- 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

Saturday, April 28, 2018

The Socio-Politics of Migration...?

humanistic ----------------------------------- mechanistic

Julian Simpson (2018) Migrant architects of the NHS - South Asian doctors and the reinvention of British general practice (1940s-1980s). University of Manchester Press.

Alex Matthews-King. The Independent, Jeremy Hunt backs special visa for foreign people coming to work for NHS. 9 May, 2018.

My source (book): Noted in Blackwells, Manchester, £25 from £75.

Friday, April 20, 2018

Happy Birthday blog - 12 years old & Goodbye

Well since April 20th 2006 and my first post here there's been a few milestones:

  • separation and divorce 2008-2011
  • cataract ops (left and right) c/o Messrs. Heaven & Mars at Wigan's Royal Albert Edward Infirmary
  • Same employer (since 1985) but was able to move from Chorley & Preston to West Lancashire (nearer to home)
  • Presentations on the Health Career Model in Colombia, Jordan, Barcelona and other UK venues
  • Blog archived by The British Library (http://www.webarchive.org.uk/ukwa/target/264142857/source/search)
  • Former website ISP ceased trading/operations 2015
  • Completion of an MRES in e-Research and Technology Enhanced Learning
  • Ongoing publication while full-time as a Community Mental Health Nurse
You can see and explore the blog's numbers if you have time, suffice to note from 28 posts in 2006 to -
2159 published in total
244 still in draft form (many of these need deleting)
1,044,546 page views
Of course a great many posts concern conferences, journal issues and announcements of various sorts. I have wondered about deleting these to isolate the posts on Hodges' model but I will leave as is.

The biggest milestone is becoming a Grandad: magic indeed.

The most glaring milestone is how early Drupal was mentioned on the blog then at version 4.7 in 2007. Still no site with Drupal now at 8.5.2.

There seems little point continuing here given the traffic and interest. So, we will see if any content here has a 'long tail'. Maybe I should refer to 'The Health Career Model'? Attaching a name as I have always sought to acknowledge, appears to stress the thought:
  • not invented here
In the race for 'evidence' people are passing over a veritable collage of care littered with theory and practice. A great loss given the potential utility in helping to address 21st Century challenges.

Thanks to everyone who has read and agreed to my posting their material.

If you have some suitable content by all means get in touch, otherwise posts will be much less - while I focus on Drupal and that new site...


Digital health interventions: How might we measure “meaningful engagement”?

I admit I am struggling to stop blogging, even as the pull of Drupal and a new site will (must) win-out. The above tweet prompts these thoughts ...

A key point from Kathleen Ryan's blog post reads:

"The design process* needs to be reflective..."

I wholeheartedly agree - it is the way that we reflect to achieve a socio-technical synergy that counts. Even with the socio-technical bases covered there are other factors too:

humanistic ----------------------------------- mechanistic
Person-related issues
(e.g. their beliefs, cognitions and values).

What 'x' means to me.
"... attention, interest and how the person feels and thinks about the intervention (where more attention / affect / enjoyment = more engagement)."

Patient (Person?) Activation measures?

Yes - 'person-centredness' is 'up-here' according to the axes of the model, BUT we must take into account the social and political milieu of the individual concerned.

*design purposes
Technology-related issues

"No matter how well-crafted and evidence-based the intervention, active ingredients proven to effect health behaviour change simply cannot work if the technological components that house them are not accessed by participants. As such, lack of adequate engagement with DHIs poses a barrier to evaluating the effectiveness of these interventions."
*design process
Law of Attrition
Usage metrics:
statistics, logs, frequency, totals

e-health and m-health
prevention & treatment of -
'lifestyle diseases'

social incentives
'health seeking behaviour'
Health literacy

 "human contacts can allow for “supportive accountability” via remotely delivered prompts, social support and encouragement."

*design practices

National use of 'Patient activation'?
(Forms of profiling)
Incentives - health policy
Nudge - behaviour change?
Health insurance/credits

HEALTH meaning within? SYSTEMS
 paternalistic--'degrees of freedom'?--autonomy
'The Market'

*design policy

Perhaps, future measures need to simultaneously combine analysis AND synthesis - the subjective AND objective... a job for AI ..?

