Being very new to the ‘art’ of blogging I pondered long and hard as to what the blog content should focus upon. Then, as we all do sometimes, my mind wandered back and a ‘familiar saying’ made me think for a while.

Having been in the health and social care environment for ‘dare I say it’ thirty four years now, the service demands, political drivers, complex patient needs together with the ever changing care provision landscape, presents, as we are all well aware, on-going challenges. However some things never change.

As a novice general student nurse working in the early 1980’s, my aspirations certainly never included ‘becoming a ‘Lecturer in Continuing Professional Development’ within a University. Indeed, way back then my focus, apart from wanting to care for my patients, included making sure the bed wheels ‘faced the same way’ and ‘the end opening of the patient’s pillow cases were correctly aligned’ so as not to face the entry of the old Nightingale wards. This, if not adhered to would induce the ‘wrath’ of the old fashioned ward sisters. I remember how intimidated I felt, we have come a long way since then.

I feel extremely honoured and humbled that my role as a nurse and midwife has enabled me to be present to support and care for a person’s life at birth and ultimately at death, a true ‘cradle to grave’ experience. To be able to offer this, my then ‘training’ and further qualifications gained, empowered my aim to deliver empathic,  safe, effective patient care and support. I know that is the focus of what everyone within the health and social care environment will also want to do. I remember when I came across this quote many years ago it had a profound effect upon my ‘reflecting’ on my role and equally applies to all students and colleagues whether we are working directly at the’ clinical coal face’ or within the health and social care education arena.

People will forget what you said, they will forget what you did, but they will never forget how you made them feel! (Maya Angel)

I wonder if the old fashioned’ Sisters’ mentioned above had ever read this quote, probably not I feel. However it shaped the way I mentored students and now within my teaching role.   Definitely ‘food for thought’, which reminds me I must stop procrastinating and focus upon writing a ‘blog’.

Dawn Suffolk, CPD Lecturer CPD, D.Suffolk@staffs.ac.uk

 New dates for our workshops and training courses have just been added to our website and places are available to book now!

The aim is to make a positive difference to the quality of patient care as well as enhancing the personal and professional development of health and social care staff.

Cervical Cytology Initial Training – Sample takers initial training is delivered over one day followed by half a day six months later and is designed for any qualified registered health care professional who will undertake cervical sampling as part of their employed role.

Cervical Sampler update – is an intensive half day workshop aimed at Registered Nurses and Doctors who are cervical sample takers.

Travel Health sessions – Updates and intensive full day sessions available for those who work in a primary care setting

Immunisation sessions – Intensive two day course which delivers a basic introduction and also available a half day session to update registered nurses who regularly immunise patients

Ear Care workshop – Intensive full day course aimed at Registered Nurses and Health Care Support Workers … last course for 2017 in October – places available

Vaccination – two day training course aimed at those who are new to Vaccination against influenza, pneumonia and or shingles. Only one course running in July/August 2017 – places available

… to find out more information and to book your place on all the above

click on this link now:-

http://www.staffs.ac.uk/academic_depts/nursingandmidwifery/courses

On my drive into work this week an item on Radio 4 came on about ‘Sex Robots’ apparently already on the market and much R+D underway in this area. All news to me. An invited speaker was a professor of ethics from Delft University who outlined some of the problems that society may incur with this development such as the potential for ‘Child’ sex robots and the setting of a new norm where sex is not a consenting activity between adults.

When asked what the advantages to society would be from these robots she answered that they could help the elderly and disabled. I didn’t think much about it in that moment but then I got to thinking about what she had said. When did the need for human to human intimacy belong to the young and able bodied?
Is the best society has to offer older people and people with disability who may be experiencing isolation and loneliness a sex robot? Surely this can’t be the right narrative. I am not saying there is no role for these robots but I would be against seeing them as the answer to real human and society issues which is about connectedness, human interaction and a sense of having a valued place in society.

