tag:blogger.com,1999:blog-31568338215063705432024-02-20T21:27:38.621-08:00Healthcare ChatThis began life as one of the blogs which complemented the bi-weekly discussion thread on twitter (#healthcarechat) moderated by Ali Handscomb who is a blogger and nurse and Director of GTR Coaching LTD and Carol Haigh who is a Professor of Nursing of Manchester Metropolitan university & full-time geek goddess.
These days Carol uses this site to blog about other healthcare issues when things bother her!Loracenna@gmail.comhttp://www.blogger.com/profile/18195902043884586453noreply@blogger.comBlogger19125tag:blogger.com,1999:blog-3156833821506370543.post-9879089063288607342015-01-22T06:22:00.000-08:002015-01-22T06:22:12.725-08:00Before you sign the CDF petition...<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4afR-r8d00l5DT_gWGfZTeB1o1LqWtJZqHK2mdp-dwzgFGLW_GjSKqzOieHLnQhoo72WndrgfXNP9U3n_bg3gz7epbO0luuxeA-LvgMfA0X59vpLW5FjbULXukwbOHwvZ219Qz5QhLeFE/s1600/patient-safety_155003654.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4afR-r8d00l5DT_gWGfZTeB1o1LqWtJZqHK2mdp-dwzgFGLW_GjSKqzOieHLnQhoo72WndrgfXNP9U3n_bg3gz7epbO0luuxeA-LvgMfA0X59vpLW5FjbULXukwbOHwvZ219Qz5QhLeFE/s1600/patient-safety_155003654.jpg" height="180" width="320" /></a></div>
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span>
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span>
<span style="font-family: Trebuchet MS, sans-serif;">I love a good petition, me; equal marriage, women's rights, end of life care, I'm all over issues like that and usually first in line to add my name to the cyber-voice but as I get numerous requests from Facebook friend and Twitter chums to sign a petition protesting against cuts to the UK Cancer Drugs Fund (CDF) I'm afraid that I must decline. I do not intend to get into a justification regarding my non-participation, instead I would ask that you, dear reader, just consider the following points before you decide to sign the petition or not.</span><br />
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span>
<br />
<ol style="text-align: left;">
<li><span style="font-family: Trebuchet MS, sans-serif;">The CDF was created to meet a political agenda not a clinical need. The lobbying power of big pharma companies and the ideological stance of the coalition government translated into what Professor Peter Clark (an oncologist who runs the CDF) refers to as a way of exploits the special willingness to pay for cancer drugs (<a href="http://www.bbc.co.uk/news/health-30834543">http://www.bbc.co.uk/news/health-30834543</a>)</span></li>
<li><span style="font-family: Trebuchet MS, sans-serif;">In the UK NICE take responsibility for assessing both the clinical and cost effectiveness of medications and treatments. Despite the image portrayed by certain sections of the media, a NICE meeting does not consist of a group of uncaring people seated around a table dismissing treatments by simply saying saying' this is too expensive'. On the contrary, NICE committees are made up of experience</span><span style="font-family: 'Trebuchet MS', sans-serif;">d </span><span style="font-family: 'Trebuchet MS', sans-serif;">clinicians</span><span style="font-family: Trebuchet MS, sans-serif;">, academics and lay people and they scrutinise all submissions very carefully. Often, the weaker the submission the harder the committee tries to find evidence to support funding the treatment. Believe or not, the people of a NICE committee do not have 'No' as their default setting. However, the cancer drugs fund will consider funding any treatment that is too new or too expensive to obtain NICE approval. What has this done to the pricing regime of the pharmaceutical industry? What has this done to NICE?</span></li>
<li><span style="font-family: Trebuchet MS, sans-serif;">There is clearly an underlying attitude that providing extra time for people who are dying is a societally acceptable, and this cannot easily be contested as a bad thing. However this begs the question; why only people dying of cancer? Why are people dying of AIDs or MS or any other number of terminal illness not equally worthy of preservation? It would be cynical in the extreme, perhaps, to point out that generally cancer is a disease of old age and older people are the ones likely to vote.</span></li>
<li><span style="font-family: Trebuchet MS, sans-serif;">There is no bottomless pot of money here, if we continue to support he CDF, what services do we reduce or close? IVF clinics? Dementia centres? Drug and alcohol services? The money must come from somewhere. Helen Crump, in her recent <a href="http://www.nuffieldtrust.org.uk/blog/cancer-drugs-fund-question-values" target="_blank">blog </a>on this subject his highlighted that we have no information about which services have already suffered through the development of the CDF and this is an important issue in these increasing squeezed times</span></li>
<li><span style="font-family: Trebuchet MS, sans-serif;">There are increasing concerns regarding the relationship between charities and big pharma. Some are open about this relationship see <a href="http://scienceblog.cancerresearchuk.org/2008/05/19/striking-a-deal-with-%E2%80%98big-pharma%E2%80%99/" target="_blank">here</a>, for example but others may be less transparent, this has been discussed by <a href="http://www.amazon.co.uk/Patient-Paradox-Sexed-Medicine-Health/dp/1780660006" target="_blank"> GP Margaret McCartney</a> and further highlighted by blogger Dick Puddlecote <a href="http://dickpuddlecote.blogspot.co.uk/2012/03/hypocrisy-of-pharma-funded-health.html" target="_blank">here</a>. Once this relationship is considered it make the lobbying of charities a little harder to countenance.</span></li>
</ol>
<span style="font-family: Trebuchet MS, sans-serif;">Cancer is a terrible disease and one that most of us fear, if we are honest, and initially this makes protecting the Cancer Drugs Fund a no-brainer when we are asked to sign the petition because who would want to deny treatment to dying cancer patient. What I hope this blog post will do is make people think about the consequences of continuing to support this black hole of funding which overspent by 30.5 million pounds in the last financial year, or at least <a href="https://www.google.co.uk/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#safe=off&q=cancer+drugs+fund+" target="_blank">google</a> it to get both sides of the argument before they make up their mind whether to sign or not.</span><span style="font-family: 'Trebuchet MS', sans-serif;"> </span><br />
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span>
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div>
Loracenna@gmail.comhttp://www.blogger.com/profile/18195902043884586453noreply@blogger.com2 Manchester, UK.54.775345859364471 -3.867187534.185935359364471 -45.1757815 75.364756359364463 37.4414065tag:blogger.com,1999:blog-3156833821506370543.post-14986726910669276802013-05-28T09:26:00.000-07:002013-05-28T09:36:23.365-07:00Challenging the Nightingale Myth<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimNuOOurm9HwHPIw6DlNLLqGnx2KN0S6W1sNGefTtQGpCNp-66vc-hkM6FsjN6oFNdQrGmV5aIn7OLNpge4LTiHJokpeMkSSS9u99Dyro5GNUYedL4D7hKcjtRiT5pUjMzlAymzYhmY314/s1600/_49466732_florence.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="225" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimNuOOurm9HwHPIw6DlNLLqGnx2KN0S6W1sNGefTtQGpCNp-66vc-hkM6FsjN6oFNdQrGmV5aIn7OLNpge4LTiHJokpeMkSSS9u99Dyro5GNUYedL4D7hKcjtRiT5pUjMzlAymzYhmY314/s400/_49466732_florence.jpg" width="400" /></a></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">I</span></span><span style="font-family: 'Trebuchet MS', sans-serif; font-size: 12pt; line-height: 150%;">n 2009, the one hundred and fiftieth anniversary of
the publication of the seminal work ‘Notes on Nursing’ passed more or less
un-remarked across the planet. This lack of interest, particularly when
compared with the global interest that has been focused upon ‘Origin of
Species’ (which shared a similar anniversary), raises the question – is
Florence Nightingale’s still relevant to nursing?</span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<!--[if gte mso 9]><xml>
<w:WordDocument>
<w:View>Normal</w:View>
<w:Zoom>0</w:Zoom>
<w:TrackMoves/>
<w:TrackFormatting/>
<w:PunctuationKerning/>
<w:ValidateAgainstSchemas/>
<w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid>
<w:IgnoreMixedContent>false</w:IgnoreMixedContent>
<w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText>
<w:DoNotPromoteQF/>
<w:LidThemeOther>EN-GB</w:LidThemeOther>
<w:LidThemeAsian>JA</w:LidThemeAsian>
<w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript>
<w:Compatibility>
<w:BreakWrappedTables/>
<w:SnapToGridInCell/>
<w:WrapTextWithPunct/>
<w:UseAsianBreakRules/>
<w:DontGrowAutofit/>
<w:SplitPgBreakAndParaMark/>
<w:EnableOpenTypeKerning/>
<w:DontFlipMirrorIndents/>
<w:OverrideTableStyleHps/>
</w:Compatibility>
<m:mathPr>
<m:mathFont m:val="Cambria Math"/>
<m:brkBin m:val="before"/>
<m:brkBinSub m:val="--"/>
<m:smallFrac m:val="off"/>
<m:dispDef/>
<m:lMargin m:val="0"/>
<m:rMargin m:val="0"/>
<m:defJc m:val="centerGroup"/>
<m:wrapIndent m:val="1440"/>
<m:intLim m:val="subSup"/>
<m:naryLim m:val="undOvr"/>
</m:mathPr></w:WordDocument>
</xml><![endif]--><!--[if gte mso 9]><xml>
<w:LatentStyles DefLockedState="false" DefUnhideWhenUsed="true"
DefSemiHidden="true" DefQFormat="false" DefPriority="99"
LatentStyleCount="276">
<w:LsdException Locked="false" Priority="0" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Normal"/>
<w:LsdException Locked="false" Priority="9" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="heading 1"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 2"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 3"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 4"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 5"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 6"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 7"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 8"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 9"/>
<w:LsdException Locked="false" Priority="39" Name="toc 1"/>
<w:LsdException Locked="false" Priority="39" Name="toc 2"/>
<w:LsdException Locked="false" Priority="39" Name="toc 3"/>
<w:LsdException Locked="false" Priority="39" Name="toc 4"/>
<w:LsdException Locked="false" Priority="39" Name="toc 5"/>
<w:LsdException Locked="false" Priority="39" Name="toc 6"/>
<w:LsdException Locked="false" Priority="39" Name="toc 7"/>
<w:LsdException Locked="false" Priority="39" Name="toc 8"/>
<w:LsdException Locked="false" Priority="39" Name="toc 9"/>
<w:LsdException Locked="false" Priority="35" QFormat="true" Name="caption"/>
<w:LsdException Locked="false" Priority="10" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" Priority="1" Name="Default Paragraph Font"/>
<w:LsdException Locked="false" Priority="11" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" Priority="22" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" Priority="59" SemiHidden="false"
UnhideWhenUsed="false" Name="Table Grid"/>
<w:LsdException Locked="false" UnhideWhenUsed="false" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" UnhideWhenUsed="false" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" QFormat="true" Name="TOC Heading"/>
</w:LatentStyles>
</xml><![endif]-->
<!--[if gte mso 10]>
<style>
/* Style Definitions */
table.MsoNormalTable
{mso-style-name:"Table Normal";
mso-tstyle-rowband-size:0;
mso-tstyle-colband-size:0;
mso-style-noshow:yes;
mso-style-priority:99;
mso-style-parent:"";
mso-padding-alt:0cm 5.4pt 0cm 5.4pt;
mso-para-margin-top:0cm;
mso-para-margin-right:0cm;
mso-para-margin-bottom:10.0pt;
mso-para-margin-left:0cm;
line-height:115%;
mso-pagination:widow-orphan;
font-size:11.0pt;
font-family:Calibri;
mso-ascii-font-family:Calibri;
mso-ascii-theme-font:minor-latin;
mso-hansi-font-family:Calibri;
mso-hansi-theme-font:minor-latin;
mso-ansi-language:EN-AU;}
</style>
<![endif]-->
<!--StartFragment-->
<!--EndFragment--><br />
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">Historically, Nightingale’s theories formed the
foundation of nurse education systems in countries from China and Japan to
America and Australia. A brief examination of the literature suggests that,
although the debt owed to Nightingale is often acknowledged by nurse
educationalists, there is little evidence to show if (or how) these theories
are ever deliberately reviewed or consciously incorporated into contemporary
nursing curricula. What is clear is that Nightingale holds an unassailable role
as the creator of modern nursing, and this role is rarely if ever questioned.</span><span style="font-family: Times New Roman;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">Nightingale’s
