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This is my personal blog. This is the place where I rant and witter inanely about all sorts of things that take my interest from opposition to odious far right groups to personal learning projects such as my intermittent study of evolutionary psychology or the history and development of civilisation.

If you’ve arrived here looking for information on my mental health and social care training and consultancy services you might want to click this link instead. That’ll take you to my commercial website: The Care Guy

You might also enjoy taking a look at Care To Share Magazine while you’re about it. That’s not affiliated with my business at all (or indeed anyone’s business). It’s a community of people who are interested in sharing ideas and insights into social care without any distractions from political ideologies, corporate agenda or media ‘fashion’.

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Civilisation 26: Euclid of Alexandria

Welcome to the ‘Civilisation’ blog series. This is my attempt to categorise some of history’s most famous (and infamous) names. Sometimes it’s serious and sometimes it’s silly. I hope you like it.

EuclidEuclid of Alexandria is sometimes described as the ‘Father of geometry’. In fact his textbook (Elements) was a core mathematical textbook for over 2,000 years. His name translates roughly as ‘renowned’ which seems pretty appropriate in the circumstances. And that’s about all we know about his actual life. He came from Alexandria and was called ‘Euclid’. That’s assuming we don’t accept the hypothesis that Euclid was a psuedonym used by a number of collaborating scholars (who may or may not have had something to so with Alexandria). We don’t even know for sure ‘when’ he lived.

Euclid’s greatest skill seems to have been in pulling together the work of many earlier mathematicians into the world’s first, properly coherent account of mathematical theory. In doing so he devised, collated and articulated a set of mathematical ‘proofs’ that we still teach today. His geometry starts with the assumption that points, straight lines and circles exist (who’d have thunk it?). These are the foundational principles for everything else. If you think it starts simply don’t be fooled. It gets much more complex.

Euclidian geometryOf course when I say ‘we’ still teach Euclid, I don’t actually mean ‘we’. I remember being the schoolboy ‘victim’ of Euclid’s geometry but, like many others I don’t for a moment pretend to have sufficient knowledge to teach it. What I mean is that people bright and educated enough to understand Euclid teach it. Other plebs like me just stand in awe. I’m afraid mathematics was never my strong point.

Fortunately he wrote about other stuff too. Euclid wrote ‘Optics’ among other things. This work on the impact of distance, reflective surfaces, shaped mirrors and lenses predated Newton’s famous work on the same topic by around 1900 years. Not bad eh? He also wrote about erroneous reasoning or ‘Fallacies’, a topic close to my own heart and writings.

You can find links to each post in the ‘Civilisation’ series here.

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Privileged glimpses 3: People do the best they can with what they’ve got

This series of blog posts first appeared a few years ago on a now defunct blog called ‘Care Training’. It was inspired by the training maxim of ‘making the unconscious conscious’. It is intended to take what really ought to be the most basic principles of health and social care and put them down on paper. The series isn’t only an exercise in stating the obvious though whatever the title might suggest. It’s actually intended as a philosophical foundation manual for workers and informal carers to help them get their care ‘on track’ and then to keep it that way.

sweet shopImagine a small child in a very large sweetshop. The lights are off and it’s completely dark except for a single spotlight illuminating a tiny piece of shelving. On the shelf, visible in the little pool of light are three bars of chocolate. One bar is milk chocolate, another dark while the third is white chocolate. That is all the child can see.

The child has one simple instruction…

Take your pick…

Obviously the child will choose one of the three chocolate bars he can see. It doesn’t matter what other treats might be in the shop because he can’t see them – he doesn’t know that they are available options.

This little post isn’t really about chocolate bars and children in sweetshops though. It’s about social care service users and the options they have available.

The sweets in the shop represent coping strategies. They’re behaviours. Choices about what to do in different situations. And just like the child in the sweetshop service users (along with everybody else) only choose the options, the behaviours that they know about.

So if someone you work with makes poor choices that’s not necessarily because they don’t want to do better. It’s more likely because they either don’t know what else to do or because they don’t think that other options will work for them. Many people understand intellectually about good coping skills, socially acceptable behaviours but don’t believe that they will be given the opportunity to make different choices work for them. If they’re used to being treated with mistrust they won’t believe that the truth will work for them. If they’re used to being ignored they won’t believe that not drawing attention to themselves will meet their need for human contact. And they may well be right.

So, just like the child in the sweetshop they take the best option available to them.

They do the best they can with what they’ve got.

You can follow the entire blog series as it develops here.

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Ukip rejected by Nurses and Farmers | aliberallife

It seems I’m not the only nurse to see through UKIP’s stupidity. See this post from ‘A liberal life’
https://aliberallife.wordpress.com/2015/02/25/ukip-rejected-by-nurses-and-farmers/

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Civilisation 25: Aristarchus of Samos

Welcome to the ‘Civilisation’ blog series. This is my attempt to categorise some of history’s most famous (and infamous) names. Sometimes it’s serious and sometimes it’s silly. I hope you like it.

