Month: April 2015

43 hours in the care of the NHS

~ drjfernihough ~ Leave a comment

Today I am continuing a theme that I love: process, and the absence of its value when someone could have been left to use their brain instead. Don’t get me wrong, to paraphrase a quite brilliant fellow MBA colleague, process porn excites me just as much as the next Project Manager. I love the way it can enhance our lives when everything is there at the touch of a button. Then we call it “intelligence by design” or “user friendly” to avoid using the ugly word, “process”. But process is only dehumanising when it fails, raining absurd crushing blows on our heads, sending us internally spinning, and often into a lengthy British queue. I’m getting ahead of myself……………..

Recently, my husband and I spent one of those days juggling one kid off to a cub-scout day trip, one off to badminton club and with the third pair of hands, one kid went to the park to exhaust me. Never did I realise you could push someone on a zip-wire, for hours……..

Suitably exhausted I returned home to find number one girl curled up on the settee clutching her phone, looking particularly more emo than usual. This is the exact moment I learned at what age people start Googling symptoms to self-diagnose an illness. The answer is 11. Suspected appendicitis cannot be treated with painkillers or a hot water bottle for fear of rupture and instant death (I’m paraphrasing WebMD on her phone here). To be honest, if the lower right quadrant of your belly hurts like hell and the left side doesn’t, appendicitis was all I had to go on too, so off we went to the nearest A&E, time of arrival 3:15. Obviously, you can’t park near A&E. If you’re not ill enough to turn up with all sirens blaring in an ambulance you have a 20 minute drop off waiting zone (full) or the maternity car park half a mile away.

So, I’m trying to carry an 11 year old in my arms like a baby from the maternity wing car park. I get as far as the maternity wing (i.e. 10 metres) before I want to collapse, breathless and in agony. Looking not dissimilar to every other patient arriving at the maternity wing, I rush in, looking for a wheelchair. A saint of a porter appears out of nowhere and number one girl is chauffeured round to A&E, in the fetal position. There, she is rushed through as an emergency case for triage. Because a nurse says so, she also agrees to take some paracetamol. She is “overbooked” on the next available appointment at 4pm.

Here’s the first part of my process confusion, how do you get to the point where double booking an appointment is a normal process? Have they cloned the staff to be able to do this effectively? The waiting room was pretty much standing room only with loads of kids with suspected broken limbs, still dressed in football kit. One young girl was skipping with a bloody nose and a scraped knee. I can’t help thinking that perhaps a tube of savlon and some paracetamol was all many of them really needed, not a four hour wait sat next to a paranoid, anxious parent, hoping to be double booked over someone else’s suspected broken wrist.

Surprisingly at exactly 4pm, my girl is called through to see another nurse to go through exactly the same triage process as before, only with the addition of a urine sample request and without the paracetamol again. Also, I suspect because the nurses are fed up of documenting scraped knees on the computer system, our answers are first written on the back of an envelope (I kid you not) before being typed up after we leave that room. It’s a tricky process getting an unsteerable wheelchair alongside a toilet cubicle so that a girl bent double with pain can wee into a small pot inside, but we managed. Don’t ask me to repeat that task.

Second point of confusion, why not just copy the stuff from one form onto the next form? How are our answers going to differ from one hour to the next? Why even have a second form if it has all the same questions on it? One of the questions sounds like, “Is she known to cams?” If you understand this question, then you know it is actually “Is she known to CAMHS, which is the child and adolescent mental health services. If you answer this question, “no” rather than “what is cams?” no-one bats an eyelid or asks how you have come across the mental health services if it wasn’t for one of your kids. I was all ready to say “Oh, it’s our youngest son who’s clearly insane” but no, the box has been ticked, job done. Nurse number 2 seems very skilled and lovely, and “cannot rule out appendicitis” as the urine sample is fine. She’s “going to be assertive” and demand that a doctor sees my daughter. We’re sent round to the paediatric ward half an hour later, and ours not to reason why, but here’s the process on arrival, which in practice is about an hour after we arrive……………A nurse has a look at her, and asks ALL THE SAME QUESTIONS AGAIN, including the urine sample request. This time the urine test has a cardboard bowl to put under the toilet seat with a sterile packaged, plastic container insert inside, which has to be weed into, but only after opening it without compromising its sterility. I go and fetch another wheelchair………… Apparently, although the last nurse wrote up her notes from the back of an envelope onto the system, a) this did not include the results of the urine sample and b) they have big blue folders on the wall of the paediatric wards and you need to click paper in and out of these to look efficient, so to generate more paperwork, we have to start again.

