A Word on Bravery Certificates ...

I had another lightbulb moment today - a truly privilidged experience of "walking in my patient and their families shoes" and understanding the very importance of the impact healthcare professionals can have upon those under their care.  For a while now one of my guiding principles has been an inspiring quote by the great writer Maya Angelou.  She said:

With that context in mind, for those who do not mix in paediatric healthcare circles - let me explain the principle of a "bravery certificate".  A Travel Health Nurse specialist describes bravery certificates as "one of the most popular items nurses like to use when seeing children".  It's very true.  In my 13 years qualified as a nurse, I have seen again and again how important they are to the young people and their families.  But largely within the NHS - they are often seen as a "luxury" that a nurse can only personalise for their patients if they have time.  Sadly the comment I often receive if I am taking time to colour in a bravery certificate for my patient is - "well you obviously aren't busy if you have time to do that".  I understand that comment - in an NHS often consummed with bed numbers, targets, waiting times and so on - a "little" thing like a bravery certificate is seen as unnecessary.

But here's what made me re-energised in the important part they play in the overall experience for especially children and young people and their families - twice this week, and from two different families, I have been able to find the time (usually during my break) to colour in bravery certificates for my patients and have given them on discharge.  And both times I got the same comment from the families;

"Oh wow - look at that "Billy" - we will frame that and put it on your wall!".

Let me make it clear - I am no artist.  My colouring is poor and I sometimes step outside the line.  It is no masterpiece worthy of the National Gallery!  So why this response I wondered?

My reflection leads me to believe that it is quite simply that this certificate reinforces to your patient and their family the fact that you - their nurse - have thought of them as a PERSON - not as a bed number.  The very little bit of colouring demonstrates that you have taken a little bit of extra time in your busy day (and your patients know you are busy - they are mostly watching you!) to express your admiration for the bravery they have demonstrated.  And I think that by giving them this little gift along with their discharge paperwork - you are showing that you recognise they and their families have been through a great deal in coming into hospital and going through the procedure they have or the treatment they have.

My call to nurses is - it doesn't have to be bravery certificates.  It's not about "what".  It's about "how you make them feel".  It is the little action of showing your patient and their family that you are recognising they are people, they have their own individual stories and hopes and fears and aspirations.  It shows that you recognise them coming into hospital is a big deal for them (and possibly scares them rigid) and you care about that and their feelings.

So don't think "it's nothing - it's not important" as yes - bravery certificates can't be quantified, and don't meet CQUIN standards for NHS Trusts.  They are important I feel, because they make a difference to the patients and their families at that moment in time, and improves their patient experience ten-fold.  And that is the one opportunity we have.  Chief Nurse of NHS England - the wonderful Jane Cummings - always says "we only have one opportunity".  And back to my opening quote from Maya Angelou;

"They may forget what we said, they may forget what we did - but they will never, ever forget how we made them feel".

And as nurses - our NMC Code of Conduct binds us - we MUST put patients first!

To Strike - Or Not to Strike? That is the Question ...

There was a fascinating discussion on the Nursing Times twitter feed today which I eagerly took part in.  It was centered around the debate as to whether nurses in the United Kingdom should consider strike action over the on-going pay dispute.

For those non-nurses among us - simply put, nursing and midwifery pay in the UK has effectively been frozen for the last 5 years or so, and the small increases when they have come have been so below inflation that they effectively equal a pay cut.  To add to the anger among my colleagues - it doesn't help reading about MP's voting and awarding themselves pay rises of considerably more.  Or (closer to home) perhaps some senior NHS managers receiving also larger pay rises.  A further note of discomfort for many colleagues is that our regulator - the NMC - is consulting to raise our yearly registration fee from £100 to £120 which is mainly use to hold Fitness to Practice panels often resulting in nurses being struck off over doubts over their capability.

Nurses are angry.  That is common knowledge.  But is striking the best way?  I responded a strong "NO"!  I've suffered too.  I had to take out a loan to renew my NMC registration this year.  My hero - Nursing Times Editor Chief Jenni Middleton commented this to me;

It made me take a step back and think.  Am I disgracing my profession and colleagues by such a standpoint?  Should I be marching with placards out in the street?  Are the government really cackling in glee at such a "naive" view as mine?  But here's my issue.

The Code of Professional Conduct - which defines myself and all colleagues as a nurse or midwife says this;

"The people in your care must be able to trust you with their health and well being. To justify that trust, you must make the care of people your first concern".

In it's closing statement to the "Mid-Staffordshire Public Inquiry" chaired by Sir Robert Francis, the Department of Health submitted this key statement:

"The patient should be at the center of all that the NHS does".

So before I personally consider strike action - no matter how angry I or colleagues may be - the patient must be considered!  Now a couple of unions have proposed variations on a complete strike.  What about emergency cover only (such as firemen often do)?  But here's the rub.  What constitutes "emergency" cover for the patients under my care?  Let me walk a few moments in my patient's shoes.

• What about the young person admitted to Surgical Daycare for the insertion of a Hickman line?  He has just been diagnosed with leukemia and needs to commence chemotherapy.  I guess the insertion could be cancelled - but the longer his chemotherapy is delayed, the longer the potential for spread.  I would argue that procedure constitutes an emergency for that family.
• What about the young person who has an outpatient appointment with a cardiologist - she's been having "funny palpitations" but as yet undiagnosed.  Without an OPD nurse, that appointment could be cancelled.  But the fears and worries for that family that their beloved daughter has a heart problem needing heart surgery would constitute an emergency in their case.
• What about the disabled child with learning disabilities who has been waiting months for an appointment to be fitted for a wheelchair?  They have been getting sore and uncomfortable and have outgrown their current chair.  Without that nurse-led appointment they may have to wait months more.  To that child and family - it's an emergency.

I am aware this very personal view may be seen as a "betrayal" in my colleagues eyes.  I will understand if some unions vote - and indeed go on strike to protest the unacceptable pay decisions imposed upon us as a profession.  But at present - I just cannot see myself personally and professionally accepting going out on strike.  The trust of the patients and their families just mean too much to me.  I have read the complete "Francis Report" and I think the actions of a few have brought the nursing profession into disrepute.

This doesn't concern me - it challenges me!  It is up to us - and me - to re-gain that trust and that respect from the public.  Patient by patient.  Family by family.  And I fear that strike action would further damage the profession I so love.

A Review of "Little Stories of Life and Death" by Dr David Drew

I don't often review books on this blog - but this book was and is an exception.  It is very important to me personally for a number of reasons:

• It is about child patient safety - something both Dr David Drew and myself have dedicated our lives to.
• It is about injustice - something that I cannot tolerate personally or professionally.
• It is about endurance - the story doesn't always end with a happy ending.  But has the story ended?

A few words about how I came across Dr David Drew.  I am an unashamed social media advocate.  Yes I do believe it can be used for harm, and can (like any medium) be misused.  I am grateful as a nurse - to my regulator the Nursing and Midwifery Council - for not blanket banning use of it but promoting professional use.  Any nurse, midwife, doctor or Allied Health Professional must bear in mind at all times we can be called to give account for what we say, write or do.  But the massive benefits of social media mean a far wider social and professional network beyond your immediate workplace.  So it was due to Twitter that I became familiar with the account of Dr Drew and his whistleblowing account, and difficult personal and professional experience at the hands of Walsall NHS Trust.

Haven't heard of Dr Drew?  This page is the best summary with links to appropriate news articles.  The most heart breaking link is this news report concerning baby Kyle Keen.  "Little Stories" - Dr Drew's autobiography - is dedicated to the memory of baby Kyle.  It can be objectively argued that his professional difficulties began when he argued that the manner in which baby Kyle died was unacceptable and should not have happened.  But for more detail on that - you will have to read the book.