life reconsidered</span></span></i></b></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-AU"><span style="font-family: Trebuchet MS, sans-serif;"><span style="font-size: small;"><span style="line-height: 150%;">Without doubt it is clear that </span></span><span style="line-height: 24px;">Nightingale</span><span style="font-size: small;"><span style="line-height: 150%;"> was born
into a wealthy and highly privileged environment, spending her early years touring Europe with her
parents and her older sister. </span></span><span style="font-size: 12pt; line-height: 150%;"> </span><span style="font-size: small;"><span style="line-height: 150%;">Just how
wealthy and comfortable Nightingale’s life was up is best illustrated by the small
fact that she dressed herself and fashioned her own hair for the first time in
1853, when she was in her early thirties.<o:p></o:p></span></span></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-AU"><span style="font-family: Trebuchet MS, sans-serif;"><span style="font-size: small;"><span style="line-height: 150%;"><br /></span></span></span></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">Nightingale
was extended a degree of autonomy that was unusual in Victorian gentlewoman in
that her parents appeared to hold a relaxed attitude towards matrimony for
their youngest daughter. Women of the upper middle classes depended heavily on
marrying "up" into the upper classes, therefore gaining social
prestige as well as a great deal more worldly goods (Rowbotham, 1989). However
Nightingale refused to marry, keeping one suitor Richard Moncton Mills waiting
seven years for an answer to his marriage proposal, finally rejecting him on
the grounds that she could not have “work” of her own if she chose to follow
her heart into a society marriage. Marriage would destroy her chance of serving
God’s call.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">Thus
Nightingale is perceived as a force for good and change agent from whom all modern
nursing flows. However excavation of an almost archaeological nature can
present a slightly different picture of “The lady of the Lamp”. The image of a
solitary woman making her way through the wards of Scutari watching over the
sick and injured also underlines the fact that Nightingale did not work well
with other people, for example<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-AU" style="font-family: 'Trebuchet MS', sans-serif; font-size: 12pt; line-height: 150%; text-indent: -18pt;"><br /></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 43.1pt; mso-add-space: auto; mso-list: l1 level1 lfo3; text-align: justify; text-indent: -18.0pt;">
</div>
<ul>
<li><span style="font-family: 'Trebuchet MS', sans-serif; font-size: 12pt; line-height: 150%; text-indent: -18pt;">She rejected Mary Seacole’s offer
of help when the Cholera epidemic was at it’s worst even though Seacole was an
acknowledge expert in the disease (Simkin 2003)</span></li>
<li><span style="font-family: 'Trebuchet MS', sans-serif; font-size: 12pt; line-height: 150%; text-indent: -18pt;">She displayed
considerable resentment towards people, Crimean doctors in particular, who had
dared to rise above their station (Williams 2007)</span></li>
<li><span style="font-family: 'Trebuchet MS', sans-serif; font-size: 12pt; line-height: 150%; text-indent: -18pt;">She was noted for her exaggerated statements and
vituperative asides in relation to the senior medical staff, even going to far
as to assert that John Hall (Principal
Medical Officer in the Crimea) had no adequate medical qualification, when in
fact he was an FRCS, by examination, and had an MD from St Andrews (Williams 2007)</span></li>
</ul>
<!--[if !supportLists]--><br />
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">It is unlikely that Nightingale would have achieved what she
did in the Crimea and afterwards without having a strong personality.
Nonetheless she wasn’t averse to using the achievements of others to further
her own ambition:<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<br /></div>
<ul style="margin-top: 0cm;" type="disc">
<li class="MsoNormal" style="line-height: 150%; mso-list: l3 level1 lfo4; text-align: justify;"><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">Nightingale publically stated that she regarded
the establishment of a medical statistical branch as one of her most
important proposals adopted by the Royal Commission in 1857. When, in fact
been Andrew Smith (director general of the army medical department)
proposed in 1855 that a board for medical statistics be established
formally within his office, a function that it was already performing</span></span></li>
</ul>
<ul style="margin-top: 0cm;" type="disc">
<li class="MsoNormal" style="line-height: 150%; mso-list: l3 level1 lfo4; text-align: justify;"><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">She took credit for the idea of the need for an
army medical school although the idea had been proposed some 50 years
previously<o:p></o:p></span></span></li>
</ul>
<ul style="margin-top: 0cm;" type="disc">
<li class="MsoNormal" style="line-height: 150%; mso-list: l0 level1 lfo2; text-align: justify;"><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">St Thomas’s was selected by Nightingale to host
the first nurse training school as this allowed her to <span style="mso-spacerun: yes;"> </span>to capitalise upon the<span style="mso-spacerun: yes;"> </span>work of Mrs Wardroper, the Matron, who
had already initiated a programme of reform in 1855<o:p></o:p></span></span></li>
</ul>
<div align="right" class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: right;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">(Williams, 2008)<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">Even Nightingale’s own sister, Parthenope with whom Florence
had a stormy relationship at best noted that Florence was 'a shocking nurse’,
arguing that;<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">“She has little or none
of what is called charity or philanthropy, she is ambitious - very, and would
like... to regenerate the world... I wish she could be brought to see that it
is the intellectual part that interests her, not the manual.'<o:p></o:p></span></span></i></div>
<div align="right" class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: right;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">(Cited by Bostridge, 2005)<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">Nightingales
actions on arrival in Scutari would also suggest that she had no real “feel”
for nursing; one of her first actions being to dismiss the nurses that were
already working in the military hospital. This caused two main problems,
firstly it removed a number of effective nurses from the caring arena and
secondly it left 38 nurses, the women Nightingale had taken to Crimea with her,
the unenviable task of caring for over 3,000 patients.<span style="mso-spacerun: yes;"> </span>Within a few months of Nightingale’s arrival,
patient numbers had risen to 5,000 but no extra nurses were requested (Williams,
2008). Indeed, when Mary Stanley, a long standing friend and admirer, met with
Nightingale in December 1855 to offer the services of 21 Catholic nurses whom,
inspired by Nightingale she had bought to Turkey to nurse the injured and sick,
the offer was curtly rejected (Baylen 1974).<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<span style="font-family: Trebuchet MS, sans-serif;"><span lang="EN-AU" style="font-size: 12pt; line-height: 150%;">It is not inappropriate to suggest that the opportunities
afforded to Nightingale by the public engagement with the Crimean war, it was
after all the first war to be fully reported in the national press, allowed her
to promote herself and her activities in a remarkable manner. The emotive and
evocative picture of “The Lady with the Lamp” only came about because
Nightingale herself had banned all women from the wards at night (Cohen, 1984)
on the grounds of alleged immorality, although no one seems to have questioned
how an immoral environment could flourish with patients as sick and badly
wounded at those at Scutari. <span style="mso-spacerun: yes;"> </span>John Hall,
the </span><span style="font-size: 12pt; line-height: 150%;">Principal Medical Officer in the Crimea, denounced her
as a </span><span lang="EN-AU" style="font-size: 12pt; line-height: 150%;">publicity seeking meddler (Williams 2008).<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;"><span style="mso-spacerun: yes;"> </span>Regardless of the
subdued rumble of criticism, Nightingale managed the Victorian media with a
skill that would be recognisable to a number of ‘celebrities’ today. Such was
the level of public adoration for this woman – evidenced by paintings, poetry
and even a fan club - that experienced and skilled nurses who took issue with
her approach to care felt unable to express their approbation in the public
domain. Baylen (1974) cites a letter from Mary Stanley, written in 1855 in
which she notes;<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<span style="font-family: Trebuchet MS, sans-serif;"><i style="mso-bidi-font-style: normal;"><span lang="EN-AU" style="font-size: 12pt; line-height: 150%;">“</span></i><i style="mso-bidi-font-style: normal;"><span style="font-size: 12pt; line-height: 150%;">I came out loving
Florence [Nightingale] … I was long and loth (sic) to believe she was not as
great as I believed her to be.<span style="mso-spacerun: yes;"> </span>If you
knew what it was to me to hear every one complaining of her and to feel that
the blessing given by the nurses is so immense, and that so few comparatively
enjoy it.” <o:p></o:p></span></i></span></div>
<div align="right" class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: right;">
<span style="font-family: Trebuchet MS, sans-serif;"><span lang="EN-AU" style="font-size: 12pt; line-height: 150%;">(Baylen, 1974 p 189</span><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">Nightingale’s strangle hold on the organisation and
delivery of care upset a number of experienced nurses who felt their only
option was to return to England.<span style="mso-spacerun: yes;"> </span>In the
same letter cited above Stanley goes on to complain;<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<i style="mso-bidi-font-style: normal;"><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">“Miss
Emily Anderson has been for a fortnight at the General Hospital, but she has
sent in her resignation for she felt she could not work with Florence.<o:p></o:p></span></span></i></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">And further notes that,<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<i style="mso-bidi-font-style: normal;"><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">Miss
Tebbutt has I believe written to you. She, I think, will wish to go home, she
is so miserable. … the work they are allowed to do is so very small compared
with what might be done, or what they could do at home. The Irish nurses feel
this especially.”<o:p></o:p></span></span></i></div>
<div align="right" class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: right;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">(Baylen, 1974 p 189)<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 7.1pt; text-align: justify;">
<span style="font-family: Trebuchet MS, sans-serif;"><span lang="EN-AU" style="font-size: 12pt; line-height: 150%;">It is clear that Nightingale did not appear to have the
skill of friend making, although she never hesitated to exploit the influence
of acquaintances to further her own ends.<span style="mso-spacerun: yes;">
</span>Rajabally (1994) suggests that Nightingale’s judgmental attitude made
her an unsympathetic character even though her public manner was gentle and
unassuming.<span style="mso-spacerun: yes;"> </span></span><span style="font-size: 12pt; line-height: 150%;">Elizabeth Gaskell, a contemporary of Nightingale’s
wrote that under her charming exterior there existed a hardness and singleness
of purpose which had developed through years of frustration. Nightingale’s <span style="mso-spacerun: yes;"> </span>remaining letters illustrate <span style="mso-spacerun: yes;"> </span>her crushing sarcasm and how she plotted and
planned and subdued people to her will (Bishop, 1960) Rajabally (1994) goes fso
far as to suggest that her <span style="mso-spacerun: yes;"> </span>controlling
and manipulative behaviour <span style="mso-spacerun: yes;"> </span>whilst at
Scutari and her reclusive behaviour following her return from the Crimea was symptomatic
of narcissism and self-hatred.<span style="mso-spacerun: yes;"> </span></span><span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: Trebuchet MS, sans-serif;"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="EN-AU" style="font-size: 12pt; line-height: 115%;">Nightingale
