Wednesday, 30 April 2014

A Welsh Hymn

Today

This Inspired Me

Starting Out

@JoGwilym - 2nd Year Student Nurse - Swansea University

Tomorrow's Nurses

 Well Educated - Skilled - Reflective  - Compassionate 

And Good Singers 

Jo is caring for a dying man she has just met, sitting with him at his end.....

"What could I do? I remembered reading that that the last sense to leave the dying person is hearing. So I decided to talk to him. 

But there was a problem. Never usually short of words I suddenly found myself in a black hole for vocabulary. After reassuring Robert that he was not alone, that I was here for him and would not leave him, I dried up. 

What do you say to a person you do not know. I though about reading him a passage from the book on his bedside table, but there was no bookmark. I did not know whether he had started it, was halfway through, or had nearly finished. My concern was that Robert could become frustrated if I read him  something he had already covered, and the last thing I wanted to do was upset him in any way.

I then thought I could talk to him about my family, but I did not want Robert to end up being an agony uncle as I poured out my personal woes. Again I was at a loss.
My main aim was to keep Robert as comfortable and unafraid as possible. So I decided to sing a Welsh Hymn to him quietly. Within minutes Robert had passed away.

It is an experience that will always stay with me. It is`a privilege to be able to offer comfort to dying patients, and I am glad I was able to hold Roberts hand as he took his last breaths, reassuring him he was not alone."


Wednesday, 16 April 2014

The Evening Office Cleaner

THE ONGOING TALE OF THE EVENING OFFICER CLEANER

A TALE OF COURAGE, AMBITION AND SUCCESS 

------------------------------------------- 


16-4-2014 


A Funny Thing Happened At The Office Today.....

Now those of you who know me know that I keep a well stocked large jar of boiled sweets in my office, Humbugs, Pear Drops etc etc. These I dish out liberally to students and staff. Its my little eccentricity. Over the years I have often left a note on the jar telling the evening cleaners (who I have never met) to "have a sweetie". Occasionally I have had notes back saying "thank you".

Today I was sitting in my office (door open as always). Outside was a small group of brand new shiney student nurses all laughing and happy - they were waiting to see their personal tutor. I went out with my jar and offered them a sweetie. One young woman looked at me and said "I have had your sweeties before - I love your office".

Lisa Jones had been my evening office cleaner - who left me little thank you notes. She would browse around my Nursing books - and was inspired to become a nurse. Well done Lisa - we are proud to have you with us.

Students are - THE FUTURE







----------------------------------------------------------

29-7-2014 - UPDATE ON Student Nurse LISA

Today I met Lisa as she bounced down the Corridor - resplendent in her Purple Uniform. Beaming she handed me a letter - written by a patient she had cared for. The letter glowed with praise for the care she had given to the author, a man who had suffered a Stroke. Lisa he described as a wonderful caring Student Nurse.

Well done Lisa - We knew you would do us credit...

Remember - we didn't tell you it would be easy - we told you it would be worth it!


---------------------------------------------------

UPDATE 27-1-2017

THE EVENING OFFICE CLEANER IS NOW A REGISTERED NURSE

AND ITS ALSO HER BIRTHDAY!

CONGRATULATIONS LISA

------------------------------ 

UPDATE 3-3-2017 

GRADUATION BALL
'STAFF NURSE' LISA JONES

------------------------
UPDATE 17-4-2017 

STAFF NURSE JONES


Remember - we didn't tell you it would be easy - we told you it would be worth it!

 UPDATE 24-7-2017 

The Evening Office Cleaner Graduates

“People will forget what you said, people will forget what you did, but people will never forget how you made them feel.” ― Maya Angelou

Lisa - Holds the Lamp High.... 

"Nursing - its a reflex - its what you do" If you're a nurse you will understand this ... #Nursing When your poorly #Nurses Matter

The Brave Office Cleaner - now changing peoples world.....



Tuesday, 1 April 2014

STILL TEACHING THEN DAVE!

STILL TEACHING THEN DAVE!

