Hodges' Model: Welcome to the QUAD: March 2010

- learn about the conceptual framework Hodges' model. A tool that can help integrate HEALTH and SOCIAL CARE, INFORMATICS and EDUCATION. The model is situated, facilitates person-centredness, integrated - holistic care and reflective practice. A new site using Drupal is an ongoing aim - the creation of a reflective workbench. Email: h2cmng @ yahoo.co.uk Welcome

Tuesday, March 30, 2010

Hodges model: The realm of the Centaur...?

I've rather messed about here before with ideas for the new website, banners and graphics. In reading I've switched from SF to Ken Wilber, who with David Bohm I have intended to read for many years.

In Wilber's book No Boundary I found a gift of an iconic image, as in health and social care we constantly strive to achieve integrated and holistic care.

Much of my day-to-day work involves mind-body : body-mind and the suffering between.

In No Boundary we read about the Centaur:

Let us return to the level of the total organism and continue with the story of the growth of the spectrum. At this level, the individual is identified solely with her organism, existing in time, in flight from death. Nevertheless, she is at least still in touch with her entire psychophysical being. This is why we usually refer to the level of the total organism by a simpler name: the centaur. A centaur is a legendary animal, half human and half horse, and so it well represents a perfect union and harmony of mental and physical. A centaur is not a horse rider in control of her horse, but a rider who is one with her horse. Not a psyche divorced from and in control of a soma, but a self-controlling, self-governing, psychosomatic unity. p.72

Related posts:

Holistic care and 'where' it means....

20/20 vision minus 1, 2, or 4 blind spots....

Physio-Political ... musings, songs and dances...

Ken Wilber (2000) No Boundary: Eastern and Western Approaches to Personal Growth. Paperback / Shambhala Publications, ISBN 978-1-57062-743-9.

Image source:

Friday, March 26, 2010

MCQ (question) on clinical coding and classification

Q. The development of clinical coding and classification systems, such as International Classification of Diseases (ICD) is …

  1. a manifestation, since the 1960s, of health care specialisation and technology in medicine?
  2. a product of the National Programme for Information Technology and the International Health Terminology Standards Development Organisation (IHTSDO)?
  3. a product of Körner statistics and resource management in the 1990s?
  4. a product of the 18th century driven by death?
  5. an international initiative prompted by The Plague and launched by Dr Who?

Answer and further reading to follow next month.

Thursday, March 25, 2010

Design an interactive space - 2 meters square - for Expolab project

My source: DESRIST discussion LinkedIn

Hello DESRIST members.

This is about an interactive design project, and the folks at Citilab are very interested in design research. Check it out if you're interested.

Letting you know that Citilab Cornella has an open call for exhibits that explore digital technology for their new project "Expolab". This experiment challenges designers to design 1 or more Expolab cubes with interactives that explore how new digital media and tech affects how we share memories, connect, travel through time and space, work, and experience safety. An opportunity to experiment, and work with the brilliant Expolab team Irene Lapuente, Ramon Sangüesa, and Astrid Lubsen of Citilab.

Start with the cubed 2mx2m space, then modify the space/walls as needed to make it experimental and interactive. Spaces will be equipped with electric and internet connections if needed. Citilab will build 6 of these and put them on display in Barcelona. Expolab cubes can have any number of walls, you can design the whole thing as long as it fits in 2mx2m. The Tech Virtual hosts free 3D prototyping space in Second Life for you to build or document your entry ( http://slurl.com/secondlife/The%20Tech%202/160/211/33 ). If you'd prefer to use your own tools that's fine too, just upload your screenshots after creating a project at:

Looking forward to some new input on this experimental venture! Expolab team comes online for live design reviews Thursdays at 13:00 EST / 10:00 PST / and 18:00 CET (Barcelona). Did I miss anything? Send a note to ...

About Expolab:
"Expolab is a new way to understand exhibitions. It is a laboratory devoted to researching and creating new exhibitions in the area of technology, innovation, science and design, which are the main focus of work at Citilab. Expolab raises the possibility of creating exhibitions with strong citizen participation and contribution from the very beginning of an exhibition, and not just using the audience as providers of feedback once the exhibitions is one. This represents a new challenge within the world of museums and exhibitions.