on the World Wide Web</span></i></b><i style="mso-bidi-font-style: normal;"><span lang="EN-AU" style="font-size: 12pt; line-height: 115%;">.</span></i></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: Trebuchet MS, sans-serif;"><i style="mso-bidi-font-style: normal;"><span lang="EN-AU" style="font-size: 12pt; line-height: 115%;"><br /></span></i></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">Nightingale
maintains her presence on the World Wide Web – A search on Google Scholar using
the Search term “Florence Nightingale” shows 33,700 hits, using the search term
“Florence Nightingale and Nurse Education” provides some 21,500 hits and the
search terms “Florence Nightingale in the 21<sup>st</sup> Century” gives 2, 860
hits. That implies that in excess of 33,000scholarly papers focused upon or
quoted from Florence Nightingale’s works. <span style="mso-spacerun: yes;"> </span>These works are not confined to nursing
journals but cover medical, historical and philosophical journals also.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<!--[if gte mso 9]><xml>
<w:WordDocument>
<w:View>Normal</w:View>
<w:Zoom>0</w:Zoom>
<w:TrackMoves/>
<w:TrackFormatting/>
<w:PunctuationKerning/>
<w:ValidateAgainstSchemas/>
<w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid>
<w:IgnoreMixedContent>false</w:IgnoreMixedContent>
<w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText>
<w:DoNotPromoteQF/>
<w:LidThemeOther>EN-GB</w:LidThemeOther>
<w:LidThemeAsian>JA</w:LidThemeAsian>
<w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript>
<w:Compatibility>
<w:BreakWrappedTables/>
<w:SnapToGridInCell/>
<w:WrapTextWithPunct/>
<w:UseAsianBreakRules/>
<w:DontGrowAutofit/>
<w:SplitPgBreakAndParaMark/>
<w:EnableOpenTypeKerning/>
<w:DontFlipMirrorIndents/>
<w:OverrideTableStyleHps/>
</w:Compatibility>
<m:mathPr>
<m:mathFont m:val="Cambria Math"/>
<m:brkBin m:val="before"/>
<m:brkBinSub m:val="--"/>
<m:smallFrac m:val="off"/>
<m:dispDef/>
<m:lMargin m:val="0"/>
<m:rMargin m:val="0"/>
<m:defJc m:val="centerGroup"/>
<m:wrapIndent m:val="1440"/>
<m:intLim m:val="subSup"/>
<m:naryLim m:val="undOvr"/>
</m:mathPr></w:WordDocument>
</xml><![endif]--><!--[if gte mso 9]><xml>
<w:LatentStyles DefLockedState="false" DefUnhideWhenUsed="true"
DefSemiHidden="true" DefQFormat="false" DefPriority="99"
LatentStyleCount="276">
<w:LsdException Locked="false" Priority="0" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Normal"/>
<w:LsdException Locked="false" Priority="9" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="heading 1"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 2"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 3"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 4"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 5"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 6"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 7"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 8"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 9"/>
<w:LsdException Locked="false" Priority="39" Name="toc 1"/>
<w:LsdException Locked="false" Priority="39" Name="toc 2"/>
<w:LsdException Locked="false" Priority="39" Name="toc 3"/>
<w:LsdException Locked="false" Priority="39" Name="toc 4"/>
<w:LsdException Locked="false" Priority="39" Name="toc 5"/>
<w:LsdException Locked="false" Priority="39" Name="toc 6"/>
<w:LsdException Locked="false" Priority="39" Name="toc 7"/>
<w:LsdException Locked="false" Priority="39" Name="toc 8"/>
<w:LsdException Locked="false" Priority="39" Name="toc 9"/>
<w:LsdException Locked="false" Priority="35" QFormat="true" Name="caption"/>
<w:LsdException Locked="false" Priority="10" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" Priority="1" Name="Default Paragraph Font"/>
<w:LsdException Locked="false" Priority="11" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" Priority="22" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" Priority="59" SemiHidden="false"
UnhideWhenUsed="false" Name="Table Grid"/>
<w:LsdException Locked="false" UnhideWhenUsed="false" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" UnhideWhenUsed="false" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" QFormat="true" Name="TOC Heading"/>
</w:LatentStyles>
</xml><![endif]-->
<!--[if gte mso 10]>
<style>
/* Style Definitions */
table.MsoNormalTable
{mso-style-name:"Table Normal";
mso-tstyle-rowband-size:0;
mso-tstyle-colband-size:0;
mso-style-noshow:yes;
mso-style-priority:99;
mso-style-parent:"";
mso-padding-alt:0cm 5.4pt 0cm 5.4pt;
mso-para-margin-top:0cm;
mso-para-margin-right:0cm;
mso-para-margin-bottom:10.0pt;
mso-para-margin-left:0cm;
line-height:115%;
mso-pagination:widow-orphan;
font-size:11.0pt;
font-family:Calibri;
mso-ascii-font-family:Calibri;
mso-ascii-theme-font:minor-latin;
mso-hansi-font-family:Calibri;
mso-hansi-theme-font:minor-latin;
mso-ansi-language:EN-AU;}
table.MsoTableGrid
{mso-style-name:"Table Grid";
mso-tstyle-rowband-size:0;
mso-tstyle-colband-size:0;
mso-style-priority:59;
mso-style-unhide:no;
border:solid black 1.0pt;
mso-border-themecolor:text1;
mso-border-alt:solid black .5pt;
mso-border-themecolor:text1;
mso-padding-alt:0cm 5.4pt 0cm 5.4pt;
mso-border-insideh:.5pt solid black;
mso-border-insideh-themecolor:text1;
mso-border-insidev:.5pt solid black;
mso-border-insidev-themecolor:text1;
mso-para-margin:0cm;
mso-para-margin-bottom:.0001pt;
mso-pagination:widow-orphan;
font-size:11.0pt;
font-family:Calibri;
mso-ascii-font-family:Calibri;
mso-ascii-theme-font:minor-latin;
mso-hansi-font-family:Calibri;
mso-hansi-theme-font:minor-latin;
mso-ansi-language:EN-AU;}
</style>
<![endif]-->
<!--StartFragment-->
<!--EndFragment--></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span style="font-family: Trebuchet MS, sans-serif;"><span lang="EN-AU" style="font-size: 12pt; line-height: 150%;">By
searching on the main Google web site, arguably the search portal that many
non-academics would use in preference to Google Scholar, the search term
“Florence Nightingale” brings up 1,150,000 web sites which include Wikipedia (</span><span lang="EN-AU"><a href="http://en.wikipedia.org/wiki/Florence_Nightingale"><span style="font-size: 12pt; line-height: 150%;">http://en.wikipedia.org/wiki/Florence_Nightingale</span></a></span><span lang="EN-AU" style="font-size: 12pt; line-height: 150%;">
), the Florence Nightingale Museum (</span><span lang="EN-AU"><a href="http://www.florence-nightingale.co.uk/"><span style="font-size: 12pt; line-height: 150%;">http://www.florence-nightingale.co.uk</span></a></span><span lang="EN-AU" style="font-size: 12pt; line-height: 150%;">
) and pages that are designed to appeal to school children who, clearly are
still being asked to investigate Nightingale as part of their studies (</span><span lang="EN-AU"><a href="http://www.thekidswindow.co.uk/news/florence_nightingale"><span style="font-size: 12pt; line-height: 150%;">http://www.thekidswindow.co.uk/news/florence_nightingale</span></a></span></span><span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">).
Almost without exception, these pages perpetuate the Nightingale image as the
saintly and heroic “ Lady of the Lamp” and reiterate the same historical facts,
many of which show Nightingale in a highly positive light. Even the entries on
Google Scholar which, one would anticipate would show a higher degree of
critical appraisal, tend, in the main, to be laudatory. </span><span style="font-family: Times New Roman;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;"><b>Nightingale's Legacy</b></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: Trebuchet MS, sans-serif;"><span style="font-size: small;"><span style="line-height: 150%;">It is ironic that whilst Nightingale is widely held to
be the originator of the educated and professional nurses that practise today
it is the area of education that her ideas are most irrelevant. Whilst the
clinical concerns that she wrote of remain focuses of concern today her ideas
about education; no exams, no registration, the role of the nurse as a
subordinate care provider, are not. Whilst her legend is promulgated via the
World Wide Web she will be perceived as a selfless crusader and the less
positive aspects of the birth of the modern nursing will be sidelined. Although
teaching nursing history has, in many cases been sacrificed in order to focus
upon practical, care driven subjects, there is still a place for educators to
encourage nursing students to explore Nightingale’s actions and legacy and to
examine her motivations and decisions from a more balanced and critical
perspective than is currently the fashion. I'm not </span></span><span style="line-height: 24px;">saying</span><span style="font-size: small;"><span style="line-height: 150%;"> we should denigrate her </span><span style="line-height: 24px;">undoubtedly</span><span style="line-height: 150%;"> spectacular achievements, but I am </span><span style="line-height: 24px;">saying</span><span style="line-height: 150%;"> that for a </span><span style="line-height: 24px;">profession</span><span style="line-height: 150%;"> that prides itself upon using evidence and subjecting ideas to critical appraisal we seem strangely </span><span style="line-height: 24px;">reluctant</span><span style="line-height: 150%;"> to subject Miss </span><span style="line-height: 24px;">Nightingales</span><span style="line-height: 150%;"> actions and legacy to such scrutiny. Nonetheless, however Nightingale is
viewed; saint or sinner, the contribution that she made to nursing cannot be
ignored. Making allowances for the style of writing of the time, her obituary
in the New York Times, perhaps sums up her current relevance best;<o:p></o:p></span></span></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-left: 18.0pt; text-align: justify;">
<i style="mso-bidi-font-style: normal;"><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">“Perhaps
the greatest good that has resulted from her noble life has been the setting in
motion of a force which has led thousands of women to devote themselves to
systematic care of the sick and wounded”.<o:p></o:p></span></span></i></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">
<!--[if gte mso 9]><xml>
<w:WordDocument>
<w:View>Normal</w:View>
<w:Zoom>0</w:Zoom>
<w:TrackMoves/>
<w:TrackFormatting/>
<w:PunctuationKerning/>
<w:ValidateAgainstSchemas/>
<w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid>
<w:IgnoreMixedContent>false</w:IgnoreMixedContent>
<w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText>
<w:DoNotPromoteQF/>
<w:LidThemeOther>EN-GB</w:LidThemeOther>
<w:LidThemeAsian>JA</w:LidThemeAsian>
<w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript>
<w:Compatibility>
<w:BreakWrappedTables/>
<w:SnapToGridInCell/>
<w:WrapTextWithPunct/>
<w:UseAsianBreakRules/>
<w:DontGrowAutofit/>
<w:SplitPgBreakAndParaMark/>
<w:EnableOpenTypeKerning/>
<w:DontFlipMirrorIndents/>
<w:OverrideTableStyleHps/>
</w:Compatibility>
<m:mathPr>
<m:mathFont m:val="Cambria Math"/>
<m:brkBin m:val="before"/>
<m:brkBinSub m:val="--"/>
<m:smallFrac m:val="off"/>
<m:dispDef/>
<m:lMargin m:val="0"/>
<m:rMargin m:val="0"/>
<m:defJc m:val="centerGroup"/>
<m:wrapIndent m:val="1440"/>
<m:intLim m:val="subSup"/>
<m:naryLim m:val="undOvr"/>
</m:mathPr></w:WordDocument>
</xml><![endif]--><!--[if gte mso 9]><xml>
<w:LatentStyles DefLockedState="false" DefUnhideWhenUsed="true"
DefSemiHidden="true" DefQFormat="false" DefPriority="99"
LatentStyleCount="276">
<w:LsdException Locked="false" Priority="0" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Normal"/>
<w:LsdException Locked="false" Priority="9" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="heading 1"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 2"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 3"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 4"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 5"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 6"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 7"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 8"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 9"/>
<w:LsdException Locked="false" Priority="39" Name="toc 1"/>
<w:LsdException Locked="false" Priority="39" Name="toc 2"/>
<w:LsdException Locked="false" Priority="39" Name="toc 3"/>
<w:LsdException Locked="false" Priority="39" Name="toc 4"/>
<w:LsdException Locked="false" Priority="39" Name="toc 5"/>
<w:LsdException Locked="false" Priority="39" Name="toc 6"/>
<w:LsdException Locked="false" Priority="39" Name="toc 7"/>
<w:LsdException Locked="false" Priority="39" Name="toc 8"/>
<w:LsdException Locked="false" Priority="39" Name="toc 9"/>
<w:LsdException Locked="false" Priority="35" QFormat="true" Name="caption"/>
<w:LsdException Locked="false" Priority="10" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" Priority="1" Name="Default Paragraph Font"/>
