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Phil-on-a-bike's Latest Activity

  1. Phil-on-a-bike

    Payrise - well, not really

    Interesting post-script to this: our local Unison branch have distributed flyers to all departments 'clarifying' the figures. The text of the flyer says that they're doing this in response to the wave of enquiries generated by the RCN's misleading coverage of the subject. Wow. Just... wow. Our profession may have been - once again - bent over like the new boy in an Alabama prison, but let's not lose sight of what's important here... scoring points off rival professional organizations. Unbelievable. And this is a glossy, 3-page production, too. I mean, sure, somebody desktop-publishing savvy, with pre-existing publication templates to hand, who was prepared to drop everything and work on this as soon as the RCN's press release came out, could probably have produced this in response. What I'm saying is: if you told me they had this written in advance and ready to go... I wouldn't automatically dismiss that possibility. Just when we need our professional organizations to present a united front, they're squabbling like infants. If anybody needs me, I'll be playing Billy Bragg and listening with a mix of bruised idealism and rueful cynicism.
  2. Phil-on-a-bike

    Cartoon Caption Contest WIN $250! Nurses Week 2018

    The day was saved by swift administration of a Triple-H enema. Five minutes later, Mr Jenkins was far too scared to cough...
  3. Phil-on-a-bike

    Avoid the UK

    It was unjustified and unnecessary because... and this is not rocket science... those nurses who wanted to pursue an academic path already had access to further development. There were already existing degree paths in nursing science. Most Trusts already offerred financial support and study leave for their staff. The UKCC - as it was then - were 'addressing a problem' which didn't actually exist. The drive to academicize British nursing took one entirely valid career option... and tried to make it the norm for the career development of all RN's. In doing so, they managed to eradicate the State Enrolled Nurse discipline entirely - something that should have been entirely beyond their remit to decide. It's not just my opinion that this was a retrograde step: The re-introduction of non-RN para-nursing disciplines shows that the genuine, real-world need for clinically trained but sub-degree nursing staff still exists. I thought it was horrifyingly obvious right from the get-go that the workplace gap left by the needless discontinuation of SE-nursing would have to be filled. (Maybe I'm psychic...?) Of course, the concern remains that AP's, ODA's etc are unregistered. And the NMC stands ready to address that by floating ideas for registration of para-nursing staff! At which point, the wheel will have turned full circle, and we will start looking elsewhere for new ways to flush the NHS budget down the macerator. "Mopping fevered brows and giving out bedpans"? Really? Cheap shot, Madeline. But let's turn it around: Do you really think all nurses need to be able to identify in which respects their clinical area satisfies Kolb's defined paradigm of the 'Behaviourally Complex Learning Environment'? Yeah. That's going to heal a whole lot of venous ulcers. But make no mistake - I was, and remain, firmly in favour of genuine advancement of Nursing as a profession. In my opinion, however, academia was absolutely NOT the way to go. I think the profession, and our patients, would have been much better served by a drive to advance clinical skills. I'm happier working with nurses who may not be able to define levels of abstraction in interactions between concepts - but who are not baffled when confronted with a vacuum-dressing set-up. Less nursing theorists - more nurse prescribers! Thing is, though... clinical skills are hard. Hard to perform effectively, requiring regular practice to stay effective, taught and evaluated by highly skilled and experienced practitioners, and with actual, serious clinical repercussions when they go wrong. Who wants that, right? I mean, sure 'nursing wants to be taken seriously as a profession', but only insofar as we can achieve it by going and sitting in a classroom.
  4. Phil-on-a-bike

    Has anyone heard about the new movie called "Constipation"?

    You do realize what a constipated mathematician does, don't you? That's right. He works it out with a pencil.
  5. Phil-on-a-bike

