Showing posts with label dialogue. Show all posts
Showing posts with label dialogue. Show all posts

Wednesday, October 27, 2010

Fran Biley's video: Students on nursing theory

I came across this great video created by Francis Biley Bournemouth University through the Martha Rogers list:


Quite some time ago I wondered about having dummy - animated heads to carry out a dialogue. It is great to see how e-media forms and tools have developed now.

I have my own thoughts and ideas on nursing, perhaps over time I am drafting them in the bibliography and here on W2tQ?

Additional links:

Nursing theory resources SCIENCES links
Virtual Reality in Nursing: A dialogue from 1991
Nursing Telemachus and Computers: A dialogue from 1995

Friday, October 1, 2010

Healthy Active Ageing Virtual Global Discussion Forum: Int. Day of Older Persons 2010

Dear Colleagues,

The World Health Organization, Departments of Reproductive Health and Research, Human Resources for Health, University of Iowa Hartford Center of Geriatric Nursing Excellence, and Partners would like to invite you to join Healthy Active Ageing Virtual Global Discussion Forum - 1-12 October 2010.

Join us in creating an interprofessional network involving representatives from health professions, policy makers, programme managers, international organizations/agencies, universities, research institutes and our clients to share our knowledge and experience on issues that affect healthy ageing.

REGISTER NOW! http://knowledge-gateway.org/ahaa

Share your experience, your opinion on issues that affect us all, as individuals, families and health practitioners. Contribute through this forum to the policy and practice dialogue.

During this twelve day forum you will receive two emails per day; one email to introduce the day’s questions and one daily digest of the contributions. Daily questions will be disseminated within three topic areas:

  • Challenges and opportunities to support healthy active ageing
  • Sharing of success stories
  • Caring for older persons with dementia
Once you have registered you can participate in the forum simply by responding to the daily emails or sending a message directly to ahaa at knowledge-gateway.org

You can also log into http://knowledge-gateway.org/ahaa to browse the archived discussions and resource materials.

For any questions on this Virtual Global Discussion Forum please contact the forum facilitator: 

Christina Fusco christyfusco at gmail.com

Please pass this invitation onto your colleagues and networks.

With kind regards,

Maggie Usher-Patel
Scientist/IBP Secretariat
WHO/RHR


My source: HIFA2015

Additional links:
Full of Life  - http://www.dwp.gov.uk/policy/ageing-society/full-of-life/
International Day of Older Persons - http://www.timeanddate.com/holidays/un/international-older-persons-day

Sunday, September 5, 2010

compose, direct, conduct and 'dilute to taste' outcomes

In Drupal musings 12 I mentioned that the classification of nursing practice is not necessarily at the forefront of nursing's mind set against the turbulence and rush of clinical areas.* This is especially so at the moment as nurses on wards, clinics and community try to identify savings.

I am interested in classification in part as this is the raison d'ĂȘtre for the health career model; on a mental (cognitive) level, in practice and potentially in virtual representations of health care activities. For learners it is an extra to hold the bicycle saddle for those first turns of the pedals. Additionally, for those who have completed many rides and races (lifelong learners) they can reflect on how they got there, and plan for the next round.

As a conceptual framework then h2cm is, like classification, in the background. The model can help to compose, direct and conduct (c-d-c) nursing (health and social) care. Classification matters to ALL nurses because we need to know not only the c-d-c of nursing but the outcomes too.

If all the above is in the background, then together with classification the health career model can help differentiate nursing as a discipline and make nursing visible. We can only take heed of the adage "divide and conquer" by being able to differentiate nursing from other disciplinary contributions. Then perhaps we can truly identify and so define the facets of integrated, interprofessional and multidisciplinary care that must also be person-centred. As nurses and the team respond to the individual's trauma (assault, illness, chronic disease ...), they can also assure their combined values, which must be defined and articulated if there is to be a unified philosophy.

If the respective professions have not noticed (I am sure they have) 'professionalism' is itself under assault in terms of unique knowledge and skills, respect, power and status. To a degree this a good thing. It is also called 'progress': countering restrictive practices, improving service access and challenging institutionalised and state paternalism. Professionalism is accorded for reasons of accountability, education, responsibility, integrity and advocacy. Amid the public (mental) health disaster that we face - the professions - are needed more than ever and if the assault is taken too far ... ?

