Saturday, April 05, 2014

Phil Johnson speaks against Celebrity Christianity

I am not normally a staunch proponent of John Macarthur or the Shepherds Conference (see previous posts on "Strange Fire") but I am so grateful to Todd from Dubai for this.  He is right - it's excellent, and something I am becoming increasingly convinced of as a great error and problem in evangelical Christianity at the moment.  I say that as one who spent years almost worshipping "heroes" in the faith.  The whole sermon is well worth a listen to!

May add some key quotes shortly.

Monday, February 17, 2014

Life after "Strange Fire"

I've made no secret of my struggle to maintain interest or passion in theological/spiritual matters this past year or two.  I still believe in God (not so sure about the church thanks to past experience).  But this is a work in progress - certainly not an unfinished story.  A few issues sparked my interest - for example, John Macarthur's "Strange Fire" conference of a few months ago.

A brief history with Macarthur:  As I was growing up in Dunstable and discovering an experiential relationship with God, my church and senior pastor were going in polar opposite directions.  And Macarthur's "Charismatic Chaos" was the instruction manual flogged around Dunstable for that.  I have always fervently believed my pastor Stanley Jebb's motto that; "the unexamined opinion is hardly worth holding".  So I read "Charismatic Chaos" and found it thoroughly interesting.  It didn't persuade me in the slightest of anything - apart from human beings are human beings and make mistakes.  Oh - it also persuaded me that John Macarthur was a throughly negative, unpleasant individual who was having a nasty effect on the pastor and my church - and it was something and someone I didn't want to be like in the slightest!

So the mention of "John Macarthur" usually makes me roll my eyes.  That's why when C J Mahaney started preaching for Macarthur - some reformed/charismatics were thrilled and thought it meant Macarthur was "softening" in his anti-charismatic views and maybe the bald-headed one was impressing him with his sense.  Rubbish.  All "Strange Fire" proved was that in fact Mahaney is taking the same path my pastor in Dunstable took, and is taking all possible steps to reject charismatic life in his church (apart from apostolic authority - in all but name).  A quick glance at Mahaney's "church programme" proves that - no room for the Holy Spirit there!

So I was interested today to find a You-Tube video of Macarthur speaking about the follow-up from the "Strange Fire" conference.  He has taken a lot of stick (quite rightly) for his harsh and intolerant suggestions that charismatics are not Christians.  This is his answer - and essentially he sticks by his views.  Another book is promised to answer his critics (around 26 minutes).  But what particularly interested me was Macarthur's taking on of Dr Martyn Lloyd-Jones and John Piper in particular (38:12) - namely that pastors and preachers have NO business seeking an anointing or unction from on high to preach!


Here it is;

Saturday, February 08, 2014

Sing It Louder!

I was thinking a lot about mental health issues today thanks to the great "Time to Talk" focus day this week.  One account particularly moved me - that of "Time to Talk" campaigner Johnny Benjamin - sharing his experience of how he almost threw himself off a bridge in London but was saved by a passerby.  It struck, worried and moved me how awful the reality of suicide is - and how surely it is OUR responsibility as a race to try and protect our own?  NO-ONE should feel so lost and alone that they end their lives!

So what keeps us going?  What keeps us living?

I have considered suicide myself personally this past year - I confess it.  Things just got "so" bad that it occurred to me as a distinct possibility.  I know that psychiatrists consider the risk of suicide greater if "there is a plan".  I had a plan.  I kept on living for a largely negative reason - I did not consider the cause of committing this final act "worthy" enough to do so.  It's not perfect but it worked for me!  The fact is that life serves good times and bad times.  And I have learned over the past year or two that rather than just "keep hoping that life picks up" - it is wiser to enjoy the good and use it as a foundation to work through the bad.

I got a little revelation today as to one of the reasons why I "keep going".  It was listening to one of my favourite song tributes to my adored and revered Her Majesty the Queen; "Sing".

The lyrics in question that moved me immensely were;

"There’s a place, there’s a time in this life when you sing what you are feeling, find your feet, stand your ground, don’t you see right now the world is listening to what we say? ... You brought hope, you brought life, conquer fear, no it wasn’t always easy, stood your ground, kept your faith, don’t you see right now the world is listening to what we say?"

