Of Crossroads and Pivots
To be at crossroads.
Most of us over the course of our lives have experienced some form of toxicity in a relationship be it at home, work, on a personal or professional level and have probably asked ourselves how did we get there or how can we leave or have recognised that we need to leave but are scared of what happens next! Fear of the unknown coupled with the uncomfortable comfort of the known. These concerns or thoughts become more profound when you have had a long relationship spanning years or even decades with whomever or whatever situation you are trying to leave behind. Most people when asked will tell you to just leave, but it is never that simple especially if it is all you have known as an adult and have a love/hate relationship. Over the last couple of years, I have found myself asking these same questions. How do I leave given the love/hate relationship I have, not to mention that my whole adult identity is tied to this very thing that is sucking the life and soul out of me? How do I leave the toxic profession that Nursing has become, when it is all that I have known but is no longer excited about, more so as a Black Nurse?
I have gained a lot in being a nurse and from nursing but at the same time nursing has taken a lot from me, sometimes I think more than I have gained. I recently came across a post on LinkedIn by a nurse, a proud one at that, who stated how nursing was and still is his whole identity and will forever be and I was conflicted because I understand his sentiment, as a nurse your whole life and identity revolves around nursing, how you act within and outside of work and how you are expected to live and interact with society. It's all consuming and the reason I am conflicted is because I currently have a love hate relationship with nursing. It's like that toxic partner that you are trying to leave but they keep reeling you back even though you know they are not good for you. Not good for your physical and mental health not to mention your financial health but they are comfortable, all you have known, familiar. Nursing doesn't love us Black nurses, be it our places of work, those we care for, our unions and even our governing body! That's a lot to deal with and one can't unsee the disdain and contempt and the appalling treatment we get. It's disheartening when you give 110%, when you look around and equitable healthcare, health services and work conditions are not afforded to those of us who are Black especially Black Women. Nurses be everywhere and that is a good thing given the diverse unique set of skills nurses have that are transferable to lots of industries. I can only be thankful for the opportunities, people and friends that I have had and met through my work as a nurse, the lives that have impacted mine and those that I have had the privilege of being a part of even though there have been days when I have questioned why I became a nurse. From the inequalities witnessed while training to the experience of racism and how widely it is embedded in everyday life, nursing notwithstanding.
Once again I find myself at a crossroad, needing to forge a new path ahead. I walk in grace and have faith that whatever path I choose at this season of my life, I will still advocate for nursing and nurses to be valued, especially Black nurses, as we are witnessing in real time the decline in health care services and patient outcomes due to how nursing and nurses and the brilliant work they do has been undervalued not only here in the UK but worldwide. As a service user myself having witnessed the health inequalities Black Patients experience firsthand, I will also still be a loud advocate for equity in healthcare for Black patients. Because racial weathering is a thing and racism does kill and should be a public health emergency, it's only fitting that I end with the words of Bossbabe.Inc:
“ I’m shifting from my hustle era to: My balanced era. My soft era. My ‘nervous system is calm’ era. My ‘work smarter, not harder’ era. My ‘know my worth, regardless of results’ era.”
Nothing to celebrate here!
It is getting harder and harder to celebrate being a Nurse.
I don’t know about you but life just feels Meh ( if that’s still a term) at the moment. Everything feels off and it is getting harder and harder to find the little joys in life with so much going on in the world right now. Yesterday was the culmination of Nurses’ week celebrations culminating with celebration of International Nurses’ Day which ironically ( for us Black Nurses) falls on Florence Nightingales birthday! There is a lot to unpack there but that is a rant for another day even though it could be argued that it does fit in with the sentiments i am about to express which is that it is getting harder and harder to find anything to celebrate about Nursing or being a Nurse more so a Black Nurse.
Nurses, who are the backbone of healthcare services all over the world and beyond are tired and feeling under constant assault. We are undervalued, underpaid,overworked and no one seems to want to hear our voices or opinions on how our livelihoods and those of our patients can be improved. Nursing is under assault and it is worldwide. Systems everywhere are out to get us and no one feels that pinch more acutely than us Black Nurses and i am tired and frankly do not feel like celebrating anything nursing at the moment. I know that for those of you have been brought up to believe that Nursing is give-all-no-complaint-noble-godly-self sacrificing vocation, this might seem as a ungrateful thing to say but unfortunately it is the reality.
Racism still has its foot on our necks despite report after report highlighting the far reaching consequences of the effects of racism on Black Nurses and although everyone acts surprised and expresses their displeasure the status quo is truly and firmly maintained or worse. It's like perpetrators and their over lords get more oxygen to double down and dream of more ways to heap misery. Cut pay, overwork them,remove any form of family support or any support for that matter, while making them jump all manner of hoops that they would be forgiven for thinking they were working in a circus. So no, there is nothing to celebrate here. Nursing is under attack and Black Nurses are bearing a huge chunk of this full on assault! I for one do not have the energy nor the required bandwith to celebrate. So until things change and the over lords start valuing nursing and the important part Black Nurses play in propping up healthcare systems worldwide and paying us our worth, there will be no celebrations.
Clocking Off: How I learnt not to take work home!
Black Woman working on a Laptop
As a Black Woman, I am well aware of the double edged sword( Black & Woman) of having to work twice as hard as everyone else on top of having to constantly assess and reassess your work because if anything would go wrong, you would most likely be the first to be blamed. I am also acutely aware of the racial trauma we endure and the need to be constantly hyper-vigilante in all spaces we occupy, which just adds to our racial injury.
The COVID-19 global pandemic has forever changed how we work and the workplace culture that accompanies our jobs, so to speak. In the midst of a forced shutdown, companies and employers were forced to bring in changes that many have been asking for years that most employers have mostly paid lip service to! Working from home became “THE THING” and the era of employer led as opposed to employee led flexible working came into place. Gone was the so-called rat race and all over the world employees were reflecting on what life meant to them and what changes they wanted to make. I for one was here for all of it.
Woman on Laptop and Smartphone
The world of clinical research is a fast paced one with specific timelines on collecting clinical data and reporting them. For example, more often than not, sponsors require data on SAEs to be reported to them within 24 hours of one being reported. As a clinical research nurse/study coordinator, participants had my work number and preferred to call me as opposed to the emergency number they were provided with at the start of the trials. It was great that i had such a close working relationship with our trial participants and that contributed to the smooth running of our trials but it also meant that i was almost always the first to learn about issues arising like an SAE!
That was how i found myself dealing with an SAE and the paperwork that followed, not to mention the numerous phone-calls to the sponsor on a Friday evening way after work, on my own unpaid time. Having a work phone and carrying it home with me, seemed like a great thing to do as a way of getting on top and planning my work but it also meant that it ate into my private home time and i could not really switch off. I literally carried work home with me everyday! No wonder i was constantly tired, feeling like i was being pulled from all sides, but, hey, wasn’t burnout a great marker that you were doing something right?
Black Woman reading a book.