    Avoid the UK

    Duly noted - I hunched over the keyboard well into the evening on Wednesday writing an Individual Submission to the Committee. Seven points: * 2015 NHS pension changes (from 'highest salary' to 'career average') led directly to the en-masse retirement of our most experienced staff - this was widely predicted and could easily have been avoided if the pension changes had been rolled out progressively. *The discontinuation of the bursary for nursing students makes it financially advantageous to choose almost any other career path in preference to nursing - the timing of this measure means that even if it were reversed immediately, we have already sufferred one vastly reduced intake of students, and will likely have another short intake before any remedial measure takes effect. This will result in a catastrophic shortage of RNs circa 2020/21. *The NMCs OSCE fees are prohibitively high and a deterrent to overseas-qualified RNs. (I compared and contrasted with other nation's fee structures, including the USA's CGFNS & NCLEX fees, to illustrate that other nations are now far more attractive prospects for overseas-qualified RNs) I pointed out that, unlike the previous system (Overseas-qualified RNs worked in a reduced capacity, at a reduced rate-of-pay, with support & supervision, for a probationary period, on completion of which their overseas licence was recognised) the NHS workforce gains no benefit from the OSCE system. *Concern about the deterrent effect of uncertainty about the post-Brexit status of EU-qualified RNs working in Britain is a problem without any possible solution, insofar as a degree of uncertainty is bound to persist until after the post-Brexit situation solidifies, and no amount of Pre-Brexit reassurance will change that. The Brexit timeline means that EU-qualified nurses seeking to work in the UK is likely to reach a low point at the same time as the numbers of UK-qualified RNs reaches its low point. *Para-nursing disciplines such as Nursing assistants, Operating Department Practitioners and Assistant Practitioners will play a far larger part in hands-on clinical care, and because said disciplines are not registered, 'sign-off' accountability for their practice will devolve to nurses whose role will change to accomodate this. RNs are likely to become managers for teams of para-nursing carers who will perform the actual hands-on care. I pointed out that the former system of two-tier nursing - State Enrolled Nurses and Registered Nurses - was superior to this, because it provided two tiers of registered, licenced practitioners, whist reflecting the reality that not all nursing care tasks require an RN to perform. (I also pointed out that this efficient and serviceable system was dismantled by the unjustified and needless drive to academicize British Nursing.) *Agency staff should be recognised for their contribution and not used as scapegoats for NHS Trust's failure to recruit and retain staff. At a time when zero-hours contract workers are being portrayed as exploited and deserving of protection, zero-hours contract workers in the health sector are portrayed as parasites. Disingenuous hospital management bemoan the higher hourly rates of agency staff, while failing to mention the saving they make in not having to pay for holidays, maternity, study leave, sickness, benefits and pension contributions. *The future of UK nursing is Scottish. The absence of tuition fees for Scottish students means that nursing remains a vastly more attractive career option in Scotland than it does in the rest of the UK. The implications are that well-staffed Scots hospitals will find it easier than their staffing-crisis English, Welsh & Northern Irish counterparts to acheive high CQC ratings, meet targets (and secure the funding which accompanies that) attract top clinicians, research projects and to acheive 'Centre of Excellence' status. That - in seven assorted nutshells - is what I submitted to the Enquiry Committee. If anybody's got any petitions they want signing now's the time to ask, because it appears I'm in concientious mood and that won't last.
  6. Phil-on-a-bike

    Permanent contract or full time bank nurse?

    Hi Rosmbre, The voice of experience here: I did this for eight years, and I loved it. BUT: there are a couple of points you might want to bear in mind. First, your reluctance to join an agency. Seriously - get over it. Why? Because - I cannot stress this enough - DO NOT GO ZERO HOURS WITH ONLY ONE SOURCE OF WORK. I was on the bank at my local NHS Trust - I was also on the bank at our neighbouring Hospital Trust - and registered with an agency. With those three sources of work, I was never once in the position of wanting to work, but without available shifts. With only one source of work, things are entirely out of your hands - you have to take what you can get, and go without when there's nothing available. That's like crossing your fingers and calling it a viable career plan. Second, your lack of interest in working other departments - get over it. A major part of bank nursing is the ability to walk in to an unfamiliar department - make a good impression - orient quickly - fit into the team and the system - and start contributing right from the off. It takes some front - but you're an A&E nurse - you've definitely got the bottle for this. I reckon it does wonders for your confidence as a practitioner. Plus - how are you going to find out what clinical areas and specialties you enjoy, if you don't try them? I guarantee you'll find other units you enjoy working on. You'll find others less satisfactory.... and you need never go back to them again! I would not worry about lack of access to training. Make enquiries - I'm sure your trust gives their bank staff access to training. (Ive never met one that didn't) And since you can pick and choose your hours, you can attend whichever training sessions are most convenient. Similarly, any agency will have training - usually via an independent training contractor - to keep you current with your mandatory subjects and your revalidation. And not all agency work is a last-minute night shift at St. Incontinentia's. I did my fair share of that stuff, but I also did shifts on a movie set, Occ. health shifts at shipyards, Steelworks and a Police training facility, nurse practitioner at a walk-in clinic, annual vaccination programs at a college and an army base, health promotion work at Uni Fresher's week, my first taste of clinical research - loads of fun stuff. Not just one-off shifts, either - six month contracts, I year contracts, holiday cover, maternity leave cover - it's not all "a day here, a day there". IF you're going to do this - and it's not for everyone - then forget working for one bank at one unit. You'll get nothing but crumbs from the table. Go big - register with multiple sources of work, and try different things. Hope that helps!
  7. Occasionally, when somebody asks me if I'm carrying the keys, I say; "Nah, it's just the way these trousers hang."
  8. Guys... it's Craigslist. The only 'Doctor' I know who regularly gets work from Craigslist is "Doctor Stripoffsky MD", and he's not technically a doctor.
  9. Phil-on-a-bike

