Showing posts with label NHS. Show all posts
Showing posts with label NHS. Show all posts

Sunday, 7 May 2017

Returning with a spring in my step

I have really missed writing this blog, but there are times in all of our lives when other priorities need to take precedence over our own pleasures – if we care about other people then we cannot put ourselves first. Since I last touched a keyboard my family has suffered death, illness and deep disappointment and my job has been the most demanding I can remember in what is a long career. 


I write this because I enjoy doing so; it is very satisfying finding out relevant information and verifying my facts. However, it is a personal indulgence and not a necessity. I have missed putting words on a page, and now that things feel a little calmer, I’m back.

Louis Warner Sculpture - Returning
It feels appropriate to base this piece on communication (as, to me, that is what a blog is all about – even if I am only talking to myself). 

Photograph by Saratola Ban
Today is International Dawn Chorus Day – a chance to listen and recognise one of Nature’s daily wonders. I am fortunate in that when I am in Somerset, with my mother and sister, I listen to the Dawn Chorus most days – the power and quantity of birdsong is much greater than you will hear during most of the rest of the day. (Today the Chorus in London was quite restrained, but there was excellent BBC coverage, with live coverage from India to Ireland, from midnight until nearly 6.00am earlier today.) 

wren singing on hawthorn
There are many theories as to why birds sing first thing in the morning – some say that it is due to “temperature inversion” – when a layer of cold air is trapped close to the ground by a warmer layer above.  The boundary between these layers acts like an acoustic mirror reflecting the sound, so that it travels further. In addition, dawn is a good time to communicate (as the light is less good for foraging, and a bird might as well do something useful once it is awake), perhaps most importantly, singing at daybreak enables a bird to signify to rivals and prospective mates that it has survived the night, is in robust health and able to put on a good show. More promiscuous birds, such as blue tits and reedbuntings, may opt for a bit on the side courtesy of a Dawn Chorus introduction (so the Chorus is an avian aural form of Tinder), while others, who are fiercely territorial (such as blackbirds and robins), use it as an opportunity to intimidate their adversaries. I suspect the message for many of us from the Dawn Chorus is the importance to take best advantage of the opportunities available and select times to communicate that will ensure maximum impact and optimum outcomes.


I have just finished reading The Sellout by Paul Beatty – my CEO gave it to me as gift, as it had made him laugh. It is an excellent read – a witty, no-holds-barred, satirical take on attitudes towards racism and society in the USA. There is one statement, made by the main character near the end of the book that has stuck with me:

“I think about my own silence. Silence can be either protest or consent, but most times it’s fear. I guess that’s why I’m so quiet and such a good whisperer, nigger and otherwise. It’s because I’m always afraid. Afraid of what I might say. What promises and threats I might make and have to keep.”

Given the prevalence of elections (France is voting for its new president today – either Macron or Le Pen will be a clear break with tradition, my guess is that Macron will win; the UK has an election in early June; and Germany goes to the polls in September), we should all be mindful of the promises politicians make and the likelihood of their being able to honour what they say. Similarly, we, the people, need to make our thoughts and hopes known. We must appreciate that the inclination towards remaining silent and not making a stand for what is important can have severe repercussions. Not turning out to vote is as damaging as voting for something because you don't believe that what you are voting for will actually happen, just to "make a statement". We need integrity and determination to see us through the challenging times ahead.


Earlier this year there was an atrocious terror attack on members of the public and a policeman on Westminster Bridge near the UK Houses of Parliament on 22nd March. I am a governor of Guy’s and St. Thomas’ NHS Foundation Trust and we discussed the medical response to the attack at our recent Board and Governors’ meetings. Everyone was immensely proud of the way in which medical and other staff of the Trust responded - rushing to provide support (St. Thomas’ Hospital is located at the opposite end of the bridge to where the attack occurred). However, we were bemused by the decision to take casualties to various hospitals a significant distance from the disaster site when St Thomas’ was so near and had appropriate facilities – the decision as to where casualties should be taken was part of the wider London terrorist attack plans that had not previously been communicated to the Trust.  These plans, that ensure that there is a pre-determined response in the event of a terror attack or other incident, were devised by the Department of Health and NHS England – I appreciate the need for secrecy and tight security measures, but perhaps further consideration regarding the proximity of leading hospitals and medical facilities and the sharing plans with relevant parties would make things easier if there is ever such an awful event in the future.