I have been a Nurse Teacher in Swansea for the last 24 years. During that time I have had literally thousands of student nurses pass through my hands in one way or another. I have been a personal tutor, I have given lessons on just about everything you can think of, I have marked countless thousands  of essays and assignments, visited hundreds of wards, issued warnings, given encouragement, and mopped up an awful lot of tears. I have applauded success and watched these students go on to have their careers as nurses in a bewildering array of settings. Some have come back for further studies; some have gone to great things and lofty roles.  Some have actually cared for me in recent years as I have got older and developed my various ailments.

With all that in mind let me tell you about something that happens to me quite a lot. I am frequently accosted by old students of mine, in Tesco’s, in restaurants, walking the dog, wandering through hospital corridors. And their opening line is always the same “Hi Dave – still teaching?”. This will be made more colourful if you can imagine this in a rich Welsh accent.

Still Teaching? I am sure everyone who ever reads this will identify with that moment when you realise that very few people actually understand the intricacies of what you do, of what your job actually entails. “Still Teaching?”, “Still Nursing?”, “Still Doctoring?” what do these comments mean? Or alternatively – does it matter – as long as you know what you do!

When faced with a “Still Teaching?” question I usually respond simply by saying “Yes – still Teaching” – this often accompanied by a quite awkward inward reflection as to who the hell the questioner is? Now I know ALL nurses will identify with that: Patient “Hello Nurse – how are you”, Nurse “I’m fine thanks” (thinking who are you – where do you know me from!).     

ANYHOW – I digress.  It is totally understandable that we cannot all understand the intricacies of everyone elses occupational role, how could we. But I am intrigued by stereotypes, and how we view professions and their roles.  And hence my interest and focus on this very specific, and seemingly innocent quest “Still Teaching Then?”.  My point, or issue if you prefer, is that being a “Teacher” of nursing for me is so much more than just “Teaching”, and that the world of education is complex place. In fact “Teaching” for me is a way of life.

For example, over the years I have been met countless times with the view that teachers have it easy, working just nine moths of the year with all the summer off. Nothing could in fact be further from the truth.  In Universities the Summer months are some of our busiest, marking, preparing next years timetables, admissions, A Level results and endless other tasks. Teachers work at weekends, preparing lessons, marking. They work in the evenings. In fact - Teachers work hard!

Now don’t get me wrong, I will not bore you with my weekly timetable!  The irony here is that when I agree to the comment “Hi Dave, still Teaching?” I am in fact not really telling the truth. It has been some time since my role was that of a frontline teacher.  Today I am a senior academic and a strategic manager. I spend endless hours in meetings, juggling budgets and politics, networking across the NHS and with Government. Some of this is terribly exciting, and some of it quite mundane. Then there are the days when I still actually “Teach” – and these remain the best of my days.  My first passion is being a nurse, my second passion is teaching nursing.

So ultimately that simple reply to that simple question - “Still Teaching Dave?” - “Yes – still Teaching” is strangely profound.  Still Teaching after all these years and still loving it......

"@DonnaCardilloRN: Blessed are the nurse educators, for without them none of us would be nurses!" @JuneinHE @Bartontd



Sunday, 30 March 2014

Waiting to be Found Out

WAITING TO BE FOUND OUT (STILL) !!

Associate Professor - Dave Barton Ph.D. M.Phil., B.Ed,. Dip. N., R.N.T., R.G.N.

About fifteen years ago I was asked to write a simple article on my experiences of Post-Graduate studentship.  In 2005, five years later, I was then asked to provide a short account of my success with my Ph.D. studies.  

All this reflection.....

Firstly, let me say that having a Ph.D. says nothing about the person.  After thirty-four years of nursing, I can firmly state that education does not correlate with how nice, or not, a person may be.  There are many well read academics that I would not share a pint with, and many who have less letters to their name who I would count as dear friends.  

