The fable of the napkin folder 

There was once a factory in a far away land . The factory owner Fred  took immense pride in his factory .

This was no normal place to work , the employees had to fold napkins at the same time as caring for an elderly person . This care involved mainly talking to the elderly person and making the person happy through conversation – this was an intrinsic  part of their work – but I’d like you remember that  the employee also had to fold napkins .

Suki was an employee at the factory , she was an amazing napkin folder and the top napkin folder at the factory . The factory owner raved on and on about how good Suki was at her job – he promoted her and used her as a role model of efficiency whenever he went to other napkin folding factories . Suki felt very proud and kept working hard .

One day Suki’s chair broke – so she had to move to another area whilst it was fixed . Suki sat next to Giles who was also a napkin folder – Giles wasn’t very productive but he did attain adequate levels of napkin folding  to keep himself in employment . Suki noticed amazing things about Giles he was working but also chatting away to his allocated elderly person quite a lot , the elderly person was called Gertrude . Suki noticed that Gertrude looked very happy and Suki suddenly realised that all the years at the napkin folding factory her own allocated elderly person had never laughed like Gertrude . 

The next day Suki went to see Fred the factory manager and told him about Giles & Gertrude . “I think we should watch Giles” Suki said . Fred the factory owner went to see Giles and immediately noticed how joyful he was in his work – Suki was happy but Giles had that extra ‘je ne sais quoi’ . The factory owner also checked all the records of all the elderly people that Giles had sat with whilst he folded napkins . A wonderful thing had come to light not only had no one complained but there were letters of thanks from families of the elderly people stating how kind Giles had been and recommendations for his promotion .

The next day Fred the factory owner made an announcement to all the people at the factory  

“All of us within this factory should give a higher priority to making each elderly person happy  over and above folding napkins. In this wonderful life  we are simply spreading kindness , compassion and the human spirit . Look at Giles and Getrude and the happiness they emit and share . ”

Over the next few months the factory workers tried their best each day to give their priority to each of their allocated elderly people. A remarkable thing started to happen – productivity increased and surprise,y more napkins were folded than ever before  but also the workers felt more valued  and much happier about being at work – plus much more than that the physical and mental health of the elderly people involved took a significant improvement – because in the end we are on earth to be human .

I hope you enjoy my fable . 
Thank you for reading 
❤️Jenny❤️

#LeadToAdd 

LeadToAdd click HERE to learn more is the latest NHS England campaign # is #LeadToAdd. As a Caremaker I will be linking this on Twitter with my work on #skinToskin , #futuremidwives and #couragebutter to inspire others to see themselves as leaders regardless of their role . Patients, women, families and non-clinical staff are also leaders .  
I feel this will inspire/activate different meanings to different people

Here are some of my thoughts around it

What does to lead mean ? 
To take charge , to be at the front , to inspire , to educate, to be diverse 
Leading is about being at the front and CONSTANTLY looking back to bring others with you

Leading is about being the first to begin something but not necessarily holding onto that but looking at how your actions impact on the way others fulfil their role. Leading is being a positive role model, leading is about looking inwards at your own behaviour and also looking outwards at the behaviour of others . 

In the NHS all staff need encouragement to recognise themselves as leaders and also to see that some behaviours do not embody leadership. We are all learning each day, so don’t stay still – question yourself and the way you speak to others . Ask a colleague to listen to you talking to patients and staff and to give you feedback -what could you change ? Integrate telephone conversations into drills training-  talk to your practice development team – think outside the box . 

Someone who leads others into poor practice is a poor leader but a leader non the less so be aware of your own commitment to pass the positive leadership baton . We are human and it’s ok to make mistakes , however we must learn, evolve and change .