It is now 5:30 and the nurse recommends taking a blood sample so that the results will be available to the doctor when they arrive to help their decision making. “That’s great” I say, “How long does it take to get the blood results then? What time do you expect the doctors to come round?” Here are the clues to the answers I’m expecting: How long = answer in units of minutes/hours; what time = something O’clock. The answers I actually got were, “oh, they come back almost immediately” and “she called me 15 minutes ago, so not long I imagine”. Right, let’s start with “they come back almost immediately” shall we? I distinctly remember weeping into many biochemical tests in a hospital based lab as a PhD student, so I have a little bit of experience with these.  It’s really very frustrating to spend two days carefully moving very small, and usually radioactive solutions from one type of tiny tube to another, only to discover that in your sleep deprived state, you wired up the terminals to the last machine in the process the wrong way round and now your samples are swimming in vast quantities of (also now radioactive) solution that you need to carefully clean up and pour down an appropriate sink somewhere. There were no tests that gave you results “almost immediately”. I understand that tests designed for the NHS have to be more robust than the ones I cocked up years ago, but still, the results are not coming back, “almost immediately”. I would bet my hospital parking fee on it. Moving on, how does the past event of “she called me 15 minutes ago” relate in any meaningful way to the arrival time of said doctor? She may live in Timbuktu, she may have 15 wards to walk round and 20 life-saving surgeries to perform before she gets to the blue folder filled paradise that is room 16.

So, sure in the knowledge that it is 5:30pm, but absolutely none the wiser on anything else, we watch anaesthetic cream being put on the back of my daughter’s hand, which will take half an hour to work, after which time, the blood test will be done.

6:35, blood test performed. No doctor around. She’s still nil by mouth and getting hungry. At about 7, dad turns up with the welcome distraction of brothers. As a new face on the scene, dad asks a nurse if there’s any danger of seeing a doctor or a blood test result any time soon. “The blood test results will take an hour” and “the doctors are on their way”. I bite my tongue. Eldest brother asks me why they can’t just X-ray his sister to find out if she has appendicitis. Grateful for the diversion, I discuss the use of X-rays with him and their ability to see bone, but not wiggly appendices, and the value of high resolution, but expensive imaging techniques like MRI and CT scans, versus cheaper, quicker, low resolution techniques like ultrasound.

8pm, we go wild and crazy and ask again if either a blood test result or a doctor are going to turn up any time soon. Miraculously the doctor appears and lets us know that blood test results take two hours to come back. He also asks my girl pretty much, all the same questions we have now answered three times already. However, this time we have brothers present, which livens up the process enormously. When asked if the previous day’s activity was normal, youngest son’s hand shoots up: boy does he know the answer to this one: “we cycled to the river where you can swim and I found a dead fish and a live mussel”. Unfortunately, this information has minimal clinical relevance and the doctor smiles politely. This is seen as a cue for eldest son (aged 10) to ask very bluntly, “Why don’t you just do an ultrasound to look at her appendix?” Gloriously shocked into action, the doctor informs us (in words of one syllable, despite the clear understanding that my son has of the situation, never mind his rather academically qualified parents) that this is exactly what they will do in the morning. Nil by mouth restriction is lifted and supper is offered to my picky eating number one girl. When I say supper, I believe the exact offering was “I think we have a cheese and tomato or egg sandwich in the fridge still?”  The look of horror on my girl’s face was enough to send me to the only thing open on a Sunday evening, a vending machine, so that she could eat an entire bag of Haribo Starmix (other types of carpet underlay are available). This can only be good for someone who has essentially had nothing to eat all day on top of severe bowel pain.

9:55pm, a surgical registrar comes to tell us that her blood test results are all normal, which is not strictly true as I pestered the nurses at 9pm and they said that “a couple of things are raised”. They’d like to keep an eye on her overnight before the ultrasound the following morning. My daughter is distraught as it has finally sunk in that she is definitely going to miss her maths test the next day. I drive home to get an overnight bag, incurring a £6 parking charge to leave the car park, even though this is the fee for anything over 5 hours, up to 24 hours. Although I am back within the hour there is no button to inform the machine of this and I start the whole parking ticket process all over again. I return to the ward with teddies and kiss my girl goodnight. Then I go to parents’ room 3 to sleep under the thinnest blanket ever manufactured, whilst ironically bearing a label that says “Imperial quality”; perhaps it was at the time Britain had an empire. I am reminded that your importance to the clinical care of the patient is directly correlated to the temperature of your surroundings. If you are the patient, you are placed in a room heated roughly to body temperature. If you are a mere parent, you are in an unheated room with draughty windows, where the curtains stop 6 inches short of the window ledge.

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Any visible source of heating with apparent thermostatic controls is simply there to lull you into a false sense of warm security. I spend the night fully clothed, putting two threadbare towels on top of my imperial quality blanket in an attempt to remain warm blooded. Day 2 continues in the post below.