Wednesday, March 24, 2010

Lovelace, women's IT and QUADratic equations

When you stop and think about it - really stop and think, the foresight of Charles Babbage was astonishing, even though he did not quite achieve his objectives. What is even more amazing then is the role that Ada Lovelace played in the development of computing and scientific computing.

This post is to celebrate Ada Lovelace Day. As per this post 12 months ago, I am and always will be celebrating Enid Mumford and her work on the need and importance of socio-technical insights when we attempt to apply IT in the work place*. Her work also exemplifies what women can and do contribute to IT.

In terms of the 3R's I am 'literate', but real maths evades me at least the level of ability I wish I had. Namely, the expertise to exercise some of puzzles in the social sciences.

BBC radio 4's Woman's Hour has regularly featured maths education for women and girls, bemoaning the maths abilities of the female population. Some maths has come to me through programming in BASIC, sorting, recursion, functions and using SPSS (DOS version!).

They should teach more programming in schools. Computing and maths are often equated (sorry!) and fittingly the BBC have also featured the genius of Ada Lovelace.

So all these things are connected: the pioneering insights of Ada Lovelace, the state of mathematics education for girls and how girl's are engaged in IcT today globally.

Additional links:

Gender IT: https://www.genderit.org/
Association for Progressive Communications: http://www.apc.org/
Alice innovative 3D programming environment

Image source:

* Jones, P. (2009) Socio-Technical Structures, the Scope of Informatics and Hodges’ model, IN, Staudinger, R., Ostermann, H., Bettina Staudinger, B. (Eds.), Handbook of Research in Nursing Informatics and Socio-Technical Structures, Idea Group Publishing, Inc.

Saturday, March 20, 2010

More SF (speculations on person-centred care...?)

I've been reading a bit more SF - this time Joe Haldeman's, The Forever War here's a fascinating excerpt:

I went to the phone in the kitchen and with some difficulty managed to get through to the hospital. A plain girl in her twenties formed in the cube. "Nurse Donalson, general services." She had a fixed smile, professional sincerity. But then everybody smiled.
"My mother needs to be looked at by a doctor. She has a --"
"Name and number, please."
"Beth Mandella." I spelled it.
"What number?"
"Medical services number, of course," she smiled.
I called into Mom and asked her what her number was.
"She says she can't remember."
"That's alright, sir, I'm sure I can find her records."
She turned her smile to a keyboard beside her and punched out a code.
"Beth Mandella?" she said, her smile turning quizzical.
"You're her son? She must be in her eighties."
"Please. It's a long story. She really has to see a doctor."
"Is this some kind of joke?"
"What do you mean?" Strangled coughing from the other room, the worse yet. "Really -- this might be very serious, you've got to--"
"But sir, Mrs. Mandella got a zero priority rating way back in 2010. "
"What the hell is that supposed to mean?"
"S-i-r . . ." The smile was hardening in place.
"Look. Pretend I come from another planet. What is a 'zero priority rating'?"
"Another -- oh I know you!" She looked off to the left.
"Sonya -- come over here a second. You'd never guess who .." Another face crowded the cube, a vapid blonde girl who smile was twin to the other nurse's. "Remember? On the stat this morning?"
"Oh, yeah," she said. "One of the soldiers -- hey, that's really max, really max." The head withdrew.
"Oh, Mr Mandella," she said, effusive. "No wonder you're confused. It's really very simple."
"It's part of the Universal Medical Security System. Everybody gets a rating on their seventieth birthday. It comes in automatically from Geneva."
"What does it rate? What does it mean?" But the ugly truth was obvious.
"Well, it tells how important a person is and what level of treatment he's allowed. Class three is the same as anybody else's; class two is the same except for certain life-extending--"
"And class zero is no treatment at all."
"That's correct, Mr Mandella." And in her smile was not a glimmer of pity or understanding.
"Thank you." I disconnected. Marygay was standing behind me, crying soundlessly with her mouth wide open. ...

