Nurses & Social Media - mise en scène

... health on the thrust stage

From: Wordsmith.org

1. The setting of a scene in a play, movie, etc.
2. The setting or background of an event.

ETYMOLOGY:

From French mise en scène, literally "put on stage".

The health care domains model provides a 2 x 2 stage.

It may be a conceptual stage, but it is nonetheless demanding. It demands we perform the translation from theory to practice and check constantly exactly where we are AND where we need to be.

Should we become so ill that hospital treatment is needed the dependency and the sense of vulnerability this provokes often makes us feel that we are 'performing'. Not only that but as a  patient we find our selves on a thrust stage. When illness strikes it seems we are surrounded by this audience of clinicians who can potentially see us from all angles and be privy to very personal information about us.

The demands cut both ways though. Modern health care IS collaborative. Stagecraft here then means there should be minimal furniture and scenery to hide behind. Strange then that in terms of personalised care background details really do matter.

So, everyone matters. Teamwork counts. We try to keep patients off the stage. Patients and carers as expert carewrights may already know their lines - they can teach us. Suddenly everyone is an actor. Suddenly all the players must pass by way of the vomitory and the responsibilities that passage demands. On this stage care also needs to be exercised as per the direction of the NMC.

Original image source:
http://hs-theatre-ib1.ism-online.org/2010/10/14/night-of-the-assassins-thrust-stage/

Is the Individual-Group axis health's proscenium arch?

Speech: “All the world’s a stage”

By William Shakespeare
(from As You Like It, spoken by Jaques)

          

     All the world’s a stage, 
And all the men and women merely players; 
They have their exits and their entrances; 
And one man in his time plays many parts, 
His acts being seven ages. At first the infant,
Mewling and puking in the nurse’s arms; 
And then the whining school-boy, with his satchel
And shining morning face, creeping like snail
Unwillingly to school. And then the lover,
Sighing like furnace, with a woeful ballad 
Made to his mistress’ eyebrow. Then a soldier,
Full of strange oaths, and bearded like the pard,
Jealous in honour, sudden and quick in quarrel,
Seeking the bubble reputation
Even in the cannon’s mouth. And then the justice,
In fair round belly with good capon lin’d,
With eyes severe and beard of formal cut,
Full of wise saws and modern instances;
And so he plays his part. The sixth age shifts
Into the lean and slipper’d pantaloon,
With spectacles on nose and pouch on side;
His youthful hose, well sav’d, a world too wide
For his shrunk shank; and his big manly voice,
Turning again toward childish treble, pipes
And whistles in his sound. Last scene of all,
That ends this strange eventful history,
Is second childishness and mere oblivion;
Sans teeth, sans eyes, sans taste, sans everything.

Source: https://www.poetryfoundation.org/poems/56966/speech-all-the-worlds-a-stage

TIME FRAMES

'As Shakespeare and his contemporaries wrote for the epic scale, the imaginative commitment and the 360-degree embrace of the Globe so, three hundred years later, generations of playwrights wrote for the velvety darkness, the enclosed acoustic and the picture framing of the proscenium arch.

For a century, the story of the changing world was told inside proscenium theatres, by a series of remarkable playwrights. In over sixty irreverent, illuminating pen portraits – of both famous giants and lesser-known talents – Dominic Dromgoole takes us on a journey from 1865 to 1965, revealing how these writers used the framed stage to reflect the social upheavals of their times.' 

This post began with: 'All the world's a stage', but I realised I'm no Shakespeare. Hodges' model is a frame; and users of the model can put it to work, readily. Be that in the sciences, arts, and across curricula. The 'arch' in Hodges' model appears to be inverted, working from within, rather than out. Similarly to the proscenium arch, however, the model provides a structure, for whatever performance, situated, will surely follow.

Hodges' model: Axes and Domains

Of course, the question posed here might be re-framed as: 

Are the axes of Hodges' model, life and death's proscenium arch?


Dominic Dromgoole (2026) Time Frames: A century of proscenium playwrights. London: Faber. 
https://www.faber.co.uk/product/9780571374113-time-frames/ [Text source].

Previously: 'drama' : 'stage' : 'frame'

Drupal musings 6: Content types - Reflection!

Does anyone have any experience in using established models of reflection in:

• education (nursing, public health, information technology)
• practice
• therapy
• supervision
• carer support
• eHealth
• ... ?

If so please get in touch [h2cmng at yahoo.co.uk].

In its initial downloaded state Drupal has two content types:

1. story
2. and page.

The option then is to use these which would be rather limiting. Add to these two by enabling other core modules. Drupal administrators can extend the core functionality by adding other modules which provide new content types.

You can also roll your own. A key content type for the new site is one that uses the health career model to facilitate - reflection - one of the original purposes for the model.

This also provides an opportunity to adopt a model of reflection that is itself supported by research. This may be Gibbs:

• Stage 1: Description of the event
• Stage 2: Feelings and Thoughts (Self awareness)
• Stage 3: Evaluation
• Stage 4: Analysis
• Stage 5: Conclusion (Synthesis)
• Stage 6: Action Plan

John's Model of Structured Reflection

• Aesthetics – the art of what we do, our own experiences
• Personal – self awareness
• Ethics – moral knowledge
• Empirics – scientific
• with its Cue Questions

Smyth’s Framework for Reflection on Action

• Activity
• Inform (Analysis)
• Confront (Self awareness)
• Reconstruct (Evaluation and Synthesis)

There are many others. ...