<w:LsdException Locked="false" Priority="11" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" Priority="22" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" Priority="59" SemiHidden="false"
UnhideWhenUsed="false" Name="Table Grid"/>
<w:LsdException Locked="false" UnhideWhenUsed="false" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" UnhideWhenUsed="false" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" QFormat="true" Name="TOC Heading"/>
</w:LatentStyles>
</xml><![endif]-->
<!--[if gte mso 10]>
<style>
/* Style Definitions */
table.MsoNormalTable
{mso-style-name:"Table Normal";
mso-tstyle-rowband-size:0;
mso-tstyle-colband-size:0;
mso-style-noshow:yes;
mso-style-priority:99;
mso-style-parent:"";
mso-padding-alt:0cm 5.4pt 0cm 5.4pt;
mso-para-margin-top:0cm;
mso-para-margin-right:0cm;
mso-para-margin-bottom:10.0pt;
mso-para-margin-left:0cm;
line-height:115%;
mso-pagination:widow-orphan;
font-size:11.0pt;
font-family:Calibri;
mso-ascii-font-family:Calibri;
mso-ascii-theme-font:minor-latin;
mso-hansi-font-family:Calibri;
mso-hansi-theme-font:minor-latin;
mso-ansi-language:EN-AU;}
</style>
<![endif]-->
<!--StartFragment-->
<!--EndFragment--></span></span></div>
<div align="right" class="MsoNormal" style="line-height: 150%; text-align: right;">
<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">New York Times, August 15<sup>th</sup> 1910</span><span style="font-family: Times New Roman;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></span>
<br />
<div style="text-align: center;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">*********************************</span></span></div>
<div style="text-align: center;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></span></div>
<div style="text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;">There is a slide share presentation to complement this blog <a href="http://www.slideshare.net/carolhaigh/florence-nightingale-in-the-21st-century-a-critique">here</a></span></span></div>
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;"><b>References</b></span></span></div>
<div class="MsoNormal" style="line-height: 150%; text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 150%;"><span style="font-family: Trebuchet MS, sans-serif;"><b><br /></b></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 115%;"><span style="font-family: Trebuchet MS, sans-serif;">Baylen,
JO <span class="citation-abbreviation">(</span><span class="citation-publication-date">1974) </span><span style="mso-spacerun: yes;"> </span>The Florence Nightingale-Mary Stanley
controversy: some unpublished letters. <span class="citation-abbreviation"><i style="mso-bidi-font-style: normal;">Med Hist</i> </span><span class="citation-volume">18</span><span class="citation-issue">(2)</span><span class="citation-flpages">: 186–193.</span><o:p></o:p></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: Trebuchet MS, sans-serif;"><span style="font-size: 12pt; line-height: 115%;">Bishop,
W. I. (1960). Florence Nightingale’s message for to-day. Nursing <span style="mso-bidi-font-style: italic; mso-bidi-font-weight: bold;">Outlook, 8,246-247<b><i>.</i></b></span></span><span lang="EN-AU" style="font-size: 12pt; line-height: 115%;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 115%;"><span style="font-family: Trebuchet MS, sans-serif;">Bostridge,
M (2005) Florence Nightingale: the Lady with the Lamp. Available at<o:p></o:p></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: Trebuchet MS, sans-serif;"><span lang="EN-AU"><a href="http://www.bbc.co.uk/history/british/victorians/nightingale_01.shtml#two"><span style="font-size: 12pt; line-height: 115%;">http://www.bbc.co.uk/history/british/victorians/nightingale_01.shtml#two</span></a></span><span lang="EN-AU" style="font-size: 12pt; line-height: 115%;">
<o:p></o:p></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: Trebuchet MS, sans-serif;"><span lang="EN-AU" style="font-size: 12pt; line-height: 115%;">Cohen,<span style="mso-spacerun: yes;"> </span>IB (1984) </span><span style="font-size: 12pt; line-height: 115%;">Florence Nightingale<i>.<span style="mso-spacerun: yes;"> </span>Scientific American </i></span><span style="font-size: 12pt; line-height: 115%;">250(3):128-137<i><o:p></o:p></i></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: Trebuchet MS, sans-serif;"><span lang="EN-AU" style="font-size: 12pt; line-height: 115%;">New
York Times (1910) OBITUARY Miss Nightingale Dies, Aged Ninety. Available at </span><span lang="EN-AU"><a href="http://www.nytimes.com/learning/general/onthisday/bday/0512.html"><span style="font-size: 12pt; line-height: 115%;">http://www.nytimes.com/learning/general/onthisday/bday/0512.html</span></a></span><span lang="EN-AU" style="font-size: 12pt; line-height: 115%;"><span style="mso-spacerun: yes;"> </span><o:p></o:p></span></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: Trebuchet MS, sans-serif;"><span lang="EN-AU" style="font-size: 12pt; line-height: 115%;">Rajabelly,
M (1994) </span><span style="font-size: 12pt; line-height: 115%;">Florence Nightingale’s personality: a psychoanalytical profile</span><span lang="EN-AU" style="font-size: 12pt; line-height: 115%;"><span style="mso-spacerun: yes;"> </span><i style="mso-bidi-font-style: normal;">Int</i></span><i style="mso-bidi-font-style: normal;"><span style="font-size: 12pt; line-height: 115%;">. J. Nurs. Stud.,</span></i><span style="font-size: 12pt; line-height: 115%;"> Vol. 31, No. 3, pp. 269-278, <o:p></o:p></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: Trebuchet MS, sans-serif;"><span style="font-size: 12pt; line-height: 115%;">Rowbotham, J (1989) <i style="mso-bidi-font-style: normal;">Good Girls make Good Wives</i>. Blackwell. Oxford</span><span lang="EN-AU" style="font-size: 12pt; line-height: 115%;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal">
<span lang="EN-AU" style="font-size: 12pt; line-height: 115%;"><span style="font-family: Trebuchet MS, sans-serif;">Simkin, J (2003) <i style="mso-bidi-font-style: normal;">Florence Nightingale</i>. Available at <o:p></o:p></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: Trebuchet MS, sans-serif;"><span lang="EN-AU"><a href="http://www.spartacus.schoolnet.co.uk/REnightingale.htm"><span style="font-size: 12pt; line-height: 115%;">http://www.spartacus.schoolnet.co.uk/REnightingale.htm</span></a></span><span lang="EN-AU" style="font-size: 12pt; line-height: 115%;">
<o:p></o:p></span></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<!--[if gte mso 9]><xml>
<w:WordDocument>
<w:View>Normal</w:View>
<w:Zoom>0</w:Zoom>
<w:TrackMoves/>
<w:TrackFormatting/>
<w:PunctuationKerning/>
<w:ValidateAgainstSchemas/>
<w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid>
<w:IgnoreMixedContent>false</w:IgnoreMixedContent>
<w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText>
<w:DoNotPromoteQF/>
<w:LidThemeOther>EN-GB</w:LidThemeOther>
<w:LidThemeAsian>JA</w:LidThemeAsian>
<w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript>
<w:Compatibility>
<w:BreakWrappedTables/>
<w:SnapToGridInCell/>
<w:WrapTextWithPunct/>
<w:UseAsianBreakRules/>
<w:DontGrowAutofit/>
<w:SplitPgBreakAndParaMark/>
<w:EnableOpenTypeKerning/>
<w:DontFlipMirrorIndents/>
<w:OverrideTableStyleHps/>
</w:Compatibility>
<m:mathPr>
<m:mathFont m:val="Cambria Math"/>
<m:brkBin m:val="before"/>
<m:brkBinSub m:val="--"/>
<m:smallFrac m:val="off"/>
<m:dispDef/>
<m:lMargin m:val="0"/>
<m:rMargin m:val="0"/>
<m:defJc m:val="centerGroup"/>
<m:wrapIndent m:val="1440"/>
<m:intLim m:val="subSup"/>
<m:naryLim m:val="undOvr"/>
</m:mathPr></w:WordDocument>
</xml><![endif]--><!--[if gte mso 9]><xml>
<w:LatentStyles DefLockedState="false" DefUnhideWhenUsed="true"
DefSemiHidden="true" DefQFormat="false" DefPriority="99"
LatentStyleCount="276">
<w:LsdException Locked="false" Priority="0" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Normal"/>
<w:LsdException Locked="false" Priority="9" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="heading 1"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 2"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 3"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 4"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 5"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 6"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 7"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 8"/>
<w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 9"/>
<w:LsdException Locked="false" Priority="39" Name="toc 1"/>
<w:LsdException Locked="false" Priority="39" Name="toc 2"/>
<w:LsdException Locked="false" Priority="39" Name="toc 3"/>
<w:LsdException Locked="false" Priority="39" Name="toc 4"/>
<w:LsdException Locked="false" Priority="39" Name="toc 5"/>
<w:LsdException Locked="false" Priority="39" Name="toc 6"/>
<w:LsdException Locked="false" Priority="39" Name="toc 7"/>
<w:LsdException Locked="false" Priority="39" Name="toc 8"/>
<w:LsdException Locked="false" Priority="39" Name="toc 9"/>
<w:LsdException Locked="false" Priority="35" QFormat="true" Name="caption"/>
<w:LsdException Locked="false" Priority="10" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" Priority="1" Name="Default Paragraph Font"/>
<w:LsdException Locked="false" Priority="11" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" Priority="22" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" Priority="59" SemiHidden="false"
UnhideWhenUsed="false" Name="Table Grid"/>
<w:LsdException Locked="false" UnhideWhenUsed="false" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" UnhideWhenUsed="false" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" SemiHidden="false"
UnhideWhenUsed="false" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" SemiHidden="false"
UnhideWhenUsed="false" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" SemiHidden="false"
UnhideWhenUsed="false" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" SemiHidden="false"
UnhideWhenUsed="false" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" SemiHidden="false"
UnhideWhenUsed="false" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" SemiHidden="false"
UnhideWhenUsed="false" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" QFormat="true" Name="TOC Heading"/>
</w:LatentStyles>
</xml><![endif]-->
<!--[if gte mso 10]>
<style>
/* Style Definitions */
table.MsoNormalTable
{mso-style-name:"Table Normal";
mso-tstyle-rowband-size:0;
mso-tstyle-colband-size:0;
mso-style-noshow:yes;
mso-style-priority:99;
mso-style-parent:"";
mso-padding-alt:0cm 5.4pt 0cm 5.4pt;
mso-para-margin-top:0cm;
mso-para-margin-right:0cm;
mso-para-margin-bottom:10.0pt;
mso-para-margin-left:0cm;
line-height:115%;
mso-pagination:widow-orphan;
font-size:11.0pt;
font-family:Calibri;
mso-ascii-font-family:Calibri;
mso-ascii-theme-font:minor-latin;
mso-hansi-font-family:Calibri;
mso-hansi-theme-font:minor-latin;
mso-ansi-language:EN-AU;}
</style>
<![endif]-->
<!--StartFragment-->
<!--EndFragment--></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-AU" style="font-size: 12pt; line-height: 115%;"><span style="font-family: Trebuchet MS, sans-serif;">Williams,
K (2008) </span></span><span style="font-size: 12pt; line-height: 115%;"><span style="font-family: Trebuchet MS, sans-serif;">Reappraising Florence Nightingale. <i>BMJ</i> 337:a2889. 1461-1463</span><span style="font-family: Times New Roman;"><o:p></o:p></span></span></div>
</div>
Loracenna@gmail.comhttp://www.blogger.com/profile/18195902043884586453noreply@blogger.com1tag:blogger.com,1999:blog-3156833821506370543.post-70010606095128118232013-03-13T06:50:00.002-07:002013-03-13T06:50:52.672-07:00Time for a re-think?<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg71JiBWxMVXows1IGcwbcRALr6ndXF33ou0r_DtN-XleTFNF4e-NpxwXQcQSfw2uour_r0Glk1kZa75zPZlRYa3kg0UXzn9OW585vzG9tfA0MHMB1Exz-0rxVxyaLMDx1sp9YCNVfJdL09/s1600/396562-beside-cockpit.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="180" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg71JiBWxMVXows1IGcwbcRALr6ndXF33ou0r_DtN-XleTFNF4e-NpxwXQcQSfw2uour_r0Glk1kZa75zPZlRYa3kg0UXzn9OW585vzG9tfA0MHMB1Exz-0rxVxyaLMDx1sp9YCNVfJdL09/s320/396562-beside-cockpit.jpg" width="320" /></a></div>
<span style="font-family: Trebuchet MS, sans-serif;">Patient centered care has been around health and nursing care for as long as I can remember, in fact its been around for so long that few of us can remember a time before we all began involving patients in decisions about their care. The problem, however is that because patient centered care has been around so long practitioners are getting sloppy about how they interpret it. So let us first clear up a couple of misconceptions about what patient involvement in care or patient centered care is;</span><br />
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span>
<br />
<ol style="text-align: left;">