Thanks to Kathleen Ryan

Ack. This week learned of 'Patient activation' attending a Best Practice Meeting.

 *The 4Ps within Hodges' model. 

What is meant by 'universal' design?

Yes, there is an ironic element to this post and recent others in respect of 'meaningful engagement' and 'the meaning of evidence'? Do people recognise 'evidence'? 

Thursday, April 19, 2018

Workshop on Research Objects (RO2018)

2018-10-29 at IEEE eScience 2018, Amsterdam, The Netherlands

## Timeline

2018-07-01 Abstracts due
2018-07-15 Research articles and software/data articles due
2018-08-31 Notification of acceptance
2018-08-31 IEEE eScience 2018 early-bird registration deadline
2018-10-29 RO2018 workshop at IEEE eScience 2018

## Research Objects

Scholarly Communication has evolved significantly in recent years, with an
increasing focus on Open Research, FAIR data sharing and community-developed
open source methods. A question remains on how to publish, archive and explore
digital research outputs.

A number of initiatives have begun to explore how to package and describe
research outputs, data, methods, workflows, provenance and structured metadata,
reusing existing Web standards and formats.

Such efforts aim to address the challenges of structuring multi-part research
outcomes with their context, handling distributed and living content and
porting and safely exchange what we collectively can call “Research Objects”
between platforms and between researchers.

## Call for Papers

In the workshop RO2018 we will explore recent advancements in Research Objects
and publishing of research data with peer-reviewed presentations, invited
talks, short demos, lightning talks and break-out sessions to further build
relationships across scientific domains and RO practitioners.

RO2018 welcomes submissions of academic abstracts (1-2 pages), data/software
articles (3-6 pages) and short research articles (4-8 pages) on cross-cutting
case studies or specific research on topics including, but not limited to:

  FAIR metrics; platforms, infrastructure and tools; lifecycles; access control
  and secure exchange; examples of exploitation and application; executable
  containers; metadata, packaging and formats; credit, attribution and peer
  review; dealing with scale and distribution; driving adoption within current
  scholarly communications and alignments with community efforts; and
  domain-specific and cross-domain Research Objects.

## Submitting

Submitted abstracts and articles can be in a range of open formats (e.g. HTML,
ePub) and are particularly encouraged to be submitted in a FAIR research data
packing format.

Accepted abstracts and articles will be included in the IEEE eScience 2018
proceedings. Submitted preprints will, upon acceptance, be made available as
Green Open Access on the RO2018 website with DOI links to the Zenodo record and
(eventually) the published IEEE proceeding article.

It is a requirement that at least one author of each accepted submission
attends the RO2018 workshop and at the IEEE eScience 2018 conference, where
registration fees applies.

Further details on submitting:

RO2018 encourages open peer review, and recommend that reviewers
are named and attributed; however reviewers may be anonymous if so
desired. Reviewers are welcome to publish their reviews using the
same guidelines as the research articles.

For any questions, email the RO2018 Workshop Organizers at
ro2018 AT easychair.org

Stian Soiland-Reyes (my source: by email)
The University of Manchester

Journal: Learning Health Systems - April 2018


Learning Health Systems is an open access peer-reviewed journal dedicated to the science, engineering and design of continuous improvement of health and health care.

The new April 2018 issue is now available. Click here to read the latest articles. All articles are freely available to read, download and share.

My source:
Email: Kathleen Young
Editorial Assistant, Learning Health Systems
Room 210 Victor Vaughan
1111 East Catherine Street
Ann Arbor, MI 48109

Wednesday, April 18, 2018

ERCIM News No. 113 Special Theme "Smart Farming"

Dear ERCIM News Reader,

ERCIM News No. 113 has just been published at https://ercim-news.ercim.eu/

The Special Theme "Smart Farming" was coordinated by the guest editors:

Mirco Boschetti (IREA-CNR) and Erwin Schoitsch (AIT)

The research & society section of this issue features the topic "Research Evaluation", edited in cooperation with Informatics Europe by the guest editors Hélène Kirchner (Inria) and Fabrizio Sebastiani (ISTI-CNR).

The section "Research and Innovation" reports on news about research activities and innovative developments from European research institutes.

This issue is also available for download in pdf and ePUB

Thank you for your interest in ERCIM News. Feel free to forward this message to others who might be interested.