Secondly, let me remind you of the story of the anxious professor that I told of all those years ago.  Apparently, this professor’s career had progressed by chance rather than by design.  As a young man, he had passed his O'Levels and then A'Levels with little distinction.  As an undergraduate, he muddled his way through his studies, never academically brilliant, but always just enough to get through.  Then as time passed he studied for his Masters degree, and again he managed to pass, not outstandingly, but nevertheless he passed.  Then there came his Ph.D and again to his surprise he succeeded. There was a progression of promotion, publication and success, and eventually he became a professor.  But this professor was haunted with the suspicion that, despite his apparent success, despite everyone else's belief in him, he knew he was in reality a complete fraud.  Surely someone, somewhere, who knew him better would come forward and let the world know that he was really only at the peak of his profession by mistake, and that waiting in the sidelines were the real professors.  I understand that he is still there to this day, justifiably regarded as an expert by all, and yet still waiting for the day that someone will 'find him out'.

I liked this story, partly because it was true, and partly because I can relate to the essence of its suggestion, that long-term education brings uncertainty rather than confidence.  At the time of the original article I was criticised for painting the wrong picture of Academic development.  But I stand by its essence, as even now the story mirrors the anxieties that I have as a result of my long career as a nurse, as a student, and as an academic.  Then, as now, instead of ever-higher qualifications increasing my confidence, I remain often uncertain and unsure of myself.

For example, there is a well-established law that states that we are all constantly moved forward to our maximum level of incompetence.  Just when you think you have got the hang of something and truly become good at it, they promote you.  Just when you think your there, high and dry, you look up to see the next hill to climb.  The worrying thing is that the more you climb, the more people think you are a good climber, instead of an idiot who doesn't know when to stop and might still yet fall.

Indulge me - let me bore you with some personal history as it may illuminate this personal perception of academic fraudulence that I, like the professor, have.  I became a student nurse in 1980, a most recent entry to the profession I am informed by some of my colleagues.  During those three years of student apprenticeship, I learnt the basics of my future career.  Looking back on those days I can remember having heated debates over the academic nature of nursing (you see nothing is new), personally standing steadfastly against those dreaming and isolated pinnacles of academia, so far removed from what I saw as the sharp edge of clinical nursing!  I regarded any nurse with a list of qualifications after their name with deep suspicion (in some ways I still do!).  Nursing, I would have said, was rooted in practice and tradition.  When you qualified as a Nurse, you were set to practice for life.  What amazes me now was that I was so confident in these opinions, that I was so sure about what was right and wrong.  Were did all that confidence go I wonder?

Well despite my strong and youthful opinion that perpetual study was against the grain of clinical practice I found that within two years of qualifying, I was a student on an ENB Intensive Care Course.  I rationalised that this was purely a means to an end - although it was apparent that I was unsure what that end was to be.  I continued to view academia in a dim light, particularly in regard of research in nursing, which was being mercilessly plugged by the profession.  Why, I thought, should nurses have to research that which we instinctively knew!  In spite of these ongoing misgivings within another year, I had started a three-year Diploma in Nursing - why - because it seemed a good thing to do, because I wanted promotion and because I was bored.  My reserve about research finally began to weaken ( I suspect because my brain finally began to work) and I found myself unwillingly becoming a supporter to many of the ideas that my teachers espoused.  However, as I felt clinically confident, I felt only slight anxiety that as a novice academic I was obviously at best bluffing, at worst a complete fake.

Life has a funny way of creeping up on you - suddenly I was out of clinical nursing and into nurse education.  Why - well the hours were better, the pay was certainly better and I guess I got lucky.  Despite my misgivings over my academic credibility (I had no doubts about my clinical credibility) it was clear that with enough front, and with a bit of playing the system, I could even bluff my way as a teacher - for how long I was unsure!

Then to my amazement, I found myself an undergraduate.  I muddled through and managed to pass although not with any great distinction.  This you might think would have been a good point at which to call it a day, but by now had the study bug badly.  On top of this I reasoned, education was changing and it was clear that if I wanted to retain the job (and privileges) to which I was rapidly becoming accustomed to, I was going to have to take another stab at this educational business and see if I could finally become competent at something.  Thus I plunged uncertainly (bluffing every inch of the way) into an M.Phil. and four years later completed it with only some degree of success.  Then madness gripped me and I registered for a Ph.D.  This was very nearly my nemesis!

Thus, you see, I have arrived in my present position somewhat by accident, not with any great distinction, and certainly not as a result of any grand life plan.