What occured to me is this (and bearing strongly in mind; "Time to Talk" campaign) - one POWERFUL reason to "keep going" - is that there may be others out there who are encouraged, find strength, find hope from the story that we tell.  I shared a tweet the other day about the reality of living with an anxiety-related disorder.  It's horrid.  But if by speaking out - I can encourage or remind or tell another person that they are not alone and are not alien or weird - then surely I must do it!

There is a reason for keeping on living - and keeping on going.  We do not live alone in isolation.  If we live or die - this does have an impact on our fellow human beings!  And we have the opportunity to affect the world we touch by the words we speak!  So my hope and my aim right now in life is to try and take courage and speak out honestly about problems and solutions.

If it were one day to save a life, or to even just encourage someone that they aren't alone - that would make the ups and downs of my life ALL worthwhile!

Keep singing!

Monday, January 20, 2014

How Her Majesty the Queen helped me survive these past 1.5 years.

Dedicated to every brave soul who daily choses to continue living - even if it means facing demons, hardship and heartache.  Dedicated also to the fabulous Rev Dave and CEO Lisa who together gave me the bravery to speak out and put pen to paper.

It is amazing that even in the 21st century, it still isn't very easy to speak openly about mental health issues - particularly on a personal leveMORE empathetic and compassionate rather than building walls and de-personalising our patients!  Somehow anyone within the NHS, there is a ridiculous notion that "we are professionals and shouldn't struggle on this level".  But the unspoken reality is that the NHS is wonderful because it is staffed by human beings who do go through similar problems to the patients and families we see on a daily basis.  That reality should make us

My own personal background was somewhat more complicated by the fact that I came from an extremely fundemental religious background where mental health issues were particularly disapproved of, and usually put down to "sin" on some level.  When I first went on antidepressants some 10 years ago for a time, I didn't dare tell my parents for some years - as it was seen as an admission of "failure".  I have seen my General Practioner and various Occupational Health services through work pretty regularly - and the clinical feeling is that I am not "depressed" per se - I apparently tend to struggle with "chronic anxiety".  In short - I daily seem to imagine up (I have a very vivid imagination) all sorts of fears, worries and panics about what life may bring.

The last year and a half has been particularly rock-bottom in terms of experience, health and work.  Two or three times I did in fact consider suicide and whether it really "was all worth carrying on".  Those low points were often prompted by events I read, such as the tragic account of the nurse involved with the Australian DJ scandal while Prince William and Kate were in hospital expecting Prince George.  Reading that account made me feel an affinity with the nurse - but in a ludicrous way, a rather morbid wondering if I also committed suicide whether the Chairman/Chief Executive of my workplace would make a statement to the press.  I decided they wouldn't bother - and somehow found that enabled me to "keep living" that particular low day.

But the benefit of this year has meant that I have been forced to confront some of my worst fears headon - with no support, help or alternative.  That's a story for another time - but what I found was that actually - my imagined fears were WORSE than the reality!  But what I wanted to focus on in this post was what enabled me day by day to "keep going" this year.  And that was the person and example of Her Majesty the Queen.  Before you snigger - let me explain why.

I am sure there may be psychological reasons why the Queen means so much to me personally.  I lost both my beloved Grandparents at significantly low times in my life to cancer, and both losses affected me deeply.  I guess there may be a degree to which I long for a "Grandmother" figure.  But Her Majesty's example has meant more than that this year.  It is well known and commonly cited that her life motto is;

"Duty first - self second".

When Her Majesty was 21 she made a monumental speech in South Africa where she committed her life to;

"I declare before you all that my whole life whether it be long or short shall be devoted to your service and the service of our great imperial family to which we all belong".

Her committment to duty has ruled her life and service - even if at times it has meant that her family life and personal life has been affected as a result.  Many commentators (and we never know what Her Majesty herself thinks - as she does not give interviews) suggest that call to duty is something that has remained with her, and has driven her throughout her life and reign - to the present date, her amazing 86 years of age and her now-over 60 years of reign.

Let me make it clear - I do not equate myself in ANY way to Her Majesty the Queen in ANY sense (other than to count myself fortunate to be one of Her subjects).  But what remained with me throughout this blackest of years, was initially a thought - does Her Majesty the Queen ever get down or low?  And this wondering grew into an interest that lead me to reading many of the biographies written about the Queen, and the difficulties that have beset her (especially her famous "annus horribilis" year and the year where HM lost both her beloved mother and her sister) - yet continued to perform her duty.