Next issue:
No. 114  July 2018
 Special Theme: "Human-Robot Interaction

ERCIM - the European Research Consortium for Informatics and Mathematics - aims to foster collaborative work within the European research community and to increase co-operation with European industry. Leading European research institutes are members of ERCIM.
ERCIM is the European host of W3C.

Follow us on twitter @ercim_news
and join the open ERCIM LinkedIn Group http://www.linkedin.com/groups/ERCIM-81390

Peter Kunz*               
ERCIM Office

join the ERCIM Linkedin Group

* My source

Tuesday, April 17, 2018

Enough Nurses - Special Collection c/o Journal of Research in Nursing


"JRN is pleased to introduce this online special collection of papers. Edited by Jane Ball, this collection comprises previously published papers and reviews that give a taste of the constellation of issues that contribute to having 'enough nurses'. They illustrate the complexity and interdependency of the many elements that must be addressed to achieve the elusive goal of having the right staff, in the right place, at the right time."

My source: https://twitter.com/JRN_latest/status/985889478882578432

Monday, April 16, 2018

#EndPJparalysis - NHS 70

humanistic ----------------------------------- mechanistic
For people who are agitated and living with dementia their carers may learn to remove such cues as hat, coat and shoes.

Seeing these may cause increased agitation as a need to be elsewhere.

For #EndPJparalysis perhaps we can reverse this and use the sight clothes and footwear as a cue for 'get up & try to go'.

My source:

Sunday, April 15, 2018

Q. What is nursing work? A. Hodges' model

Image: Jennifer Jackson

The above also reflects the domains of Hodges' model which is derived from the following questions:

Who do nurses (healthcare professionals, carers) care for?

This provides us with the INDIVIDUAL - GROUP (Population) vertical axis.

What types of activities, tasks - work do nurses then have to carry out to deliver care?

This question accounts for the horizontal axis of Hodges model.

humanistic ----------------------------------- mechanistic




Friday, April 13, 2018

Hellblade: Senua's Sacrifice

humanistic ----------------------------------- mechanistic

My source: BBC World Service

Thursday, April 12, 2018


"An independent documentary looking at the hearing voices (HV) movement, chronic psychosis and the schizophrenia label.

A film offering multiple perspectives: is schizophrenia hard science or an arbitrary, catch-all term with no real meaning? What does it mean for those experiencing psychosis? The film is a series of wide-ranging interviews with voice hearers, medical historians, anthropologists and psychiatrists from Britain and America.

Featuring: Erin Emiru, Rai Waddingham, Kevin Healey, Mark Roininen, Angela Woods (Ph.D), Edward Shorter (Ph.D), Dr Avery Krisman, Dr Albert Wong, Suman Fernando, and Stefen Ecks (Ph.D)."

humanistic ----------------------------------- mechanistic

My source:

Wednesday, April 11, 2018

Borders & Boundaries 2018: Debating the limits and possibilities of Education

The Department of Educational Research invite international speakers every summer, and this year we are opening the event up to invite critical interdisciplinary scholars to engage in a range of events which bring together our three research centres: Higher Education Research and Evaluation; Technology Enhanced Learning; and Social Justice and Wellbeing in Education.

This year’s theme is Borders and Boundaries, which will be unpacked by our internationally renowned speakers and a programme of conference presentations on 3rd and 4th of July in the historic city of Lancaster.

Borders and Boundaries: Debating the limits and possibilities of Education

Borders and boundaries is an important theme in educational research and practice, having multiple meanings and interpretations. At one level, this notion reflects critical conceptualisations of place, territories and educational (im)mobilities which have come to the surface in recent years as a response to political and policy changes that seek to limit the movement of people and ideas. Alternatively, borders and boundaries may be taken to refer to theoretical demarcations and interactions, and the increasing emphasis on interdisciplinarity within research, and the associated instability of categories such as academic, practitioner, researcher and educator in the context of efficiency and structural changes within schools, universities and other institutions. This theme also has analytical value for framing debates about the perceived fluidity of formal and informal educational space in the digital age, simultaneously democratising knowledge and blurring the boundaries between professional and personal identities for many educators and academics. Finally, we envisage the theme of borders and boundaries as providing a way into discussions about social distinctions and emotional separations, which shape educational experiences, transitions, and outcomes in a broad range of ways.


