Blue skies and thoughts on leading with heart...

This week we have stumbled into Narnia and the white witch has ensured it's ever winter. A snow flurried Holy Week. But I had a short break and the photos I took belie the temperatures. The sky is blue and you couldn't guess from them that even with several layers, a hat, a scarf and gloves I still needed to buy a snood for another layer of warmth!

But I had a lovely break , well pampered and lots of putting the world right.
( Still a way to go!). The hotel had excellent customer service, everyone from the local girl ...to the young man from Bulgaria,a credit to their organisation and countries. Its a lovely hotel in the elegant bay at St Andrews so there will be a prestige attached to a job there, but the pay won't be great and the hours are long. But the atmosphere was calm and happy and that helps in a large, complex institution like that. The customer focus was evident, good systems and training was in place, there was a good level of staff and there was respect and value between them...with a sense of fun and friendliness. Good leadership focused on the right things. NHS watch and learn was my thought....

But it can't be much fun in the NHS just now. Especially for nurses, being the target for criticism and ill thought out solutions. If we want to see the NHS perform better we need person centred solutions for team NHS as well as those they look after. Compassion is not a one way road. It will need person centred leaders to make the difference.

This week I captured this photo from twitter from the wonderful @herdyshepherd1 in the Lake District. It's seemed a fine analogy...the wise elder sheep leading the herd to safety. And she achieved it I believe, when many sheep were not so fortunate..Now sheep get bad press often but maybe there is something to learn from that lovely herdwick sheep (and anyway I loved the picture....!) Modern leadership means skills of collaboration, empathy and clarity of purpose are crucial and the best leaders also know how to lead their team with vision and heart.

On the road home from my trip away we visited the wee town of Crail. It was an azure sea looking over to The May Isle from the pottery cafe. The hens visited the gate to remind the cafe owners of their pressing need. They charmed us while we ate and after the fresh crab, the coffee was served with a piece of tablet....! Perfect end to a much needed break...I must do more of this. I realised this week just how much the transitions this last few months have depleted my energy but also how much I am enjoying my new challenges too.

Reasons to be heartful.
It's been a week of time with good friends , many laughs and much sorting the world out....and Cara on a charm offensive, especially when the fire was on! What could be better. Wishing you the same this Easter.

Will you still need me, will you still feed me...

I realised this week that its 20 years since my Godmother died of breast cancer. She was ever a warm presence in my young life. Her ability to name each wild flower, to nurture her own garden and her aura of gentle kindness enriched my childhood in a way I will never forget.She was my Mum's good friend and one of many she has now outlived. A sad situation for her ........but she has also been luckier. She has been able to see her grandchildren thrive and make her proud, enjoy many a family celebration and find joy in her great grandchild.  And she has even in her 85 year moved to a new home and starting a fresh...life is still an adventure, even if that can be scary too.

And in  the same week the House of Lords committee have reported on our response in the UK to our aging society. We are woefully unprepared they say. We need to look at so many of our structures like housing, pensions, workplaces, care services, it effects them all. But it does strike me that we tend to see all of  this in terms of deficit; not cause for celebration but instead for concern. I wonder if this in part reflects the ageism that defines our society. That worshiping youth makes us judge longer life as a challenge to our lives as we know them rather than a blessing and a good fortune.If we re-framed it, would we see less gloom and more opportunity from this changing demographic? Would we celebrate those who enjoy longer years rather than express them as a burden?

Of course we will need to change our approach to care, to build more suitable housing, invest in pensions properly, have age appropriate cities and so on but if we see this as investment in the future it may help us find the way....positively. Language can be so telling and influential. I noticed recently a care of the elderly facility renamed as a centre for the third age. That different name already creates a different expectation and approach. And I have seen the difference that name can make. They offer a joined up service with NHS, social care and third sector working together.......and more this is done with great kindness. It does show that these approaches and alongside a culture of person centred care can enable a transformation in care for older people.

If this were the case everywhere  we would not have a society that has a care system that feels its acceptable to create a service I read of recently that suggested a visit of 15 minutes a day could meet the need of a 90 year old man. His situation means that he only sees that one carer each day and their role is to address his needs in 15 minutes and then leave him...... to his loneliness. Their contract means they cannot make contact with their clients beyond their role, or they could be sacked. I cannot imagine the price each carer has to pay personally to engage so briefly with such need, then move on swiftly. It seems cruel for all involved does it not?