7am, Monday morning, on the paediatric ward

~ drjfernihough ~ Leave a comment

After a surprisingly OK shower, I head towards the parents’ kitchen which proudly bears the sign “free tea and coffee” on the door. I need to defrost; I do not need powdered coffee with no milk. Note to self – find café. I go to see how my girl is getting on, still fast asleep in bed, so I return to my room to tidy up. It is only now I appreciate the true beauty of my temporary accommodation. What more could an anxious parent need than Monet’s “Waterloo – Gray Day” painting on the wall to cheer them up? Surely the picture they left down the back of the plastic armchairs was better than this?

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8am – despite being told that breakfast starts at 7am and the ward round would start at 8:30, cold toast and rice crispies are just arriving now. This is followed by the water jug game. This hasn’t changed in the 10 years since I spent a few nights in with my eldest son, and it’s a hoot, you’ll love it. In the searing heat of the wards, water is pretty essential, some might say, as essential as the medical care given here. So, with my love of process shining bright, it is always curious to me that every morning all the water jugs are removed from the ward as these could be a source of infection and are therefore a health risk to be removed. However, it is not the job of the person who removes the water jugs to replace them. Oh no. This happens later, much later, much much later when dehydration has set in, particularly for nursing mothers. So the water jug game involves smiling sweetly (a lot) and walking around the floor trying to find the rare beasty that is a jug and two cups, or even better, a nurse who can find these for you. Eventually we find water and dad arrives to take over at 9:30. I have an appointment on the other side of town in half an hour, persuading predominantly female life science researchers to become entrepreneurs.

It strikes me that on balance, being a female, techy entrepreneur is considerably less stressful than being a parent. Many, many women leave well paid jobs armed with little more than breasts to take up the mantle of childcare single handed, whilst dad tries to keep his eyes open at the desk job. The woman is left on her own at home with an incredibly valuable, challenging, essentially unpaid job, 24/7 with no training. Not getting it right first time is really risky. If you sit and listen to Margaret Heffernan (http://www.mheffernan.com/index2.php) and I am lucky to have done so on more than one occasion, starting and running a company is remarkably similar to having children. So how is it that when asked, many women would not start their own company, citing the challenges of fitting this round children as one of many imagined barriers? If you’ve even considered having children or actually managed it without the intervention of social services I cannot think of anything more invigorating and suited to your skills base than starting a company.

I digress. Whilst I am persuading a fabulous scientist to pursue her dream, my husband is watching my daughter’s internal organs being examined by ultrasound. I return to the ward at 3pm, for the changing of the guard (dad does actually have a job to go to) and to hear my girl declare herself as “losing the will to live”. In practice this means it’s time to eat a KitKat (other forms of dental decay inducing, chocolate based life forms are available). Having eaten baked beans for lunch I can’t help thinking once again that my daughter’s diet since entering hospital and sitting in bed all day has not exactly been ideal for intestinal disorders. My daughter spends much of the day having 1:1 art tuition with an amazing woman and has already amassed a sizeable collection of plaster of paris artifacts that need painting. An educational assistant keeps walking round and remarking on our daughter’s maths skills. I wonder if she is officially employed by the hospital for frequent flyers/long stay car parkers; simply volunteering, or whether the nursing staff have just given up on trying to get her to leave the building.

5pm, and a mere 7 hours after the ultrasound has been performed, all internal organs are declared fit for purpose (in words of one syllable of course), if not swimming in a little more fluid than is normal, by another surgical registrar. They’d still like to keep an eye on her for another night. Smiling, the doctor leaves. Staying, my girl bursts into tears. I text my husband and warn him we’re going to need warm bedclothes and another spare change of clothes. My girl has supper – a jacket potato with a side order of potato wedges. They have no soup, and the ice cream is “the same as school’s, I’m not eating that”. *sigh*

7pm that evening, dad turns up with a second overnight bag to do a swap for the nightshift. The bag contains no change of underwear for our daughter and no change of clothes for me at all. He has brought the film Maze Runner on a USB stick, chocolate brownies and our daughter’s duvet. He holds up our eldest son’s sleeping bag for the arctic parents’ room and offers to stay the night. I let him; at least as far as his knees, he’ll be warm. Youngest son wants to stay and watch the DVD. There are many problems with this, not least the fact that this is not going to fit into the free 20 minutes parking allowed. Despite looking like the mutant lovechild of Metal Mickey and a Nintendo Wii, there is no remote control for the “Starlight” system. As a result, it’s almost impossible to hear the film from two foot in front of the screen, and my daughter has already watched the first half hour twice as a result of hitting the stop button on the front of the player, but without being able to hit fast forward on the remote. This lack of remote control is slightly dampening its promise of “brightening the lives of seriously ill children” emblazoned on the side.