Here's what struck me about the book:

1.  Dr David (and all HCP's) is first and foremost HUMAN and have stories.

This book is published at a time when our beloved NHS is coming under a lot of criticism (much of it deserved) because NHS professionals are sometimes not giving their human patients the respect, dignity and care that they deserve.  Much of this inexcusable care is often delivered because a basic human fundamental truth is being forgotten - PATIENTS are HUMAN BEINGS (Mid Staffs and Winterborne show an appalling demonstration of this).  But we must not forget that NHS professionals are human beings too - there's a reason why we ended up wanting to care.  And when that duty of care fails - is anyone asking why?

So I urge and encourage and recommend the first few chapters of "Little Stories" because Dr David writes candidly and honestly as to how he "ended up" in medicine.  I very much found an affinity with him because like him, my parents did not actively encourage me into nursing.  I ended up in nursing quite by accident.

Throughout the account of "Little Stories" - I found myself being drawn time and again to the pain and agony that Mrs Janet Drew must have gone through - living Dr David's pain as an observer.  Again it is something I am hugely familiar with.  In a way healthcare professionals families can suffer uniquely because they have to watch (and not understand) the pain their loved one experiences being mistreated at the hands of their employer.  All they can do is watch.  Their healthcare professional loved one must walk it alone!  And for that (as has been said before) Mrs Drew is very much the heroine of "Little Stories" for standing and walking by his side - what a wife!  What a hero!

2.  Dr David cares passionately about his patients.

Any reader of "Little Stories" - whether they be critic or supporter - cannot deny (I feel) that Dr David cares passionately about the patients under his care.  The quite incredible case of extremely low temperatures on the paediatric ward due to facilities failures demonstrates his concern greatest.  I was gripped by his account of getting up during the night and coming in to direct equally concerned night nurses to ensure electric heaters were distributed appropriately and babies were clothed with woolly hats.  

His heartbreaking account of Baby Kyle - and the healthcare failures that led to his premature death - again demonstrate this beyond doubt.  The reader can easily get into Dr David's head and ask; "Could I have done more?".  To any healthcare professional reader - who has gone through the agony of losing one of their patients, this will be familiar territory.  While death is an accepted part of life, something within our very souls rejects it as abnormal and wrong - particularly in the paediatric world.

I noted particularly - in scouring the Employment Tribunal hearing of Dr David, that the Trust did not once claim he did not care about his patients.  Their claims were directed elsewhere.  The Nursing and Midwifery Council is making this statement key in it's review of the Code; "Make the care and safety of those in your care, your primary concern".  Dr David did this - but confusingly he paid an awful price for it.  The reader must ask - is this right?  Is this just?

3.  Dr David won't give up if patient safety is at stake.

This is the issue for all whistle-blowers I feel - and it is an issue that the Department of Health, NHS England and perhaps the Government have yet to grasp.  They are not trouble-makers.  They are not makers of "toxic culture" - ridiculous phrase.  They - we - are simply people who care desperately about the best for the patients and families under our care.  If they - we - see politics or bureaucracy interfering or hindering that care, then they - we - get mad.  And the whistleblowers - Julie Bailey, Deb Hazledine, Dr David Drew, Sharmilla Chowdhury and so many more - are mad people.  They are not mad because of loss of income, indignity, reputation - no, they are mad because of loss of due right to the patients under their care.

I am ashamed to say there was a part of me that was inwardly begging Dr David to accept the gag bribe that Sue James - the CEO of Walsall Manor - was offering him.  It would have provided temporary safety and security to his family and would have ensured a "happy ending" - that he and Walsall Manor parted company.  But THE hero moment of the account of "Little Stories" comes when Dr David comes home and reports the gag offer to Mrs Janet Drew and his sons.  Her response?

"If you accept that money - I will divorce you".

His sons response?

"If you accept that money - we will never speak to you again".

THAT is family!  THAT is support!  I leapt and whooped in my chair while reading it.  I am ashamed to admit that if I were in Dr David's position, I suspect some of my family may urge me to take the gag offer for the simple results of immediate financial security and peace.  But as healthcare professionals we have a duty to constantly ask ourselves - yes, but is our patients at risk because of our actions?  Dr David rightly noted that his patients WERE at risk if he compromised to the offers from Walsall Manor.  So he didn't.  At his personal detriment.  I hope that Walsall Manor have learned from that experience, and I hope desperately that patients are far safer today than ever before.  I don't know.  But I hope.

But I closed the chapters of "Little Stories" absolutely without question - a true NHS Whistle-blower who really cares for their patients will NEVER accept a gag offer - if the safety and security of their patients is left at stake.  And whistleblowers and their supporters hope and pray the day is coming when the government, the Secretary of State for Health and the Department of Health are wakening to the fact that the safety of our patients will ALWAYS be of higher concern than the "reputation" of any NHS organisation.  Let's face it.  Any "reputation" of ANY NHS organisation based on spin and lies and not on true fact of patient safety - really isn't worth the paper it is written on.

So in conclusion:

I cannot commend "Little Stories" highly enough to you.  If you are the Chief Executive of an NHS Organisation then you need read this.  It may save your career.  You may save your organisation and "political face" in the short term.  But you are managing people.  And truth will out.  Stand for truth - and you will be respected.  Hide - and spin - and you will never escape.  If you are a healthcare professional - nurse or doctor - then you need read this.  It will make you ask the question: how much am I willing to sacrifice for my patient's well being?  Am I willing to remain silent to their cost?  Why am I in nursing or medicine?  And if you are a parent, family member or patient - you need read this.  We who are looking after you are human.  We are fallible.  But the most of us really do care.  So let us connect with you.  Tell us your fears, your hopes, your dreams.  We want to help.  We want to care.

Phil Johnson speaks against Celebrity Christianity

I am not normally a staunch proponent of John Macarthur or the Shepherds Conference (see previous posts on "Strange Fire") but I am so grateful to Todd from Dubai for this.  He is right - it's excellent, and something I am becoming increasingly convinced of as a great error and problem in evangelical Christianity at the moment.  I say that as one who spent years almost worshipping "heroes" in the faith.  The whole sermon is well worth a listen to!


May add some key quotes shortly.

Life after "Strange Fire"

I've made no secret of my struggle to maintain interest or passion in theological/spiritual matters this past year or two.  I still believe in God (not so sure about the church thanks to past experience).  But this is a work in progress - certainly not an unfinished story.  A few issues sparked my interest - for example, John Macarthur's "Strange Fire" conference of a few months ago.

A brief history with Macarthur:  As I was growing up in Dunstable and discovering an experiential relationship with God, my church and senior pastor were going in polar opposite directions.  And Macarthur's "Charismatic Chaos" was the instruction manual flogged around Dunstable for that.  I have always fervently believed my pastor Stanley Jebb's motto that; "the unexamined opinion is hardly worth holding".  So I read "Charismatic Chaos" and found it thoroughly interesting.  It didn't persuade me in the slightest of anything - apart from human beings are human beings and make mistakes.  Oh - it also persuaded me that John Macarthur was a throughly negative, unpleasant individual who was having a nasty effect on the pastor and my church - and it was something and someone I didn't want to be like in the slightest!