* Should you know of examples where classification IS at the forefront of nursing practice please let me know - h2cmng @ yahoo.co.uk.

Thursday, November 19, 2009

World Philosophy Day 2009

The world's population really needs the skills (literacy!) to balance arguments and debate issues. Today being World Philosophy Day, 19 November 2009 we can see this need as global events re-frame our words. For decades now some of the world's cities - capitals have become synonymous with fevered political debate, equality, equity, poverty, power.... 'Copenhagen' is the latest example, stressing the need for informed argument and rationale thinking on an individual and group level, as the UNESCO introduction reveals:
Ever since its inauguration as a “Philosophy Day at UNESCO” in 2002 and particularly since its institutionalization in 2005 as a “World Philosophy Day”, this celebration of philosophy has inspired much enthusiasm. With its aim to bring philosophy closer to everyone, academics, students and the general public alike have all shown great interest in this activity that offers new opportunities and space for philosophical reflection, critical thinking and debate.
My previous studies comprised a joint honours degree in computing and philosophy, which may account for the appeal of Hodges' model and the reflections here on W2tQ. As mentioned previously, in the 1990s I wrote a dialogue (of sorts):
The aims of this 'dialogue' are threefold. First, simply to explore through the minds and voices of two ancient characters, contemporary nursing informatics and telematics issues. Secondly, to test the viability of the dialogue as an alternative format to the usual academic paper. And thirdly, to introduce unfamiliar readers (students?) to 'the' master of the dialogue form - Plato.
Readers may (hopefully) be stimulated to seek out Plato's works, which are freely available in affordable paperback editions. 'The Last Days of Socrates' is recommended as a starting point. Plato captures in the dialogues the technique employed by Socrates, that still bears his name - 'Socratic questioning'.
As health professionals search for ways to reassert values amid unprecedented technical and social change, philosophy is once more on the agenda. This attempted 'dialogue' has two protagonists. Telemachus, who is in name from Homer's Odyssey and other Hellenic literature. The name appeals to me here due to the study of 'tele'-matics, a key branch of informatics research.
Epictetus (50-120A.D.) was a philosopher of the stoic school. Sometimes we find unexpected connections in things, as with Epictetus: nursing - health - ethics/values - philosophy - Enchiridion (Manual) health - how to live ones life - leadership - 3,000 drachmas paid for E.'s lamp after his death - Florence Nightingale - nursing!
Telemachus is a student of the Academy established by Aristotle, starting his third year of nurse training. Epictetus is staged as a professor, a member of the faculty for health. With apologies...

There is also a philosophy listing on the INTER-INTRAPERSONAL links page. One initiative here in the UK which I must admit I have not attended thus far is Philosophy in Pubs. Many colleges also do courses were you do not necessarily have to sign-up for the whole deal - that is exams - but you can still enjoy what is a marvellous subject. I remember a lady of some 70 years who did just that with literature, she also beautifully shredded my unspoken thoughts on Sylvia Plath's Ariel and other works. So do go and check what's happening in your area.

Despite the significance of today it is troubling that the existence and value of university philosophy departments can be thrown into doubt as recently as March this year. I must check what happened in Liverpool? And also wonder what there is to learn from Eastern and African philosophy?

Monday, June 8, 2009

What wright to care?

At senior school I had the challenge and pleasure of appearing in Arthur Miller's The Crucible at the age of 15. My part was of course that of Francis Nurse. I can still remember most of my lines [as I didn't have many ;-)]. I have always been interested in drama, but even more so - dialogue, which helps as a member of this family and a mental health care professional.

Over several years, the above plus studies in literature and philosophy prompted me to dabble with dialogues of my own. One from way back when concerned nurse training and virtual environments; while another was set in Athens addressing the impact of informatics upon nursing.

The professionals of dialogue - playwrights - feature on BBC R4 Start The Week and this made me think of another dialogue as I recognised that my colleagues and I are in fact carewrights.

Now though with long term medical conditions, self-care, recovery, personalised care, individualised budgets and other policy permutations we are not just concerned with the words we say. With patients and carers seen and heard as experts no longer are we just putting words into their mouths - they are putting words in ours.