Her Majesty's personal difficulties are made worse by far because they are so often in the sight, criticism and debate of the press and therefore the public of both the United Kingdom and Commonwealth.  At the very least any personal problems I have, were able to be limited by myself to the people I trust and were able to depend on (and to them - a few in number - I owe them a debt of gratitude I will never be able to repay!).

While working through - day by day - the blackness, the lowness and utter desolation of the past year - at times, it was quite simply the fact of seeing Her Majesty the Queen at an official function (I follow several blogs that track and report the Court Circular) that gave me courage and conviction to try and "live the day".  At times, this was as pathetic as leaving the safety of my flat and walking to the corner shop to buy a pint of milk.  It sounds ridiculous to write this - but my mentality was;

"If Her Majesty can go to yet another engagement despite the wealth of possible aches and pains she may have as an over-80 year old, smile constantly even though she may not feel it, and shake umpteen hands even though she has done nothing but for the last over 60 years of her reign ... then surely I can put clothes on, leave the flat and do a simple task?".

That simple role-model and mentality enabled me to gradually build and grow in confidence, activities - and as a result I found my mood and outlook on life improving, my determination to work through my difficulties strengthen, and focus my goals beyond just "surviving the day".

It is for this reason I will never fail to be grateful to the unfailing example of Her Majesty the Queen.  The couple of visits I have been SO fortunate to make to Buckingham Palace only served to enhance that.  It is why I am a Royalist through and through!  I know this example will not work for everyone who suffers with anxiety, depression or any other mental health disorders.  But I do think it underlines the importance when you are struggling so hard to "keep living" - sometimes it can be the most simple or obvious of things that help keep you "living"!  It could be a family pet that needs feeding.  It could be a planned outing in a few weeks time.

The majority of the victims of suicide almost invariably state; "they ran out of hope".  So for us - as NHS professionals - one of the key responsibilities upon us is to help find that hope (and it will be individual to each person).  But we can only do our job well and effectively - if WE are honest about our struggles and experiences.  Small things such as a "thank-you" from a Chief Executive or a line manager can change the complete "mood" of a working week!  More importantly - cared-for staff give better care (it is widely acknowledged - I cite an excellent PICU Intensive Care Consultant as an example) so it is vital that if NHS staff do share mental health struggles and issues, they are supported and not vilified or patronised (as has sometimes been my experience).

Positive thinking (in my opinion and experience) is absolutely vital to "keeping on going".  For many of my 36 years of living - I thought that positivity and happiness was a reaction to the experiences that life forces upon us.  If life was going well - then I was happy!  If it was going very ill - then I was not.  But I have come to realise and understand (thanks to Twitter friends - in particular Kath Evans, Head of Patient Experience for NHS England and her friend 'Engaging Emma') - that in fact positivity and happiness come from "within" and are a state of mind that can be increasingly immune to life's changes and events!

My conclusions?

1.  Life isn't fair or just.
2.  We all have a choice - to continue and fight or opt out.
3.  We can all chose to benefit from our experiences and use them for good.
4.  There is always hope - even if it is the smallest glimmer (such as the Monarch carrying on her duties!).
5.  The night cannot last forever - the dawn does comes, even if it seems forever!

Tuesday, January 07, 2014

A View of Things That Matter

This blog post is dedicated in particular to Julie Bailey, Deb Hazeldine, James Titcombe, Liza Brady and Dr David Drew - among so many other whistleblowers.  It takes tremendous courage to speak out and "rock the boat" - courage perhaps more than I possess.  These people have suffered unbearably but want - only the best.  We need to hear from them.

It's been on my mind to write about the last year's public opinion of the NHS for some time.  The important whistleblower revelations of Mid-Staffs, Morcombe Bay and others have broken the rose-coloured fallacy that the "NHS is perfect because it gives free care to people who need it".  That is true and it is wonderful.  But the NHS is made up of imperfect human beings from the porters and domestics who enable hospitals to run, to Chief Executive Officers who lay down vision.

As is common in human behaviour, we tend to hold opinions of extremes (I hold up my hands and admit I personify this!).  If we do not love something passionately, we hate it with a vengance - particularly if wronged by it.