But there are some innovative solutions to meeting  care needs, like the robot seal , programmed to respond to human contact and engagement. It's use with older people has led to them being more alert and engaged, which in turn has led to their carers also being able to reach them. The robots touching a deep place of contact, unlocking emotions hidden by dementia. Powerful and also ....maybe just a little scary? As a dog lover I was more drawn to the concept of dementia dogs, trained to provide support to people with dementia. Undoubtedly unlocking emotions too and providing love and care for human and dog alike. If my time comes, I'll have the dog ok?

And finally this was the week I learned that the life of one amazing young woman was lost at the age of 34. Lisa wrote a blog called Alrightit about her experience of breast cancer, diagnosed in her twenties. It's both funny and shockingly  illuminating. She also wrote a book about the experience and said it was always her ambition write one but writing it about her cancer was a bit like taking the Heathrow Express ; it got her there quicker but it cost a lot more. Indeed it did. My thoughts have been with her family and friends this week. A very stark reminder that there are many things much worse that getting older.......in particular never having had the chance.

I once read the following poem out at a conference in the Royal College of Physicians. I hoped it might reconnect some people to why they came to a caring profession. We of course need the systems, organisations and communities that support this too.

If I can stop one heart from breaking,
I shall not live in vain ;
If I can ease one life the aching,
Or cool one pain,
Or help one fainting robin
Unto his nest again,
I shall not live in vain.

by Emily Dickinson

Reasons to be heartful
I visited my Mum in her new home this week. Her new community is reaching out and that's so heartening. Her favourite birthday gift last month was from her grandchildren. It was a bird table. The robin, blackbirds and many others enrich her day. As you will see the dog was intrigued but happily didn't scare them off.It's my reminder that its the simple things that can lift a day, ease a pain.....and maybe we can all do that for each other at some level? And lets be grateful that we are living longer as well as keeping in our hearts  those who don't....

Women, twitter and challenging us all to do better.

Thanks to Nancy at Nancy's Point for this great quote

Women in Kenya heading to vote this week.

Its been a week when I have seen the impact of some really special women.  But it didn't start well from that perspective. I noticed a flurry of activity about a fundraiser on twitter that had the hashtag of #hundredhooters. Now I have deleted most of my rant as I know at heart it is well intended so I will just say, please , please think about all the issues that have been raised this week around international women's day.

Women across the world are a long way from experiencing equality and this kind of activity is not empowering ...just demeaning. So long as women think this is ok then how can we expect issues of women's place in society to be taken seriously.  I was shocked to learn  that women from across the world aged 15-44 are more at risk from rape and domestic violence than from cancer, car accidents, war and malaria combined. It's down to us  to do everything we can to tackle this. We need to demonstrate that we are serious about ending violence against women and girls. And to provide better support for the survivors of abuse and challenge sexism when we encounter it.

I have joined The Woman's Room and entered my name in the list of women with experience or expertise. This was set up to challenge the BBC and other media to ensure that women's expertise is sought as well as mens. It was a news article on breast cancer that provoked this. Only men had been asked to provide their opinion. Given the gender issue and the fact that many women ,unsurprisingly , have expertise and opinions in this terrain, this -rightly in my view -provoked outrage.  So go on women join up and stop thinking I'm not good/experienced/whatever enough......just do it!http://thewomensroom.org.uk/

And in this week alone I witnessed the power of the informed female advocate in the monthly European tweet chat. Marie of @JBBC from  Dublin and I have started this very tentatively to enable women in Europe to join to discuss issues around breast cancer-#BCCEU. We have started small but already have had some great chats. This week it was on whats new in breast cancer research. I had asked a former colleague who leads the research team in Breakthrough Breast Cancer, the fab Dr Julia Wilson, if she would want to take part. She sent her first tweet the day she joined the tweet chat....a brave woman indeed. Summarise answers on genetics and dormancy in breast cancer in 140 characters and you will grasp the enormousy of the challenge. She was fantastic , communicating complex science with clarity and sensitivity to her audience. Take a bow Julia! And the questions were wide ranging from deeply personal to internationally challenging. Providing richness to the chat were the experienced and informed advocates from the US #BCSM group. They have an amazing chat every Tuesday evening but its 2 am our time so aside from reading the transcripts it's hard to take part from here. But join if you can, it's influence and information is impressive.

