Learning as a Nurse to “Watch This…” and enable others by Jackie Geddes & Pam Airey

Nurse (noun):  the first person you see after saying “Hold my drink and watch this!!”  but seriously Nursing remains compassionate, caring, and intuitive of ethics.  Humanistic, a calling and a person with a resilient positive sense of humour!    However there is no doubt the profession has changed over our combined 60+ year’s experience (or whatever it is!).

Having worked across diverse areas of nursing including Renal, Critical Care, Blood Transfusion and Marie Curie, we have represented and promoted our profession with passion and pride locally and abroad. As we sat down to write this blog and reflect on how much our practice has changed over the years we realised that the uniform was one of the smaller changes!

Can we say that have always promoted the independence and confidence of our patients (service users) whilst evoking the nursing compassion and care?  We aren’t sure. Perhaps we did not empower them all?  We cared, supported and believed in people, however did we enable them and stop doing for them? On reflection our main aim was to keep them safe, help them get well and return home and we were content with that as an outcome.

So when the “Nursing 2030 Vision” document was released by the Scottish Government in 2017 we eagerly poured over it curious as to the future direction of our profession.   We discovered the contents and aims reflected our current day to day working lives, from promoting self-management of long term conditions and wellbeing to the use of technology whilst collaborating with service users, multi-disciplinary teams and stakeholders.

As we reflected on what has changed we looked at the past 10+years as time we have both worked in the short term assessment reablement service STARS.  We have shared our skills as Nurses across the team supporting extended skills but importantly learned with our Allied Health Profession colleagues (AHPs) and Social Work about how to promote independent living skills, decrease dependency and take a strength based outcome focused approach to ‘what matters to the person’ to live their own good life.  Being safe and alive is no longer enough.  Empowering people to live a unique good life is what we want to demonstrate.  Hopefully independently however if Care at Home is required we have learned from our care provider partnerships how this can be transformed through enablement rather than ‘doing to’.

Collaboration and constructive compassionate professional conversations as leaders has become recognised as essential to innovation.  We welcome this and most importantly nurtured it within our team culture and partnership networks. In a bid to continuously learn and improve our skills we regularly undergo practice observation not simply by nurses by our Occupational Therapy and Physiotherapy colleagues to ensure that we are indeed providing robust enablement skills and knowledge with service users. We have learned to embrace these sessions, our nursing care and compassion instincts can still peep through when, unconsciously our hand might stretches out to reassuringly steady a service user.  We have learned a range of potential meanings for the recipient of this ‘caring touch’.

As a nurse, touch and feel are so very important in our working lives not only as an instrument to check health but as a means of comfort and reassurance to our patients.  However in rehabilitation and reablement it can give the opposite effect potentially implying that support and assistance are required, rob the individual of their confidence and unwittingly start a journey of premature dependency. Our AHP colleagues, whom we trust, have very kindly and discreetly removed our hands generating a reflective smile between us.  These moments of professional growth are shared as we help our AHP and social work colleagues understand and optimise the when and how of nursing skills.

Reflecting on our nursing careers, so far working in reablement has been the most satisfying, challenging and fulfilling area as we continue to learn, impart our knowledge and demonstrate compassion in its fullest sense.  Skills utilised not only at work but in personal life such as supporting a frail parent to keep active and enjoy living independently at home.

To close this blog we celebrate our unique Nursing skills proudly whilst recognising the importance of doing so in trusting partnership with our Service Users, AHPs, Social Work, Third and Independent Sector colleagues and many Carers.  This way we can learn to enable independence, choice and control when living in beautiful Dumfries and Galloway.  So lets raise a glass and say ‘cheers’ to continuing progress across Health and Social Care Partnerships.  Just one thing before you take a well earned sip… please don’t FALL over!!  

Jackie Geddes and Pam Airey, Senior Charge Nurses/Case Managers within The Short Term Assessment Reablement Service STARS.