Duke of Cambridge visiting St Thomas' Hospital in London
to thank staff who helped during the terror attack
Press Association photo
After the horrors of the terror attack in March, London felt different. On the 23rd I went in to work as usual but the tube was surprisingly quiet at rush hour – many people chose to travel by bus, rather than using the tube, or stayed at home, perhaps after seeing the numbers of police guarding the entrances to Underground stations. The blog London Wakes, written in response to the occurrence by my friend David D’Souza, resonated with me. In this post he urges people to “build a bridge”. He is right, like Beatty’s comment in The Sellout, silence is often the product of fear and if we want a safer environment we need to speak, discuss and understand. Elaine Dang was a victim of the terrorist attack in Nairobi in 2013 when al-Shabaab opened fire in a shopping mall killing 67 people. After the event she remained traumatised long after her physical wounds had healed. She came to appreciate that the only way to dispel her fears was by enhancing her knowledge and awareness, in her case of Muslims and Islam. Since 2013 she has gone out of her way to learn and make connections and now she appreciates that the heinous actions of a few do not justify labelling a whole group as dangerous and she is no longer afraid; we all need to engage and gain understanding, especially with and from groups and people we don’t know well, if we are going to make the world a better, safer place. Hiding from the unknown, sharing in “group-think” (by only communicating with like-minded people who support our own world-view) exacerbates distrust and misunderstanding.

Photograph by Daisuke Takakura
In a much smaller way, after the Westminster terrorism event, I made this discovery for myself. That week I was trapped working late on the Friday and only escaped the office after most people had been out for hours, celebrating the end of a traumatic week. There was a very noisy crowd at the tube station when I got there – of particular note were a group of men, who had clearly been having a good time and were raucous. I kept my head down and tried to avoid catching their eyes (how very British of me). However, they got into the same tube compartment as I did and their loud banter continued. One of them deliberately sat down beside me and became insistent on starting a conversation. Not wishing to seem rude or wanting to attract further attention from the wider group, I responded, cautiously at first. It transpired that they worked for a subsidiary of a large German bank and that they had indeed been socialising for hours. A senior colleague was over from the States. He had been very kind, when one of them had been working in America, and they wished to return the hospitality. He had taken their colleague to a Blues bar so, having shown him a traditional British pub, they were heading off to see The Stranglers in concert at The Academy in Brixton.

Stranglers playing at Brixton Academy March 2017
I asked what the man I was talking to usually did in his spare time and he told me he wrote. It transpired that he used to work night shifts, which impacted on his ability to spend time with his daughter. He used to read her a story before he left for work but after a while she said she wanted him to tell her something different. He asked her what she wanted to hear about and she gave him some ideas and named some familiar objects – this was the start of his making up stories for her. Each night he would tell her the tale he had crafted during the previous night’s security shift, before being given the subject matters for the story for the following day. He has five year’s worth of tales crafted with love and his story made me see him as a sensitive and caring man, rather than the intimidating person he had seemed to me when he got on the train and forced me to speak. I walked home with a grin and a spring in my step. The world is a surprisingly good place – and made even better when we communicate.


Friday, 16 December 2016

“A modern Nativity the old fashioned way” (aka “Ostentatious Over-Sharings of a Smug Git”)

Day 17 (Saturday 17th December 2016)

17 thousand solar cells on the wings of Solar Impulse 2
enabled it to achieve its record making fossil-fuel-free flight
around the globe. It has a wider wingspan than a Boeing 747.
The journey started on 9th March 2015 and was completed on
26th July 2016 when it arrived back in Abu Dhabi.

We have reached the weekend and, even though I suspect that you have a busy day ahead of you, I hope you find time to read today's post and perhaps catch up on ones that you have missed or merit a re-read. I am sure you will agree with me that the blogs so far have been extraordinary; today's is no exception. Jo Mortimer, one of the UK's leading recruitment experts, specialising in administrative and office roles is a Divisional Leader at the highly regarded Angela Mortimer Group. Jo can be found on Twitter, her handle is @J0Mortimer. Jo has a 1st class degree in Psychology from Cambridge and has retained an interest in questioning the world and the people around her. She is well-travelled and engaging company. A Buddhist, she practices Taoist Tai Chi. She has an excellent voice (singing folk and as part of a capella group). Jo is a feminist, as you will be able to tell from her post.