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To be honest, it’s a blessing in disguise as Maze Runner is not entirely appropriate for the 6 year old girl in the bed next door (or our youngest son for that matter) and we’ve killed another half hour of time with the DVD repeat. I manage to tear our youngest son away from playing with the bed controls and take him home in time to avoid a parking fine and to pick up the eldest son from cubs.

9:30am Day 3 and I’m back on the ward as soon as the school run is done. This was a slightly prolonged affair as it involved 1) a lot of parents asking after our daughter (lovely); 2) the receptionist remarking on the fact that the educational assistant up at the hospital had already called and informed them that our daughter had been discharged (inaccurate, slightly creepy and in breach of confidentiality somewhere I’m sure) and 3) a friend asking if I can watch her son for 15 minutes later that day (a walk in the park after the last couple of days especially given the laid back nature of their son compared to ours). Back at the hospital and again, in the magic 20 minutes allowed by the ruler of free parking, I hand my slowly defrosting husband a cup of tea and he leaves for work. In reality this involves telling him that I have left the tea on the desk at reception as you’re not allowed hot drinks on the ward. Hot food is barely allowed in, it’s only fair.

A few minutes later, just as I am preparing myself for a long haul DVD watching/bird drawing/heart painting session and texting the parenting classes’ teacher to let her know I can’t make week 2 of 11, the surgical consultant shows up with a whole clutch of green student medics flurrying in his wake. They all remain silent while he barks at one blue clothed doctor for the blood test results. Armed with data, the anomalous, raised results are read out to a reception of total apathy. A little bit of excess peritoneal fluid is also unimpressive if you’re female, apparently. So, with that, we are free to go. They are happy to keep her in for longer but if I am confident to keep an eye on her at home, she is officially discharged. My daughter is already putting her shoes on and hobbling, bent over in slight pain, for the door. I reassure the consultant that despite not being medically qualified, I have a suspicion I might be just fine. He smiles, calls me a proper Dr, and provides cursory details on what circumstances would warrant returning. I walk half way round the hospital to pay the additional £12 parking fee, with coins, no cards accepted, no change possible. If anyone in the family is seriously ill now they are in grave trouble as I have just blown my job seekers allowance at the same rate it was accrued solely on parking one car.

What did we learn:

  • My daughter, when asked, “how are you?” now answers with a number on a 0-10 pain score scale as she has been accustomed to doing at two hourly intervals for the last 43 hours to generate a lot of completed forms for nurses.
  • There are a LOT of things that your body can do that will baffle the most senior of medics and for which an army of tests will be inconclusive. You will be absolutely fine.
  • It will have cost the NHS several hundreds of pounds to complete 1 and 2 for which I am eternally grateful, but also feel could have been better spent somewhere else. Perhaps on some training on managing customers’ expectations; subtitled “how not to lie about how long all NHS processes take and report past events as a false guide to future ones”.
  • Don’t google your symptoms, simply follow the scheme below:

Do you need to attend A&E? (Follow these instructions at your own peril)

Have you had an accident that has caused your limb to be seriously bent at an awkward angle, NOT where it normally bends?  If yes – go to A&E.

If no, have you had an accident that caused your parent to go white as a sheet, as though they are very scared and/or sick and they are trying not to cry? If yes, lie them down, reassure them everything will be fine, administer tea and wait for a bit. If you were able to do this without hitting a 10 on the pain scale, i.e. the worst pain imaginable, take paracetamol, neurofen and savlon as necessary and stay at home with a DVD player with a working remote control.

If you have not had an accident, but are in pain; as they say in Big Hero 6, “woman up”, at home. Take paracetamol and neurofen as necessary and watch your temperature. If your pain reduces, even slightly, after 30-40 minutes and your temperature remains normal, the drugs are, on this occasion, working. Rest, perhaps with a DVD player with a working remote control.

Do you have a high temperature, vomiting, pain and diarrhoea? If yes, you probably do need to go to A&E and there will probably be a sign on the door saying that anyone with a sickness bug is not allowed on the ward. Pack a decent overnight bag with you, using an ascent on Mt Everest after a long haul flight with airport parking paid in cash as the guide for the quality and quantity for the contents.

Take a seat!