Once the hedgehog-headlights glare has passed, this is going to be a really interesting project. There must be a way to link one (or more) of the above with each of h2cm's care (knowledge) domains. There must be a way to create a first version that can be extended and support other content types. The possibilities are really exciting - hence the glare (reflected of course!).

Entry to the Theatre of Nursing & Space

I do understand that reading theatre related texts, joining a theatre group, my writing a play is still pi in the sky. It's the journey, that's all. In Hodges' model I've differentiated between structure and content. This is the center of the stage about which Hodges' model turns. In the guided discovery by which students and audiences can discover the model,  these are the bases to touch in turn.

Sir Alan's focus on construction in writing: is narrative, time, location, characters (p.12). The overall message for me is, the frequently uttered - less is more. I must take heed and listen. During Ayckbourn's career, he has encountered the full retinue of writers and directors young and 'experienced'. Reading this, it is nice to be both 'new old-er' -

'Then there is the new old playwright. Far more difficult to deal with. They have probably nursed this script for twenty-five years and they're damned if you're going to mess it up for them when they've waited so long. Especially someone your age who wasn't even born when their harrowing play about World War Two was still raging, dammit.' p.110. (My emphasis in bold.)

Thinking about 1959 and the start of Sir Alan's career, his reference to WWII, made me recall nursing assistant and student nurse studies and placements at Winwick Hospital in 1977. On the geriatric wards for entertainment it was WWI songs were often sung, or records played. Long players, indeed.

In health we are usually accustomed to stopping before the 'true' end, with the exception of palliative care, although even then the ending should be 'better' than what it would otherwise have been.

If I am nursing Hodges' model, I've been doing so ever since 1987-88. As Sir Alan also observes of writers, while passionate about the utility of the model - my project - not my model; I am filled with self-doubt. Is this an over-valued idea - in my hands (and mind!)?

In other reading - Stagecraft. The Complete Guide To Theatrical Practice, by Griffiths Trevor R. 1982, I came across the word 'proscenium'.

'Incidentally, when we came to stage [the play in question is 'Woman in Mind' PJ] the London proscenium version this was far more difficult to achieve. Proscenium theatres generally make scenic statements whether they want to or not; the round makes none unless called upon to do so.' p.32. 

There are many insights into sets, design, and the various pros and cons. In May and earlier this month, with three other cast members I performed a role 8-9mins in a Living Newspaper (40-50 mins in total). It was fascinating to watch the various aspects developing from the initial reading in January. With Hodges' model an idea, the question of set design is not straight forward. But as with over-valued ideas, I am probably over-thinking (as usual) making things more complicated than necessary.

One golden nugget of advice, is if you are the writer and write well, well you don't have to think the set design. That is a problem for someone else to solve. Hopefully you will be impressed by the interpretation and realisation (often in film credits) of your work.

That is, unless you're unlucky and find yourself on the receiving end of Obvious Rule No. 13:

Beware of competitive set designers, particularly those with a 'concept'.

The name Ayckbourn is synonomous with The Stephen Joseph Theatre, which is in the round:

'The Round provides a truly unique experience as the audience is seated all around the stage. Not only does the audience see the performance from every angle, it also brings the actor into the same space as the audience.'

"Let’s have the actors in the same room as the audience, let’s have four front rows, let’s get really excited about this acting business!"

Stephen Joseph, 1959 - https://sjt.uk.com/about-us

From the mid-1980s and 90s I used to visit Bolton's Octagon quite regularly. Performances were frequently in the round. Last month, Abigail's Party was too (the last night).

Whatever, the staging, set, I'd be interested to see the 'concept'. On directing:

'As regards interpretation. you may need to tread more warily. As I said earlier, many playwrights are not naturally theatre creatures - certainly they are rarely visual theatre creatures, I have seen them sit there and watch their play physically anfold with a look of total amazement. pordering sometimes on delight, sometimes on dismay. What was in their head has been made three-dimensional flesh.' p.111.

Space has been and remains fundamental to my thinking about Hodges' model. Even pushing the envelope to topology, this is well beyond my ken. But not other gifted researchers. Hodges' model provides inter- multi- transdisciplinary bridges: we need to Before the time of schools becoming fenced and patrolled sites, we used to play cricket, tennis and football. There was a large wall at front of a former school, great for tennis, but not return of serve. Now a projection shared in the round - so everyone sees the same thing (yes, another rule!) might hold potential. There's acknowledgement that technology moves on too (p.123). And room for comedy, Ayckbourn's starting point. 

'Designers, it has been said, even the best of them, sometimes get hold of the wrong end of the stick. ... Always get to look at drawings, ground plans and, most helpfully, scale models of what they intend.' p.120.

The Crafty Art of Playmaking by Alan Ayckbourn. Faber, 2004, softcover, ISBN 0571215106.

https://www.concordtheatricals.co.uk/s/45898/the-crafty-art-of-playmaking

'Drama classes help GPs handle difficult patients' c/o BBC

'Hull Truck Theatre has just won the Innovation prize at the Stage Awards for their new training scheme for GPs. Associate Director Tom Saunders and GP Dr Eman Shamsaee discuss why drama classes are helping doctors treat patients.' 

BBC Radio 4 'Front Row' https://www.bbc.co.uk/sounds/play/m002q2jz (15 mins ...)