It particularly troubled me to see the horrendous backlash against key whistleblowers such as Julie Bailey and Deb Hazeldine, James Titcombe and Liza Brady.  For those unfamiliar, these two ladies lost their beloved parents in the most appalling failures of care and were not giveNOT just treat "the patient".  That "PERSON" comes as part of a family - and care given to them (whether good, bad, excellent or dreadful) will impact upon the closest people to them.  A caveat: I can somewhat understand why a lot of the backlash comes from the people of Stafford who face losing their hospital.  They are looking for a scapegoat, and inevitably (I suppose - however unacceptable) will look to the whistleblowers.
n the answers and reassurances they deserved - and so began to campaign.  The NHS and health professionals owe them a debt!  They are a reminder that we do

But I want to ask - does anyone mildly rationale think these two ladies - Ms Bailey and Ms Hazeldine EVER considered "becoming campaigners" or "whistleblowers" five to ten years ago?!  We must consider why fate led them to this.

1.  A Step Back and Pause for Thought:

Over this past year I have had a lot of time to think, read and consider the NHS as something incredibly important to me.  The availability of the Mid-Staffordshire Inquiry has enabled in depth reading and consideration of the mistakes and errors and lapses in communication.  In particular I wanted to read the accounts of families like Julie Bailey and Deb Hazeldine to learn and ensure that in my experience - this would NEVER happen again in my human power or sphere of capability wherever I work.  I was seized by a comment Deb Hazeldine made in her testimony to the Inquiry that I think it incredibly telling - she made it early in the complaint (point 25);

"If Martin Yeates had been up front and honest in the first place, I would have walked away.  I just wanted justice.  If he had said; "Hands up, it's bad" but could demonstrate in a robust way that it wouldn't happen again - I would have walked away secure in the knowledge that vulnerable people were not at risk".

I would hesitate a guess that virtually all families who have suffered unjustly or through human error would be actually satisfied with a swift, sincere apology and evidence of real lessons learned and proof that identical mistakes would not be made - would be enough.  I wonder if we can allow for the fact that whistleblowers have happened - because one of the human errors of the human NHS is that we collectively haven't been good at admitting error and learning from mistakes?

When I was at school (a private Christian religious school run by my parent's church) we used to have reports on our progress - both academic, but being religious, also character.  One consistent character point I scored very badly on was called; "Responds Well to Correction".  I can only assume at heart at that point I was an intensely proud and/or stubborn character as I consistently would score; "Needs Improvement".

This is an error I have somehow (I am not sure how) been keen throughout my life to remove and hope will continue to do so.

2.  Applaud the Good but Admit the Bad - and Learn and Improve from It!

There was a report in the Independent today that somewhat ignited the difference of opinion about the NHS.  Sir Mike Richards - the Chief Inspector of the NHS - wrote and commented favourably about the NHS.  He said;

Compassion in the NHS is alive and well.” And then with extra emphasis: “We’ve also seen some really excellent care.”

This surely is good news?  But on Twitter again opinion was divided.  Those desperate to see the tide of public opinion turn on the NHS highlighted the story and applauded it.  The whistleblowers still seeking "something more" were justifiably concerned - all is still NOT well in the NHS and there is a great distance still to go.  The Sir Mike article states it itself;

"It is what I hoped I would see,” he adds. “But seeing is believing.”

There is a reason that I love reading the Birmingham Children's Hospital Foundation Trust Parent and Carer Feedback page on their website that collates feedback from the instant "Feedback Application" (Award winning!).  It demonstrates so clearly that feedback and performance change.  Some days the NHS gets it very right.  Some days the NHS gets it very wrong.  We are human.  We change!  But as long as we are transparent, live, love and learn - surely there is hope?

I for one - as a proud current NHS healthcare professional - promise and pledge here and now to devote the rest of my working life (up to 70 now I believe!?) to ensuring the patients and families under my care NEVER have any cause to have to raise concerns about the standards of my care.

PEOPLE matter.  End of.  FAMILIES matter.  End of.  And it is our (my) everlasting privilidge to be able to care for some of these vulnerable people when they need it most.  That expression of trust must not be ever let down.