Jo has written a very personal post influenced by a significant high during her past 12 months: the birth of her daughter. She also, deliberately, raises a number of topics that are not often discussed or even are considered taboo in our western society.


*************************************

“A modern Nativity the old fashioned way”
(aka “Ostentatious Over-Sharings of a Smug Git”)

Around this time last year, an eagerly anticipated event came upon us – the birth of our daughter.

It was beautiful, though not in conventional Hollywood terms. Like all newborns, her grey skin was more “Shaun of the Dead” than “Casa Blanca”. I’ll spare you the analysis of bodily fluids in the birthing pool.

Image: Shaun of the Dead, Dir: Edgar Wright, 2004

But the process of giving birth really was beautiful – one of the greatest highs of my life. Not just the “phew it’s all over and we have a baby” bit, the whole experience. And that’s an unusual thing for a woman to say.

Why?

At this point, I get on my feminist high horse.

In modern history, patriarchal society has, I contend, embraced an image of the weak and helpless woman, feeling faint in a corset and heels (this is not a bygone era – remember Nicola Thorp, the receptionist sent home from PwC earlier this year for not wearing heels?). Such delicate and lovely creatures cannot be expected to do, well, hard labour.

Image sourced from www.marriedtothesea.com

Enter the men in white coats with their trusty sidekick, technology.
“Lie on your back my dear while we strap you to this recording device, give you pain relief rendering you immobile and then inevitably have to cut you in some way to wrench the poor grey specimen out of you.”

This is the prevailing model of first world childbirth, talked about by new mothers ad nauseam. The competition for top horror story makes “Rosemary’s Baby” look like “Toy Story 2”.

Rosemary’s Baby, Roman Polanski, 1968
And women with a positive birth story can hardly speak up at these coffee meets. Rule number 1 of the playground: when you’re making new friends, try not to be the smug git. So women with positive birth stories remain the silent. This does all women a disservice.

It takes courage to step outside the prevailing paradigm. I came under pressure from the well-meaning family to have a hospital birth. This was motivated by loving concern for our welfare, and in the context of the modern norm is understandable.

But taking control of your choices is key to ensuring that you feel relaxed and comfortable, and that you have the best chance of a gentle, natural birth. Our mammalian cousin, the household cat, is renowned for shunning birthing baskets meticulously prepared by owners, favouring instead the solitude of the garden hedge.

Image source: Dailymail.co.uk

The “hypnobirthing” movement, championed by Marie Mongan amongst others, sounds whacky but has at its heart a simple physiological fact: as with all mammals, if the mother is relaxed, the muscles of the womb will contract easily. If the mother is tense and fearful, the muscles of the womb will not want to contract. They will fight to remain closed to delay the birth until the mother feels safe and secure – ‘out of the lion’s den’. This is likely to result in an extended and painful labour.

I decided to create a ‘birthing nest’ in the front room of our house. My husband surpassed himself with birth pool logistics (getting an inflatable Jacuzzi filled with water that remains at a stable 37 degrees isn’t as easy as it sounds), a perfect playlist (Max Richter’s “Sleep” amongst others) and a veritable shrine of candles. Oxytocin, the hormone associated with love and relaxation, was flowing and the birthing goddess was ready to emerge!

And she’d been training.

Realising the importance of a relaxed mind, I repeatedly listened to a man (Phil Parker) telling me in deliciously rhythmic tones that I was going to be “amazed by the easy…simple…and natural process of giving birth”.

Image source: www.prenatalyoga.com
I also tried pre-natal yoga, which gave my pregnant body some vocabulary to move with. For some years, I’ve ‘played’ Taoist Tai ChiÔ (www.taoist.org), a powerful tool for improving physical and psychological health. Tai Chi teaches how to ‘let go’ in body as well as mind. The Chinese have the concept of ‘yin’ force (the opposite of the ‘yang’ force), associated with the empty, yielding, the ‘hollow’. It is the essence of feminine strength, the heart of natural birth.


The second stage of labour (commonly referred to as the ‘pushing’ phase) was long, because hypnobirthing teaches not to ‘push’. In breathing through contractions (and don’t get me wrong, this was not a quiet experience - there were many noises coming out of my mouth that choir girls have no use for), the baby gently moves down. If the modern hospital birth scenario is akin to relieving yourself at work as quickly as possible to avoid breaking wind in a board meeting, this was akin to a relaxed Sunday morning experience with plenty of time to read the weekend supplements.