◇

Holly Phillips, East Yorkshire and Lincolnshire and Ian Youngs, Culture Reporter

Published - 21 January 2026

'A theatre company is using drama training to help doctors deal with challenging patients.

Hull Truck Theatre's classes feature actors performing difficult GP consultations, with GPs giving feedback before taking over the consultation themselves.

The theatre recently won the Innovation Award at the Stage Awards for the programme.

Dr Eman Shamsaee, who has taken part in the training scheme, described it as a "really creative way of doing GP training".'

BBC News:  Drama classes help GPs handle difficult patients

INDIVIDUAL

|

 INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

The training programme has completed its pilot stage and is now in the delivery phase

A reminder of co-working to deliver STORM training with a Clinical Psychologist colleague. 

See also: 'communication' : 'primary care' : 'GP' : 'drama'

"What's in a (blog) name?"

As regulars here will be aware I've been wondering what Hodges' model might learn from other conceptual frameworks produced around the world. ...

When I first read the following blog title - 'World Health Care Blog'

I thought - 'World Health Care' - now this sounds really interesting.

Unfortunately, upon investigation the world health contextual cupboard was bare.

I looked again at the label.

I looked in the tin.

I'm sorry, but from the top-down this blog proved a disappointment.

It's not that I was expecting a paper on world health care models or frameworks.

Don't get me wrong the business (economic, industry) world of health care is essential (reading) for those who want to stride - not step - from today into the future. Health care has been commodified for ages, for all ages. To be fair the 'subtitle' and 'about' statement makes the focus of the blog very clear. From the bottom-up there is clearly content to satisfy the ardent business-info-addict with posts and contributions from leading players.

Maybe it's me and my digital preoccupation has regressed to hairs; but this title IS imho very misleading. How so? Well from the perspective of world health care business-industry insiders all seems well with the-ir world. Meanwhile, non-'business' visitors like this one, may spend their visit exercising ruined expectations. (If the target audience is specific then somebody had better go sort the stage and the sights: there's still a debate to had.)

'Stuck' (and essentially 'skint') as I am here in Lancashire, UK I can't exactly throw stones. Hodges' model is a small - very tasty - fruit (when ripe!) with four (or five) kernels possessed of global - world health aspirations. We need global conceptual frameworks for health and social care and education.

Browsing the 'World health Care Blog' and searching for 'world health' revealed posts totally unrelated to what many people would consider the real issues surrounding 'world health'. There are posts on global health funding and global health program, India, Mexico, Thailand.

At the time of writing 'World Health Care' is not even listed as a category. Try 'poverty'...?

Perhaps 'world health' is implied in the content, but is this sufficient given the title?

Noting the sponsor perhaps there's a risk of confusing or conflating 'World Health Care - Congress' with 'World Health Care'?

The World Health Care Blog is not listed on the main Corante site, so perhaps this blog is off the beaten track?

All this makes we wonder about Google-SEO ranking and semantic web weighting? [Actually, where does (will) the weight of blog, website, and Web 2.0-3.0 application purposes and titles feature on the semantic web?]

'Corante' may have been the world's first English language newspaper, but *global health care* comprises a multitude of languages that must be given a voice. Especially as many of those languages are threatened species (including Danish).

There - was - an interesting brief video clip by Dr Anil Kumar

I realise of course that many contributors and agencies at the World Health Care Blog and Congress will be greatly involved in major world-wide humanitarian and philanthropic projects. The concern is one of impressions.... Reflecting on the meaning of 'world health' and the inclusion of these term(s) might pay great dividends in terms of publicity, balance, governance, corporate and social responsibility.

So, come on Corante if you - as blog managers - insist on this title, on this stage then pick up the theme of 'World Health Care' holistically - you know you want to.... since after all

Corante = Enactor

'To act (something) out, as on a stage: enacted the part of the parent.' http://www.answers.com/enactor&r=67

Lead the way...

All trademarks acknowledged.

The moon, Saturn V, policy and holistic care

The last time human kind ventured to the moon it took a three-stage rocket to get us there.

Unlike the space race and Kennedy's breathtaking commitment, there never has been a political objective akin to - "We choose to achieve holistic care in this decade, and do the other things like multidisciplinary, integrated, electronically supported collaborative care. ..."

Perhaps the UK's series of National Service Frameworks goes some way towards this, with the Next Stage Review over the next decade set to make the holistic difference?

So, it appears that the objective of holistic care isn't easy, like going to the moon it is hard and in this problem domain - care engineering - we have had more than a decade to get there.

There has been a space race in nursing. A race to fill curricula, wards and the heads of many with models and theories of nursing.

Like Apollo this race has petered out.
Like Apollo this programme is safety critical.
Like Apollo ambition can be re-kindled.

We need a new imperative. Something to charge policy landscape of our time. There is still a need to deliver on this and the other things....

Hodges' model is a marvellous delivery system.

Unlike the Saturn V it boasts four stages.
Like the Saturn V it incorporates the means to take us to some place and make the journey back: quantity - quality and the universe between.

The stages of h2cm are interchangeable their use dictated by the situation and context. There is even recourse to a virtual fifth stage as required, since as the astronauts found:

you can find bliss up there : looking down here

Image source: ABC News

Ack: John F. Kennedy Moon Speech - Rice Stadium

'Space' - 'travel' and aftercare

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

'Of Course I Still Love You' "Aftercare"	5 4 3 2 1 0 . MAX Q .. 1st STAGE (MECO) ... 2nd STAGE   (SECO) .... 1st STAGE ENTRY BURN .....
Governments must know there are many spaces to understand and assure  that human rights are upheld for all.	Congratulations USA!

