'Thinking Nurse'.

Despite all this left-leaning hand wringing, I cannot deny the pleasure I felt when I realised that someone had felt it worthwhile to take a gamble on the future success of this blog, and even more delighted when I saw it was HypnoKitten who had bought them, a person whose speculation has netted her a 600,772,271,679.81% increase in her share values in ONE MONTH. Makes you wonder if she thinks Thinking Nurse is capable of a growth in value of such proportions! Perhaps, like George Soros, anything she invests in will attract a wave of 'copycat' investments, making her choice of shares a 'self-fulfilling prophecy'...

On the other hand, perhaps she plans a takeover bid, then to sack half the workforce, get the other half onto casual contracts, then split up the blog and sell the bits on at vast rates of profit...

Lucky for me that Blogshares is just a 'piece of fun' that mimics the capitalist system, without any of it's nastier consequences.

In the meantime 'Thinking Nurse' will remain entirely independent of any shareholders or advertisers, and continue to put out content totally free from any commercial considerations. By the way, I find GloopCo Chocolate bars a satisfying meal on their own, and enjoy two or three every lunchime. Every nurse should have one in her bag, next to the big diary with a massive elastic band and a giant paper clip...

"Naming Is Not A Simple Act"

2005-04-22T10:52:00.000+01:00
Bob Gates very recently changed the name of the 'Journal of Learning Disabilities' to the 'Journal of Intellectual Disabilities', and he reflects on why he did this in the editorial of the March edition of that publication.

People do not like to be labelled. Labelling people leads to all kinds of ramifications, and the disability movement has the slogan 'label jars not people'. People with learning disabilities have been, and still are, given the label 'mentally handicapped', 'retarded' 'subnormal' 'low grade' etc etc, but they themselves argue that they simply want to be referred to as 'people', like anybody else.

Rob Greig takes this approach in his Valuing People Support Team Report to the Valuing People Review Throughout the text, he refers to people with learning disabilities as 'people', which is of course, exactly what they are.

Nevertheless, people with intellectual/learning disabilities do have particular needs. Professionals who work with these people do need particular skills. In today's society, in order to get the support they need, people have to show that they meet certain criteria, and join the community of people with the label of 'disabled'.

Publishing a journal that is read by the professionals who work with people with Intellectual Disabilties is hugely important. The name of a journal can 'set the tone' for the attitudes we express toward the people we work with. Gates is aware of this
changing the name of this journal has been fraught with a degree of hesitancy on my part. This is because I wished the journal to have a title that had international meaning, but did not wish to further marginalise people with learning disability by adopting a title that might be seen by some as inappropriate, or even negative, nor be seen to further disempower people with learning disabilities. (Gates 2005)

I have thought for a while that the term 'learning disabilities' is confusing. It is very similar to the term 'learning difficulties' an educational term used to describe children with dyslexia and other problems that affect their learning. The confusion has affected some of the services I work at, with inappropriate referrals coming from people who have only a vague idea of what a 'learning disability' actually means, (including some professionals who you might expect to know better).

Perhaps Gate's use of the term 'Intellectual Disability' will catch on, and all the services will change their names to 'Intellectual Disability Service', and LDN's will describe themselves as 'Intellectual Disability Nurses', we will have to wait and see! (I can see tens of thousands of pounds from tight budgets being reallocated for new letterheads as we speak...)

The idea of an 'Intellectual Disability Nurse' is actually quite close to the pseudonym I chose to write this blog: 'Thinking Nurse'.

I chose this 'nym' for a variety of reasons:
* I am a nurse who likes to think.
* My blog 'thinks' about nursing.
* I work with people whose 'Thinking' is different from the mainstream, I am someone who supports and facilitates people in their thinking, making me literally a 'Thinking Nurse'.

"Nursing Moments" - Publication Date Announcement

2005-04-22T08:56:00.000+01:00
The launch of Nursing Moments has created a buzz around some of the various nursing blogs.

I hope it will be a way that nurse bloggers can begin to draw together as an online community, sharing ideas, supporting each other, promoting the wonderful writing about nursing that is appearing every day in the blogosphere, and making sure that the best articles dont get lost like precious needles in the online haystack.

I hope it will also generate discussion and debate, and get people THINKING about nursing.

Nursing Moments #1 will be posted on or before May 4th 2005

The DEADLINE for receipt of your contributions is May 2nd 2005. send them to thinkingnurse AT coolgoose DOT com.

You dont even need to be a nurse to contribute! As long as the article relates to nursing and healthcare, it will be considered for publication. Poetry is just as welcome as prose.

THINGS WE NEED

We still need a logo - so budding artists out there get your pens and brushes out!

We need publicity - I dont want people to miss the chance to promote excellent pieces of blogging, just because they never heard of this carnival! Mention it on your own blog, get the word out!

We also need volunteers to host future editions of Nursing Moments. I think we should aim to publish it monthly, at least to start with. Hosting a carnival is not just a service to the nurse blogging community, but also a way of promoting your own blog, and generating lots of extra hits!

Think carefully - what have you written in your blog, that the rest of the world badly needs to see?

How To Pass Your Driving Test, And All Your Nursing Exams

2005-04-22T08:39:00.000+01:00
Exams and tests are tough. They are highly demanding on the body, as well as the mind!

I tend to rationalise the sweat and misery they cause with the thought that if they were easy, they would not be worth doing.

I had a mock exam on Wednesday, and a driving test on Thursday morning. The good news is that I have finally passed my driving! I have failed this test twice before, last time with a total nervous 'shed collapse'. I think the examiner was as relieved as I was when we finally got back to the test centre.

Yesterday however, although I was nervous, I managed to control it, keeping the ride largely smooth and calm, though I was a jelly when I finished.

Is there a secret to passing exams and tests?

I dont really think there is. There are things you can do, like planning, revising, preparing yourself.

I find with exams that it helps a lot to actually be interested in the subjects that you are studying - if you are interested in something, you tend to remember the facts and ideas you will need to pass.

The other side I suppose is just not giving up. Nobody passes every time, and when you dont pass, you have to deal with the awful feelings that creates, then get back on your feet and do it all again.

The good news is that the more tests and exams you do, the better you get at them, so even an exam where you dont pass is not wasted effort.

Every so often, I try and think of a better, fairer way for nurses, or people who want to drive on the roads to demonstrate their abilities than at least partly in a test or exam. I really wish I could think of one!

Nursing Moments #1 A Nursing Blog Carnival is Launched

2005-04-15T13:59:00.000+01:00
My suggestion that there should be a carnival for nursing blogs met with a surprisingly strong and positive response.

I have therefore decided to launch it.

It will be called Nursing Moments, being a title that can embrace all branches of the nursing profession.

If you are not a nurse, you can still post to it, if your post is related to nursing, nurses or experiences of the nursing profession (good or bad).

DEADLINE for receipt of links to your articles is 2nd May - send me them NOW!

I also need a nice logo for the carnival - if anyone is good at this kind of thing and willing to work for the glory of having their logo displayed on my page, and no money, please send me a link to your efforts (you will need to host your image too!).

As a newly launched carnival, it will also need publicity - please big it up on your own blogs, so that everyone in the 'nursey' part of the blogosphere gets to hear about it!

SO ALL YOU NURSE BLOGGERS OUT THERE - GET WRITING!

What has Learning Disability Nursing Got To Do With It?

2005-04-15T13:41:00.000+01:00
This is another report from the 'positive choices' conference, continuing from the reports I made here: Bob Gates and Jason Grundy and here:PCP in Northern Ireland.

This time I am writing about Ruth Northway's speech 'But What Has Learning Disability Nursing Got to Do With It?'

Ruth Northway is editor of the RCN publication 'Learning Disability Practice'.
Like Bob Gates, she looked at learning disability nursing from the perspectives of past, present and future. Learning Disability Professionals, she said, became almost 'accidentally' part of the nursing profession, and the existence of learning disability nursing has been continually challenged, for example in publications like the Jay and Briggs reports.

This was a symptom perhaps of a lack of understanding of the role of the learning disability nurse.

LD Nurses have a position that is influenced by the views, wishes and needs of clients, by the views wishes and needs of families, by a changing professional context, by changing social policies and by changing models of service provision. Against such a background, one of the key attributes of the profession has been flexibility, indeed, according to Mitchell (2003) the survival of learning disability nursing 'depends on the profession's continued ability to change in line with government policy.' creativity and flexibility are part of the identity of the learning disabilty nurse (Turnbull 2004)

What is important however, is that LD Nurses should also be drivers of change, as well as simply responding to it. We need to be looking to the changing needs of the community of people with learning disabilities, for example the growing number of young people with profound and multiple disabilities, and the rise in the number of elderly clients, with even more elderly carers.

She pointed out there was a need for the development of practice, education and research to reflect such changing needs, in partnership with people with learning disabilities at individual, group and population levels.

She cited Kim (2005), Learning Disability Nurses need 'VIP' - Vision, Integrity and Passion.

One Year of 'The Unlikely RN'

2005-04-12T15:07:00.000+01:00
'The Unlikely RN', a nursing student blog of genuine quality has reached it's first blog birthday. Join the celebrations here!

Congratulations to EmJC, the prolific author of 'The Unlikely RN'.

One thing is for sure, the nursing blogger community is growing in breadth, depth experience and entertainment value. It is equally certain that 'The Unlikely RN' is one of the shiniest jewels in that growing treasure hoard.

Cranial Nerve Mnemonic

2005-04-12T15:06:00.000+01:00
I dont have to remember the names of the 12 cranial nerves, but if I did, I am sure I would remember them easily thanks to this rather splendid Cranial Nerve Mnemonic posted on the 'Journal of Genki' by Steve from the Shameless Antagonist blog.

The names of the 12 cranial nerves are:
olfactory, optic, ocolomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory, hypoglossal.

The unforgettable mnemonic: "Only One Object Transcends Time and Foams Vivaciously: Glorious Vagina! All Hail!"

Anyone want to suggest a similarly memorable mnemonic for the titles of the 11 objectives of 'Valuing People' (2001), the British Government's White Paper that aims to improve the quality of life of people with learning disabilities by promoting Rights, Independence, Choice and Inclusion?

These are:
1. Disabled Children and Young People
2. Transition into Adult Life
3. More Choice and Control
4. Supporting Carers
5. Good Health
6. Housing
7. Fulfilling Lives
8. Moving into Employment
9. Quality
10. Workforce and Planning
11. Partnership Working

A good mnemonic will be of immense use to me, as one of my exam questions is on the implementation of Valuing People: so post your suggestions below!

A Carnival For Nursing Blogs? - Who Wants One?

2005-04-07T12:36:00.000+01:00
I have been thinking more about starting a Nursing Blog Carnival. Basically the definition of a blog carnival is where a group of bloggers each sends their best posts (or nominates other peoples best posts) to a central blogger, who collates them, then presents them as a 'carnival'. This is done on a regular basis, and the person who hosts the carnival can alternate. It is a great way of getting your blog more widely known, and of finding out about some of the excellent writing that is going on.

WHY A NURSING BLOG CARNIVAL?

Why a nursing blog carnival I hear you ask - are there not already very excellent carnivals in existence, like the wonderful and popular 'GRAND ROUNDS'.

Yes indeed there are - and nurses have posted some excellent bits of writing there, (even I have put a couple of my own efforts up) but isnt it time we nurses as a profession came out of the shadow of the biomedical establishment, and expressed our own collective reflective voice?

After all we come from a rather different perspective from many of the other medical professions - a unique 24 hour/lifetime professional relationship with the people we care for. So we have unique things to say, which we have every right to express in an independent way.

WHAT SHALL WE CALL IT?

I'm not sure yet, but I have thought of two alternatives: 'Nursing Moments' (Inspired by the idea of the 'Nursing Moment', that therapeutic instant of connectedness between nurse and client), or 'Head and Heart and Hands' - (Inspired by the true tools of nursing; our abilities to think, feel and act). I am open for suggestions if people can think of a better name, and for indications about which alternative is preferable.

WHO WILL DO IT?

I am willing to host the first carnival, if there is a call for it. - But it means that YOU will have to post your best articles to me via my email: thinkingnurse AT coolgoose DOT com. If you are up for such a carnival, and willing to play your part, please post a comment below. If you think that nurses should not have a blog carnival of their own, or are not capable of sustaining one, please post below too!

Orac And The Tangled Bank

2005-04-06T18:25:00.000+01:00
Orac is hosting a blog carnival today called 'Tangled Bank'. It's like Grand Rounds, but devoted to posts about science (both medical, biological, physical or any other science). Orac is a fellow medblogger (and past host of Grand Rounds). The permalink is here: http://oracknows.blogspot.com/2005/04/tangled-bank-xxv-dear-journal-editor.html

Positive Choices Conference - Student Presentations: Person Centred Planning in Northern Ireland

2005-04-05T12:35:00.000+01:00
The Positive Choices conference kicked off with an inspiring contribution by Bob Gates, which is covered here: Bob Gates and Jason Grundy
I will now write a little about the excellent presentations made by the students who attended the conference. In the difficult first spot were Orla MacAllister and Johnathon Pollock, of Queens University Belfast reporting on the work that had made them 'RCN Student Nurses of the Year 2004' (Well done!).

The two intrepid students had brought Person Centred Planning from off the pages of the idealistic textbook, and into a Nursing Home that housed people with learning disabilities who had complex health needs. They engaged with staff attitudes to PCP in a straightforward and honest way, offering training to the whole staff team, and dealing frankly with the various attitudes and beliefs about PCP that exist in every care setting where this is introduced as a new concept.

The scepticism of some staff was expressed in the statement "I dont think that the person is capable of participating meaningfully in a PCP" - Jonathon Pollock felt that often the people who made this kind of statement were actually projecting their own fear that they were themselves incapable of doing PCP onto the person with Learning Disabilities.

They did not win everyone over in the Nursing Home to Valuing People's bright vision of Person Centred Planning - this would have been impossible - instead they followed up with the 'propaganda of the deed' - they carried out a Person Centred Plan, involving people at every level from the client's circle of support. The best way to prove that something can be done, after all, is to do it.

The plan they organised was for 'Mary' (a pseudonym), ensuring that she was at the centre of the process by asking questions of all the members of the circle of support like "What is it that would really add quality to Mary's life? If Mary had a dream, what would it be?".

I am still waiting for full details of MacAllister and Pollock's presentation to be posted on the Positive Choices website - keep checking, it is worth a read particularly because of the objective way they have reported staff opinions of PCP. No starry eyed idealism here, but gritty realism, and a determination to make it work.

Coming Soon: More reviews of student presentations.

Tips For Nurses and Health Professionals On How To Work With Someone With A Learning Disability

2005-04-04T12:57:00.000+01:00
People with learning disabilities are not getting proper treatment from health services. They are not getting accessible information, staff are not spending the time to explain things. Many staff are scared of people with learning disabilities, avoid them, or treat them disrespectfully.

Here is a great video to watch, made by another student learning disability nurse, and two people with learning disabilities, giving some handy tips so that medical staff can avoid some of the pitfalls that so often crop up when people with learning disabilities try to access mainstream services, but instead find themselves being dealt with in a way that fails to meet their needs:

INTO THE MAINSTREAM

You need broadband to see the video, otherwise, you still get audio. Check out the rest of the site too - one of the best I have seen for a long, long time.

The Disability Discrimination Bill aims to make it a statutory duty on all public authorities to promote disability equality - so if you work for any public organisation, you need start thinking about how you can make your practice accessible for people with learning disabilities!

Positive Choices Conference Report - Jason Grundy and Bob Gates

2005-04-04T08:28:00.000+01:00
For the first time ever, a national conference of student learning disability nurses brought together hundreds of students at the University of Nottingham.

The conference was the brainchild of Jason Grundy, who, incidentally, holds the world speed record for rowing around the Isle of Wight. Unfortunately for Jason, he also gained the world speed record for descending a flight of stairs, the night before the conference, so he was unable to open the proceedings, spending the morning at casualty instead! (He was there for the afternoon - giving an impressive speech. I made a note on my pad: "Jason Grundy - a name I will hear again".

First speech at the conference was by the eminent Professor Bob Gates on the theme "Choosing to be different", it was also a tour of the past, present and future of learning disability nursing, conducted, thanks to the wonders of 'Powerpoint' via a working model of Dr Who's Tardis.

He described his own 'Choice to be Different' when he made the decision to become a learning disability nurse, much to the chagrin of his father. He cut a rather remarkable figure in his role at the local 'Mental Subnormality Hospital' with his buttock-length hair, tie-dye T Shirt and purple velvet loons.

He pointed out, that while many people make the choice to be different, some people have no choice, and that the dearest wish of some people with learning disabilities is to be accepted as 'ordinary people'.

People with learning disabilities, he stated are the most socially marginalised group in society. When they access mainstream health services, they are faced with a disproportionate risk of ill health, limited health education, poor screening, hostile environments and segregation.

Gates briefly covered the main aims of the government White Paper 'Valuing People', and described some of the research he had been involved in, about people with learning disabilities and mental health problems experiences of accessing mainstream mental health services.

People with learning disabilities who used such mental health facilities had a simple list of wishes and dreams, such as 'more support to go out more often' 'getting a good explanation of my medicine' 'more workshops and training for staff on awareness of mental health and learning disability'. (Bob's presentation on this issue will be posted soon on the
Positive Choices Conference website.

The major experience of people with learning disabilities and mental health issues, is that it is not enough just to 'get in' to these services - when they do they are pushed to the margins and treated differently - real access means staff becoming aware of the needs of these people, and respecting them.

The experience of people with learning disabilities of accessing mainstream services that cater for physical health are very similar. The Disability Rights Commission are launching an enquiry into the major health inequalities that lead to people with learning disabilities having a mortality rate up to 4 times higher than the general population.

Bob asserted that Learning Disability Nursing has 'a wonderful future' - our role will be as 'Agents of Social Inclusion', battling against the 'fear and misunderstanding' of people with learning disabilities that exists in mainstream health services, including among nurses:

"Some people need help to achieve ordinariness, extraordinary people are needed to help with this". Learning Disability Nurses are ideally placed to be these people, they are the only current social care practioners who spend 2 of their 3 years preparation for practice specifically in the field of learning disabilities. Our task as agents of social inclusion lies in bringing the needs and wishes of people with learning disabilities to the fore in mainstream services.

(More on this conference to come - including reports of Ruth Northway's presentation, and most importantly, the excellent presentations made by the student Learning disability Nurses.)

Blogitus Interruptus

2005-04-04T08:17:00.000+01:00
Just a note to say I'm sorry to have been away for so long.

Had a pile of work to be handed in today - so blogging took a back seat while I rushed to write up my coursework (at the last minute as usual).

I Have both mocks and real exams coming up too, so my blogging will be reduced in frequency, but hopefully not in quality.

The next item I blog will be the report that I promised from the 'Positive Choices' conference that took place in Nottingham last Friday. I managed to drag myself away from the monstrous heap of paper that surrounds my workstation to get to this extremely successful and enjoyable conference. This report will be posted here VERY SOON.

New Government Safety Campaign

2005-03-22T00:00:00.000Z

The dangers of eating a whole pack of extra-strong mints...

Blair's NHS: The Effects of Foundation Hospitals and PFI

2005-03-18T11:04:00.000Z
I found this extract analysing the state of the NHS, and the direction and consequences of government policies on the NHS, in a much longer socialist analysis of the state of Britain, written in Feb 2005, which you will find by clicking on this link: Socialist Party
then clicking onto "Socialist Party Statement on Britain" in the sidebar.

I am publishing it here because it is an excellent collection of facts and figures on the condition of the NHS, and gives an alternative point of view to the rosy corporate gloss that we get from most 'official' sources. Nurses and other health workers need to be strong advocates for the rights of our clients to decent healthcare, particularly as our clients are often not in a position to speak up for themselves.

"The NHS has suffered badly from the government's onslaught on the public sector in a number of ways.

Although the government has tried to promote their increased NHS funding of recent years, which is now an unprecedented 9% of GDP, the amounts being put in are nowhere near enough, coming after previous decades of underfunding including the continuation of the Tories' spending levels during New Labour's first few years in power.

The Audit Commission has said that 107 NHS organisations (hospital trusts, primary care trusts and strategic health authorities) failed to break even last financial year, about a sixth of the total, compared with 71 the previous year. Only one out of 28 English strategic health authorities is predicting a surplus for this financial year.

The latest cost-cutting scandal is that of MRSA, caught by 100,000 patients last year and causing the deaths of about 5,000 people each year. A recent study by Unison showed that the number of hospital cleaners has halved over the last ten years; there were 100,000 in 1984, yet there are now just 55,000.

Coupled with underfunding has been the ongoing privatisation drive, handing public money to private hands while worsening services at the same time. Blairand his co-'modernisers' want to turn the clock back to the pre-NHS days when the ill could only be treated if they had the money to pay for it, or if a charity stepped in to help them.

But as the NHS is so popular, won by the working class through great pressure in the post-war period, Blair has been unable initially to go for charges at the point of use(though there are charges for dental care, glasses and prescriptions), and is instead destroying the service by introducing privatisation into treatment provision.

This process of privatisation is now turning into a fiasco as great as that in the rail industry. The last round of 'reforms' in the NHS, presently being forced through, are causing immense problems in many areas for NHS workers and patients. NHS and private fast-track treatment centres are being opened, in market competition with existing NHS hospitals. The government intends that from 2008, patients will be able to choose any hospital 'that meets NHS prices and standards'. By then, all are supposed to be foundation trusts, run like businesses but without shareholders.

In the meantime, the Department of Health is insisting that 8-10% of hospitals' non-emergency work is bought from the 'independent' sector. But the independent treatment centres take the easiest and most 'profitable' treatments, leaving the mainstream NHS hospitals with the more difficult and expensive cases. The 'independent' sector is also in most cases giving more expensive treatment, for instance: "Birmingham and Black Country Strategic Health Authority is being told it has by 2008 to shift 20-30,000 cases out of its hospitals and into the independent sector on contracts that cost around 15% more per case than average NHS treatment". And the contracts stipulate that the NHS has to pay for operating slots in the private centres whether or not it uses them! All this has raised the spectre of NHS hospitals going bust.

The British Medical Association's conference of senior hospital doctors warned last June that after the next election, the government's policies would lead to "the biggest hospital closure programme ever. It will spell the end of the NHS and it must be stopped". Even the hand-picked bureaucrats at the top of the NHS, the chief executives, are feeling forced to voice opposition to the government. In a survey by the Health Service Journal, three quarters of them do not believe the government's use of private sector treatment centres is good value for money, and almost 80% say that they divert resources from the NHS.

Fearing hospitals collapsing before the general election, the Department of Health has decided to throw more money at private consultants to set up a "failure regime" aimed at "identifying the warning signs of failure". This has been triggered by the experience of hospitals like the Bradford Royal Infirmary, one of the first hospitals to be declared a 'foundation trust' - chosen because it was considered to be a leading hospital in relatively good financial health. However, a report in the Observer revealed that the hospital has gone into dire crisis since its new status was awarded, suffering a dramatic decline in its finances in just a few months. The Financial Times subsequently reported that "The Bradford Teaching Hospitals went from a projected £1m surplus into a possible £11m-plus deficit within four months of starting operation". Now emergency cuts are affecting all aspects of the hospital, including clean linen and basic equipment like tubing.

Foundation hospitals were a project spearheaded by Blair's favoured successor Alan Milburn, now promoted to be New Labour's election organiser.

Money for provision of new health service buildings continues to be poured into private hands through the Private Finance Initiative. The Association of Chartered Certified Accountants recently confirmed that the government has paid up to 30% more to construct PFI hospitals and concluded that "PFI is likely to lead to redistribution of income from the public at large to the corporate sector" and that "the chief beneficiaries are the providers of finance, leading to a redistribution not from the rich to the poor but from the mass of the population to the financial elite".

Health workers not only face constant stress as a result of all the above turmoil, but are also suffering attacks on their pensions and changes to their working arrangements and pay as a result of the Agenda for Change agreement.
This latter deal brings in a small increase in the NHS minimum wage, to £5.69 an hour (£5.88 from April), from £4.85, but increases flexibility in the interest of management and means that around 80,000 workers have to have 'protection' to stop their wages from falling, will face several years with no pay increases and could have their pay cut after 2011."

Anyone have any comments on the issues raised in this assessment of the NHS? I would be interested to hear of any experiences of PFI, foundation hospitals and 'Agenda For Change' from the 'sharp end'.

Abortion Clinic Days - Blog Review

2005-03-17T12:11:00.000Z
A few days ago, I posted about how some people use blogging as a form of therapy. Another vital and interesting use of blogs is to give a window into areas of the world where society tends to prefer not to look.

The blog 'abortion clinic days' is just such a window. It is an honest and realistic account of experiences of a person who works in an abortion clinic, and of some of the people she has helped.

It goes into true-life stories, explaining the real circumstances of real people - the best way to answer the rabid howls of the anti-abortion zealots who spend a large amount of time and energy posting comments, of varying degrees of coherence, on her blog.

These comments are very revealing of the mindset of the anti-abortionists. In one discussion on a woman who needed to have an abortion because she had serious medical problems, and going full term might have jeapordised her life and future health. The anti abortionists were still insisting that she should take the risk anyway.

This is an illustration of the reversed thinking of the anti-abortionists. The foetus is portrayed as a fully-fledged person with rights, but the mother is simply a vessel within which that foetus exists, with no rights whatsoever - a piece of tissue for whom motherhood is a fate rather than a choice.

I would recommend 'Abortion Clinic Days' as something to read through, and to think about each case carefully, as the author herself clearly has done. Writing a blog like this, in these days where family planning workers are harassed, threatened and even murdered by 'pro-life' fanatics, is an act of courage to be respected.

I would have more respect for the right-wing politicians, who spout the 'pro-life' mantra, if they had any concern for the foetus after it was born. When these people start taking action to abolish slum housing, tackle child poverty, provide decent state nursery and childcare provision, and child benefits that actually match the cost of raising a child, I will listen to them more seriously.

If more people could be lifted out of poverty, and could feel confident that they and their families could live a decent life, perhaps many fewer women would be faced with the stark choice of an abortion in the first place.

Values and Capacity - Online Conference - Papers Open

2005-03-16T13:43:00.000Z
What follows is a press release I received over the invaluable 'Janet Cobb Network'.
I have already written a little about the Mental Capacity Bill, and the Rights of Vulnerable People and I hope to make a few little contributions 'from the floor' at this conference, essays and access to the internet permitting:

Papers are now open at the Values and Mental Capacity conference.

This free, online conference takes place at the Connects Conference Centre from 1 PM on Wednesday 23 March.

. The Connects Conference Centre can be found at http://www.connects.org.uk/conferences
. The easy-read version of the conference can be found at http://www.connects.org.uk/capacity

About the conference

This conference will address a wide range of issues concerning values and mental capacity as they affect people of all ages with mental health problems and people with learning disabilities.

This is an area of fundamental importance in relation to policy, practice, and personal perspectives. It is critical that individuals, organisations and services recognise the centrality of values in defining people's identities and their capacity to make decisions. The conference builds on the Values in Mental Health Conference, held at the Connects Conference Centre in March 2003. It also takes account of recent and proposed legislation on mental capacity within the United Kingdom.

Key themes,

The conference will explore a number of themes, including

. What is mental capacity and why are values important to mental capacity?
. Whose values are we talking about?
. What's been going on with values since the last conference?
. How can mental capacity be assessed in ways that take into account people's often different values?
. What's currently happening in UK policy and legislation about mental capacity and values?

Conference aims

The purpose of this conference is to provide an opportunity to discuss
these crucial issues and themes.

Who should attend?

The conference will be of interest to a wide range of people, both in the UK and other countries, including

. people of all ages with disabilities, including people with mental health problems or learning disabilities
. carers, including family and relatives of people with disabilities
. service providers, including health care professionals
. policy makers, within the UK and other countries
. academics and researchers

Registration

You can register for the conference at www.connects.org.uk/conferences

You do not need to register to view the papers at the easyread version of the conference. However, you will only be able to see key points from the papers, not the full papers.

Registration at the conference is free and should take no more than 2 minutes.
To participate in the conference you will need access to the World Wide Web. You will also need an email address if you wish to contribute to the discussions.

Programme

Thursday, 13 January 2005

Foyer and Exhibition open

You will be able to talk to other delegates before the conference begins.
You will also have a chance to view the conference exhibition

Wednesday, 16 March 2005

Papers open

You will be able to view the papers for the conference from Wednesday, 16 March 2005 - one week before the conference opens.

Contributors will include

. Baroness Ashton of Upholland, Parliamentary Under Secretary at the Department for Constitutional Affairs (responsible for Mental Capacity Legislation)
. Professor Anthony Sheehan, Director of Care Services, Department of Health

Wednesday, 23 March 2005 13.00 - Conference Opens

You will be able to view and participate in any/all of the following discussions:

. What is mental capacity and why are values important to mental capacity?
. Whose values are we talking about?
. What's been going on with values since the last conference?
. How can mental capacity be assessed in ways that take into account
people's often different values?
. What's currently happening in UK policy and legislation about mental
capacity and values?

17.00 - Conference Closes

At the time of going to press this programme was deemed correct. We reserve the right to alter or cancel any part of the programme due to unforeseen circumstances.

More information

You can find more information about the conference, including the full programme, at http://www.connects.org.uk/conferences

If you wish to exhibit at the conference, please contact us at the address below.

The Connects Conference Centre

The Connects Conference Centre is the leading online venue for mental health and learning disability conferences. It is a place where you can meet hundreds of other people to talk about key issues affecting people with mental health problems
and/or learning disabilities.

It is part of Connects: the mental health and learning disabilities portal. It is owned and run by the Mental Health Foundation and the Foundation for People with Learning Disabilities, 9th Floor, Sea Containers House, London SE1 9QB. Tel 020 7803
1100.
Email portal@connects.org.uk. Company Limited by Guarantee No 2350846 Registered Charity No 801130

'Blog Therapy' - An Evaluation of an Online Self-Help Phenomenon

2005-03-14T09:57:00.000Z
'Blog Therapy' - A Way of Coping With Stress and Illness, A Way of Promoting Health?

A Definition of Blog Therapy : In this article I will be writing about 'blog therapy', although this is a term in common use among bloggers, it is a practice that has yet to be recognised outside the blogosphere. In this article, I will use the term 'blog therapy' to mean the practice of writing about personal problems, emotions and traumas, then publishing these writings on the internet, where others can read them. This normally takes place in the form of an online journal or 'blog', though some people also post to message boards and chat rooms.

The key difference between 'blog therapy' and therapies such as writing a personal journal, is that these personal writings are made available for many other people to read online.

Blogger's Own Views of 'Blog Therapy'

Although I do not write much about my deepest personal traumas or worries, I personally find blogging therapeutic. It is giving me something else to think about outside work and and daily life, a way of expressing myself, letting off steam at the things that make me angry and pointing out things that need changing in the world.

The use of blogs as 'therapy' is a new, spontaneous internet phenomenon. Without advice from counsellors, psychotherapists or other health professionals, hundreds of people have begun to use the blog as a method of self help. Blogging in this way has a particular set of benefits, and also a particular set of risks.

A technorati search revealed 161 bloggers who had already coined the term 'blog therapy' (it is likely that many more are using blog therapy as a practice, without naming it in this way) - Scheherezade at Stay
of Execution writes: "There is a complex, and sometimes therapeutic, relationship between my own sense of self and this blog"

She has a very instructive description of the battle between her instinct for honesty and her instinct for self-censorship, rightly knowing that everything she writes is permanently indexable by google (which is indeed how I found her blog!)

This blogger at 'Netsmarts' thinks blog therapy is 'an idea whose time has come'.and that blog therapy is a 'democratic' way for people to express their thoughts and worries. Blogging is certainly cheaper than paying a psychoanalyst, from one of the many and varied schools of psychoanalysis.

House of Karma sees blogging as a 'concept and environment of healing words and writing' and offers links to many sources of 'online therapy'. I am not casting aspersions at any particular source on that list, but there is a big danger on the internet of falling into the hands of charlatans and quacks who exploit human weakness and suffering, some for financial, some for other ends.

I personally tend to avoid sites that seem too 'crystal jangly' - the point of blogging is to express yourself and find your own meanings, rather than to seek advice from people who feel protected from the consequences of their advice by the anonymity and distance afforded by the internet. My advice (protected by the anonymity and distance afforded to me by the internet) is 'be careful out there!'

That of course was only a very cursory glance at a few of the blogs that have mentioned the therapeutic nature of blogging - by the very nature of blogging, it is very difficult to build up an exhaustive list of everyone who has written on a certain topic - and I have probably missed many of the best articles out - but part of the fun of blog reading is the hunting down of new articles, there could always be a fantastically well written and insightful piece of writing, by someone you have never heard of before, hiding deep down somewhere on your next list of search results.

Psychological Theory of Disclosure

I will now consider some of the theories and evidence that might back up the practice of 'blog therapy' as a self-help tool.

I found 44 articles containing the keyword 'blog' on a combined search of Ovid and CINAHL, but none on a search of PsycARTICLES. Most of the articles describe blogging as a useful tool for research and education (for example Margaret Maag), but the therapeutic potential of blogging, and the reality that hundreds of people are already using the internet as a outlet for their emotional turmoil, seems yet to be recognised by the leading academic journals.

There are however articles on the beneficial physical and psychological effects of keeping journals and diaries, and of writing about traumatic events;
For example, Yori Gidron found that parents who wrote about their experience of receiving their child's diagnosis of leukaemia experienced less distress in later months.
Pennebaker et al (1999) found open acknowledgement and disclosure of stress and emotion, particularly through journal writing was a method of 'revealing organising and reorganising the self', Willis, Stroebe and Hewstone (2003) see journal writing as a useful tool for 'insecure homesick students' suggesting that such techniques 'provide avenues for (re)structuring stressful experiences' and allow 'assimilation of events into the self-concept' as well as using cognitive resources that were 'previously used for inhibition to tackle the changed environment'

Scott found that writing about a recent traumatic event speeded up wound healing - in a rather remarkable study; participants were physically wounded (a small skin puncture). Half the sample wrote about a recent traumatic event, the other half about time management, those that had described their traumatic events had significantly smaller wounds two weeks later! Having a means to express feelings thus seems to encourage the body's internal healing mechanisms: Writing Improves Wound Healing

The researchers who seem most up-to-date with some of the therapeutic applications of communications technology are Sheese, Brown and Graziano (2004) who look at the potential for email interactions between client and therapist, arguing that "writing about trauma, particularly about feelings and emotions related to trauma, appears to have a long-term positive impact on a variety of physiological and psychological health outcomes" they point out various advantages of email, which also apply to blogging, such as the overcoming of physical and geographical boundaries, but also point out that people reliving traumatic and emotional experiences may need access to immediate care due to short term increases in emotional affect, immediately after writing, care which may not be present over an electronic connection.

Of course, the kind of writing described by these psychologists is a private journal, written by the individual, and used in confidential discussions with a trained counsellor.

It seems likely that blogging could have similar beneficial effects on both mental and physical health, due to the Pennebaker disclosure effect, and it can also be a way of bringing together people who have suffered similar emotional trauma, but, ending on a cautious note, it must be remembered that:
1. Blogs are written by individuals, without the presence of a trained health professional to mitigate any distressing effects of writing about negative experiences. If bloggers do experience such effects, they would be well advised to contact appropriate telephone helplines and see their doctor.

2. Blogging is not an alternative to spending time with friends and socialising. If blogging is taking over such a large proportion of a person's time, thought and energy that their work and social life is suffering, then blogging could be having a negative rather than a positive effect.

3. BLOGS ARE (usually) AVAILABLE FOR PUBLIC CONSUMPTION, and even where blogs are anonymous, there are often ways that people will find out who you are, and there are people out there who might wish to use what you write to their own advantage -
scheherezade's circumspection on certain topics is thus a sensible strategy to imitate.

In this article I have compared the practice of blogging, with the practice of writing about thoughts and feelings in a personal and private journal. In some ways, this may not be an entirely fair comparison to make - perhaps it is the fact that blogs are publicly available that gives blogging it's particular power, and provides some people with the motivation to continue blogging. It could be that blogging is a practice that appeals to a different set of people, who would not neccessarily use other forms of therapeutic writing.

It is also clear, that just as 'blog therapy' is a self-generated phenomenon, it is not likely to go away simply because its risks are pointed out. In this technologically savvy age, people are increasingly aware of the risks of public disclosure on the internet, and largely blog responsibly in a way that is informed by this awareness.

I would be interested to hear of the experiences of people who have used blogging as a way of 'talking through' their bad times and traumas with themselves (and their audience) in particular, I would like to know whether you felt it beneficial, and whether you regret having disclosed certain things.

Some handy references using The Harvard Referencing System:

Pennebaker, J. W. Keough K.A. (1999) Revealing, organizing and reorganizing the self in response to stress and emotion. In R.J. Contrada and R.D. Ashmore (Eds) Self, Social Identity and Physical Health; Interdisciplinary Explorations Oxford; Oxford University Press Pp101-121.

Sheese, B, E. Brown, E. L. Graziano, W.G. (2004) Emotional expression in cyberspace; searching for moderators of the Pennebaker disclosure effect via E-mail. Health Psychology 23(5). Pp457-464

Willis, H. Stroebe, M. Hewstone, M. (2003) Homesick blues. The Psychologist 16(10) Pp526-528.

"Blog Therapy" - Watch This Space....

2005-03-13T01:36:00.000Z
As promised, my article on blog therapy is now online; available from: Thinking Nurse's Evaluation of 'Blog Therapy'

Psychological Differences Between Left and Right

2005-03-09T13:50:00.000Z
I was very interested to read this article in the Psychological Bulletin, where exhaustive research has been conducted into the cognitive styles of people holding left and right wing opinions - the study by Jost, Glaser and Kruglanski (2003) found that there are 'significant cognitive and motivational differences between the political left and right' (p384).
They characterise right-wing conservatism as 'positively related to dogmatism and intolerance of ambiguity, uncertainty avoidance, fear of threat, loss and death, system instability and epistemic needs to achieve order, structure and closure, as well as negatively related to openness to experience, integrative complexity and self esteem'

later they argue that 'conservative opinions acquire coherence by virtue of the fact that they minimise uncertainty and threat while pursuing continuity with the past (i.e the status quo) and rationalising inequalities in society...extreme right wing movements are typically obsessed with purity, cleanliness, hygiene, structure and order'

The authors of this paper will be speaking on it at the American Psychological Society 17th Annual convention I would love to be there to hear the debate!

Here is one example of the kind of response it will receive Psychobabble as motivated political liberalism Even the title of this riposte inadvertently confirms part of the argument it is replying to - psychologists are writing things that seem critical of the right - so all psychology is dismissed, in black and white terms as 'psychobabble', a threat to the certainties and fundamentals of 'morality' and 'tradition' in which the right is so emotionally and cognitively entangled .

Here is a link to a pdf of the article that started all the fuss: Political Conservatism as Motivated Social Cognition

Personally I think psychology is often a way of stating the blindingly obvious - and the discovery that right wing politicians are rigid, functioning on fear and crude stereotype, demanding that all issues should be posed in black and white terms of right and wrong, rather than the shades of grey that we encounter in reality, and the fact that they are complacent about widening levels of inequality and injustice in society, is hardly news to anyone who has ever tried to engage such individuals in constructive debate.

The authors judgement of 'liberal' and 'left' thinkers should be taken on board however - we are seen as 'relatively disorganised, indecisive, overly drawn to ambiguity' - perhaps if the left sorted it's act out, we could start to challenge the rise of the neo-con fear factory...

Belated International Women's Day Post

2005-03-09T10:57:00.000Z
Apologies for missing International Women's Day, a day dedicated to the half of the world's population that suffers disproportionately from poverty, violence and oppression.

Hope I can make recompense for this oversight, by dedicating todays' posts to Juana Trinidad Ramirez de Vega, an indigenous Guatamalan Ketchi activist, who campaigned to promote women's health and against violence against women. She paid for her health campaigning in 2002 by being shot and killed by an unknown assailant.

Here's a link to Women's Aid an organisation that campaigns against violence against women, and also a link to Respect an organisation that promotes best practice among providers of services to perpetrators, in helping perpetrators of violence against women to take responsibility for their violence, change, and develop alternative, positive and constructive human relationships.

3 Months, 50 Posts, 3000 Clicks.

2005-03-07T12:52:00.000Z
I set this blog up, and made my first post on December 8th 2004, with a few articles calling for more social conciousness in nursing theory and putting forward a charter for human caring in nursing.

I have posted general political articles, and articles specifically relating to nursing and people with learning disabilities, such as this one on the Mental Capactiy Bill and the Rights of Disabled People, and this one on the way that people with learning disabilities face discrimination from health services.

3000 clicks is a lot less than many other blogs achieve, but I think it is good for a brand new blog, and for one with such very specific subject matter. There are not that many learning disability nurses out there - we are a very small percentage of the total number of nurses. However, from the feedback I get, I know that this blog is being read much more widely - by learning disability nurses, by nurses from mental health and general backgrounds, by other health professionals and by many people with a general interest in the politics and philosophy of health and disability.

This is a thankyou to everyone who has visited and read articles from this blog, particularly those who have left a comment, positive or negative. It is through your emails and comments that I can improve this blog, and write about things that interest you as much as they interest me!

Ideal PC Birthday Present

2005-03-05T13:50:00.000Z

No need to buy your boy a military action figure.
Now you can give him 'Male Nurse Man'.
Imagine the delight on his little face when he unwraps this!

Ecstasy And Depression

2005-03-04T15:16:00.000Z
Here's a link to a study that links the clubber's drug Ecstasy to depression.

I have posted previously about the mental health implications of Cannabis: A drug-induced mental health crisis.

Both ecstasy and cannabis are commonly regarded as being relatively harmless, and are used regularly by large numbers of young people in Britain. These studies are just part of a growing body of evidence that we should be using to challenge such complacent attitudes.

We also desperately need to be talking openly about the many social problems that are driving young people into heavy use of drugs and alcohol as a means of escape, problems of poverty, inequality and lack of opportunity that Tony Blair and New Labour try to pretend no longer exist.

Death of Jef Raskin

2005-03-04T05:39:00.000Z
I have just heard about the tragic death of Jef Raskin, the brilliant designer of computer interfaces.

I was lucky enough to have a flurry of correspondance a few months ago, with Jef about Nursing Theory.

I had read and greatly admired his critique of Martha Rogers. 'Humbug Nursing Theory' so I sent him an email, asking a few questions about his arguments. He replied in great detail and depth, and we were soon having an interesting debate.

I discussed a few of my own ideas about nursing with him, and he was very helpful in making me clarify my thoughts and terms (In fact he was merciless in exposing their wooliness and weakness! - particularly about my use in some of my arguments of the term 'technologies' to apply to methods of thought - which did not fit with his definition of a technology - I have now stopped using that term in that way!).

I went on to write two posts about Jef Raskin, the first is here: 'Jeff Raskin Vs Martha Rogers’ where I discuss his brilliantly written biting destruction of Martha Rogers' rather supernatural nursing theories, and the second here:
'Nursing: The Humane Interface, More on Raskin and Rogers’ where I use the analogy of Raskin's humane interface between human being and computer to discuss the role of the nurse, as a 'humane interface' between the person and the highly complex healthcare machine: We nurses need to find ways to open up healthcare to all people in the same way that Raskin found ways to open up information technology.

Jef Raskin is everywhere - chances are you are at this moment using a device or a piece of software designed according to Raskin's principles. The really great thing about Raskin was that he opened up computing to everyday people, making the Computer a tool of the masses rather than just of a small technocratic code-literate elite.

Thinking Nurse sends deepest condolences to Raskin's family, and to everyone who knew him. His contribution to modern society is far greater than is yet realised.

Deptford Park - Green Space Under Threat From Housing Developers

2005-03-03T15:13:00.000Z
I received this email from a friend of mine in London. Looks like politicians are planning to ride roughshod over the wishes of local people, and destroy a rare green space in a part of London where green spaces are desperately needed.

"Save Deptford Park
Put our park space before business interests.
London and Quadrant Housing Association are trying to ignore the protests of people in Deptford who are angry at the arrogance and contempt this organisation and the Labour controlled, Lewisham Council has shown to local people who want to save their park. This housing association is planning a 38 plot development on a large chunk of the only green space in south London between Southwark and Greenwich parks. Even though government and council regulations ban such developments.

Campaigner Vicki Mence sums up the feelings of local people. ‘I grew up here. I’ve seen the council let the park get run down so they can justify building on it. The park’s been here over 100 years. We understand the need for affordable housing, but this is about London and Quadrant making money because it’s easier and cheaper to build on the park. There are plenty of obvious brown sites (previously used areas) which the council have ignored.’

As Socialist Party Councillor Ian Page said ‘London and Quadrant would do well to remember that it is there to provide a service to the community, not increase it’s income through opportunistic development.’

But local people are taking on this organisation that acts like a quango, organising, petitions, t shirts, banners, press releases and protests. There are regular meetings of 40-50 people and now the campaigning activity has been linked to a possible legal challenge to consultation process. Only 70 people were consulted and were given mis-leading information about the location of the development. London and Quadrant are so dismissive of local feelings that they have even refused to meet a delegation of local councillors headed by our two Socialist Party councillors. Labour’s attitude is summed up by their Councillor Heidi Alexander, who says she’s against building on green spaces but not in this case because it’s easier than a brown field site.

This situation is a result of Labour turning to business orientated organisations instead of providing good quality council housing. Local needs get pushed aside and consultation is just a token exercise as business interests take priority. We need to provide council housing but with proper consultation and fully using all available brown field sites.

Contact Save Deptford Park Campaign at team@deptfordpark.com website www.deptfordpark.com

A private road will be built directly across this area - other beautiful spaces will be blighted by blocks of flats and a car park. Get to the website, get onto the council and the developer, and tell them to listen to the people!

Local kids add their voices to the 'consultation'...

MMR Vaccine and Autism - There Is No Connection

2005-03-03T12:24:00.000Z
New research has been published which adds to the weight of evidence that. '’ there is no link between the MMR vaccine and Autism

I have worked with people with learning disabilities for over a decade now, including many with autism, and I have always been sceptical about this supposed link.

When a child has an unexplained disability, their parents are desperate for any kind of an explanation about why their child has been affected. The MMR vaccine filled this need for a while, but the rising fear of such immunisations has meant a greatly increased risk of harm to children due to the decline in ‘herd immunity’ in the general population, to what can be very serious illnesses indeed.

The antics of politicians like Tony Blair has not helped promote vaccination. He refused to publicly say whether his own children had been immunised, while preaching to everyone else that the vaccine was perfectly safe.

When the public suspects that politicians are not telling the truth, they are, more often than not, absolutely right. Sadly in this case, the politicians were telling the truth, but behaving as if they did not believe it themselves…

Faith and Force - Dangerous Idea

2005-03-03T10:02:00.000Z
Faith and Force – Dangerous Idea

The ripples from my post about 'theistic and humanistic nursing’ are still spreading across the blogosphere. One blogger who took up the debate is Victor Reppert at 'Dangerous Idea’

His contribution to the debate went thus:
“Persons following the discussion of theism and rights might be interested in following a parallel discussion of similar issues between the ‘Imago Dei’ team and Thinking Nurse. Imago Dei quotes an interesting passage from Michael Shermer in The Science of Good and Evil when he says

These rights and values [human rights] are grounded not in religion, or any other transcendental state or supernatural force, but in themselves. They stand alone. Humans deserve life, liberty, and happiness, not because God said so but because we are human. Period. These rights and values exist because we say they exist, and that is good enough. They are inalienable because we say they are, and that suffices. (p. 156)

But if we have these rights because we say they exist, what happens when someone with bigger guns comes along and says they don't exist?”

Here is my reply to this post:

“Nice to see my discussion with Imago Dei is generating further discussion and debate.

As I see it, your point is that in any society not based on religious principles, the ethical system of the person or group with the greatest capacity to use force will prevail.

The implication is, that divine authority, with it's ability to save or damn our souls, is the 'biggest gun of all'.

The behaviour of many followers of religion implies that they too believe that the ethical system of the group with the greatest capacity to use force will prevail, using violence through crusade, jihad and pogrom to assert their own faiths and wipe out the faiths of others. Less obvious, but equally insidious use of force includes denying children access to science, by teaching creationism as fact.

Any system of thought based on faith rather than evidence must use force to assert itself, because rational persuasion requires the use of evidence to change people's minds. Without science and evidence, force is all that theism has left.”

Victor replies to these points:

I appreciate the comments provided by Thinking Nurse. She writes:

As I see it, your point is that in any society not based on religious principles, the ethical system of the person or group with the greatest capacity to use force will prevail.

Not simply that it will prevail, it is that I can't think of any fact that would entail that that person or group ought not to prevail. Of course religious people have misused force; that doesn't make them right.

The implication is, that divine authority, with it's ability to save or damn our souls, is the 'biggest gun of all'.

No. The idea that I have is that the right and the power are grounded, according to theism, in a perfect loving being, whose has desires for us that coincide with the fulfilment of our natures as human beings. If the power were not concentrated in a perfectly good being, the presence of supreme power would not solve the problem.

The behaviour of many followers of religion implies that they too believe that the ethical system of the group with the greatest capacity to use force will prevail, using violence through crusade, jihad and pogrom to assert their own faiths and wipe out the faiths of others. Less obvious, but equally insidious use of force includes denying children access to science, by teaching creationism as fact.

They may believe that. A great achievement of Christian thought after the 17th Century was the acceptance of the idea that Church and State can be separated; that governments should pursue the legitimate goals a human happiness and fulfillent, and leave the salvation of souls to the Church. The idea is in Thomas Aquinas, but it took awhile to sink in.

I don't know of anyone who is denying children access to science by treating creationism as a fact. If someone does teach creationism as fact, I take it is because they believe it to be the best science. They may be wrong about this, of course, but they teach what they believe to be the truth. W0uldn't you teach your children what you believe to be the truth?

Any system of thought based on faith rather than evidence must use force to assert itself, because rational persuasion requires the use of evidence to change people's minds. Without science and evidence, force is all that theism has left.

I would categorically deny that Christianity is based on faith rather than evidence. It is where, believe it or not, my understanding of the evidence has led me. My book is an attempt to defend an argument against philosophical naturalism. The argument may be unsuccessful, but I quite honestly think I have a good argument here.

C. S. Lewis wrote: " am not asking anyone to accept Christianity if his best reasoning tells him that the weight of evidence is against it. That is not the point at which Faith comes in." So why would I feel I had to use force, if I thought that the weight of the evidence was on my side?”

I think both sides have stated their case well in this dignified and appropriate debate. I leave it to readers to make up their own minds based on the discussion and their own experience of life.

One final point though – Victor has got my gender wrong – illustrating the dangers of making assumptions about the nature of things we have not seen, especially where we have no evidence upon which to base such assumptions!

'To The Teeth' A Social Justice Medical Blog

2005-03-02T11:10:00.000Z
I have just found this excellent blog ‘To the teeth’ at http://totheteeth.blogspot.com

To the Teeth describes itself as a weblog devoted to issues of health justice, medicine public and private, race in America, public health in its broadest sense, globalization, innovations, and honest discussions around strategies in advocacy.

It is firmly based in pragmatic principles of social justice, by people who are putting these ideas into practice: Andru Ziwasimon, is a family medicine doctor in Albuquerque, New Mexico, and a lead member in a powerful coalition to address health care access and disparities locally. He is currently building his own fair and just medical clinic from scratch.

Ziwasimon believes that Western systems of healthcare are corrupt in their values, which are founded on financial rather than human priorities.

The other author is Anjali Taneja, a 4th year medical student in New Jersey, and 2003-2004 Jack Rutledge Fellow for Universal Health Care and Eliminating Health Disparities at the American Medical Student Association. She's also a DJ/producer, and member of the mutiny dj crew of hiphop and drumnbass heads.

Their blog is an exciting mix of news about putting ideals into action, of questioning of the value base of US society, and of poetry and inspirational writing from a people's rather than a corporate perspective.

It is heartening to read about individuals trying to build a different kind of community-based, grassroots healthcare based on principles of social justice rather than the profit motive. This is one blog I will be revisiting regularly.

"A Drug-Induced Mental Health Crisis" - Cannabis and Psychosis

2005-03-01T12:42:00.000Z

I posted in January about the rising awareness among mental health campaigners 'Rethink' of the link between cannabis and schizophrenia. Now another piece of research has been published, which suggests that the risk of a severe mental illness is actually doubled by the use of cannabis.
Read it here: http://news.bbc.co.uk/2/hi/health/4305783.stm

I know a lot of people on the left have a very relaxed 1960's attitude to cannabis, believing it to be less harmful than tobacco (an argument I have never been able to take seriously, as most cannabis users actually mix the cannabis in with tobacco, no doubt multiplying the harmful effects of both substances) and to generate less harm than alcohol, with it's multitude of harmful effects (although again, the same people tend to smoke their dope after a few drinks).

Modern cannabis is usually much more potent than what the hippies in the 1960's smoked.

Perhaps now that evidence is stacking up about it's harmful effects, perhaps those who previously had such a liberal attitude to it's use might at least start acknowledging some of the very serious risks now being shown to be associated with cannabis use.

I strongly suspect that the idea of a 'Soma' (the totally benign, mood-enhancing drug from Aldous Huxley's 'Brave New World') is always going to be an illusion. Any drug that alters brain chemistry must have some adverse effects, at least with prolonged and heavy use. The drug culture that is so endemic in Western Society implies that there is 'a pill for every ill', sadly this is rarely the case.
Many people are using drugs to individually cope with socially generated problems, when perhaps society should be finding collective solutions to such problems

Healthcare Discrimination and People With Learning Disabilities

2005-02-28T14:03:00.000Z
Discrimination in healthcare against people with Learning Disabilities

I have posted before about some of the shocking ways in which people with learning disabilities or mental health problems suffer serious discrimination from health services – discrimination that actually shortens life expectancy and reduces quality of life: http://thinkingnurse.blogspot.com/2004/12/disability-rights-commission-expose.html

There can be little doubt that if a racial or religious minority suffered this kind of discrimination, it would be a national political scandal, but because it is people with disabilities who are suffering, their voices are hardly heard at all.

A document produced by MENCAP ‘Treat Me Right!’ (Available from www.mencap.org.uk/treatmeright ) is full of frightening examples of discrimination, going on in the UK today, and it’s painful and deadly consequences for people with learning disabilities.

True stories from this document include the tale of ‘Max, who broke his hip at 30, suffered immense pain, having fits, moaning and punching himself in the face. It was too late when doctors finally realised he had blood poisoning because of kidney problems. Max died.

Other people, like ‘Sarah’, found that regular, generic services were unwilling to treat her, instead referring her back to the learning disability team.

‘Ibrahim’ found that GPs never spent the necessary time to let him explain what was wrong with him, or to explain the treatment so that Ibrahim could understand it.

‘Cathy’, a girl with Down’s syndrome had her ear damaged by a doctor who did not know that people with Down’s syndrome have smaller ear canals, he pushed an instrument to deeply into her ear, and irreparably damaged her hearing.

‘Anthony’s’ parents had to stay with him 12 hours a day, during his stay in hospital, because otherwise nobody bothered to feed him.

One mother heard a doctor remark about her daughter “That’s not coming in my room, it will destroy the equipment’.

People who work in learning disability services can furnish many stories of health professionals who have acted in a discriminatory way – operations that have been refused using the learning disability as a reason, post mortems that have cited ‘learning disability’ as a cause of death, doctors who have remarked ‘I need to have the skills of a vet with this person’. Mental Health services that flatly refuse to accept referrals of people with learning disabilities who also have mental health problems.

Opening up health services to people with learning disabilities so that they get the same quality of healthcare as everyone else is not necessarily that difficult – it simply requires a little thought and effort, a readiness to be flexible, to listen to the person and their carers, and to respect their expertise on the individual. Parents and carers who have worked with a person for years, are the best people, for example, to recognise when a person who cannot talk is in pain, far more than a doctor who has seen the person for five minutes.

Taking a little extra time, to explain things more slowly, and in simpler terms is very worthwhile, producing patient leaflets with pictures, larger text and easy words opens up healthcare not just to people with learning disabilities, but to a whole layer of the population.

Discrimination against people with learning disabilities in healthcare is not acceptable. They have the same human right to live a full and satisfying life as everyone else. Professionals in health services need to start thinking about, and examining their practice now - if we are not part of the solution the we are part of the problem. If we can combat this discrimination, it will mean better lives for hundreds of thousands of people.

Nurses' Network Revamp

2005-02-28T10:34:00.000Z
Bluegnu and Clodagh over at Nurses Network: http://www.nursesnetwork.co.uk/envo/index.php have been busy revamping this excellent nurses' website.

Basically Clodagh had done a huge amount of research and written a whole array of articles useful to nurses, but they were kept separately from the discussion boards, which were the most heavily used part of the site.

Now these articles have been combined cleverly into the discussion boards themselves, making them much easier to find, and considerably improving the whole 'feel' of the site.

I have been a moderator on the Nurses' Network Student Nurses discussion boards for nearly 3 years now - so maybe I am a little biased, but I feel that Nurses Network is a useful asset to the nursing profession, and especially to students. Through the network, many students have been able to support each other, get advice and help from qualified nurses, and grope our way through the confusing maze that is modern healthcare.

New Humanist

2005-02-28T10:04:00.000Z
The 'New Humanist' has listed 'Thinking Nurse' as one of it's 'blogging friends'.

This post is to repay the compliment. The New Humanist site is packed full of interesting articles, debates, news, and other interesting bits and pieces. Here it is: http://www.newhumanist.org.uk/

Willy Mason - Talent and Truth From the Heart

2005-02-26T11:49:00.000Z

It is rarer that you are touched by music when you reach my age.
It is partly physical - as a teenager, your senses are keener, your emotions quicker to leap at a note or a chord, and of course the world seems new, you are the first person to feel alone, the first to feel rage, the first to love and to revel in cold night air and damp streets. Then when you hear music you realise that other people feel like you too, that you are conncected in strange ways to millions of people around you, that you share a secret.
When you are older, you have seen all the kids with guitars a million times.

They all sound like cheaper versions of the heroes of your youth, and with the corruption and decay of the music industry being so manifest, you suspect strongly that indeed they are.

Then, tonight I heard Willy Mason sing 'Oxygen'. He spoke about being young, about freedom and about hope for the future. The hair literally stood up on the back of my neck.
He said
"I wanna see through all the lies of society
To the reality,
happiness is at stake I wanna hold up my head with dignity
Proud of a life where to give means more than to take
I wan't to live beyond the modern mentality
Where paper is all that you're really taught to create"

Then the cynical side of me fought to get back to the surface. Come on it said, this guy is part of the 70's revival, just like everyone is wearing suede coats with fur collars, and little Chinese hats, they need an ersatz Bob Dylan, a Jack Kerouac to go with all the cowboy boots and ponchos.
I cant make my mind up whether this is true, heartfelt, youthful, rebellious poetry, or just more product placement and manipulation by the record industry - will Willy Mason be picking up an OBE in a few years time like so-called 'streetfighting man' Mick Jagger?

Perhaps it is a bit of both.
Willy Mason is clearly a poetm and a talented singer, and I can see that he writes and speaks from his heart, and so what if he has been placed by some cunning record executive - the words he speaks are truths:
"it's easy to see that something here isn't right
I know the future looks dark
But it's there that the kids of today must carry the light."
I intend to enjoy this talent and this truth, at least while it lasts.
http://www.willy-mason.com/

A Victory For US Anti-War School Students

2005-02-26T00:24:00.000Z

I was very encouraged to read this report about a small group of school students who stood up for their right to free speech, against undemocratic attempts to suppress them by the school authorities:
"High School students win free speech victory
Solidarity appeal forces authorities to drop ban against anti-Iraq war activists
Brandon Madsen, Senior at Kennedy, Youth Against War and Racism, and Ty Moore, Socialist Alternative (cwi US)
In just over 24 hours, authorities at Kennedy High School, Minnesota, reversed a ban stopping Youth Against War and Racism student activists running an information stall in the school. This swift U-turn is the result of an immediate solidarity campaign by student activists, who appealed to students, school workers, the local community, and to anti-war activists internationally.

Student activist, Brandon Madsen, reports on what happened in his college on 23 February:
Under pressure from the American Legion, the Bloomington(Minnesota) Public Schools Superintendent, Gary Prest, banned Kennedy student anti-war activists from setting up a counter-recruitment table on 23 February, while allowing military recruiters unfettered access to our fellow students.
We responded with a solidarity appeal, urging people to call the Bloomington Superintendent, Gary Prest, and the Principal of Kennedy, Ronald Simmons, and
urge them to respect our right to free speech, and our right to set up an anti-war information table when the military recruiters come to our school.
Background information
Weeks ahead, we planned to set up an anti-war information table on 23 February, when the military recruiters were scheduled to table at Kennedy High. We had obtained permission and reserved a table. But on the morning of 22 February our Principal got a visit to his office by representatives from the American Legion.

They told him that unless he stopped us from tabling, they would stop donating money to Bloomington Public Schools. Our principal also got a call from the District Superintendent, who had also met with the American Legion, and the District Superintendent also instructed him to shut down our club, Youth Against War and Racism.
This repression of our rights follows months of negotiations with our Principal to get the right to set up a table. Last December, the Bloomington School District lawyer finally gave his opinion that we had the right to set
up a counter-recruitment information table when military recruiters came to Kennedy. On 8 December, the recruiters came, and our counter-recruitment tabling met with huge success. Over 230 students signed our petition against military recruiters being allowed into Kennedy High in the following days.

Our Superintendent and Principal allowed themselves to be blackmailed by the American Legion. We immediately decided to fight this suppression of our First Amendment rights.

Victory!
Socialist Alternative member, Ty Moore, describes how the Kennedy students' solidarity appeal forced the authorities to back down:
On the evening of 23 February, about 14 Kennedy students gathered to discuss how to fight back against this attack, and decided, among other things, to defy the order and set up a table anyway, whatever the consequences.

On the morning of 24 February, they gave out 300 flyers, explaining the issue to their fellow students, demanding their free speech rights, and urging students to join them at the lunch table to show support. Also, the flyer advertised an after-school teach-in/protest, and urged students to have their parents call in to the Principal and Superintendent to complain.

Also that morning, thousands of Minnesotans woke up to find in their email inboxes an appeal for solidarity, urging them to call the Principal and Superintendent. A press release was sent out, as well, explaining the attacks on students? rights, and calling an after-school press conference.

At lunch, shortly after the students set up their table, the Principal and other administrators approached the students threatening three days suspension if they didn't leave. When the students refused to leave, the administrators physically grabbed all their literature and told them the afternoon teach-in (in the school cafeteria) was cancelled.

The Principal demanded they stop asking people to call his office to protest.
"It?s been overwhelming," he said.

The students packed up and went to the Superintendents office across town, and had a meeting with him. By this time, it seems the Superintendent had also received many protest phone calls. He realised the students would not back down quietly, and that they were capable of mobilising community support. So, when the students talked to the Superintendent, he tried to play the whole thing down, as a big misunderstanding. He said that from now on they would have permission to run information tables when army recruiters came.
So the teach-in protest after-school turned into a teach-in/victory meeting, with around 30 students and 10 community supporters in attendance.

Alongside three speakers (Vets for Peace, Palestinian activists, and Ty Moore, from Socialist Alternative), Brandon Madsen gave a general summary of the previous two days of events, with a clear analysis of why the students had won. Many of the other students got up and said their piece as well, describing the days? events. The main Minneapolis newspaper, two radio stations, and the Bloomington newspaper all sent reporters."
It is small victories like this, that will build up into a massive movement against the war in Iraq, and for social justice in the US, Britain and across
the world, so this is a message from 'Thinking Nurse' saying well done to Ty and Brandon, and all their comrades in Youth against War and Racism and at Kennedy High School.

You can now Email Thinking Nurse

2005-02-24T14:31:00.000Z
I have set up an email address so that people who wish to make suggestions, comments, or even complaints about the Thinking Nurse blog and it's content can now send an email to me.

I dont want to get overrun by spam from spiders and other automated crawling web devices, so I am putting some extra characters in the address - take out the 'x's and 'z's and you have the email (alternatively just click on the 'email' button at my profile.

Here is the address for your comments and feedback: thinkxingznursez@xcoolxgoosez.com

Nursing Blog Roundup

2005-02-24T11:04:00.000Z
I have previously posted on the need for more nursing blogs, and I hope to use this blog to encourage the development of a community of nurse bloggers.
To this end, this roundup will look at highlights of some of the best, and newest of the nursing blogs I have found so far.
This is by no means an exhaustive list - there are millions of bloggers out there, and a fair number of them must be nurses - the more we post, search, and link with each other, the more we can draw together - so if you are a nurse who likes to blog, please post below.

One nursing blog that has made a big impression on me is 'Baskets of Blessings', by 'Barbara' particularly her post 'True Story': True Story where her living experience burns through the screen: "The abuse began again. My husband had drank when we first got married and for awhile after. He was a bit rough with Matt. He would spank him and leave whelps. He would spank him for such stupid things...like reaching for things in the store. What child less than two years of age doesn't?? Then it got better for awhile. He quit drinking and we were much better off for a year or two. I hadn't been beaten in awhile...or abused much. He would punch me in the head with his fist so that no one could see that he hit me. Sometimes he'd keep me up all night for several nights denying me sleep until I was delirious. He smashed things against the walls....threw phones through windows...broke things that meant a lot to me...force me to have sex against my will....etc. Then he had started this back. This time though, he was chasing Matthew through the house like a madman, spanking him and telling him that he'd get it worse if he told me when I got home from work (I didn't find out for awhile), throw things at us, smash things on the wall over his head for the scare affect, throw him across the room onto the couch or a bed, ask him to answer questions that he couldn't possibly answer and make his punishment worse when he didn't...and on and on."

We like to think of nurses as cool professionals, but we are also human beings, with real experiences who need to name our worlds and share them, there are many people, including many nurses who will have shared similar experiences to Barbara, she has done them all a service by daring to write about them so honestly.

This post from 'Third Degree Nurse' describes some of the real fear felt by Nursing Students, even mature experienced adults with existing academic qualifications ; What Is This Fear?

"I keep thinking if I could name this fear it will dissipate. It is not real and I won't let it consume me.

However, I do recognize that my stomach has been upside down and, quite unlike me, I have not been able to sleep.

It's been this way since I got accepted into the nursing program.

Maybe I read too many nursing blogs. There are a lot of horror stories out there, people. Some are as bad as some of the things I remember from the state school (although that was often more comic than tragic) or corrections.

And now my math phobia has resurfaced."

I have been in a class of nursing students attempting to work out dosages, and it is a real eye-opener!

In this post 'Head Nurse' describes the single downside of nursing: Downside of Nursing "There is, near as I can tell, only one real downside to nursing as a profession.

I'm not joking, people. The hours are long and the pay can be miserable, but there's always another (possibly better) job out there. Physically, it's hard work--but there's always another (possibly better) job out there. Patients and coworkers do share bugs with you now and again, but you get better. Mostly. Even the caffeine addiction can be broken, with time and careful medical management.

No, friends, the downside of which I speak is Not Being Able To Dress Oneself Any Longer."

Tomv32 in his brand new blog, posts on his experience of the problems experienced by relatives with strong religious beliefs: Prayer
"The problem is not the people feel better if they pray. The problem is that people count on God to do some thing that is just not going to happen. The more religiously conservative a person is the more likely they are to believe that God will actually help them. I an a nurse and have seen several people die. The more religious a person is the harder the death of the loved one is because they have asked God to heal their family member."

Nurses can write poetry too - as Heidi proves in 'Tales of an Aspiring Nightingale" Tales of Aspiring Nightingale here is an extract from her most recent:
"oh
How I nearly plunged into ecstasy
when I pulled you over
my hips
and fastened you
just below my waist
your softness caressing every inch
of my legs
The image of you and me
as one
showed me
how you fit me like a glove
how you held my thighs perfectly
how you molded my backside
into two perfect orbs"

(It is an ode to a pair of jeans!)

Finally, this post from the excellent 'Seyms Nurse in Training Blog' Seyms argues convincingly for more nurse involvement in the drafting of National Institute of Clinical Excellence Guidelines (very relevant as NICE issued new guidance on managing violence in Mental Health care environments yesterday), and for nurses to advocate more clearly for their profession:

"I am suddenly more aware of the need rather desperately for nurses to advocate more vocally for their role and perspective which, after all, is forged uniquely in 24hr hands-on-care of clients. In order to do this it may even be needful for some to get over the "identity crisis" I sense in Psychiatric Nursing. "What should we be doing and how should we be doing it?" is highlighted, too in the article by Phil and Poppy. I have seen mental health nurses in the community fight tooth and nail to distinguish themselves from social workers and other MDT members but we need something a great deal more positive than "we have a different training" and something a bit deeper than "they do sections and we do depots.""

I think these few extracts demonstrate the vast creative and thinking energy that exists out there among the nurse bloggers - so lets nurture this!

If you know of a good nursing blog, why not leave a link to their best post below!

Holocaust Memorial Wreath Incident Sparks Stupid Prosecution

2005-02-23T16:19:00.000Z
Martin Gleeson, secretary of the Oldham branch of the Trade Union AMICUS was arrested on holocaust memorial day, for placing his Trade Union's wreath on top of that of an unauthorised wreath placed by the notorious fascist group the British National Party. He was immediately arrested and charged with criminal damage to the BNP wreath, which cost £20!

The BNP leadership have a history of racism and of denying that the holocaust even happened. Was their attendance at this memorial day an organised attempt at provocation?

Martin Gleeson has had hundreds of messages of support from Trade Unionists, Socialists and Anti-Fascists. To add to this flood of outrage at this needless and expensive prosecution, visit www.oldhamtuc.org.uk

(for the BBC report on this, click on the title of this post)

Thinking Nurse Highlights

2005-02-22T16:12:00.000Z
The acceleration in readership of this site is continuing - I am aware that many people come to this site, and will read the post at the top of the pile, and maybe miss out on reading some of the articles which I consider to be most worth reading.

This post will list some of the articles which I have had the best feedback about, or which have created the most discussion:

One of my first posts at this blog is 'A charter for human caring in nursing' where I point out some of the difficulties of offering full human solidarity and human caring with our patients/clients in modern society, I think this post 'set the tone' for the rest of my blogging.

The next big post would be The Twisted History Of Margaret Sanger, Woman, Rebel, Nurse, Oppressor where I evaluate the strange political and ethical journey taken by this radical nurse, from socially conscious anarchism to the clutches of the eugenics movement.

This post on the 'Gassing of Aloisia V; Hitler's Mentally Ill Relative' goes further into the question of eugenics, and the culpability of healthcare professionals, including nurses in the so-called 'euthanasia' of hundreds of thousands of people with mental illnesses, and physical and mental disabilities that was the first part of the holocaust.

This post: More on Raskin and Rogers - Nursing, the Humane Interface explores the role of the nurse as a 'humane interface' between the person and the health system, using Jef Raskin's graphical interface with computers as an analogy for this role.

This book review Tregaskis, Constructions of Disability highlights a brilliant piece of experiential qualitative research that I think is highly useful to learning disability nurses, and other people working with people with learning disabilities.

This post:Theistic and Humanistic Nursing is the one that has caused the most discussion, but I am surprised that I have not had more comments on my attack on the Harvard Referencing System: .
Harvard Referencing System - A Bizarre Academic Ritual where I turn the techniques of evidence based critical thinking nursing onto the practices of the academics who taught us them!

Here is an interesting article on the new internet phenomenon known as Blog Therapy

Back to the subject that concerns my work most directly - this is an important post on the continuing 'discrimination suffered by people with learning disabilities in their access to healthcare'. It is time for health professionals to make that little extra bit of effort to make their services accessible to ALL their users.

Finally this post on the banning of hunting with dogs: Hunting Ban - Will it work? is at least worth a look, just to find out the weekend habits of some members of the British establishment!

I hope most readers who come here have been enjoying their experience, and getting something out of it - I am always open to suggestions...

Carnival of The Godless

2005-02-21T11:54:00.000Z
The fourth 'Carnival of the Godless' is now online, at this site: Philosophy Etc.
I would have posted about the existence of this carnival at it's inception, but only learned of it's existence in the last few days. I immediately posted my article on 'Theistic and Humanistic Nursing' to it's administrator, and am pleased that they accepted it for the carnival.

The idea of a 'carnival' is a great way of encouraging quality blogging. Basically a blog author announces a carnival and calls for articles on a certain topic, bloggers then post in their best work on that topic, the carnival host then makes a post containing links to all the best articles - a great way for bloggers to get together, exchange opinions and ideas.

Perhaps some of the Nurses and other Health Professionals who blog (plus other people with opinions on health - health belongs to everyone after all) could think about starting a 'Carnival of Health'. Anyone who would be enthusiastic about such an idea should post below, as it takes a few enthusiasts, and a few excellent articles to get anything like this off the ground.

Defend the Iranian Bloggers

2005-02-21T11:29:00.000Z
This is an emergency alert to all bloggers.

Visit this blogsite now: http://committeetoprotectbloggers.blogspot.com/2005/01/committee-to-protect-bloggers_20.html

The reason for the emergency: two bloggers have been detained by the Iranian authorities; they are Mojtaba Saminejad and Arash Sigarchi here are the links to their stories:
http://committeetoprotectbloggers.blogspot.com/2005/01/arash-sigarchi-has-been-arrested.html
and
http://8mdr8.blogspot.com/
Please visit the Committee to Protect Bloggers Site and take the suggested action - if all bloggers act together, we can show our collective strength and perhaps help the cause of Freedom of Speech.

(I had to take the pictures out of this post as it was bloggering up the way my blog displayed!)

'Choice', Smoking and Health Promotion

2005-02-21T11:15:00.000Z
I got rather animated, even "abrasive" in a recent discussion on the International Council of Nurses Student Nurses Discussion Boards here: http://icn.ch/cgi-bin/ubb/ultimatebb.cgi?ubb=get_topic&f=6&t=000390.

It was a discussion about smoking and whether Student Nurses who smoke can give health promotion advice. I felt that a lot of the posters were thinking in terms of 'individual choice', either in the argument 'it is someones choice to do it, so we should respect that choice' or the other argument 'it is their choice to do it, so they deserve everything they get'. I disagree (at least partially) with both these arguments, and feel we need to think a lot more deeply about how we go about promoting health - to find out why, read on....

I think 'choice' is one of the most misused words in the dictionary - particularly in the modern world.
I had a 'choice' of whether I shop at the local greengrocer, butcher and baker, or whether I go to the big multinational superstore that opened up out of town - until those shops went out of business because the superstore was there. Now my elderly neighbours who dont have cars have to eat convenience food out of packets bought from the local newsagent (the only source of food within walking distance) - so much for their ability to make healthy choices...

We are told that smoking is a 'choice'. But of course once you're hooked, it isn't a choice any more, if it ever really was in the first place - how many smokers out there ever made a conscious decision 'I am going to be a smoker' - most people get into smoking by having the occassional cigarette with friends at school - they dont think about it any more deeply than that, until they are on 20 a day...

Then the health fascists (I.e. nurses!) tell them that they should give up smoking, otherwise they will not be entitled to certain treatments, and The insurance companies jack up their premiums.

Noone looks at the amount of tax smokers are paying on their habit, (far more than the total cost of smoking to the health service), or at the fact that because smokers die earlier, they save the state and pension companies a fortune in pension payments, and noone says 'perhaps these people are just as entitled to health services as the rest of us?' because their behaviour is 'self-inflicted' and they deserve everything they get - dont they?

Smoking is an addictive behaviour, so is drug taking (illicit or prescription), alcoholism, overeating, dieting, getting tattooed, gambling, self harm, marathon running, extreme sports, cult membership, church membership, surfing the web and writing blogs.

Some of these behaviours are more harmful to a person's health than others, but once you get into them, it is very very difficult to get out.

People who have no knowledge of you, or the things you are dealing with by using these behaviours, are not helping when they judge you for them.

Such people are very, very unlikely to succeed in ever persuading you to change these behaviours - and when they do, chances are you will replace them with something else far worse, unless they can come up with something better that fills the same function as the original addictive behaviour.

As for nurses - we indulge in all the behaviours listed above, and many more - even though we know slightly more than the general population about the harm these things can do. We do them because we are human beings in a stressful job, and stressful situations, and we use them to cope, just like the rest of the population.

Time to get real - if we want to promote healthy behaviour, and healthy lifestyles, we are going to have to get into things a bit more deeply than simply preaching the gospel of fresh fruit and vegetables, exercise and non-smoking. Nobody listens when they are preached at. They have heard the same message a million times, and it hasn't worked. Perhaps instead we can share information, and explore together with real people ways of making our lifestyles better, in ways that fit in with real lives and circumstances?

And perhaps we can also explore some of the social and economic reasons for unhealthy behaviour - such as the demise of local greengrocers and the rise of supermarkets and multinational fast food chains. Such as the brewing and gambling industries funding political parties so they can get more liberal licensing laws. Such as the long working hours culture that leads to high levels of stress - stress being THE major factor in inducing people to behave in ways that are harmful to their health. Such as POVERTY, the biggest single factor in ill-health by a mile, and at the root of so many other problems.

If we want to really promote healthy lifestyles, we are really going to have to think at a deeper level about why our society seems to be promoting precisely the opposite?

One place to start: The film 'Supersize me'.

Hunting Ban - Will It Work?

2005-02-19T16:38:00.000Z
Today was the first day that it became illegal to kill live quarry with dogs. But there were probably more people out 'riding to hounds' than at any time in the last 30 years. They are attempting to exploit the loosely written nature of the anti-hunting law, by pretending they are following aniseed trails and suchlike, and if the hounds catch the trail of a fox and follow their 'natural killer instincts' and tear the fox to pieces, why that would just be an unfortunate and unintended accident, entirely unforeseeable that such a thing might happen...

I dont usually get that animated about 'animal rights' issues - they are well down the scale of importance for me compared to the many abuses of human rights that happen every day, and I am prepared to put my neck on the line and defend the use of animals for medical experimentation, simply because of the many human lives that have been saved by the discoveries that these experiments have supported, however I do find the idea of watching animals getting torn to pieces by dogs a rather distasteful way of gaining pleasure in the 21st Century.

Now that it is illegal to hunt, I was wondering whether all the anarchists who used to follow hunts in order to disrupt them would be out trying to support them in their law-breaking, and defend them from the oppression of state forces. Actually of course, the anarchists, in a quite bizarre role-reversal are now acting as civilian law enforcers, videoing the hunts to try and prove that they are indeed acting illegally, and to goad the police into taking action (which I think they are very unlikely to do, given the class backgrounds of the people who participate in hunting).

Making the hunt illegal could actually make it far more popular: - the savage pleasure of watching a wild animal being slaughtered by a pack of dogs, will now be seasoned with the additional spice of knowing that you are doing something illegal, and getting away with it. Banning things has a very poor success rate for making people stop doing them.

The magistrates, justices of the peace, town councillors and police superintendants who still enjoy their bit of hunting every weekend, will be going back to work on monday and coming down hard on working class youth from the local council estates, handing out ASBOs, curfews and electronic tags, for breaches of the law that some might consider less violent, aggressive and illegal than what they themselves had been up to the day before. So much for the 'classless society'....

NHS Pension Robbery

2005-02-18T15:28:00.000Z
I was standing in the cold and rain outside a hospital today, with about 50 other UNISON members, to protest about the government and management plans to change our pension rights.

Basically there are two threats - one is to raise the retirement age for all NHS workers to 65 - this seems madness - are they expecting 64 year olds to staff orthopaedic wards? The consequence of such a policy will simply be to raise the number of nurses and other staff 'on the sick', as backs and morale give way.

The other is to get rid of the final salary pension scheme, and bring one in based on career average salary. If this is such a great option, why havent MPs and top managers chosen it?

Now is a good time for public sector workers to be protesting about these things, showing Tony Blair for what he is, as there is a general election on the way.

The other thing that really annoys me, is the way our union, UNISON, is funding the Labour Party, despite all the attacks the Labour Party carries out on public services - PFI, Foundation Hospitals, and now this dipping in to our pensions. We are literally 'feeding the hand that bites us' as Roger Bannister put it.

It's time for our unions to stop giving money to Mr Blair and the Labour Party to help them attack our public services, and our public service workers, and instead start to use it for campaigns to defend the membership and the services we deliver.

Religion and Patient Care

2005-02-17T14:34:00.000Z
My recent post on the differences between theistic and humanistic nursing has generated considerable discussion, the vast majority at an excellent level of reflection and argument.

Some though think that I should not be bringing the issue of religion into it at all :quote:
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The RELIGIOUS groups that you speak about that are terrorizing the world have nothing to do with the care of patients.
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Unfortunately of course, they do; through the promotion of beliefs such as the division of the human being into two parts - body and soul, religions have had a huge impact on human health, particularly as religion emphasises the primacy of the soul over the body, allowing religious people to 'mortify' their bodies for the benefit of their souls, and to participate in violence against other people's bodies - where this is believed to be in line with 'Gods will' (I.e. the tortures of the Spanish Inquisition, or the infamous crusade against a town where many 'heretics' lived, where the instruction was 'slay them all, the lord will know his own', as well as the oppression of the female body through institutions such as purdah, hijab and 'female circumcision' - in reality genital mutilation). On top of all this comes the denial and suppression of human sexuality, leading to mental anguish, and worse.

A full assessment of the impact of religion on human health could well be the subject for another 'Thinking Nurse' post, as I dont have time to cover it all today - I do recognise that there can be positive effects too, particularly those associated with 'belonging' and sociability.

Religous groups do participate in health care provision - particularly where there is no, or minimal state provision, and they do so in a way that is affected by their religious dogmas, certainly they are strongly influenced by teachings about 'charity' and by the opportunity for proselytising, while I would regard health as a 'human right' rather than something to be given to 'the deserving' and held back from the 'undeserving', and the delivery of healthcare as a form of 'human solidarity', due to everyone regardless of religious orientation, ethnicity, gender, disability, sexuality or perceived morality.

Patient care is affected when religious groups attack family planning clinics and the nurses and doctors who staff them, or when AIDS awareness programmes are interfered with, or when people are taught that illness is a product of 'sin', that disability is the product of bad karma from a previous life, or a punishment for the sins of that person's parents, or that mental illness is due to possession by demons, or when creationism is taught in schools as 'fact' disrupting the scientific education of the new generation of human carers.

None of these attitudes encourage people to seek help for their problems, instead they encourage shame, guilt, ignorance and stigmatisation. This is a type of 'spirituality' that our patients and clients do not need.

I therefore make no apology for raising this issue. It is one that nurses at least need to think about, even if they do not agree with everything I have said.

People with strong religious beliefs have a right to have their beliefs and customs respected - I feel that atheist and humanist nurses can respect the beliefs of others, where people with strong, but different religious beliefs can find it difficult.

Personally I have been involved with taking my clients to churches of many denominations to participate in worship - I feel this accords perfectly with my own atheism, as I am enabling my client to express their own spirituality, and participate in the wider community, though often I have cringed at what is being spouted from the pulpit!

Harvard Referencing System - A Bizarre Academic Ritual

2005-02-17T10:43:00.000Z
Every Student Nurse, in the UK at least, will know the misery created by the Harvard Referencing System, the method our tutors, and presumably the NMC, the Department of Health and the Quality Assurance Agency think that student nurses should use to reference their work.

As a consequence, students spend hours torturing little blocks of text, agonising over whether to italicise the Journal Title or the Article Title, scanning through textbooks to find their year of publication and the city where they were published.

Of course we are being taught to be 'critical thinking nurses' - to examine and scrutinise our practice, to seek out and destroy 'nursing rituals' that are there for no apparent reason, apart from 'thats the way it has always been done'. Practice must be justified with evidence that it is actually of some use.

Perhaps it is time to apply this method to the bizarre academic ritual that is the Harvard Referencing System. Here are a few questions we could use to interrogate the practice of using it.

What use is it to patients that their nurse knows how to reference an article?

Does use of the Harvard Referencing System provide any evidence of either a nurses' practical skills or of their ability to think?

Does use of the Harvard Referencing System make a student nurses essay any easier to read, or their message any clearer?

Does the Harvard Referencing system provide any more useful information than a simple bibliography at the end of an essay?

Should a nurse fail their course because they cannot get their head round how to reference correctly?

Of course the answer to these questions is NO! Patients and clients do not care one jot about the Harvard Referencing System, or whether their nurse knows when to use bold text in a reference.

Using the Harvard referencing system is a mindless rote exercise - it demonstrates a student's ability to unquestioningly obey arcane rules - precisely the kind of thinking that is meant to be discouraged by the modern nursing 'critical thinking' curriculum.

Articles written using the Harvard Referencing System are difficult to read - the flow of an argument is constantly interrupted by irrelevant names, dates and page numbers. We need to be trained how to present clear, easily accessible information to our clients, instead we are being trained to make our essays into headache-inducing mazes of references.

I can understand the need to use references correctly when writing for a peer-reviewed journal - here the provenance of ideas and facts becomes an important issue - but is it really neccessary for student nurses at undergraduate level? At this level, a simple bibliography should suffice - tutors would in reality be just as able to detect plagiarism, poor thinking and invented facts using this system as with Harvard.

The fact is that some student nurses do fail because they lose marks for referencing (and conversely, perhaps some pass because they can reference, even if they are not good at much else?) Should this process really be part of how we select who should become a nurse?

Perhaps there are legions of fans of the Harvard referencing system out there, who can explain why it is so vital that nurses should be able to reference a parliamentary paper correctly - if there are, I hope they will post here and explain it to the rest of us!

Theistic and Humanistic Nursing

2005-02-15T11:03:00.000Z
Theistic and Humanistic Nursing

As an atheist, and a humanist, my view of nursing differs fundamentally from those (perhaps the majority of nurses worldwide) who approach nursing from a theistic perspective. Bringing God into nursing however leads to huge logical and practical problems for nursing thought.

One theistic nurse, for example, writes: “I believe all humans are created in the image of God. For me this provides a rational basis for loving and caring for one another that is stronger than humanism's strongest (which still befuddles me)”

The theistic justification for caring for human beings is thus that they are made in the image of God, and God is more important than anything (including human beings).

The humanistic justification for caring for human beings is that they are human beings – and being human is what ultimately matters.

Theistic nursing is serving God, a spiritual quest expressed through the medium of the people who present as patients. Humanistic nursing is showing solidarity in a human way with other human beings

Putting a divine being above the human race, and arguing that the divine, the spirit, the soul, is higher than the human being has immense dangers. How many wars, massacres, genocides have been justified by claiming that these are spiritual ‘crusades’, with the backing of the divine? This is one consequence of placing the spiritual above the human.

Another danger is this question of the ‘ideal man’ – if we are made in the image of God, and we are all so different, some of us must be closer to the image of God than others. Traditionally religions have argued that men are closer to the image of God than women – one reason why they have resisted the idea of women priests. Presumably they also imagine that non-disabled men are closer to this image than men with disabilities, mentally stable men closer than people suffering from psychosis.

My theistic friend falls into this trap “ Even the mentally ill or deformed are still made in his image”, the words ‘even’, ‘still’ and ‘deformed’ speaking volumes about the theistic attitude to humanity.

A Humanistic view of nursing avoids this pitfall. For humanists, there is no ‘ideal’ human being. Humanity, in all it’s wonderful diversity, is a material fact that we accept. ‘Nothing human is alien to me’ was Terence’s humanistic, accepting and tolerant concept, expressed in 154 BC. If humanity had followed such sentiments think of the wars, witchunts and persecutions that might have been avoided over the last 2000 years, the human beings that might have been accepted instead of being shunned, or actively hunted down, by the theistic majority.

For humanists, nursing at it’s best, is an activity conducted by one human being, in a human way, with another human being. The nurse is attempting to open dialogue with the person in front of them, find a way to connect, as one subjective human being with another. This is all. There is no ‘hidden agenda’ of seeking to find the divine in another human being, or to serve God through that human being – the agenda is simply to find, and be with that person, for who they are. This makes humanistic nursing achievable, realistic, rooted in the material rather than seeking to ask nurses or their clients/patients to rise above or reject their humanity.

Of course this humanistic nursing is frequently not achieved. It is difficult to be human and behave in a human way, it is difficult to reject our programming and accept people rather than judging them, it is difficult to ‘be with’ rather than ‘do to’ in understaffed, bureaucratic, undervalued environments and to reject the social prejudices that divide humanity – even so, it is vital that we struggle toward it, for otherwise we become part of the system of prejudices, theologies, bureaucracies that exclude and oppress so many of the people that nursing serves.

Need for More Blogs By Nurses

2005-02-10T09:43:00.000Z
There is a definite need for more blogs by Nurses. According to Seyms' Nurse in Training Blog, there are currently only 6 (including Thinking Nurse and Seyms - if you know of any more, please let me know!).

Why is it useful for nurses to blog?

Nursing is an incredibly diverse and exciting sphere of activity. Nursing penetrates into every aspect of life, every social sphere. We see and experience things the rest of society likes to pretend are not there. We go to places that the rest of society would prefer not to go. We interact with people who exist on the margins of conventional society and learn things that society collectively ignores. This means that nurses have (many) unique perspectives that should be expressed and shared: - Shared with each other, because we are often dispersed and atomised, constrained within hierarchies and bureaucracies, and shared with society, because our messages, once expressed, debated and digested can enhance the physical, mental and social health of whole communities.