I then started wondering (and dredging my memory from my days of studying sociology) whether the work by Durkheim on suicide where he describes a social condition known as anomie would provide me with a link to my thinking. Looking at the definition of anomie I think it might.

‘Anomie is a “condition in which society provides little moral guidance to individuals”. It is the breakdown of social bonds between an individual and the community, e.g., under unruly scenarios resulting in fragmentation of social identity and rejection of self-regulatory values.’

Although needing to be mindful that much of Durkheim’s work was driven by his concern for morality and the rules needed in society to maintain morality. I am not trying to be moralistic about sex and the use of sex robots but more want to really unpick what was said by this ethicist and whether this kind of narrative reinforces the view that only the young and able bodied are of value and that others in society are lesser and can have their basic needs such as intimacy met in this way.

I don’t know the answer but it left me thinking and reinforced for me my belief that healthcare professionals need to have this capacity to think and question as it is likely that they will encounter these things in their work with service users. Society is complex, issues that arise are complex and graduate level critical thinking skills will be needed by healthcare professionals to help people if asked to navigate around these kind of issues

Ann Ewens, Dean – School of Health and Social Care, Ann.Ewens@staffs.ac.uk

On June 28th, 2017, the Council of Deans of Health celebrated their 20th anniversary at the Museum of the Order of St John in London. This was a well-attended event with council members and invited guests from a variety of organisations. The format of the event was a 10-minute presentation from 4 leaders on the topic of leadership followed by an address from Dame Jessica Corner the outgoing chair of the Council of Deans and from the incoming chair Brian Webster-Henderson.

The 4 speakers included Jacqui Lunday, AHP Officer Scottish Executive Health Department, Jean White Chief Nursing Officer Wales, Danny Mortimer CEO NHS Employers and Professor Thomas Kearns Executive Director Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland.

As the speakers shared their views on leadership I started to think about what they were saying and whether this matched my own view of leadership and what I expected of both myself as a leader and what I expected in others involved in healthcare.
Certainly, I found myself agreeing about a lot of what was said about for example needing to engage in collaborative team working, ensuring we act as influencers and getting a place around the decision-making table. Good advice from Jean White was don’t wait to be invited and take your own seat if there isn’t one left for you!
All the speakers engaged in discussion on the workforce shortages being faced in health and social care and the challenges facing us and how we ensure safe and effective practice. As the presentations unfolded I got to thinking about the role of leaders in this context where on the one hand the call for person centred, safe care but a reminder that globally there is increasing demands and globally a shortage of 12 million skilled healthcare workers. It struck me has people talk about needing registered healthcare professionals to work ‘at the top of their license’ a term I heard again today used by Professor Ian Cummings to address the challenge of a limited workforce that we need to be clear what we mean by this term.

My concern is that in trying to address the workforce issues we will see the continued pressure for registered healthcare professionals to take on more and more of the ‘technical’ aspects of healthcare seeing these as the ‘top end’ end of their scope of practice in the mistaken belief that the more hidden but actually more complex graduate levels skills of communication, education, negotiation and decision making that take place alongside what looks like more ‘basic’ tasks will be delegated away to a less educated workforce.

My role I feel as a leader is to voice my concerns that there is a danger of failing to protect the poor and vulnerable thinking that their healthcare needs can be addressed by others whilst we use our limited resource of graduate level practitioners to do what looks like highly skilled technical things that in the future (possibly quite near future) will be done by the technology without human intervention. Inequalities in health are widening despite increased healthcare, we need our best educated healthcare professionals to be working at their ‘top’ using their graduate level skills to address the big health issues facing our society and not doing more and more technical tasks.

Ann Ewens, Dean – School of Health and Social Care, Ann.Ewens@staffs.ac.uk

Stafford’s Centre of Excellence open day was held on Saturday 24^th June . This was a great event with both academic staff and students available to offer support and guidance for prospective students to inform their career choice. Visitors commented that there was a great vibe, we offered a personal service, were friendly and provided the opportunity of hands on activities.

