Return to work

Today was the first day back doing clinical nursing after 6 weeks off. Granted, I've been pretty busy in that time but I haven't been on a ward. It was good to be back though!

There was a programme on the BBC the other night about Tourette's Syndrome. It was brilliant - it follow up on a man named John who had done a programme in the 1980's and a fifteen-year-old boy from North Yorkshire who had the condition, called Greg. There were some very candid interviews, and they must've been very brave to have participated in the programme.

It was interesting to see the difference they had experienced; John had been diagnosed in the 1980's and there was little support for him or his family. As such, John had become isolated and withdrawn. Greg, on the other hand, had a very supportive family who had sought information, services and professionals to help them cope and know more about Tourette's. Had John grown up in this day and age, it is likely that he would have found it easier.

Very little is known about Tourette's; it is a neurological condition where people suffer from tics that need to be released. Their behaviour can often be challenging both for themselves and those around them, and contrary to popular belief only few sufferers shout random swear words out loud. It is known that Tourette's is genetically inherited, and a sufferer has about a 50% chance of passing that gene on to their offspring.

A few theories are currently being thrown around; one that is particularly controversial is a streptococcal infection of the throat that results in antibodies interacting with brain tissue. In people with Tourette's, MRI scans of the basal ganglia are abnormal and it is believed that this may be a cause of Tourette's.

Diagnosis of Tourette's involves a process of elimination to rule-out other conditions that may be causing the symptoms, and the treatment is simply education and support. Symptom control can be undertaken with several drugs if they become a problem. Deep-Brain Stimulation (DBS) is a relatively new and experimental treatment and may be effective.

For more information see Tourettes Action or the BBC Health page on Tourette's.

Congress day 5: a tumultuous end

Day 5 at the RCN Congress played catch-up, debating and voting on resolutions that were lagging behind due to the earlier events of the week.

A resolution That this meeting of RCN Congress urges RCN Council to ensure that its own diversity reflects the diversity of RCN members was hotly debated - eventually not being passed, possibly due to a misunderstanding as to the actually meaning of the resolution. Cecilia Anim, the proposer, undermined her proposed resolution by saying that she wanted to be on the Council, and suggested that candidates should be voted in proportions representative of its members, whereas the majority of debaters expressed a wish that people should be voted in on the basis of merit and what they can offer.

From the RCN website:

Report on this debate

Cecilia Anim from the RCN Islington Branch told members that diversity meant difference and it was important for these differences to be harnessed. She said that creative solutions were needed if the RCN wanted to be a world class champion of diversity. This could not be the case if RCN Council does not represent the membership. She asked members to take positive action 'not because it's the popular thing to do but because it's the right thing to do'. The resolution was seconded by Zeba Arif who asked Congress to support the resolution as it would benefit nurses, patients and the RCN.

Members were restricted to speaking for one minute as there were so many who wished to speak on the subject. Mojisola Olaye said that multi-cultural Britain should be reflected in RCN Council and Gareth Phillips urged members to remember that diversity is not always obvious as he said that Council was already a diverse entity in a number of ways.

Damian Ronksley referred to the way in which the National Union of Students works - having dedicated seats for women and LGBT students and Charles Gomedza reminded that diversity is nothing to be afraid of.

Several members emphasised that the skills and ability to work as a Council member and get the best person for the job were the most important issues to be taken into consideration. Saffron Brown received a standing ovation when she told members that as a black woman, she would be offended if she were to be employed or elected to a position based on the colour of her skin.

Alan Mawbey, the Council Diversity Lead encouraged people to stand for Council. "If people don't stand, you end up with what you get" he said.

There was some discussion about the meaning of the wording of the resolution. The resolution was not passed. Following the debate, RCN President, Maura Buchanan said that she wanted to encourage everyone to stand for Council.

Results of the resolution

For: 105 (29.58%)
Against: 250 (70.42%)
Abstentions: 19

Not passed.

Congress ended (as it does traditionally) with a slideshow to music of pictures taken over the week. Few non-voting members remained until the very end, and there was some debate as to where so many of the funded voting members were; who are supposed to stay until the very end.

It has been a very enjoyable week, and for me the highlight was definitely Sir Michael Parkinson.