And now you can now see the difficulties I have when asked to answer questions on my ‘achievements’.  Indeed, those who have known me for a long time are still laughing that I ended up as a Head of a University Nursing Department - my Nurse Teachers all those years ago would have been dumbfounded. 

However, I did not wish this Blog to be some bland tale on academic success, as the real achievement for me, my greatest achievement, has been the opportunity to play a part in the development of future, capable healthcare professionals.  


Sunday, 2 February 2014

Dave's Sensible Blog

Welcome to Daves Sensible Blog - I guess I ultimately had no choice.

I created New Nightingales as a Blog 2 Years ago, having written the Book and wanting it to have an audience. Two years later it has an astonishing 44 Thousand Visitors. 

The New Nightingales Chronicles  

Egged on by others I created St Twitters as a Blog a year ago, the Private Eye equivalent of the NHS. Tongue in cheek irony it pokes fun at Nursing and Healthcare, whilst offering some interesting historical perspectives. A year later it has received 25 Thousand visits.

St Twitters

And then there is me, a 58 year old Grand Father. A Nurse, a Teacher, an Academic. 

David Barton RN, ENB100, DipN, B.Ed. M.Phil, PhD !!! SoMe user / communicator

I never expected to be a 'Blogger'. 3 Years ago I had never heard of Blogging. OK I had a FaceBook account, but Twitter was a mystery.  And as I explain in the closing Chapter of New Nightingales where I had no plans, no visions or ambitions for being a Senior Academic Nurse in 1979, no more had I of Social Media participant in 2007. And yet here I find myself on a dark February Sunday Night in 2014 'Blogging', Tweeting (with a ridiculous following of 3400 - nuts), engaging in a new virtual space of human communication. 

Oh.. BTW - This is one I prepared earlier :o) 


ASTONISHING – TECHNOLOGY
HUMANS AND THE FUTURE

Today I sat watching Dafydd, my 2 year old grandson, with astonishment. He sat (well he fidgeted actually - constantly) next to his father whilst he stared intently at a touch screen Smart Phone screen. He then deftly used his finger to flick through screens. He giggled as he got to the Games screen, opened his favourite game, and went to find the hiding rabbit! He is 2 years old and he had grasped the concept not only of a touch screen but also its interface. That cognitive step has humbled me, not because he is my grandson, but because we humans always underestimate the genius of the human mind and its ability to learn and invent at an extraordinary rate. That ability defines us, and perhaps is what sets us apart. 

Let me take you on a personal journey – a history of technology in my life time. I was born in 1956 – for some this was a long long time ago. I have early childhood recollections of a grainy 8 inch flickering black and white television and a large wooden gramophone player – and very grand they were. The house telephone was a large black machine with a shiny metal dial, it was a party line, shared by 3 different households.
 
Then I remember my Fathers bursting pride when we had our first colour TV when I was 12 in 1968. There was much excitement that night as he fiddled with the contrast, colour mix, and of course the blasted Arial position – we were captivated by the large 15 inch screen. We watched Neil Armstrong take his first steps on the Moon on that TV. It was not long later before I had my first portable record player for Xmas, playing black vinyl singles and long players – learning to love the music of Led Zepplin, Jimi Hendrix and the Doors. As I entered my 20s in 1976 I was delighted when I got my first Digital Watch – how cool was that – a watch with moving numbers.

In 1980 I started my studentship as a Nurse at Kings College Hospital. We were shown Cine films by Nurse Tutors of pathologies and surgery through large flickering projectors – some were really quite good. But by the time my first son was born in 1983 we saw the arrival of Video Tape – the BIG question was VHS or BetaMax. Shortly after I bought my 1st Video Tape player and watched a film on out little rented colour TV – you could stop it if you need to have a cap of Tea or nip to the Loo. It was I thought a technological miracle.

In 1885 Live Aid was broadcasted to a global population of 1.2 Billion Humans – communication technology was, it seemed, beginning to change the world. By the late 1980s, in my early 30s, we first heard of a mystical future communication technology – microchips and the Internet – it meant nothing to me. However my treasured Vinyl collection was now consigned to history and being replaced by “Compact Disks” (CDs), and mobile CD players where Ghetto Blasters were the in thing.