Fast forward to a new job and I am going through all the IT set-up and but this time I have no work phone, so I would not have to carry work home with me and I could maintain that work like balance that I so craved and had etched out but I am also a work in progress, because in the middle of setting up emails and teams, I found myself synchronising my phone to my work emails and teams! Luckily I caught myself just in time to remind myself that I was already doing enough, giving my 100% at work and that work stayed at work!
But we all know that it takes years to unlearn traits that have been part of ones identity formed from societal pressures and perceptions. So I have to fight the daily urge to be on top of everything and synchronise my phone to work emails and teams and remind myself that when I leave work, I make sure I leave ‘work’ behind!
How do you maintain your work life balance? Drop us a comment.
The Wandering Nurse!
x
WHAT'S IN A NAME? When being Kenyan saved my Nursing job!
I would be lying if i said i have never really given much thought to my name(s), after all they are me, my identity even during the times i have rebelled against said names! My whole life has been defined by my names so it came as no surprise when my career was about to be defined by them, even i did not see in what way.
I have ( and I know, many other Black people/ Nurses) lived and worked in a world where my name determined whether I got a job interview, whether I got a job, whether I got promoted or paid equally as my peers! You get it! My name seemed to be a barrier, so when the opposite happened and it became my saving grace, I was very surprised to say the least.
Working for an agency or the nurse bank gives you the flexibility to choose your working hours as well as where it is you would like to work. You also get to work with different teams on different wards and develop working relationships (or not), and this knowledge is often filtered through the various agency/trust bank grapevines. Which wards/units and teams were okay and which to avoid. This meant that there were wards/units that always struggled to get their vacancies filled and the ward and duty managers got clever. They devised ways to get these vacancies filled, unbeknown to us by creating false vacancies within the popular wards/units thus taking away choice, safety nets and in some cases putting patient safety at risk.
I got caught up in these ‘work houdiniships’ on a couple of occasions and apart of causing a of angst and disorientation, they also caused pay disputes with regards to who was meant to sign the timesheets and whose budget the pay would come from! you ended up chasing payments weeks after you had completed your shift. So, i tried to avoid them as much as possible, but oneday i got caught up in one houdiniship from hell.
I had booked a shift on a ward that i knew very well as i had worked on this particular ward as a permanent staff member before and knew the staff and the layout well. I turned up for my shift, bright and early only to be told that they were fully staffed and did not need me and had not booked me! I called the trust bank to let them know what was happening and was told that yes i was indeed booked in for that ward but was meant to work elsewhere to go help with washes and be the healthcare assistant for the day. The ward i was to be sent to was one everyone avoided due to how rude the staff there were making it a very unpleasant ward to work on, hence why they struggled to fill any vacancies. I declined and stated that i would rather go back home as the whole essence of agency/bank work was the freedom and ability to be able to choose when and where you worked, a point that neither the trust bank call handler nor the duty manager took kindly to and i was threatened with referral to the Nursing and Midwifery Council (NMC) for breaking the patient safety code of conduct by leaving the hospital short staffed.
I left the ward after explaining the situation to the manager and matron and went home. On my way home, i received a call from the trust bank informing me that i had been suspended and all pending shifts cancelled pending an internal investigation, and that my return to working for the trust bank would be dependent on the outcome of the investigation. I was annoyed that they would do that and i was confident that nothing would come of the investigation as i had done nothing wrong! So i told her that while i felt it was unfair, their action, given that i was a full time bank worker, i would await the outcome of the investigation. I was then told to write a statement of events, which i did and emailed it to the head of the trust bank as requested.
Two weeks later i received an email from the head of the trust bank asking me to report to her office. Being summoned is never a pleasant experience but i was surprised this time. It was a friendly setting and a very relaxed chat. She said she wanted to meet me and talk to me face to face before she decided how the investigation was to proceed. She proceeded to ask me where i was from as my name reminded her of a brilliant Kenyan Doctor she had worked with years ago at a previous trust. We talked about all things Kenya and how while my name was similar to the Doctors, we were not related in anyway and that i had never met him, let alone met anyone with the same surname as mine professionally during my working career in the NHS.
She then asked me to narrate what happened on the day, which i did and i also told her how common these houdiniships were becoming especially when the duty manager was the same one who had been on shift on that day and how on many occasions, she had moved me to wards where i was way out of my depth, like surgical trauma and when i voiced concerns she had replied that i was a qualified nurse with a PIN. This is when, i was informed of the complaint the duty manager had written, claiming that she had requested me to go to a different ward to help cover due to a crash call and i had refused. It was the first time i was hearing of this false account of events. I told her that she could confirm with the ward manager who had taken the call and spoken to the duty manager and then relayed the message to me, that there was no crash call and that i would not have refused to go to that ward nor left if that was the case! I also got to hear of the letter of support from the ward manager and matron decrying the drastic measure that had been taken to suspend me.
She then told me she had wanted to look me in the eye when talking to me, as she could not believe that a Kenyan would behave in the way that the duty manager had described, because she had worked with Doctor Onyango and other Kenyans and they were all very good at their jobs, reliable,honest, hardworking and put patient safety above all else, so she could not believe that i had been negligent. She had also looked at my file and in the five plus years i worked for them and there had been no complaints made against me nor any caution on my file. She lifted my suspension but said she would keep a note on my file for two weeks and if no issues arose during the investigation, then my file would be wiped clean.
I later found out that the duty manager was sacked after complaints from other nurses about her attitude and false statements amongst other things. I would like to say that houdiniships are a thing of the past but that’s not the case, unfortunately and because the largest agency/bank workforce are from the Global Majority, they bear the brunt of vexatious complaints. I picked up a great assertive tip from (yes), a brilliant Kenyan Nurse for those times you find yourself in a houdiniship:
“State that your skills set do not apply on that ward that you are being moved to, however, if they are happy to guarantee a waiver in writing that they will take full responsibility for any clinical and safety shortcomings that could potentially or accidentally occur, then you are more than happy to work on the new ward!”
I still haven’t met this Doctor Onyango but if he ever reads this, i would like to say a big thank you/erokamano and also a very big thank you to all my fellow Kenyan Healthcare Workers out there.
x
Shamim aka The Wandering Nurse.
Are you Hustling backwards?!
Onwards to new adventures!
One of my favourite programmes on the BBC used to be ‘Wanted Down Under’. It followed families who wanted to relocate to Australia or New Zealand, from helping them find homes, jobs while also giving them a reality check via a comparison cost of living between the UK and their dream new life in a bid to find out if the dream was affordable. For some the better salary and cost of living afforded by moving made the dream a reality and for others it meant hustling backwards, with their dreams deferred or abandoned.
Making the decision to leave home and start a new and hopefully better life in a new place or country is something humans have been doing since time immemorial and it’s a decision that is never taken lightly. For some it is the lure of a better work life balance, affording them more family time or more time to indulge in life long hobbies or passions. For others it is the promise of a regular paycheck and the job security that comes with it, a way to support themselves and their families free from worry and stress of not knowing if they would be able to do so day after day. It is this latter reason that i would like to focus on, because more often than not, the lure of a regular paycheck and job security blinds us and we do not take into account the full picture of what the cost will be and if it is at all worth it.