Joe Haldeman, The Forever War, Gollancz, SF Masterworks, pp.148-149.

Thursday, March 18, 2010

The need for a hybrid propagator

Feynman PropagatorIn the Northern hemisphere now is the time to be out there planting seeds. Here in the NW of England Spring is just around the corner (the first turn of the year). If you have a greenhouse you can start early. If you have a propagator you can start even sooner and possibly experiment with more exotic flora.

Plants are a known quantity in terms of their needs: temperature, soil, sun, wind, frost, position. ... You just need to add the green fingers to make it work: plus the weather!

It really is magic sowing the sweet peas and seeing the display and smelling the scent in summer.

When it comes to health and social care though we need a special propagator: a true hybrid. Just consider the needs:

physical emotional assessment outcomes quality reflection safety personal social history finance consent intervention person-centered carer demographics information education self-care value for money personalisation dignity respect care collaboration engagement values involvement risk ...

Image source: A Feynman Propagator - Wikipedia

Additional link: The Garden Song

Monday, March 15, 2010

Prime Minister’s Commission on the Future of Nursing and Midwifery in England – 2010

Earlier in March The Prime Minister’s Commission on the Future of Nursing and Midwifery in England published its final report.

You can download the report in full.

Box 3.1.2 (on page 43) features key statistics on nursing and midwifery:

  • In 2009 there were nearly 595,000 RNs on the register residing in England, 77% of them registered in the adult nursing branch.
  • In 2009 there were over 31,000 RMs on the register residing in England.
  • Nine out of 10 of RNs in England are female.
  • There are disproportionate numbers of men in more senior nursing positions and certain specialties: a third of mental health nurses, for example, are male.
  • Nearly all RMs in England are female. There are 131 male midwives.
  • Well over half the RNs and RMs working in the NHS in England (57%) are aged between 35 and 54, with less than 3% under 25. Almost 70% of RNs and RMs on the NMC register in England are aged 40 and over.
Reporting on the Commission's report the RCN Bulletin (10 March) notes the need to encourage more men into the profession and people from black and ethnic minority groups. As the list above highlights, however - There are disproportionate numbers of men in more senior nursing positions and certain specialties: a third of mental health nurses, for example, are male.

From my early nurse education days (especially from mental health to general nursing) you had no choice, but be aware of gender and just w(h)ere you had landed. Upon my first encounter with Hodges' model, the model stood out in the list of theories and models of nursing.

It was not listed on the original nursing theory website.
(Hence, the initial website project)
The majority of models and theories were created by women and outside England.#

The future of nursing depends on successfully addressing* the numbers: totals, proportions, recruits, retirees*. ... We can use the numbers, quality, safety and I have to say - Hodges' model to help craft the creative and innovative messages needed. We really are in for a fascinating and exciting 20-30 years in nursing; here in the UK, EU and Internationally.

* Note the use of 'addressing' not balancing - that's why this is also challenging.
# This is not a complaint, just an observation.

Sunday, March 14, 2010

RCN member's survey on spirituality & H2CM

Originally published - 10 March 2010Source: http://www.rcn.org.uk/newsevents/news/article/uk/rcn_seeks_members_views_on_spirituality
The Royal College of Nursing has launched a survey to improve its understanding of nurses’ views on spirituality.
RCN members are invited to submit their thoughts on what they understand by the concepts of spirituality and spiritual care and whether they consider these to be legitimate areas of nursing practice. Specific questions will ask what level of training and support should be given to nurses to deal with spiritual issues.
RCN Executive Director of Nursing and Service Delivery Janet Davies says:

“The RCN is committed to the promotion of holistic care*, but we recognise that spirituality is a complex area. Although understood as an area of human life that applies to all, spirituality can also be subject to taboo and misunderstanding. We are committed to understanding nurses’ views on spirituality and to explore this issue further.”
The results of the survey will shape the RCN’s work in this area and will be presented at a fringe event at RCN Congress in April.
RCN members: Complete the spirituality survey by 31 March 2010.

* My emphasis.