About 10 people attended the Operating Department Practice (ODP) talk where they were informed about the profession and given in-depth information about the course and their career and employment options. Their questions were answered to enable them to make a choice whether to consider ODP as their profession and to study at Staffordshire University.

The operating theatre skills lab was opened to allow perspective students the opportunity to see the state of the art theatre that provides a purpose designed operating theatre that is used throughout the course.

Skills-based activities are integrated into the ODP curriculum and the operating theatre skills lab provides students with access to the equipment that they will used during anaesthetic, surgical and recovery placements. The skills facility allows several clinical procedures to be simulated in the first instance therefore enabling students to reach a level of confidence and proficiency before carrying out procedures on real patients. Many clinical skills have already been utilised and this has received positive feedback from both students and placement providers.

Essential equipment within the skills lab is an anaesthetic machine, operating table and scrub sink. A high-fidelity SimMan 3G is used to simulate activities ranging from the delivery of basic care through to managing emergency situations. Enabling the students to experience practical skills within a safe learning environment allows them to apply theory to practice, increase their confidence and their ability to perform core clinical skills therefore improving patient safety and reducing learner anxiety.

The skills lab had many visitors who were given the opportunity to use the airway management trainer. The anaesthetic machine was set up and the sim man was prepared for a surgical procedure.

A giant operation game was on show where visitors could take the challenge of removing body parts which proved to be a great success. A few people said “how they enjoyed the day and liked how it was interactive and not just people standing talking to them in one room”.

A small version of the operation games was given as a prize for the person completing the activity in the shortest time.

Karen Latcham, Senior Lecturer, K.W.Latcham@staffs.ac.uk

On 12-14th June 2017 the International Learning Collaborative (ILC) on Fundamentals of Nursing Care http://intlearningcollab.org/ met for its 9th annual meeting. ILC is a member-based organisation, set up in 2008 to bring together like-minded healthcare and nursing professionals, academics and leaders to transform the way we deliver care in high tech environments and to elevate the standard of fundamentals of care around the world.

At the meeting this year in Uppsala Sweden the ILC members from 11 countries were represented and the focus of the one day conference followed by a two-day meeting was ‘Involving the patient’. The first day is held in conference format with a wider audience and then a members meeting was held over the next 2 days. This gives ILC an opportunity to explore issues in depth and ensure we are realising and setting actions each year towards our goals.
At the conference we heard a number of presentations and I was privileged to be part of the expert panel bringing the education perspective to the debate. One presentation by Professor Jack Needleman, economist from the University of California Los Angeles really struck home to me and I wanted to share Jack’s presentation and editorial he has written (Presentation) (Editorial) with Jacks permission of course and to share with you the essence of Jacks thesis and the thoughts it left me with. Jack has been researching in this area for 3 decades and is well placed to propose his thesis.
Can we afford the fundamentals of care – Professor Jack Needleman
In summary from Jacks excellent presentation I took away the following; in short yes, we can afford the fundamentals of care. In more detail, Jack argues that nursing is treated as a cost centre rather than a core service. Efforts to contain costs result in cutting the number of registered nurses or replacing them with lower skilled workforce.
He argues that there is now a strong evidence base established across the USA, Europe and other countries that lowering the % of registered nurses leads to poor patient outcomes including higher mortality, infection, falls and longer lengths of stay. He goes onto to say that the consequences of relying more on less educated staff rather than registered nurses is not so well established in the evidence.
Jack as an economist has undertaken work that has enabled him to estimate that the costs to services is higher when the % of registered nurses are reduced and substituted for less educated staff.
Jack further argues that another reason for persistent interest in substituting lower skilled personnel is that work of nurses is not well understood. The most visible work of nurses is task orientated as a result misguided administrators think that nursing can be easily substituted. In contrast Jack argues that the work of nurses is complex both cognitively and managerially. Alongside the visible tasks nurses are assessing, monitoring, risk assessing, intervening, educating patients and families, providing psychological support and have a critical role in team-based care co-ordinating across different professional groups.
My reflections
Whilst I sat listening to Jack presenting the strong evidence base to support the value of registered nurses and the dangers for patients even if not fully quantified of deskilling the workforce I started to think about the recent developments in the healthcare workforce in the UK. I sat there wondering is the motivation to move towards the nursing associate a result of the idea that nursing is a cost
centre and costs needs to be controlled or will healthcare services take the opportunity to increase the number of workforce hours in the system to provide better and safe care. I will leave you to ponder on that one but my plea would be to service providers to avoid the tempting scenario of thinking that the number of hours within the workforce is a valid measure. I would ask service providers and nursing leaders to challenge this and argue for ensuring the ratio of registered nurses is kept at the levels evidenced as having positive patient outcomes.
What does this mean for me and can I translate these reflections into tangible actions? One area I am looking at is how we can support our service partners to best meet their workforce needs under very difficult circumstances. For example, I am aiming that we will work collaboratively with our partners to develop new degree level pathways into nursing alongside the more traditional 3 year undergraduate full time degrees and we shall be supportive of developing new and innovative routes such as degree level apprenticeships.
If we are challenged that the fundamentals of care cannot be afforded then we can give a robust response when asked ‘Can we afford it?’ our response must be – ‘YES WE CAN’ and it is for us all to advocate the value of well-educated nurses in the workforce.