The other day I had a car journey with Joan Pons Laplana (@ThebestJoan on twitter) and once again he made me think hard about how the 6Cs are integrated into practice . Joan said to me that as a health care professional all tasks and procedures must embody the 6Cs – even answering a telephone call. 
As a form of reflection I’d like you to read passage one and then passage two
Passage One 
Busy labour ward – phone ringing , midwife answered the phone – we will call the person making the call Tony and his partner who is having a baby is called Dolores. The midwives name will be Darcy . 
Midwife ( confident and cheery) ” hello labour ward , midwife speaking how can I help you?”
Tony (nervous voice) ” oh hi – err my partner thinks she’s in labour , it’s our first baby and we are a bit nervous . Could I ask you some questions , she’s here but having a contraction right now and then she feels sick for a few minutes after its gone. 
Midwife “oh right well I need to talk to her please and decide what’s happening’  
I’m not going to continue this but could the midwife change her approach ? Is this midwife you ? A colleague? This approach has been learnt from a peer
Passage Two 

Busy labour ward – phone ringing , midwife answered the phone – we will call the person making the call Tony and his partner who is having a baby is called Dolores. The midwives name will be Darcy . ….

Midwife ( confident and cheery) ” hello labour ward , my name is Darcy Jones I’m a midwife and how can I help you?”
Tony (nervous voice) ” oh hi Darcy – I’m Tony – err my partner Dolores thinks she’s in labour , it’s our first baby and we are a bit nervous . Could I ask you some questions , she’s here but having a contraction right now and then she feels sick for a few minutes after its gone. 
Midwife “ok well I would like to take some details first whilst Dolores has a contraction . Thank you so much for ringing us . How are you feeling ? This is your first baby ? How exciting for you both!” 
I’m not going to continue this but could the midwife change her approach In either scenario – which is the best one in your opinion ?  ? Is either of these scenarios you ? A colleague? This approach has been learnt from a peer. 
So you see two examples each one leaving the person contacting  the service with different emotions . 
Start your journey as a #LeadToAdd leader today  ❤️
Thank you for reading 
Love , Jenny ❤️

The natural caesarean / the gentle caesarean 

There’s a debate on Twitter this morning about the ‘natural caesarean’ as a term that promotes a positive experience of birth by caesarean. I don’t agree with the term and I think as health care professionals working in the area of birth we should ensure that every birth is a positive birth . Milli Hill started the The Positive Birth Movement  with this goal in mind (@birthpositive on Twitter ) 

Bearing this in mind I’d like to ask the following questions for you to consider and share with with your colleagues, family , friends , midwives and obstetricians . 
1. How many women who have an emergency caeserean and/or instrumental birth (forceps or ventouse) are given information in the antenatal period about the far reaching health and psychological benefits of skin to skin contact in this setting to both mother and baby ? 

2. Compare the above with how many women are given information about  skin to skin contact around normal birth ? 

3. Compare both to how many woman are informed that skin to skin is possible during manual removal of placenta and repair of any perineal trauma in the theatre setting ? 

4. Are women informed 

  • They can TELL midwives to defer the weighing of their newborn in order to enjoy the benefits of prolonged skin to skin contact 
  • That they should never be separated from their baby unless a clinical situation becomes apparent or they themselves choose not to have skin to skin contact despite being FULLY informed
  • That their baby could ‘self latch’ at the breast without any handling by staff and also correct its own acidosis and stabilise its own breathing because of skin to skin contact ? 
  • That skin to skin and early breastfeeding “Pronurturance ” is linked to a reduction in the incidence of  postpartum haemorrhage?  CLICK RIGHT HERE for the Pronurturance paper 
  • That if babies could talk they would choose skin to skin contact despite their birth environment 
  • That skin to skin contact is the building block for a persons social and psychological development 

The midwives and staff on social media who talk about caesarean are not promoters of it , they are giving women information about choice – so that if the operation (which is major surgery) does take place then these women are able to not only enjoy their birth experience but give their relationship with their baby the best possible start . 

I suppose it’s similar to the question “does having a teenage pregnancy strategy increase teenage pregnancy rates ?  (and I much prefer the term  “young women”to ‘teenage pregnancy’) 

Does having full information about your choices if you do go on to have a caeserean increase caesarean rates ? I don’t know the answer to either of these questions but I do know that the women I have assisted and sometimes fought for to have skin to skin contact with their newborns in different birth situations have all told me this 

 
-that they never realised the positive impact it had on them as a successful mother

To me this is enough .   
Thank you for reading 

With love , Jenny ❤️

I am also promoting #MatExp as a platform which enables and encourages discussion between women, families and health care professionals . 