    Feeling Bad Looking for Another Job

    The closest thing to a genuine revelation I have ever had is realising this: We choose our reactions. Take a moment, look in your emotional playbook and choose a new outlook. Personally, I'd reccommend getting 'excited about moving on'. That's always worked well for me!
  10. Phil-on-a-bike

    Why do patients.....?

    Random thoughts, from in my brain-jelly... I have every sympathy for patients who cannot swallow a handfull of pills at once - I know I couldn't - and for those who lack the dexterity to pick them out of the medicine pot... ...however.... If that's the case, what's your alternative method? You tip them into a tray? Fine. You spread out a tissue and pour them onto it? Spiffing. But all too often the alternative method is: tip them out onto my bedspread and watch glumly as they roll off onto the floor. Or: tip them out onto a hand - which you were last able to hold anywhere-near-horizontal when Max Headroom was a thing - and watch glumly as they roll off onto the floor. How did I know that was going to happen? 'Cause that's what happened yesterday. Frequently, "How I take my tablets" is actually "How I spill my tablets". I don't mind going along with any personal method of tablet taking, as long as your personal method works. As for questions... Doctor: So, your blood's a little thin at the moment, and we're going to stop your warfarin for a couple of days, then check it again. I've prescribed you a new tablet called a statin, to help lower your cholesterol a bit. Is there anything you'd like to ask me? Mrs Jenkins (Beaming beatifically): No, thankyou doctor... Doctor: Lovely, well, I'll see you tomorrow. (turns to leave) Mrs Jenkins: No, I think I'll wait 'til the 22:00 med round, when everybody's hitting the call-buzzer simultaneously and every IV pump's alarming, and somebody's pulled out their cannula and there's a code brown of epic proportions going on, and the lady in the bed opposite has gone very quiet and a bit grey, then I'm going to ask where my little brown ones are. I always have the little brown ones. And what's this one? I don't have that. These aren't my medicines. I'll need an antacid. Taking tablets always gives me heartburn. Doctor: What was that? Mrs Jenkins: Nothing......
  11. Phil-on-a-bike

    True ER stories

    For anyone who doubted that the 'Benny Hill Show' was, in fact, a fly-on-the-wall documentary series: Night shift, central London Accident & Emergency, circa 1990. Blue-light ambulance for an adult male with sudden onset chest pain. The patient turns out to be none other than our own hospital's Head Porter - a strapping, square-jawed, crew-cut six-footer in his late forties. I'm attaching ECG leads to his ankles, when.... hold on... what's this? Sheer black nylons. Painted toenails. Of course, neither of us says a word about this, and - carrying on as if it's the most natural thing in the world - I suggest that he may want to change into a gown. Into a discreet patient property bag go his clothes, including, as it turns out - a black lacy suspender belt. ECG performed, I get some acetone for the toenails, and he tells me how he and the missus were enjoying a lively bit of 'role reversal' when the chest pain struck. His wife called 999 and they set about getting him changed... but the ambulance arrived before they could get the stockings and sussies off! He hurriedly pulled a pair of pants over them and just styled it out. More power to 'em, I reckon - upholding the fine old English tradition of behind-closed-doors rampant deviancy!
  12. Phil-on-a-bike