Thoughts from Hodges' model (PJ):

Nurses most definitely need to be aware of and have due regard to care management theory and practice associated with spirituality. That is - how individuals, families, communities (and the State) express belief or non-belief concerning self, others, humanity, their environment, and their relationship with all that is, has been and will be. They need to discern when spiritual matters enter into religious affairs and the customs and rituals that exist ancient and modern. Nurses need to recognise when and where to seek guidance in how to proceed. Legislation, human rights, professional codes of conduct, local and national policies are also critical to a nurse's understanding and attainment of spiritual literacy.

This is an area were confusion can arise over terminology. What is the difference between spirituality, religion and beliefs (mine, yours)? In their training and ongoing careers students need to demonstrate an openness to spirituality in the sense of being neutral with regards to their own beliefs. In specific situations and medical procedures again professional advice may be needed.

Hodges' model is an ideal tool to support nurses in their appreciation of spiritual (and pastoral) aspects of care. The model is ethnoculturally neutral. This neutrality serves as a reservoir of deep respect, rapport and empathy and provides a foundation, a space upon which all spiritual elements of care can be written.

The spiritual is represented in h2cm as a whole.

The model's four care domains collectively represent a 5th domain - the spiritual. Strangely, as per the use of the term in technology circles, the model can be described as 'agnostic'. Not in the religious sense, but due to the fact that h2cm does not demand knowledge of, nor ascribe to any particular spiritual, religious or belief stance.

Saturday, March 13, 2010

Drupal musings 2: Drupalese and Nursese - help or hinder

Drupal logo
As I repeatedly wade into the blue Drupal waters and then run out again (the water's hot) I note ongoing conversations at Drupalversity, Drupal dojo, Drupal-kata and similar forums about the challenge of learning Drupal. (I know the cure. That - is so simple, just do it: CREATE A SITE!)

On Drupalversity a comment by Becky Kinney caught my attention as Becky also refers to Drupalese. There's been discussion about how learners can make progress getting to grips with Drupal, but then because they lack prerequisite knowledge and skills the learning materials / instructions lapse into Drupalese.

Coming to Drupal is like nursing in so far as experiential learning is helpful. Any programming experience may help (or hinder), at the very least newbies (do I hate that term?) will be familiar with how websites appear to work, in the same way that would-be nurses are aware of the effects of infection, trauma, basic healing processes and treatments, what it feels like to be 'sick' to some degree, symptoms and signs. There's a point though that with a burgeoning new vocabulary of nursing, medical and care terms this challenge also becomes Nursese.

That reference above to help or hinder is similar to nurses who work as care support workers initially, or part-time. There is a risk (which should not exist these days) that prior to starting formal nurse training they may pick up bad habits. Drupal is no different in the sense that it is complex and there are several ways to achieve the same outcome, but which is the most effective, efficient, future proof, safe and secure. ...?

Hodges' model can help nurse learners, but what about Drupal learners - this one included?

Not a chance.

A conceptual framework is not going to help here. While Hodges' model does have socio-technical credentials, it is no software engineering shoe-horn, life jacket...

It will take (several) new Drupal websites to exercise the beast, my mind, fingers and what I hope is a potential community out there. Time for another paddle and reddened feet ...

Friday, March 12, 2010

More lines - scribed in SF

I've just finished and greatly enjoyed reading Greg Bear's EON which includes:

There are an infinite number of alternatives to the Way, each originating in an alternative world-line, yet reaching beyond that world-line. Until now, Way researchers have not known quite how the alternate Ways were stacked or arranged, or indeed whether they could even be considered real. Since the Way intersects a large number of alternative world-lines - perhaps all - could there be more than one Way?

The variety of emotions available to a reconfigured human mind, thinking thoughts impossible to its ancestors . . .

The emotion of -*-, describable only as something between sexual love and the joy of intellection - making love to a thought? Or &&, the true reverse of pain, not "pleasure" but a "warning" of healing, growth and change. Or (^+^), the most complex emotion yet discovered, felt by those who consciously endure the change between mind configurations, and experience the broad spectrum of possibilities inherent in thinking and being.
pp. 492-493. Gollancz, paperback, 1985.