So together -
lets literally go taste the health and social care culture and break a leg!

Image sources:
book cover Amazon
Drama mask image: Saskatchewan Drama Association


Additional links:

Top 30 languages of the world

Top 20 countries by number of languages


International Mother Language Day 21 February


I note there are several instances of 'carewright' as a surname, trade / commercial name - my use and the context should be clear.

Sunday, March 1, 2009

Squaring circles: Compressed patient care pathways = rich(er) patient experiences?

The use of Lean and Six-Sigma, their combination and other service improvement approaches has resulted in much more effective patient care pathways. A shining example is that of diagnostic medicine and subsequent out-patient appointments, apparently patients can attend for diagnostic services such as imaging and on the same day also attend for their first out-patient appointment. This saves time for all, with expensive imaging technology also proving its worth and RoI by working from 0700-2200.

Trust Boards are well pleased with such progress, but there is no such thing as a free lunch. Managers and execs know the lunch (diagnostics and imaging) isn't free, but quantitative aspects aside what does does this mean in terms of quality and assurance? Quality in the sense of:
  • patient (and carer) experience;
  • staff capacity to find and take advantage of patient learning (self-care, patient health career management) opportunities;
  • assessment and evaluation of patient (carer) comprehension;
There is a circle to be closed by relating quality to quantitative aspects; such as, re-referral rates, re-admission, medication / treatment concordance, plus the infusion of intelligence from local and national patient related outcome measures [PROMS] to new patient journeys.

In information science there is the concept of information compression, taking out the redundancy - repetitive data in an image or text to save on processing, transmission, and storage. As Lean Six Sigma assists teams to remove tasks, processes that do not 'add value' then the result is a richer experience. The patient journey has in this sense been compressed. The patient has fewer hospital and clinic visits with fewer bus, taxi journeys, or they pay less in car park fees. Health personnel and specialists are primed to help and deliver services that really count.

What does this compressed - 'denser' experience - mean though? Does it mean that:
  • patient's are exposed to more information (2-3 significant interviews / leaflets / instructions)?
  • there is less time available for education, health promotion, info Px giving?
- or alternately:
  • does this 'value packed' patient journey help by providing rapidly successive hooks - experiential threads to integrate patient (carer and staff!) learning?
It will be interesting to see answers to these questions and how extensive the scope of benefits are of these patient experiences across different care contexts.

Is there an optimal number for 'clinical encounters' before things start to go awry?

PROMS are quite specific (as they need to be initially), but amid richer and varied patient journeys there will be a need for other (national and local) measures.
What about the extent and level of 'care complexity' and 'holistic care'?

Additional links:

Lesley Wright on lean thinking and respecting NHS staff, HSJ, Dec 2008.

NHS ready for PROM date. NDS News Distribution Service.

Image source: http://www.navyenterprise.navy.mil/knowledge/tools/sixsigma.aspx

Sunday, October 26, 2008

Working with the mind in dementia, not against it

The following (edited) item was posted to the NURSE PHILOSOPHY list by Phil Benjamin;
plus
Sandwell Third Age Art's DVD: ‘Fountain's Jolly Inn’:

You may be interested in a novel and sophisticated model for aged care in Tasmania. This model is based on a sophisticated psychological interventions based on an understanding of the intact affective life and needs of patients, even with the most severe cognitive disabilities - useful links below:

Dementia can produce challenging and erratic behaviours. The disease itself is one cause, but so is the world outside. Which psychosocial interventions really make a difference? And, a tour through an orthodox nursing home for the most extreme cases -- there's a bus stop with no bus, a car that won't go -- and it really works.
http://www.abc.net.au/rn/allinthemind/stories/2008/2390391.htm

http://www.adardsnursinghome.com.au/

http://www.adardsnursinghome.com.au/arnason.htm


Sandwell Third Age Arts DVD: ‘Fountain's Jolly Inn’

This film is about the making of a pub themed area inside a residential home for older people with mental health needs.

It was made by Paul Nocher.

The DVD shows how a little imagination can go a long way in creating an interesting and stimulating environment in a residential home and how the transformation of a space can enrich the lives of the people who live in it.