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The operating theatre tea party – read on to find out more 

This week I was lucky enough to be in the multi-disciplinary team involved in the care of women pre peri and post – Caesarean section . 

Lucky you say ? Aren’t midwives supposed to only be focused on PHYSIOLOGICAL  birth ? well yes that’s one of our roles but we also care for women in the antenatal period – we run triage clinics with the fab support of a skilled maternity support worker – running tests on women then contacting the Dr for advice with the results – pure team work . We also care for women in labour who have complex medical needs , complex mental health issues and we work WITH the obstetric team to find the best plan of care – we do this together with the woman’s input . I am proud of everyone I work with – they give me hope . We also work on birth centres and attend pool births . We are community midwives we attend home births , we support women who have safeguarding issues , women who live under the threat of Domestic violence and women who have disabilities. We manage wards , units , we are heads of midwifery , we are ward midwives , labour ward midwives , specialist midwives  and we are mothers , fathers ,single women/men  , gay women/men  , straight women/men  , married men/women , we are spinsters / bachelors but most of all we are HUMAN BEINGS .  

Each birth I see means a lot to me as a woman, a midwife and a human . I don’t judge a woman because she has a more complex or simple birth than the births I had – I’m in MIDWIFERY because I want women to feel positive about their birth experience and EVEN after this weeks news I am still determined to try my best to promote physiology in all birth settings . 

Anyway back to the operating theatre . 

The team in the operating theatre where I work are so together with the families they meet . They all know the importance of #SkinToSkin contact and how utterly important it is for the woman involved to hold her newborn asap . So the ODP makes sure that the woman tucks one sleeve of her theatre gown under her arm , places the ECG electrodes on the woman’s back and adds a mini – extension to the top of the theatre table so as to give the woman a greater sense of space to hold her newborn . The scrub nurse prepares a sterile space on the cot for the obstetrician to place the baby onto AFTER delayed cord clamping has taken place . The baby is dried on the theatre table and then placed on a sterile sheet on a cot with wheels – the Midwife assesses the baby’s condition at the side of the parents – so they feel involved and the baby is not weighed – we aim for skin to skin contact prior to 5 minutes of age – unless there are concerns with the baby’s health – both parents see the baby immediately and one of them cuts the cord . The other parent is then helped with placing the newborn on the mothers upper chest safely in a prone position and the midwife STAYS next to the woman and her newborn supporting them so that skin to skin can continue for as long as possible , I have piloted this and women who are supported hold their babies for longer – so I leave my records until we go into recovery area . Photographs are encouraged (as many as the family want to take) and also music . This week we asked a woman which music she’d like – we don’t yet have a Bluetooth speaker in  theatre just yet (watch this space)  so I put my phone on as Coldplay was requested . The consultant anaesthetist (Dr Richard Cross ) left the senior registrar in anaesthetics in charge whilst he was away for two minutes . When he returned he was holding a metal NHS supply teapot – we all looked puzzled 😕 . Then he carefully placed my phone into the empty teapot – this acted like a mini speaker and it was just the right volume for the family – but not too loud to disturb the surgeons and the safety in the theatre . 

What I’m trying to say is that this kind gesture was all for the family – especially the woman – we were making memories for her – she’ll always remember that she held her newborn , whilst listening to Coldplay from a teapot – what could be better than that 

Once safely in recovery (transfer to recovery area takes place with skin to skin ongoing ) we encourage birthcrawl by the newborn and praise the infants behaviour as this helps with the maternal connection . The woman is offered water quite soon after (unless she has had a general anaesthetic- in which case we wait until she is safe to tolerate water ) and then a cup of tea ( two half cups so none has the potential to spill onto the newborn ) and some toast which helps with enhanced recovery – we try to take our time with being in recovery as the woman needs more time to bond with her child due to restrictions on movement due to theatre drapes & position . 

Thank you Richard Cross and all the team in theatre for your kindness , laughter , compassion and care 
I hope you enjoyed reading this latest blog 

P.S what I didn’t mention was that there was a language barrier , but kindness , compassion and communication still took place – and the music connected us all ❤️