How can i make sure that my take home pay will be sufficient?
In my book ‘ The Extreme Sport of Nursing While Black : A Survival Guide’ , I talk about the importance of negotiating your salary so that you get paid your worth as well as really scrutinising your contract for any issues before signing on the dotted line. While this is still sound advice, i would like to add another tip, especially for Nurses being recruited from abroad, and that is to carry out a cost of living calculation to find out if would be able to live comfortably with the money you would be paid, your take home pay.
The first step would be to find out what your take home pay would be after all deductions, do not be fooled by the salary figure quoted, as that is normally your gross and not net which is likely to be significantly lower! Remember to ask during the recruitment process and not after you have signed your employment contract! The Salary Calculator is a handy site that helps you calculate how much your take home pay would be approximately. You can customise to see your take home pay yearly, monthly, weekly or even daily. This would give you a rough idea of what you are actually being paid and from that you can then do your cost of living calculations.
Armed with this information and your calculations, you can then make an informed decision whether it is worth it to take that job and uproot yourself from all that you know, or if you can negotiate for a better pay or hold out for one or better still, if staying and diversifying your income portfolio would be best. Whatever decision you make, make it work for you and having the full picture salary wise is one step in that direction and towards a financially secure future.
Here’s to Hustling forwards, always!
The Wandering Nurse x
A Bundle of Joy and a Great Sadness
It was the last week of Block 2 exams and we were busy revising, while waiting to find out where our next placements would be. I was also waiting for news about my friend who was due to give birth any day soon. I did not have to wait long, because, the afternoon of 30th August, she sent word that she was in labour and being a Nurse/Midwife and a Primigravida, she was waiting until her contractions were frequent before coming into hospital. So i waited anxiously .
Around 7pm, i was informed that she was at the maternity ward and was asking for me. The ward was full as it was baby boom season and we quickly settled her in but my friend had other ideas. in the absence of any pain relief, she decided to go crouch by the water tank. This water tank was the bane of all Nurses/Midwives as it was outside in a dark area with no light source, not to mention filthy, but labour pains made my friend forget all this. So we sat, cursed( she doing the cursing) while i cajoled her to please consider coming inside.
After hours and lengthy negotiations and her insistence that i not leave her side at all, i managed to get her into the delivery room for one last V.E to check her dilation progress, in between reassuring her husband that all was fine. At 8 cms it was almost time. Room prepared and delivery pack at the ready, it was time. Although tired and sleep deprived, given it was around 2 am next morning, i was excited that i was finally going to meet this bundle of joy. At 10cms, we ask her to push with the next contractions.
It soon becomes clear that an episiotomy is neccesary, she just wants it over with. Crowning, screaming, swearing with lots of encouragement, out pops the head with a great deal of lovely black hair. i remark at how lovely the mop of hair is, my friend goes into full meltdown. Turns out she wanted a bald child and refuses to push any further! we are stuck, she is determined to close her legs and go to sleep. We enter panic mode, appealing to maternal instincts not to harm the child. To please push so we can deliver the child safely.
She is having none of it! but at least she stays on her back. It's now all hands on deck or we lose the child. Hand on belly with next contraction two apply fundal pressure while the rest try to get the child safely out. Finally the child is safely delivered. All is well, she is tired but thrilled and both parents are happy to meet their Son. I am tired to say the least, sleep deprived and have exams in a couple of hours. I finally excuse myself with a promise to come back later to visit before they go home.
I walk back to the nursing school, its almost sunrise. Exams start at 8am and i have not slept a wink. As i pass by the dining hall, breakfast is being prepared. i relay the good news to the cooks. The telly is on and the News about Princess Diana’s death is being announced. As i climb the stairs to my room, shocked and numb. I am reminded of the reality of life: one life begining, whilst another one was ending!
The Importance of Grieving!
I came across a post ( link at end of post) on my timeline on X ( formerly twitter), by a Kenyan Nurse in the U.K talking about her nursing experience in Kenya especially with the managers, which was mostly negative in terms of their support for anything progress related as compared to her experience at an NHS hospital on a ICU unit, where the leadership encouraged progress and supported it. According to her, this latter experience cured her fear and insecurities around sharing her nursing career goals and dreams. From the replies to her post, it seems that she is not alone in having this fear of nurse managers in Kenya. While i can understand where she is coming from and i am happy that she found healing and a positive leadership style at this NHS ICU, unfortunately this is not the case all over, especially from the point of view and experiences of alot of Black Nurses working across NHS hospitals and even beyond.
What Nurse Cate had done was significant and in those series of tweets ( or Xers), she had demonstrated that she had grieved her past job experiences and resulting traums, healed from the traumas and celebrated her victory in her journey towards her nursing career. In her podcast episode( link at end of post) titled ‘How long can you grieve a job’, Dr Monica Cox talks about how much we can lose from our jobs, in terms of how we enter our workspaces full of high hopes and great expectations to grow and thrive, only for the opposite to happen, and we end up leaving, full of disappointment and disenfranchisement. She talks about how these loses are profound for People of Colour (POC) and those from maginalised communities, and how grieving for those loses ( job satisfaction, promotions, safe working places etc) is important to both mental and physical wellbeing, and is something that should be encouraged and acknowledged.
I was reminded how as Black Nurses, we come into nursing full of hopes and expectations to grow and thrive in our workplaces. We enter the workplace in all innocence, giving our all and, more often than not twice as everyone else, shrinking ourselves to fit into places, institutions and structures that are hell bent on drowning our voices and keep us out. We are forced out of jobs and with it out of our careers, growth, seeing through our work and projects we started. We do not get to bear the fruits of our labour, for the workplace is structured to reward hardwork with progress in relation to climbing ladders, one we do not get to do. It is not by accident that we make up the largest agency workforce, because leaving our jobs and working on our own terms is the only way we can survive, provide and protect our peace. We carry with us all of this trauma of loss, loss of identity, loss of self and loss of security. We carry on best we can and rarely do we stop, take stalk and grieve, to heal.
According to Dr. Cox, we need to grieve our work losses and also celebrate the victories no matter how small. When we allow ourselves to grieve, we start on the healing path. Just remember the saying ‘ grief is not linear’ , there is no timeline. Grieve the loss of a stable workplace but also celebrate the reclamation of your peace, working on your terms and protecting your peace.
Tell me what you think. Is grieving for your job important?
The Wandering Nurse X
Harnessing the POWER of the Beauty and Grooming Industry for Community Health.
Salon image from Unsplash
“The beauty industry in Kenya is a booming sector with plenty of growth opportunities. It has been estimated that the market for beauty products and services in the country is valued at over KES 20 billion, making it one of the most attractive markets for investors. The Kenyan beauty industry has grown exponentially over the past few years, mainly due to increased consumer demand for quality cosmetics and skin care products and services.”- The Star Newspaper Kenya.