The Gentle Caesarean – Gentle with what ?

Last year I was lucky enough to work in a general theatre for a week . I met a wonderful general surgeon and watched him perform bowel surgery . I noticed immediately how gentle and kind he was with the internal tissues and how calm and respectful he was not only towards the patient and his body , but also the staff in the operating theatre. All the staff admired this surgeon – you know when you can just tell ?  

I asked the surgeon afterwards about his technique and he said this

 “I always respect the tissue Jenny- tissues , blood vessels  , muscle and skin are part  of our human make up and being gentle with them means I am showing tissue respect and respect to the patient who is a fellow human . Being a gentle surgeon takes longer but believe me the outcomes are better and I know that there is less trauma , post-op bleeding , infection, pain and therefore happier patients and staff .”

Currently there is a lot in the news and emerging research around “The Gentle caesarean” and I am looking at this from a different angle  (and for those who know me well I don’t do acceptance well – I like to ask things so that others unable to ask might think differently ) so I am questioning what this term “Gentle Caesarean” actually means . Does Gentle Caesarean mean just the moment of birth or should it be right from the decision or choice of the woman to have an operative birth through to arriving home ? 

So for all those who work in the field of midwifery , obstetrics , intra-operative care, surgery , pain management -I would like you to watch a caesarean from start to finish and ask yourself “was that a gentle caesarean from that the moment that the woman arrived in theatre ? Was there gentleness with the woman’s feelings and choices ? Did the obstetrician, scrub midwife and others maintain gentleness towards the internal tissues and the to the baby? Was the transfer to the bed from the operating theatre table gentle ? Was privacy and dignity maintained at all times? 

Just because we have always done something a certain way does not mean that “the way” is always the best . 

I hope I spark someone to change practice and make “The gentle caesarean” standard across the NHS because then it will spread  globally – we must question on a  daily basis what we do and why we do it .
Thank you for reading , please leave feedback and / or share this blog with your colleagues 
With love and midwifery kindness , 

❤️Jenny❤️
Addendum today I am thrilled that The Times journalist Katie Gibbons has written an article about skin to skin contact at Caesarean  CLICK HERE to access or being the rebel that I am here’s a photo 😁

 

The Cupcake caper by The White Rabbit 

A curious incident has reached our ears from Dublin. Late last night we had news about the International Day of the Midwife(5.5.16)…….. to do with … missing cupcakes!
It is a wonderful day, the 5th May- a day to rejoice for midwives of the world . It’s a day that  has grown in celebratory conferences,  meetings, greetings amongst and for midwives around the globe. 

Irish midwives are also up for the party, a terrific day of celebration which shares positive stories globally  about our wonderful profession midwifery –  for whom the future is looking bright. 

 We hear things are changing in Ireland at a great pace: a new national maternity strategy, community midwifery, midwifery led units, autonomous practitioners, midwives really able to be ‘with woman’ at last. 

A thoughful gesture added kindness compassion to the celebratory day . This gesture was a delivery made to the three great Dublin maternity hospitals. Midwives love cakes and these cakes were no exception.Beautiful cupcakes painstakingly baked with love and affection as a thank you to midwives. The photos of the cupcakes almost went viral on Facebook , showing  the smiling face of a happy young boy helping his Mum pack the cupcakes into their boxes. 

By mid-afternoon, there were delightful pictures of midwives sharing their cupcakes. In Merrion Square  a little boy welcomed back to the hospital where he was born,”thank you midwives” he grinned happily. Off to the “Essence of Midwifery”  conference went the cakes and their makers . Michel Odent sits with the little cupcake maker ..oh joy…midwives are eating cupcakes, did Michel have one too?

Is this a tea party?

No, wait! News from the hospital which in 1916 overlooked the great rebellion, we hear shocking news! The cupcakes left sitting on the midwives’ desk were there one minute the next minute they’d vanished ! Gone ! confiscated! Not allowed! “Don’t Eat These Cupcakes!” How had the cupcakes crossed the line into the hospital? There must be a Full Investigation! 