Happy Saturday -with love  Jenny xx 

r – Evolution in the NHS is happening right now 

Let’s go right back to 1980 the year I joined the NHS . I was a student nurse . My first ward was E1 a male surgical ward which was run like a tight ship. The captain was the sister and she ruled the seas – quite literally especially when I flooded the ward because I’d left the metal bed pan steriliser running during a ward round !!! 💦💦The consultant was paddling in his leather shoes, his trousers suspended at half mast like sails  – he never spoke to me but I was told off , humiliated and belittled. I wonder if that’s when I first saw the value of humour at work ?  Because suddenly the patients adored me ! Fast forwards 33 years to 2013 , you’d think I’d have learnt my lesson ! A busy shift and I was working on the beloved birth centre , women were spilling  into it because the delivery suite (a term I do not like – birth ward would be better) was full . A midwife friend asked me to keep an eye on the birth pool she was filling and I forgot as the woman I was with was overflowing with oxytocin and gave birth . So the best thing I hear is someone shouting ‘flood!’ Oops a daisy – run outside the woman’s room (not the room or my room – take note!) to find Mr Amu our lovely consultant standing in water laughing at me and saying “how do we sort this ?” My friend Carol the cleaner in hysterics with me as we rallied water suction machines , towels , sheets ANYTHING to stop the water moving further . Do you see the difference between 1980 and 2013 ? Now those of you who know me well know I’m a joker as I regularly shout to lovely Carol the cleaner “quick I’ve had another water incident !” Of course I’m joking and of course we laugh out loud and Carol tells me off – giggling . 

The evolution is happening because  as the years have passed social media has been accepted as a form of communications and is effective connecting more staff and service users than emails and/or phone calls. However much more than that NHS staff can find out what’s happening (or not as the case maybe) either within their own trusts or in other trusts they may never ever visit or work at . By sharing evidence, good practice  , learning from others and communicating openly we are slowly stamping out poor practice and improving quality . Patients talk to staff within an open forum , staff read more articles and are constantly trying to improve the patient experience . 

For me I think the lightbulb moment has been that I can make a difference , I can challenge practice and I allow myself to keep learning, growing and connecting . I’ll take you back to 1980 – all I knew was where I worked – now I see so much more-  and the wonderful people I’ve met on social media ? Well we would have never met ! So thank you social media from the staff and families of the NHS.

Let’s keep on evolving 
Thank you for reading 

With love  , 

Jenny ❤️

Sharing evidence in the NHS 

We’ve all been there – in a busy clinical area and a person or family  are advised there is a change in care due to clinical findings, investigations, laboratory results . Time is limited but each person being counselled varies in their knowledge, understanding, intelligence and how they process the facts that are  imparted to them. It can’t be a one size fits all but how exactly do health professionals communicate quality evidence to the people they care for and maintain an individualised approach? 

Several NHS trusts are going paperless with leaflets available on line. This is a way forward but we must ensure  there is access  to computer or a phone with wi-if access . Some health care users may not want to admit they are technophobic, don’t have a computer or laptop or perhaps cannot read and/or write. I promote the use of libraries and also show how to access the hospital free wi-fi . It’s important to flag the hospital wi-fi which should be available for all staff ,visitors and patients – Trusts that don’t provide this are failing their patients and staff . Access to wi-fi has been jokingly added to the Maslow triangle 
  

but on a serious note it’s standard in cafes, restaurants and hotels so please NHS follow suit – our business is hospitality after all . 

Questions to ask about giving information 

  • Is it relevant ?
  • Is it current ?
  • Does it link to evidence and research ?
  • Who decides how in depth it should be ? 

Giving a leaflet is simply  a starting point for a wider discussion it’s not a final statement . As health care professionals we should be constantly asking women and families “is there anything you need to know ? Any questions you have? ” as well as promoting a learning environment . We are helping women to become leaders for other women when we give valid , useful information out . There is no excuse for us to say  “I wasn’t asked” anymore. 

Health professionals must start the spark that gives the public a thirst for knowledge about their own health . I recently counselled a woman about carbon monoxide(CO) – she didn’t smoke but two of her close family members did . I offered them all Carbon Monoxide screening . The two family members CO levels were 1. Above 30 2. Above 25 . The non-smokers was 19 and wait for it I also measured my CO as a control – mine was 15 . I then realised I’d been in a closed room with the family for over an hour . The CO had affected all of us . This led to a discussion about the effects of smoking , the safety of nicotine but the dangerous effects of carbon monoxide and the way the tobacco industry makes an addictive product with hidden perils . The family chose smoking cessation as the results of the screening test surprised them (and me !)  I didn’t nag them I befriended them and helped them to focus on how they could remove the product from their lives and not their guilt . 

Below is a recent article by Jonathan Cliffe Midwife about personalising care for every woman – published in the British Journal ofMidwifery August 2016 . 