    Northern Ireland Nursing

    Hi Enairarian, I spent 2012-13 working in a rural area of Fermanagh, a few miles outside Enniskillen. I enjoyed NI - but I do have a great deal of experience of working away from home for long periods. A lot depends on whether this is your first time working away. If it is, then NI's not the easiest way to start. Apart from Belfast, the towns are small - if you're used to a big city, you may find things a bit quiet. Also, it helps if you drive. I ran into just one incident of (anti-English) racism. It happens. Among my colleagues was a nurse from Barbados. He had no trouble at all in Fermanagh, but he transferred to Portstewart and said, unfortunately, that he did encounter some abusive behaviour there. Generally, the people in NI are brilliant - very welcoming and helpful. I have to say, though - I trained in London and lived there for a few years. London's brilliant. If you get the chance to go to London, I'd say make that your first choice. Hope that helps!
  13. Phil-on-a-bike

    Is Faith Enough?

    Thanks for your civil and reasonable swing at my pitch, Chryssa! Random thoughts, in the spirit of chewing the topic over in a friendly way: I've always disliked the 'I sent a boat, etc' trope, for two reasons... First, the 'seeing evidence of G's handiwork in everyday events'. To me, this suggests the mindset of a medieval peasant! A partridge flew widdershins round the watermill on St. Swithin's eve? It's a sign! Perkin Thickett overturned his spelt-bucket, and the grain fell in the shape of a benedictio? It's a siiiiign! This is looking for omens, pure and simple, much as the Greeks did in the entrails of sacrificed animals, the Romans in the patterns of smoke from burnt offerings, or the ancient Britons in the blood-spatter of human sacrifice. Granted, you're looking for small moments of happiness and optimism in everyday life, but make no mistake, you're looking for omens. The insidious thing is - those who choose to go looking for omens will always find them. It says nothing about the supposed "cause" of these so-called omens, but it says a great deal about the person looking! Also - have you noticed how geographically convenient omens tend to be? Child pulled from floodwaters in Uttar Pradesh? It's a sign from Vishnu and the 330 million divine beings of Hinduism! Child pulled from floodwaters in Louisiana? It's a sign from God! A cynic might even say that these are everyday events being interpreted as confirmation of whatever belief system is locally prevalent anyway. Second: here's how I see things from the perspective of the Guy With The Boat: "I'm going to help. My community is in trouble, and I identify as a part of that community. My parents raised me with a sound set of values, and I know they'd want me to do the right thing. I can see my neighbour on the roof of his flooded house - personal friendship and common humanity move me to help. Normal, healthy psychology gives me the ability to empathise with others and being part of a functional society has shown me the benefits of altruistic action, and to be mindful of how my actions will be viewed by the rest of society. And my culture is one in which personal bravery and selfless action is celebrated. In short... pass us me wellies, Gladys; I'm going to get roof-guy off his roof." BUT... the point of the story is: LOLno, none of that matters, free will is irrelevant, individual human morals and societal mores count for nothing, God sent you. By magic. Wow. Seen from that POV, it's one depressing story. On to "ignorance", "hatred", and "psychopaths" as reasons for flying planes into skyscrapers: "Hatred"? Granted, but so what? Those engaged in any sort of conflict usually hate their perceived opponents. "Ignorant"? I'd be careful with that label. The average Middle-Eastern activist has a thorough knowledge of the sociopolitical situation in a region which the average American can't find on a map. These guys learn to recite the Koran by heart, in Arabic - even if Arabic is not their first language. If somebody had studied the Bible so thoroughly they could recite it by heart - in its original Greek/Latin/Hebrew - would you seriously describe them as 'ignorant'? I'd consider the possibility that rather than being 'ignorant', they may be, y'know... religious. The 9/11 hijackers included several university graduates including an architect, an Imam, the son of an Imam, several war veterans from the Bosnian and Chechnya wars, and men who were trained agents who'd operated successfully from the Phillipines to Malaysia. And yes... one guy with a history of mental health problems. Lastly, psychopathy: It's maybe a tad undiplomatic to ascribe so much of the world's problems to mental illness... on a Nursing Forum! But since we're here, I think it boils down to this: holding a radically different view from you in the matter of religion is NOT a definition of mental illness. But here's the thing: hatred, ignorance and psychopathy are equal-opportunity phenomena. They occur right across the board, affecting the religious and irreligious, believers and non-believers alike. So... That being the case... Where are all the agnostic suicide bombers? Where are the atheist mobs lynching albino children in Africa? Why don't the religiously uncommitted bomb abortion clinics? Why is Joseph Kony's organisation called the "Lord's Resistance Army" rather than the "Humanist Resistance Army"? Face it. There are several irrefutable common threads which run through violent extremism, and one of the strongest and vilest is that of religious faith. Okay, where are we? Red/green colour blindness? Taken "on faith"? Really, that's how you'd describe it? I'll see you one better: There are some parts of the light spectrum that nobody can see. X-rays, for example. So... do you really think we "take it on faith" that there are such things as X-rays? Or.... do we actually have plentiful, solid, verifiable evidence that they exist? I'm going with option 2. Lastly, the dog-whistle? Now, I'm aware you're not being literal here, I do realise it's just a metaphor, but... I would respectfully point out that you are employing the same argument you just refuted when applied to 'planes into buildings'! You weren't willing to entertain the notion that violent extremists are 'receiving a signal which you cannot hear' when it comes to religion. Anyway, enough of that. Please give your dog a good rub behind the ears and a nose boop from me! Cheers, Phil.
  14. Phil-on-a-bike