I have placed the conference themes within Hodges' model:

humanistic ------------------ Borders & Boundaries ------------------ mechanistic
This theme also has analytical value for framing debates about the perceived fluidity of formal and informal educational space in the digital age, simultaneously democratising knowledge and blurring the boundaries between professional and personal identities for many educators and academics.
... critical conceptualisations of place,
 territories ...

... borders and boundaries may be taken to refer to theoretical demarcations and interactions, and the increasing emphasis on interdisciplinarity within research, and -

Borders and boundaries is an important theme in educational research and practice, having multiple meanings and interpretations.

Finally, we envisage the theme of borders and boundaries as providing a way into discussions about social distinctions and emotional separations, which shape educational experiences, transitions, and outcomes in a broad range of ways.
- the associated instability of categories such as academic, practitioner, researcher and educator in the context of efficiency and structural changes within schools, universities and other institutions.  

factor immobility
occupational immobility
academic / educational (im)mobilities

My source: Jill Anderson, Lancaster University.

Monday, April 09, 2018

Paper: Understanding the micro and macro politics of health ... mapped to h2cm

"Almost a decade after WHO Commission on Social Determinants of Health published its influential report (2008), health inequalities within and across countries remain high on the research agenda. Acknowledging the complexity of the issue, scholars increasingly stress the need for the development of a theoretical framework that will integrate the multiple factors involved in shaping health inequalities, from individual social positions and experiences to institutions (Beckfield et al., 2015; Krieger, 2012, 2011)." p.92.

From Google:
noun: intersectionality; plural noun: intersectionalities
  1. the interconnected nature of social categorizations such as race, class, and gender as they apply to a given individual or group, regarded as creating overlapping and interdependent systems of discrimination or disadvantage.

    "through an awareness of intersectionality, we can better acknowledge and ground the differences among us"

humanistic ------------------ INTERSECTIONALITY ------------------ mechanistic
category salience and individual experience

"Intersectionality as an analytical tool of social stratification (Yuval-Davis, 2015) challenges the idea of a single, fixed social hierarchy. It perceives social positioning as a spot within a matrix of intersecting power axes (Crenshaw, 1992). Hence, there are no sociological categories (e.g. race, gender) that have an a priori greater significance in shaping individual experience." p.93.


methods & methodology
analysis - synthesis

"Yuval-Davis (2015) elaborates on that and describes intersectionality as a context informed analytical tool (situated intersectionality) that focuses on the categories that reflect the social divisions shaping most people's lives (e.g. race and gender) in certain contexts and simultaneously it is sensitive enough to render visible other divisions shaping the experience of individuals and groups at marginal positions (e.g. sexuality)." p.93.
race, ethnicity, class, gender, sexuality

social history 
social class
social exclusion  

"... intersections between social categories -

"Studies have focused mainly on welfare states classified across certain typologies (eg. Esping-Andersen, 1990) as mechanisms that rank people into social hierarchies and (re)distribute social determinants of health." p.94.

Institutions, immigrant status
political minority struggle
 colonisation, enslavement

are .. reflections of intersecting systems of power" p.94


Anna Gkiouleka, Tim Huijts, Jason Beckfield, Clare Bambra, Understanding the micro and macro politics of health: Inequalities, intersectionality & institutions - A research agenda, Social Science & Medicine, Volume 200, 2018, 92-98, ISSN 0277-9536.
Keywords: Health inequalities; Intersectionality; Institutions; Health politics; Social positioning

My source: Prof. Dennis Raphael
Politics of Health Group Mail List Messages
Visit PoHG on Facebook: https://www.facebook.com/282761111845400
Follow us on Twitter: @pohguk

Sunday, April 08, 2018

A new Paradigm? No just Paragraphs...

While I have not had the practical reason to apply it (to my shame) I have known of 'maintenance mode' for donkey's y-ears. I have been listening. As tweeted earlier this week, I've been trying to remove Webform so I can update / replace it. I'm avoiding core 'experimental' modules in an attempt to avoid future problems. I'd managed to remove webform bootstrap, but trying to delete from the usual Drupal interface did not work. I checked the tables and those for webform were empty. Impatience set-in and I removed the folder within modules. That was the big mistake. For a time there, I could not access the localhost site on my laptop. I thought it had gone...