<li><span style="font-family: Trebuchet MS, sans-serif;">Patient centered care is not about giving the patient a long list of options for treatment and then expecting them to tell us, the expert, what they want done. It is not in appropriate for patients to expect us to explain things to them, highlight the risks and the benefits to each option and even (and I know this is heresy) offer a personal as well as a professional opinion. Telling an 89 year old lady that she can have an operation or stay in bed and wait for the hip to heal is not giving her a choice. Explaining the risks of surgery balanced against the risks of 12 weeks bed rest allows her to make an informed decision and possible not the one the health care staff would want her to make.</span></li>
<li><span style="font-family: Trebuchet MS, sans-serif;">Providing a patient with paperwork to do under the guise of being 'self-monitoring' is not patient centered care. If we don't expect the patient to share their readings with us on a regular basis (and by regular I mean more than 6 monthly) or are prepared to discuss changes to treatment on the basis of them what is the point. Patients are not stupid and will soon realize that they are being fobbed off with 'busy work' to give them an illusion of control</span></li>
<li><span style="font-family: Trebuchet MS, sans-serif;">Patient centered care is not about listening to experienced patients and then totally disregarding what they tell you. It might be nice for the patient to feel that their practitioner is listening to them but if their experience is not translated into bespoke approaches to care then the entire exercise is futile.</span></li>
</ol>
<div>
<span style="font-family: Trebuchet MS, sans-serif;">I would suggest it is time that we re-think what we mean by involving patients in their care and do it in a way that is actually practical, useful and impacts on treatment and takes full adavantage of development like mobile techonlogy. For example, one of the major problems underpinning good pain management is lack of both assessment and evaluation of pain treatments. If patients who were able, were encouraged to download a suitable pain assessment app to their mobile phones that they could use whilst in hospital, especially if it were an app that could communicate with the ward technology then it would go a long way to addressing poor pain management and would be <i>actual</i> patient involvement. If people with diabetes monitored their blood sugar using any one of the many monitoring apps on the market they could share that data with their GP's practice and actually be partners in the management of the diabetes.</span></div>
<div>
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div>
<div>
<span style="font-family: Trebuchet MS, sans-serif;">I understand the nay-sayers will come back with things like 'not everyone has or knows how to use a smart phone' or 'older people do not use technology ' or 'people who are in hospital are too sick to rate their own pain' but a lot of people do use smart phones and would be happy to take that level of control of their illness or disability, the boundaries of what constitutes 'older people' are becoming increasingly fluid and a lot of individuals who fall into that category now have indeed an awareness of and a level of competency in using mobile technology and this tech-friendly population will only increase in the coming years. </span></div>
<div>
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div>
<div>
<span style="font-family: Trebuchet MS, sans-serif;">I guess what I'm saying is rather than just assuming that talking to patients about their treatment options is the only way to facilitate patient involvement, lets really make patients our partners by giving them responsibilities and according those responsibilities the same level of importance that we give our own tasks. I wouldn't have a problem recording my own blood pressure or blood sugar and just e-mailing it to the surgery every week, in much the same way I wouldn't have a problem using a smart phone app to record my pain scores - I'd be happy to be part of my care especially if it would free up practitioners to look after those patients who actually need their attention in that area </span></div>
</div>
Loracenna@gmail.comhttp://www.blogger.com/profile/18195902043884586453noreply@blogger.com1tag:blogger.com,1999:blog-3156833821506370543.post-19461578316223395702012-10-16T09:30:00.000-07:002012-10-17T00:10:54.835-07:00Things I'd like to tell my health care professional<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhrKkn0946PXgQCJ9FyTm2yfcL26_69i3q0UmS0-Di7mUX27vLCaZCIDsjcARs9yLHXgryfVXOLgGPmTNNQlN6F4UqtyfvK1fvWeEuD76hxgPtI4IiUQhuy1Ucirqlcc5zNwX8PHEdCXgSz/s1600/funny-cat-pictures-can-you-hear-me-now.jpeg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="238" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhrKkn0946PXgQCJ9FyTm2yfcL26_69i3q0UmS0-Di7mUX27vLCaZCIDsjcARs9yLHXgryfVXOLgGPmTNNQlN6F4UqtyfvK1fvWeEuD76hxgPtI4IiUQhuy1Ucirqlcc5zNwX8PHEdCXgSz/s320/funny-cat-pictures-can-you-hear-me-now.jpeg" width="320" /></a></div>
<div style="text-align: left;">
</div>
<div>
<br /></div>
<span style="font-family: Trebuchet MS, sans-serif;"></span><br />
<div style="text-align: left;">
<span style="font-family: Trebuchet MS, sans-serif;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></span></div>
<span style="font-family: Trebuchet MS, sans-serif;">
</span>
<div style="text-align: left;">
<span style="font-family: Trebuchet MS, sans-serif;"><span style="font-family: Trebuchet MS, sans-serif;">I had to endure organised health care again today. Here are 7 things I wish I had the guts to tell my healthcare professional....</span></span></div>
<span style="font-family: Trebuchet MS, sans-serif;">
<div style="text-align: left;">
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div>
<div style="text-align: left;">
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div>
</span><span style="font-family: 'Trebuchet MS', sans-serif;">1</span><i style="font-family: 'Trebuchet MS', sans-serif;">. Do NOT lecture me in a patronising way about my activity levels whilst you sitting on a bottom so big it bends space-time.</i><span style="font-family: Trebuchet MS, sans-serif;"> I have no problem with people or even health care professionals being fat, I, myself, am morbidly voluptuous and so are a number of my lovely (and healthy) friends. I think there are a lot worse things to be, evil for example, or vindictive, or a contestent on Britain's Got Talent, but don't presume to lecture me about exercise when you are obviously as fat and un-fit as I am. Why not try empathising instead?</span><br />
<div style="text-align: left;">
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span><span style="font-family: 'Trebuchet MS', sans-serif;">2. <i>Do NOT use 'we' when actually you mean 'me</i>. For example, 'we need to get onto a strict diet' Fine, you start and let me know how that turns out for </span><span style="font-family: 'Trebuchet MS', sans-serif;">you</span><span style="font-family: Trebuchet MS, sans-serif;">, I'll join in later after I've finished this cake. Including me in the health focussed "we' doesn't make me feel like we are a team, it makes me feel like a toddler, and we all know how diligent and responsible 3 year-olds can be don't we?</span></div>
<div style="text-align: left;">
<span style="font-family: 'Trebuchet MS', sans-serif;"><br /></span></div>
<div style="text-align: left;">
<span style="font-family: 'Trebuchet MS', sans-serif;"><br /></span></div>
<div style="text-align: left;">
<span style="font-family: Trebuchet MS, sans-serif;">3. <i>Don't assue that everyone who comes through your door has the intellectual capacity of a cheese sandwich</i> - I'm actually quite clever and I bet I'm not the only smart person on your patient list so explaining the causes of diabetic neuropathy as ' when the sugar floats round in your blood some of it sticks to the ends of your nerves and that means messages for your brain can't be heard properly' only makes me think you have a very shaky grasp of biochemistry and neurophysiology and doubt your competence both as a reasoning human being and a qualified health care professional.</span></div>
<div style="text-align: left;">
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div>
<div style="text-align: left;">
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div>
<div style="text-align: left;">
<span style="font-family: Trebuchet MS, sans-serif;">4. <i>Listen to what I mean as well as what I say - </i>When I tell you I don't eat breakfast because I leave for work at 5.45 in the morning, I'm telling you that I don't much want to eat in what, for most people, is still the middle of the night. Suggesting getting up 10 minutes earlier so that I can make porridge? Not helpful!</span></div>
<div style="text-align: left;">
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div>
<div style="text-align: left;">
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div>
<div style="text-align: left;">
<span style="font-family: Trebuchet MS, sans-serif;">5. <i>Try not to be too obviously astonished that I am stil functioning - </i>Being so blatantly surprised that I am still working full time (I know, I know - I'm a miracle!!), in fact even asking the question, does not endear you to me. Richard Feynman was almost 70 when he sat on the enquiry into the Challenger space shuttle diaster and no-one batted an eyelid, and Sir John Gurdon, the 2012 Nobel Prize winner for medicine is 79 so clearly old does not necessarily mean useless or infirm. At 53, I like to think I can pull off full time academia without causing too much shock and awe amongst the healthcare profession so your surprise confuses me.</span></div>
<div style="text-align: left;">
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div>
<div style="text-align: left;">
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div>
<div style="text-align: left;">
<span style="font-family: Trebuchet MS, sans-serif;">6. <i>Do NOT make appointments for me without consulting me</i> - You may think you are being helpful but I do have a life and a job outside of my diagnosis and your assumption that my real life is secondary to your need to evaluate and categorise me is insulting. Also know that, when you do that, I WILL tell you I can't attend whether I actually can or not.</span></div>
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
<span style="font-family: Trebuchet MS, sans-serif;">7.<b><i> SEE ME</i></b> - Look at who I am, ask me about myself, </span><span style="font-family: 'Trebuchet MS', sans-serif;">Amazon has managed to get to know me pretty well and and I </span><span style="font-family: 'Trebuchet MS', sans-serif;">spend</span><span style="font-family: 'Trebuchet MS', sans-serif;"> less time with them than with you. Help me to </span><span style="font-family: 'Trebuchet MS', sans-serif;">think about how my life will impact upon my diagnosis (not the other way round, which seems to be how you view it) then tailor your help and </span><span style="font-family: 'Trebuchet MS', sans-serif;">information</span><span style="font-family: 'Trebuchet MS', sans-serif;"> to what I need.</span><span style="font-family: 'Trebuchet MS', sans-serif;"> I know sticking to </span><span style="font-family: 'Trebuchet MS', sans-serif;">your</span><span style="font-family: 'Trebuchet MS', sans-serif;"> pre-prepared script is </span><span style="font-family: 'Trebuchet MS', sans-serif;">comforting</span><span style="font-family: 'Trebuchet MS', sans-serif;"> and safe but in the long term actually <i>seeing</i> your patients will be much more rewarding.</span></div>
</div>
Loracenna@gmail.comhttp://www.blogger.com/profile/18195902043884586453noreply@blogger.com1tag:blogger.com,1999:blog-3156833821506370543.post-62230720814619896232012-06-25T11:05:00.000-07:002012-06-25T11:17:28.822-07:00You may be uncomfortable but I AM NOT!Experienced a rather irritating experience today, let me explain...............<br />
My husband and I (same sex couple and married as far as I am concerned) have recently bought a house, cutting a long story short, Daniel had a negative mowing the lawn experience resulting in acute back pain. Being the nursing professional I am I knew how to manage this without seeking help but my partner's condition deteriorated resulting in a new symptom 'active vomiting'. I was concerned and took him to the walk in centre *oh yes I know not to waste A&E time, it is for emergencies only after all*<br />
After waiting for 2hrs in the waiting room *patiently* we were finally seen by the GP who did routine tests and asked for a sample of urine from Daniel who reported to me " I have only just been before I came in" to which I replied "well squeeze some more out, in my authoritative tone". GP diagnosed him with a urine infection and started him on Nitrofurantoin for 3 days. In my clinical mind I was thinking.. let's see how this one plays out. <br />