Image source: http://www.123rf.com/
Our baby was born gently into the water, did not cry and was calm and alert during her first moments outside the womb. I also got off very lightly from the experience (apart from several months of urinary incontinence, which virtually all new mothers suffer from (why does nobody talk about this?)). There was no inflammation to the lower spine, and the wonderful post-natal massage therapist @beccyhands said she wished she could show my lower back to a room of medics to demonstrate the benefits of a gentle birth without intervention.

In her brilliant book, “Birthing From Within”, Pam England explains how in some cultures childbirth for women is held in the same regard as going to war is for men: it is an intense and high risk experience from which you hope to emerge bloody and victorious, shrouded in honour.


The nature of war is that you don’t always emerge victorious. Giving birth is challenging.  It’s bloody.  It’s perhaps our closest shave with death. Many have a tougher experience than I; and if I give birth again, I may not have such good fortune.

If things do go wrong, thank goodness for the amazing staff of the NHS. The Juniper Community Midwives were outstanding in the home care they provided and I felt in very safe hands. Had things gone wrong, we were lucky enough to have King’s College Hospital a short ride away.

Image source: http://www.healthwatchlincolnshire.co.uk

As it was, we did not need a hospital bed, and the baby did not need to be exposed to the increased infection risk from being outside the home. Many of us in our jobs feel we need to be ‘busy’ and ‘doing’ as much as we can in order to be effective. The community midwives understood that the less they intervened, the more effectively they were supporting us.

So as with any battle, the reality of giving birth is likely to surprise. But let this not stop us from training for the big day, eagerly anticipating it and visualising a positive experience. And whilst I’m not advocating medals, for the sake of future mothers, let’s not shy away from talking about our beautiful victorious experiences. I dare say our men folk would!


Monday, 4 May 2015

"Space Matters" - Part One


This is the initial post of a two-part blog about the workplace, inspired by the CIPD HR Leaders’ Network event on the topic.


“Space Matters” wise words from Neil Usher, the head of Workplace at Sky, who was the main speaker at last week’s CIPD HR Leaders’ Network evening.  Late last year I suggested to the CIPD that I bring together a collection of passionate advocates for workplace strategy as, increasingly, I am of the opinion that leaders (both in and outside HR) need to be mindful of the space and surroundings in which we expect people to perform and be productive. 

Selagas Cano Architects office, SpainPhoto by Iwan Baan
Our environment (be that at home or at work) has changed significantly over the past two decade and continues to evolve. Technology, transport, the manner in which we work, collaboration, project-based targets, generational expectations and capabilities – all of these have influenced the requirements and individuals’ expectations of the place in which we work.


Making a place accommodating and pleasant in which to work is certainly important – rudimentary necessities such as clean, accessible lavatories/broader wash room facilities, sufficient air, warmth, drinking water – are indeed a fundamental need. However, there are other quite basic requirements that all too frequently are ignored in deference to cost constraints. Personal, secure storage (especially as “hot desking” is popular, combined with flexible working practices, which often result in a change of clothing as a person moves from one environment to another), employees need somewhere to keep their possessions. 


Communal spaces are important – as Lynda Gratton says in her book Hot Spots, we are at times energetic, positive social animals and will congregate where we find a spark of energy (be that the water cooler, a vending machine, local watering hole or around popular colleague’s desk) if not given an area to meet and mingle we might miss out on enjoying the benefits of a Hot Spot’s energy. Many of our best and innovative ideas come from bouncing problems and concepts off others, not from sitting in isolation in a cubicle or “Brainstorming” at a boardroom table.

Intentional office Hot Spot

Another basic, but often ignored, human requirement is natural light – it is well known from numerous research studies that daylight enhances human health – workers exposed to daylight sleep, on average 46 minutes longer than their natural-light-starved colleagues and sleep has a huge impact of wellbeing, for example reducing stress levels. Yet according to research, by Mental Health Research UK, one in ten workers in the UK have no access to natural light at work and 30% of us leave before dawn and return after dusk during the winter months. 