I do LOVE the way twitter connected this community of interest who not only were engaging their intellects on this complex disease but also their compassion for each other. When an exchange happened that spoke of the possibility of exploring tissue banks for metastatic disease I got goose bumps....in this way the future could change. Perhaps not necessarily through that particular idea but in the exchange of experience and drive for change. And it was Julia who summed it up for us all when she said towards the end "keep challenging, keep asking us to do better...we can end this devastating disease". If you have an interest and want to read the transcript here it is. And we will be asking Julia back!
http://www.symplur.com/healthcare-hashtags/bcceu/

And finally and in my reasons to be heartful this week, I want to acknowledge the other great women in my life. My Mum, my sister, my daughter and step daughter, step granddaughters, my sister in law, my nieces and friends of all ages. You all make my life richer. Just imagine if the world could truly embrace all that you as women have to offer what a richer, better place it would be. So in a week that has International women's day and Mother's Day...step forward all and take a bow, you are fantastic, thank you.

Doing my bit for the baby boomers?

 

I was walking along in the winter sunshine the other day when I took a call about my request to take my pension early. I decided to do this to act as a security should I need more treatment for cancer in the future , to act as an income buffer for me if I was unable to work. Not what I plan you understand , nor what the risks would suggest but no guarantees either so it made sense.  They had good news for me, was the message. Because of my reduced life expectancy I would get a bigger annual sum. Now it's meagre so any enhancement is frankly welcome. But having your reduced life expectancy confirmed whilst walking along Princes St is a bit of a blow. Clearly my plan is to take the money and,  if not run, just walk away with my head up all the while planning to prove them wrong!

With this backdrop I considered the recent awareness raising with regard to changing demographics and the impact on health and social care. I personally may buck the trend but in the main my baby boomer generation will live long lives and in time need care and support sensitive to their situations and likely complex health needs. We won't  present neatly with a cancer or heart disease or arthritis, we will have maybe a history of all three with the complexity of living on our own and less people to act as formal or informal carers. The Queen or King of future times will have a sore wrist writing those telegrams to celebrate those getting to 100 and beyond and care homes will resonate to the sound of the Beatles and Fleetwood Mac rather than Vera Lynn! Clearly there is much to celebrate in this if it heralds a healthy third age where our wisdom is sought, our contribution to society still valued , our communities engaged and supportive.

But at some point the dependency ratio will tip so much that we have to recognise that our current approach to health and social care won't cut it. And what's of real interest to me is what that realisation will result in.  We do have the opportunity now to influence it. To fully embrace the person as a full partner in their care, to work with their assets, to enable the person and relationships to be key and recognise that through this improved health and  effective services will emerge.

Of course it takes courage to change, it can be messy, targets might get missed or need changed, mistakes will happen but progress from that can emerge. Services that join and connect around people are efficient and empowering for all but to be achieved people will need to give up their pasts and work flexibly into their futures. That will be uncomfortable but what's our alternative? I have oft heard politicians say that in health and social  there is much agreement across parties. I have seen this to be true at least in private. Whatever government is the hue they are going to have huge demographic challenges and it will need our collective will, courage and collaboration to enable success. So feel free to thank me for doing my bit, being a baby boomer who may not boom as long......the rest of them/us are going to challenge the system in all respects and it will need to be responsive to that.

Reasons to be cheerful!
This week I finalised my new website. The design is by the fabulous young Scottish designer Emily Hogarth. The words have been agonised over by me and I suspect I will change it over the next months and years.  Describing myself so roundly when frankly I even hate having my photo taken, is really hard. So the mirror has been held up in many different ways this week. And not only do I describe myself as a baby boomer I am also a coach who just loves working with others and a creative consultant who brings curiosity and connection to her work. And I may be doing my bit to bring down the life expectancy but I am really enjoying my latest part of the story.

Looking back to look forward

Crocus in beautiful Glasgow

I had a moment this week reminded me of when I first started work with Breakthrough. It was just me and blackberry at that point. And after an afternoon of trying to connect a printer wirelessly with my laptop in a grotty office ,which has since been knocked down, I sat down and wept. I had tried traditional methods such as swearing loudly, kicking it, going for a walk around the block but my undoing was when a friend phoned and asked how I was. The silence at the end of the phone was me trying not to sob!

