The Weekend Read – This is Going to Hurt by Adam Kay

Posted on September 29, 2017 by Alun Rees

Very few, if any, books have made me weep with laughter and cry with upset in the space of a couple of pages but Adam Kay’s memoir of his years as a junior hospital doctor managed it. The final chapter left me in bits for many reasons.

I ordered the book thinking it would be a 21st century continuation of Richard Gordon’s, “Doctor in the House” or Colin Douglas’s “The Houseman’s Tale”. In one sense it is; the language is not entirely medical, Adam refers to Obs & Gynae, his chosen speciality, as “brats and twats” and there is plenty of normal hospital human behaviour. Clearly the author was able to tolerate the life of a junior doctor even though, “The hours are terrible, the pay is terrible . . . But there’s no better job in the world”, until something happened.

The significant difference is that whilst the idealism, the diseases, the people and their mistakes have remained much the same, the political interference and attitude to professionals has fundamentally changed. Doctor in the House was written in the idealism of the immediate post-Bevan years (1952) and The Houseman’s Tale just pre-Thatcher (1978) when I was just starting my spell as a hospital resident. This is set in am era dominated by Jeremy Hunt’s predecessors and their ilk, (the author includes an open letter to The Secretary of State for Health) where there has been a slow strangulation of health care in spite of the best efforts of those working within it the system. These diaries were written during the years 2006-10, sadly things have not improved.

Essential reading for anyone who works in or is a recipient of healthcare in the UK – perhaps not if you and your partner are expecting your first child.

Available from The Book Depository HERE

 

 

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The Monday Morning Quote #449

Posted on September 25, 2017 by Alun Rees

When bad men combine, the good must associate; else they will fall one by one, an unpitied sacrifice in a contemptible struggle.

Edmund Burke

 

 

 

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Dental Sedation Adult and Paediatric Immediate Life Support course

Posted on September 21, 2017 by Alun Rees

Lynn Fox has asked me to promote her course on Dental Sedation Adult and Paediatric Immediate Life Support. As someone who practiced sedation I believe that on going training and updates on sedation techniques and particularly Life Support are essential.

Details:

For clinical dental staff who wish to provide / assist with conscious Inhalation Sedation or both Inhalation and IV sedation for adults and children. The Dental Sedation Immediate Life Support course fully complies with IACSD standards for Conscious Sedation in the Provision of Dental Care 2015 who state “Practitioners must be able to provide age-appropriate immediate life support as defined by the main elements of the Resuscitation Council (UK) ILS and PILS training programmes. It is not essential to undertake a Resuscitation Council (UK) accredited ILS/PILS course. Alternative courses with equivalent content which are adapted to the needs of dental practice are acceptable: these might also include the management of common sedation, medical and dental emergencies.”

We are responding positively to this by offering these main Resuscitation Council elements on a non Resuscitation Council, tailor made, one day Dental Sedation Immediate Life Support course which has been developed specifically for the Dental team. This Dental Sedation Immediate Life Support course clearly combines the main elements from the RC Immediate Life Support Course (ILS) and Paediatric Immediate Life Support Course (PILS) in one day.

The course developer and lead instructor is Lynn Fox, a Resuscitation Council accredited instructor in ALS/ILS/EPLS/GIC. Lynn has 11 years of experience in teaching to hospital cardiac arrest teams and has previously lectured on anaphylaxis for the British Dental Association which is now a BDA online lecture. Lynn also teaches Dental Medical Emergencies to in-house dental practices and groups including The Oxford Post Graduate Dental School at Thames Valley Health Education.

Next open course date:

26th October 2017 in Oxfordshire.

Dental Sedation Immediate Life Support course content includes:

  • Causes and prevention of cardiorespiratory arrest in the adult and child
  • ABCDE approach including the management of dental, medical and common sedation emergencies in the adult and child including respiratory depression, aspiration, anaphylaxis and other associated emergencies
  • Basic Life Support and Automated External Defibrillation scenarios for adult and child
  • Adult and child airway management using basic maneuvers & airway adjuncts: BVM, OPA, NPA and supraglottic airway (i-gel)
  • Team roles and responsibilities
  • Assessment will focus on the compromised airway both for the respiratory and airway compromised patient and during cardiac arrest.

Certificate will show 7 hours verifiable CPD as per GDC requirements.