Where did the cupcakes go? Were they stolen? What will happen when the Full Investigation has concluded? Will there be a trial? Will Alice in Wonderland be there to declare ‘Stuff and nonsense’? We can only hope. 

The cake caper mystery ……  who stole the cakes ? 

…….. To be continued — perhaps  

 

This story has no connection with me whatsoever – I was told it and I agreed to put into my blog so that others might question the way that gifts which have no benefit except to try and raise others spirits must not be seen as suspicious – we are after all humans learning  the best way each and every day ❤️

Aiming and succeeding – the journey of others  

Today I’ve been reading a lot on the Internet and twitter about “The Secret” which is a dramatisation of real events that took place in Northern Ireland in 1991  -a tragedy that totally disrupted and still continues to affect the families of the victims . 

The courageous daughter of Lesley Howell (Lauren Bradford) tried her best to stop a programme going ahead . This programme has been advertised and aired on ITV as a “drama”. The drama is based on a tragic event that tore through the hearts of the families involved as well as their respective families and their friends . Lauren decided to make her own voice as well as others heard and wrote an outstanding, impactful letter to The Guardian about why she disagreed with the “drama” and the unforeseen effect of it being on aired on TV  would cause . The letter is  HERE

I feel that Lauren has written this letter to ROAR for her own mother  Lesley , a wonderful, strong, kind   and giving mother. Lesley’s voice was silenced by murder and so she cannot speak for herself about her life or how much her treasured children meant to her . Much more than this however Lauren has given other victims the chance to see that they too CAN  and MUST  speak out   – so in writing her wonderful letter she will have helped others to realise that their voices WILL  be heard . The media must no longer hold the power of ‘story telling the lives of others’  in order to make money or gain viewers or readers, they must realise that they don’t know the story so therefore it will never belong to them -it’s not their story after all is it?

Speaking out as a victim must be very difficult – which newspaper does a victim approach ?  Which TV company ? How does a victim ensure that their views enable others to empathise with their true story? Here’s how – be like Lauren   – write with truth and dignity in your heart. 

I am so immensely proud of Lauren  because through her words and thoughts she is actually helping others who may not be able to speak out to also have their voices heard . In addition to this Lauren is encouraging us all to think differently about how cases are reported and written about . How can it be right that a person can actually make money from someone else’s tragedy ? 

Thank you for reading and please leave your thoughts and comments on Lauren’s article . This will to help the media see there are two sides to every story .
❤️Jenny❤️

Tales of my aunt 

I have been spending time with my auntie Anne (my dads sister)  . She’s over 100 years old and very strong willed , positive, agile, intelligent  and bright . As I’ve got older I always connected more with my mums sister and her husband Auntie Hilda and Uncle Bill) and they were always delighted to see me . Sadly my dear Uncle Bill  died last year after years of missing my late Auntie Hilda – I was heartbroken but I have happy memories of making wooden hearts with home on his jig saw machine and  long conversations on my mobile phone from his landline when he’d ring me and chat . He used to press coins into my children’s hands and say “buy yourself something , your mum needs money for food and your home” 

My younger sister clicked more with my Auntie Anne. Despite this I’ve always loved my Auntie Anne it’s just that we don’t realise the way that time passes . One day we are wondering what job to do and the next it’s time to think about a retirement plan . We miss seeing others and spending time with them whilst we are busy planning our futures . 

Back to my story – around  Easter time my Auntie had a fall and broke part of her pelvis (the superior rami to be exact) . I had to help so I offered my support to her daughter Judi and went to stay for a couple of nights so that Judi could go home  . 