According to the cover I note that Mr Bear is married to the daughter of Poul Anderson an author who also figures in my (dated!) SF collection. A favourite is Tau Zero which I also recently re-read and passed-on. As to the quotes above I will let them stand for themselves. ...

Wednesday, March 10, 2010

Walls, Lines, Dykes and Health Care

We are accustomed to defensive care and medicine.

Costs aside it seems the driving mantra (always served with a smile) is avoid risk at all cost; but we also recognise the need to balance risk in its negative and positive forms.

When it comes to thinking about care though we need to be open to new ideas, territories and opportunities and what being defensive means in practice and theory in the 21st century.

Additional links:


It is unlikely that the Dyke was constructed as a defensive earthwork. No army of the period could defend a 120 plus mile long earthwork. It is more likely that the Dyke was constructed as a political statement of power and intent.

Sunday, March 07, 2010

CfP International Journal of People-Oriented Programming (IJPOP)

********************* CALL FOR PAPERS *********************
(edited here for length)


International Journal of People-Oriented Programming (IJPOP)

Official publication of the Information Resources Management Association

Co-Editors-in-Chief: Steve Goschnick & Sandrine Balbo
Published: Semi-annual (both in Print and Electronic form)

Mission of IJPOP:

The International Journal of People-Oriented Programming (IJPOP) is cross-discipline in range yet singularly focused on empowering individuals to conceptualise, design, program, configure and orchestrate Internet-powered mashups, game mods (modifications), aggregate and structure personal media and build standalone cloud-based and client-side applications (on smartphones, netbooks, laptops, desktops, home network and novel appliances) – into self-fashioned tools and products that ultimately suit the user's own unique needs and aspirations. Other individuals may well take up such apps, mods and mashups for themselves, further customising, enhancing and embellishing them, or they may in part be used in a social or family context (to the benefit of the collective aspirations of those Social Worlds of which the individual is a part) – nonetheless, the focus of composition, development and customisation is on a product for oneself, upon theory, concepts, techniques, methodologies and ultimately tools that service a market of one. Our mission is to be the first journal that comes to mind to academics and practitioners alike and remain the best with regard to all aspects of People-Oriented Programming. Our papers and reviews will be insightful and compelling to both educators and researchers, and often to a wider audience too – the people for whom this paradigm of software development has come about.


People-Oriented Programming requires high-level tools to empower both the technical and non-technical user, which in turn calls upon research into meta-models that inform design and construction, that aid comparisons of these tools, and facilitates the interchange of content between them. The meta-models of most interest to POP initially, are drawn from two disparate disciplines – the Task Analysis (TA) and Agent-Oriented (AO) paradigms– both of which often have models with representations of entities matching the needs of POP, e.g. goal, task, object, agent, individual, role, intention and communication. Several AO architectures and methodologies have called upon branches of Psychology to formulate AO meta-models that incorporate mentalistic notions such as perception, motivation and intention, but which are most often aimed at constructing artificial humans and the like. In POP we too call upon those same Psychologies and similarly enhance and formulate meta-models and methodologies influenced by them, but with the intention of augmenting and empowering the individual human, in areas where they themselves desire aid or have identified a gap in their own abilities or resources, which they want to enhance.

From Sociology, POP draws upon ethnography with a focus on self-ethnography using tools such as cultural probes, life blogs and life logs to capture aspects of the individual's own life, themselves (or through a life coach), from which they draw the desire and/or frame the need for new technological artefacts to be used in their own lives. Interactivity, with respect to facilitating and streamlining a regular user's intention to build their own artefacts, and situatedness in terms of the individual's current location and activities, are two other facets of HCI (human computer interaction) that POP encompasses.

Video gaming is the first application area where large numbers of everyday users have been able to envisage and then developed their own innovations within existing games. So-called game mods are working examples of POP where players have appropriated userfriendly tools, usually built into the game engines by the vendors (e.g. The Sims, World of Warcraft, etc.). Video games have joined other media (e.g. movie, novel, comic) in the new genre of transmedia storytelling (e.g. franchises such as Tomb Raider, The Matrix, Harry Potter), allowing the player to enter the story 'so far', extending it in the 'now', constructing their own individualised narratives and increasingly, with the capability to enhance and extend the realm of the game itself. These individual constructed game mods allow players to extend virtual realms and narratives in real-time, in directions often unforeseen by the game engine makers. Such activities are increasingly a part of an individual's entertainment and education. Game modding as described, and the engines and tools that enable it, are within the scope of POP.