I had a MySQL backup and imported this while a CTRL 'Z' restored the folder. This did the trick. I have the HTML source for the archive pages as files too.

At several Drupal events Paragraphs has been presented as very useful site building module. With four 'basic pages' whatever follows will benefit from and no-doubt demand more thought about content types. Checking out some videos Paragraphs really does seem to fit the bill when allied with field group.

I'm looking forward to the local Drupal meetup in Manchester this Tuesday.

This coming week I'll try and install the latest version of Drupal 8 on the host and import - upload my pages - site. The old site (very defunct - some links may no longer work, inc. my old work address) has been copied over - almost as a backup...

Saturday, April 07, 2018

World Health Day 2018: Universal Health Coverage

humanistic ------------------------------------- mechanistic


World Health Day 2018 Stamps


NY postmark

Description (UNSTAMPS)

"Today, at least half of the world’s people are unable to obtain essential health services. Many households are being pushed into poverty because they are forced to pay for health coverage out of their own pockets. This strain on the populace seriously undermines a country’s ability to develop socially and economically.
This is why Member States of the United Nations have pledged to provide universal health coverage for all people globally by 2030 as part of the Sustainable Development Goals (SDG 3.8). This means ensuring that all people have access to the health services they need. Countries have pledged to ensure that these services will be of sufficient quality to be effective and also that their people will not suffer financial hardship when paying for these services.
When this happens, people’s health will improve. Universal health coverage reduces poverty, creates jobs, drives economic growth for all, helps improve gender equality and can stop disease outbreaks turning into epidemics.
Each year, WHO offices, Member States, civil society and partners around the world observe the Organization’s signing of its Constitution and founding on 7 April, World Health Day. In 2018, WHO is dedicating World Health Day, its seventieth birthday, to universal health coverage: #HealthForAll.
The World Health Organization is delighted to be working with the United Nations Postal Administration to promote worldwide awareness and action to achieve health for everyone everywhere."

Friday, April 06, 2018

c/o @TheLancetPlanet - Paper: Residential greenness and prevalence of major depressive disorders... or "All colours fictitious"

humanistic ------------------------------------- mechanistic


Any significance that might be deemed between greenness as identified in Hodges' model with mental health, psychology, ecopsychology, memory, personhood, emotional, beliefs, mood ... and other colours* as portrayed is, of course, entirely coincidental.

 *colours to include black & white

Search of 'mental health' posts:

Wednesday, April 04, 2018

Paper: IJIC - Building Competencies for Integrated Care: Defining the Landscape c/o Miller & Stein

humanistic ---------------- Integrated Care --------------- mechanistic

"Transformation does not only involve gaining new knowledge and skills but a more fundamental* shift in our conceptual paradigms about our roles, responsibilities and relationships." [RRR]

Clinical integration (mental health) through person-centred care of someone's health and wellbeing

building blocks 1. Electronic health records,

Functional integration (data, information)

Uni-professional education
Clinical integration (physical health) through person-centred care of someone's health and wellbeing
through the active engagement of
service users as partners in care

 Act-ions - Practice

[RRR] social change

[ My obs.: Health literacy
- need for a generic framework -
for health education arbitration -
as there is a sociopolitical dispute]


through the active engagement of
service users as partners in care

2. Budgetary processes,
3. Governance structures

[RRR] political change (inc. policies, professional bodies...)

Organisational & Systemic integration


Normative integration

*There's that word again...

Q. Reflect upon the following using the above model - not only the text but the model itself:

"To achieve the transformation required by integrated care, this means three things: we need to include the principles of integrated working into our formal education and training systems; we need to recognize that learning continues in our workplaces; and accept that we ourselves will be informal educators throughout our careers."

