debate on the nhs

I have been listening to , and reading the current debate about the NHS , as an ex nurse and nurse tutor I feel I have some views on the subject which may have value . At the time they were introduced I was against the six bay wards, the six bay bed design does not increase the patients privacy to any extent and as I said at the time this can only really be done by single rooms . The Nightingale wards were more efficient in allowing less staff to supervise more patients as all were visible , and also allowed better supervision of staff .The social aspects of the ward for the patients were also improved as patients would wander down the ward to talk to one another . I have run both types of ward and give me nightingale every time. The writer in the I paper this morning was also decrying the loss of a clear leader and again I unfortunately agree , Some of the old ward sisters were frankly insane ,but they all had one thing in common by virtue of experience and knowledge they were the clinical experts and clinical managers for their wards . The buck stopped with them. In the army where I trained if a patient developed a pressure sore the ward sister had to go to the matron and explain what care deficit had allowed this to happen . Noise was also mentioned .I remember well the creep down the nightingale ward at night every half hour to check the clients being very quiet . For even as Florence Nightingale said an excess of noise is evidence of an absence of care. This is not just an old farts ramblings as I realise things change and the knowledge base of present nurses is much greater than when I trained , as is all to often the severity of the illnesses cared for. But as my students often heard me say "never treat people as things" and "get the basic care right and the rest will follow "
The photo is me in those days , The photograph was taken for an RAMC pamphlet ,at the time I was working in orthopaedics; so actually didn't have the faintest idea what i was supposed to see whilst peering down this guys throat .

"you percieve with your mind"

Nicking a line out of the gorillaz song. "You don't see with your eyes , you perceive with your mind" and a later line "its all in your head " . Tim Leary and others used hallucinogenics to widen their perception . Shamen have been using various vegetable products to do the same thing for years . My question is, that If as I believe perception is very individual , How do we work as a society ? Even communication is in doubt . This can be seen very clearly in one type of dysphasia where the words you speak are perceived by the patient as being different words. The brain is interpreting the physical signals in a different way . We achieve a consensus agreement in society through social leaning , conditioning . and constructivist learning about the meanings of stimuli that are necessary for the functioning of a particular society . They are almost agreed metaphors rather than meanings.As Susan Sontag(Illness as a Metaphor (1978) explains some illnesses are perceived , i:e have metaphors that are stronger and have more impact on the individual, and society than their physical symptoms : are perceived as being more or less important than the physical symptoms would suggest . So is this true about many other aspects of our lives , of course it is ask an arachnophobic about the importance of the spider metaphors to them . Perhaps what Leary and the shamen are doing is removing the brain from this agreed consensus . Some mental health issues have been described as socially constructed , perhaps this is another example of a mind that refuses to join the consensus club . I believe that Einstein was criticised as a poor student probably because he did not perceive things in a consensus way . This raises problems for traditional type education if the consensus parameters are set , then anyone moving out of those parameters is mad , bad , or confused . We don't value challenges to the group consensus as they will affect the structures that support our own perception and make us challenge our social and individual learning which contribute to our perceptions . Perhaps the only way foreward for society is the constructivist pathway ?