The beauty industry in Kenya is said to be worth billions, with the Star newspaper putting the value at Kes 20 billion and still growing. One would ask how this is the case in the midst of a global cost of living crisis and other economic challenges? This is actually a worldwide phenomena, In the U.K, analysts found that the sale of red lipstick increased whenever there was an economic downtown, the explanation being that, looking and feeling good, boosted morale, giving folks a reason to carry on. Something behavioural economists call “The Lipstick Effect”.
What Is the Lipstick Effect?
The lipstick effect is when consumers still spend money on small indulgences during recessions, economic downturns, or when they personally have little cash. They do not have enough to spend on big-ticket luxury items; however, many still find the cash for purchases of small luxury items, such as premium lipstick. For this reason, companies that benefit from the lipstick effect tend to be resilient even during economic downturns. - Adam Hayes, Investopedia.com
Why am i talking about this and why do i care about why people are spending their money within the beauty industry? I care because this industry has the power to transform healthcare, community healthcare to be precise. It is a public health gem just waiting to be discovered and tapped into. It will literally put back the “Community” into Community Healthcare!
How can the beauty industry help? I hear you ask? Hear me out!
Man at Barber shop by @chrisknight on Unsplash
Grooming and beauty routines have been a part of human nature since time immemorial, whether is was done in the privacy of one’s home, within an informal community gathering or in formal settings like hair salons, barber shops or highend spa centers. They also act as social gathering places, where people talk and focus on the daily goings on of life in general, private problems and politics, while also having some downtime to themselves away from their daily hectic life routines. Hair salons and barber shops can be found almost everywhere in any setting, be it the city, informal settlements or rural communities. They exist in some shape or form, more often than not, providing not only beauty and grooming services , but also group and individual therapy of sorts, comradery, sense of belonging and most importantly TRUST. The bond between a hairdresser, barber or beautician and their client is sacred and built on trust. That is why people stick to their hairdresser or barber (shop) for a long time, sometimes even travelling for miles to where they are and feel bad, almost like committing adultery, when they go get services elsewhere.
For quite a while now medicine and the pharmaceutical industry have focused more on curative medicine than preventative medicine, especially for non-communicable diseases, like Type 2 Diabetes, High Blood Pressure, Cardiovascular diseases and cancer. This lack of focus has caused an increase of people being sick and diagnosed with preventable diseases, putting a burden all over the world on healthcare systems, resources and economies. While preventative medicine is slowly making a comeback as the world realises that “prevention is really better than cure”, screening services are still not up to par and people are falling through the cracks and Black people are more disproportionately affected than any other community.
According to The World Health Organisation ( WHO ) Africa, 25% of hospital admissions and 13% of deaths in Kenya are due to Cardiovascular disease, with hypertension being the most significant risk factor ( WHO Africa, 2018). This led to the launch of the national cardiovascular diseases guidelines by the Kenyan Ministry of Health. A survey conducted in 2015 by The World Organisation (WHO) Africa, found that due to demographic and social changes which included an aging population, urbanisation and the adoption of unhealthy lifestyles, led to a rise in Diabetes in Kenya, with 88% of people not knowing their diabetes status, which was a cause for great concern given the costly public health implications for the country. The third leading cause of death in Kenya after infectious and cardiovascular diseases, is Cancer , with Cervical Cancer being the 4th most frequently diagnosed cancer and the 4th leading cause of cancer in death in Kenyan Women(National Cancer Institute of Kenya, 2023). Other cancer statistics are available on the National Cancer Institute of Kenya’s website. A third of Cancers are preventable. Early screening and detection improves the possibilities of successful treatment.
Early Screening and Detection: the gaps and possible solution.
If there is one thing i have learnt, it is that time is money and it is scarce, but with proper planning and time management, one can make good use the time they have. The other thing i have learnt, is that going to a hospital or clinic is a big deal, both in terms of time and money and most Kenyans are weary of hospitals. Both things would explain the low uptake of screening services provided. People are time starved and mostly use hospitals as a last resort for treatment, less so for screening services which tend to be provided during working hours and are focused around international themed days or months that are centred around those particular diseases. For example, the various Kenyan agencies, like the Ministry of Health, use social media to highlight their various screening campaigns, but you would be hard pressed to find any leaflets around those campaigns and where they are situated when you walk into any government office building, supermarket, malls or generally anywhere frequented by the targeted population!
The whole public health strategy to screening and raising awareness needs a rethink with the introduction and utilisation of different stakeholders, because clearly, the current strategy is not working. Meet the people where they are at, where they are more comfortable and where they prioritise their time with the person(people) they trust. You need to look no further than the barber shop, the hairdressers and salon and the spa centres.
One research study published in The New England Journal of Medicine in 2018, showed that when 52 barbershops offered blood pressure monitoring services, their participants blood pressures dropped. Joseph Ravenell, in his Ted talk, explores how barbershops can keep men healthy( links located at the end of post). So the precedent is there. It can be done and with successful results.
Imagine if you went to your local Kinyozi and while you were having you weekly shave or treatment, you could have your blood pressure checked? You could have a conversation about the importance of Prostate Cancer screening and where you can get one? You could have a blood test to check your blood sugar levels and your risk of type 2 diabetes? You could talk to your fellow men about their experiences? Have that support?
Imagine if your local hairdressers or salon had leaflets about the importance of early screening? Information about the five gynaecological cancers that affect women and what to look out for? If your smear test and vulva health check could be done at the same time as you were getting that brazillian wax? If your appointment included a wellness check? A blood draw to check for your hormonal levels? Your Vitamin D levels? If you could have an all round wellness check while having your selfcare session at your local salon, spa centre or barber shop? Imagine how many lives that could be saved due to early screening and just good old conversation within well managed time constraints? The list is endless.
Now ask yourself: WHY ARE WE NOT HARNESSING THE POWER OF THE BEAUTY AND GROOMING INDUSTRY FOR COMMUNITY HEALTH? We have done it before during the AIDS/HIV Pandemic, why can it not translate to other Non-Communicable Diseases?
For my fellow Healthcare Workers in Kenya reading this, there is an opportunity here to step in and offer these much needed services. Find a salon, a barbershop, a spa centre, a lab, a Pharmacist, a Registered Nurse to partner with.
The Wandering Nurse. @thewanderingnurse.rn
Sources and Further Reading:
Kenya launches national cardiovascular disease management guidlines: https://www.afro.who.int/news/kenya-launches-national-cardiovascular-disease-management-guidelines-0
No-cost diabetes care saving young lives in Kenya: https://www.afro.who.int/photo-story/no-cost-diabetes-care-saving-young-lives-kenya#:~:text=Diabetes%20has%20been%20on%20the,not%20know%20their%20diabetes%20status.
National Cancer Institute of Kenya: https://www.ncikenya.or.ke/index
An overview of the Kenyan beauty industry: trends and opportunities- https://www.the-star.co.ke/news/2023-01-12-an-overview-of-the-kenyan-beauty-industry-trends-and-opportunities/
Lipstick Effect: Definition, Theory, Value as Economic Indicator: https://www.investopedia.com/terms/l/lipstick-effect.asp#:~:text=The%20lipstick%20effect%20describes%20the,them%20forget%20their%20financial%20problems.