Aristarchus of SamosAristarchus of Samos lived from 310 BC – 230 BC. He was the very first man (so far as we know) to recognise that the sun is the centre of the solar system and that the earth orbits around it. Forget Copernicus – Aristarchus got there close to two thousand years earlier. It’s interesting that Copernicus originally credited Aristarchus in his notes when writing down his own heliocentric claims but later removed all reference to him in the published version, even going so far as to claim he had never heard of the Greek. Such is the vanity of man!

Aristarchus was a renowned mathematician, one of only seven considered by Vitruvius, the Roman architect, as expert in all mathematical sub branches. He inspired Archimedes and Plutarch, both of whom summarise Aristarchus’ argument placing the Sun at the centre of the solar system in their own writings. He also invented a particular type of sundial involving a bowl and an upright pin to cast the necessary shadow.

Not everyone was convinced though. Indeed Cleanthes, a stoic contemporary of Aristarchus insisted in his treatise ‘Against Aristarchus’ that Aristarchus should be prosecuted for ‘impiety’ when he claimed that the earth moved around the Sun.

Aristarchus’ heliocentric theory wasn’t accepted by the majority of Greeks, primarily because of the popular view that the universe was an enclosed sphere with the earth at the centre and all the stars at fixed points around the edges. If Aristarchus was correct then the stars would all seem to shift position in relation to the earth as it moved around the Sun. The fact that they did not meant that they must be very far away indeed (as, of course. they are) and that didn’t sit comfortably with the ancient Greeks at all.

After Aristarchus’ death his works were improved upon by the likes of Hipparchus and Ptolemy but it wasn’t until the 20th century that genuinely accurate measurements and understandings of the relationships between the ‘heavenly bodies’ became possible.

You can find links to each post in the ‘Civilisation’ series here.

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Tredinnick – the astrologer’s best friend

David Tredinnick sits on both the government’s Health Select Committee and (amazingly) the Science and Technology Select Committee. Unfortunately he clearly knows nothing about either.

I mean – for pity’s sake. It’s 2015 and he wants to base medical science on astrology, homeopathy and sympathetic magic!
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I despair of these people, really I do.

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Privileged glimpses 2: People are just people

This series of blog posts first appeared a few years ago on a now defunct blog called ‘Care Training’. It was inspired by the training maxim of ‘making the unconscious conscious’. It is intended to take what really ought to be the most basic principles of health and social care and put them down on paper. The series isn’t only an exercise in stating the obvious though whatever the title might suggest. It’s actually intended as a philosophical foundation manual for workers and informal carers to help them get their care ‘on track’ and then to keep it that way.

Be uniqueFollowing on from the ‘no such thing as ‘us and them’ post I’d like to make a more general point about people. Nobody is special. There – I’ve said it. You are not indispensible at work and your boss, your colleagues, your friends and your favourite service user are all replaceable. Nobody is special because people are just people.

If you work in mental health or social care services you will be used to certain professionals behaving as though they are more important or somehow more worthy of respect than others. You may even be tempted to behave that way yourself. Many in my own profession of nursing seem as though they have been pre-programmed to emphasise their own importance way beyond all recognition.

Different professional groups have different responsibilities and different levels of education are important but they don’t make us special. I’m a nurse – a pretty well educated and experienced nurse at that but that doesn’t put me in a position to tell a newly qualified social worker with a basic professional education how to do their job. I’m not special and I don’t know everything.

Similairly whilst I’ll happily defer to a GP when dealing with complex physical problems I’m not about to take their word when planning a cognitive therapy strategy for someone with psychosis. I will listen to them though.

By the same token I may be responsible for planning and organising a shift and delegating care tasks to support workers but I’d better not forget that they are more likely to know the best way to hoist, bathe or feed a particular resident than I do because they know their own jobs.

Nobody is special.

Nobody is indispensable.

Nobody is irreplaceable.

People are just people.

You can follow the entire blog series as it develops here.

 

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Dear Nurses – Nigel wants us to spread the word

I returned home after a hard day’s nursing to see one of the most ridiculous political tweets of the campaign so far. It’s UKIP’s remarkably regressive plans for nursing and medicine – but mainly nursing. It seems that Nige and his mates don’t like the fact that we nurses don’t know our place any more. The heady days of 1950s doctors’ handmaidens are long gone and, true to form, UKIP wants them back.