The following dimensions are listed in the editorial and above :
  • Dimension 1. Person-centred care (i.e. the improvement of someone’s health and wellbeing through the active engagement of service users as partners in care)
  • Dimension 2. Clinical integration (i.e. care services are coordinated and/or organised around the needs of service users)
  • Dimension 3. Professional integration (i.e. existence and promotion of partnerships between care professionals that enable them to work together)
  • Dimension 4. Organisational integration (i.e. the ability of different providers to come together to enable joined-up service delivery)
  • Dimension 5. Systemic integration (i.e. the ability of the care system in providing an enabling platform for integrated care, such as through the alignment of key systemic factors like financing and regulation)
  • Dimension 6. Functional integration (i.e. the capacity to communicate data and information effectively within an integrated care system)
  • Dimension 7. Normative integration (i.e. the extent to which different partners in care have developed a common frame of reference of vision, norms, and values on care integration)

Miller R, Stein KV. Building Competencies for Integrated Care: Defining the Landscape. International Journal of Integrated Care. 2018;17(6):6. DOI: http://doi.org/10.5334/ijic.3946

Monday, April 02, 2018

Fundamentals of Care - mapped to Hodges' model

While I try to delete the Webform module from my Drupal 8 install here is a tweet I responded to:

The definition Prof. Jackson subsequently pointed to is as follows:
"Fundamental care involves actions on the part of the nurse that respect and focus on a person’s essential needs to ensure their physical and psychosocial wellbeing. These needs are met by developing a positive and trusting relationship with the person being cared for as well as their family/carers."
I've taken the fundamentals of care from the International Learning Collaborative and mapped them to Hodges' model. The psychosocial list has been divided across the two applicable domains - you'll see what I've done.

humanistic ----------------------------------- mechanistic

PSYCHOsocial fundamentals of care

  • Communication (verbal and non-verbal)
  • Privacy
  • Education and information
  • Emotional wellbeing
  • Choice
  • Having values and beliefs considered and respected

Physical fundamentals of care

  • Personal cleansing (including oral/mouth care) and dressing
  • Toileting needs
  • Eating and drinking
  • Rest and sleep
  • Mobility
  • Comfort (pain management, breathing easily, temperature control)
  • Safety (risk assessment & management, infection prevention, minimising complications)
  • Medication management

PsychoSOCIAL fundamentals of care

  • Being involved and informed
  • Dignity
  • Respect
  • Education and information
  • Having values and beliefs considered and respected
  • Social engagement, company and support
  • Feeling able to express opinions and needs without care being compromised
  • Having interests and priorities considered and accommodated (where possible)

Relational fundamentals of care

  • Active listening
  • Empathy
  • Engaging with patients
  • Compassion
  • Being present and with patients
  • Supporting and involving families and carers
  • Helping patients to cope
  • Working with patients to set, achieve and evaluate progression of goals
  • Helping patients to stay calm

As this domain seems to be 'empty', I  will add some thoughts in the POLITICAL domain... 

You can imagine a series of layers here. 
As per the physical fundamentals above include - safety and homeostasis would be uppermost. Difficulties in the above instantly raise alarm bells and the old chestnut construct of dependency. 

The lack of specifics on mental health suggests something that is incomplete and appears to assume a certain degree of functioning?

The psychosocial actions invariably overlap and with the relational. We are hopefully socialised into dignity, respect, compassion, empathy and related attributes. What impacts  on a person's privacy, dignity may vary from person to person to some extent. This however introduces the humanistic care of engaging with people, their carers and the need to be person-centred. On privacy ... and preserving the integrity of an individual (and their 'group'), there are of course (duty of care and) professional standards (in this domain) that help guide our advocacy and accountability.

Clearly, there is much to do..

Previous posts on 'fundamental-ism'

c/o Nursing Times "Has healthcare lost its humanity?" or "Your subscription has expired"

I followed a link to this opinion piece from an email c/o Nursing Times. On their website the invite to comment was a reflex.

The subtitle -

Do you think healthcare has become just about systems and processes so that the individual - staff and patient - are just cogs in the ever-turning wheel?

- is a real tease of course. Hodges' model sees the cogs, hears them turn. The model can follow the implications - when they politically grind.

Is it me, or am I reading more about humanity, humanistic AND healthcare and nursing of late?

Logged in (after a great many months) my comment written - I 'submit'. There was a problem with the 'human test'. I tried again and was rewarded with:

"Your subscription has expired

Your access to this article has been denied because your subscription to Nursing Times has expired. To gain access to the content please renew your subscription."
My comment seemed lost: surely they can test and warn you of your status? Why allow you to write and submit? The two existing comments were anonymous. I'm happy to comment as 'peter jones'. I tweeted to NT; no (holiday) response.

