Sunday, 8 June 2014

Guest Blog: When Cagney met Lacey...
...aka Louise & Susan

At the start of Diabetes Week, Louise and Susan are hard at work planning something very special for November.

I do hope you can all support them in their endeavours to make a difference in diabetes care.

So please enjoy the latest guest blog from these two detectives!

A light hearted blog by @louisebrady17 & @SusanMason66 about friendships, diabetes & nursing through the eyes of two detectives....
To set the crime scene, you must have a quick listen to the theme tune!!!

We all love a good detective series.....Sometimes there are parallels between nursing and detective work....... partnership working with colleagues, carefully collecting reviewing and documenting the the ‘evidence’ to inform best practice...shadowing medics, and caring for patients who have been victims of a crime. Detectives know their territory. They can look at a person’s shoes or tire tracks on a car, and know where he/she has been. Nurse’s territory is knowing their patient well... we must find out why are they here? How can we help, what shared goals can we discuss to foster health & wellbeing?

Detectives and Nurse’s must cultivate an eye for detail... In addition, a good cop will observe the landscape closely, whilst nurse’s will refine their communication skills, because every piece of information they discover will may make a difference to that person’s care and recovery.

We know that suspects may lie to avoid incrimination, whereas some patient’s may hide the truth, out of embarrassment, a lack of understanding or cultural beliefs...

Cagney & Lacey was a bold US drama series set in the mid eighties... streets ahead of its time, and brilliantly written. The show itself, seemed to tackle some of the more complex social determinants of health, and covered topics like breast cancer, alcoholism, being a single parent, and the struggle of bringing up children against the backdrop of poverty and social exclusion.

At the centre of the drama, a beautiful friendship develops between the 2 main characters Cagney played by Sharon Gless, and Lacey played by Tyne Daly. To coin a well known phrase... just sometimes, life REALLY can imitate art.

In a similar vein to Cagney and Lacey, and from very different clinical backgrounds, Susan and I meet at the latter end of 2013.. Our assignment came from GP Lead Andy Hershon..(AKA the Diabetes lieutenant) to improve the nursing contribution to local Diabetes care.

Not any easy task, by anyone’s standards... Susan is a passionate diabetes nurse specialist. I am a practice nurse with a special interest in diabetes Care. Like our detective counterparts, the relationship got off to a rocky start... I meet with Susan and the ‘old team’. As is often the case in policing, the initial debate centred on ‘what do generalists actually do for patients with diabetes?’ versus the highly skilled nurse specialist role... Like detectives, both of us value our teams... and were particularly precious of our own ‘branch’. Do practice nurses possess the necessary credentials for the task ahead? (A very diplomatic interrogation!) Well of course we do... but we required ‘backup’ from the specialist branch! We had to focus on gathering lots of information from the chiefs (our patients). This would be the modi operandus, and therefore we deduced that there was no room for ‘rank and file’.

Following some very animated and analytical discussions, about roles, relationships and teams.. We got down to the ‘nitty gritty of police work’.

There was a killer out there (Diabetes) and it was our job to hunt it down... Pre conceptual care being offered in general practice, reaching vulnerable groups across community and hospital, mental health and Diabetes, patient partnerships and non medical prescribing were hot topics.. The pieces of the puzzle were beginning to make sense...We listened and took our ‘clues’ from each other.

Some elements of diabetes care still remained a mystery.. However we had a hunch that if we shared positive and negative experiences and exchanged ideas, we would have some chance at ‘cracking the case’. I learnt all about Susan’s role in supporting the Xpert patient programme, whilst I described the central role of the practice nurse within the diabetes journey, partnerships with patients and the wider community.

We ate..and drank lots of coffee (and tea) in a ‘dingy’ back office (#NHS). This was our de- brief (clinical supervision). We talked about ‘cold cases’ and eventually progressed to meeting in more pleasant surroundings, in the form of local cafe for coffee and cake (minus the cigarettes). There, we hit the pavement running, to hone our observational and critical thinking, gather patient histories and sort through the facts.

Time to review the evidence...

Our newly integrated diabetes team is still in its infancy, but has so far received positive ‘hits’ from colleagues and patient’s alike. There are still many bumps in the chassy.. But we are hopeful that the reports from headquarters (Tameside and Glossop CCG) will be the breakthrough required....

Does this mean that the case is now closed? Not for us.. The plot continues to take sharp twists and turns... Susan and I have fostered a friendship beyond diabetes, where we hook up to ‘chew the fat’. Family, friends, hobbies and foibles, now dominate our conversation. Both of us are mom’s bringing up young men... We both share a love for music; Susan prefers the velvet tones of Canadian crooner Michael Bubble, whilst I subscribe to the Dylan (esk) qualities of Mr Jack Savorettti. Do our inner working relations have anything to do with diabetes care? Not really.. But we do advocate good detective work, through making connections and friendships...

Diabetes continues to be the main perpetrator of many a crime; the landscape requires careful examination, and inclusion of all elements of vital evidence... with patients at the hub of the police department.

No more alibi’s or excuses.. Diabetes care cannot really be ‘policed,’ but needs highly skilled sleuths up and down the country to begin to ‘crack the case’.. As a duo, we have a thirst to continue to help others move beyond traditional ways of working, make connections, and get ‘creative in care.’

In 2014, Cagney and Lacey needed to become far more techno savvy, so we called in ‘The special’ (AKA Dr Amir Hannan) to investigate. With his intuitive powers of persuasion and his technical ability, we were able to the develop a local online forum for networking. We knew we had to examine the crime scene, ‘comb the area’ and encourage more detective work, across our locality...

This assignment is far from over, as there is still much work to do, to achieve ‘the right result’ (patient engagement.. shared learning and opportunities for interdisciplinary learning)... Susan and I started to engage on twitter...Two of the best detective agencies we found reside at @wenurses and #ourD.

Cagney and Lacey’s next assignment comes in the form of hosting a diabetes collaborative event in November, lead by patients, supported by the detectives. As sleuths, we will continue to fight the perpetrator (diabetes) and recognise this is only the beginnings of ‘cracking the case. ‘We hope to become partners with others, build relationships with the wider community, and encourage innovation and creative avenues to improve care.

Please come along to our event in November! We offer fun, friendship and detective work... Tickets and details of the event will be on sale next month... for more information you can DM Cagney or Lacey!