Wednesday, January 01, 2014

Not WHAT we do but the WAY we do it

I am having a lovely relaxed New Years Day (mainly sheltering from the West Midlands grotty rain!) but hav been "seized" again by a comment made by a patient on a programme I am currently watching.  Having been away from critical care nursing for so long - it is frustratingly agonizing to watch the various ER programmes available and long to be involved!

The programme in question this first evening of 2014 is "Kings Cross ER: St Vincents Hospital" in Sydney, Australia.  11 years in nursing doesn't stop me watching with my toes curled as the ER team treated a poor young man who got stabbed in a nightclub in Sydney.  An ultrasound revealed that the knife pierced the left ventricle and he was bleeding out into the pericardial sack.  The cardiovascular surgeon was too far away by car to be present to save his life so the ER team looked as though they were going to have to perform the life-saving procedure by mobile phone.  Fortunately the young man managed to cope until the surgeon arrived and he was taken to theatre.

The next programme showed our young man re-admitted with possible infection and shortness of breath - and it was a thrill to see he survived the trauma!  However I was fascinated to note the one comment he made about his awareness of the life-saving surgery he had.  He said this;

"I remember hearing the voice of a lady doctor.  She kept telling me I would be okay.  She sounded like she had the voice of an angel".

It struck me again as we enter 2014 - healthcare workers have a UNIQUE privilidge in what we do in caring for patients and families often at their lowest point.  And yes - our patients and their families arrive at the point of care needing something - the care they can only get often from us.  But my point is this - the WAY we deliver that needed care is something that will stick with them for ages to come - far more than the care they needed.  We need both!  From Chief Nurse Jane Cummings "6Cs" - care and compassion run hand in hand.

A good New Year's resolution for all of us who may have the privilidge to care for patients in 2014?!

Monday, December 23, 2013

Another Take on "Making Every Contact Count"

To those non-NHS types, forgive me for another "care-orientated" post.  Much of the last two years have been massively dominated by my nursing role and my proud membership of the National Health Service - and hence my blog does tend to represent my current passions.  I do still maintain my theological/spiritual interests and have a few subjects brewing - but this one is a post that could not wait!

"Making Every Contact Count" is a very important initiative in the NHS at the moment - we are realising that as health professionals we have a unique position of serious responsibility and privilidge with the patients under our care and their families.  Mistakes in the NHS have been made in the past where care has been delivered but not in the right way.  One of my NHS heroes - Chief Executive Officer Sarah-Jane Marsh said (in a CEO briefing at her Children's Hospital in Birmingham);

"It is not just what we do that matters, but the WAY we do it".

Consider nervous parents accompanying their young child to have their tonsils removed - a relatively minor procedure in context.  Imagine if the surgeon did his job and removed the necessary tonsils, but their entire hospital experience was negative.  Say the surgeon was brisk, rude and dismissive and the nursing staff pre-and post operatively did their job and monitored the child but gave the parents and child no compassionate care and support.  The objective may be achieved - removal of tonsils - but the family and child could and would be scared by such a negative experience.

THIS is why it is not enough to simply have competent NHS staff treating the patient.  We MUST have compassionate and caring (AND competent!) staff who support and defend the patient and family from admission to discharge ensuring the whole point of contact with the NHS is positive.  "Making Every Contact Count" is a vital initiative used in the Birmingham Children's Hospital at present;

But I did find myself wondering if many nurses, student nurses and allied health professionals like myself struggle to come to terms with what actually; "every contact" means?  Does it mean if we are simply taking our parents a cup of tea we should sit down and commence a sermon on smoking cessation?  Surely not!  So it was while thinking these matters through that a common motto came to my mind;

"When a butterfly flaps it's wings in Texas, it causes a tornado in China".

This is in other words known as "Chaos Theory".  It is technically defined as; "a minor change in circumstances can cause a large change in outcome".

I am not entirely sure if healthcare professionals are entirely aware of the enormous potential of their actions (and contact) with patients and their families - whether positive or negative.  The Mid-Staffs scandal demonstrated the hideous enormity of negative contact - and it is a nightmare the NHS should NEVER forget.  But something the Chief Nurse of NHS England - Jane Cummings - is vitally reminding the negatively-biased media is that POSITIVE experiences also have a crucial impact.  