Thankfully I'd copied my missive whilst writing so here it is.

Hello Kathryn,

The anonymous comment of "Wake up UK" rings true on two counts at least -

1. Nursing academia is falling far short in recognising the lessons of history and ignoring tools that can assist us in recognising so many of the points you raise from the event (which sounds excellent!).

2. The challenges of 21st C. care needs us to address health promotion and the health literacy of the public. Is there a need for a separate service - as with social care?

We protest at lists, box ticking, intentional rounding and yet some of the tools to help us argue the case for Nursing skills and humanity in care must utilise such heuristics and aide memoire.

Hodges' model covers the dimensions of care as defined and as you write Kathryn:


The HUMANISTIC (yes really!) aspects of why, how we care and the MECHANISTIC

These dimensions create a space for reflection across nursing as in the SCIENCES, POLITICS (crucial! for staff and the public we care for and teach to self-care), INTERPERSONAL the mental health care and SOCIAL - responding to culture and social trends and expectations.

This model can be used to help present and argue the case for humanity in care. In future balancing the application of technology whether software, hardware will be central to not just maintaining humanity in care but how it is perceived and defined.

The model is not just for nurses but across all health and social care. See the latest post on social workers and reflective practice:

Paper: How social workers reflect in action and when and why they don’t - mapped to h2cm

As mentioned in Kathryn Godfrey's post I wish the Point of Care Foundation and other groups would be open to a dialogue, presentation, workshop... on this model which is free, open and easy to learn and apply.

The number of 'health' and 'patient' agencies suggests a great deal of duplication of effort. They do have a role and are inevitable arising from Community Interest Companies (CICS) and Social Enterprises and sheer public goodwill. Perhaps, however, this duplication suits certain political agendas? As evidence-based care and staff support is sought and literature searched - still the quality of care is found wanting - the point and centredness of humanity - is difficult to locate and so experience?

Is there a hint of sour grapes? Yes, sure after 41.5 years they are mine and - I think - hard-earned - so hands-off ;-) Seriously, Hodges' model has increasing utility and relevance and my passion and compassion to improve care is undimmed whatever those in the ivory towers, the nurse theorists in their respective furrows and management fashionistas say...

There is a bibliography and more info at:


etc, etc close ...


The link may be accessible to you?

To close -
I don't submit.
The value here: Our values can and need to be learned, applied, tested, conveyed, assured and sustained.

Sunday, April 01, 2018

Paper: How social workers reflect in action and when and why they don’t - mapped to h2cm

humanistic ---------------------------- mechanistic

The self - personhood

Reflection (as core concept)
has value and limitations

Non-reflection to protect the self

Unbearable anxiety

psychoanalysis - findings

defended nature of the self

thinking & non-thinking
'suspended self-preservation'
Self - Two perspectives - Service User

emotional intelligence
internal supervision
intuition - improvisation

Helicoptering - metacognition

Sexuality (form of bracketing-off of oneself)*
lived experience of the senses

Theories of reflection

Frameworks for reflection (reflective practice)

physical / somatic effects of anxiety

ethnographic study

audio recordings

Reflective practice demands that
you learn from experience.
It requires you to be self-critical.
It expects you to analyse
what you think, feel, and do...

#When is it better NOT to reflect?



risks (being completely non-reflective)

experiences and the (mobile) body
*limits capacity of some aspects of relational work

 Social Work Practice

Home visits

Family home children and parents
'tacit knowing-in-action'
Reflection in Practise

Fieldwork - home, car

SW composed when service users in distress, absorb their sadness, shame, fears,
and at times their joy #

Face-to-Face interviews

Relationships: sexuality, gender

offloading informally - office

Clinical-Case Supervision

 offloading formally

Two Local Authorities

Management Supervision and Governance

Child protection


Organisational risk management

Policies, Procedures

Lone working...

Harry Ferguson (2018): How social workers reflect in action and when and why they don’t: the possibilities and limits to reflective practice in social work, Social Work Education, DOI: 10.1080/02615479.2017.1413083

My source: Twitter

April 1st - I couldn't resist...(1...)*

*Yes, this could become a series of posts (but won't)!