Now onto the juicy bit... I contacted my local surgery to register ourselves as new patients (must add that I went there only a week ago to get the forms to be told that "you must book a patient assessment before you can be registered". I took this a caring intervention and said "I will look at our diaries and ring you back with a convenient time".<br />
Anyway, back onto contacting the local surgey.... RING RING... RING RING.... confronted with "Hello surgery".... I reply "is this ********** **** Surgery?"...... "Yes".... "oh I didn't know it was ********** ******* as all I heard was SURGERY".... not a good start the first conversation eh?<br />
<br />
I explained that I picked up the registration forms last week and was ringing to make an appointment for my partner and to come and have a patient assessment (added in that unfortunately I had to take my partner to the walk in centre yesterday and he needs a follow up with the GP this week)... this is where it gets climactic....<br />
<br />
"What is her name?" to which I replied "HIS name is Mr bla bla bla"..... phone goes silent...<br />
<br />
At this point I would like to state that a normal person with effective communication skills would have replaced the previous phrase with "Can I have your partner's name please" or stated "excuse me for that" now I am not the biggest complainer but this is common sense.<br />
<br />
Now she obviously was uncomfortable with the situation but I kindly explained my relationship status as a matter of course. <br />
<br />
I then asked the receptionist to confirm the appointment times back to me for each of us and then experienced a complete reluctance to state my partner's name. <br />
<br />
Moral to the story... people might be uncomfortable with conversations relating to relationship structures but this receptionist is an employee of the healthcare service; simple adjustment in thinking and sensitivity for patients situation is needed.<br />
<br />
<br />Anonymoushttp://www.blogger.com/profile/15473573512854031970noreply@blogger.com1tag:blogger.com,1999:blog-3156833821506370543.post-33289512527765295092012-01-30T02:16:00.000-08:002012-01-30T04:19:09.267-08:00Don't judge me<div dir="ltr" style="text-align: left;" trbidi="on"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjMCohIAMuIPUAzKHdgb0TPvd6KKz8vy1YQi8n11Xuc3KRbGwNQVTWPeU6TQLSXFU6D32rnTop-KtCPi1EKC5IAcYEnR04_1vQxv2adMpsXJTDHjgnx0HoCNq9gjCtCcTjLnsk51iokIZBx/s1600/judgemental-cat-disapproves-lolcat.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="172" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjMCohIAMuIPUAzKHdgb0TPvd6KKz8vy1YQi8n11Xuc3KRbGwNQVTWPeU6TQLSXFU6D32rnTop-KtCPi1EKC5IAcYEnR04_1vQxv2adMpsXJTDHjgnx0HoCNq9gjCtCcTjLnsk51iokIZBx/s200/judgemental-cat-disapproves-lolcat.jpg" width="200" /></a></div><div style="font-family: "Trebuchet MS",sans-serif; text-align: justify;">I have to go back to my doctor's this week and I suspect that neither of us are looking forward to the experience all that much. We hear a lot about how important it is for health care professionals (HCPs) to be non-judgmental in their dealing with patients but very little about what happens to the HCP/patient relationship when the patient is doing the judging.</div><div style="text-align: justify;"><span style="font-family: "Trebuchet MS",sans-serif;">Although I haven't visited my GP very much (not at all in the last 30 years) we have settled into a nice mutually judgmental relationship. He finds me irritating and demanding because I understand health care, know what treatment I need and ask for it repeatedly. I find him patronizing and </span><span style="font-family: "Trebuchet MS",sans-serif;">unhelpful because he insists on doing tests to find out what is wrong with me rather than just giving me the treatment I want. Neither of us are wrong - we just understand each others position, disagree with it and try to work round it. This attitude does not necessarily have a negative effect our relationship, rather it places it upon an equal footing which is often lacking in other HCP/patient interactions. </span></div></div>Loracenna@gmail.comhttp://www.blogger.com/profile/18195902043884586453noreply@blogger.com0tag:blogger.com,1999:blog-3156833821506370543.post-26439112140969679332012-01-19T06:52:00.000-08:002012-01-19T06:52:15.118-08:00How informed is informed?<div dir="ltr" style="text-align: left;" trbidi="on"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi6svm31p7JuC0ml6tE7Y7as_VWm6c69yyAs1ovjeE7-kxx4RjGRgZsux32OOM0E6A_n_q-Px_7K0syVyTfzrdz-ZJkZ7YMouB14nEp4u4fZQkUKGOftFe-E2s6dpiuWYxN-88Lhbw_lEdN/s1600/Sniff%252BEconomist.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="182" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi6svm31p7JuC0ml6tE7Y7as_VWm6c69yyAs1ovjeE7-kxx4RjGRgZsux32OOM0E6A_n_q-Px_7K0syVyTfzrdz-ZJkZ7YMouB14nEp4u4fZQkUKGOftFe-E2s6dpiuWYxN-88Lhbw_lEdN/s320/Sniff%252BEconomist.jpg" width="320" /></a></div><br />
<br />
<br />
<br />
<span style="font-family: "Trebuchet MS",sans-serif;">I recently fell into the hands of organized health-care which necessitated a visit to the ultrasound department of my local hospital. In the spirit of ensuring I was informed about my forthcoming visit they sent me a helpful leaflet about drinking water an hour beforehand, how long the investigation would take, what to expect (gel on tummy) </span><span style="font-family: "Trebuchet MS",sans-serif;">etc. </span><span style="font-family: "Trebuchet MS",sans-serif;"><i><b>NO MENTION AT ALL</b></i> of the invasive part of the procedure!!!!!</span><br />
<span style="font-family: "Trebuchet MS",sans-serif;">Is this because they think that's the most fun part <i>(*hint*</i> it really really isn't) and want it to be a nice surprise or is it because they think if women know about that bit they won't turn up? Either way my consent was only semi-informed at best</span>, <span style="font-family: "Trebuchet MS",sans-serif;">the information I was given seconds before the procedure began was inaccurate ("this won't hurt much") and I am not a happy patient. </span><br />
</div>Loracenna@gmail.comhttp://www.blogger.com/profile/18195902043884586453noreply@blogger.com0tag:blogger.com,1999:blog-3156833821506370543.post-49231535978491396592011-10-02T04:09:00.000-07:002011-10-02T04:09:15.502-07:00The Neutral Zone<div dir="ltr" style="text-align: left;" trbidi="on"><div style="text-align: justify;"><span style="font-family: "Trebuchet MS",sans-serif;">The thought occurred to me this week -</span><span style="font-family: "Trebuchet MS",sans-serif;"> when did we become an either/or society? We seem to be becoming increasingly polar in our opinions, either Microsoft or Apple, iphone or Blackberry, books or a Kindle. Those are surely unsustainable positions. Why can't we acknowledge that there are elements of both which would work for us at different times. After all, when you buy a Kindle it's not like Amazon send a big skip round to your house and take away your existing book collection is it? </span></div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><span style="font-family: "Trebuchet MS",sans-serif;">What sparked this off in me was attending a meeting of Healthcare Professionals for Assisted Dying (<a href="http://www.hpad.org.uk/">HPAD</a>) at the <a href="http://www.dignityindying.org.uk/">Dignity in Dying </a>offices in London. It was a good meeting, focusing upon how HPAD could inform the healthcare profession's debate around assisted dying and also support doctors and nurses in practical ways...and it changed my mind for me. Not in terms of being a whole hearted supporter of choice at the end of life but in terms of what we should be expecting from the Royal Colleges in terms of their guidance to practitioners. I admit that when the Royal College of Nursing adopted it's neutral stance towards assisted dying in July 2009, I was a little disappointed that they hadn't gone the whole way and come out in clear support. However <a href="http://www.hpad.org.uk/steering-committee/">Professor Ray Tallis</a> made the point that neutrality is the obvious and most desirable outcome. Why? Because it's the only outcome that complete acknowledges the autonomy of the individual. This is not an issue to be controlled by healthcare professionals who set themselves up as gatekeepers, it's an issue that that cements the partnership between the patients and their health carers/providers. We need neutrality in order to encourage our professional organisations to provide support for healthcare professionals who both do and do not support this contentious question and we need neutrality to enable us to direct patients to the best sources of advice, whatever those sources may be. This is not about either good palliative care OR assisted dying, it is, what it has always been, about informed choice.</span></div><div style="text-align: justify;"><span style="font-family: "Trebuchet MS",sans-serif;"><br />
</span></div><div style="text-align: justify;"><span style="font-family: "Trebuchet MS",sans-serif;">Finally, I was a little depressed to note that only 66 of HPADs 380 members are nurses. This despite the fact that nurses would argue that they spend more time with patients than doctors, they act as patient advocates and that some polls suggest that nurses are more open to a change in the law around assisted dying. Nurses care about this question so I would hope that more of them will join <a href="http://www.hpad.org.uk/">HPAD</a> and make sure their voices are heard.</span></div><br />
</div>Loracenna@gmail.comhttp://www.blogger.com/profile/18195902043884586453noreply@blogger.com0tag:blogger.com,1999:blog-3156833821506370543.post-31763959202349068252011-08-12T07:34:00.000-07:002011-08-12T07:34:07.932-07:00Virtual loss, real grief<div dir="ltr" style="text-align: left;" trbidi="on"><span style="font-family: "Trebuchet MS",sans-serif;">Like a number of people I have a lot of on-line friends, more if I'm honest than I have in the off-line world. And this week I lost one. One of my tweeps (that's what I call my </span><span style="font-family: "Trebuchet MS",sans-serif;">friends</span><span style="font-family: "Trebuchet MS",sans-serif;"> on the micro-blogging site Twitter) has died after a long health struggle that he bravely kept to himself. This was a person I had never met in the off line world, didn't know what he looked like or what his off line name was. I know he was tolerant and kind and quirky, I know we shared a love of opera, shoes (he was a self-declared transvestite), take away food and most importantly a sense of humour. @daminicustard was always ready with a virtual hug when I posted a sad thought or a witty quip, we recommended each other to our own followers and I like to think we made each other laugh</span><span style="font-family: "Trebuchet MS",sans-serif;">. It's hard to think that I'll never get another *mwah*</span> <span style="font-family: "Trebuchet MS",sans-serif;">for giving him a #ff recommendation or making him smile.</span><br />
<br />
<span style="font-family: "Trebuchet MS",sans-serif;">So don't tell me that relationships in the virtual world are some how less authentic or meaningful than those in the off line world. If they were the grief I'm feeling at the moment would be much less painful and much less real. As health care professionals this may be an area of loss we have not even begun to think about addressing but it is an area of care we cannot ignore for much longer. Social media has made communication both more immediate and more intimate and working out how to support individuals who have lost people they never really had in the 'real' world is possibly one of the next big challenges in nursing care.</span><br />
<span style="font-family: "Trebuchet MS",sans-serif;"> </span><br />
<span style="font-family: "Trebuchet MS",sans-serif;">So, goodbye @daminicustard, I'm sad you never knew how special you were, it was a privilege to be one of your Twitter friends and I hope, wherever you are now, you are finally happy.</span><br />