I LOOKED IN THE MIRROR……….. by Anonymous

I looked in the mirror……..AGAIN. Same feeling as last time and the time before that. The fear….struck me again. What happened last night? What part of the proceedings can I remember? When did that go blank? Did I say anything to upset anyone? Did I offend anybody. I am never quite sure, but that sinking feeling tells me everything. I don’t remember, I can’t recall. But, that same sense of disgust and self-hatred washes over me. NOT AGAIN……WHY couldn’t I stop? Why did I need one more? Shame and guilt. If only you knew how I felt about myself at this moment. I can’t go any lower. Where did I get that cut? Where did I fall? How? What did I hit on the way down? Then comes the accusations, the reprisals. The feelings of disgust and self-loathing deepen and linger.

BUT this morning is going to be different. This time IS the last time of never again. No more excuses, no more regrets, no more next time. This time is now!!

The decision had become easy. I did not want to look at that face reflected back at me anymore. I did not want to see in the eyes of my children THAT look. I need this family to breathe, to sleep soundly and to be normal. To NOT live in fear when Daddy DRINKS!

There are no more excuses.

No more reasons to drink.

No more; I need a drink after the day I had.

But it always compliments a curry.

Let’s celebrate

Oh just a cheeky wee glass

Its Christmas……..

STOP!

Like any addiction it’s about breaking the habit. Getting help, having the strength to ask for help, having that person who will listen and not judge. Keeping that contact a regular part of your routine. Filling your time with enjoyable activities. Telling yourself YOU can do this. Being amazed by every little achievement. Looking at that reflection without fear. Not looking away. It’s not easy we are surrounded by this enticing social drug 24/7. It’s everywhere and makes NO apology for it. It’s on TV, social media, adverts, films and posters. It’s infiltrated every part of our lives and being. It’s WINE o’clock! There are so many ups and even more downs, but I see those days more clearly now. I recognise them and I have learnt to deal with them better.

YOU can do this, but you MUST WANT to do it. Be strong. Keep going. Each day gets easier. Each hurdle should be a celebration. Christmas was hard, very hard, VERY VERY hard. The public acceptance at this time for drinking alcohol when you are abstaining is dumbfounding. Everywhere I looked it was there. Turning on the TV and watching an advert before anyone can even purchase alcoholic beverages was a particular highlight! It wasn’t even 9.30a.m. Seriously!! Well done Tesco and Watchdog, this adds a new meaning to watershed. But I’m still here and still dry. It no longer feels a battle. I don’t fight alone, but I fight HARDER. I see in others who I was. I see their personality change, their sense of reason fail and their aggression. I want them to see what I see before and after THAT third glass, when everything changed.

I see things differently now, feel differently, I have so much more energy and I’m finding peace. MY PEACE. I am winning. I am FREE.

I looked in the mirror……AGAIN! I like who I see.

Women’s Work by Penny Halliday

I never imagined in my young and inexperienced days that International Women’s Day would mean so much for so many women including me!

However, I ask myself what real changes have taken place and in some respects the world of women is quite different, but for some, I fear, things have remained the same.  Women whose lives are still blighted by inequality usually have great strength of character, they are known to put everyone else’s needs before their own and do so with a smile on their face but slowly lose their own identity and as a result neglect themselves.  I think of my own mother and how, like many women of her generation, her life consisted of caring for 6 children, my Dad, our grandparents on both sides of the family and any child who was hungry  she came across .   She didn’t have much in terms of money to cushion the demands made on her but was a magician when it came to meal making, our clothes (which were mainly knitted or mended by her) and a house that sparkled it was so clean, but her capacity to show compassion for kids who were worse off than us or a sick neighbour was immense and when it came to a local homeless man she showed him respect and fed him.  Her wardrobe was sparse and she would always have the smallest portion of food on her plate at meal times telling us that she wasn’t hungry and had had something to eat earlier.  As the years went on she impressed on me that being a woman required strength of spirit, self respect and compassion, that I should take advantage of educational opportunities and with her complete support to go as far as I wanted to in creating my own identity as a young woman.  So much so, that with the help of her sister, my aunt, they saved enough money to ensure I would be the first to go on to tertiary education which I did and never looked back.  This is important because, at that time, some in society viewed educating women as a waste of money because we were going to have a family and that investment would be wasted – yes I realise this is hard to believe but it was said openly!!