 

The current financial status of the NHS is forcing many  trusts  to cut back on small things, but I believe that it’s the small things that make the NHS wonderful. The fact of the matter is we are here to provide a priceless service to families, parents and people. If we keep our focus on doing the best we can do each and every day by imparting the evidence which applies to the individual , looking at how the individual might help us to gain new knowledge, opening our minds to  improving outcomes, valuing staff and patients alike  then the only way  that the NHS can possiblY move  is in a toward direction. 
I suggest you google “How to share evidence –  NHS”  you might find some valuable information to help your own NHS trust . 

Thank you for reading , please leave a comment .
With love , 

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 ❤️

Processes within the NHS 

There is a phrase “going around” that takes the impact of what it’s like to be an elderly person without support and this derogatory term totally dehumanises a very human situation. Talking about humans as processes instead of shouting out loud that caring does not start and begin in a hospital is like saying that once a person reaches 70 nobody really cares about them. The roots of care, compassion and indeed humanity itself  are intertwined into community , family life and neighbourhoods. Love and care begin at birth when the impact of instinctual kindness and love from one’s own mother is portrayed immediately at the moment of arrival by her display of emotions, indescribable craving and total need to hold her newborn child. It is my quest that every midwife, obstetrician and in fact anyone who is privileged to be there when a child is born knows this and thinks about it every second before birth occurs and is instrumental I helping to facilitate it or shout out when it doesn’t seem to be . 

NOW I’d like you to imagine that you are a senior NHS manager questioning your clinical leaders about how to address the problem of  “bed blockers” you are driven and you don’t tolerate excuses . Suddenly fast forward your own life – you are 79 years old and living alone . Your family live just far enough away from you to prevent a daily visit . You are isolated and feel depressed so gradually without any realisation of it , you stop looking after yourself . Your home becomes as uncared for as you are and then you fall . The reason for your fall is that you didn’t like the new slippers your granddaughter bought you for Christmas they were too much like shoes. You therefore continue to wear your old worn ones and on this particular day as you descend your steep unsafe-for-a-79-year-old stairs, your slippers “tread free” soles slip on the edge of a stair – suddenly you’re in flight mode. Your hip dislocates and your femur breaks – time to realise after your operation and recovery in a rehabilitation centre that you can’t get home. Mainly due to the fact that your family are away for a few days in France and social services have deemed your house as unfit for you to move back into . One particular day you are “sat out” in a chair behind some curtains and you overhear a Dr and an occupational therapist talking – your name is used and that familiar term “bed blocker” Is mentioned. The words ring in your ears from when you used to say them about others and now you are one. 

Did you know  when ambulance crews take patients to accident and emergency that they have to wait and cannot leave their charge until the care is taken over by the hospital team. I know this because last year  I worked with an ambulance team for a day . We were transferring a woman to another hospital & I was the escort midwife – once in another zone the ambulance was recognised on the radar and unable to leave each time a 999 call was made . It was like being in another galaxy unable to return to our own a sort of NHS antithesis to Brigadoon. So if SEVEN ambulance crews arrive at a particular Accident and Emergency department all waiting to handover the care of their patients -SEVEN ambulances are simultaneously  off the road-what’s to be done about this?

A few months ago I realised I was digressing from my ” #skinToSkin” work and asked a friend what I should do . Political issues were starting to interest me more , I felt more aware of care for people living with dementia . I had started reading about how mental  health issues are addressed and pigeon holed. Nick Chinn taught me about silos and I realised that the NHS works in silos. My friends reply was “keep going Jenny – as a NHS Midwife you have a duty to be political so that you can tell others about the day you spent with the ambulance  crew, why skin to skin matters to society and is a public health issue . To be frank I’d be more worried if you said you felt apolitical” 

So my friends let’s keep going and let’s keep championing good care , outing systems that don’t put the patient and/or family at the heart of what we do – one day that “bed blocker” might just be you . 

Thank you for reading please feel free to leave comments – your input helps me to reflect and develop as a midwife , mother and human . 

❤️Jenny ❤️

What Sparks Your Joy ?

I enjoy making my home feel like a warm welcoming place to my family and to friends as well as to myself  . A calm happy home gives me the ability to relax as well as work hard. However, I do own some clutter and although my home is clean I have spots that need organising . So this week I bought the book “Spark Joy” by Marie Kondo- it is about keeping items in our homes that make us feel joyous and getting rid of things that do not . Whilst reading it I was suddenly struck to consider what “sparks my joy” in midwifery? What should I cherish love and hold onto ? 