~ drjfernihough ~ Leave a comment

*sigh* it’s that time again – you know, the one that comes round annoyingly twice a month and involves signing your name and swearing on the badly photocopied piece of paper that you’re looking for work, when not wasting your time in  the job centre. Today was “Spring into action Jobs Fair” day though. Be still my beating heart, I can hardly contain my excitement. I was told this would be a compulsory part of my signing on though, so I turned up especially early. So early in fact, I had to queue to get into the building as soon as it opened. This is 10am, for anyone who thought that the job centre might ironically have normal working hours. I even managed to avoid the eye of the security guard-come-receptionist-without-a-desk as I went in, thereby avoiding having the pointless conversation about which of the other two beige painted floors I was heading for, the one with bad carpet, or the one with domestic abuse posters everywhere. Unfortunately avoiding the eye of the security guard also meant I avoided getting a sheet of badly photocopied paper that told me what Job Fair company stands were located on what floor of the building. So, up to the domestic abuse I floor I went to hand in my “work plan book” for signing on. Still early for my appointment, UF (unnamed female – never engage with the unwashed, remember) grabbed my work plan, turned her back on me and barked at me to take a seat. That was tricky, as all the seats had been removed to make space for a jobs fair. I’m going to have a small rant about the value of following a process when it’s there to help, whilst still allowing space to use your own thought process when it doesn’t, in this and my next blog, there doesn’t seem to be enough made of this balance in life. So I stood and waited. As it happened, I was stood right next to the First Group stand, staffed by people who took one look at me and also turned their back on me. Apparently, I do not look like a potential bus driver. It’s a shame. I was once overcharged for a bus ticket for my youngest son, making the journey more expensive than a taxi. When I pointed this out to the driver and requested a refund he closed the door on me. Not, closed the door after I left. No, he physically closed the door on me with my body in the doorway at the time and called the police. When I wrote to the managing director of First and complained I was offered a month’s free travel on the buses. I politely declined his generous offer. I avoid using the bus now, particularly since taxis are cheaper for a whole family and cycling is cheaper for just me, but I would have loved to have asked the recruitment guys what the officially training manual recommended under such circumstances. I gather from the managing director that the driver had at all times followed the company policy process by not giving me a refund at the time.  Alternatively, as a regular train commuter for 14 years, for over an hour every day, I could have asked them what training they provided for staff who were struggling to be “on brand”.

Anyway, my musings were diverted by a very kindly looking UF who asked me if I would like to take a seat. I smiled and said I didn’t. She looked panicked but managed to give me a sheet of badly photocopied paper and asked me if I knew that there was a Jobs Fair on today. I thanked her and remained standing. Still clearly concerned about my height perhaps, she pointed out 3 occupied chairs approximately 3 metres away. As she explained, these are nearer to where my name would be called to sign on and perhaps I’d like to sit over there. I took two steps towards the chairs and she seemed happier, at least she stopped asking me to take their chairs. James then called me to sign on and once I had sat down, he said, “well I can see this will be a quick one”. Unemployed and at the job centre; surely, this is the only time that phrase can be welcome. Eight signatures later and I’m even registered on the electronic system. Farewell use of my Montblanc pen on alternating Wednesdays. Perhaps I should offer to do the cost analysis for the benefit of the electronic system over paper and pen. Then again………… I don’t think they could afford my day rate with all the money they’ve spent on domestic abuse posters literally papering every inch of the beige walls and electronic signing systems.

So, duly signed on, what to do with 15 minutes to kill before going to the cinema? Ask the nice people at the Learning Direct stand if they provide software coding training of course.

So, what to do with 14 minutes and 50 seconds to kill before going to the cinema? Ask the Firebrand guys what their IT skills training looks like. As an aside, I feel the need to explain my IT interest further…… I went to a very old fashioned, all girls, private school that was sold off to Roedean during the recession. The land and buildings were then sold again, presumably because the sum of its parts held more value than the whole as an educational establishment. When the school was established over 150 years ago, its mission was to turn girls into young governesses. When I attended, until 1989, its goal seemed unchanged. The school certainly did not envisage a world where writing an app would be a more useful skill for me to know than the art of choux pastry. I digress, in short, Firebrand’s training looks expensive. I asked if there was any funding available from the government to attend their courses. The very smart and helpful man looked at me, perplexed. Perplexed is better than panicked, but no more informative. “We’re a commercial company, the only money the government provide for people to attend our training courses is through an employer taking on an employee, who then attends our courses”. I didn’t have the energy to point out that if the company was paying for the employee, I failed to see how the government was involved at all. I did point out that everyone he would be meeting at the Job Centre today would be unemployed, so he may struggle to sell courses, for which you either need £2,450 or an employer.

It didn’t matter, he’d already launched into a description of a two year apprenticeship which would start by placing me at the first level of customer service for people with IT queries. I have a mother and two parents-in-law, I feel I have enough experience already to skip this step and thanked the man for his help on the apprenticeship, but perhaps that wasn’t for me. He continued, however, telling me that as an apprentice for two years, my employer would pay for me to go to Cambridge and attend several quite intense residential courses, the longest being 9 days duration. I gave up. I have a PhD and MBA and at times like this, you just have to bring them out, both guns firing. I pointed out that “intense”, and “long duration”, was not an issue, but the requirement to be several hours drive away from home for days on end, with three children to look after before 9am and after 3pm, every day, was more of an issue. Eventually I managed to extricate myself and left the domestic abuse floor.