Screen shot from The Apartment, 1960
No windows, no natural light, no colour, no view, no plants...
We instinctively know that daylight is good for us. SAD afflicts many during the dark winter months and can have serious ramifications – it is usually induced by a prolonged lack of exposure to natural light and yet 46% of European offices provide no natural daylight. Employers have a duty of care to their employees and, knowingly putting people into a situation that is bad for them is wrong. It took us a while to appreciate the harm from smoking and asbestos, I suspect that depriving people of natural daylight will be seen in a similar light in the future (excuse the pun).

De La Rue Technology Centre, Hampshire, UK
Daylight is not to be confused with sunlight. In a modern workplace sunlight can prove problematical, for example by having an adverse impact on heat, especially in offices with large expanses of glass, and the glare can make it hard to work (who hasn’t had problems trying to see a screen in direct sunlight and pulled down the blinds – thereby negating the positive efficacy of access to natural light?). However, these problems are due to our technology and not an individual’s needs. We require sunlight to produce Vitamin D (useful for healthy bones and teeth) and to encourage our bodies to create vital hormones, which regulate the internal clocks that influence our moods, appetites and energy levels. 

Komorebi (Japanese word meaning sunshine through leaves)
with credit to Jo Stephenson
I am writing this post while sitting in the garden – the sound of the birds, the warm sunshine on my skin and the scent of the blossom is wonderful. I can feel myself perking up just by sitting here. Fresh air and sunshine are good. It is proven that wounds heal more swiftly when exposed to daylight and sunshine (Florence Nightingale insisted that her Nightingale Wards had their long sides south facing, with a windows that could be opened between each single bed to let in the sunshine and fresh air - the ensuing Edwardian habit of wheeling the ill (especially those with Tuberculosis) and infirm in their beds out into the sunshine was less misguided than some of us believe.

Bed-ridden patients getting fresh air
City Hospital, early 1900s 
(Photo, City of Edinburgh Museums and Galleries Collection)
It took the threat of biological warfare to encourage two Ministry of Defence scientists, based at Porton-Down in the UK, to undertake research into the effect of sunshine and fresh air on bacteria. Henry Druett and K.R. May were concerned by what would happen if deadly pathogens were exploded over a major city – how long would the microbes remain a threat? To prevent the bacteria being blown away, they wound cobweb around a comb and dusted it with the common gut microbe, Escherichia coli. Some combs were placed in the open air on the rooftop and others placed beside them in a covered container. Much to the scientists’ surprise, the bacteria when exposed to sunshine and fresh air died within two hours, whereas the enclosed samples were still thriving and viable. This research might make us want rethink our attitude towards air conditioning. It is so easy for bacteria or fungi to breed in warm, sheltered spaces. I am aware of a couple of Directors severely poisoned by the unclean air pumped into their offices after aircon filters were not cleaned or replaced for a number of years – one’s lungs were reduced to those of  a 75 year old, despite being in her early 40’s and the other, who was not so swiftly diagnosed, has since not been able to take on full-time employment for nearly a decade. Increasingly employers will be held to account for putting employees’ health at risk.

Often found in Air Conditioning systems
While on the subject of nursing and health – nurses provide a great example as to how sensible workplace design can enhance employee health and wellbeing and also improve patient care. My grandfather, whom I have mentioned in an earlier blog about his involvement in the invention of the iron lung, was a medical professor, based out of Guy’s Hospital in London (which, by coincidence, is one of the hospitals in the Foundation Trust where I have the privilege of being a Governor). Early last century he undertook research into the amount of walking that a nurse does each day and found that over a third of the time spent at work involved walking, with just over half being dedicated to actual patient care. He argued that if you could reduce the amount of time getting to and from patients and the nursing station, pharmacy, etc… there would be more time for care. A similar study in the USA a little earlier this century came up with the same findings. At Guy’s and St Thomas’ we are trying to make the environment better for patients and staff. Simple changes, like moving a facility away from the noise and bustle of the public areas, has resulted in less mistakes and lives have been saved by transferring the intensive care ward from the top floor to closer to A&E at ground level – thereby reducing the time that a patient takes to reach required support and treatment – time wasted in a lift. Changing a workplace for the better does not require specialist knowledge – it just requires the application of common sense and an appreciation of the fact that “space matters”. But be mindful of Winston Churchill's words:
"We shape ours spaces and then they shape us."