<span style="font-family: "Trebuchet MS",sans-serif;"> </span></div>Loracenna@gmail.comhttp://www.blogger.com/profile/18195902043884586453noreply@blogger.com1tag:blogger.com,1999:blog-3156833821506370543.post-43377086161412073682011-07-11T11:54:00.000-07:002011-07-11T11:54:55.061-07:00When did playing outside become a disease?<div style="font-family: "Trebuchet MS",sans-serif;">I couldn't believe when, watching TV the other night I saw an advert for Oralyte for healthy kids. For those who have not come across this before, it marketed in the UK as Dioralyte and is a drinkable salts and glucose mixture used to help rehydrate patients who have severe intestinal problems and had nifty little animations demonstrating how salts ad electrolytes are lost through sweat and how easily they are replaced by Oralyte. This advert was encouraging mothers to feed this stuff to their children who "become dehydrated when playing outside. I'm sorry....what??????????</div><div style="font-family: "Trebuchet MS",sans-serif;">In a society which seem sdetermined to prevent children from playing In streets parks and gardens, walking to school and generally rushing around on bikes this seems the final step to far. Kids who are playing outside require (I'm told from my friends with kids) frequent feeding and watering and if this is done the there is no need to seeking medical treatment.</div><span style="font-family: "Trebuchet MS",sans-serif;">It seems to me that this is a cynical attempt to frighten parents into buying a treatment for their kids that is unnecessary and redundant. Whilst electrolyte replacement </span><span style="font-family: "Trebuchet MS",sans-serif;">compounds have been used to treat severe diarrhoea in children there is no evidence that in ordinary thirst it is any more effective than ordinary water or fruit juices especialy in healhty individuals.</span><br />
<span style="font-family: "Trebuchet MS",sans-serif;">This does 2 things, firstly it exploits parents by implying that the old way to look after their children in the summer is to make them drink electrolyte supplements and secondly it emphasise a more important trend in today's society to find medical ways of treating ordinary life experiences. Is this how we want our children to grow up - frightened to play in case they dehydrate? </span>Loracenna@gmail.comhttp://www.blogger.com/profile/18195902043884586453noreply@blogger.com1tag:blogger.com,1999:blog-3156833821506370543.post-36799841253156980032011-07-07T00:15:00.000-07:002011-07-07T00:15:27.893-07:00Feet of clay?<span style="font-family: "Trebuchet MS",sans-serif;">The first professional idol I had was a ward sister called Angela Knight. I worked on her ward at the start of my third year of training and she was the first person that I looked at and thought " When I'm a ward sister I want to be like her!" Fortunately my placement was only for 10 weeks so I left the ward with my awe intact. Since that innocent time I have been sadly disappointed in my ( very few) idols since. Finding an individual I held in great regard operated, on closer inspection, in a cloud of glamour with little substance behind the show, meeting a key nurse theorist who changed the way we think about nursing and finding them to be inarticulate and shy was a massive disappointment. It shouldn't detract from the esteem in which I hold their work but somehow.... </span><br />
<br />
<span style="font-family: "Trebuchet MS",sans-serif;">And maybe that is the way to ensure that your professional idols maintain their mystique, appreciate them from a far and never, never get to know them!</span>Loracenna@gmail.comhttp://www.blogger.com/profile/18195902043884586453noreply@blogger.com0tag:blogger.com,1999:blog-3156833821506370543.post-13869497345688879262011-06-14T06:06:00.000-07:002011-06-14T06:06:07.989-07:00Meetings, meetings<div dir="ltr" style="text-align: left;" trbidi="on"><span style="font-family: "Trebuchet MS",sans-serif;">In the 21st century isn't it about time we came up with something to replace the endless and pointless meeting to which we all go. Why do I have to travel 50+ into work to sit in an over or under heated room (depending upon whether it is summer or winter) with only half of the people who should be there to attend "a meeting". I have lost count of the number of meeting that I have turned up for that have been cancelled at the last minute because too many people sent apologies. Why do we have to have "team meetings" it's not for team building purposes because, generally, half to two-thirds of the team are missing and it can't be for communication purposes because, well....half to two-thirds of the team are missing. If something is vital for everyone to know - send an e-mail, or a text, or tweet about it. If you want more people to attend - hold your meeting in cyber-space via Skype. If I hold a meeting, it has a clear purpose, stated aims, a proposed outcome, an agenda - to which we stick- and is targeted at the people who will help to make those aims a reality. Does it make me naive to if I wish that al meetings could be like that?</span><br />
<span style="font-family: "Trebuchet MS",sans-serif;">I now have two goals for meeting attedence;</span><br />
<span style="font-family: "Trebuchet MS",sans-serif;">1. The pupose of the mmeting, and my contrubution must be clear to me from the moment the invite to attend reaches me.</span><br />
<span style="font-family: "Trebuchet MS",sans-serif;">2. The meeting should not be higher that then first floor of any building.</span><br />
<br />
<span style="font-family: "Trebuchet MS",sans-serif;">Actually, the last point has little to do with the effectiveness or otherwise of meetings and more to do with my lack of desire to slog up more than one flight of stairs for anybody!.</span><br />
<span style="font-family: "Trebuchet MS",sans-serif;">If anyone wants to discuss this further, contact me with some diary dates and we'll set up a meeting</span></div>Loracenna@gmail.comhttp://www.blogger.com/profile/18195902043884586453noreply@blogger.com0tag:blogger.com,1999:blog-3156833821506370543.post-2791883324223137462011-05-31T11:15:00.000-07:002011-05-31T11:15:07.758-07:00Who cares?<div dir="ltr" style="text-align: left;" trbidi="on"><span style="font-family: "Trebuchet MS",sans-serif;">From time to time, I am "invited" to take part in selection interviews for student nurses. At some point in the interview some one on the interview panel will ask THE question - which is, of course, "why do you want to be a nurse?"</span> <span style="font-family: "Trebuchet MS",sans-serif;">To which the interviewee inevitably gives THE response "Because I want to care for people"</span>. <span style="font-family: "Trebuchet MS",sans-serif;">I struggle a bit with this answer I have to be honest - why is nursing still primarily associated with caring rather than say, a satisfying career, the opportunity to do health care re</span><span style="font-family: "Trebuchet MS",sans-serif;">search or a fulfilling academic challenge? If people are so keen to care why not become lollipop ladies/men. They also care, they have a cool uniform and they only work about fours hours a day</span>!<br />
<br />
<span style="font-family: "Trebuchet MS",sans-serif;">These individuals clearly have a view of nursing that is predicated upon the concept of caring, even thought they often have only the vaguest notion of what that may mean. They come into nurses education keen to care, nurse educators invest a great deal of time and energy in encouraging caring but once such students make it into the stress filled world of clinical delivery...guess what is the first thing to be subsumed?</span><br />
<br />
<span style="font-family: "Trebuchet MS",sans-serif;">This is why, in the UK at least, we have things such as the North Staffs enquiry, continuous reports about poor care for older people and only last week the report that doctors are now having to prescribe water to patients in hospital in order to prevent them dehydrating. This is shameful. Its not what potential students mean when they say they want to care, it </span><span style="font-family: "Trebuchet MS",sans-serif;">isn't what universities are teaching so what is going wrong?</span><br />
<br />
<span style="font-family: "Trebuchet MS",sans-serif;">My friend became a grandmother for the first time earlier this year and found her daughter in such an appalling state post delivery that she signed her out to take her home. Not a bad idea, mother and baby were perfectly healthy, if not being washed, fed or being relieved of an over flowing bed pan that had been used two or three times but not removed. On top of these indignities, the final words of the "caring professional" as this distraught first-time mother was helped from the ward by her family were "If your baby dies tonight - that won't be our problem"</span>.<br />
<br />
<span style="font-family: "Trebuchet MS",sans-serif;">That's a damning anecdote, but what it is worse is that every one who has fallen into the hands of organised health care, even briefly has a story that is similar or worse. My friend is a strong, assertive woman (wouldn't be my friend otherwise) but she didn't feel that it was worth her while to complain. If we as nurses and unaware that our caring attitudes are eroded by practice and our patients are not encouraged to be the custodians of our caring skills - then what hope is there for caring in health care?</span></div>Loracenna@gmail.comhttp://www.blogger.com/profile/18195902043884586453noreply@blogger.com0tag:blogger.com,1999:blog-3156833821506370543.post-30686583108575417512011-05-25T08:13:00.000-07:002011-05-25T08:13:24.728-07:00Where are the maverick ward leaders of yester year?<div dir="ltr" style="text-align: left;" trbidi="on"><span style="font-family: "Trebuchet MS",sans-serif;">Reluctent though I am to turn into one of those annoying people-of-a-certain-age who start every rant/blog with " When I was in clinical practice.." but.....</span><br />
<span style="font-family: "Trebuchet MS",sans-serif;"><br />
</span><br />
<span style="font-family: "Trebuchet MS",sans-serif;">When I was in clinical practice if I considered my leadership skills at all (and I didn't) I would have assumed that because I was willing to bend the rules for my patients and support my staff if they did the same I was a good leader. I ran a trauma ward in an area with a large elderly population, often we admitted elderly women whose husbands had never had to cook or shop for themselves so we would 'fiddle' the menus so that we could feed them. We would allow people to have their pets bought into to visit them (although not small babies!). We'd let people visit outside of visiting hours, in fact as a ward team we did all sorts of things that I suspect ward leaders theses days are too scared or too down trodden to contemplate and as a consequence we were a team that had a strong sense of both our professional identity and our professional responsibilities.</span><br />
<span style="font-family: "Trebuchet MS",sans-serif;"> </span><br />
<span style="font-family: "Trebuchet MS",sans-serif;">I wonder why we see very little evidence of leaders like this in modern health care. Ward leaders seem less willing to go the extra mile for their patients, whether this is because they are less caring (I don't think so) is it because they are frightened about maintaining their registration or have other hospital become places in which the individual has not place? I hope when I fall into the hands of organised healthcare, somewhere to care for me </span><br />
<br />
<span style="font-family: "Trebuchet MS",sans-serif;">Continue the discussion this Thursday on #healthcarechat at 8pm GMT+1</span> </div>Loracenna@gmail.comhttp://www.blogger.com/profile/18195902043884586453noreply@blogger.com0tag:blogger.com,1999:blog-3156833821506370543.post-54766703458877853342011-05-17T03:03:00.000-07:002011-05-17T03:03:17.044-07:00Poor pain management? I blame Margot......<div dir="ltr" style="text-align: left;" trbidi="on"><div class="MsoNormal" style="margin: 0cm 0cm 10pt; text-align: justify;"><span style="font-family: Calibri;">Without doubt the most significant development in pain management in the UK was the publication, in 1990, of the College of Anaesthetists and Royal College of Surgeons working party report on pain after surgery. It was this report that lead to the creation of Acute Pain Services who would take the lead for improving pain management in hospitals.<span style="mso-spacerun: yes;"> </span>Since then analgesic drugs have improved, we have better delivery methods and awareness of the importance of good pain management in a patients recovery has been fully emphasised. So, the question remains – why are patients still experiencing poor quality pain management?</span></div><div class="MsoNormal" style="margin: 0cm 0cm 10pt; text-align: justify;"><br />