I was briefly tempted by the first floor stands – waitressing, kitchen jobs, care in the community, housekeeping and landscaping jobs. I even briefly flirted with the idea of signing up as a volunteer “to assist in the care of people with brain injuries”. However, I figured that if I didn’t have any patience with the job centre staff this was unlikely to be a forte. Instead, I drove out of town to watch the Second Best Exotic Marigold Hotel. This is a very predictable, but quite beautiful film, portrayed by a stunning range of actors, demonstrating that with determination and enthusiasm, there is no time or place in your life that prevents you from starting a new career: you just need a supportive environment.

Cycling and petting for the disabled

~ drjfernihough ~ Leave a comment

Don’t worry – it’s not that kind of blog, at least not yet, I will explain…….

Today I cycled into town. Before you get excited about this and start sending me information on Lycra and padded shorts and nutritional supplements to help me rehydrate/revitalise/recarb or reload protein or whatever you’re supposed to do; I am not about to threaten any government recommendations for getting fit just yet. Twice in a week is probably the most cycling I will ever manage and I can hardly lay claim to an energetic cycling style. In fact I suspect psyching myself up to do it burns almost as many calories as the cycling itself, and this is my main issue with exercise. Realising at half past midday that I hadn’t got any tuna for supper despite promising to do this, and having fully psyched myself to the max, I had to get a very quick lunch out of the fridge to give me enough time to cycle to and from town (and be back at the school gates, of course at 3:15 for the obligatory cake sale). I am sure this weekly extraction of money will pop up again in future posts, I digress. As my middle son is away on a school trip I realised I could could eat his carton of covent garden pea and ham soup (other liquidised green goo is available) and replace it before he got back. A whole carton – don’t pretend that half a carton is a serving, Covent Garden – has 270 calories. It’s positively skinny. So, how many calories do you burn cycling 10 km in total into and out of town along a very flat canal path? Well, mapmyride has 58 different bike ride options to select from when calculating this pressing issue, and thank god one of them is “hybrid cycling – shopping/errands”. It’s almost like they knew I was headed for Waitrose. Total estimated calories burned for a woman of a certain age (44) and weight is 329. I haven’t done the maths yet, but I’m pretty sure the white and milk chocolate chip brownie I ate as a result of being starving when I got home had slightly more than 59 calories in it. According to another site I found, if I keep up this level of cycling, (presumably without the brownies) I could get my BMI down by a couple of units into a more healthy zone in only one year. One year! I’m going to struggle to do this for more than one week. I’m not going to visit that site again.

So, once in town, I was intrigued to see a man outside Waitrose, standing by a Shetland pony shouting, “for local disabled kids”. Now, I wondered whether he had astutely realised (or read the metro on many occasions) that most people don’t give a monkey for disabled kids close to them, never mind ones far away; OR, that unless your disabled kid needed to be carried literally just round the corner and back, the pony wasn’t going to make it with those tiny legs. As a fully able person, the last time I tried to get on a Shetland pony as young (tall) girl, I half mounted, half stepped over it. The result was crumpled girl on the ground on the other side of a Shetland pony.

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It turns out that this is a petting pony for disabled kids. Again, I have issues with this. Simply because you can raise money for something, stood next to a shrunken, fuzzy pet, it does not mean you should. Alternatively, at least work out what you are going to do with the money first. In reverse date order, my youngest disabled son has petted the following three animals in as many weeks:

1. Very flat, dead frog, found just outside the house. Begged me to take it home after showing it to all his friends at school and the teacher refused to keep its fragrant body in the classroom.

2. Slow worm in the garden: awepic (cross between awesome and epic). Conversation followed for hours about how much of a slow worm, or normal worm for that matter, you could cut off its owner before you got one or even possibly two slow worms to grow back.

3. A hissing cockroach at the zoo on the basis that it would probably feel nice, but in fact felt stickily and hissed (go figure).

My middle son, also disabled, pets our cat but drew the line at the hissing cockroach. He was probably hiding his disappointment that we had turned up hoping to see a scorpion and he was still waiting for an answer as to why snake skins, when shed, are not as colourful as the snakes they came from. Perhaps my sons have the wrong kind of disability for petting Shetland ponies? Perhaps you have to be wheelchair bound to feel a warm fuzzy glow from a warm fuzzy pony and have your world improved beyond measure for a brief moment. Now I know Shetland ponies are not the most expensive of horses to own (who’d have guessed? What did we do before Google), but I wonder how much net worth Mr shouty Shetland got for the kids today. He felt obliged to give me a sticker for capturing the photo above which I wore with pride, but this too must eat into some pretty meagre margins.

I can’t help thinking that Mr shouty Shetland could have spent the time helping every other disabled person I know fill out the appeal form for having their Disability Living Allowance benefit turned down, a lengthy process that takes 11 weeks for the Department of Works and Pensions simply to read your letter. Perhaps there’s something we don’t know about the reading age of DWP employees. It’s a great way of lowering the benefit budget, how long will it take to do something after they’ve read it I wonder? Anyway, helping with DLA admin may have been of some practical benefit, rather than roasting the poor animal in the sun for a few hours.