So the mention of "John Macarthur" usually makes me roll my eyes.  That's why when C J Mahaney started preaching for Macarthur - some reformed/charismatics were thrilled and thought it meant Macarthur was "softening" in his anti-charismatic views and maybe the bald-headed one was impressing him with his sense.  Rubbish.  All "Strange Fire" proved was that in fact Mahaney is taking the same path my pastor in Dunstable took, and is taking all possible steps to reject charismatic life in his church (apart from apostolic authority - in all but name).  A quick glance at Mahaney's "church programme" proves that - no room for the Holy Spirit there!

So I was interested today to find a You-Tube video of Macarthur speaking about the follow-up from the "Strange Fire" conference.  He has taken a lot of stick (quite rightly) for his harsh and intolerant suggestions that charismatics are not Christians.  This is his answer - and essentially he sticks by his views.  Another book is promised to answer his critics (around 26 minutes).  But what particularly interested me was Macarthur's taking on of Dr Martyn Lloyd-Jones and John Piper in particular (38:12) - namely that pastors and preachers have NO business seeking an anointing or unction from on high to preach!

Astounding.

Here it is;

Sing It Louder!

I was thinking a lot about mental health issues today thanks to the great "Time to Talk" focus day this week.  One account particularly moved me - that of "Time to Talk" campaigner Johnny Benjamin - sharing his experience of how he almost threw himself off a bridge in London but was saved by a passerby.  It struck, worried and moved me how awful the reality of suicide is - and how surely it is OUR responsibility as a race to try and protect our own?  NO-ONE should feel so lost and alone that they end their lives!

So what keeps us going?  What keeps us living?

I have considered suicide myself personally this past year - I confess it.  Things just got "so" bad that it occurred to me as a distinct possibility.  I know that psychiatrists consider the risk of suicide greater if "there is a plan".  I had a plan.  I kept on living for a largely negative reason - I did not consider the cause of committing this final act "worthy" enough to do so.  It's not perfect but it worked for me!  The fact is that life serves good times and bad times.  And I have learned over the past year or two that rather than just "keep hoping that life picks up" - it is wiser to enjoy the good and use it as a foundation to work through the bad.

I got a little revelation today as to one of the reasons why I "keep going".  It was listening to one of my favourite song tributes to my adored and revered Her Majesty the Queen; "Sing".



The lyrics in question that moved me immensely were;

"There’s a place, there’s a time in this life when you sing what you are feeling, find your feet, stand your ground, don’t you see right now the world is listening to what we say? ... You brought hope, you brought life, conquer fear, no it wasn’t always easy, stood your ground, kept your faith, don’t you see right now the world is listening to what we say?"

What occured to me is this (and bearing strongly in mind; "Time to Talk" campaign) - one POWERFUL reason to "keep going" - is that there may be others out there who are encouraged, find strength, find hope from the story that we tell.  I shared a tweet the other day about the reality of living with an anxiety-related disorder.  It's horrid.  But if by speaking out - I can encourage or remind or tell another person that they are not alone and are not alien or weird - then surely I must do it!

There is a reason for keeping on living - and keeping on going.  We do not live alone in isolation.  If we live or die - this does have an impact on our fellow human beings!  And we have the opportunity to affect the world we touch by the words we speak!  So my hope and my aim right now in life is to try and take courage and speak out honestly about problems and solutions.

If it were one day to save a life, or to even just encourage someone that they aren't alone - that would make the ups and downs of my life ALL worthwhile!

Keep singing!

How Her Majesty the Queen helped me survive these past 1.5 years.

Dedicated to every brave soul who daily choses to continue living - even if it means facing demons, hardship and heartache.  Dedicated also to the fabulous Rev Dave and CEO Lisa who together gave me the bravery to speak out and put pen to paper.

It is amazing that even in the 21st century, it still isn't very easy to speak openly about mental health issues - particularly on a personal leveMORE empathetic and compassionate rather than building walls and de-personalising our patients!  Somehow anyone within the NHS, there is a ridiculous notion that "we are professionals and shouldn't struggle on this level".  But the unspoken reality is that the NHS is wonderful because it is staffed by human beings who do go through similar problems to the patients and families we see on a daily basis.  That reality should make us

My own personal background was somewhat more complicated by the fact that I came from an extremely fundemental religious background where mental health issues were particularly disapproved of, and usually put down to "sin" on some level.  When I first went on antidepressants some 10 years ago for a time, I didn't dare tell my parents for some years - as it was seen as an admission of "failure".  I have seen my General Practioner and various Occupational Health services through work pretty regularly - and the clinical feeling is that I am not "depressed" per se - I apparently tend to struggle with "chronic anxiety".  In short - I daily seem to imagine up (I have a very vivid imagination) all sorts of fears, worries and panics about what life may bring.

The last year and a half has been particularly rock-bottom in terms of experience, health and work.  Two or three times I did in fact consider suicide and whether it really "was all worth carrying on".  Those low points were often prompted by events I read, such as the tragic account of the nurse involved with the Australian DJ scandal while Prince William and Kate were in hospital expecting Prince George.  Reading that account made me feel an affinity with the nurse - but in a ludicrous way, a rather morbid wondering if I also committed suicide whether the Chairman/Chief Executive of my workplace would make a statement to the press.  I decided they wouldn't bother - and somehow found that enabled me to "keep living" that particular low day.

But the benefit of this year has meant that I have been forced to confront some of my worst fears headon - with no support, help or alternative.  That's a story for another time - but what I found was that actually - my imagined fears were WORSE than the reality!  But what I wanted to focus on in this post was what enabled me day by day to "keep going" this year.  And that was the person and example of Her Majesty the Queen.  Before you snigger - let me explain why.

I am sure there may be psychological reasons why the Queen means so much to me personally.  I lost both my beloved Grandparents at significantly low times in my life to cancer, and both losses affected me deeply.  I guess there may be a degree to which I long for a "Grandmother" figure.  But Her Majesty's example has meant more than that this year.  It is well known and commonly cited that her life motto is;

"Duty first - self second".

When Her Majesty was 21 she made a monumental speech in South Africa where she committed her life to;

"I declare before you all that my whole life whether it be long or short shall be devoted to your service and the service of our great imperial family to which we all belong".

Her committment to duty has ruled her life and service - even if at times it has meant that her family life and personal life has been affected as a result.  Many commentators (and we never know what Her Majesty herself thinks - as she does not give interviews) suggest that call to duty is something that has remained with her, and has driven her throughout her life and reign - to the present date, her amazing 86 years of age and her now-over 60 years of reign.

Let me make it clear - I do not equate myself in ANY way to Her Majesty the Queen in ANY sense (other than to count myself fortunate to be one of Her subjects).  But what remained with me throughout this blackest of years, was initially a thought - does Her Majesty the Queen ever get down or low?  And this wondering grew into an interest that lead me to reading many of the biographies written about the Queen, and the difficulties that have beset her (especially her famous "annus horribilis" year and the year where HM lost both her beloved mother and her sister) - yet continued to perform her duty.

Her Majesty's personal difficulties are made worse by far because they are so often in the sight, criticism and debate of the press and therefore the public of both the United Kingdom and Commonwealth.  At the very least any personal problems I have, were able to be limited by myself to the people I trust and were able to depend on (and to them - a few in number - I owe them a debt of gratitude I will never be able to repay!).

While working through - day by day - the blackness, the lowness and utter desolation of the past year - at times, it was quite simply the fact of seeing Her Majesty the Queen at an official function (I follow several blogs that track and report the Court Circular) that gave me courage and conviction to try and "live the day".  At times, this was as pathetic as leaving the safety of my flat and walking to the corner shop to buy a pint of milk.  It sounds ridiculous to write this - but my mentality was;

"If Her Majesty can go to yet another engagement despite the wealth of possible aches and pains she may have as an over-80 year old, smile constantly even though she may not feel it, and shake umpteen hands even though she has done nothing but for the last over 60 years of her reign ... then surely I can put clothes on, leave the flat and do a simple task?".