Ann Hutchinson Guest (Obit.), 'Authority on dance notation ... '

'Although there are many forms of dance notation going back to Pierre Beauchamp's system for Baroque dance in the 1680s, Nijinsky had developed his own cryptic version. Ann Hutchinson Guest first tried to reconstruct his work in 1956 after the choreogapher's widow, Romola, gave her his notes. "I spent years trying to work it out," she said, adding with a laugh: And I'm supposed to be the leading authority on dance notation in the world. She told how Nijinsky had revised his notes many times, often contradicting himself. 'We couldn't get anywhere. Romolo was furious. She said it was taking much too long."

    Hutchinson Guest studied dozens of different dance notation systems, translating many of them into Labanotation, a system developed in the 1920s by Rudolf von Laban who was a central figure in European modern dance. According to a  press report in 1954: "The printed Labanotation page looks like a combination of hieroglyphs, pictographs, Morse dots-and-dashes, đoodles, and a musie score turned on edge" 

    It was not until 1980 that she and Claudia Jeschke, a dance historian, succeeded in cracking Nijinsky's code after finding a copy of his annotated score in the British Library.'

Register, The Times.

My source: Ann Hutchinson Guest (Obit.), 'Authority on dance notation known for reconstructing Vaslav Nijinsky's scandalous ballet, L'Après-midi d'un faune'. Register, The Times. 20 April, 2022, p.48.
https://www.thetimes.com/uk/obituaries/article/ann-hutchinson-guest-obituary-hkw8z88ns

INDIVIDUAL

|

     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

abstraction representation interpretation observation - translation code - formalism	body (bodies) symbols - forms dance choreography movement - 4D - time
group ensemble 'anthropological composition?' 'diagnostic grouping'? social - cultural category . . .	'collective power & attention  evinced as time' 'The stage: the space for health'^

Hutchinson Guest in 1956
 Source: The Times.

'Dance has been called moving architecture, a truth which the complexities of contemporary choreography may mask. Not only does the dancer's body form shapes and groups of dancers form moving or static designs, but also group arrangements carve up the stage space, establishing areas of open as well as enclosed space which are significant in their changes and contrasting effects.

While the rccording of movement on paper-dance notation-does not look like movement (disregarding primitive stick figure drawings), there is an "architecture" in the sequence of graphic symbols used to record dance patterns. Over the centuries many different devices have been used to capture dance steps on paper. What are the elements that have to be represented?

The process of dance notation requires reducing four-dimensional movement (time being the fourth dimension) to a two-dimensional surface. The parts of the body in action have to be defined, as does the form of movement involved (flexion, extension, rotation, directional placement) and the duration of each in relation to the overall time structure. In group dances the relationship of dancers to one another must be determined and recorded, as well as their location on stage and their paths of travel. In a dance score each performer is like a small orchestra-arms, legs, head, torso, etc. in motion-this is then multiplied by the number of dancers who are performing individual sequences.'

Guest, A. H. (1990). Dance Notation. Perspecta, 26, 203–214. https://doi.org/10.2307/1567163

^Health is always performed in the political domain, make no mistake (excuses, or exceptions). It is not:

1. Acknowledged, masked - covered by the 'set design' (see #2 below);
2. Implied in the medical, biomedical, bio-psycho-social model;
3. The intermission is neither the time, or place, to reflect upon and critique the political in health :: health in politics.

See also: https://archives.nypl.org/dan/19629

https://en.wikipedia.org/wiki/Ann_Hutchinson_Guest

Previously: 'dance' : 'architecture' : 'movement'  : 'notation'

Book review: i Critical Mental Health Nursing: observations from the inside

If the book's title does not suggest the challenge to come then perhaps the editor's "Our apology" just might.

The editors declare the limitations of their apology as mental health nurses (mhn) given the precariousness of life, the environmental situation, the power of global corporations and how the industrial-military complex can also affect and define the role and work of mental health nurses. It is clear, that for example, the past decade (at least) of mental health service provision and development has been impacted by political and socioeconomic trends. The reduced number of mental health beds; the subsequent phenomena of out of area referrals (that also redefine 'area'). This past month, commentators have pointed to the lack of a work-force plan that should precede NHS Long Term Plan.

From the start the vocabulary here is rings of 'anti-psychiatry' and seeks, if not redress, then redesign of formal mental health services. Anyone putting the book down at this stage would be doing themselves, patients, carers, health and social care and their own learning a great disservice. Clearly, it is not only that existing services are reductionist, invalidating, self-serving, drug-pushing and re-traumatising; but the editors stress it is how they are all too often experienced.


As a mental health nurse the introduction and apology gets to heart of the matter, if not the mind. All of what mhn's do is tinged with coercion; whether with people on locked wards or those in their own home. The list of what mental health nurses are party to is a long one and makes difficult reading: the detention and restraint of people and administration of antipsychotic depot medications. The profession hides behind the ethics of acting in a person's 'best interests'. The negative impact of this experience is not just limited to a vulnerable minority who are in most marked emotional distress, but others as the book attests. If this suggests a caveat, there are several, as I hope this review across several posts will reveal. That custard cream shared with a patient (person, householder, tenant, citizen...) in their home will never taste the same. So, more on that to follow and not just to address any sense of trivialisation, but the many caveats that apply.