After all that I did check with my youngest son on the merits of petting a Shetland pony. It would be great he said, “better than a hissing cockroach”.

Back to school learning to be a parent

~ drjfernihough ~ 1 Comment

For those of you new to this page, I am going to explain why I have ended up in parenting classes weekly from now until mid-July this year. I have a charming seven year old son called Connor who has ADHD, you know, that syndrome that’s basically extra-naughty-and-we-should-discipline-him-more-disease. On top of this he has Oppositional Defiance Disorder (ODD), which is medical speak for saying NO, all the time.  When he grows up (Ha!) this combination frequently ends up being labeled manic depressive or more accurately – bipolar. Now, the specific labels are really handy, because for ADHD it means that people can feel really much better about themselves as they look down on you for being a bad parent whilst reassuring me that my son will, of course, grow out of this (statistics show he won’t). The ODD is a great label for letting me know that really clinicians have no idea what to do with ODD.

So, as an example of what the ADHD/ODD combo can achieve;  I drop him off at holiday club, give him a kiss and cuddle good bye and ask for his especially awesome behaviour as I am planning a lunch meeting with a friend 70 miles away from home. One hour (and a daily £30 fee) later and I am being called by the manager to take him home. Connor has run off, and once the assistant caught up with him to stop him running into a building site, Connor kicked her and called her a fucking idiot. I am reassured by Connor that he learnt the swear word from a kid in Class 7, not us.

Fucking marvellous.

For especially awesome behaviour like this, on many occasions in the past, we have been referred to CAMHS (Child and Mental Health Services). A very well meaning woman at CAMHS has done two things for us:

1. Attended a meeting at the school for 3 hours where she did and said absolutely nothing at all apart from mentioning that she had never met Connor. (We haven’t seen her since)

2. Forgotten that she met Connor at a previous appointment when she took him away from Mark to ask him questions away from the presence of a parent.

To get a referral again to this amazing support service (but presumably with a firework up the proverbial from a consultant to do something slightly more constructive) we need to prove we have tried everything else first, hence parenting classes.  “The Incredible Years” program that is delivered for this purpose gets glowing reviews in America where it is run for 21 weeks. In the UK, there isn’t funding for the program that works, so here it lasts “only” 11 weeks, a schedule for which there is no statistical positive evidence of an effect. Anecdotal evidence suggests that many parents who complete the course express relief and become more confident, realising that their kids are normal. I have been warned this may not be the class for us. However, the first session was yesterday, so off I went, open mind and all that. As an aside, because the classes are held on the opposite side of town where the new Lidl is being built, I decided to combine this class with a renewed attempt to get fit so cycled over there; something I have not done for about three years. The only lasting impact of the first session is my arse hurts.

I digress……………… the class itself………………..

Apparently it’s really bad form to blog about a classroom filled with parents trying to do a better job. The concern is that anything stupid I say or do may be posted on Facebook – by someone else. I know, ironic. So despite so much great material and the suspicion that someone was texting the class live throughout the whole two hours I am going to have to stick with my observations from the book written by the woman who established this class in the States, Carolyn Webster-Stratton PhD. She has a whole chapter in her book on tangible rewards, incentives and celebrations. I quote from p63:

“Rewards should be given for positive behaviours after they have occurred. It is helpful to remember the “first-then” principle. That is, first you get the behaviour you want, then your child gets the reward.”

As I’m in the mood for it now, I shall refer you to another very valuable source of information on rewards and incentives, from Daniel Pink. Daniel Pink is described by Wikipedia as the author of five books about business, work, and management that have sold two million copies worldwide and have been translated into 34 languages. The quote below is from his book, “Drive” but also from a great TED lecture he gave that has been watched over 13 million times. http://www.ted.com/talks/dan_pink_on_motivation?language=en
“These contingent motivators — if you do this, then you get that — work in some circumstances. But for a lot of tasks, they actually either don’t work or, often, they do harm. This is one of the most robust findings in social science, and also one of the most ignored.”
I can’t help but put two and two together here and think that if the circumstances under which “if/then” rewards work are the relatively simple situations encountered during the whole of early childhood, we really are doing an excellent job training a whole generation for the world of work:
if then

pernickety

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This blog is pretty much a shrine to pernickety, but today even more so. All I have done all day (9-3 for those of us enslaved to the school run) is set up this blog. So I am delighted that  Wordpress in its wisdom allows me to share this fact on Facebook with a seamless click of a wireless mouse. And yet…….. what gets posted is the generic “About” page found on a blank template. *sigh* If you were brave enough to click, find the real page AND come to here, well done.