That simple role-model and mentality enabled me to gradually build and grow in confidence, activities - and as a result I found my mood and outlook on life improving, my determination to work through my difficulties strengthen, and focus my goals beyond just "surviving the day".

It is for this reason I will never fail to be grateful to the unfailing example of Her Majesty the Queen.  The couple of visits I have been SO fortunate to make to Buckingham Palace only served to enhance that.  It is why I am a Royalist through and through!  I know this example will not work for everyone who suffers with anxiety, depression or any other mental health disorders.  But I do think it underlines the importance when you are struggling so hard to "keep living" - sometimes it can be the most simple or obvious of things that help keep you "living"!  It could be a family pet that needs feeding.  It could be a planned outing in a few weeks time.

The majority of the victims of suicide almost invariably state; "they ran out of hope".  So for us - as NHS professionals - one of the key responsibilities upon us is to help find that hope (and it will be individual to each person).  But we can only do our job well and effectively - if WE are honest about our struggles and experiences.  Small things such as a "thank-you" from a Chief Executive or a line manager can change the complete "mood" of a working week!  More importantly - cared-for staff give better care (it is widely acknowledged - I cite an excellent PICU Intensive Care Consultant as an example) so it is vital that if NHS staff do share mental health struggles and issues, they are supported and not vilified or patronised (as has sometimes been my experience).

Positive thinking (in my opinion and experience) is absolutely vital to "keeping on going".  For many of my 36 years of living - I thought that positivity and happiness was a reaction to the experiences that life forces upon us.  If life was going well - then I was happy!  If it was going very ill - then I was not.  But I have come to realise and understand (thanks to Twitter friends - in particular Kath Evans, Head of Patient Experience for NHS England and her friend 'Engaging Emma') - that in fact positivity and happiness come from "within" and are a state of mind that can be increasingly immune to life's changes and events!

My conclusions?

1.  Life isn't fair or just.
2.  We all have a choice - to continue and fight or opt out.
3.  We can all chose to benefit from our experiences and use them for good.
4.  There is always hope - even if it is the smallest glimmer (such as the Monarch carrying on her duties!).
5.  The night cannot last forever - the dawn does comes, even if it seems forever!

A View of Things That Matter

This blog post is dedicated in particular to Julie Bailey, Deb Hazeldine, James Titcombe, Liza Brady and Dr David Drew - among so many other whistleblowers.  It takes tremendous courage to speak out and "rock the boat" - courage perhaps more than I possess.  These people have suffered unbearably but want - only the best.  We need to hear from them.

It's been on my mind to write about the last year's public opinion of the NHS for some time.  The important whistleblower revelations of Mid-Staffs, Morcombe Bay and others have broken the rose-coloured fallacy that the "NHS is perfect because it gives free care to people who need it".  That is true and it is wonderful.  But the NHS is made up of imperfect human beings from the porters and domestics who enable hospitals to run, to Chief Executive Officers who lay down vision.

As is common in human behaviour, we tend to hold opinions of extremes (I hold up my hands and admit I personify this!).  If we do not love something passionately, we hate it with a vengance - particularly if wronged by it.

It particularly troubled me to see the horrendous backlash against key whistleblowers such as Julie Bailey and Deb Hazeldine, James Titcombe and Liza Brady.  For those unfamiliar, these two ladies lost their beloved parents in the most appalling failures of care and were not giveNOT just treat "the patient".  That "PERSON" comes as part of a family - and care given to them (whether good, bad, excellent or dreadful) will impact upon the closest people to them.  A caveat: I can somewhat understand why a lot of the backlash comes from the people of Stafford who face losing their hospital.  They are looking for a scapegoat, and inevitably (I suppose - however unacceptable) will look to the whistleblowers.
n the answers and reassurances they deserved - and so began to campaign.  The NHS and health professionals owe them a debt!  They are a reminder that we do

But I want to ask - does anyone mildly rationale think these two ladies - Ms Bailey and Ms Hazeldine EVER considered "becoming campaigners" or "whistleblowers" five to ten years ago?!  We must consider why fate led them to this.

1.  A Step Back and Pause for Thought:

Over this past year I have had a lot of time to think, read and consider the NHS as something incredibly important to me.  The availability of the Mid-Staffordshire Inquiry has enabled in depth reading and consideration of the mistakes and errors and lapses in communication.  In particular I wanted to read the accounts of families like Julie Bailey and Deb Hazeldine to learn and ensure that in my experience - this would NEVER happen again in my human power or sphere of capability wherever I work.  I was seized by a comment Deb Hazeldine made in her testimony to the Inquiry that I think it incredibly telling - she made it early in the complaint (point 25);

"If Martin Yeates had been up front and honest in the first place, I would have walked away.  I just wanted justice.  If he had said; "Hands up, it's bad" but could demonstrate in a robust way that it wouldn't happen again - I would have walked away secure in the knowledge that vulnerable people were not at risk".

I would hesitate a guess that virtually all families who have suffered unjustly or through human error would be actually satisfied with a swift, sincere apology and evidence of real lessons learned and proof that identical mistakes would not be made - would be enough.  I wonder if we can allow for the fact that whistleblowers have happened - because one of the human errors of the human NHS is that we collectively haven't been good at admitting error and learning from mistakes?

When I was at school (a private Christian religious school run by my parent's church) we used to have reports on our progress - both academic, but being religious, also character.  One consistent character point I scored very badly on was called; "Responds Well to Correction".  I can only assume at heart at that point I was an intensely proud and/or stubborn character as I consistently would score; "Needs Improvement".

This is an error I have somehow (I am not sure how) been keen throughout my life to remove and hope will continue to do so.

2.  Applaud the Good but Admit the Bad - and Learn and Improve from It!

There was a report in the Independent today that somewhat ignited the difference of opinion about the NHS.  Sir Mike Richards - the Chief Inspector of the NHS - wrote and commented favourably about the NHS.  He said;

“Compassion in the NHS is alive and well.” And then with extra emphasis: “We’ve also seen some really excellent care.”

This surely is good news?  But on Twitter again opinion was divided.  Those desperate to see the tide of public opinion turn on the NHS highlighted the story and applauded it.  The whistleblowers still seeking "something more" were justifiably concerned - all is still NOT well in the NHS and there is a great distance still to go.  The Sir Mike article states it itself;

"It is what I hoped I would see,” he adds. “But seeing is believing.”

There is a reason that I love reading the Birmingham Children's Hospital Foundation Trust Parent and Carer Feedback page on their website that collates feedback from the instant "Feedback Application" (Award winning!).  It demonstrates so clearly that feedback and performance change.  Some days the NHS gets it very right.  Some days the NHS gets it very wrong.  We are human.  We change!  But as long as we are transparent, live, love and learn - surely there is hope?

I for one - as a proud current NHS healthcare professional - promise and pledge here and now to devote the rest of my working life (up to 70 now I believe!?) to ensuring the patients and families under my care NEVER have any cause to have to raise concerns about the standards of my care.

PEOPLE matter.  End of.  FAMILIES matter.  End of.  And it is our (my) everlasting privilidge to be able to care for some of these vulnerable people when they need it most.  That expression of trust must not be ever let down.

Not WHAT we do but the WAY we do it

I am having a lovely relaxed New Years Day (mainly sheltering from the West Midlands grotty rain!) but hav been "seized" again by a comment made by a patient on a programme I am currently watching.  Having been away from critical care nursing for so long - it is frustratingly agonizing to watch the various ER programmes available and long to be involved!

The programme in question this first evening of 2014 is "Kings Cross ER: St Vincents Hospital" in Sydney, Australia.  11 years in nursing doesn't stop me watching with my toes curled as the ER team treated a poor young man who got stabbed in a nightclub in Sydney.  An ultrasound revealed that the knife pierced the left ventricle and he was bleeding out into the pericardial sack.  The cardiovascular surgeon was too far away by car to be present to save his life so the ER team looked as though they were going to have to perform the life-saving procedure by mobile phone.  Fortunately the young man managed to cope until the surgeon arrived and he was taken to theatre.

The next programme showed our young man re-admitted with possible infection and shortness of breath - and it was a thrill to see he survived the trauma!  However I was fascinated to note the one comment he made about his awareness of the life-saving surgery he had.  He said this;

"I remember hearing the voice of a lady doctor.  She kept telling me I would be okay.  She sounded like she had the voice of an angel".

It struck me again as we enter 2014 - healthcare workers have a UNIQUE privilidge in what we do in caring for patients and families often at their lowest point.  And yes - our patients and their families arrive at the point of care needing something - the care they can only get often from us.  But my point is this - the WAY we deliver that needed care is something that will stick with them for ages to come - far more than the care they needed.  We need both!  From Chief Nurse Jane Cummings "6Cs" - care and compassion run hand in hand.

A good New Year's resolution for all of us who may have the privilidge to care for patients in 2014?!

Another Take on "Making Every Contact Count"

To those non-NHS types, forgive me for another "care-orientated" post.  Much of the last two years have been massively dominated by my nursing role and my proud membership of the National Health Service - and hence my blog does tend to represent my current passions.  I do still maintain my theological/spiritual interests and have a few subjects brewing - but this one is a post that could not wait!

"Making Every Contact Count" is a very important initiative in the NHS at the moment - we are realising that as health professionals we have a unique position of serious responsibility and privilidge with the patients under our care and their families.  Mistakes in the NHS have been made in the past where care has been delivered but not in the right way.  One of my NHS heroes - Chief Executive Officer Sarah-Jane Marsh said (in a CEO briefing at her Children's Hospital in Birmingham);

"It is not just what we do that matters, but the WAY we do it".

Consider nervous parents accompanying their young child to have their tonsils removed - a relatively minor procedure in context.  Imagine if the surgeon did his job and removed the necessary tonsils, but their entire hospital experience was negative.  Say the surgeon was brisk, rude and dismissive and the nursing staff pre-and post operatively did their job and monitored the child but gave the parents and child no compassionate care and support.  The objective may be achieved - removal of tonsils - but the family and child could and would be scared by such a negative experience.

THIS is why it is not enough to simply have competent NHS staff treating the patient.  We MUST have compassionate and caring (AND competent!) staff who support and defend the patient and family from admission to discharge ensuring the whole point of contact with the NHS is positive.  "Making Every Contact Count" is a vital initiative used in the Birmingham Children's Hospital at present;



But I did find myself wondering if many nurses, student nurses and allied health professionals like myself struggle to come to terms with what actually; "every contact" means?  Does it mean if we are simply taking our parents a cup of tea we should sit down and commence a sermon on smoking cessation?  Surely not!  So it was while thinking these matters through that a common motto came to my mind;

"When a butterfly flaps it's wings in Texas, it causes a tornado in China".

This is in other words known as "Chaos Theory".  It is technically defined as; "a minor change in circumstances can cause a large change in outcome".

I am not entirely sure if healthcare professionals are entirely aware of the enormous potential of their actions (and contact) with patients and their families - whether positive or negative.  The Mid-Staffs scandal demonstrated the hideous enormity of negative contact - and it is a nightmare the NHS should NEVER forget.  But something the Chief Nurse of NHS England - Jane Cummings - is vitally reminding the negatively-biased media is that POSITIVE experiences also have a crucial impact.  

Many nurses (and I have been guilty of this in the past) have come to work at times bringing "home life" with us.  Aches, pains, heartaches or simple headaches - have meant that we as healthcare professionals have not been "properly" operating in the "6Cs" framework we should to truly impact our patients and families for the good.  It may seem little to us - a more formal sober greeting of our families after handover and perhaps a distinct lack of smiles and easy small-talk during the shift than perhaps we may do.  This may seem like just an "off-day" to us.  But what of the impact on our patients and their families?  That "off-day" may be their ONLY contact with the NHS during their lives - and the impact they take away is our lack of smiles, care and - presumed - lack of motivation to give them the patient experience they need.

When a butterfly flaps it's wings ... a tornado happens.

When a nurse smiles at a patient and family (even though his/her heart may be breaking due to a recent family dispute) a positive tornado of change and impact happens and that family may leave the hospital or care setting with a positive experience of trust and confidence in the NHS.

When a butterfly flaps it's wings ... a tornado happens.

When a nurse sits with a devastated, bereaved family and is seen to visibly shed tears, that family may leave the hospital knowing that they were cared for (even though the outcome was not what they hoped) by a human being who was impacted by their loved one.  The loss - still and always devasting in the extreme - will be tempered by the fact that they did not suffer it alone as though on a factory production line ("when's the bed available?") but as an event that impacted the healthcare professional with them at the time.

When a butterfly flaps it's wings ... a tornado happens.

When the worried and anxious family sitting in the Accident and Emergency Department, so concerned about their loved relative suffering beside them, are brought a cup of tea by the nurse and an apology for the wait and an explanation - suddenly the nightmare fear that "they just don't care" evaporates and the slight reassurance (though the concern for their relative remains) that humans are in charge and that they are not just another number in the queue potentially breaching their "targets".  But the experience they take away is that they are told and explained that the department is horrendously busy and prioritisation of care is taking place, but their relative is not forgotten and is under observation (even though it does not seem it) - ANY deterioration in health will be responded to swiftly.

When a butterfly flaps it's wings ... a tornado happens.

The devastated parent sitting with their terminally ill child on Christmas Day looks up as yet another nurse comes in to deliver the required chemotherapy (even though the parent knows it will make the child sick) the difference cannot be expressed if the chemo nurse comes in smiling and compassionately open to what the child needs and does his/her utmost to deliver the necessary medication but with the right approach.  That effect will last with them forever, just as a rushed, brutally efficient but distracted nurse who charges in, injects the medication and rushes out without comment.

When a butterfly flaps it's wings ... a tornado happens.

A family sits in a busy Outpatients department worried sick about the appointment with the consultant.  The results are in and in a few words they will be told whether they have a positive, rosy future full of hope and promise - or further worry, dread, more appointments, "maybes", "I hope" and other subject phrases spoken by healthcare professionals.  The Outpatients department is running drastically behind schedule and the worried family know they are now 30 minutes behind their appointment time.

To be approached by an Outpatients nurse who sincerely apologises for the delay, explains the reason and asks if they need anything (an English cup of tea never goes amiss!) will create a tornado of effect, even if the news from the consultant is negative - as compared to a stressed, harressed nurse who is charging around (to the family's view - and they DO see everything) accomplishing little - who then snaps that; "Dr So-and-so will now see you.  Quickly!".

There are many, many more examples and scenarios that could be cited and may ring true with healthcare professionals across the NHS.  But I hope the few examples that have come to my mind will prove my point.  I believe fervently as current HCP in the NHS - we must, must, MUST never forget that we are in a position of ultimate privilidge, trust and opportunity.  

Every action (whether it be a smile, a story read, a hug, or a cup of tea) can have a far greater wave of impact upon our precious patients and their families than maybe we will ever know.