There is a huge amount of value placed on effective mentorship in clinical practice, nursing students spend 50% of their course in clinical practice it is therefore essential that the experiences they have support their ongoing development and guide them to achieving their clinical competencies as required by the Nursing and Midwifery Council (NMC) (2010). As a profession, nurses and midwives accept the responsibility for assuring the competence of its workforce to protect public safety, and the mentor plays a central role as a gatekeeper in this process. Students on health profession courses find the support invaluable when effective. It is also important we as academics and student nurses and midwives understand what the term mentor actually means to ensure effectiveness is monitored and expectations are met.

NMC (2008) page 19 define a mentor as:

“A mentor is a registrant who has met the outcomes (of a mentor preparation course) and who facilitates learning and supervises and assesses students in a practice setting”

The NMC (2008) also established a framework to support learning and assessment in clinical practice that describes the knowledge and skills needed to apply in practice this identifies eight domains mentors use to provide effective mentorship. In order to be effective a mentor needs to be able to facilitate pre-registration students’ learning whilst encouraging students to critically reflect on their learning experiences. By supervising, supporting and guiding students in practice mentors are able to provide constructive feedback and manage the failing student by implement approved assessment procedures through summative assessment. This is particularly important as students on NMC approved pre-registration nursing education programmes, leading to registration on the nurses’ part of the register, must be supported and assessed by mentors.

This you tube clip was created for our first mentor conference and demonstrates what our students perceive as effective mentorship.

https://www.youtube.com/watch?v=0B5TXiiF0ZU

Mentors work closely with clinical placement facilitators, practice educators and academics in order to facilitate students transition from one learning environment to another and ensure they achieve their learning outcomes whilst being accountable for confirming competencies as set out by the NMC (2010) standards. These aim to develop a student’s professional and inter-professional working relationship with members of the multi -disciplinary team. The Shape of Caring report (2015) also emphasises the importance of inter-professional working in the delivery of safe and effective care. This may require a shift from a uni-professional to a multi-professional approach to mentorship.

Mentorship is a vital part of pre-registration nurse and midwifery training, as it helps to establish a positive environment for learning and that nurturing from mentors encourages personal and professional development.

“Good mentorship is important because it instils confidence in the student.”

The importance of ensuring that students are exposed to safe and effective practice leads to good quality patient care being delivered by the next generation of nurses.

Helen Ashwood, Adult Nursing Course Lead, School of Health and Social Care, h.ashwood@staffs.ac.uk