The editor's frame their apology outlining the basis for mhn: as a profession, a university degree, codes of conduct and accountability. p.viii As a 'profession in our own right' the critical thinking we espouse (yes - here too) and are supposed to exercise has failed to question and counter the increase in detention and the assault on mental health services themselves. At one stage I believed there was some coherence to mental health policy development, but if it is there now - it is intangible in its quality. MHS have not developed progressively as might have been anticipated if not exactly predicted. As a new Community Psychiatric Nurse in 1985 I am now a 'Community Mental Health Nurse', what else might my colleagues and I have become? At the end of the day we may longer return to the hospital (Winwick, Eaves Lane, Ribbleton - all gone), but what are we returning to when we go back to the office, the base? There is an office move in this book; and the final chapter considers the profession's very title.

The editor's apology does not just set the scene, it places mhn and all practitioners on the stage - front and center. This RMN (SRN) (to be ageist for a moment) is all too aware that despite all the talk about the need for integrated, holistic, person-centred care they are, more often than not, still lacking. I've come to see these as 'legacy issues', but that is another 'book'?

The book itself has 260 pages in total. The cover of my (softback - as above) is a pleasing contemporary design. The mainly white cover is already a suffering grey as it's been on numerous trips. Thirteen chapters follow the apology and an introduction. There are notes on the editors and contributors. The print is an excellent size and the overall format easy on the eye. Even if lightly edited, the editors have done a good job as the chapters cohere. Two indices cover names and subjects and are sufficient. So with chapter 1 beckoning I was all-eyes and ready page turning...

Thanks to PCCS Books for my review copy.

Part ii

Part iii

Part iv

Bull, P., Gadsby, J., Williams, S. (Eds.) (2018) Critical Mental Health Nursing: observations from the inside, Monmouth: PCCS Books. ISBN 9781910919408

Launch of the National Care Service in England

Source: Department of Health, 30/03/2010

In the biggest change to the welfare state since the creation of the NHS, everyone who needs care when they are old or disabled will get it for free, Health Secretary Andy Burnham announced today as he launched the National Care Service in England.

The National Care Service will be based on a principle of shared social insurance and will be funded by contributions from everyone in a fair way. The National Care Service will ensure people get high quality care when they need it and it will give peace of mind that savings and homes will be protected from the expensive care costs that arise from serious long term conditions, such as Alzheimer’s or recovering from a stroke.

Andy Burnham said:

“Today we are launching a National Care Service that is fair for all, ending the cruel care lottery we have today. Like the NHS, everyone will contribute and everyone will get their care for free when they need it. This is the biggest change to the welfare state since 1948 and, like the NHS, it’s going to take time to build.

“The National Care Service will mean that people will be treated with dignity and respect, people will have control and choice over their care and they will be helped to stay in their homes for as long as possible. People who have to live in residential care will, from 2014, get their care for free after two years and there will be more help to pay the residential costs.

“We’re not replacing the millions of carers or families who look after each other. They are the underlying principle of the National Care Service and we will better support them.

“We’ve already laid strong foundations through reforms over the past few years. But, with an ever growing older population – there will be 1.7 million more people needing care in the next 20 years – we must radically overhaul the way care is paid for and provided.

“I feel very strongly that this is a responsibility we must all help to shoulder. And it’s clear from what we have heard from the thousands of people who have given us their opinions on this over the past twelve months, that people agree. That’s why we know that the fairest way to help everyone who is affected by a serious disease, illness or disability is for us all to pay into a system so we get free care when we need it.”

The cost of care is currently a cruel lottery. No one has any way of knowing how much care and support they may need in the future. A 65-year-old can expect to need care costing on average £30,000 during retirement. However, some people, for example people with severe dementia, could end up needing care costing as much as £200,000.

The National Care Service will put an end to this unfair system. It will be built on strong foundations of recent reforms and will overhaul the way care and support is paid for and provided. It cannot be built overnight and will be phased in three stages:

Stage One
• Build on the best of the current system through reforms that are already underway and deliver the Personal Care at Home Bill.

Stage Two
• From 2014 extend the coverage of free care so that people will receive free care if they need to stay in residential care for more than two years.
• Set up a commission to support consensus and advise the Government on the fairest and most sustainable way that people can make their contribution to a care system which is free when they need it.
• Set up a National Care Service Leadership Group of expert stakeholders who will advise Government on the implementation of the National Care Service, focussing on the systems and business processes that need to be put in place to make the National Care Service a reality.
• Introduce a National Care Service Bill to set the legal foundations of the National Care Service.
• Enshrine in law for the first time nationally consistent eligibility criteria for social care helping to remove the postcode lottery of care that exists now
• Push forward with the prevention agenda and continue the drive towards personal budgets so that by 2012 everyone who would benefit from a personal budget will have one.
• Ensure accurate, relevant and accessible information about what people are entitled to, how the assessment process works and how to access care services is provided to everyone.
• We want to improve the gateway for accessing social care and disability benefits to make simpler and easier for people.
• Introduce a quality framework including a body to drive up quality in social care.