How Barber Shops can keep Men healthy: https://www.ted.com/talks/joseph_ravenell_how_barbershops_can_keep_men_healthy?language=en
What happens when you put a Pharmacist at the Barber: https://www.menshealth.com/health/a19430360/barber-shops-blood-pressure-study/
Why Barber shops may be the key to improving Black Men’s Health: https://time.com/5480371/barbershop-blood-pressure-program/
A Case for Clinical Nurse Specialists in Kenya?
Whilst the long awaited rainy season is upon us in Kenya, it also heralds the season of joint aches and pains for my dad, especially his knees. A trip to the doctors saw him sorted out with some pain killers, with a recommendation to come back and see a specialist should he not see any improvement in his symptoms. The said specialist could only be seen on a Wednesday, as that was the only time he held a clinic.
A couple of weeks later, with no significant improvement in his symptoms, he decided to go see the specialist. He called me once he was there and quickly handed over the phone to the doctor, who introduced himself and then to my surprise revealed that he was an orthopaedic surgeon. You see, i was at a loss as to why my Dad was seeing an orthopaedic surgeon and not a Rheumatologist? I was also questioning as to if seeing folks with joint pains was actually the best use of the surgeons time and what, if any was the waiting list like to see him? Anyway, he managed to convince my Dad that it was indeed time to start using a walking stick to help take the pressure off his knees abit.
All this got me thinking about the state of specialist care in Kenya and the under utilisation of nurses and their skills within this sector. Why are there no Clinical Nurse Specialists in Kenya? And is it time ( long overdue) to introduce this branch of Nursing?
Healthcare worker with a patient.
Nurse training in Kenya, be it via government training institutions like the Kenya Medical Training Colleges ( KMTC) or via private colleges and universities, in my opinion, is one of the most rigorous and thorough all round training programme and produces very knowledgable, highly skilled and competent Nurses, who can work in various sectors and departments. These Nurses qualify with a wide range of skills from history taking, clerking, pharmacology, management just to name a few, making them well equipped to work as part of a team within a hospital setting to autonomously within a rural health centre setting.
So it makes no sense as to why Nurses are not being used to their full potential. Why patients have to wait to see a specialist. Why there is no proper follow-up or aftercare of specialist patients who are on long-term care, because there is a shortage of specialists.
Why are Clinical Nurse Specialists Important?
The concept of a Clinical Nurse Specialist is not something that is new within the Kenyan healthcare system. We do have Nurses who are specialists in areas like Immunisations and Family Planning, Infectious Diseases just to name a few areas. The problem is that, it has not extended to other speciality areas like Rheumatology, Diabetes, Cancer, just to name a few, where long-term care and close follow-up is needed to optimise treatment and improve patients quality of life. This would also create a new career path for Nurses, which would in turn help solve the employment crisis that is plaguing the Nursing sector and seems to mainly affect degree holder Nurses but also improve continuity and consistency in patient care.
So who is a Clinical Nurse Specialist and why are they important?
“Clinical Specialist Nurses/ Clinical Nurse Specialists ( CNS) work in a variety of acute and community settings, specialising in particular areas of practice, as part of a multidisciplinary team to provide high quality, patient-centred, timely and cost-effective care. They provide tailored care depending on the patient’s level of need. They also provide education and support for patients to manage their symptoms, particularly patients with long term conditions and multiple morbidities”- Royal College of Nursing(RCN).
Like every other country in the world, Kenya has a shortage of healthcare workers, and that includes Specialist consultant Doctors. This shortage means that there is a high demand often with long waiting times for one to be seen and diagnosed, as they divide their time between their hospital(s) and private practice, and often incurs a hefty price in terms of consultation and various fees. Access to specialist care also involves travelling to the big city hospitals or Doctor’s plaza, where they have their private practices. All these are barriers towards patient care and safety, as more often than not, continuity of care is lost, with the patient sometimes ending up being worse off, as their condition deteriorates, where follow-up care involves them going through the whole process above. Having a Clinical Nurse Specialist can help bridge or even close those gaps.
A Clinical Nurse Specialist can take over the supervision and follow-up care of already diagnosed patients, freeing up the Consultant Specialist to diagnose new patients and more complex patients who require a their input. This then ensures that the patients are followed-up and continuity of care is maintained which in turn helps to keep the patients out of hospital admission. From a revenue point of view, patients save money on consultation fees, transport and hospital admission costs and the specialists increase their revenue by being able to see more new patients.
On the whole, Clinical Nurse Specialists help improve patient outcomes, decrease specialist consultants workload and deliver high quality care. So isn’t it high time the Kenyan healthcare system utilised the valuable resource that is the Clinical Nurse Specialist?
Useful Links:
The Busyness of DYING!
Hi, welcome to another episode on the wandering nurse podcast.
This episode is about me rambling on about Men's boxer shorts and my personal issues around death and my own mortality.
Psst... Let me tell you a secret.
Please allow me to interrupt your scrolling as I bring you News about boxershorts and not those fancy boy shorts but plain old Jersey mens boxer shorts! Lend me your ears, for you will not want to miss this piece of life changing news!
I have reached that age where i value comfort above all else. I don’t have time for fancy underwear that make me wonder what my femoral artery did to them, as they try to cut off my blood supply! and do not get me started on thongs! Why someone would want to walk around with a constant wedgie and sore bum crack is beyond me, but if that is your thing, much respect to you.
It is not much to ask for some level of comfort out of the many contraptions we are required to wear and it looks like i am not alone in this thinking because the history of women’s underwear has somewhat come full circle from drawers in the 18th century to 21st century boy shorts gaining popularity. So when my sister called me a couple of months ago to inform me that she was now wearing her husbands underwear, courtesy of her having forgotten to do her laundry, hence running out of clean panties and that from then henceforth she would be wearing his underwear! I laughed as it was soo her ( she does the most random things, like calling me yesterday as an emergency, just to let me know that Aquaman had been returned to sender- her words), any way i digress.
So i found myself one lazy morning adopting her sharing is caring ways and that is when i realised we had truly been conned as women! The levels of ease and comfort i got from the boxer shorts was on another level. My femoral artery could now do it’s God given work unhindered plus everything was all held in one place, comfortably . So i quickly used my Amazon prime addiction( it is a thing) to find women’s boy shorts and 48hours and quick wash and dry later , i was the proud owner of a couple of packs.
They unfortunately turned out as another con , like everything else marketed to women( like how are women’s shaving razors so expensive, while the same make of Men’s are cheaper and do the same job?). They were not as comfortable and by now i should have learnt that most of these concepts only work on industry size/ shaped women’s bodies ! So off i marched to Primark ( i was not about to spend premium money! i was not aiming to look like David Gandy or Beckham, see underwear adverts for reference) and bought me a pack of cheap as chips, men’s jersey boxer shorts underwear and lets us just say, i have not looked back since( well except for the odd days, mother nature pays her monthly visits and reenforcement trounce comfort)
Don’t take our word for it( we may just be a pair of mad sisters ). Go and get yourself a pair and you can thank me later! For those who already knew this secret and did not share, may your bum cracks be forever sore .Thank you for listening/reading and normal service shall resume next week .