Internet-based mashup tools (e.g. Google Wave) have opened up a second application front beyond game mods, where POP is likely to gain mass adoption and occasionally produce radical user innovation. The selection and orchestration of disparate distributed services (e.g. web services; information feeds; the Cloud) by an individual within a user-friendly toolkit or framework, is also in the scope of POP. While the formal protocols and the technical enactment of such specific services are of little interest here, the quality, access, usage, aggregation and orchestration of them by the individual themselves, into a personalised synergy of capability made available through some enacting technology, are of acute interest to POP. Modeling techniques and people-friendly notations that bridge and coordinate distributed services together with local resources within POP tools – ones that the layperson can understand and use in conceptualising their designs - encompasses another cross-discipline facet of POP.


Topics to be discussed in this journal include (but are not limited to) the following:

* Activity theory and modeling
* Agent meta-models, mental models
* Alert filter and notification software, automated task assistance
* Augmented reality, augmented interaction
* Automating personal ontologies, personalised content generation
* Client-side conceptual modeling
* Computational models from psychology
* Context-aware systems, location-aware computing, ubiquitous computing
* Cultural probes, self-ethnography
* End-user composition, end-user multi-agent systems
* Game development support tools
* Game mods, game engines, open game engines
* Home network applications
* Human-centred software development
* Interface generators, XML-based UI notation generators
* Interface metaphors
* Life logs, life blogs, feed aggregators
* Mashups, mashup tools, cloud mashups
* Model-driven design, didactic models, model-based design and implementation
* New generation visual programming
* Personal interaction styles, touch and gestures
* People-Oriented Programming (POP)
* People-Oriented Programming case studies
* Personal ontologies and taxonomies
* Personalisation, individualisation, market of one
* Personas and actors
* Real-time narrative generation engines
* Role-based modeling
* Service science for individuals
* Situated computation, social proximity applications
* Smart-phone mashups, home network mashups, home media mashups
* Software analysis & design, software process modeling
* Software component selection
* Speech and natural language interfaces
* Storyboarding, scenarios, picture scenarios
* Task flow diagrams, Task-based design
* Task models, task analysis, cognitive task models, concurrent task modeling
* Use case models, user interface XML notations
* User-centered design, usage-centered design
* User interface tools, XML-based UI notations
* User modelling, end user programming, end user development
* Wearable computing, bodyware
* Web-service orchestration, web-service co-ordination

Prospective authors should note that only original and previously unpublished articles will be considered. INTERESTED AUTHORS MUST CONSULT THE JOURNAL’S GUIDELINES FOR MANUSCRIPT SUBMISSIONS at:

PRIOR TO SUBMISSION. All article submissions will be forwarded to at least three members of the Editorial Review Board of the journal for double-blind, peer review. Final decision regarding acceptance/revision/rejection will be based on the reviews received from the reviewers. All submissions must be forwarded electronically to: stevenbg AT unimelb.edu.au

All inquiries and submissions should be should be directed to the attention of:

Steve Goschnick
International Journal of People-Oriented Programming
E-mail: stevenbg AT unimelb.edu.au

Additional links:

Goschnick, S. (2009). People-Oriented Programming: from Agent-Oriented Analysis to the Design of Interactive Systems, In. J.A. Jacko (Ed.): Human-Computer Interaction, Part I, HCII 2009, LNCS 5610, pp. 836–845.

Friday, March 05, 2010

Romeo and Juliet – the care home version

Bristol Old Vic image
Octogenarian versions of Shakespeare's lovers to feature in Bristol production

Directed By Tom Morris

Fresh from co-directing the West End hit, War Horse, and Tom Stoppard and Andre Previn's orchestral experiment Every Good Boy Deserves Favour at the National Theatre, Tom Morris' own theatrical exploration of Bristol Old Vic begins with a project that has been twelve years in the making: Juliet and Her Romeo, the story of a flourishing love affair in one generation, crushed by the financial and political concerns of another.

