The truth is our only weapon....

Never underestimate the power of the truth.  The Dahlia Lama recently said 'The only weapon we possess is the truth.'  The following article will help you realize the importance of standing in your truth and not backing down because when you give up people suffer.  http://www.heraldscotland.com/news/home-news/nhs-under-fire-over-calls-to-free-hotline-for-whistleblowers.23092976  Stand by those who speak the truth and let them know that we are with them and supporting them in their role, Rob a nurse featured in the article, stood up for patients, only to be ignored.  The system isn't as committed to patient safety as we are led to believe and I don't mean those who have had to look into the recent NHS scandals are part of the system.  It seems to be those who hold the reigns to the hospital budgets and the government departments that are responsible as  Mr. Williams reports in The Herald, Scotland do not wish to disclose what has been done.
I thank those family members who stood up for their relatives being (mis)treated at the Mid Staffordshire Trust, even while at the same time nursing organizations went in and said everything was up to standard.  How frustrating it must be to have your concerns brushed off because of the way the system works together, perhaps unintentionally those responsible don't use critical thinking because of collaborative relationships.  I heard of an award given for bringing attention to The Mid Staffordshire Trust lack of care and that is appropriate.  The nurses bore the blunt of the blame and were labeled as uncaring.  Never a mention of the 10 million pound cut to the budget that preceded the tragic course of events or that the Director of Nursing never had to face charges for her role in overseeing staffing levels and care of patients under her charge even though the bedside nurses did.  At sea it is clearer to see who is responsible and will take the blame.  The captain is the head of the ship and has to answer for the safety of those who are under his/her charge.  But unfortunately we are landlocked and seemingly deadlocked with more episodes of lack of adequate care and patient safety and more it would seem on the horizon.

In The Sunday Telegraph, January 19th 2014 article by Patrick Sawer and Laura Donnelly describes the tragic circumstances for families at the Bristol Royal Hospital.  The common thread in this tragic saga like Mid Staffordshire, is that there were not enough nurses on duty.   The Care Quality Commission (CQC) had previously warned the hospital that conditions were unsafe and that not enough nurses were on duty.  The hospital amended the situation to 'compliant' by decreasing the number of admissions.  It seems a mystery how when all this was going on, the National Institute for Cardiovascular Outcomes Research could report the hospital -  'delivery safe service with good outcomes.'   Again, I think that it because of collegiate relationships and a culture of collaboration rather than critical thinking at the top.

Nurses should be aware that criminal investigations have been initiated at The Mid Staffordshire Trust and as one of the children who should have been moved to the ICU two days before his cardiac arrest, and died at the Bristol Royal Hospital.  Hiding or destroying any part of the chart that can be used as evidence is a crime, and as his medical record for the morning of his cardiac arrest and death have gone missing, I would assume a criminal investigation will follow.  A similar pattern occurred at Mid Staffordshire, where 500 incident reports went missing before an inquiry was held.  William Booth, Matron at The Bristol Royal Hospital stated that 'ratios could have been better,'  - as my friend always said 'No sh-t Dick Tracy!'  Since these tragic events and suffering by the children's parents,  1.3 million pounds has been spent on the paediatric high dependency unit and hiring more theatre nurses, ward nurses and two additional consultants.

Sarah Knapton, wrote in The Daily Telegraph, January 7th 2014, that nurses will be required to pass a competency test every three years to ensure that they keep their skills and competencies.  Robert Francis QC who investigated the Mid Staffordshire Trust scandal called for more robust checks on nurses.  What I read into this is that nurses are uncaring and perhaps considered careless and incompetent with their patients.  The effects of chronic stress is described in an article by Laura A. Stokowski, RN, MS in Medscape.com January 14th 2014.  The article is entitled 'The Risky Business of Nursing: Clear and Present Danger.'  Nursing is physically and psychologically demanding profession.   Psychological harms associated with stress are:  fatigue, bullying and incivility in the workplace.  'Presenteeism' is a term coined to encapsulate the phenomenon associated the effects of chronic stress in the workplace for nurses:  low productivity, more medication errors and patient falls.
The Nursing Times posted an article by Press Association, 14th January 2014.  Nursing staff levels were found to be variable at Barts Health and staff felt bullied when they raised concerns, lowering morale which has been compounded by a decision to cut 200 nursing posts before Christmas and cut pay for several hundred more.  Patients felt that they were not listened to which is understandable and fits the pattern that has evolved elsewhere.  In future nurses will have patient feedback as part of their evaluation process and that puts them in a catch 22 situation when they can't tell patients or family members when staffing levels are not adequate.  Even more important for there to be more transparency from the hospital administration to post these numbers on the wards so that the public can be informed.