P/S- they are a hundred percent cotton ( all round goodness for your ladybits!)
The Busyness of DYING.
January 29 2023
Today i was completely paralysed in bed, i could not get up, i felt like i could not breathe, like i had to train my body onto how to draw breath. This has been happening a lot lately, not the paralysed in bed part but the feeling like i can not breathe, like i am having a panic attack. I keep on telling myself that I'm probably too stressed for my own good.
My dad had called, very early in the morning, which is unlike him, so that spooked me and when i called back i expected the worst and yes it was bad news, a friend of a friends had died and while i did not know her that well, i had known her enough to feel saddened by her death and the family she leaves behind. This reminded me of life and how short it is and i was reminded of something that i have become aware of lately, in the past couple of years: I have been soo busy dying that i have forgotten to live!
To understand my busyness with dying, we have to go back a couple of decades to when i think the trauma of death and dying started, but i wasn’t aware of it till later( self reflection and introspection and all!). A friends wife shared a video post about childhood trauma of her talking about how she can not nurse any of her family members and gets annoyed when her husband falls sick as all she can think of is that he is going to die. It was a post i could totally relate to because i was the same, having looked after loved ones from a young age and watched most of them die, i had not realised how those experiences had affected me. Despite being a nurse by profession, i totally freeze when any of my family members are sick, i go into withdrawal mode and sometimes even anger, angry about why they are weak and have fallen sick. I literally struggle to look after them in any capacity and i had not realised that it was a trauma reaction caused by my childhood experiences of being a carer for several relatives and for my own mother as well.
But while witnessing those that i loved and cared about die around me definetly instilled the fear of nursing those close to me, my busyness with dying was majorly sparked by the death of my Mother. My mother died at the tender age of 46. When you are a child, you always see your parents as old and rarely think of their lives as individual people outside their role of being your parent. The significance of her age at death( which i only found out years later as i never knew her year or day of birth till later after her death) only hit me when i became a parent( although it took time for me to realise it).
Becoming a parent really changes your perspective of the world at large, suddenly everything is frightening and dangerous and all you want to do is to protect this/these little beings that are now dependent on you who do not come with an instruction manual. It is literally on a wing and a prayer and sometimes on lots of unsolicited, unhelpful advice! And also it is from your childhood experiences of how you were parented or how you witnessed others being parented. You suddenly start to see your parents through and from a different lens. You start to wonder and be interested in their lives as individuals, as parents, what their hopes and dreams were and you also start to measure yourself via their milestones ( or maybe that's just me).
I found myself calculating my mothers age at different stages and milestones of her life: how old she was when she had her first child, my half-brother? How old was she when she got married and had me? How old she was she had my other half siblings, you get the picture, and i would then compare her milestones to my own. It helped me know and try to understand her better, helped me try to understand the decisions she made ( good, bad and ugly). It also shaped my parenting skills and what experiences and skills i wanted my children to have and each time something went wrong or they didn’t meet my expectations at that moment, i would find myself telling them that i was doing/teaching them (whatever it was at that time) so that they would be able to stand on their own two feet and look after themselves when i was not around! It was all so automatic that it never occurred to me that from the day they were born, i had been preparing my children for my death.
I had built my whole life structure, work, experiences, memories, everything around my death. I was so busy dying that i was not living, not living my dreams and aspirations, not giving my self any grace or leeway to get anything wrong. I was constantly on a schedule to get everything done and done right so that when i was dead, my children would not struggle.
Talk about unresolved childhood trauma! In my head, i could not possibly outlive my mother ( why i thought that is something i still have not figured out, given that i could go with my dad and live well into my nineties! But that is a story for another day).
So you must be wondering what all this has got to do with my being paralysed in bed, suffering from what seems like a panic attack, willing myself to breathe? Well it has everything to do with it, because this year i turn 45, which means i only have one more year to live ( if my fears are anything to go by!). My children, ( who might need therapy later), thank God ,are
on their way to becoming individual, wholesome adults and i was in a great place spiritually. In all sense and purposes i had accomplished what i had set out to do and i was ready, but was I? Why was i lying in bed paralysed with fear, unable to breathe? Why was i having frequent panic like attacks? The truth is, i don’t know! All i know is that somewhere along the line, i had completely forgotten to live, i had been so focused and wound up in being busy trying to prepare my family for my death that when i finally thought i had achieved that, i realised that i did not know what to do. If i was not busying dying what was i meant to do, how was i meant to live? And how was i meant to live in this one year that i had left? ( i know! Im a work in progress)
Surely if my fear was of dying, then my chosen profession of Nursing, would have cured me of that ( if we go b y Immersion therapy! ) as i had wholly and totally immersed myself in the art and science of life and death, so it stands to reason that my fear is of living! The irony is that i am a firm believer in fate and pre ordained destiny, th at when one’s pre-ordained time is up then it is up and that no one knows how or when they will die.
So in theory i could drop dead any minute, or right at the age of 46 ( not tempting fate) or go on to live a long and healthy life like my dad! I would never know, but in the meantime i am paralysed by the year i supposedly have left and learning the art of living. ( i did say i am a work in progress),
So while i figure out how to eat, pray, love my way to my supposed death, i am trusting and charging you all to keep me in check. Should i actually die at 46 or live past it, i hope you will all teach me how to live ( once i am done with the busyness of dying).
How do we build wealth and financial security as Black Female Nurses?
Tweet by David Ring RN
I have stopped reading any reports that come out about racism at work and society because as a Black Woman, I live it everyday and no report or survey is going to tell me what i and other Black people do not already know. Reports and surveys without actual change and actions do nothing but perpetuate the racial trauma we already experience. So when i saw the above tweet highlighting an NMC report about Black African Nurses, i was not surprised, because again, it is something i have talked about and written about. I chucked it up to another casualty of racism and how it frames our careers and lives as Black Nurses.
As days went by, this tweet stuck with me and i reflected on the ways racism and the status quo goes on to affect every aspect of our lives as Black Nurses. Nursing is a predominantly female profession and so it stands to reason that those most affected by the statistics reported by the NMC report would be Black female nurses. Nursing is a career and a career implies progression, climbing the ladder or whatever it is you want to call it! But is it just a job and not a career when your gender and race are barriers to your progression?
Countless studies and reports have shown that women earn far much less than their male counterparts in all parts of society( google can be your friend if you want to read all about it), not to mention the time off and part time working that women have to take on, if they want to start and raise a family. This gap in payment also translates to pensions thus affecting women’s retirement. As Black female nurses we get to fight on two fronts, the gender pay gap and the ethnicity pay gap, add the lack of career progression into the mix then you start to get the stark and bleak picture that this all paints for our futures!
