Purplegerberas's Blog

A rambling collection of my thoughts about life, my children and crafty things

Stopping and thinking

I’ve had a difficult week. I’m under a lot of pressure at work with far too much to do. Things at home haven’t been good and came to a head on Tuesday. Its left me thinking about lots of things, perhaps too much. I spent most of the week not sure what to do. I felt stuck in a bit of a hole without seeing a way out of it all. I’m now calmer, feeling more focused and level headed and planning to work through my worries in my own time. There’s no rush to make any decisions so will not add pressure to myself even further.

So, some positives for the week –

We are a nappy free household

Samuel has suddenly become dry overnight so I’ve ditched all nappies – yay! I’m really surprised as Eloise was still in nappies overnight until she was 4 and a half so for Samuel to be confidently sorted day and night before two and a half I think is a big achievement. It’s rare for him to have an accident so I’ve also thrown out my faithful nappy changing bag. For a boots freebie, its lasted the 5+ years well. I wasn’t sad to see it go though.

I am a little bit sad though that there will not be anymore days of lovely cloth nappies hanging on my washing line

Competition winnings

I am slightly addicted to entering competitions. I can waste many an hour on loquax looking for competitions to enter. In the past I’ve had a few successful runs and recently have had another. It started with a DVD, nothing major but still a DVD I want to watch and will happily be passed to my mum and sister so a bonus. Next came a stash of make-up from Tescos after I retweeted a message. I’m plucking up the courage to paint my nails the interesting shade of blue they’ve sent me. I think I will try it this afternoon. I’d wondered if good luck comes in threes and yes it did! I had an email to say that after completing a questionnaire online for work, I had won an ipad 😀 I’m still waiting for it to arrive so currently spending time mentally kitting it out and making lists of apps that will completely revolutionise my life.

Eloise has unfortunately been introduced to my Mum’s ipad so I can see future fights to get near it!

Successes at Work

Things have been moving since our meeting with the chief executive last week .  No concrete developments or changes but questions are being asked and people who have previously been difficult to talk to are suddenly asking for more information. Staffing remains my highest priority and whilst there has been no mention of this, I remain confident that something will be done.  We are taking part in the trusts annual nursing conference in three weeks time (the source of most of my workload at present). I’m giving an hour long presentation and I am hoping this will be an excellent opportunity to promote my fellowship project to a wide audience and get more people supporting the changes I want to make. The conference also incorporates the trusts annual awards and I heard yesterday that my team has been nominated for the Innovative Practice Award for the work we did on Productive Community Services. My team has been so positive and willing to try and make changes that  I think I had taken for granted the amount of work that we had done. My work looking at and comparing our staffing and activity levels showed me that we are working far more effectively than in the past – our low staffing forced us to do this and as a result we are now working really well.  On Wednesday I went to speak to another team who had not made any changes in the light of low staffing levels. As a result their work is quite sporadic and my questioning or requests for action from them met a very defensive reaction.  The challenge of meeting patient needs under pressure was simply met with ‘we won’t do it’ rather than ‘is there a better or easier way of doing this?‘ which is the attitude my team takes. The teams who are shunning adaptation are key partners in my fellowship project. I realise this will make my project harder but at the moment I am very grateful for the rich material they are providing me for my current assignment.

Fellowship

The week ended with two days of fellowship which ended on a really good session on emotional intelligence. I found a book in the library this morning which is packed with self assessment tests (nice lists with boxes to tick 🙂 ) so that will keep me occupied this weekend. It will give me something to work on in coaching.

We also did some work around Belbin’s team roles. I was completely not shocked to learn that I am a completer-finisher

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Things that I am fed up of

  • Too much work to do
  • My inability to say no and stopping myself taking on to much
  • Having someone’s aggression taken out on me
  • A son who won’t go to bed
  • A son who trashes his room
  • Two children who do not care about their things and leave them broken everywhere
  • Repeatedly telling children to look after things
  • Threatening to put children’s possessions in the bin
  • Not being allowed to respond to unfair comments without being accused of being aggressive myself
  • Being tired
  • Feeling like I could cry too easily
  • Not having a break
  • Lack of family support nearby
  • The fact that my mother in law doesn’t get me
  • Feeling like whatever I do, I cannot make everyone happy and this is all my fault
  • Preferring to be at work than at home
  • Wanting to run away but realistically have no where or no one to go to
  • Trying to lose weight but end up emotionally eating rubbish
  • Having no money
  • Feeling not good enough
  • Sky Sports
  • Being stuck on a treadmill
  • The terrible twos
  • That stupid whistling noise that Steven has started making
  • My brain talking to loudly
  • Doing 14 things at the same time
  • Being treated like a doormat and then being treated like the most unreasonable person on earth when I eventually stand up for myself
  • Being a misery

 

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Marble cake

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Not a bad effort for today’s cake

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Nursing cuts: honesty is the best policy

Our chief executive came to our team meeting yesterday.