</div><div class="MsoNormal" style="margin: 0cm 0cm 10pt; text-align: justify;"><span style="font-family: Calibri;">Personally I blame Margot McCaffery. She it was who coined the annoying phrase “<i style="mso-bidi-font-style: normal;">pain is what the patient says it is and occurs when the patient says it does</i>”. On the face of it, there is little wrong with this, it raises the importance of believing patients when they say that they are in pain and that can only be a good thing, furthermore it’s catchy and easy to remember – and that is the bit I object to. It seems to me that one could walk into any clinical area in any hospital in the UK and say “Complete this sentence. Pain is what the patient says it is and.....” then brace yourself for the noise of all the staff finishing it off in loud and confident unison. The problem is that although every nurse in the UK knows and believes this statement, hardly any of them <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">act</i></b> as if they believe it. I think the difficulty if that this short statement has a nice bouncy rhythm, like the old drinka-pinta-milk-a-day or clunk-click-every-trip, to it that makes it easy to parrot and trot out at appropriate time. It has the advantage of sounding clinically empathetic without having to invest a great deal of intellectual effort. Nobody stops to consider that often pain is <b style="mso-bidi-font-weight: normal;">more</b> than the patient says it is and occurs <b style="mso-bidi-font-weight: normal;">more often </b>than the patient says it does.<span style="mso-spacerun: yes;"> </span>It also implicitly excludes those patients who, for whatever reason, will have difficulty communicating their pain to the health care profession. Thus, despite parroting this annoying little phrase at every opportunity, there is little evidence that patients are believed when they report their pain, significant evidence that certain sections of society and not only disbelieved but labelled as drug abusers when they report their pain, and no evidence at all that a patients previous history of analgesic use is taken into account when prescribing and administering pain killing drugs. </span></div><div class="MsoNormal" style="margin: 0cm 0cm 10pt; text-align: justify;"><span style="font-family: Calibri;">It seems to me that despite all those better drugs, better delivery systems, enhanced prescribing practices and more supposedly patient/practitioner partnerships, pain management is still poor in the UK and it’s all down to McCaffery and her annoying little phrase. Time, I think, for educators and nurses to leave it behind and move on towards genuinely believing what patients tell them about pain and using their not inconsiderable resources to alleviate it.</span></div></div>Loracenna@gmail.comhttp://www.blogger.com/profile/18195902043884586453noreply@blogger.com0tag:blogger.com,1999:blog-3156833821506370543.post-92205717929074644962011-05-17T02:49:00.000-07:002011-09-19T04:33:40.493-07:00Curated ChatsOur curated chats can be viewed by following these links:<br />
<br />
5th May - <a href="http://stanzr.com/healthcarechat-2011-05-what-is-assisted-dying">Assisted dying</a><br />
<br />
12th May - <a href="http://stanzr.com/healthcarechat-2011-05-what-is-role-of-government">The role of government in healthcare </a><br />
<br />
19th May - <a href="http://stanzr.com/healthcarechat-2011-05-is-pain-always">Pain Management</a><br />
<br />
26th May - <a href="http://stanzr.com/healthcarechat-2011-05-26-leadership-in-healthcare">Leadership in Healthcare</a><br />
<br />
2nd June - <a href="http://stanzr.com/healthcarechat-2011-06-Does-caring-still-have-a-place-in-modern-healthcare-">Caring</a><br />
<br />
9th June - <a href="http://stanzr.com/healthcarechat-2011-6-What-effect-is-the-informed-patient-having-on-treatment-decisions-And-is-there-more-we-can-do-to-inform-them">Patient choice - open mic </a><br />
<br />
16th June - <a href="http://stanzr.com/healthcarechat-16th-June-8pm-GMT-1-Why-do-we-have-so-many-meetings-">Meetings </a><br />
<br />
23rd June - <a href="http://stanzr.com/healthcarechat-23-Jun-2011-20-00-GMT-What-is-genetic-testing">Genetic testing </a><br />
<br />
30th June - <a href="http://stanzr.com/healthcarechat-2011-June-30-What-is-online-learning-">Online learning</a><br />
<br />
7th July - <a href="http://stanzr.com/d36m6yi4">Professional Idols - are they up to scratch?</a><br />
<br />
14th July - <a href="http://stanzr.com/healthcarechat-2011-July-14-What-is-normal-in-terms-of-health-">The medicalisation of normal</a><br />
<br />
21st July - <a href="http://stanzr.com/healthcarechat-2011-July-21-How-much-are-patients-really-involved-">Involving patients in their care</a><br />
<br />
28th July -<a href="http://stanzr.com/healthcarechat-2011-July-28-Is-healthcare-a-right-or-a-privilege-"> Paying for healthcare</a><br />
<br />
8th September - <a href="http://stanzr.com/healthcarechat-2011-September-8-What-do-we-mean-by-quality-">How do we measure quality in healthcare?</a><br />
<br />
15th September - <a href="http://stanzr.com/healthcarechat-2011-September-15-What-lifestyle-factors-are-considered-in-healthcare-decisions-already-">Should we refuse care based on a patients lifestyle? </a>alirichardshttp://www.blogger.com/profile/04827737068085384643noreply@blogger.com2tag:blogger.com,1999:blog-3156833821506370543.post-3850752462989033332011-05-09T09:24:00.000-07:002011-05-09T09:24:57.237-07:00Time to choose?<div dir="ltr" style="text-align: left;" trbidi="on"><span class="Apple-style-span" style="font-family: "Trebuchet MS",sans-serif; font-size: 11px;"><span class="Apple-style-span" style="font-size: x-small;"><span style="font-size: small;"><a href="http://alihandscomb.blogspot.com/">Ali Handscomb </a>argues that ".. the role of government in healthcare is to balance what is affordable with best quality and outcomes for the people it serves" and that seems to be a point of view that it is difficult to argue against. However, the divided nature of politics in the UK - especially in the present coalition situation would suggest that large proportion of the people will not be so served. Whilst the government feels the need to tinker with health care provision and attempts to sell such tinkering as providing extra choice to service users, they seem to be missing two key points and they are these...when has increased choice ever been an issue and how does increased choice<b> NOT</b> translate into greater cost ( not less as proposed) Most people of my acquaintance want access to good health care, when they need it and they want it locally.</span></span></span><br />
<span class="Apple-style-span" style="font-family: "Trebuchet MS",sans-serif; font-size: small;"><span class="Apple-style-span"> Many are not equipped to exercise any so-called choice since they don't consider different types of healthcare until they are in a position to need them. My fear is that by offering "choice" the danger of removing large elements of society from healthcare provision is extreme. I live in a fairly diverse neighbourhood where the middle-aged, (say those over 50) tend to be well educated professionals with small families and the younger element... not so much. It is clear that should the government sponsored choice materialise it will be driven by the vocal middle-aged. Good news for people like me who will need hip replacements one day, not so great for those who need teenage pregnancy midwives or drug addiction services. Cheaper though!</span></span><br />
<span class="Apple-style-span" style="font-family: "Trebuchet MS",sans-serif; font-size: small;"><span class="Apple-style-span">The choice that is being held up as the key outcome of the new NHS reforms seems to me disingenuous. Reform should not necessarily be the role of government, monitoring and auditing of service driven reform that is informed by all of the members of local communities should be</span></span></div>Loracenna@gmail.comhttp://www.blogger.com/profile/18195902043884586453noreply@blogger.com0tag:blogger.com,1999:blog-3156833821506370543.post-72213108131539475452011-04-29T15:11:00.000-07:002011-05-04T15:17:59.164-07:00#healthcarechatWelcome to #healthcarechat.<br />
<br />
We will be meeting each Thursday between 8-9 pm GMT (currently +1 as its BST) on twitter via a chat facility called Stanzr. You can register or log in with your facebook or twitter account at http://stanzr.com/healthcarechat<br />
<br />
We hope that the topics are informative and interesting for anyone working in the healthcare field. This is an open community and we welcome people from different countries, healthcare spheres and healthcare users. We want to be as inclusive as we can so anyone with an interest can be involved. Each month we will have an open mic session where any questions can be posed to the community and we will be asking for topics from you as a community as well as thinking of them ourselves. We also hope to invite authors and interesting speakers along to become the focus of chats every now and then.<br />
<br />
Each week there will be a couple of blog postings here and on<a href="http://alihandscomb.blogspot.com/"> Ali Handscomb's Blog </a> to discuss our chosen topic and pose four questions. Hopefully it will get you ready for the chat and prepare you to think about the topics and questions we will be posing throughout the hour.<br />
<br />
We will ask you to introduce yourselves at first so we get to know each other as a community. Carol or Ali will try to always welcome you by name but if the conversation is fast paced and we miss we dont mean to be rude at all nudge us!<br />
<br />
As we move through the blog we will ask each question as Q1 - 4 and we would encourage you to put A1 - 4 before each answer and to always use the hashtag when answering. Using a question format makes keeping up with the twitter stream far more simple for everyone following.<br />
<br />
At the end of each week we will ask people to post a <i>Take Away</i> which is basically the top thing they have learned form the chat in 140 characters.<br />
<br />
It is easier to follow chats on something like tweet deck because then you can open up a column just for the chat and are not distracted by other tweets during the hour. For some really fast paced chats people often also open up twitter and look at the moderators stream as well but it is not always necessary.<br />
<br />
As the chat develops we will be posting new information on this blog to make sure you keep up to date with any developments. Most of all we really hope this becomes a supportive and informative chat which helps people discuss current issues and topics in what is an increasingly complex field.<br />
<br />
Our chat starts on the 5th May at 8pm GMT +1and Carol has already posted on the topic of Assisted Dying. My <a href="http://alihandscomb.blogspot.com/">blog</a> today has highlighted the questions that will lead us through the topic.alirichardshttp://www.blogger.com/profile/04827737068085384643noreply@blogger.com0tag:blogger.com,1999:blog-3156833821506370543.post-55080215559539663122011-04-28T07:22:00.000-07:002011-04-28T07:22:29.978-07:00Why I support assisted dying<div dir="ltr" style="text-align: left;" trbidi="on"><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-family: "Trebuchet MS",sans-serif;">Unless we are particularly unfortunate, or live under some form of oppressive regime, everything we do in our lives is more or less under our own control. What we eat, what we wear, where we live who we sleep with/marry/secretly lust for - it's all up to us. Until it seems you come to leave this life, when that happens the decisions about how and where you die can be taken out of your hands by family or healthcare professionals with little or no regard to your own preferences. I like being in control of my own life and the thought that I will not be in control of the end of it fills me with horror, and that is why I am a supporter of assisted dying. <a href="http://www.dignityindying.org.uk/">The Dignity in Dying </a>website defines a</span>n assisted death as one where a doctor prescribes a life-ending dose of medication to a mentally competent, terminally ill adult at their request, and the patient then chooses to administer the medication themselves. Assisted dying is different to euthanasia and assisted suicide. Euthanasia is a term often used to describe life ending medication being administered by a third party. Assisted suicide refers to providing assistance to die to someone who is not dying. When it comes to it, I would prefer to chose how and when I die. This is not about doubts about standards of palliative care, not about concerns about adequate pain management and not because I have my doubts about the quality of end of life care in the UK - it is all about ending my life the way I've lived it....on my own terms</div><br />
<br />
<span style="font-family: "Trebuchet MS",sans-serif;">I appreciate that there are some people who hold equally strong beliefs, religious, moral or otherwise about the sanctity of life and I respect their right to hold those views. What I cannot understand is why such people are not willing to afford a similar level of respect to me</span></div>Loracenna@gmail.comhttp://www.blogger.com/profile/18195902043884586453noreply@blogger.com1