I have not worked in the care home sector, so really can not speak to work and career progressions within that sector but i’m sure it holds the same prospects for Black Nurses as in any other sector: cheap labour and barriers to progression. As for the agency sector, it holds no progression whatsoever but provides that work flexibility that doesn’t exist with a substantive post, without the job security( but then again is job security a luxury afforded to us Black Nurses?)! More often than not, we sacrifice our dreams and hopes for that fulfilling career as a nurse( and i’m not talking about job satisfactionhere), and buckle down and work the hand that we have been dealt, as we have our immediate and extended families depending on us both here and abroad( back home), as well as the ever present bills and everyday living costs.
How do we ensure that we secure ourselves financially in the present and for the future? That we have something to show for all our hard work and that we can retire and live comfortably with our health both physical and mental, intact? That we can build or start to build that generational wealth? That we can leave our children better off? While the nursing path career now has more choices than just bedside nursing, we as Black Nurses, especially female nurses, have to find a way to diversify like some of our white colleagues who have taken to providing beauty treatments like botox or like Doctors and other Allied health professionals who can open a private practice We can not just rely on that one income stream from working for a care home or agency. How do we make our nursing NMC PIN work for us?
I can not pretend to have the answers as to how we can secure ourselves financially, i will leave that to the experts, but i hope this post starts a conversation, starts something, a spark, a desire to learn about wealth management, to have wealth, blessed wealth, to live comfortably , to not shy away from the notion that we are worthy, worthy to live a comfortable and financially secure life.
If you are looking for some direction or inspiration, then i would recommend reading ‘The Professional Troublemaker: The fear fighters manual’ https://amzn.to/3uHMLbYby Luvvie Ajayi Jones and also listening to the podcast as well. Another great book to read would be ‘The Power of Expertise’ https://amzn.to/3HJaQXVby Elle Pierson RN and ‘We should all be Millionaires’ https://amzn.to/3BqbFAWby Rachel Rodgers another one would be ‘Get Good with Money’ https://amzn.to/3W5XSHtby Tiffany Aliche. You can also follow their accounts on social media for hints and tips if reading is not your thing( you can get them in audio format as well!).
Here is to taking charge of our financial security and to a better future as Black (African) Nurses!
What are some of the best career advice you have heard?
🩺Was busy minding my own business, curled up on the sofa, catching up on my favourite show #sweetmagnolias when I heard this 👇🏾 and I had an Aha moment! One of the boys working in the kitchen wanted to know how to become a chef and how much school would cost? So Erick, the chef tells him, he has to be sure it is what he wants as it can be a lonely profession with long hours, leaving no time for a social life let alone family life!
🩺It has to be up there with some of the best career advice out there. Basically what he was saying was that if you are not passionate about something, then choosing it as a career will be a slog! You will tired down doing a job you hate just to pay off the debt you took to study it 🙆🏾♀️😶😭.
🩺I immediately thought of #Nursing (as that's my profession ) and how thankless the work can sometimes feel, especially now with everyone just about hanging in there, with nothing more left to give. Don't get me started on the pay! As much as it has been labelled as a calling by some, even the most charitable, passionate and vocational Nurse is struggling at the moment 😕, questioning how much longer they can hold on for?
🩺But it is not all bleak( believe me). Records show that alot of people have been inspired to take up Nursing, having witnessed how brilliant nurses have been during the pandemic( we have always been brilliant, but we will take our flowers 💐 even if late). All that is great given the huge financial burden one now has to take on to train as a nurse! That makes this 👇🏾 quote even more poignant - 🗨make sure you love it, before going into debt for it 🗨 and if that is the case, then a Huge welcome to you all #studentnurses and aspiring futures nurses into the wonderful, rollercoaster life that is Nursing.
💊🩺💊🩺💊🩺💊🩺💊🩺💊
#NHS #nursingschool #Nursing #careeradvice #mentoring #nurseconsultant
WHAT IS BLOCKING YOUR CAREER PROGRESSION?
“The days when NHS staff can progress at equal level is the day NHS can say they are truly inclusive and equal. If newly graduated nurses can reach to Band 8 within 3 years and non-clinical support staff to Band 6 but ethnic minority staff have to wait atleast minimum 10-20 years”. Mushtag
@mskahin1 (Twitter)
The above tweet from Mushtag was as usual a ‘pause for thought’ read and it reminded me of something a couple of Nurses from an ethnic minority background told me when i asked them why they had not applied for the Band 7 post in their department? Their answer was sad, but not shocking and was one i had heard several times, including from myself- They did not want the added stress and lack of support that came with moving up and that they were comfortable where they were, not happy or content but comfortable. A put your invisible head down and get on with the work, kind of situation. Get your pay and maintain the status quo!
As a Black Nurse, i understood this all too well. When opportunities seem like traps, not because you are not qualified, (in fact you are most likely overqualified, given that we always have to put in twice the work!). But because, you have witnessed those before you, who worked hard, climbed the ladder only to find that there is no support whatsoever at the top. That you would be expected to take on much more and often for much less. That the brick walls you will encounter will knock you so hard that you will end up being a shell of the person you once were and that finally you will pay heavily with your health, only to realise that even in sickness/illness, we are still not the same!
At one former workplace, Black Nurses were terrified of promotions. They told me that it was because they had witnessed their colleagues being sacked right after being promoted. To them a promotion to either Ward Sister or Manager = a P45. There was this one ward that seemed to have problems and no manager had ever survived once they were moved to that ward, most had to be redeployed elsewhere. So when one of the Black senior Nurses on our ward, after years of applying, got given the post of ward sister and moved to that ward, instead of celebrating her promotion, all the Black Nurses were sad, a mourning of sorts, because they were sure she was on her way out. That is how messed up this whole situation was.
This whole situation is also reflected in the Ethnicity Pay Gap as is evident in the research paper below ⬇️ . One may say, that Agenda for Change(AFC) has eliminated inequality and the pay gap or that within the NHS it is not common for there to be pay gaps amongst Nurses due to banding. But even within those banding, there are different pay-points and your moving up a pay-point is dependent on your managers assessment during your PDR, also on what progresses you have made. If you have not been given those opportunities to better yourself, to improve your practice, access to training which is not just the run of the mill mandatory training! If you have not been afforded those opportunities but instead have had your workload increased, as a warped way of rewarding your hard work, that you have proved that you can handle more responsibility, but without the correct pay, then a pay gap ensues and inequality is at play, do not be fooled.
What was your first encounter of racism? Talking Racism with Getrude of World Class Nurse.
As part of Black History Month in the U.K, I talked racism in life in general and in Nursing with World Class Nurse- Getrude on her platform. We also talked about what help is out there for Black Nurses in terms of support.
We also talked abit about my book, it’s inspiration and how it can help Black Nurses. I will be donating a couple of books to World Class Nurse as well.
Click on the link below ⬇️⬇️ to listen to the talk.
https://youtu.be/CPLF0MpgH2o
What's New? Flexible Working and the NHS.
There has been a lot of talk about flexible working in the media, especially now that we have a stressed and burnt-out workforce in the NHS , not to mention staff shortages. The pandemic has also shown the importance of work-life balance and people’s perspective as to what is important in their life has also shifted. A more balanced life is now more than ever appealing than the rat race we were all sold. So it came as no surprise when an email from work had an article about the new changes to flexible working procedures. Apparently as a Nurse, you can now make unlimited flexible working hours requests right from day one on your job ( Personally i would rather have it ironed out during recruitment/interview stage and have it written down in my contract before commencing employment).