It is our responsibility, duty and joy to ensure that we do not just deliver "competent" care (although that is vital) but we deliver such care in a compassionate manner that thinks ahead of the actual care delivered - and anticipates and expects that our patient and their family will leave the NHS and the care with an overwhelmingly positive experience that they can remember for a long time.  Even if, tragically, the care delivered sees that precious and beloved relative not coming home - let our precious families go home knowing that their relatives were treated with the highest dignity, compassion and care possible and that they did indeed die in the "best hands possible" with their families by their side.

When a butterfly flaps it's wings ... a tornado happens.

The Human Beings Behind the Trust Boards

I am writing this short blog post inspired by a tremendous friend I have yet to have the privilidge to meet (awesome Twitter effect again!).  Rev Dave is a chaplain in Worcester and he runs an outstanding blog celebrating the good news stories within the NHS.  This is something we both feel PASSIONATELY about and have spoken of much.  Much of the media focus on the NHS at the moment is negative - and perhaps rightly so.  There have been awful cases of unforgivable poor care and we must learn, take responsibility and make every effort to ensure it never happens again - and as NHS privilidged staff we REALLY make every contact count.

Rev Dave was published recently in local media writing an article about his local Trust Board that profoundly impacted me because of it's unique slant and his passionately, positive attitude shining through.  So I want to reflect somewhat similarly on my local Trust Board at Birmingham Children's Hospital FT.  I could write about many NHS Trust Boards that I have watched through the wonderful medium of Twitter and the new transparent accountability it brings (national heroes of mine include Chief Nurse of NHS England, Jane Cummings, NHS Employers CEO Dean Royles, Patient Experience Lead for NHS England, Kath Evans and of course - never forgetting Sir David Nicholson, CEO of NHS England himself - among many others such as the wonderful CEO of South Tees FT Professor Tricia Hart).

But many of us in the NHS work locally, and it is therefore obvious that most of our contact and observation is to our local Trust Board.  I have been MASSIVELY privilidged as a mere Band 5 staff nurse to perhaps have a little more contact and observation from afar of the BCH Trust Board than others (mainly through the wonderful participation I used to have on the BCH Flufighter Team).  So like Rev Dave - I want to write personally as a frontline nurse on what I have seen of the BCH Trust Board and the people who carry responsibility for the hospital.

One word about salaries - it is, I supppose obvious, that in the popular critical culture of media coverage of the NHS, that some spotlight is put on the salaries of Trust Boards.  This is guaranteed to raise my blood pressure and incense me beyond words.  Here's why.  A quick Google search through the Financial Times reveals that CEOs or Directors in the private sector earn ridiculously more than NHS Trust Boards.  How can you compare a salary of $4.1million (salary of the CEO of Barclays) even with the current salary of the CEO of NHS England?!  One CEO of course takes responsibility for the money passes through an organisation.  But NHS CEOs and Trust Directors take responsibility for HUMAN LIVES.  And they are paid far less for that responsibility.  I have said before - and again - I never resent them a penny, who can imagine the pressure they are under for running our hospitals?

So - the Trust Board of Birmingham Children's Hospital Foundation Trust (in similar vein to Rev Dave - let me tell you some stories):

Chairman Jo Davies: (I must add BCH have been ably cared for by acting-Chairman Keith while Chairman Jo was away and I understand they are looking for/interviewing a new Chairman).  But my first real contact with the pinnacle of our Trust was breathtaking in real humanity!  Chairman Jo was eager for her #flufighter jab, and I was invited to her office a few years back to give it.  I was on full, "political correctedness" mode but she breezily popped her shoulder out for me and presented, without fear!  Further contacts amazed me with her absolute fierce passion for the BEST care for the children and families coming through the hospital.  I can only imagine the tight rule she had over Trust Board meetings and the questions she would have (somewhat like HM the Queen to encumbent Prime Ministers?) if she wasn't content the best was being done!

But this amazing, force of nature could sweep through the hospital wearing the most amazing coats of a variety of velvet, gold and all manner of materials!  Presence was the word!  But this Chairman could sit happily with the children (most important in her eyes) and talk and laugh with them.  I have no doubt her successor will have to live upto her high standard!

Chief Executive Sarah-Jane Marsh:  Ah where to start with this absolutely amazing lady.  Like the Chairman, my first contact was through promoting the Trust "Flufighter" campaign.  I was amazed at the strong support from the CEO that came through persistently and positively.  Sarah-Jane always was interested in uptake results, and still is to this current day - the amaze current campaign is here!  Through that initial contact I became progressively vastly impressed with her committment to the absolute and best patient experience (this was pre-Francis) for the patients and families who came through BCH.  I seized many, many quotes from various CEO briefings I was fortunate enough to hear that I have never forgot such as;

"It's not just what we do - it is the WAY we do it that really matters".

A couple of times I heard from parents under my care who hadn't had the best experience and were upset about it.  It was without fear, and complete trust that I recommended they contact the CEO Sarah-Jane.  I would tell them of my brief contacts with her and suggested I felt she would care, and would seek to make changes.  One father in particular excitedly told me he had written a 6-page letter to Sarah-Jane!  I did have a brief moment of complete fear and anxiety wondering if my P45 would be in the post!  I was floored to be updated now and then that Sarah-Jane and our Chief Nurse Michelle (more later) had met the father and implemented REAL change from what they had learned.

One final unforgettable encounter with this amazing woman - I had the amazing opportunity to meet Sarah-Jane just before Christmas (related again to flu I think) and she asked me genuinely how my substantive work (then as a PICU staff nurse was going).  I related to her a very tragic account of being so privilidged to care for a family who were going through the tragedy of facing the withdrawal of care on their poorly child and palliative care for them.  I was stunned to see visible tears in her eyes as she connected instantly with the pain and anguish a family was going through who she had not met.  I have never forgot that.

Chief Nurse Michelle Mcloughlin:  The CEO Sarah-Jane quite rightly refers to Chief Michelle as; "a force of nature".  Patient Experience Lead Kath Evans refers to her; "Can do - will do" attitude!  This so accurately represents a role model in the most excellent, highest standard of patient care and experience delivery - I have been privilidged to meet.

Once again, my first real contact with Chief Michelle was through the contact of the "Flufighter" campaign in 2009.  I was amazed to find that Chief Michelle had expressed her wish to become an "Immunisation Champion" and join in immunising staff.  This was highly unusual around the time - typical NHS practice was to run campaigns via Occupational Health services.  Chief Michelle was key in spreading the positive message of flu vaccination to top consultants who previously may have avoided frontline immunisation nurses.

My later contact with Chief Michelle before leaving the Trust was focused around patient experience and in particular the importance of play therapy and input for our patients.  I again was Patient Experience Application" which has won several awards - and also the "Dignity Giving Suit" - which I think is the most FANTASTIC innovation for giving dignity to young people ever!
amazed at her passionate focus on improving and exceeding everything in the Trust that could be affected and improved.  I caught that vision, loved it, and it remains with me to this day.  Like Sarah-Jane - the CEO - Chief Michelle has been one of the main hero impacts on my nursing career.  Since being away from the Trust, Chief Michelle has been influential and behind the "

Chief Medical Officer - Dr Vin Diwakar:  I have always have had something of a tremendous soft spot for expert clinicians.  This comes from, I think, my esteemed and expert uncle - Dr Andrew Long (Consultant Paediatrician at Great Ormond Street Hospital FT and head of the London School of Paediatrics as well as being on the Board of the Clinical Ethics Team).  Dr Vin has more than earned my tremendous respect and admiration again - all through the accounts of his patient experiences.