Link to the course website for more information and to book your place  HERE

 

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One rule for you, one rule for the rest…

Posted on September 18, 2017 by Alun Rees

Inspired by John Naughton.

Picture this – one dentist manages to lose one set of notes of one patient, who was one month old, who had made one visit to the practice as an emergency and treatment consisted of examination and parental reassurance. The notes are passed to a recognised third party for disposal but turn up on a patch of waste ground. The CQC and the GDC would be involved and that dentist would probably go through months of anxiety whilst it was decided how big the case was for them to answer.

Meanwhile…. “sometime between mid-May and July, Equifax was hacked via a security flaw in the Apache Struts software that it used to build its web applications. The flaw, which gave hackers an easy way to take control of sensitive sites, had been fixed on 6 March and patches were made available to every organisation that used Struts. That meant, as various commentators pointed out, that Equifax’s IT department had the tools to plug the security holeand two months in which to do it. For some reason, they didn’t.

As a result, the hackers were able to steal the personal information of 143 million Americans. It is the most important financial data available on any citizen – names, dates of birth, social security numbers, home addresses and in some instances a lot more, including credit card details of more than 200,000 US consumers (and some UK consumers). It’s everything you need to engage in identity theft on an epic scale. “On a scale of 1 to 10 in terms of risk to consumers,” said a fraud analyst at consultancy firm Gartner, “this is a 10.””….

…Equifax discovered the breach on 29 July, but didn’t reveal it publicly until 7 September, no doubt because the internal investigation was long and complex. During that period, however, three of its senior executives unloaded shares in the company valued at $1.8m. But this, apparently, was completely coincidental: the poor dears (who included the chief financial officer) were not aware that an intrusion had occurred when they sold their shares. 

…..if some poor unfortunate forgets to pay a library fine and then discovers that they can’t get a loan because a check on Equifax’s database reveals the payment lapse, well… that’s just tough. If you want to understand the populist revolt, then this is a good place to start.

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The Monday Morning Quote #448

Posted on September 18, 2017 by Alun Rees

“Instead of thinking outside the box, get rid of the box.”

Deepak Chopra

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The Weekend Read – Solitude by Michael Harris

Posted on September 15, 2017 by Alun Rees

This makes the ideal companion to “Deep Work” of which I have already written. This book which feels like a collection of essays explores the fact that our connectedness means that we have lost something that is vitally important to our lives, namely our solitude. I found it entertaining, thought provoking and important.

The author’s argument is that our increasing busyness, our being always “on” and the ever present communication devices (count how many of the next 50 people you see have got a ‘phone, smart or otherwise, in their hand) has resulted in our being unable to turn ourselves off, to experience being alone with ourselves. We all need time to think, to re-charge, to turn off without it we are losing something wonderful and valuable.

Our days are consumed by the desires that others place on us. These others are often unseen and unknown from advertisers trying to convince you that you need whatever they are selling this time through Facebook checking to see that others are having the time of their lives whilst you’re Billy no-mates to the incessant supply of emails that “demand” to be read.

We know that choice does not make us happy, that many Facebook users have or develop a need for social assurance. We are now being encouraged to make our homes connected via “The Internet of Everything”. When I ask the question “why” the only answer that I understand is, “because we can”. That’s not good enough.

When was the last time that you were truly on your own, disconnected from “the grid” as some say? Have you consciously allowed this lack of solitude to develop or has it just crept in without your specific permission, “everybody is so everybody should”.

Earlier this week I used the “Google Maps” app on my phone to guide me to someone’s house in a suburb of Manchester. I had looked at the route before I set off, it was a 25 minute walk, a pretty easy route but rather than trust my memory, my good sense of direction and my instinct I used the app. I had been there once before 4 months or so ago and didn’t want to get lost. The result – I did get lost, for some reason the app chose (can I really say it chose? Surely I was the one making the choice) to take me round three sides of a square instead of leading me to the destination directly. I knew it was wrong but allowed it to happen. Why trust something so fallible, something that has been programmed to sell me things that “it” has decided I need? I don’t know either.

A lovely book, entertaining, amusing and questioning, you’ll never see your iPhone in quite the same way again. I agree with Douglas Coupland, “I came away from this book a better human being. Michael Harris’ take on existence is calm, unique, and makes one’s soul feel good.”

You can get it from The Book Depository.

 

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Sometimes you have to be grateful….