The only interruption to my day of new blogging has been the postman who needed me to sign for a box marked “collection only”. Don’t even get me started.

In other news, after another 3 pages of HP photo paper and 12 images later, I think I may have a passable passport photo for my son and me. Time and £118 fee will tell.

New email. Simple. February 24th 2015

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Need a gmail account for my new company – simples – go to Google. Get half way through the interminably complicated procedure of demonstrating that I own my own domain and realise that I am actually going to have to host my web page somewhere to show that I own it. I build my web page and transfer hosting domain. In this process, I discover that a) I now have superior technical app development and software coding skills that I’m not sure I will ever use again until the moment I forget how to do this and b) my web hosting provider is cheaper than Google for a google email address. Buoyed by my new skills, I apply for a gmail account with my web hoster only to be told that Google still thinks I want this domain and has an account open for me, they can’t give me a second one. Enter the neverland of google app account deletion (I am now a jedi software manager) and receive an email to say I don’t exist. Brava. Log back on to web hoster and get the same message again that Google thinks I STILL have that domain, but they will refund payment, honest guv. Log back into Google with Bath gmail details to enter the neverland again, but can’t do that, because my Bath account isn’t an administrator account, I’ve deleted my company’s administrator account and don’t exist any more, yah boo sucks to you. This all started because I logged on to register for VAT and the form asked me for my company email address. Loving the paperwork vibe this week.

Ratio of qualifications to images produced on an HP printer

~ drjfernihough ~ 1 Comment

Combined skills of two PhDs and two MBAs and 18 images on 9 sheets of photo paper later, we still haven’t got A SINGLE F*****G PASSPORT PHOTO PRINTED FROM THE HP PRINTER!!!! Calm………. This always happens. I think the easiest solution now is to paint my face orange with multiple vertical lines down it whenever I need to travel internationally. For now, I am going to reheat sticky toffee pudding.

Signing on incompetence never ceases to amaze me (April 8th 2015)

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Today I had my appointment rescheduled by someone over the phone, so they started by asking me some security questions to check they were talking to the right person. 2 out of 3 of these questions were “when did you start claiming, roughly, and what day do I normally sign on?” So that narrows down the number of people who can fraudulently sign for me to about 300 Facebook friends then. At my new allotted time I walk in to the building and fail to miss the eye of the security guard/receptionist-without-a-desk. They always start a conversation by barking the name of the benefit for which they think you are claiming. Under hypnosis I couldn’t tell you any on the list I’ve heard but they’ve never guessed job seeker. Perhaps I don’t “look like a job seeker”. I was then told I wasn’t signing with Richard as Richard is never there on a Wednesday – I make the mental note to try harder to avoid catching the eye of the security guard in two weeks time as I am directed to the same place I have gone for over 3 months. Now 2 mins late I then wait another 15 minutes while the 2 security guards/receptionists discuss across me, almost out of earshot, incorrectly, my appointment time and what might have happened to the staff member to cause the delay. At no point do they update me. Now the fun starts. Unknown Female (remember they never reveal themselves to us) calls me over 20 mins after my nominal appt time. She asks me how my search is going. I make polite conversation about how terribly wonderful everything is. She then changes her tone and tells me in no uncertain terms that I should be signing with the same person each time. I point out that this is something only they can sort out and is well beyond my control. She repeats her command that I should sign with the same person each time. I remain silent. She then invites me to take the time to use the electronic signing pad for the first time. It’ll take a little while to train it, she says, but she’s clearly excited that I will then be able to sign on it rather than paper for all my next visits. I feel only a slight pang of sadness as I see that my montblanc pen go unused (Shirley Mitchell will understand). Training involves signing my name 6 times. I notice there are pen marks on the screen from where people have actually tried to use a pen rather than the stylus hard wired to it. *sigh* The machine hangs on the last go and we’re obliged to start again. Anyone who has signed their name repeatedly 12 times will now recognise that an Icelandic banker could have walked in and done a better job of my signature towards the end of this process but at least the system hasn’t hung. I have time to wonder that if they trust a glitchy electronic system to differentiate fraudulent signatures rather than humans with eyes and fuzzy logic processes and an ability to ask for ID if they don’t recognise the person who has presumably been signing with just them for weeks on end, it doesn’t bode well for the humans. I then actually have to sign on with the system. I read the commandments, scroll down the screen and touch “sign document”. UF nearly has a fit and asks me to read the text first. I point out I have, she says most people read slower. I point out that if you have a PhD and an MBA you learn to read quite fast. The electronic system now asks UF what my “new claim” is for and she is paralysed into inactivity, for I have the weary air of someone who is clearly not a new claimant and the computerised system has completely let her down. She folds a piece of paper in half, dates it, and hands it to me to sign. I pick up my montblanc pen……….