As a Paediatrician, Dr Vin Diwakar has cared for and built up a tremendous rapport with many of his patients, and I have heard that many of them have his personal phone number so they can seek support and help if they need it.  He manages to balance his Executive and clinical duties somehow (who knows how!?) and is seen frequently on ward rounds, but also of course at Board meetings promoting patient interest - and the vital role of safety in the Trust.  Just as per Chief Nurse Michelle, Vin strongly supports the Trust "Flufighter" campaign and was pictured this season with Chief Michelle being jabbed!

Chief Finance Officer - David Melbourne: - Non-clinical Directors often receive a less-than-high-profile.  They have no obvious cause to circulate among patients and are often seen to be hiding in offices.  David is not guilty on all counts!  He acted up as Chief Executive while Chief Sarah-Jane was off on maternity leave, but now is frequently seen around the Trust.  I have heard many accounts of his sheer generosity and giving attitude (in an atmosphere of austerity when the NHS should be counting every penny) if it benefits true patient experience.  Quite rightly and deservedly he won the austure "Finance Director of the Year" from HFMA in 2011.

I have no doubt he manages the finances of the Trust sensibly, carefully and accurately - but love accounts where he eagerly invests money if and when it directly benefits the patient experience at BCH.

There are of course, many other BCH Trust Board Directors who I do not have the privilidge to have encountered, but have no doubt (from reading the Trust Board minutes as I do monthly) that they daily defend the importance of nothing less but excellent patient care.  But like Rev Dave - I wanted to highlight the PEOPLE I have had the honour and privilidge of meeting who step up and take responsibility for the care of the precious and vulnerable children a
nd families who are daily cared for by BCH.  I haven't even had the time to talk about the Non-Executive Directors of BCH like Professor Jon Glaseby - who again I am positive carry out a vital role in the care of the children and families in BCH.

They are nothing less than true NHS heroes and want nothing but the best and most excellent care for the patients.  For that they should be saluted!  Of course there will be some "human" Trust Boards who do sadly fail the patients they are entrusted with (such as Mid Staffs) and they should rightly face the accountability of the Secretary of State and the Department of Health and indeed the nation if appropriate.  But until such errors are revealed and proved, Trust Boards across NHS England need our support and thanks as they seek to lead the NHS to do better - and better.  A never-ending journey for the good of our patients.

To end with Rev Dave's words;

"And OK, since you’re asking, (I can’t resist it) here would be my words: expert, professional, passionate, caring, engaging and visionary. But then my Mom always used the quote from Disney’s Bambi and tell me: “If you can’t say anything nice, don’t say anything at all!”

Obamacare and Christians

This blog is a slight detour from my usual ponderings on the Holy Spirit, His Person, His work and His gifts.  It touches on another passion of mine - the National Health Service and the provision of free healthcare to those who need it.  Article 1 of our NHS Constitution reads;

"1. The NHS provides a comprehensive service, available to all irrespective of gender, race, disability, age, sexual orientation, religion, belief, gender reassignment, pregnancy and maternity or marital or civil partnership status".

The key principle for NHS healthcare is Article 2;

"2. Access to NHS services is based on clinical need, not an individual’s ability to pay".

Article 2 is a principle which our Chief Executive of the NHS - Sir David Nicholson (a personal hero of mine) has defended vigorously.  He said;

"The NHS was set up to provide high quality care for patients, free at the point of need".

So it is with that in mind (as my personal context) that I have followed with interest the introduction of "Obamacare" in the USA (a country very dear to my heart).  It seems incredibly similar to our NHS and is something I applaud.  The fact that individuals below the poverty line can access healthcare for themselves and their loved ones is great!  Or is it?  I have observed at times that for a reason I cannot understand - that Christians in the USA do not seem as delighted.

Here's why I wrote this blog today.  President Obama was speaking about "Obamacare" and made some points that again, from my context, I would very much agree with.  He said;

"Nobody should have to choose between putting food on their kids table or taking them to see a doctor".

It was Christian tweeter and renowned cessationist blogger Frank Turk who responded quite quickly and got my brain whirring.  Turk said;

"But they better buy their health insurance before the groceries and from the government, right?".

Other bloggers responding to President Obama made various mentions to their pro-life beliefs as well - which also confused me as to it's relevance to healthcare for those who need it.

So here is my question to American friends and in particular American Christians;

What is the deal?  What's the problem with free healthcare to those who need it?  Can healthcare be so incompatible with Christian beliefs?  After all didn't Jesus Christ heal the blind, beggars, needy - not the rich Pharisees?  So is it so incompatible that Christianity should applaud a civil healthcare system that ensures that those who cannot afford expensive care, can still receive the treatment they need?

I'm just interested - teach me!

Dr R T Kendall on "Why I endorse the Toronto Blessing"

I am grateful that Dr R T Kendall chose this moment around "Strange Fire" controversies - to share this video via his ministry link.

A bit of context: as I was growing up into life of the Spirit and the charismatic movement, I always tended to see R T Kendall as the "negative/reverse" to our then senior pastor Dr Stanley Jebb.  Both were amazing and outstanding teachers of the Word of God.  And both had the potential to hold the wonderful tension between "Word and Spirit" or reformed doctrine and charismatic experience well.  Dr Jebb sadly was put off by excess he saw and was revolted by.  R T Kendall on the other hand was at the same time opening up to the Holy Spirit and the variety of His work.  It was wonderful to travel down quite regularly to Westminster Chapel to hear R T Kendall's ministry during the dark days of cessationism in Dunstable.

So I am glad to hear again a message I am familiar with (having read it in Dr Kendall's books);

The "Dangers" of Charismatic Worship!

I've still been thinking and lurking-reading the continuing "Strange Fire" and John Macarthur controversy.  I do look forward to reading the book when it becomes available in this country at some point.  But the issue Macarthur has with "charismatic" worship does deserve careful thought.  Do the songs we sing and love potentially deceive and lead us astray?  Or in fact do they bring us close to the Throne of Grace and a living encounter with the Risen Son of God?

There are two scenarios I can think of in my church experience.  The more reformed/functional cessationist settings were my home church in Dunstable when Stanley Jebb had taken it out of the charismatic movement and essentially banned all choruses.  We sang hymns and raising of hands was not approved (and tongues were most certainly forbidden!).  The other reformed/functional cessationist situation was when I lived in Bristol and attended the SGM church for 2 years - and most of their SGM songs were "cross-centered".

The other scenario of course has been the charismatic churches I have attended, and the glorious conferences that seek to teach the whole gospel - Cross through to ascension and glorification and outpoured Holy Spirit.  Now cessationists would shudder I am sure at the examples I present - but if you can ignore the raised arms and upturned faces to heaven - hear the words!



I love particularly;

"You have overcome the grave, Your glory fills the highest place - what can seperate me now?  You tore the veil, You made a way when You said that it is done!!".



And this amazing one; "Worthy is the Lamb! Seated on the Throne!  I crown You now with many crowns - You reign victorious!  High and lifted up - Jesus Son of God! The Darling of Heaven crucified - worthy is the Lamb".

How much more Gospel-filled can you get?!  Because the fact is - the Son of God isn't hanging on a cross broken and dying.  So what is the point of "kneeling at the old rugged cross"?  Of course we will be forever grateful for His sacrifice, but like Pilgrim in John Bunyan's classic - that is where our burdens roll away!  We are then free to stand and march on towards the Celestial City knowing that one day we will see Him face to face!