And so I know it's normal that  when we make a change or transition there is a point where the obstacles just seem a bit too many to face and there will always be that moment but it will pass. So after a bad day, failing to speak to an actual person in a bank about setting up a new account, the swear box was a bit fuller. But now I am gradually getting new systems in place and let's just say everyday is indeed a school day...

I was recently asked to take part in a letter to your 14 year old self and I must admit it was quite liberating. I hadn't at that age reached my Leonard Cohen fan stage or grown my hair very long ( aging hippy..yes you guessed). I was fortunate not to have too many spots as a teenager but I did carry other teenage  burdens of self doubt and shyness which could isolate me at times. Oh to have had the knowledge then that I have now, mostly knowing what  really didn't matter at all. That process of looking back at  how you have changed and developed really is helpful. But how often do we do that or get the opportunity to capture it. There are photos that are moments in time but how reflective are they of the whole time?

Blogging has been really my only experience of capturing feelings and experiences and its been helpful on so many levels. There is no doubt it's cathartic at times, it helps me process my experience and I hope will perhaps help others.  But what it also is , is my own journey, reminding me of how it felt at different points and how I have also changed through this process. It's collected my reasons to be cheerful as well of course. I understand better what inspires me. I have seen my moods wax and wane . I have seen my anxieties come and go. I have seen a life in turmoil find a different rhythm again. I have learned yet again that this too will pass.

If you are reading this with your own life going through change, your own turmoil, maybe try capturing it in some way. My experience is that it will help, you will recognise more how things have changed over time. You will understand your self better and see your resilience  and maybe it makes the next bit, however it's going to be, just a little bit easier. I read a quote this week that said within the deeper truths there is often a paradox . I think there is a paradox inherent in making or going through change. Facing into the darkest parts makes it easier to see the light would be the one I recognise from my experience of blogging.

Reasons to be cheerful
It's been a beautiful week, cold and crisp and bright. The best kind of winter weather but with crocus spotting to brighten the day. And this week too has been about reconnecting, with friends and colleagues. In particular I spent time with the inspiring Dr David Reilly again learning more about his wonderful work helping people back to health,The WEL programme. Its a whole person approach that transforms individuals, practitioners and individuals alike. The paradigm shift that our health care approach so needs.

I also have a timely day of mindfulness to look forward to this weekend and an opportunity to touch base with friends. But Cara has been a little poorly as this photo suggests so fingers crossed she will turn the corner and we can enjoy some beach walks too.

I want to be alone...

Loneliness and the long distance cancer survivor....

A promise of spring?

Loneliness: it's the word that's been in my head this week. Why? Well a few reasons really. One of  them no doubt my worry about that transition to self employment might mean a loss of being part of a team , no water cooler conversations, no deconstructing the latest film or TV show. No one to tell the weekend tales to.. But it's been OK, avoiding distraction has probably been my greater risk. And twitter conversations about love shacks ( don't ask) and such like keep me linked in!

But what's clear is that it's a very real issue for many. Loneliness has a huge impact on health, affecting survival after major illness like cancer, indeed having the same impact on health as 15 cigarettes a day. Staggering, isn't it?
And of course illness itself can be so isolating , particularly chronic pain or disability making many things so difficult; dementia isolating those people from the world that is increasingly scary, cancer treatments destroying health and well being for some time, depression causing withdrawal from the world. Is it inevitable then that this happens, that people become so isolated and lonely? Well , no I don't think it is.

Just this week I read of a community that has been developed to have an ethos and practice of mutual support ,aimed at reducing social isolation. Investing in those very communities assets to increase social cohesion and support simple kindness. I also saw the launch of a dementia friends initiative to train members of communities about how to support people with dementia in their communities , fostering independence and connection for as long as possible.

We learned too that those living with cancer are more isolated than others. Their illness and maybe their life expectancy separating them from the wider world.  The message from  a cancer charity who were campaigning on this was, reach out and look out for people being treated for cancer. Loneliness will compound their issues, worsen the pain both physical and mental. That's so true for many who suffer with their conditions long term.