Stage Three
• The introduction of a comprehensive National Care Service that is free when they need it for all adults with an eligible care need, funded by contributions.
Following the biggest ever consultation on care and support that saw over 68,000 members of the public, carers and representative organisations have their say, it is clear that people believe it is right that everyone should contribute to a care system that is free when people need it– similar to the NHS. However, the necessary consensus on how people should pay into such a system has not yet been reached. A National Care Service Commission, will therefore be established to advise Ministers on the fairest and most sustainable way for people to do so.

Care Services Minister Phil Hope said:

“We must find a fair way of funding the National Care Service. The stakes are very high. That’s why we must have a clear consensus. We are setting up a commission to tell us what would be a fair way for everyone to pay into this new system.

“Everyone will pay into it in a fair way and in return everyone will then have peace of mind that their savings and homes will be protected from high care costs. The whole of society will benefit and the National Care Service will support individuals and families for generations to come.”

The National Care Service will have six founding principles. It will:

1. Be universal – supporting all adults with care and support needs within a framework of national entitlements.
2. Be free at the point of use – based on need, rather than the ability to pay.
3. Work in partnership – with all the different organisations and people who support individuals with care and support needs day-to-day.
4. Ensure choice and control – treating everyone with respect and dignity, ,putting people in charge of their lives.
5. Support family, carers and community life – recognising the vital contribution families, carers and communities play in enabling people to realise their potential.
6. Be accessible – easy to understand, helping people make the right choices.

Contacts: Department for Health Email: NDS.DH at coi.gsi.gov.uk

Additional links:

DoH: 30 March 2010, The White Paper, Building a National Care Service

The Big Care Debate

Allport's Scale of Prejudice - 1 to 5

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

?

?

?

Antilocution: Antilocution occurs when an in-group freely purports negative images of an out-group. Hate speech is included in this stage. Although antilocution itself may not be harmful, it could set the stage for more severe outlets for prejudice (see also ethnic joke). Avoidance: Members of the in-group actively avoid people in the out-group. No direct harm may be intended, but psychological harm often results through isolation (see also social exclusion). Discrimination: The out-group is discriminated against by denying them opportunities and services, putting prejudice into action. Behaviors have the intention of disadvantaging the out-group by preventing them from achieving goals, getting education or jobs, etc. Examples include Jim Crow laws in the US, the Statute of Kilkenny in British Ireland, Apartheid in South Africa, the Nuremberg Laws in 1930's Germany and antisemitic laws in the Middle East. Physical Attack: The in-group vandalizes, burns, or otherwise destroys out-group property and carries out violent attacks on individuals or groups. Physical harm is done to members of the out-group. Examples include pogroms against Jews in Europe, the lynchings of blacks and Italians in the US, ongoing violence against Hindus in Pakistan and Muslims in India. Extermination: The in-group seeks extermination or removal of the out-group. They attempt to eliminate either the entirety or a large fraction of the undesired group of people. Examples include the Cambodian genocide, the Final Solution in Nazi Germany, the Rwandan genocide, the Armenian Genocide, the Genocide of the Hellenes and ethnic cleansing in the Bosnian War.  Source: https://en.wikipedia.org/wiki/Allport%27s_Scale

 

Gravells, A., Simpson, S. (2009) Equality and Diversity in the Lifelong Learning Sector, Exeter: Learning Matters Ltd. pp.65-66.

See also: 

IMPACT: Prejudice and Discrimination i

Allport, Gordon (1954). The Nature of Prejudice. Cambridge, Mass. Addison-Wesley.

Call for Papers (ii) Community Development and Preventative Care With Older People: New Values and Approaches

 I drafted this with (i) but didn't want to distract from the call and journal itself.

 With three working titles in a 250 word abstract in response to:

"How can prevention in social care be better conceptualised?" - 

I am open here (as ever) to expressions of interest towards collaboration. Support (help) would be invaluable, whether advice/co-author - to develop ideas on Hodges' model as a mathematical object(?). Even if this includes telling me to stop the barking and leave the tree alone. That point aside, the reading and videos are a challenge, but really enjoyable too.

In reading the call, Quaternary prevention will be added to:

"While applied in the context of complex social problems, discourses of prevention are most coherent and established in the realm of public health (e.g., tertiary, secondary, and primary prevention). As Rapoport highlighted in the 1960s, however, translating the unified view of prevention associated with public health into social welfare is inherently problematic. This remains the case. Preventative social care and support necessarily operate in complex and dynamic systems, generally where knowledge of causation and the consequences are unclear, and an imaginative application of care needs and contexts is required."

The result will be abstract. With “'re-imagine' social care" taken literally. 

Since there are quinary industries ( 'ours' no less), is there, should there be - quinary prevention? I think so, and this - and several legacy issues encountered in my career and ongoing today (also accentuated in the future?) will form the basis of discussion. Early days, but also need to decide upon the manuscript type:

• Article: a paper containing original research results that has not been published elsewhere. Articles shall have a maximum length of 6,000 words (the word count limit includes title, abstract, tables, figures, and references list). During a potential revisions stage, after peer-review, authors can extend the article length to a maximum of 8,000 words to better address the reviewers and editors’ comments.
• Commentary: an opinion piece providing a critical evaluation of a published article or topic of interest to the readership of the journal. Letters to the Editor and replies should be submitted as Commentaries. Commentaries shall have a maximum length of 2,000 words (the word count limit includes title, abstract, tables, figures, and references list).
• Review: a paper which comprehensively sums up the current state of research on a particular topic. Reviews shall have a maximum length of 6,000 words (the word count limit includes title, abstract, tables, figures, and references list). During a potential revisions stage, after peer-review, authors can extend the article length to a maximum of 8,000 words to better address the reviewers and editors’ comments.