In 1991, at the age of 35 I started my first degree, and bought my 1st computer. The Amstrad 9512, you had to load the disk operating system (DOS), and then it ran an early Word processor “LocoScript” - it was in the stuff of science fiction – a “home” computer. Mind you I was a little sceptical about the new “Windows” programme – why I wondered would you want to open more than one programme at a time. In 1995 I was given my first Email address at work – Wow – goodbye to paper memos. We got our 1st mobile phone – it was the size of a brick. I connected from home for the 1st time to the “Internet” via America Online (AOL). As I sat there boggling my wife passed by – looked at the screen and said “So – so what”?  And forget Video Tape - let’s talk DVDs.

OK – what happened next was exponential. Today Email is considered by the younger generation as passé, Social Media has connected he world in a way that just 10 years ago was unimaginable. I have a mobile phone that exceeds many times all the total computational technology that enabled the Apollo 11 Moon landing.  I am writing this “BLOG” on my Netbook whilst half watching a 42 inch HD Flatscreen TV. I am connected wirelessly to the Internet. I am connected to Social Media  – and there are 4 computers in my house. My wife banks on-line, and shops on-line (she discovered her “So What”). I can talk instantly to people half a world away and I am good friends with people I have never actually physically met. And, despite the world’s ills, in the main we have used all this technological advance for the greater good of humanity – and to our extraordinary ability to find new ways to communicate.


In just under 60 years I have gone from that little flickering Black and White Screen I remember as a young child to this technology that has connected our world – a Global conversation - a result of our human genius. And now – at just 2 years my grandson is grasping technologies that were indeed the stuff of Science Fiction when I was his age. Dafydd will grow up never knowing a time before the Internet, before Google, Facebook or Twitter. I cannot imagine what he may be doing 56 years from now – but I expect it with be extraordinary. 

Born to be a Nurse / Taught to be a Nurse Or Forever a Student

Born to be a Nurse / Taught to be a Nurse
Or Forever a Student

In 1919, after a 30 year debate, Parliament passed the Nurses Registration Act, this leading to the formation of the General Nursing Council (GNC).  For the first time, to practice Nursing, you had to be “registered”, and you had to be trained / educated, for that role. Today we can scarcely imagine a time before regulation, when anyone anywhere could call themselves a nurse, and where educational preparation to be a nurse varied from the ‘occasionally good’ to ‘absolutely nothing’.

Nearly a hundred years later the Profession of Nursing is again beset by a similar debate. Should Nurses be educated in Universities? Nursing we are told by the tabloids needs to ‘go back to basics’! Nurses are, after all, born, not trained! Nurses today are apparently too posh to wash, too clever to care! Every day the tabloids report on the latest scandal in the NHS, and nurses are frequently a focus of press indignation over lack of compassion and care. Don’t get me wrong, I am not in denial, what happened in Stafford was real, and it’s a sad fact that ‘care’ can go terribly wrong, but that is often because a lack of education, not because of education itself.

Thus, I (like others) am curious as to why catastrophic failures in care are seen as a result of education. The governments own Willis report (DoH 2012) clearly pointed to the benefits of graduate education for the future of the Nursing profession.  Consequently I am constantly surprised by the media view that an educated nurse is necessarily a bad thing.    

Let me unpick these thoughts a little.  

You will all have heard of the nature / nurture ‘trait’ debate. It is here that notions of being born with certain innate personal characteristics are contrasted with the idea that we can teach diverse skills and behaviours to people.

Firstly, consider “Nature”. It is widely believed that we are born with different natural qualities; a skill for music, or mathematics, or indeed a natural inclination for care and compassion.  It is suggested that these traits emerge as the child grows. With this in mind it may seem a paradox that humans are also all born with a common and extraordinary innate ability – the ability to learn. Acknowledging this leads to the concept of “Nurture”, the human ability to enhance or develop new skills, new behaviours and new attitudes. 