Of course there are many organisations large and small who offer support. I found the warmth and support and meditative space from my local Maggies centre an oasis in the bleak landscape that is caused by cancer. The self management fund funded by the Scottish Government and , in a fine partnership, created and managed by The Health and Social Care Alliance is an essential creative impetus for many groups supporting people across Scotland. Groups  like the Pink Ladies of Midlothian who have reached out to women whose lives have been scarred by depression and other issues . Through their kindness, encouragement and belief they have changed lives for the better. For a small investment lives are turned around, the hand of welcome when people are willing to reach out , delivers so much in return.

I could go on but you hear my point I'm sure, loneliness isn't inevitable necessarily but it will be if we don't act to change things and turn around the direction of travel . After all ........it might be us one day.

I've been a secret shopper again this week in the NHS and once more I was impressed by a very thorough  visit to a respiratory clinic. I was quite relaxed about it, not expecting miracles but open to them should they be on offer. So when I was sent for a chest X-ray, I was unprepared for the moment of fear that took over. I rationalised why this would be done and managed to return my heart rate to normal. No it was nothing to do with cancer , just a sensible base line. And it was fine, thankfully. The team were kind and the assessment was detailed. I left relieved and with a plan which I hope will help. And just a bit shattered after yet again being surprised by how the "c"word can jump up and bite you when you aren't looking. The title of this blog came to me as I was waiting to be seen, "Loneliness of the long distance cancer survivor". It does feel like a marathon sometimes , never quite knowing  just where and what the finish line might be; alone in the experience and all it entails.

Reasons to be cheerful. We've had a lovely family weekend, with birthdays and housewarmings to celebrate. The sun shone, the birds and flowers suggesting its spring and us all feeling maybe we can shake of winter soon. Lets hope so.

Mid staffs...holding up the mirror on society?

I was 8 years old when I decided I wanted to be a nurse. I had had my tonsils out and was a bit scared and definitely sore. The nurses who cared for me, made me think, I want to be like them...they make people feel better, they stop people feeling scared. I would like to do that.

Fast forward a few years and I am choosing a future career on leaving school. You can't become a nurse, you should go to university was one of the main themes of advice I got. What I heard in those words was the lack of respect for the profession, the implicit why would nurses (women after all in the main...) need to be educated at university? Caring work in our culture is not valued, poorly rewarded and generally not seen quite good enough as a profession by some let’s be honest.

But I found a way to do both, go to university and study nursing. I loved the course as it focused from day one on a person centred approach. Now it’s many years since I have been a nurse, but scratch the surface and it’s still a nurse you find. It's that drive to help people back to health, to ease pain, to make a system better to enable the best care, to make every person count- that makes me do what I do.

The Francis report has therefore grieved me deeply.  I do believe there is excellent care provided in health and social care and I have personally experienced it recently. My family however have seen both sides of the coin. A lack of person centred care resulted in a readmission, creating more fear, loss of confidence, physical decline. It could have been avoided. Organisation centred care not person centred is costly and less safe.

I have said before I think this is driven by systems and targets and laws of unintended consequences in part. But I suspect-no-I know, it's more than that. Does the system drive out compassion, killing the very motivation that brought people to the profession in the first place? Do we honestly need to teach nurses and (other health care professions let’s not forget) compassion or do we need to create the right environment for that to flourish? But we do need to help health and social care professionals understand and fully embrace a person centred approach. Right now its counter cultural and that needs to be the focus for change.

But what of our wider society? Is this crisis in care not in part a reflection of our wider society? Have we lost the art of caring for each other? I know animal charities see elements of this. Dogs returned for re homing because they just don’t suit any more, like an old handbag. Pets bored and under stimulated returned for scratching the furniture. Loneliness is our fastest growing long term condition, with a similar effect on health as smoking. Ageism is in part driving cultures of care. Need I go on?

Its complex but we collectively must tackle this. Let’s not scapegoat a profession who deserve better and have been told for years we must focus on organisational needs like targets and budgets not caring for people. And let’s not pretend more resources or more regulation will fix this. 

And so I return to heartfulness……..heartful health and social care, heartful organisations to work in and a heartful society to be part of and contribute to. It’s a whole hearted/ whole system response we need. Now I’m up for making that happen…are you?

Reasons to be cheerful….walking on the beach in February.My new self-employed status means I am flexible enough to plan my walks around the tide some days this week and it’s been uplifting. Cara has had to move up a size in her coat and as you will see she looks like she has pinched her Mums coat to wear….but she was cosy and its cold out there!