UKIP on healthcare education NHSTonight’s UKIP meme contains 4 policy intentions – each of which may appear superficially reasonable to the layman. But to those of us in the know (you know – nurses) they show a remarkable ignorance about modern nursing and healthcare. Let me tell you why…

1 Scrap tuition fees for medical students

OK – I admit it – I have very little problem with this one. At least I have little problem with it so long as there’s some sort of safeguard for the national purse. For example – a ‘payback’ scheme whereby doctors whose fees were waived undertake to work for the NHS for a set term (say 7 years) before they can work for anyone else. Should they leave early to go and work in private healthcare they should pay back the cash on a pro-rata basis.

2 Train nurses on wards

I’m a ‘Project 2000’ nurse. I started my training in September 1992 as part of only the second intake of ‘P2K’ students in my college of nursing. We were the butt of prejudice and fear from traditionally (1980s syllabus) trained nurses who saw us as untrained and unskilled right from the start. Even my own tutor wrote an article for a nursing journal bemoaning our lack of skills (the 1st cohort was only about 8 months into their training at the time).

Over time this ridiculous prejudice has disappeared as almost 20 years of academically trained, qualified nurses have demonstrated the value of a good academic education to the profession. That’s not to criticise nurses of the past. I’ve known many excellent traditionally trained nurses. But I don’t think that’s necessarily because of the additional 10% of practice time (which today would come at the expense of students’ study time). Today’s nurses don’t just know what to do – they also understand how to evaluate and conduct research to ensure that we all know why we’re doing it. The nursing profession has been building up increasingly sophisticated models, techniques and research-based interventions for decades. And the developments are increasing exponentially. That’s the difference that protected study time makes.

Prior to Project 2000 nurses spent 40% of their time in school and 60% on the wards. Since the early 1990s the balance has been 50:50. 10% less time on the wards. Let’s look at what that meant in practice..

Actually it meant that our study time increased by a quarter (from 40% to 50%). That has meant the difference between a nursing certificate, a diploma or a degree. Wouldn’t you like the nurses looking after you to be part of a profession that understands and contributes to its role in advancing patient care?

“Ah, but what about the practical time?” I hear you ask.

We’ve all heard the stories (usually from misty eyed pre 1980s trained nurses) about the endless hours they spent as new students making beds and washing bedpans. I’ve known nurses who (if their reminiscences are to be believed) told me that they did almost nothing else for the first year of their training. A whole year learning NOTHING about nursing and everything about cleaning. Since first publishing this post a couple of nurses have contacted me claiming that these stories about cleaning wards are untrue. They may be correct (although I’ve no reason to think my former colleagues lied about it). Either way – I think the value of academic education in making nursing an evidence-based profession stands on its own merits, regardless.

So before you lament the loss of practical time for student nurses ask yourself this…

Where’s the advantage to patients in returning that 10% of ward time at the expense of academic understanding. Nurses have entire careers to develop that experience but for many, intense, dedicated university time is much less available. The only advantage would be to those who wish nurses to know their place.

The nursing profession has come a long way since the early days of Florence Nightingale swanning romantically around in a hospital built over a Crimean cess pit. British nurses are educated, respected and sufficiently well-trained to be the envy of the world. Why on earth would anybody want to water down the education available to the person delivering their potentially life-saving health care?

3 Reinstatement of state enrolled nurse (SEN)

This might sound superficially reasonable for those not familiar with modern nursing. So here’s a tiny bit of history…

SEN status (established in the late 1940s) were much beloved of the racist conservative MP, Enoch Powell (remember him?). SEN status was a way to impose a glass ceiling on the career prospects of immigrant nurses who came to shore up the indigenous British workforce in the 1950s and onwards. Powell (health minister from 1960-63) was more than happy to use level 2 status to keep the newly arrived immigrants in their place.

I remember working with SENs (2nd level nurses) when I trained and in my first few years post reg. There were some exceptionally skilled nurses among them but they could never progress until the rules changed and they were able to convert to 1st level nurses. Today all nurses qualify as 1st level – and they have an enhanced academic understanding to match.

Given UKIP’s nationalist (racist) attitude to immigration it’s no surprise that they want to reinstate this artificial glass ceiling on certain elements of the nursing workforce. That’ll keep the immigrants in their place, eh Enoch Nigel.

4 Auxilliary staff should be able to work toward becoming an SEN

As it stands there is nothing to stop Health Care Assistants and Assistant Practitioners from training to become nurses. I’d like to see more employment-based schemes available to them but not for them to become second class nurses as Nigel would prefer. Why impose the glass ceiling again? If someone has the potential to be a nurse then go for it. If not – there are already plenty of options. Unless you want to recreate the two-tier system of the last century.

I call on all those working in UK healthcare to think through just how retrograde this set of proposals actually is. Spread the word to the general public who, understandably enough, won’t know this stuff. Explain to them just why this is such a backward step and stand up to UKIP’s blatant attempt to send UK healthcare training and conditions back half a century or more.

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