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 .

Looking at the news today I see the latest celebrity behavioural Nazi is spouting forth again. I refer of course to Jamie Oliver . Who has now seen fit to comment on the nations youth being lazy and having no work ethic . He of course being a "self made man"??? doesn't count the massive amounts of homework that children today have to complete as he obviously doesn't count academic work as work . I am really getting tired of celebrities telling us how hard they work and talking about the work ethic .Most celebrities are pretty self centred and their work ethic means fame or lots of money for them, the same goes for most successful business men . I ran an intensive care unit and worked long and fairly stressful hours for very low wages at the time , to be told by a business acquaintance that public services should have their wages cut as nobody with any ambition would work for such low wages . I am sure I and my students since, work as hard as Mr Oliver has for much less remuneration: so will he get of his soap box and get on with cooking. Which is something I have done since my wife became ill with little training . Admittedly I couldn't charge £50 pounds per setting as some of these celebrity chefs do for ingredients that cost £5 but its not rocket science .Incidentally in a previous career I was a Sargent in the army, after which I ran the unit ,and since then a team of nurse educators, and at no time have I had to resort to language used by another of our celebrity chefs and unlike a chef I couldn't eat my mistakes .
I see the prime minister is strengthening the economy and promoting the "Big Society" This I find quite ironic as a predecessor of his stated that there was no society . I refer of course to Mrs Thatcher. However the dropping (devolvement ) of governmental functions begs the question what is the role of government .I always assumed the role of modern government was to protect all of its citizens Whereas the strong economy that the pm talks about ,seems to be strong enough to ensure the bankers get their bonuses ,but not strong enough to support the poorer members of society (who incidentally were not responsible for wrecking the economy in the first place ). If the citizens are so capable of running themselves it begs the question ,Are Governments of the size we have really necessary , and couldn't bigger savings be made by getting rid of the lords and two thirds of the commons . Or insisting that governments are truly accountable .For example every war is due to an absolute failure of politicians . and ,as in the involvement in Iraq, 70% of the population are against it ,shouldn't some one be accountable? I was for any decisions I made as a nurse .

more thoughts

I have decided to ramp up my blogging , and visit the site more often. We have a couple of squatters in our garden .two collared doves have taken up more or less permanent residence . They are very tame and almost settle on your hand . They are mildly contemptuous of the dog and will sit on a fence post just out of reach andf coo at her , it drives her mad . Its funny to think that whenI was a child they were a very rare bird in England now I can see four or five by just looking out of the window . The news was interesting tonight apparently there is a chance that we may all be returning to the economic level of the fifties . The government seem to think that this is necessary to "save the economy " If we are going back half a century, who are they saving it for ??
Yet again I see that education especially higher education is being starved of funds , It might seem strange coming from a leftie like me ,but I believe that not everybody needs academic qualifications to do a worthwhile job , and be of value to society .My father was very kowlegeable and able at his job as a farm labourer, highly regarded by his employers and always did the job to the best of his ability :However I do believe very strongly that higher education should be based on merit and application .You want to save money ? then stop supporting the students of higher and further education that do not apply themselves , are never seen at lectures or in any place of study , but regard it as a right that they will get a qualification. Let there be less degrees and diplomas but let them mean that the student has worked and applied themselves . I once had a student ( not of nursing ) who took 3 years to do the first year of a course , as far as I know she is still in the system some 6 years later . Sorry rant of the day over.

I took this picture some time ago , when the dog was even smaller than she is now & I was wondering how she perceives the world . These trees look big to me but they must look enormous to her .I don't think its silly to talk about perception and concept forming in animals . The dog clearly has categories of people she recognises as "friends " and friends of different types as well . for instance she knows those who bring her gifts , those who don't and those she mustn't greet with her usual spittle laden ,wriggly madness . So to my mind there mus be some categorisation and the beginning of the concept "friend" .I wouldn't like to guess what that concept is in dog language . but there are definite reactions for disparate groups that importantly she has not been trained to do. These are categories that have been set by the dog due to some cues that I do not recognise. I think that implies at the least, behaviourist learning. As an aside ,a definite example of behaviourist learning, is that she has learnt that if she brings in a pebble from our garden , and tosses it around, I will give her a biscuit to drop it before something gets smashed. There are now less and less pebbles in the garden, as I seemed to have trained her to "fetch" pebbles

flowers

Found this growing in a flint wall by the sea

electric dreams

The new bike is a little odd , Not quite what I expected You can't just scoot off at the speed of a geriatric snail , and it doesn't really propel you up a hill of any camber , however it does make cycling a pleasure as even going up quite steep hills it feels as if you are on the flat , I have successfully negotiated a hill ,without getting out of breath which for the last 20 years has left me needing resuscitation half way up . I think I am a fan of electric bikes ( but I would still prefer a 650 cc Norton ) . Retirement is still odd I find myself talking to the dog a lot

gone electric

Hi Back again , after getting rid of the bike I felt a little deprived , but ive gone electric, ive bought an electric bike .15 miles an hour downhill with a following wind . its fun but not on a day like today