I had a number of things I wanted to speak to him about and top of my list was staffing. I heard a couple of weeks ago that someone had left my team after a long period of long term sickness. I was told that their hours had been removed from my budget as part of our cost improvement programme and that I would not be allowed to replace her.

My main gripe is that there was no negotiation in the matter. No-one asked me what the consequences of that loss would be and the impact that it would have on patient care. It’s not the first time that this has happened. I realised that over the last 6 years our overall staffing has just consistently been cut every time someone has left, retired or requested a reduction in working hours. I worked out the spend on nursing time six years ago and compared it to today – both in financial terms and whole time equivalent. I was shocked by how much it has reduced when you consider that our county’s population has increased by 5% in this time.

Frequently the message given by the government is that spending cuts will not affect patient care and that front line services will be unaffected. This is absolute rubbish. By doing it slowly through natural wastage nurse posts are being cut without any consultation on what impact that will have on patients. Comparing our workload with 6 years ago we are still  seeing similar numbers of patients. We have made many changes that have made our working processes more efficient, saving time and money and the huge difference is our waiting times. Currently people may wait up to 17 weeks for an appointment to see us.  I do not think this is acceptable and compares to 8-12 weeks when our staffing levels were higher.

Looking specifically at continence, a clear link has been shown between cuts in specialist nursing numbers and increases in spending on disposable products. It saddens me that pressure on our workload means people are not receiving high standard of care and I feel more people are simply being given disposable products because we do not have the capacity and time to offer a good treatment programme. A recent publication made the recommendation that there is one continence advisor per 100,000 of the population. My service operates at less than half of this suggested figure.

So, warts and all, as a team we explained this situation to our chief executive. He said that as a trust we have a waiting time limit of 12 weeks – he would prefer it was lower. Our waiting list has never been highlighted as an issue to the board and he felt that our current waiting time is a concern. I feel we were able to demonstrate that whilst we are ‘coping’ on lower staff numbers, the implication is that people will wait longer for an appointment.  He was also unaware of the practice of staffing hours being cut without consultation. He felt it should not be happening without some sort of conversation about impact on care. I explained that I would not necessarily be looking for like for like replacement but I could offer suggestions that would still deliver cost savings without compromising patient care.

It shows that cost savings need to be considered with input from clinicians in order to keep the interests of patients at the heart of it. I feel I am in a good position to offer this – I have the interests of the people our service treats at the forefront of my mind but I am also capable of making a sensible business judgement on the financial implications for the wider NHS. My recent experience is that this conversation is not happening and it also seems that the board are unaware of this practice.

In the past I think there might have been a temptation to hide perceived flaws in services such as waiting times for fear of being seen as doing a bad job. I feel why hide the truth? Unless the full picture is given then nothing will change. I was keen to point out that we are doing a great job despite working under huge pressure and that potentially we are capable of so much more.

I’m crossing my fingers for a positive outcome from the meeting.

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Happiness Online – April

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Another month and another set of resolutions. This months theme is ‘lighten up’. It aims to make you focus on the small pleasures that make life happier.

So my resolutions are –

Listen to music

I know that this features in the Happiness Project book but I’m not certain it was for this month. Anyway, I’m stealing it. It was pointed out that it is difficult to be in a bad mood when singing to the radio and its true. Mornings are busy and manic in our house and if I’m going to lose my temper its usually first thing (which then leaves the whole day on a bit of a downer). So music will be on and I will be singing.

Do More Knitting

At the start of the year I decided to put anything crafty/creative away and focus on work. I knew this was a short term thing whilst I was doing the fellowship and that I will get the chance to do some more projects another time. I just feel I can’t commit to anything and I get frustrated by the piles of unfinished projects stashed all over the house. I do get a huge amount of calm and relaxation from sewing and knitting and it is frustrating me. Knitting is easy enough to do in the evenings though and I have a long trip to the caravan planned for Easter so that is also prime knitting time. My plan is to waste less time on facebook games and spend more time knitting.

Complete 3 Things on my Day Zero Project list

Its a bit scary realising that I have less than a year left for my Day Zero Project. I still haven’t decided on everything to go on the list. In the past I’ve really enjoyed working through. Yes, I’m a sad list obsessive who gets immense satisfaction from ticking something off the list.  Its been a bit neglected over the last few months so I will get back onto that.

At the moment I’m struggling to think of two more. Perhaps a sign I need to have more fun. I will sleep on it and come back to this page later in the week.

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