Posted on September 14, 2017 by Alun Rees

I was contacted by a prospective client yesterday who asked for testimonials from clients with whom I currently work or have worked in the past.  I want to thank the several individuals who responded to my emails within minutes with, “of course”, “pleased to help”, “send them my way” and variations on that theme.

Gratitude isn’t a good enough word.

Thanks folks, you know who you are.

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I never understood modern car loans and now I know why.

Posted on September 14, 2017 by Alun Rees

In the days when I used to borrow money to buy a car I understood what I was doing. Price was £X000 borrow money at Y% over 3 years means you repay £Z every month until you can either enjoy loan free driving for a year or two or start again. Then the game changed instead of a loan you were asked to get involved in a Personal Contract Purchase (PCP) which sounded to me like renting the car.

Hearing my friend Jimmy extolling its virtues because “you can upgrade your Merc every couple of years because you just roll it on” sounded like pass the parcel but when you eventually removed the wrapping you were left with the bill for the party – or no car.

I presumed that I just didn’t understand and went back to driving my second hand, 3-series Beemers until they died beneath me. Incidentally that’s 4 cars in 31 years – total purchase cost £25K.

It seems that I was right about this PCP business and the balloon payment idea is another bubble (hardly surprising) waiting to burst.

From The Conversation:

Are we facing a car loan credit crunch? Here are the facts

 

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CIPD’s Top 6 reasons to go to court

Posted on September 12, 2017 by Alun Rees

The biggest challenge in Dental Practices through the Spring and Summer of 2017 seemed to be people. I’m not sure if we have greater expectations of our teams and/or our leaders or whether the general feeling of uncertainty (Brexit etc) is manifesting itself in the way we behave towards each other. All I know is I have fielded more questions from clients (& non-clients) about team behaviour than ever before.

CIPD listed their Top 6 Reason employers end up in court and how to avoid it. Full article HERE

1)Discrimination

Why a tricky area of the law is only going to get trickier – and how HR can stay ahead

Among the biggest casualties of the introduction of tribunal fees in 2013 were claims for discrimination – there was a 91 per cent drop in the number of sex discrimination cases in the first year.

The Supreme Court’s decision that fees are unlawful (see page 8) will undoubtedly mean case numbers will rise….

2) TUPE

Service provision changes aren’t exciting, but they could prove costly

It’s the four-letter word every HR professional dreads: TUPE, or the Transfer of Undertakings (Protection of Employment) Regulations, has always been fraught with the potential to confuse because it is highly technical and heavy on detail.

Recent cases have focused on one key aspect of the regulations – whether there has been a service provision change during a transfer, which can then determine which employees retain their current terms and conditions (or not) under TUPE at their new employer….

3) Flexible working

Justifications matter when it comes to granting or denying requests

According to Deloitte’s Millennial Survey 2017, flexible ways of working – whether that’s location, hours or contractual arrangements – are highly valued by workers born between the early 1980s and early 2000s. Those in organisations with a high degree of flexibility are more likely to be loyal to their employer and to say this has a positive impact on their wellbeing and that of the business…

4) Religion

From dress codes to the intricacies of helping people from different faiths work together

When it comes to religion at work, one of the ways it is most visibly expressed is in the way employees dress. Two European cases have provided food for thought on whether employers can be proscriptive with dress codes in relation to religion….

5) Parental leave

Problems over parity between mums and dads could be storing up trouble

With discrimination against women during pregnancy or maternity leave costing businesses close to £280m a year, according to the Equality and Human Rights Commission, parenthood at work is potentially expensive. And discrimination is a particular consideration when it comes to shared parental leave (SPL).

6) Disciplinaries and grievances

Follow the rule book and keep a written record – or be prepared to write a large cheque 

HR isn’t all about the process. But when a disciplinary or grievance makes the news, you can be pretty certain someone, somewhere didn’t follow the rules. Both are situations that organisations strive to resolve informally and internally to avoid a costly tribunal. “Most employees are quite reluctant to raise a formal grievance because they think they will be earmarked as a troublemaker, and employers wish to avoid the fallout,”

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The Monday Morning Quote #447

Posted on September 11, 2017 by Alun Rees

“When we think we’re multitasking we’re actually multiswitching. That is what the brain is very good at doing – quickly diverting its attention from one place to the next. We think we’re being productive. We are, indeed, being busy. But in reality we’re simply giving ourselves extra work.” 

Michael Harris

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