This profound ability to learn is never more evident than in the early years of life. At birth a child is utterly dependent - as vulnerable as a human can be in every way.  At about one year of age a child undergoes an extraordinary development - that is the ability (determination) to stand and learn to walk. By two years of age the child is learning language at an exponential rate, soaking up new words and language in a way that defies imagination. By four years a child is running, talking, communicating, listening to music, dancing and learning to read – and also revealing their distinctive personality. The Nature proponents will point to the particular and unique types of innate traits, interests and skills four year olds present with – these illuminating the “Born With” trait perspective. Conversely the Nurture proponents will also point to the enormous diversity of experiences that the 4 year old child is being influenced by, even at such a young age. That diversity may be exampled by gender, culture, ethnicity and a multitude of other human influences.  For me this leads to one logical conclusion – both Schools of thought are right, and thus we may comfortably accept that concepts of Nurture follows on rationally from concepts of Nature.  Every moment of our life, from cradle to grave, we are constantly being exposed to our world, billions of influences that shape us as people, building on those innate qualities that we were born with.  After all, it must be axiomatic that life exposure is integral to learning – and learning is evident when behaviour changes.

Where does this take us in this debate over educating nurses? Well - educationalists will tell you that there are 3 quite distinct domains of learning; Psychomotor, Cognitive, Affective.


The Psychomotor Domain describes areas of complex mechanical technical skills (making your hands work) – this regarded as the easiest area of teaching and learning. The Cognitive Domain captures those skills we learn in using knowledge to understand the world, to comprehend and to reason – this a more difficult area of learning than the Psychomotor Domain. Finally is the Affective Domain, that area of learning relating to emotion, feelings and attitudes – this is viewed as the most complex area of learning. 

Our challenge is that many are troubled by the notion that we can “teach” the intangible and complex human qualities; Love, Care, and Compassion. But the evidence suggests that we can do just that.  A most contemporary and current example of this is the Terrorist Radicalisation of young adults. This subject is a favourite of the tabloids where they witness the apparent ability to teach young people to hate. I would agree with them, history provides us with countless examples on how negative attitudes can be taught to individuals and populations. But equally this implies that the opposite of this must also be possible, that we can teach people to care and to be compassionate.  Again, the evidence suggests that expert mentorship, role modelling, and values education can instil and nurture the skills of care and compassion that we want in a professional nurse.

This draws us (at this point) to fairly obvious conclusions.  Firstly we must carefully select those who wish to become future nurses. Secondly we must assure that ‘what’ is taught, and ‘how’ we teach are clearly articulated foundations of nurse education. Finally we must assure ourselves that the graduate nurses, at the point that they pass through our “Gate of Entry” as a registrant, are fit for purpose.  It is my fervent belief that we are already doing that.

However, logic also dictates that following that initial registration, qualified nurses will continue to develop further – we are after all constantly learning. It also follows that the qualified nurse could go on to develop in either positive or negative ways. Thus the notion of lifelong education in nursing must become a structured reality – with a curriculum, and with checks and balances built in. Education and learning can no longer be optional extras to the professional nurse. If another Stafford is to be avoided it will no longer be acceptable to accept clichés about being Born to be a Nurse, or time limited notions of being Taught to be a Nurse. There is no end point, no termination of your education in Nursing - there may be milestones, but you should be / will be a “Learning Nurse” – FOREVER a student of our profession.


I opened this short missive with an allusion to the history of nursing. I close it with two Educational Statements, which to me illustrate that, whilst they were both written nearly 100 years apart, they are in principle remarkably similar. That values that we held dear in 1921 that nurses should be well educated are those that we hold now.

"To stimulate and foster the nurses power  of development; increase her capacity by a  more extensive knowledge of subjects,  social  and practical, pertaining to her  profession;  to train her mind to a wider outlook  then  that usually obtained within the four walls of  an  institution, bringing into line with curative measures the no less  important  branches  of  preventative work."
GNC Curriculum Statement 1921

“Nursing education across the UK is responding to changing needs, developments, priorities and expectations in health and healthcare. Nurses who acquire the knowledge, skills and behaviours that meet our standards will be equipped to meet these present and future challenges, improve health and well-being and drive up standards and quality, working in a range of roles including practitioner, educator, leader and researcher. As autonomous practitioners, nurses will provide essential care to a very high standard and provide complex care using the best available evidence and technology where appropriate.”
NMC Pre Registration Education Standards 2010

FOREVER A STUDENT NURSE