Grounded theory and a new cake. (Back to the kitchen)

Getting my head around grounded theory is not straightforward and I find I need a little something to help me concentrate.  The Pomodoro Technique of time management allows me a half hour break after four 25 minute work periods.  Just long enough to make cake. 



Pomodoro (really not procrastinating...) crumble cake

cake
180 grams butter
180 grams caster sugar
2 eggs
115 grams plain flour
150 grams ground almonds
1 teaspoon vanilla essence
2 tablespoons of milk

crumble
100g cold butter
100g demerara sugar
100g plain flour
a sprinkling of nuts (almond flakes for the raspberry and chopped salted peanuts for the peanut butter and chocolate)

a couple of handfuls of something nice to go under the crumble layer - todays cakes are raspberry and peanut butter with chopped chocolate.

cake Beat butter and sugar until light, add eggs, beat and then add flour, almonds, vanilla and milk.
crumble pulse ingredients in food processor until rubble like in texture. Divide into two bowls and add almonds and peanuts.

Line two two pound loaf tins and divide the cake mix between them, layer on the something nice and top with crumble.  Bake in 180 degree oven for 50 minutes to one hour.

Cool and eat with gallons of tea.

Procrastination and dissertation

After completing my PGDip in the 90s I realised that I did not have anything to say in a dissertation.  The day the 5 year point passed and there was no way of progressing to MSc was a relief.  The following years I moved house repeatedly (following the husband) had children and kept what I had once called my career going as best I could. 

Emerging from the fog of the early years of mothering and with a little more stability on the home front I turned my attention to work again.  I was startled to find that ultrasound seemed to have stalled as a discipline, overtaken (not that it is a competition) by other sub specialities in radiography.  I wondered why.  I took on work outside my department, training and organising study days and getting involved with the Society of Radiographers.  I learned that there were departments where sonographers were leading services, extending and advancing their practice in ways which benefited their patients and brought professional satisfaction to themselves.  Unfortunately these departments appeared to me to be in the minority.  I wondered why and then realised that all these years after not doing my dissertation, I suddenly had not just something to say but a lot to say. 

What to do with it all?  Bore my colleagues and family to tears? Did that. 
What next? 
Do the MSc!

So now here I am, after the best part of two decades, doing the MSc.  And do I just settle down and  write? 

No.
Procrastination rules.
I have baked a lot of bread.
Made many English Muffins.
And rediscovered sock knitting.  And woken up this blog. 

I may just write the dissertation in between all these very attractive alternatives, just give me a minute while I clean the bathroom...

#notsafe #notfair The Junior Contract and the NHS

I am torn between enormous admiration for the Doctors demonstrating their disagreement for the unsafe and unfair Junior contract and horror at the existence of the situation.  Both for the Juniors and the Consultants supporting them.  When the entire Consultant body of a department feels motivated to write this

Big respect to clinical directors & other managers who stand up for their staff @IminworkJeremy pic.twitter.com/vQaVpGlJvo

— nuwan dissanayaka (@nuwandiss) October 27, 2015

We know we are all in trouble.  This should never have developed into an industrial dispute, this is a grown up profession compelled to turn to the language of strike and protest to protect us all.  This is utterly horrifying, dispiriting.  I can only think about it for short periods of time before I think my head may explode so goodness knows what it is like for the Doctors.

As a specialist Radiographer Sonographer I am part of a group actively promoting the advancement and development of a research culture in our profession with the aim of improving patient care and to retain motivated driven people in clinical practice. My recent and now apparently incorrect mantra has been that no one questions Doctors who do research.  Apparently I am wrong and Mr Hunt does question the value of anything which he does not understand as the core function of Doctors. 

I would like to believe that Mr Hunt lacks analytical skills and is unaware that using selected extracts from a paper taken out of context is a big academic no-no in any field but sadly I have to conclude that he knows exactly what he is doing.