I would keep public speaking/social media , being an advocate for women , MatExp and being a mentor. I would also extol the virtues of being a “radical” Here’s why 

Public speaking and Social Media 

I really didn’t realise this until I spoke at Uclan to the future midwives and then at the Breatfeeding Festival in Manchester. Truthful feedback is imperative to me as it enables me to develop and see myself through others eyes. My focuses as a speaker are to impart knowledge , learn myself , inspire others to leave feeling they can make a difference and change the way they seen themselves perhaps to consider presenting themselves . I have to feel a positive sense of connection with the audience and I make a solid effort to achieve this as  it’s definitely important to me that presenting is a two way process . I ask questions and I learn from the audience . As well as talking about my passion for midwifery I also openly admit that I can’t know everything . I like to involve humor and also poetry – I feel so happy when others laugh and learn with me . The other reason I love attending conferences is that I network with other midwives and people who have a shared goal in making the NHS and especially maternity services even better . I see one of my key roles as tweeting at a conference to share the experience and agenda with the global midwifery network . I have made many real friends through twitter and I will continue to reiterate Eric Qualmans words “We don’t have a choice on whether we DO social media , the question is how well we DO it” I am privileged to have just written a section in an article with Teresa Chinn MBE about this topic . Teresa’s website HERE and she is the founder of We Communities which has changed the digital face of nursing midwifery medical and allied health professionals on line . Click HERE to find out more . I never in a million years realised that Twitter would connect me with such a community of compassionate and driven people . Social media is a vehicle that helps us to share information, learn and enable . This immeasurable crucial part of the infrastructure of global healthcare gave me the courage to become a blogging midwife and connect with the MatExp team but even more reinvigorated my passion to learn even more about midwifery the NHS , leadership , kindness  and start to cherish my own long hidden rebelliousness . Through THE SCHOOL FOR HEALTH AND CARE RADICALS I e found it’s ok to be radical and that change takes time and committment – if you want to learn more join the next cohort which starry this February – you will not look back (click HERE ) 

Being a mentor 

My other joy is being a mentor I love to ask future midwives how I can facilitate their learning and yet learn from them . I see myself as a radical mentor I talk about, teach and observe for compassionate care , courage and good communication. When working with students of any discipline  I feel it’s so important to hear their voice and also to be honest to them about obstacles they may encounter to prepare them for their future roles . I am a truthful mentor and it’s just so crucial that the first meeting is positive. My goal is to melt their fear or apprehension as soon as we meet  – to let them know that I am a teacher, a learner  and also that I am helping them on a journey . I do like to give spontaneous teaching sessions and find it hard to contain my excitement when future midwives tell me about  new research or publication. Mentoring also includes being a role model to peers , newly qualified midwives and reaching out to give others  help, inspiration and guidance face to face as well as through social media. I have several key mentors in my life and career who assist me through coaching and reflection which in turn aids my development as a mentor .  I love to hear news from colleagues and students as well as sharing with them new things I’ve read via social media , recommend blogs or books  to read and upcoming conferences . 

An advocate for women 

I will have been a midwife for 23 years this June. I see myself as constantly evolving and realise that I will never reach my destination – I don’t want to though I want to keep growing each day . By having this approach I  hope that I am open to women’s families and colleagues voices .I extol the long term and short term virtues and benefits of skin to skin contact at any opportunity .  Being a midwife means being a strong communicator and embracing oneself as an ambassador for global women . It’s about being current and modern despite age or experience – this ethos should apply to all who work in the NHS . Choice and consent should be embedded into our role as advocates . Cotinuity of carer must be a priority plus a positive communicative relationship  between the midwives  and  women all embedded into what we do just as much as a building needs a roof , windows , a door and warmth .  

MatExp 

Mat Exp is all about maternity experience . It’s a change platform where anyone can participate , discuss and suggest new ways to assess , plan, implement and receive care – putting the family first in Maternity services . MatExp is also about staff who are involved in this specialty and how we can improve their experiences too. This is why I adore it – everyone has an equal and valid voice – there is no hierarchy and ideas are constantly flowing . MatExp HQ exists in a virtual digital sense – it’s everywhere and a testament to the true power of social media . Due to MatExp I’ve learnt more about PostTraumatic Stress Disorder due to birth trauma which can affect men as well as women . I understand  more about the feelings of families when their babies have been stillborn or died after birth . I have been able to connect with women, families, health professionals and radicals to  spread the word about why collaboration works because we are actually doing it  . I have also met the most amazing people from all walks of life and feel I have connected with them in making a difference . Just search #MatExp on twitter or take a look at the website HERE to read about who is already involved and how you can get involved . 

So now you know what sparks joy in me- I’d like you to visualise Change as a form of  decluttering – it’s not necessarily forgetting about the old – but it’s making sure it’s archived so that we can look back as well as forwards and see why it’s so important to keep moving shifting and changing. Let’s make NHS care “Spark Joy” in the people that use it and the ones who work in it .