I didn’t know it at the time but I would need my education later in life when I would become a divorced mother of two girls – another first for our family.

My mother and my aunt showed so much faith in me that I was able to overcome some of the inequalities I faced at that time e.g coming from a family of gypsy travellers and being a woman!!  I didn’t know it at the time but they were my first and most important mentors.  I strongly believe that women can benefit from female mentors who are relevant to them who have rich experience, commitment, realistic expectations, compassion, respect and above all a sense of humour.  I know we interact with each other on this basis a lot however, wouldn’t it be really cool, to use my granddaughters speak, to share this with women within our communities who experience inequality everyday!!

So today I would ask you to reflect on the mentors in your life who have made it possible for you to realise some or your dreams, who were they, what was it you needed from them, what difference did they make?

How do you celebrate being a woman in the age we live in do you have self compassion?

What role do you play to help other women and could you do more?

Happy International Women’s Day !!!!

Penny Halliday

Vice Chair Dumfries and Galloway NHS

IJB Chair

 

 

 

If the fish win I still win: reablement by Lewis McGregor

As an occupational therapist my interest is how people manage their day-to-day activities and occupations (activities). I work for the Short Term Assessment and Reablement service (STARS).

Reablement has been defined as ‘…services for people with poor physical or mental health to help them accommodate their illness by learning or re-learning the skills necessary for daily living’. (SCIE, 2013).

It is the teams vision to support people to maintain, regain and re-activate  existing life skills during the therapeutic reablement period. As a time limited team we are also looking to make positive and lasting changes in lifestyles by developing networks with community based support through establishing the answers to the all important “What matters to you ?” question.

I am a keen fisherman specialising in fly fishing and the tying and development of fishing flies. Not only do I fly fish and tie my own flies I also assist at the local fly tying club “The Dumfries and Galloway Fly Tiers”, where I teach intermediate and advanced fly tying and assist in running the clubs Facebook page.

So why do I fly fish? As a fisherman I struggle to understand why people don’t fish in the same way that the golfer doesn’t understand why others don’t wish to play golf. Fishing although not exclusively tends to be a solitary Sport. It allows me both times to think and to reflect and like most fishermen I would not appreciate you coming to speak to me when I am standing alone in a river or on the side of a loch.

Is fishing antisocial? Through fishing I’ve developed many enduring friendships and contacts but like most fishermen when fishing I prefer my own company. For a modest outlay you can be up and running with rod, reel and line. Fishing however as an activity requires an outlay of time. Time alone with your thoughts. Time consumed with something other than your normal routines. Time to get lost in time experiencing unique ‘occupational flow’.

What is occupational flow? The term flow was first coined by Csikszentmihalyi in 1975. The concept of flow however has been recognised particularly in Eastern cultures for thousands of years. To an Occupational Therapist flow is the engagement in a task, activity or occupation where one is fully engaged or absorbed to the point where one will lose track of time and place in a positive way. This psychological state underpins why we choose leisure activities. However not all leisure activities help with maintaining health but will allow us to experience flow.

In our increasingly sedentary lives with increases in obesity and associated physical and mental health problems,  the Scottish allied health professionals (AHP)  directors group working with Dr Murray the Scottish governments health directorates physical activity champion, agreed that all allied health professionals would work to influence and increase service users physical activity. Increasingly AHP’s are promoting increased activity (150 minutes a week as a starting point), strength and balance exercises to reduce falls. However we need to do more for our service users and ourselves.

When fishing I am physically active. I have that time to reflect to unwind. I feel relaxed and calm. More importantly I experience that loss of time associated with flow and well-being. Regardless if I catch anything or if the fish win: I still win.

So my question to all that are still reading is when did you last reflect on your activities and experience occupational flow to maintain your well-being?  More importantly what are you going to do about maintaining it?

Lewis McGregor, Specialist Therapist (Occupational Therapy) Reablement STARS.