As you may be aware, Section 33 of the NHS Terms & Conditions Handbook changed to reflect a change in approach to flexible working. This reflects the commitment in the NHS People Plan to support our colleagues to achieve a healthy work-life balance, to aid staff retention as well as attracting new and diverse talent to the organisation. Research shows that there is an increasing demand for flexible working from colleagues across all age ranges and genders.
The surprise was where this information was located, Section 33 of the NHS Terms and Conditions Handbook! This admittedly was the first time i was hearing of such a handbook and i had so many questions not to mention i was curious as to where one would find this Handbook. What was it about? Who had written it? and why had i never heard of it? So read the highlights of the changes as laid out in the email, which to me did not look like change at all but much of the same as before in terms of requesting flexible working and the person who had to approve it but at least there now was what looked like a clear stage to follow, a formal procedure consisting of 4 stages ( as per this trust ) and what actions and outcomes were expected or not and how they would be handled. I was still sceptical as to how or if it will work especially for my fellow Black Nurses as management still pretty much remained the same.
The key changes include:
· A stronger focus on creatively exploring ways to support flexible working wherever possible, whilst still supporting high quality, effective service delivery.
· The right for all employees to request flexible working from the first day of their employment regardless of the reason for the request, or the role/band or grade/area the individual is employed in.
· No limit on the number of flexible working requests that can be made in a 12 month period.
· A focus on normalising flexible working conversations through regular and informal discussions at induction, PDR, 1:1s and team meetings. The purpose of this is to explore the individual’s needs and wishes and what options might be available to help employees think about whether they want to make a request.
I did a quick google search, where would we be without google! and i found this Handbook on a website that said NHS Employers. Now this was another revelation, who were NHS Employers and if they were that important and dealt with matters NHS workforce related, how come i had never heard of them? The more i read the more perturbed and angry i got as had i known about them then my work situation in terms of flexible working requests might have turned out differently. Who are NHS EMPLOYERS and why should you know about them? They are a government agency, part of the NHS Confederation and from the looks of it a very big deal. I would call them the mother of all NHS HR.
NHS Employers is an organisation which acts on behalf of NHS trusts in the National Health Service in England and Wales. It was formed in 2004, is part of the NHS Confederation, and negotiates contracts with healthcare staff on behalf of the government.
“We are the employers’ organisation for the NHS in England. We support workforce leaders and represent employers and systems to develop a sustainable workforce and be the best employers they can be. We are part of the NHS Confederation.”
I scanned my old contracts to find any mention of them, yes we all knew about the NHS Constitution but not of this Handbook that held the answers to all things work related for the NHS. The ultimate NHS HR Bible. The reason i was looking was because this information would have been of tremendous use to me almost two years ago when i needed flexible working hours or what i now know is called an employment break ( NHS T&C section 34) in terms of taking time off but no one not even my then manager knew who or where to turn to. I wondered both loudly and privately about senior managers often consultants who were on sabbaticals and how they got those and what the process was? I even discussed this with my then manager as having this information would have influenced how i went about making the choice of caring for my Dad and work. So i am annoyed that nowhere in my contract not even on the HR page of the trust on the intranet was it mentioned that an employee could find this information in the NHS Terms and Condition Handbook! More alarming is that my then manager had no clue, while this was meant to be part of leadership knowledge so to speak. The only place i could find ant mention of them was under matters of pay as below.
“ARRANGEMENTS FOR DETERMINING PAY AND CONDITIONS OF SERVICE This appointment is subject to the National Terms and Conditions of Service that are agreed by the NHS Staff Council (and Agenda for Change: NHS Terms and Conditions of Service). A copy of the Terms and Conditions of Service is available from your Manager or on the Trust intranet.”
Anyway my time has passed now and whatever decisions good or bad have long been made but i would be remiss in my duties if i did not mention the Handbook and the importance of being thoroughly acquainted with every aspect and detail of it just like i advised in the Extreme Sport of Nursing While Black: An unofficial survival guide book under ‘wolf in sheep’s clothing aka HR’. Please have a read as it may be the answer to the questions you have been asking and might help you in making that work-life decision.
NHS Terms & Conditions Handbook: https://www.nhsemployers.org/publications/tchandbook
NHS Employers: https://www.nhsemployers.org/
Now you know!
Racism, Nursing and the NHS
Racism,Nursing and the NHS
The Extreme Sport of Nursing While Black: The Unofficial Survival Guide, started off as me passing on the do’s and dont’s to my daughter who was thinking of working for the NHS and like every other thing her race came into play. She is in the band of what i call the ‘triple threat’ i.e Woman, Black and Muslim. Unfortunately she, like many of us before her would have to do thrice the work, constantly prove herself in all that she does. I was determined to at least equip her with the weapons she would need as yes it is a war out there. At the same time there was also a lot of issues around racism and nursing on social media and this is how the book or booklet idea was born of using my experiences working as a nurse as examples of the things that are likely to trip you up as a black nurse on the NHS and how to avoid them, hence making work a tad more bearable while the NHS and other health organisations catch up to racism within themselves and work towards finding lasting solutions to eradicating it within and without themselves. For far too long, the onus of fixing the racism problems that plague the world had been left at our doors, we, the very victims. it was time the script was flipped.
It is crazy that Black people are still making firsts in 2021 worldwide and in the NHS. You would be forgiven for thinking that Black people only recently arrived in the U.K as opposed to having been part of the NHS since it's inception! How is it that out of the 223 NHS trusts only two have chief excutives from BME background , one being black? According to NHS providers.org: https://nhsproviders.org/inclusive-leadership this under representation of BME’s is repeated across NHS boards country wide, and even though they note that the number of senior BME’s is increasing, i wonder how many of them are Black? The NMC does not escape this affliction, looking at their 16 senior representatives.
How is it that those who are at the snowy white peaks of power within the NHS did not notice or question why the peak was so white? It all well and good that they are questioning this now but how is it that they did not notice this anomaly while rising up? How did they not question why their black colleagues were hardly getting out of the band 5 starting block, while they were sprinting towards positions of power? How did they not notice the email exchanges alerting them to new career progression options or the fact that some had job vacancy adverts tailored to their specific needs, just short of actually naming them? How did it escape them that they were disproportionately referring BME staff to their regulators for fitness to practice? Did they not notice or did they not want to notice?
How are we as BME healthcare staff and more importantly as Black healthcare staff now trust that these same people who most likely scaled to the snowy peaks of power on the back of our blood, sweat and tears all over sudden have been on their road to Damascus and have now realised that we as Black healthcare workers are equally as qualified if not over qualified and are quite capable to sit at and take command of the table? The proof will be in the pudding or so the saying goes because we Black people are not going anywhere! So while you all are busy trying to find ways to ‘invite’ us to the table, a table which we really don't need an invite to as we are not guests and have never been,you will come to realise, hopefully when it is not too late that We own the table!