As a form of reflection think of four things that Spark Joy for you within your own work and life and write about them . 

Thank you for reading 

Jenny ❤️ 

Ps To my grown up children , my family and friends you also spark joy within me and you are and always will be in my heart – thank you ❤️

 The gifts we can’t unwrap 

Christmas and New Year are times when a lot of people seem to dash about . Their focus in this time of the year is to give gifts and to make sure that each gift is exactly right for the person it’s meant for . The New Year can symbolise a new start but for some it might be a time of difficulty and sadness if things have not changed or challenges still exist in their lives . 

It’s pressure sometimes to fulfil this aim and perhaps time to reflect on what other things we give to others throughout the year. So below I’ve written about a few things that I feel are important to give to others . These gifts are all priceless in their own way and can’t be bought but can be shared to help others to feel better about themselves . The gifts can be given to anyone – friends , family , those we care for , those we meet . 

TIME

Giving someone your time might mean helping them in a way you see as small when actually this will make a huge difference to that person . Sending a private message on Twitter, a text , a chat on the phone, a card or a letter  – it might not necessarily mean actually seeing each other face to face – but whatever you do shows the other person you care enough to contact them and let them know they are in your thoughts . I’ve just written an article about the concept of time in relation to midwifery for the January 2016 issue of The Practising Midwife ‘Viewpoint’. 

As humans it’s important to share your time in order to be an part of the way the world works – humans are made to socialise and to care for one another . 

Showing a woman or family that you are caring for that you have time to talk can be displayed in various ways  . As a social or health care worker sitting down at the same level as the person you are communicating with can show equality, empathy and is also a visible sign of listening . An open body language can also improve communication and break down barriers – looking at the person you are talking with means you are committed and have patience to wait for their responses – sitting with someone means connection and it symbolises ‘we are the same ‘ ‘I am here for you’. So many times those in  need require to know that we are committed to hearing what they need to say . 

I know a retired cardiac surgeon who always greets people with “Namaste” and he exudes warmth and kindness – it is a beautiful greeting but when he says it the meaning is real and tangible. He retired many years ago but still gives his time to the hospital to help raise funds and make a difference for others . 

Giving your time to someone else is a wonderful thing to do and it means you value that person well as a fellow human – it will also make them feel good about themself and you might be surprised to find it helps you just as much as them. 

Kindness 

What exactly is kindness ? It’s an understanding and openness that is a way of showing warmth towards someone – it’s asking someone if they are ok , giving a smile or a touch on the shoulder to let them know you care . I blogged about this HERE – on the importance of showing one’s heart .  In the book Roar Behind the Silence edited by Sheena Byrom and Soo Downe and published by Pinter and Martin there are numerous references to compassion and kindness .  Several chapters in the book are structured to help those in healthcare and especially the NHS to investigate the practice in their own place of work. We need to challenge the assumptions of others by putting kindness and compassion at the heart of care . There are many examples and ideas  to try and put these virtues into place in the clinical setting and I urge you to read this book and share it with your colleagues, leaders and managers. 

Hugs and Words 

To receive a hug from a fellow human is a display of care and also of friendship . I’ve received virtual hugs on social media and sent them to others and I do use a hug as a form of greeting to people I know . The other week I met someone in an emotional state and I said “do you need a hug ?” They replied yes & I felt the emotions spilling out of that person – we then talked and the hug helped her . I’m not saying hug everyone you meet but assess the situation and be humankind .  Kindness helps us to thrive . 

When someone wants to talk it’s good to listen and to avoid saying “you need to do this – you need to do that “. Words as a gift should be carefully chosen as most people remember not just the words but the way they are delivered . Think about the way you speak and the language you use does it depict a caring personality ? As a person who like to send letters and cards I try to give positivity through my words I thank my friends for supporting me and I consider how I speak and communicate when I am working. Try reading an email you are about to send to someone as if you are the recipient – how do you feel reading it now ? Would you change anything ? Does your email embody the values of the NHS trust that you are employed in ? Is it true to your beliefs and moral beliefs? 

It’s a good thought to hold in your mind every day that there are people out there who care and that good things are going to happen . If you are feeling low in the New Year tell a friend – contact a support group , go and see your GP – there are organisations, groups and individuals out there specifically trained to help . 

Take the first step , tell someone or if you recognise that someone is not their usual self spend time with them and be kind – you might just be the one who helps them start the journey of becoming well and addressing their problems 

I wish you all a peaceful 2016 – thank you for reading and I’d like to thank all my wonderful real friends I’ve met through Twitter , life and midwifery for all their kindness and positivity towards me in 2015 .   

With love , Jenny ❤️