Hodges' Model: Welcome to the QUAD: Masquerade in health care but on which level?

Hodges' model is a conceptual framework to support reflection and critical thinking. Situated, the model can help integrate all disciplines (academic and professional). Amid news items, are posts that illustrate the scope and application of the model. A bibliography and A4 template are provided in the sidebar. Welcome to the QUAD ...

Friday, January 06, 2012

Masquerade in health care but on which level?

There is a Drupal module called Masquerade, the project page explains:

The masquerade module is designed as a tool for site designers and site administrators. It allows a user with the right permissions to switch users. While masquerading, a field is set on the $user object, and a menu item appears allowing the user to switch back. Watchdog entries are made any time a user masquerades or stops masquerading.
Life frequently asks more of us and the same applies for employees in whichever employment sector. For teachers and nurses they know the call. As a nurse you adopt the mask of the uniform and the role. You may not actually carry the lamp, but it's there. Sometimes it helps light the way; for the public, for you. If you are a 'bad' nurse - whether your attitude put the lamp out this morning, yesterday, or several years ago -  the darkness that follows you about speaks volumes.

It prompts Prime Ministers to make announcements:

PM announces new focus on quality and nursing care

06 January 2012 12:54
A new drive to free up nurses to provide the care patients and relatives expect has been announced today by Prime Minister David Cameron and Health Secretary Andrew Lansley.

The push will see nurses spending more time on front line care in wards and other services, a senior ward nurse with whom the buck stops, patients leading on inspections and a new 'friends and family test' to show whether nurses and patients had a good overall experience, or would want loved ones needing care to be treated at each hospital.
Prime Minister David Cameron said:
“We know the vast majority of patients are very happy with the care provided by the NHS. And I’ve seen the NHS at its very best. But we have heard recently that in some hospitals patients are not provided with the level care or respect they deserve and I am absolutely appalled by this.
“If we want dignity and respect, we need to focus on nurses and the care they deliver. The whole approach to caring in this country needs to be reset. And it needs to start with this simple fact. Caring for patients is what nurses do. Everything else comes second."
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While we all play masquerade there are many levels. As a 'nurse' it's difficult (but never impossible) to play the caring, skilled, knowledgeable, patient, warm, efficient ... representative AND ensure all records are maintained, letters written, all communications logged, targets achieved, electronic records and data gathering requirements met. ... If you need a steer-clear from the stereotypical image of Angels, then you should see the faces nurses pull behind the mask trying to satisfy the audience.

That audience does not just include managers, patient representatives, inspection agencies but policy makers and politicians. Of course the latter are expert proponents of masquerade (they practice through a 4-5 year cycle).

Closer to home and the Drupal module? Well, I can't see a role for masquerade on a new h2cm website, but the thought crosses my mind of general nurses masquerading as mental health nurses; social workers masquerading as nurses. ... Although I'm playing games :-) it makes you think about what we mean by 'multidisciplinary'. To what extent, for example, is care of people living with dementia being missed because these disciplinary distinctions - silos really do still prevail? Surely the nursing issue isn't just a lack of light?

This announcement is not exactly news given what has gone before in the UK media through 2011.

What is strange is that this policy should emerge in 2012: The Alan Turing Year.

Yes, nurses DO need time to care, but perhaps we also need a test for empathy and rapport and not just intelligence?