Congress day 4: Sir Michael Parkinson

Source: RCN

Today was Congress day 4, and the highlight of the day was a speech by Sir Michael Parkinson on dignity. As the Government's Dignity Ambassador, Sir Michael is trying all he can to improve the nation's attitude towards older people and improving their dignity by giving presentations to and visiting organisations and groups.

Sir Michael spoke of his own mother and as he did so it was plain to see that he was trying to keep back the tears. He spoke of the dementia that she suffered from in her older years and his reasons for becoming an ambassador. Sir Michael received three standing ovations: one upon entering the auditorium, one after his speech and the final one as he was leaving the auditorium - louder perhaps even than the Prime Minister's. His speech touched on some of the most dignified older people he had met in the course of his work as an interviewer, and some clips were shown from his show.

There was true warmth in the auditorium, as people sat in awe of him as he spoke. He made references to certain people he had met and had influenced his life, saying that the person he would most like to interview regarding dignity would be Nelson Mandela; and that it was remarkable that after everything he had been through he could still be so dignified.

Undoubtedly, Sir Michael's speech will be one that people remember long after Congress, and it would seem that in his job as dignity ambassador he is succeeding.

Sir Michael had said he had been "delighted" to speak at Congress, and that he was "looking forward to being able to discuss the vital issue of patient dignity at the largest gathering of frontline nursing staff in the UK".

Sir Michael Parkinson's speech will be avilable here for viewing shortly. For more information on Sir Michael's appointment and Dignity in Care, visit the DH Care Networks website.

Trackback - Sir Michael Parkinson's speech.

Congress day 3: Student's day

As well as being nurse's day, today was student's day at RCN Congress. Organised by the Association of Nursing Students, part of the RCN, over 1400 students attended: a record number for the Congress. Various lectures were given and a Q&A session was held by Ann Keen, the parliamentary under secretary for Health.

In the main auditorium there was extensive debate surrounding changes to the representation system for forums, regions and boards to vote. Currently the number stands at 1 vote per 1000 members, but this is due to change.

A busy day today, much debate and argument. Videos can be seen here.

Congress: Gordy vs Dave

It's the second day of Congress, and as the photographers swarmed two surprise visitors made an appearance today. The first was the Prime Minister, Dr Gordon Brown MP, and in his wake was Mr David Cameron, MP, the leader of the Opposition.

Both addressed the congress, with Gordon's speech going out live on news networks. Both speeches had similar undertones, with references to experiencing NHS services and the loss of their children. Whistleblowing was also a common theme, having been highlighted by a nurse recently "blowing the whistle" and losing her registration as a result.

Talking "off-the-cuff" (if you believe it) Dr Brown said of nursing that it was "a profession that you enter not for what you can get, but for what you can give", mirroring it to recent issues surrounding MP expenses claims, saying that MP's should follow the same ethos. He spoke of courageous nurses, and that the Government had the willingness to invest in the NHS as a whole, not just in doctors and nurses. Gordon also said that they were looking at social and elderly care, and were hoping to improve the lives of the 6 million carers in Britain.

He spoke of losing his sight when he was young, and that the nurses played a key role in his rehabilitation. Gordon said that "there is nothing more important than talking to the nurses of Great Britain" when referencing the fact that no Prime Minister had attended the conference in 93 years of the RCN, citing that they always said they "had something better to do".

Gordon received a standing ovation, and undertook a lengthy Q&A session, although not fully answering and perhaps tactically avoiding a question about whistleblowing.

Mr Cameron made an appearance about an hour later, with a more conservative (no pun intended!) approach of reading a pre-prepared address. He said that "welfare is now a lifestyle choice, not a last resort" when speaking about the benefit system and that we had been left with a "battered and broken society". He spoke of rebuilding society "brick by brick" should he be elected at the next general election.

David also made reference to his own experiences with the NHS, almost uncomfortably talking about when his son Ivan passed away. He said that where "nursing was good, care was good" and spoke of the services he received. David said he owed a "debt of gratidude" the nurses who helped him through.

Interestingly, Mr Cameron mentioned that he would make organisational changes in the NHS, removing centrally-allotted targets and instead concentrating on improving outcomes for patients, and "strip down targets that undermine professional responsibility". He also affirmed that he would "definitely not introduce an insurance based health system", and that he was proud that it was freely available to any and all. On that note, Mr Cameron also said he wanted to "make sure doors to nursing are open for all", with training "focussing on practical skills, rather than theory".

He acknowledged that the NHS is the largest employer in the UK, and that it was difficult to keep up with organisational changes over recent years - that "the NHS history reads like alphabet spaghetti.

Both speakers told the audience what they wanted to hear: it is, after all, MEP voting time soon and they are out on the campaign trail vying for votes. Both speakers made references to their own experiences with healthcare, and if you were cynical you could say they were going for the sympathy vote. Both discussed whistleblowing - with Gordon taking a low-impact approach and David saying he would introduce contractual and legal protection for those who felt they needed to break their silence. It was almost as if they had read each other's speeches.

Both spoke well, and I was impressed with Gordon's oratory skills. He seemed relaxed and proud to be there. Both Gordon and David received a standing ovation as they entered and left the auditorium, but Gordon's croud seemed slightly more numerous on this occasion.

Nick Clegg of the Lib Dems wasn't in attendance - he was in Wales launching their Welsh MEP campaign.

Finally, it was good to hear the Chair of the Mid-Staffordshire branch standing up during the Q&A and sticking up for the nurses he represents. He asked Mr Cameron what he would do to stop the media and politicians from harassing his nurses and why they were using focus groups, instead of actually asking the nurses who worked their what their opinion was. His answer was simply to "invite the nurses to the focus groups".

A good day at congress. It's Dr Keogh tomorrow and Parky on Wednesday, however I doubt they will have as much impact as today. That remains to be seen.

RCN Congress Pt.1

I'm up in Harrogate for the Royal College of Nursing Congress 2009. It started today with registration and an opening ceremony, with a big party tonight at the Harrogate International Centre. Over this week I'll hopefully be bringing you some discussion and comment surrounding the major issues raised. I've already seen lots of familiar faces, and word is there'll be a couple of political heavyweights attending tomorrow. You can see some video coverage of the events by clicking here. Parky is giving the keynote address on dignity this year, on Wednesday. Sir Bruce Keogh, NHS Medical Director, is delivering the keynote address on Tuesday.

The Congress programme can be found here.

Midwife at 90

A woman in Wiltshire has delivered her Granddaughter's baby. This might not seem so remarkable initially - but the lady was 90, had been a midwife before retirement and had not delivered a baby since 1954. And she's had two hip replacements. The on-call midwife couldn't reach her granddaughter in time, and she knew it was time so she just got on with it on the kitchen table.

It just goes to show - we never lose the skills we learn, and we never know when something may come in handy that we've done in the past. I could waffle on about Benner's application of the Dreyfus skill acquisition model right now but I'll leave that for another post - well done Mrs Jones!

It came...and it went...?

As of today, Swine flu has 32 confirmed cases in the UK, with 1,658 around the World. There has been widespread panic, which has been fuelled by the media - with such headlines as "the end of humanity as we know it". I believe that one was down to our friends at the Sun. People need to get some perspective.

More people die annually in car accidents than from flu, and cars are a weapon of our invention. The word is that the actual rate of death from swine flu is no more than that of normal flu, and the papers are reporting that the death rate is actually decreasing.

This kind of mass panic has happened before: vCJD was meant to be one of the big killers of our time, that was spread through prions in infected meet. Thousands of cows were culled, and European trade ground to a halt. 164 people are reported to have died from vCJD, which is a lot less than was initially thought there would be.

SARS came in 2002, a pneumonia-like disease that came close to pandemic status affecting over 8,000 people between 2002 and 2003; eventually 774 people died with the disease. In 2006, the word was that one in four people might die of Avian flu, when in fact the global death toll was 257.

I suppose the question should be - can we win? This kind of thing keeps happening more and more frequently and eventually something will arrive that cannot be conquered. Horace said 'If you try to eradicate Nature, she will in time rise up silently and confound your foolish arrogance', and that was in the 1st Century BC. You could say that Horace was well ahead of his time; perhaps he wasn't, as the same thing has been happening throughout all human history.

At the end of the day, when all is said and done - we will all die. We won't be here indefinitely. Who's to say the human race will even be here indefinitely. There is always a danger that something is just around the corner that will be the end of civilisation as we know it.

I just don't think it's swine flu.