    I thought I had heard everything..

    That brought back a long-forgotten memory: Near the hospital where I trained, in London, there was a Chinese restaurant owner who entertained the diners with his Elvis tribute act: Paul "Elvis" Chan. (IIRC, His restaurant was called 'Gracelands'.) He was quite the local celebrity. As to the original's state of health... I've got a copy of 'The Elvis Cookbook'. If he even ate half of this stuff, then trust me - he's dead.
  15. Phil-on-a-bike

    Is it wise to leave my first nursing job after 2 months experience?

    Always tough to be left unsupported, regardless of the circumstances. On a purely practical level - it's entirely doable to give notice and move elsewhere. The demand for qualified staff is high and you will find another place. There is no need, in the present job market, for qualified staff to put up with a situation they're not happy with. I suggest you 'look before you leap', though, and look at job opportunities back home, online. 1: It does no harm to look 2: It's best to get an idea of what the job situation back home is like before making any decision 3: It may make people sit up and take notice if it's known you're looking for alternative employment. While it does no harm to look, you should certainly inform your line manager that you intend to apply for other posts, before actually doing so. It's professionally courteous, and again - it might make them sit up and take notice, and maybe even address some support issues. After all - it's only fair to give them the chance to put things right. Maybe they'll come up with a level of support that makes you feel happier about staying. If you let them know you're thinking about moving on - and they don't improve your support to a level you're happy with, my personal feeling would be to go. Life's too short to put up with a workplace situation where you're personally unhappy and professionally unsupported. (Disclaimer: I'm the sort of person who thinks nothing of packing up and working a year abroad if I'm feeling a bit bored, so I have less problem than most people with the idea of moving on!) IF you want to 'take a few months break', I would strongly advise that you at least register with a nurse bank or agency back home. Then you have a source of income to ensure your welcome break doesn't turn into a problem break! (Also - registering for your local hospital's Nurse Bank enables you to apply for their internal vacancies, as well as their externally-advertised vacancies.) Hope that helps!
  16. Phil-on-a-bike

    8hr Shifts vs 12hr Shifts

    8's all the way! My department includes staff who work 8-hr shifts and staff who work 12's. I've heard the "I only work three days a week!" mantra many times. Here's something to think about, though: At the end of those three 12-hr shifts... I take handover from those staff. They're visibly exhausted, flustered, distracted, disorganized, short-tempered and dishevelled. Here's the bottom line, 12-hourers: You're a train wreck. And the thing is: you don't see it! You don't see it, because it's crept up on you gradually over thirty-six hours of solid work. But it's immediately apparent to the rest of us. And - no offence - but I don't want to look like that. I've done my share of 12-hour shifts. I was in my twenties, very fit, highly motivated, full of energy and for all I know, quite possibly bulletproof. Plus, I was working overseas, and I wanted those extra days off to Road Trip my new surroundings. And short term, it was perfectly viable. I know better than to think I could pull it off now! There's another point: we are - supposedly - an evidence-led profession. The evidence is hard to quantify, because we're mostly looking at subjective, quality-of-life criteria, but: what data there is associates longer shifts with increased incidences of poor care, adverse events, patient safety issues, and occupational hazards such as needlesticks and musculoskeletal injuries. link to a Nursing Times article citing some of those findings: The 12-hour shift: friend or foe? | Practice | Nursing Times

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