I would just add a final video which I think strikes powerfully at the heart of this "charismatic/cessationist" controversy.  It is by Noel Tredinnick - the Music Director at All Souls Church Langham Place (neither person nor church could be called charismatic in any way!).  But Tredinnick was speaking about worship in particular - the wonderful "Prom Praise" concerts held yearly at the Royal Albert Hall in London.  And he said this (the video is below);

"Now worship is two-way.  Our hearts are being lifted through the music to Christ.  We are adoring Him - we are singing our praise to the living Saviour.  That is one way - the arrow is going up.  But at the same time there is that moment, where God comes down if you like.  The veil of His robe fills the temple - His Presence.  There is a sense of His holiness where God is coming down into our midst - and that is a very exciting moment to behold".


I would suggest that is the issue.  Cessationists want to (as it seems) put God in heaven and leave Him there.  And to suggest that He is not only willing but eager to come down and reside among His people seems to shock and horrify them.  That's nothing new - it was apparent throughout revivals through the centuries.  There have ALWAYS been the rigid prayer meetings continuing to meet weekly to pray for revival, even though outside and around them God is saving souls by the thousands.  It is that eagerness to see God come - I think - which perhaps leads some charismatics to embrace experience that is of the flesh.

But that is no excuse to change one's theology and limit God to what He can and cannot do - as Dr Martyn Lloyd-Jones said quite rightly - the greatest sin of the evangelical church and all that is wrong with "Strange Fire".  As this post was touching on worship - it seems appropriate to end with another version of "The Power of the Cross" sung by Chris Bowater at the (also charismatic) Bible Week - "Grapevine".

A Word of Balance!

I am concious that John Macarthur and his "Strange Fire" conference has provoked me back into blogging thoughts but that I may have become guilty of becoming a "charismatic Macarthur" - i.e. I hate his absolute, judgemental and unloving language (and always have done since the days I read "Charismatic Chaos" in Dunstable).

I was determined therefore thanks to yet another sleepless night to expose myself to Macarthur's broader ministry and thoughts - of which I know not a great deal.  I found this video during a conference where Phil Johnson interviews Macarthur on a few points:



Points of agreement:

1.  The New International Version (in relation to Macarthur being invited to write an NIV Study Bible)

PJ:  It is (NIV) not your favourite translation?

Macarthur:  It is NOT my favourite translation.  The question is ... does anyone reading the NIV actually care what it (the text) means?!

I wince at (again) Macarthur's broad suggestion that all NIV readers are ... less than theological (although I confess to laughing).  I too dislike the NIV and prefer (and always have) the KJV or the NASB!

2.  Mark Driscoll and his comments/book on marriage and sex.

I've never made any secret of being less than a fan of Mark Driscoll.  I have no doubt his unique ministry is spreading the gospel and reaching the lost in his way.  I just hate his macho-school-bullish-rude attitude and behaviour.  His recent publicity stunt at appearing at the "Strange Fire" conference less than impressed me either.  I thought it hilarious that security (he claimed) confiscated his books, but was again shocked he distorted the truth seemingly.  But also his views on the Song of Solomon and marriage - disturb me.

PJ:  You didn't make any recent comment about Mark Driscoll's recent book "Real Marriage" - do you want to?

Macarthur:  Commercialism.  There is such a beautiful dignity to the way the Scripture speaks of marriage, such a precious veiled way in which even the intimacies of marriage are alluded to in Scripture.  That maintains it's intimacy and personal nature and beauty without painting it in commonly used pornographic laungage.  I think these are things that shouldn't be said, don't need to be said and pander to interests in the part of people.  The last thing you would ever want for the people who gather before you to hear the Word of God is to have their minds filled with your sort of uncouth, unclean speech and images that go with it.

There I COMPLETELY agree!  That is the way I was brought up under Dr Stanley Jebb.  That's the way I was raised to view marriage as beautifully portrayed by my parents.

Another fascinating Q and A session I found from the Shepherds Conference focuses around John Macarthur, Al Mohler and Ligon Duncan's preference for using a pen to prepare a sermon rather than a computer!  As a geek - I stand convicted (not that I prepare sermons!).

Excellent Robust Answer to John Macarthur - by Andrew Wilson

I was really pleased to see this robust answer to Macarthur and his "Strange Fire" silliness by one of Newfrontiers (sorry I don't know which "sphere" Wilson fits in these days!) brightest and best theologians - Andrew Wilson from Eastbourne.

Here's the article:

"Unfriendly Fire"

Following my response to the cessationist arguments put forward at Strange Fire, here are three further comments about the content of the conference, after having reflected a bit more on the whole thing.

In no particular order:

“Creeds and confessions.” In his final session, John MacArthur made the extraordinary statement that cessationism is delineated in the “creeds and confessions” of the church. Well: no it isn’t. It’s delineated in some of the Reformed confessions, including Westminster (as Kevin DeYoung explains here), and there are good historical reasons, given the nature of medieval and early modern Catholicism, for the caution expressed by the early Reformers towards miraculous claims. But you won’t find it in any of the creeds: the biblical creeds, Irenaeus’ rule, either version of the Nicene creed, the Chalcedonian definition, the Athanasian creed, the Apostles’ creed, or (as far as I know) any ecumenical creed at any point in the first millennium of Christianity. So while MacArthur’s statement gives the impression of an ecclesiastical consensus stretching from the first to twentieth centuries, what he is actually referring to is a collection of sixteenth and seventeenth century affirmations - as valuable as they certainly are! - amongst Reformed Protestants. By all means, say that Calvinists have generally been cessationist, but don’t imply that the entire church has.

90% of Charismatics aren’t Christians. I have no idea where this number comes from - research, intuition, the clear blue sky - but it is nowhere substantiated, extremely judgmental (what on earth entitles anyone to say that of professing Jesus-followers they have never met?), and strangely self-referential (since a huge number of those who reject miraculous gifts today are not Christians either. I feel certain Richard Dawkins does, for example). It is also a terrible way to argue: it is quite possible that 90% of paedobaptists are Roman Catholic or Eastern Orthodox, but I’m sure MacArthur wouldn’t accept that as an argument against paedobaptism. This silliness needs to be called out for what it is.

Babies and bathwater. One of the dangers of responding to a conference like Strange Fire, ironically, is that its very extremism makes it easy to throw the baby out with the bathwater - which is precisely what John MacArthur himself does with charismatic gifts. Yet when we peel away the inflammatory remarks, unfair representations and (in my view) arrogant judgments which have been made, there remains an important kernel of truth to what MacArthur and others are saying. There is a lot of nonsense in the global charismatic movement. Leaders within it, myself included, do not speak out against much of it with the clarity and courage needed to identify the true from the false. The exegetical foundations for various charismatic practices are much shakier than many believe (the silly link from “they were accused of drunkenness at Pentecost” to “and therefore that legitimates any bizarro practice I feel like engaging in” being an obvious, and sadly frequent, example). The prosperity gospel is a genuine threat to biblical Christianity, and is also much more closely embedded in the global charismatic movement than many of us in the UK realise. It is common to attribute babbling, blessed thoughts and psychosomatic, temporary physical improvement to the Holy Spirit, without discernment or appropriate reflection. And so on. MacArthur and others have, sadly, thrown very valuable babies out with the dirty bathwater during this conference; let the rest of us not copy his example by ignoring the valid and important points he and others have made, or (which would be equally damaging) tarring all cessationists with the same brush.

In many ways, it’s been a sad week for evangelicalism. But if we respond wisely, as many have, there are plenty of ways in which the fire of God will increase, rather than diminish, in our midst. “And the God who answers by fire - he is God” (1 Kings 18:24).