The completed draft may not be 'finished' by July, but the exercise will help develop ideas to further understanding and awareness of Hodges' model. I'm almost too close to Hodges' model and I can't discuss ideas on a daily - work basis. The other impediment, is standing on my foot, pressing me against the walls (whichever domain) is the fact that models of/for care, and nursing theory have little currency these days. Finally, having explained I have no funding, encouragement to write is appreciated. This effort is also informed by threads on (and off) the Spirit of 1848 ListServe.

Dramatherapy iii - A Specification for Care: Nye

Individual
|

      INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

|

Group

"Classical psychodrama requires five instruments, the stage, the subject, the director, the auxiliary egos and the audience. Although Moreno frequently stated that psychodrama could take place in many natural settings, he advocated the use of a stage of his own design, circular, 12-15 feet in diameter, 1-2 feet high with two surrounding stepped lower levels, seating for the audience, a 'Juliet' gallery and equipment for varying the colour and brightness of the lighting. This format was was aimed at providing a space and generating an atmosphere in which the subject could rise up to move and act with increased freedom and imagination. 'The locus of a psychodrama, if necessary, may be designated everywhere, wherever the patients are, the field of battle, the class-room or the private home. But the ultimate resolution of deep mental conflicts requires an objective setting, the therapeutic theatre. ...'". p.107-108.

Nye - National Theatre

Davies, M.H. Dramatherapy and Psychodrama, Chap. 5. pp.104-123. In Jennings, S. (Ed.), (1987) Dramatherapy. Theory and Practice for Teachers and Clinicians. Routledge, London. p.106.

Drawing - the stage of conceptual design

The health career model
- drawing -
for health and social care professionals, et al.. ...

"The Italian word for drawing, disegno,
also encapsulates the stage of conceptual design.
The ability to imagine a design
and then develop it on paper was an increasingly valuable skill."

The Purpose of Drawing: The British Museum, May 2010.

Additional link:
Disegno: Italian Fine Art Drawing

My source: 16 May 2010, Visit to The British Museum, Italian Renaissance drawings.

Paper - Categorical Social Science: Theory, Methodology and Design by Sallach (2012)

This conference paper from 2012 - cited at length here - is very encouraging as I try to work on category theory within Hodges' model. This is timely too, as a new (northern) academic year begins - post to follow ...

Sallach, D.L. Categorical Social Science: Theory, Methodology and Design. In: Conference Paper - 4th World Congress on Social Simulation. Taipei, Taiwan (September 2012). https://www.researchgate.net/publication/275584554

"The prospect of representing social processes at multiple scales, at an arbitrary level of detail, is likely to produce rich, interwoven models with the potential to provide a more effective map of historical and policy-oriented dynamics. However, this potential will also raise significant challenges in validating such a model [15].

One approach to managing the complexity (both conceptual and computational) of social models is to move them toward a higher level of abstraction."

"Category theory requires specification of a type of mathematical object in terms of identity, composition, and a group of morphisms that preserves their structure. This definition of objects and morphisms, in conjunction with two standard axioms (associativity & identity), defines a framework that is simple enough to be broadly applicable."

Conclusion:

"The present analysis introduces more analytical potential than can currently be demonstrated. Nonetheless, it makes a case for the relevance of category theory for the representation of social applications, and illustrates a variety of ways in which these conclusions are, or ultimately can become, compelling.

Category theory provides a rigorous yet expressive formalism for representing and integrating challenging modeling domains. It is also a formalism that can support extensive theoretical and modeling syntheses, while still maintaining appropriate levels of exactness. These strengths make CT particularly appropriate for providing a mathematical foundation for computational social science.

Ultimately, it is important to return to the issue of the validation of social models. The practical use of historical and/or policy-oriented models is highly dependent upon their credibility. Category theory provides a formalism that can be precise when applied to theory, explicit during the design stage, and definitive at the assessment stage, while also attending to the consistency of intermediate stages. It deserves serious exploration and investigation."

PHI MAGAZINE (Φ) - Liminal Issue [i]

 Submissions are OFFICIALLY open for our Liminal Issue.

The word ‘Liminal’ encompasses the quality of ambiguity or disorientation that occurs in the transitional stage of a process, boundary, or threshold. It comes from the Latin word līmen, relating to participants of rites of passage who no longer hold their pre-ritual status but have not yet begun the transition to the status they will hold when the rite is complete. During a rite's liminal stage, participants stand at the threshold. In many ways, this is where the world stands today.

We take all kinds of submissions: prose, photography, poetry, painting, opinion pieces, film or music—you make it, we want to publish it!

Submit to us before 14/02/2022 to be considered for our Liminal Issue.

Submit here: https://phimag.org/submit

For enquiries: submissions.phimag AT gmail.com

+++

WHAT IS PHI MAGAZINE (Φ)?

Φ Magazine is a quarterly publication aimed at showcasing the creative talents of Philosophy students across the globe outside the academic realm. Be it photography, painting, poetry, prose, or anything in between then it can find a place in the pages of Φ.

My source: 

Philos-L "The Liverpool List" https://www.liverpool.ac.uk/philosophy/philos-l/

@PhilosL @LiverpoolPhilos 

Thanks to Chiara at PHI Magazine for the cover image by Taudalpoi.

n.b. I will add a further post to relate the above call to threshold concepts and Hodges' model.