Whilst I was there I learnt a lot about my late father and the tricks he’d get up to . It turns out he was a bit of a rebel . He kept mice in the coal shed and use to take two into school with him up his sleeve. At the age of eleven he cycled to Scotland with some friends because he’d always wanted to go there . I then learnt about other things – my dad Ralph worked  as a car mechanic and was badly electrocuted an accident which led to him developing a pleural effusion . He was sent to a Strinesdale Sanitorium as part of his recovery . I googled this place and found a diary which may gave me a small insight into his week’s spent there click HERE to read (bear in mind this was years before the NHS was established)

Anyway back to my auntie … 

My Auntie was sent home with greatly reduced mobility , the hospital in Manchester did not provide an ambulance and she had to crawl up hard concrete  steps to get to her flat .  Once inside she must have felt utter relief . She was with her daughter and my sister . My auntie told me that she hated being in hospital , that staff were not visible , that times had changed and she was glad to be home despite pain and worry about how she would recover more now because she was HOME.  The staff had even argued with her about her medication and what time she should take it . 

What strikes me about this true story is that my auntie does not complain lightly her mantra is and always has been “you’ve just got to get on with it ” . My Auntie is not soft , but she is human . I would like to know how discharge planning is ” we need your bed by 6pm and we can’t get hold of your daughter”

The decision to send my auntie home  was a rushed decision without discharge planning , thought for her amazing daughter and a total lack of insight . The discharge process should have started in collaboration with my Auntie as soon as she was admitted  – it didn’t . Strangely though I am glad for my auntie because she is recovering and she is safe . What about the other elderly people sent home like this with no family or friends to help them ?  My auntie is still waiting to see a physio , when my cousin rang  the GP the other day he said “I am NOT speaking  to YOU!” 

Let’s move onto to ‘carers’ . For six weeks my auntie is ‘entitled’ to support from carers in the enablement team . They assess DAILY whether my Auntie is improving . My argument with this approach is that there needs to be time for recovery to take place. This is a catch 22 position – here’s why 

1. Assessment cannot be during recovery – for example a midwife cannot assess the mobility of a woman immediately  post caesarean – it has to be done over time , using analgesia and when the woman is safe to mobilise . There must be clear information and evidence given to explain why post-op mobility is important but staged . Recovery is a human process and as each human is different so must each recovery be individualised according to age , pain , psychology , support and  love . 

2. Telling someone you are there to watch their progress is a watching role  so why not  call carers  who are employed to observe  and not give care “Watchers” 

3. The carers or the “watchers ” told me and my cousin ( we shared stories and reflected ) that by being there we were affecting their ability to assess my auntie . So I said to them “so do you think that to make your job easier either Judi or I or whoever is with my auntie is going to walk out and stay out so that  she can struggle the others hours that you don’t come ?”  My question is did the carers see our presence as an inconvenience to them not a benefit to my Auntie ?  

One particular carer came into my aunties flat did not say hello to my auntie and then said  “are WE getting dressed ?” To which my auntie replied “no WE are not ” ( I giggled ) 

Another day a carer came in hugged my auntie and they had a lovely conversation about eye conditions and I saw the light shine from her heart into my Aunties sparkling eyes . They connected and I could see and feel their mutual respect . A much nicer experience for my auntie than the day before when another carer striped my auntie off (apart from her knickers) and sat her on the loo and left her  to get on with a wash unaided . No cover or towel – I walked into to the bathroom covered my auntie and said “would you like me to wash your back  Auntie ?” Bear in mind I have never seen my auntie naked before. Was this carer respecting my aunties decency and dignity ? When the carer (watcher ) heard me she walked into the bathroom and said “I was just coming to do that ! SHE (meaning my auntie ) needs to get one of those back washers on a stick ” 
So I’m writing to the trust involved (in Manchester )  and I’m also adding that there must be some sort of regulation for carers . My aunties “carers and watchers” team  are not NHS – they are an agency with a contract -aye  there lies the rub . I must add that there ate two women in this team that  that stand out   head shoulders  and ❤️hearts❤️  above the rest . They told me that they don’t fit in because they love their job – now there’s food for thought . I’m glad the agency don’t allow theses two women to work together as that way they will reach more people with their kindness care and compassion . 

This blog is simply to help those involved in discharge planning for the elderly . It’s to help you  learn from patients and  relatives . Also it’s to try and identify where the communication and compassion  gaps are and how we  can do our best to try and fix them 
Thank you for reading 
❤️Jenny❤️