Many nurses (and I have been guilty of this in the past) have come to work at times bringing "home life" with us.  Aches, pains, heartaches or simple headaches - have meant that we as healthcare professionals have not been "properly" operating in the "6Cs" framework we should to truly impact our patients and families for the good.  It may seem little to us - a more formal sober greeting of our families after handover and perhaps a distinct lack of smiles and easy small-talk during the shift than perhaps we may do.  This may seem like just an "off-day" to us.  But what of the impact on our patients and their families?  That "off-day" may be their ONLY contact with the NHS during their lives - and the impact they take away is our lack of smiles, care and - presumed - lack of motivation to give them the patient experience they need.

When a butterfly flaps it's wings ... a tornado happens.

When a nurse smiles at a patient and family (even though his/her heart may be breaking due to a recent family dispute) a positive tornado of change and impact happens and that family may leave the hospital or care setting with a positive experience of trust and confidence in the NHS.

When a butterfly flaps it's wings ... a tornado happens.

When a nurse sits with a devastated, bereaved family and is seen to visibly shed tears, that family may leave the hospital knowing that they were cared for (even though the outcome was not what they hoped) by a human being who was impacted by their loved one.  The loss - still and always devasting in the extreme - will be tempered by the fact that they did not suffer it alone as though on a factory production line ("when's the bed available?") but as an event that impacted the healthcare professional with them at the time.

When a butterfly flaps it's wings ... a tornado happens.

When the worried and anxious family sitting in the Accident and Emergency Department, so concerned about their loved relative suffering beside them, are brought a cup of tea by the nurse and an apology for the wait and an explanation - suddenly the nightmare fear that "they just don't care" evaporates and the slight reassurance (though the concern for their relative remains) that humans are in charge and that they are not just another number in the queue potentially breaching their "targets".  But the experience they take away is that they are told and explained that the department is horrendously busy and prioritisation of care is taking place, but their relative is not forgotten and is under observation (even though it does not seem it) - ANY deterioration in health will be responded to swiftly.

When a butterfly flaps it's wings ... a tornado happens.

The devastated parent sitting with their terminally ill child on Christmas Day looks up as yet another nurse comes in to deliver the required chemotherapy (even though the parent knows it will make the child sick) the difference cannot be expressed if the chemo nurse comes in smiling and compassionately open to what the child needs and does his/her utmost to deliver the necessary medication but with the right approach.  That effect will last with them forever, just as a rushed, brutally efficient but distracted nurse who charges in, injects the medication and rushes out without comment.

When a butterfly flaps it's wings ... a tornado happens.

A family sits in a busy Outpatients department worried sick about the appointment with the consultant.  The results are in and in a few words they will be told whether they have a positive, rosy future full of hope and promise - or further worry, dread, more appointments, "maybes", "I hope" and other subject phrases spoken by healthcare professionals.  The Outpatients department is running drastically behind schedule and the worried family know they are now 30 minutes behind their appointment time.
To be approached by an Outpatients nurse who sincerely apologises for the delay, explains the reason and asks if they need anything (an English cup of tea never goes amiss!) will create a tornado of effect, even if the news from the consultant is negative - as compared to a stressed, harressed nurse who is charging around (to the family's view - and they DO see everything) accomplishing little - who then snaps that; "Dr So-and-so will now see you.  Quickly!".

There are many, many more examples and scenarios that could be cited and may ring true with healthcare professionals across the NHS.  But I hope the few examples that have come to my mind will prove my point.  I believe fervently as current HCP in the NHS - we must, must, MUST never forget that we are in a position of ultimate privilidge, trust and opportunity.  

Every action (whether it be a smile, a story read, a hug, or a cup of tea) can have a far greater wave of impact upon our precious patients and their families than maybe we will ever know.

It is our responsibility, duty and joy to ensure that we do not just deliver "competent" care (although that is vital) but we deliver such care in a compassionate manner that thinks ahead of the actual care delivered - and anticipates and expects that our patient and their family will leave the NHS and the care with an overwhelmingly positive experience that they can remember for a long time.  Even if, tragically, the care delivered sees that precious and beloved relative not coming home - let our precious families go home knowing that their relatives were treated with the highest dignity, compassion and care possible and that they did indeed die in the "best hands possible" with their families by their side.

When a butterfly flaps it's wings ... a tornado happens.