This article explains a lot of the benefits of the web-based knowledge log: http://blog.lib.umn.edu/blogosphere/the_spirit_of_paulo_freire.html . Blogging is a method that nurses can use to reflect and communicate, to speak about and name their worlds. Blogging can foster an "unsettling (to the powers that be) critical consciousness that is within the goals of an increasingly democratized culture"

By blogging, we are adding to nursing's collective knowledge, spreading ideas and questions, gaining support and strength from each other, providing a new interface between nurses and their clients.

How can nurses blog?

Practically, it is actually very easy. For example, it took me approximately an hour to start off this blog. I do not know how to write computer code - and I have not needed to write any.

Everything I needed, including the basic template was provided free. Once the template is set up, it is as easy to post to a blog as it is to send an email. This blog does not cost me a penny to run, and can be updated during a lunch hour, from anywhere that has internet access.

What should go into a nursing blog?

The blog belongs to the person (or people) who are writing it. It's content is therefore 100% determined by them. Basic nursing ethics, such as patient confidentiality should be observed, beyond that I feel nurses should be free to use their blogs to express ideas, ask questions, tell stories, write poetry, share practice, debate, boast, complain, laugh and cry.

Advertising

If you try to set up a blog, you will be offered the opportunity to put advertising on your blog. I have resisted this pressure, as I want this blog to be entirely independent of the drug companies and other big multinationals that see healthcare as a vastly lucrative market. (Now supplemented by the companies involved in PFI and PPP).
The Nursing magazines that depend on these companies for advertising cannot, by definition, ever be fully independent, and 'bite the hand that feeds them'. I would strongly advise writers of other nursing blogs to resist the temptation of what in actual fact is likely to be a few pennies, and not allow their blogs to become points of support for these companies.

If you are a thinking nurse, it is time to get blogging!

Parenting With a Learning Disability

2005-02-06T13:22:00.000Z
The other day I was privileged to listen to three mothers with learning disabilities talk about their experiences of bringing up children.

It was inspiring to see how these women had managed, despite all the attitudes and prejudices against them, to bring up children, and to gain the courage to speak about their lives.

I am a firm believer that all should have a voice, because we need to name our worlds in order to change them. These women had been involved in a self-helping support group, for only eight months, and were now going to conferences and speaking publicly, while still managing to get home in time to pick up their kids from school.

They spoke in particular about their difficult relationship with services. In order to succeed as parents, they needed a network of support - which included family, friends and professional input, particularly in times of crisis. However they lived in constant fear that their children might be taken away from them, often making them reluctant to ask for help when they really needed it.

Research by people like Booth and Booth (available from www.supported-parenting.com ) found that 14 out of 20 parents with learning disabilities had one or more of their children placed in short-term or permanent care. Can we be confident that in all these cases, everything had been done to give the parents the chance to care for their own children? Services tend to look at parents with learning disabilities with a 'presumption of incompetence', and often have conflicting responsiblities, reacting to crises rather than putting in training in parenting skills (it has been proven that parenting skills of people with learning disabilities can be improved through training) and long term background support - there to be called on when needed - evidence shows that adequate social supports can protect against parenting breakdown.

Such social supports include support from family and professionals, but could also be adequate benefits, decent housing and proper access to health services.

Despite this Cross and Marks (1995) found that 13 children from 18 pregnancies of women with learning disabilities were subject to child protection procedures 7 of these started within 1 week of birth, 6 of those 7 starting at birth itself.

A single minded concern by services with parental inadequacies can lead to self-fulfilling prophecies.

There is clearly a need, if we are to take the principle of 'ordinary lives in the community' seriously, for attitudes to change, and for services to use an enabling approach, that creates opportunities for parents to develop and demonstrate their competence, and that seeks ways to give parents a sense of control over their own, and their childrens' lives.

I asked the women "If you were approached by someone with a learning disability who wanted to have a baby and start a family, what advice would you give them?"

The reply was a unanimous "Go for it, and fight for the right to keep your child".

Star Rating System of NHS Acute Hospitals

2005-02-01T16:08:00.000Z
This press release from the Royal Society of Medicine describes a study that illustrates what many of us have believed about the NHS star rating system since it's inception, that it is a fairly arbitrary process, riddled with problems, that often does not mean very much and can lead to 'misrepresentation of data' (a phrase that translates into English as 'telling lies') and other practices that are not in the interests of patients ('unintended and dysfunctional side effects'). The big problem is that such ratings can influence major funding decisions which can drastically affect local healthcare services:

"The problem with NHS star ratings
Since 2001, the star rating system of NHS acute hospital trusts have given the public the ability to compare one hospital from another using a standard evaluation process. What are the consequences of the results, and is this enhancing patients’ experience in NHS hospitals? Dr Russell Mannion and colleagues at the Centre for Health Economics, University of York present new research in the current issue of the Journal of Health Services Research and Policy, published by the Royal Society of Medicine Press.

The ‘importance’ of star ratings
Although the star ratings system is not the only process in place to measure the performance of NHS acute hospital trusts, the ratings system and its results gain broad media exposure and is therefore scrutinised by the public. They are also viewed as a benchmark for internal processes. ‘In addition to facilitating accountability to patients and the public, they also serve as an important tool for concentrating management attention on key strategic priorities and national targets,’ Dr Mannion writes.

Are star ratings a ‘balanced scorecard?’
Staff members at some of the hospitals surveyed thought that star ratings ‘did not represent a rounded or balanced scorecard of their own organisation’s performance.’ One of the inconsistencies of the NHS star ratings system are the sometimes conflicting results of similar, commercially-funded surveys, the author says. These differences are ‘assumed to be due to the increased weight accorded to clinical indicators in the methodology used’ by other organisations, the article states. Other complaints from staff included that they did not take into consideration ‘local contingencies’ and specific ‘mitigating factors that might help explain variations in the measure performance of hospitals.’ Many of these unique conditions are beyond the hospital’s control and it is therefore viewed as unfair that this would not be taken into consideration when the rating is calculated.

Inaccurate data is ‘not in the patients’ best interest’
This study also highlighted the ‘widespread belief that the data used to calculate the star rating were often incomplete and inaccurate,’ Dr Mannion says, to the extent that the staff at one highly-rated hospital admitted to ‘purposefully manipulating and misrepresenting data in order to improve their rating.’ Some of the tactics used included scheduling cancellations at a time to avoid unfavourable data and re-classifying trolleys as beds. One hospital with a low rating thought this was a result of the accuracy of their data, and another expressed concern that this practice was ‘not in the patients’ best interests.’

Responses to star ratings
In addition to the data and methodology of the star ratings system being evaluated, the internal effects is also relevant in determining its integrity. There were many positive hospital responses to the star ratings, including the alignment of ‘internal performance management and reporting systems with key national targets.’ The communication between central government and hospitals was improved and ‘dysfunctional senior management’ was identified that otherwise may have stayed hidden within the hospital, Dr Mannion asserts. The negative responses included ‘evidence of tunnel vision and a distortion of clinical priorities,’ reduced staff morale and public trust, and ‘bullying and intimidation.’

‘Gaps in knowledge’ and ‘dysfunctional consequences’
The authors conclude that ‘this study highlights some important gaps in knowledge and failings in current policy and practice. That star ratings may be used for good or ill makes it imperative that the Healthcare Commission monitors the impact of these data, not only in terms of the degree to which they lever beneficial change, but also in terms of any unintended and dysfunctional side-effects they generate for patients and staff.’

Link: http://www.rsm.ac.uk/new/pr163.htm

Nursing and Sex Role Stereotypes

2005-02-01T13:41:00.000Z
Nursing is typecast as a feminine profession, but as this http://www.geocities.com/Athens/Forum/6011/ rather excellent website demonstrates male nurses have played a key role in nursing since the earliest times.

The first nursing school was set up in India in 250bc it would train men,
"of good behavior, distinguished for purity, possessed of cleverness and skill, imbued with kindness, skilled in every service a patient may require, competent to cook food, skilled in bathing and washing the patient, rubbing and massaging the limbs, lifting and assisting him to walk about, well skilled in making and cleansing of beds, readying the patient and skillful in waiting upon one that is ailing and never unwilling to do anything that may be ordered."
The Charaka (Vol I, Section xv)

There have been many male orders of nursing, including ‘The Parabolani’, the Benedictine Nursing Order, the Alexian Brothers, the Knights Hospitalers, the Teutonic Knights, the Tertiaries, the Knights of St Lazarus, The Order of the Holy Spirit and the Hospital Brothers of St Anthony. Some of these were monks, some soldiers, some both. There is a tendency to describe men who are actually carrying out nursing tasks as 'healers' or 'witch doctors', so the existence of male nurses has been edited out of a lot of history.

Male nurses are much more common in learning disabilities and mental health nursing than in general adult nursing, though the numbers are growing in every branch of nursing, as sex role stereotypes begin to break down.

However, some things do not change – male nurses tend to rise through the ranks more quickly and end up in management positions more easily than female nurses, reflecting the fact that sexism is still a powerful force, even in professions where women outnumber men.
It is in the interests of all nurses to challenge the sexual stereotyping of nurses, and the assumptions that give male nurses an easy ride into management positions.

Link Between Cannabis and Psychosis

2005-01-29T14:19:00.000Z
Linking on the title of this posting will take you to the site of 'Rethink' a leading mental health charity. They are highly concerned about the growing amount of evidence that links cannabis to the triggering of psychosis.

I have always been suspicious of this government's policies on drugs and alcohol. They are liberalising access to both, and young people are binge drinking and smoking away. As a result our hospitals and mental institutions are facing crisis.

Time for some real thought...

Neurodiversity - A Human Right

2005-01-25T13:24:00.000Z
A key human right is the right to think differently from the majority of other people. By this I do not just mean the right to hold different political or religious beliefs, although this is important. I think there is a right to actually think in different ways, we should embrace ‘neurodiversity’ as a concept.

People who have been labelled as ‘autistic’ ‘schizophrenic’ ‘manic depressive’ and ‘learning disabled’ have all made significant contributions to human knowledge, culture and society, often achieving things that ‘neurotypical’ people could not. This is not to idealise these conditions, they are often associated with physical and mental suffering, but the huge social stigma and discrimination that go with these conditions are something that it is possible for nurses, and other human beings to challenge.

Have a look at this website:

http://www.neurodiversity.com/

'Positive Choices' Conference - Nottingham April 1st

2005-01-24T13:49:00.000Z
I have just learned that I will be one of the 450 student nurses attending this potentially historic conference.

Speakers at the conference will include influential figures in the learning disability field such as Bob Gates and Ruth Northway, as well as some students who I have not yet heard of, but suspect are likely to become leading figures in learning disabilities in the future.

I will of course post a full report of the conference here, as soon as I have recovered and got onto a working PC.

http://www.nottingham.ac.uk/nursing/news/conference.html

Gassing Of Aloisia V: Hitler's Mentally Ill Relative

2005-01-23T14:50:00.000Z
This news report (linked in the title of this piece) about the gassing of a close relative of Adolf Hitler, because she was mentally ill, reminded me of one of the great untold stories about the holocaust, the fact that among the first victims of the holocaust were tens of thousands of people with mental disabilities.

We would like to think that such slaughter was carried out by fanatical jackbooted Nazi soldiers. The reality however is much more chilling, and should never be forgotten by nurses who work with mentally ill or learning disabled people today. The programme to wipe out mental illness and people with learning disabilities was largely implemented by the Psychiatrists, Doctors and Nurses who staffed the mental institutions of the time. It was people like us, sensitive caring health professionals, who selected the patients, herded them onto buses, and watched them die.

This is a hard thing for nurses to believe - but it is true. It is a stark warning about what can happen when we start listening to eugenicist arguments, that some human beings are more valuable than others. But such attitudes still exist today. The World Bank promotes 'Disability Adjusted Life Years' as a method for third world countries to select which patients should receive treatment - the elderly, the disabled and thus those least likely to work and create profit are the ones who miss out on treatments as a result of such policies.

In our own country, people with learning disabilities are far more likely to suffer from, and have their lives considerably shortened by easily preventable illnesses. The Disability Rights Commission is currently investigating why these people seem to be so grieviously short-changed by healthcare services.

Eugenics is still here, in our NHS, in our own values and attitudes, just under the surface, it is a reflection of the 'Devil take the hindmost' ethic incipient in any society based on competition rather than cooperation.

T4, short for the address Tiergarten 4, was a Nazi work group of psychiatrists and physicians. During World War II, they were in charge of the killing of more than 100,000 people with disabilities.

Life with a disability often has been perceived as not worth living. As recently as 1983, fifteen US states had laws that required the sterilization of people with disabilities.

(Image from : www.tommihail.net/GreekProf_ disabilities2.html)