Through the Keyhole by @fionacmcqueen

Excellence in Care

Like most nurses, I’ve had another busy week and whilst the nature of what I’ve been involved in all led to the same core goal (excellence in care), the people I met and places I visited were just that bit different this week.

If I’m being honest, I breathed a sigh of relief at being able to meet community teams across the county before anyone (politely) observed that all my clinical visits had been in hospital wards – and acute wards at that.

And my look through the keyhole was into the meeting of Scotland’s Board Chief Executives – both their private meeting and also with Paul Gray (PAG1962), the Director General of the Scottish NHS.

My week started in meeting with Derek Barron where we discussed a number of issues, including – yes you’ve guessed – nurse staffing and the difficulties in-patient mental health wards are facing – in particular when people require enhanced observations.

Then Janet Mckay and I discussed how we improve membership of the Area Nurse & Midwifery Professional Committee and also the place of the professional committees within the Health & Social Care Partnerships.

Leadership Walkround

The pledge tree from Tommy on Tour growing healthily in S10

Grateful thanks went to SCN Lynsey Renfrew as she sent me off with a spring in my step having visited S10 & 11 on a Patient Safety Leadership Walk round. The safety walk rounds are a crucial part in the overall patient safety programme so that the Board can be alerted to issues that are affecting safe delivery of care. It’s always of course a great opportunity for staff to showcase the good work they are doing and when I do a walk round I usually take the opportunity to discuss professional practice issues.

In this case it was good to see the staff being responsive to patient needs and Lynsey taking an objective view on how the team can provide person centred care – including looking at visiting times, and the thought for the day was to check for MUST scores (with the nutrition board in the kitchen clearly outlining people’s needs for support with meals and somebody’s preference for that old favourite tomato soup).

A look through the keyhole ………..Chief Execs are Focussed on Improving Care and Services

As Chair of the Scottish Executive Nurse Directors (SEND) I attend the Chief Executives meetings every quarter and this month John Burns (@CEOAAA) had also asked me to attend on his behalf as he was on annual leave. It’s often intriguing to attend a meeting as a guest and observe how in this case, Board Chief Executives work and in particular, how they interact with the Scottish Government at their meeting with Paul Gray. The reassuring part of the day was that the topics that were heavy on the Chief Execs’ minds, were also the ones that the Ayrshire nurses I have been meeting this week were concerned about (just on a bigger scale).

The private CEs meeting discussed how we can better plan services, the pressures of unscheduled care, professionalism, health and social care integration, and from Healthcare Improvement Scotland, inspections can be carried out that are meaningful and really do lead to improvements in care without being sensationalised by the local media.

The afternoon meeting also discussed the pressures the services are experiencing, what’s happening with integration as well as taking a sensible approach to planning services so that we reach the 20:20 vision; with Paul Gray clearly articulating the need to ensure we work with our communities to make sure that services are responsive to need, as well as being safe and effective.

Perhaps the best job in the world?

One of the real privileges I have in my work is to spend time with practitioners to hear about what’s on their mind – whether that’s by visiting wards and departments, or by asking community based staff to take time out of their busy day and come to meet with me. As readers of my blogs know, I really value meeting with nursing teams to hear what’s on their minds so that I can do my job better. So this week, I’d an opportunity to meet with mental health and general community teams (in their widest sense).

I listened to concerns that staff have about their ability to provide excellence in care which included hospital discharge planning being essential to good care in the community, the need for more self-management, concerns raised about what’s happening nationally to work looking at school nursing, as well as workload pressures and how as experienced community staff leave, what we need to do to support new members of the team to flourish.

Let me know

I also took the opportunity to discuss what the profession needs to do to reliably provide excellence in care – and would be keen for people to let me know what they think needs to be done- either by e-mail or by posting a comment on my blog.

The Sorcerer’s Apprentice

Another week’s leave beckons (school uniform and other such provisions need to be bought) so again leaving my blog in Derek’s capable hands (@dtbarron).