One lovely tweet I saw suggested that a suitable Christmas gift for Mr Hunt would be the superb How to Read a Paper by Trisha Greenhalgh  https://twitter.com/trishgreenhalgh He would have plenty of time to get his head round it during his Christmas recess 17^th December – 5^th January.  For more information on when MPs are not sitting follow the link below.....

http://www.parliament.uk/about/faqs/house-of-commons-faqs/business-faq-page/recess-dates/

So, this is very much about Doctors but will soon be about all professional groups in the NHS.  Sonographers are probably safe as Mr Hunt (like most other people) has probably not heard of us and if he has, he has not the faintest clue what we do.

The sentence above should be a joke but it is clear that not having the faintest idea what a professional does is not a barrier to trying to stop them doing it.

Sonographers and stillbirth

Yesterday I met a young couple who lost their baby last year.  By luck I happened to look at the booking letter and noticed the annotation SB next to the details of her previous pregnancy.  It was a busy clinic with lots of extra scans added to the list and she was attending for a 32 week scan.  I could so easily have welcomed them into the room with a breezy ‘so why are we scanning you today?’ Thank goodness I didn’t.  I asked them if they would like me to put a SANDs sticker on the handheld maternity notes.  They did and told me about their little boy, his name, the day he was born, how much he weighed and how beautiful he was.

I can’t tell you how much I love the SANDs teardrop stickers. 

None of us go to work to cause pain but it is too easy to inadvertently do so if the sticker is not in place.

When we are busy we do not always look through the notes in detail, particularly when someone is attending for a routine growth scan amongst many others.  We grab the notes, look through the previous scan reports but don’t look at the booking letter.  There is seldom time for wading through pages of notes.  So we don’t see that this lady has had a still birth. 

Where was the SANDs teardrop sticker? 

In my experience, the hospital notes are generally marked with a teardrop sticker, most likely put there on Labour Ward or Postnatal Ward when the still birth or neo natal death happened but the handheld maternity notes often are not.  When the handheld notes are the only ones available to the sonographer that vital alert is missing.  Placing the sticker on the notes can only be done with patient consent but I have never met a mother or father who was not happy to have it.  You may find the conversation awkward but ignoring their loss or asking questions about her previous pregnancy without knowing what happened is more likely to add to parents’ distress than talking about their baby.  A quote from a bereaved mother in the National Perinatal Epidemiology Unit’s Listening to Parents Report (on the SANDs website) sums it up;

‘I am pregnant again.  I would like a ‘label’ on my notes indicating a previous neonatal death to staff, especially sonographers so that they… understand what we have already gone through.’

If you find that the sticker is missing, ask the parents if they would like one and put it on.  Don’t have any in the department?  Ask the midwives.  If they don’t have any, visit https://www.uk-sands.org and order some. 

 

 

 

 

Are we happy in our dark silos?

We are so stretched by ever increasing demands on our time and a chronic shortage of sonographers - 18% shortfall across the UK last year.  It is probably higher but the majority of departments did not respond to the SCoR survey – perhaps too busy scanning to be able to dedicate time to anything not immediately pressing?  And that pressure means that not many of us get to meetings where we can exchange ideas. 

Networking.  It is everywhere now, following and commenting are second nature to many of us and the NHS is embracing it.  Sonographers are behind the trend here, there are twitter groups for nurses, doctors, pharmacists, and now we can join in with @WeAHPs 

@WeNurses, @WeDocs, @WePharmacists and others are using Twitter to hold tweetchats – conversations and networking events, generally with a theme held at a prearranged time and usually lasting an hour. @WeAHPs will be holding their first tweet chat on Thursday 26th of March using #WeAHPs

We are a group rightly proud of our clinical competencies but we have lots more to offer.  By networking we can engage with practitioners from other parts of the country, sharing ideas and inspiring each other.  So let’s join in with @WeAHPs on the 26th of March and who knows, maybe the walls of the silos will start to weaken a little?

Where are all the sonographers?

We seem to have a problem in the Sonographer community.  Go to any department, conference and meeting and the same themes crop up over and over again.  Staff working under pressure, increasing numbers of examinations requested, insufficient trainees in the system to replace retiring staff and grow departments.  There are many other themes but this is a good starting point. 

The consensus is that something must be done and clearly there are those attempting to think creatively about the issues.  I wonder how many departments are finding innovative solutions. 

Are there any sonographers out there with ideas for progress in our profession?