When it comes to money - money is important and you need to protect your license.  For nurses who have worked in these hospitals or where you are experiencing similar work environments, I recommend that you contact a lawyer who specializes in license law at your earliest opportunity - like right now!  If you can meet with a lawyer in a group that might be a good idea so that you can write down questions and give details about how you have reported unsafe conditions in the areas where you work.  Ask your lawyer how you can protect the incident reports that you have made out as you will need to show that you have indeed brought the problems to your superiors attention.  Telling your supervisor is okay but always can be disputed, when it is put into writing it means that you have documentation that isn't contained in the chart.  http://www.jointcommission.org/issues/article.aspx?Article=Jzh%2bBUFCjFYzqxCXVJBIL7jqSaDRwc7B830G%2fJejQ3s%3d&j=1229721&e  The Joint Commission is calling for physicians to take a leadership role in the hospitals and that is something that needs to reinforced across all agencies in the UK also.  I have read of cases where physicians have been targeted for speaking out about patient safety and other concerns such as lack of proper heating etc.  It really takes an independent body like Joint Commission to hold hospital administrators accountable and to take the fear out of the leadership role doctors have always assumed and should reclaim.
http://domains-by-day.com/2013-12-12/nursestransitionnetwork.com/redirect  Fortunately that Richard is working with me on this project and the next one to develop a marketing platform for nurses.

Self inquiry and contemplation are part and parcel to personal and professional development.  Ask your self:

• Do I have an accurate idea of who I am?
• What I'm doing?
• What am I capable of?  (Venture into unknown territory)
• What's my role calling me to do?

Here are some suggestions for coping from 'Change is your competitive advantage,' by Karl G. Schoemer.  My goal is to help you see that you have more control over things than you think you do.

• Make a contribution...meet up in groups and share your knowledge and experience.
• trust your instincts, even before you know the answer.
• trust your judgement - nobody knows better than you do.
• You can control how this uncertainty affects you - whether it upsets or distracts you or challenges you to do what you can do to address your concerns.
• When you are experiencing an identity crisis people ask two types of questions:
• This isn't what I signed up for -  The light bulb goes on!  Then through self analysis ask yourself:
• Will I be able to adapt?
• What am I going to do?
• (Albert Einstein said that it was madness to keep repeating behaviors that don't work.)
• Walk the walk, and talk the talk.  This is design behavior and you have to be different from 60% of people who are in the 'default' category...I don't want to get involved...that's not my job etc. etc.
• Educate your colleagues and your friends who are in the same position as your are facing.  Eventually more people will listen and reach the point where they become part of the change - 100th monkey theory.  If you know about the classification of delusions you will understand that as long as just one person has an experience unlike the masses they will get labeled.  
• Design Behavior asks 
• How can we make this process better?'
• 'How can we make it easier?'
• Why do we do it this way?
• Why can't we try it another way?
• Because you disagree with someone doesn't mean that you are defiant.  (I have always had to deal with this issue and that's they way it is.  I have learned to just 'suck it up' as they say not that it makes me feel any better really but you can't be what others want you to be if you are true to yourself.)
• Keep this basic definition in mind: Design - focus on patient or client.  Defiant - focus on status quo.

Richard will be able to work on the new web site next week and in the meantime I will be posting here once again as it seems the red line brigade have found another hobby!  Although I have to share that it has been happening to me on LinkedIn.com.  All very odd!  Just before I went on line today I was prompted to change my password then I used the exact address in the address bar and everything went well since.  However, I did receive a call from a gentleman soon after I went on line, who said he was from the Windsor Council with an accent, like from Somalia and wanted the first line of my address.  I also found it odd that he wouldn't give me his number to call him back so I will have to wait and see if he sends a letter.  A lady called me from the American Embassy, London a month or so ago with the same brogue.  I thought it was odd not to have an American or British accent, and she asked me for my address also.

My very best wishes are with you as you work through your legal defense of your license.  Please check back to earlier blogs for meditation teachers and sites and that's the best advise I can give you as it has been my life line.  I realize that it has to be difficult today more than ever if you are unable to work and it is easy to feel fear and that is part of the journey to overcome inner obstacles.

You are not alone and I encourage all of you to connect together and meet up as much as possible in person and share information and support each other emotionally.  Fortunately I had a dear friend who helped me during the time I had to work through the legal challenges, and some will have husbands or family to turn to.  You may be the only source of support for someone who doesn't have close family or friends and that is why it's important to be there for them.

Warm Wishes, Rita.