Chairs and Beds: The Theatre of the Absurd [balance!]

Hodges' model: Stages of Care/Despair

Individual
|

      INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

|

Group

Beds needed for 'treatment' mental illness and physical, preparedness for public health events. Reduced beds for 'modern medicine', sustainable health care, reflecting health education, preventive approaches and improved health literacy (. . .?).

NHS hospital beds data analysis We look at NHS bed data in England compared to other countries, bed stocks over time, the impact of COVID-19, safety breaches and intensive care capacity.

"The Theatre of the Absurd, on the other hand, tends toward a radical devaluation of language, toward a poetry that is to emerge from the concrete and objectified images of the stage itself. The element of language still plays an important part in this conception, but what happens on the stage transcends, and often contradicts, the words spoken by the characters. In Ionesco's The Chairs, for example, the poetic content of a powerfully poetic play doe not lie in the banal words that are uttered but in the fact that they are spoken to an ever-growing number of empty chairs." p.26.

Bed Availability and Occupancy – KH03 "Bums on seats" (Lecture theatres)

Esslin, Martin. The theatre of the absurd. London: Pelican, 1982. (3rd Ed.).

Book: "The Empty Space"

The Empty Space, Peter Brook

 In July I caught up with Mr Brian Hodges who created Hodges' model. Having met previously in November 2013 we agreed not to leave it as long next time and so I returned on 7th October.

One question I had was whether in addition to Hughes there were any other influences that led Brian to the model overall?

Brian could not recall a specific reference, but mentioned the theatre being an influence. I, in turn had picked up a second-hand book on one of several recent trips to London, but the title evaded me. Once home I checked and the book is "The Empty Space" by Peter Brook. A Gower Street bargain at £4.99. Brian also checked and emailed to confirm this is the book on his shelf too.

While in London (and elsewhere) I try to visit the theatre and  now look for performances of Ibsen's plays. Whatever I do see, A Doll's House this month, before the performance starts the set design is always intriguing. I've posted on this before, Hodges' model providing a 'stage set', one that should the play require can include the operating theatre.

As a mental health nurse the themes of Ibsen's plays still resonate today. From the performances I have attended the public finds ongoing relevance in: The Master Builder, Ghosts, The Lady from the Sea, Rosmersholm, Hedda Gabler and An Enemy of the People. This is true of the work by others. The drama of life and death that Hodges' model can also stage.

Brian emailed me about a situation that stood out for him in the book, so I will revisit this. What caught my eye is the cover of Brook's book (and yes, the graphic first). Without even opening the book, the 'scene' is (possibly?) set on the book's cover "A Book About the Theatre: Deadly, Holy, Rough, Immediate" ...

 individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

Holy	Immediate
Rough	Deadly

Hughes, E. (1958) Men and their work. New York: Free Press. (Hughes was used by Brian to define ‘health career’ the idea of life chances.)

Holistic care 3: Location

Through February and March I looked at holistic care definitions and other aspects. Now for location.

The place to look for holistic care is literally everywhere. Every - where?

Well yes, if we take holistic to really mean holistic.

There is the obvious physical where that applies in the various care sectors such as; primary, secondary, community and tertiary care and the places they all encompass and contain. The locations associated with buildings and other architectural and organisational structures however permanent: hospitals, hostels, surgeries and clinics, homes, schools, prisons, refugee camps and workplaces - including inner and outer space.

The other where comprises the cognitive and virtual. Our thoughts about care, the thought processes and conscious decision making about care assessment, planning, intervention and evaluation. Except in specific psychoanalytical therapies the unconscious is a less frequently acknowledged and yet undoubtedly factor. If values are to have an origin and a safe harbour (governance) then a light must be cast on the darker, uncertain places. Accepting and utilising these places facilitates a holistic perspective, an adjunct to the more usual analytically derived views.

Speaking of analytical: recently, working on a 2nd temporary secondment, I've been preoccupied (and still am) with PROCESS and CONTENT. We tend to lose ourselves in process; the nursing process, care process, process mapping workshops abound. The problems take centre stage and because they are the patient's problems that qualifies the process as being person-centred. A tick goes in the box.

At times outside of medical emergencies this may be a mistake.

In deploying 'IT' the argument goes that the benefits of information technology in health care (various reports, effective case management, safer practice...) should be transparent, that is -

a by-product of the care process: not an add-on.

To me this suggests that the care process, the energy spent negotiating the care pathway produces a reaction. Informationally this reaction can be desirable. (I'll leave you to contemplate the alternative.)

If the person is truly at the centre of care then maybe the reaction can also be characterised as precession? Just as the Earth precesses on its axis, so our care processes result in precession around the person - the 'whole' individual and their situation at the centre of care?

But only IF we choose to take notice, factually, emotionally and informationally.

There's no disputing that care is frequently wobbly. But this oscillation can provide a periodic peek into the four (5) care domains.

At times these presentations, or windows of opportunity may be physically and emotionally draining, and arise in a highly disordered manner, they are nonetheless there.

Allied with a problem space, that other for me essential location of holistic care, you have a potentially very powerful tool.

I know this may be twaddle and I may be on shaky ground, but at least I'm trying to follow the wobble...

As highlighted previously there are alternate ways of seeing.

Before I close and follow a countdown: Thank you Darcy - a star on stage : GO STS 117 stars in space.