Developed since 1997 in collaboration with Minder producer Sean O'Connor, the production uses Shakespeare's text, but casts our lovers in their 80s, with their anxious children, not their parents, seeking to prevent an imprudent and costly match.
With Sian Phillips as Juliet and Michael Byrne as Romeo, this production invites a generation of actors of global stature to play great Shakespearean roles which they never thought they'd play again. Tim Barlow, Terry Taplin and Michael Medwin return to Bristol Old Vic as Tybalt, Benvolio and Paris. Dudley Sutton makes his debut on the Bristol Old Vic stage as Mercutio.
What family has not wrestled with the question of how we care for our parents as they become older and frailer? Who will love them? Who will support them? Who will pay for their care?
And with that care, what controls should we apply? If we have taken power of attorney, what about the freedom to fall in love, to give gifts, to marry unwisely?
As Ben Power's recent two-handed exploration of passionate love remembered in old age demonstrated, Shakespeare's text is a powerful love story for any generation.
Signed, Captioned and Audio Described Performances.
Signed performance: Sat 10 April 2.30pm
Captioned performance: Sat 17 April 2.30pm
Audio described performance: Sat 24 April 2.30pm
Additional link:
BBC Culture Show

Wednesday, March 03, 2010

Person-centred care and semantic inflation

Time laughs at us, with us and has the last laugh. If you are ever complacent and by virtue of your years you venture to think to yourself:

Well we've been working on this now for 20-30 years look at the progress we've made. ...

Time is always there to remind you:
Hey, just who are you trying to fool?
You are a lifelong learner!

The number of personnel and services that describe themselves as person-centred is an ongoing theme of so many CVs, policies, SLAs, commissioning and consultant's presentations and lectures. ...

Whether in a ward, service, or organisation's philosophy, person-centred is a term that is being diluted to the extent that semantic inflation devalues what is supposed to be the main currency? Or are we admitting that this is the cost of the political games that people play? Whatever your view, there are insights of progress won, but also reminders on how much remains to be done.

Health and social care being multicontextual demands the existence of multiple currencies. One additional currency begs that we compare A, B, C with the evidence base.

If this is the crucible of our person-centred times then what is burning?
  • Nursing ethics?
  • Nursing education?
  • Idealistic aspiration? (Yes, we will get there!)
  • New Age incense?
  • Policy initiatives?
  • Funding allocations?
  • Nursing activism (Or, are there any balls in the house)?
  • Service infrastructures?
Although the media temperature is rising here in the UK, as health, itself economically recumbent is moved to ICU being so politicised; the Francis Report provides evidence of a dire lack of person-centred care. Recalling my basic nurse training: what can be more person-centred than ensuring that a patient has the necessary fluids and diet?

For women who suffer a miscarriage - where should they be nursed as debated in today's Guardian newspaper? What is person-centred care in maternity and gynaecology services?

In-patient provision and transitions from child-youth-adult provide other opportunities and major challenges for health and social care to demonstrate their person-centredness.

There are so many ways to be person-centred, so many levels, some may even be contradictory(?).

book cover
I wonder how many of those people highlighted in the Francis Report also had a form of dementia - whether diagnosed or not? Personhood and the need to acknowledge and sustain the person are not new.

Even if a service is person-centred in terms of the environment, meal choices, therapeutic options, belongings, personal space, proximity to home and relatives ... the crux at the center is the attitude of staff, and their having the time and space:

"to be"


Additional links:


Atkins, L. (2010) NHS 'must lessen trauma of miscarriages' Parents web forum Mumsnet calls for new code of practice to help women who lose their babies, The Guardian, Tuesday 2 March.

Monday, March 01, 2010

L.A.S.E.R. - C.A.S.E.R


Light Amplification by the
Stimulated Emission of Radiation

In the Health Career Model, meet -

the CASER -

Care Awareness by the
Stimulated Emission of REFLECTION

Additional links:


Original image source: