Educating nursing

Changes to the funding system for nursing and allied health professionals is a major shift for the professions. Probably the biggest change since the move to all graduate entry to the nursing register. As such you would expect there to be major conversations and debate going on in health care provider organisations, in careers services, in professional organisations and associations. And there is some of that. However, most of the debate in nursing seems to be focussed on the change from bursary to standard student loan and the potential impact on individuals. As so often, nursing concentrates on ‘What does it mean for me?” rather than “What does it mean for the profession?” The change is both complex and complicated. Too much so for a blog, so I refer you to the Council of Deans extremely comprehensive and useful microsite of information on the whole picture.

I’m an optimist about the pre-registration funding changes. I think people will still want to study nursing at university and be proud of the education that prepares them for a life-long career. I also believe that the bringing of nursing funding into line with other disciplines studied at university says something about nursing being a serious and recognised academic discipline, and that pre-registration education has not been served well by being kept firmly under the control of those who must respond to NHS funding constraints. It has taken many years for nursing to become all-graduate entry, many years for it become established in universities and this move to the student fee system is, for me, an illustration of its acceptance on equal terms in higher education. I believe this is in the best interests of the profession for the long-term. For its value, its status and its recognition.

Much more worrying – and much less talked about – are the reductions in funding for Continuing Professional Development or Learning Beyond Registration. Conversations with colleagues show that the money available for continuing education has been reduced by anything from 40% to 90%, with more reductions to come. This at a time when Registered Nurses are under immense pressure, Trusts need to find ways of recruiting and retaining them, and research is telling us that the better qualified the nurse (i.e. degree level) then the better the outcomes for patients.

It is hard to understand why the development of the existing nursing workforce is such a low priority, and how Registered Nurses are expected to maintain and develop their critical skills without some funding support and time release for formal, substantial education that can help them to develop and change services. Instead they are exhorted by ‘Commitments’ and alliterative characteristics to work harder and do more with less and less. Sad. And infuriating.



If you are interested in the continuing story story of my mum’s dementia care, I’m still blogging about it, but on a separate site here . It was helpful to get those words down on the page, but not appropriate for my ‘professional’ blog pages.  And that started me thinking…

So why isn’t it suitable for my professional blog pages? After all, I don’t keep separate Twitter accounts for personal and professional. I mix the two, and I think it works well, and I’m very comfortable with it. On that particular social media platform it seems okay to show something of myself, to mix professional and personal conversations, to tweet to everyone who might be interested, not just a particular group. But the blog? The personal stuff just didn’t feel right. Too exposing? Too emotional? I’m not sure. I don’t even think it’s the content, I think it might be the context.

The paradox – and the beauty – of Twitter, is that for a platform that is totally open and accessible it feels comfortingly intimate. Once you’ve built up a cadre of regular co-respondents there is a sense of chatting just with them, and a satisfying predictability that whatever you put ‘out there’, someone you’ve come to know will pop up in response. All those random unknowns who may come across your tweets just don’t seem to exist.

The blog, though, that’s very different. More….crafted. Created. Deliberative. The blogs about my mum didn’t fit that – they were too unconscious, too instinctive. Too raw.

I suppose I’m reflecting on where and when to be spontaneous and where to be more restrained, without losing any sense of authenticity. It’s an interesting dialogue with myself as I refine my relationship with social media. I’d be interested in your thoughts, too.


Alternative Reality part 3

After yesterday’s decision, we start the day shell-shocked. Tearful, anxious, worried. I get up late, but from 9.30am the phone rings constantly so getting myself ready to face the day is continually interrupted. A cousin who’s been through all this with my uncle and was brilliantly supportive, my Dad’s cousin who just wanted to say we were doing the right thing and not to feel bad, my brother to say he was feeling unwell but would see us at lunchtime, the OT from the ward to ask about my mum’s most recent level of mobility, the Dr from the ward to ask what exactly happened on Saturday/Sunday. I give up trying to dry my hair and leave it to frizz naturally. I put make-up on though. Armour.

I meet my sister at my Dad’s before we go to the hospital. Dad doesn’t want to visit and we don’t push it. He says he has slept better than he has for two years. He says he is going to walk round the street delivering Christmas cards. Leaving the house is something he hasn’t done for many months. He looks ‘lighter’. We are pleased for him. We feel bad.

At the hospital Mum has been moved to a ward for the elderly. All the staff are trained to care for people with dementia. It feels so different. I talk to the OT I spoke to on the phone. She was lovely. My sister and I speak to the Dr. He has the same surname as us and we smile about it. We go to Mum’s bedside. She is sitting in a chair chattering nonsense to my niece, who is ok but visibly upset at seeing her Nan. We talk to Mum about cake, visitors, drinks and food. The Chief Nurse puts her head round the door and my sister and I go to the visitors room with her. She reminds us what we said yesterday and asks us to remember how we felt and why we made the decision. She says there will be times when we will think that perhaps we could manage after all, but that we should remember how we felt yesterday and that the decision was the right one. We cry. The Lead Nurse for the ward joins us. She reassures us about care, about processes, that Mum will be on her ward for a while before any assessment can be done and we should know that she will be safe and cared for. We cry some more.

We compose ourselves and go back to Mum’s room. She is in bed, the foot of the bed is raised and she looks dazed and sleepy. Her blood pressure has dropped. The Dr with our name is there, he prescribes fluids (she never would drink anything) and we try to get her to drink. My niece is upset but OK. Mum is drowsy, slurred speech, to weak to suck at the straw. Her blood pressure drops further. Her nurse puts in a cannula and sets up an IV. She pushes the fluid in fast. Mum is unresponsive but asleep rather than anything else. Quiet. Peaceful. We stand at the end of the bed and look at her. We are thinking the same thing. We say it. That we would rather she was like this, asleep, fading but peaceful and not angry and agitated and confused. I think we don’t want her to go back to that. We feel bad. We go for a cup of tea.

Alternative reality part 2

Yesterday we made the decision (my Dad, my sister, brother and I) that we can no longer support my Mum to continue to live at home. It was/is a terrible thing to deal with, and I suspect it will be for a long time to come. We know the decision is right for her (and for us) but…

My Mum’s dementia, a major part of my Dad and sister’s lives for the past two years, just got the better of us. She’s in hospital after a marked change in her physical condition (my sister thought she’d had a stroke) but now the round of assessments will start. There’s a long way to go. Periods of almost lucidity mean that there are flashes of the woman she used to be, and we can have a conversation, albeit briefly.Then the constantly repeated questions start, the confusion about her parents, her siblings, where she lives, where she wants to go. Wherever she is, at some point in the day – or night – she will want go ‘home’ and get angrier, and more upset and agitated. Sometimes I’m June, sometimes Anne or Mary (my sister and aunt respectively). My brother John has become Steve (her brother – dead for many years). When we left the hospital yesterday she begged us to take her home, crying and childlike. Before her admission when she was at home, she begged my sister and Dad on a daily basis to take her home too. In her agitation she becomes abusive, strident and accusatory. Fortunately (how terrible to think of it as good fortune) her mobility is very poor or she would be off and wandering. We know the decision is right for her (and for us) but…

Alternative reality

My mum has dementia. She’s 90. She’s had it for a few years now, but the past year has seen marked deterioration. She no longer walks but can manage some fairly unsafe shuffling on a frame, just a few steps. She only eats if food is put in front of her, and wouldn’t drink at all if she could get away with it.  She veers between the present day and anytime between about 1950 and 1990. She thinks her parents are still alive or have recently died and no-one has told her. She wonders who is ‘that old man who’s always in the house?’ – it’s her husband of 65 years. She is argumentative and objectionable with every member of the immediate family. Verbally aggressive and cruel.

My dad is 92. He is my mum’s carer. He has a leaking (repaired) aortic aneurysm, hypertension and suffers from chronic anxiety and depression. He can no longer deal with my mum. She shouts at him, she gets very agitated and he can’t manage her. He says he is going to kill her.

My sister has been doing as much as she can – more and more – over the past year. She spends most the day there and my dad now calls her at night too when mum goes awry – almost every night. She is constantly verbally abused by my mum. They are both exhausted.

My mum has been assessed a few times. She knows the date when asked. She can answer questions very reasonably. She is polite and accommodating. When asked – yes she can walk. No, she doesn’t need help, she has everything she needs from my dad.Yes, she can get around the house. No, there is nothing wrong with her. Yes, she looks after her 92 year old husband. On the strength of this she is deemed to be fine to be at home. She refuses to have a care package – she doesn’t need one. Last time one was arranged she contacted the GP and cancelled it.  My dad’s views, my sister’s descriptions of her behaviour seem to count for nothing. I live 100 miles away, work full-time and offer moral support as much as I can. I have the easy part.

My mum’s in hospital today. For twenty four hours previously she was agitated, confused and abusive. Constantly arguing and questioning. She couldn’t walk at all this morning, had slurred speech and increased confusion. My sister, at the end of her tether and sleepless for 24 hours called an ambulance and mum was taken to hospital. This evening mum was improved. My dad refused to go to hospital with her. He’s at home, watching tv and relaxing for the first time in two years. He say’s he won’t have her home, he can’t cope. He’s right. My sister is guilt-laden and exhausted. She cannot manage them both anymore. The fragile care from the family has broken down irretrievably. We know my mum will play holy hell if anyone so much as mentions ‘care’. I suspect that tomorrow someone will decide that she doesn’t need to be in hospital. What happens next?

A list – inspired by Anne Cooper


I was reading Anne Cooper’s blog yesterday (here) about the adjectives she would like to have applied to her. She gives a list of those descriptive words and some insights into what feedback she gets from others. That feedback seemed to major on ‘kind’, and I detected a little frisson of disappointment that although it was lovely to be recognised for one’s kindness, there were a whole load of other attributes that Annie was putting out there. It made me smile at her honesty and authenticity (a word I am growing to dislike and distrust – but not in Annie’s case, I hasten to add) and at her pondering on the effect she has on others. At the end of her blog she asks which adjectives her readers might like to have applied to them. It got me thinking. Not least about how we see ourselves and how others see us.

The list of adjectives that I’d like applied to me are:

  • Fair
  • Funny
  • Clever
  • Loyal
  • Committed
  • Open
  • Generous
  • Attractive (sorry, but there it is)
  • Wise

I’m sure there might be others, but those are the ones I would really like. At first glance they look like pretty good attributes to have, and I do know from feedback that most of these adjectives have been applied to me by colleagues, managers, people I work with. But I also know that some of these attributes are not unfailingly positive and they don’t make me some sort of paragon of the workplace. Far from it.

I am well aware, for example, that being fair and being loyal can often mean conflict. That putting fairness before loyalty can feel like unfairness to the person who expected me to be loyal, above all else. So, in others’ eyes I might appear unfair and disloyal when in fact I’m being scrupulously fair and loyal to my values.

I love making people laugh – the smart remark, the quick response, the over-the-top anecdote when everyone is looking at me and listening and shrieking with laughter – there’s no better feeling than entertaining one’s friends and colleagues and knowing that it’s you who have made them rock with laughter. So I know I’m funny. I also know that sometimes, in order to be funny I can be cruel. Not with an intention to hurt, but with an intention to amuse. Humour stands on many platforms – I have to try hard not to stray from one to another inappropriately. Especially when I’m on a roll and all attention is on me.

Committed, open and generous – what’s not to like? Who wouldn’t want these things said about them? Commitment is one of my most closely held values – I work hard, I expect others to do the same, I expect people to do the ‘right thing’ and to stand up for what they believe in. When I sense a lack of that commitment I can sometimes react too quickly – impatient, irritated, quick to judge and to dismiss. After all, everyone should feel as strongly as I do, shouldn’t they? Not so good. I had some feedback recently that made me really think about this – it wasn’t hard to take and I recognised the meaning exactly. Someone said “Ah, that’s June. She runs a bit hot sometimes.” It’s a brilliant description of my occasional lapses into astonishment that not everyone shares my strength of feeling all of the time or about the same things. That phrase was a useful mirror reflecting back to me that commitment to something requires nuance and finesse, flexibility even – even though that might feel like a contradiction in terms.

Openness – now that is something that I hear in feedback, ‘completely open and transparent’ and I really couldn’t be any other way. I am often heard saying “…so, now you know as much as I do. When I know more, you will too.” I can bide my time, I can hold on to information until an appropriate time to transmit it, but there has to be a very good reason for me to hold back information. I trust people and more often than not that trust is rewarded. There is a but though – I am open in other ways too. I struggle to dissemble, I am an appallingly bad liar, my body language is a body-language-reader’s dream. I am, as they say, an open book. When new people join my team, it’s one of the first things I say to them: ” I am very open and transparent, and that means that you will know how I’m feeling – you’ll know when I’m happy or pleased, you’ll know when I’m cross, you’ll know when I’m anxious and you will always know exactly where you stand’. Or something like that. So far, it’s worked well. I don’t play games and I don’t expect game-playing from others. It’s an approach that’s served me very well – and I think it’s one of the reasons I attract good people into my team – and keep them.

The organisation I work in has a set of core organisational values that I helped to define. One of those core values is ‘generosity of spirit’. They appear in our documentation, on the website, and underpin how we work. Generosity of spirit is the one value that most people think best reflects our organisational ethos. I think this is why I love working where I do – because it reflects my own sense of what is important. I try to be generous with my time, with my knowledge and experience, with advice, with encouragement, with lessons I’ve learned. The people who were generous with me are the people I remember. Sometimes being generous means that you get asked to do a lot. Or that you’re near the top of the list when someone needs a favour. That’s not a downside.

And wisdom? Who would claim that for themselves? Well, if it’s not too immodest, I’d like to. If wisdom comes from working through and learning from success and failure, then yes. If wisdom comes from finding out about myself and understanding why I am who I am, then yes. And if wisdom comes from recognising the positive attributes but not beating myself up when the flipside puts in the occasional appearance, then absolutely yes. I would happily accept and recognise all of the above neat and tidy list of labels. And I also happily accept that they’re not always neat and tidy. That makes me….me.

Has the moment passed…?


Safe staffing hits the headlines. Or rather the decision to scrap NICE’s work on safe staffing hits the headlines. If you’re a nurse and you don’t know about this – where have you BEEN??!! Catch up on it here as Shaun Lintern, reporter extraordinaire of Health Service Journal, first broke the news over Twitter. There’s more here and if you want to check out the whole ten days worth just search the Twitter #safestaffing and see the announcements, counter announcements and horrified responses from a very wide range of interested parties. So much shock and disbelief that England’s CNO felt moved to defend NHSEs actions, and you can read that here. I’m not going to rehearse the whole story – suffice to say I am sad, angry, even bewildered that a Francis recommendation and a post-Francis commitment  to formally and rigorously examine nurse staffing levels and to arrive at an evidence-based, expert opinion-informed suite of credible guidelines was pushed aside in such an ill-thought through way. My networks (throughout nursing – NHS, PVI sector, academia, UK and overseas) have been incandescent about it and a lot of nurses have been asking me why it happened, how it could have happened and why doesn’t that good old ‘someone’ do something about it… I have been, as ever, musing on this and trying to be relatively objective.

There were immediate strong reactions, calmly and cogently articulated – a letter to The Times from a collective of high level organisations associated with nursing and this one from Council of Deans UK, as well as concerns raised by NICE itself, Sir Robert Francis, MHNAUK, the President of the Royal College of Emergency Medicine and a number of patient’s organisations. On Twitter and in comments in response to Health Service Journal and Nursing Times articles nurses from a wide range of specialties were angry and disappointed. The sense of appreciation and valuing of their crucial contribution to safe, high quality care that the investment in the NICE staffing work had engendered seemed to have been pulled out from under their feet by an announcement that was difficult to understand. So far, so much well warranted indignation.

So what now, some ten days later? Well…nothing much – publicly at least. I’m hoping that there is work going on behind the scenes because the blogs and the Twitter conversations are dwindling. Arguably the biggest boost to patient safety and high quality care in the UK has been dismantled and there seems to be (what I hope is) a hiatus. Nurses have asked me why the nursing organisations are ‘peeling away’ from the rough and tumble, quietly but noticeably. I try to reassure them that these things are best not played out in the full glare of social media, or other kinds of media, but they are sceptical. Some reflect cynically that open criticism may lead to organisations being zipped out of the nursing ‘great and good’ tent and that’s not what people want. They suggest that the need to have ‘influence’ may trump integrity, even over something as important as this. I don’t think I believe this, though it’s tempting, and it would be a sad day if it is the case. I prefer to think that there is some careful regrouping going on, some consideration of what might be done, what approaches to take once the dust settles.

Those same angry nurses also ask about the absence of any public ‘for’ or ‘against’ comment from the most senior nurses in provider organisations. They either have an expectation that their most senior nurse should be shouting loudly and volubly that ‘the safety of our patients is at stake!’ (Who remembers Nursing Times’ cartoon Nurse Nightingale?) or they are cynically seeing conspiracy and/or helplessness.  I am more optimistic though – I think these nurses will be looking for positive and constructive ways of moving forward with the safe staffing agenda – again as the dust settles.These are tricky times and knee-jerk reactions are rarely the right way forward. The best will lead through this.

Post-Francis we hear a lot about the power of whistleblowing, speaking out safely, the rhetoric of ‘we’re all leaders now’ and how professionals on the ‘front line’ (I hate that phrase) must advocate for patient safety and show leadership. The expectation that the rest of the hierarchy should do the same is strong. But it seems to me that it is just as hard to speak up from the top of an organisation as it is from the bottom, maybe even harder. There is more visibility, fewer numbers to feel safe in, much greater peer pressure, a lot to lose if you’re in the middle of the most successful part of your career. And before being too critical, remember that senior leadership is more about playing a long game, gathering information and evidence, working carefully, cleverly, and with integrity. It’s not always visible, not always obvious. Have a little faith.

The commissioning of NICE to generate safe staffing guidelines was a ‘moment’ for nursing, and as such it was also a ‘moment’ for securing high quality, safe patient care. Has that moment passed? I don’t think so, maybe postponed a little, but the time, not just the moment, will come.

The buzz of other people


I’ve been really busy for the last few days – back to back meetings, no time for food, no time to think. I thought I was heading for an evening of just dozing on the sofa, but instead I find myself energised and excited about the possibilities that have revealed themselves during a few days of hectic activity. I feel motivated, stimulated – my brain whirring away on envisioning future scenarios, tentative list making, feeling empowered to move things along. I’ve been reflecting on the specifics that created such positive energy, that have given my week a real buzz. And it wasn’t anything complicated. In fact, it was a series of really quite small things, but with big consequences.

Monday. I had almost given up on a particular piece of work. After almost a year, there was little progress, no increasing engagement, I was bored and frustrated. Someone new engaged with the work – offered some new insights, completed some tasks that had been hanging around, had an aura of ‘can-do’, shared my forgotten vision. Boom! I was back in the zone. Sometimes other people’s motivation is a fast track to your own.

Tuesday. My PA screens all my incoming calls. He is brilliant at diverting the cold callers, the conference salespeople, the marketers. He is also brilliant at fitting people into my diary, understanding what the priorities are for me, so that no-one feels put off. Earlier this week he left a message on my desk, with a phone number and a little explanation about a man who had been put in touch by a mutual colleague and wanted to talk to me about volunteering. I confess I groaned. But I phoned. I spent 20 minutes talking to a delightful man who wanted to support the faculty, had some great ideas, knew some great people and wanted to work with us to help take forward some pretty exciting projects. Boom! Full of exciting possibilities. Never ignore something that seems inconsequential. Strangers turn out to be friends. Unexpected great stuff is really great stuff.

Wednesday. A Very Important Meeting with Very Important People. To make a case for something, answer some difficult questions, justify risk taking, convince of long term positive benefits. I was anxious, concerned about appearing defensive, of being parochial. I was rehearsing the arguments. A colleague said ‘For goodness sake, this is your stuff, you know it inside out’. At the meeting – tense, challenging – we talked about the future, about the vision, about what would be possible, about the aspirations of staff, the potential of ambition, not just for my own area but for the broadest possible benefits. The required approvals were given. Boom! Release of tension, progress on big, important stuff, a bigger picture painted. Massive air punch (outside the room) and shared the good news. So, be bold. Believe in your plans – understand how they will work, be sure about the returns, articulate the benefits beyond your ‘selfish’ interest.  And listen to those comments that remind you quietly that you have knowledge and enthusiasm – an unbeatable combination and a great platform for confidence.

Thursday. It’s a long time since I’ve had the time to put in a personal bid for research or project funding. A few weeks ago I asked someone to help me write a very short bid for some internal project funding – a very small amount, just enough to help me do a literature review I’d been thinking about for months, but not getting round to. They turned my stream of consciousness notes into a bid, I submitted and promptly forgot about it. This week I heard the bid had been funded. I couldn’t have been more thrilled if it had been a million pound Research Council grant, not a couple of thousand pounds. That colleague had helped buy me some me-time to work on something close to my disciplinary heart. Boom! Personal satisfaction, anticipation, reconnecting with something important to me. Don’t be afraid to ask for help with important, but small things that are personally meaningful – people are kind, helpful and collegiate. It was a great reminder of what terrific people I work alongside.

I could easily have filled this page with the stress, the tiredness, the long hours, the demands, the frustration. But it’s the buzz that stays with me. Always the buzz of things coming good, small or large and mostly because of other people and their unexpected and often unconscious influence.

Leadership tweeting – Tweetership?



I’ve been active on Twitter as @JuneinHE for a couple of years now. I follow almost 900 or so people and organisations and I have about 1800 followers. I tweet regularly, some would say too much – every day, several time a day – and I engage in organised Chats and informal conversations. I try hard to encourage others to use this particular Social Media application, but it’s been an uphill struggle. In spite of the obvious benefits of sharing good practice and information, the asking and answering of questions and the organised discussions, there is still a belief that it’s mostly about seeing pictures of food, kittens, and inane chatter. And yes, there is some of that, but it doesn’t have to overwhelm your timeline.

Last week we had a ‘Twitter week’ in the Faculty. A special hashtag #brookeshls and a concerted effort for those of us who use Twitter to communicate interesting stuff and an opportunity to try to convert new Tweeps. The hashtag has been a great success, with information about a range of activities and achievements from right across the faculty being sent out and even three or four new Tweeps signed up.  Myself and a colleague offered to host question and answer session for an hour where anyone in the faculty (and beyond) could ask us questions about our roles, careers, and research or other scholarly activity. We’ve posted videos, celebrated and congratulated, introduced people to each other and generally had a great time. I made sure that I frequently contributed throughout the week, finding time to Tweet from or between meetings, over lunch, or in the evenings reflecting on my day. I also tried to respond to new Tweeps, encouraging them and suggesting interesting and useful people and organisations for them to follow. Many people shared what they were up to and it was a real success – so much so that we will keep the hashtag live now.

I’ve talked above how hard it is to convince people that Twitter is a great professional development and communication tool. It’s a shame that opening up to different ways of communicating can be dismissed without any real effort to engage with it. It really isn’t acceptable to say ‘I don’t do Social Media’ when so much of our world relies on it, and for those of us working predominantly with younger people it makes no sense at all not to at least try to engage.

As PVC/Dean of a large faculty in a leading university I am an evangelist for using Twitter for professional purposes. I use it to talk about my work and my experiences, to connect with others who are doing similar things, to get advice and to give advice. I use it to ask for information, to seek out publications, to get quick links to things that I can’t immediately get hold of myself. I use it to keep up with my discipline, to relate to new starters in my discipline, and to follow conference proceedings when I can’t attend the conference. I chat to students – from my own faculty and from other universities – and I hear from staff about their work and their achievements much more quickly than I would without it. It’s only one communication method, but it works on so many different levels.

At the end of the faculty Twitter week I caught a few tweets on the timeline from new Twitter fans that encapsulates the benefit beautifully. Just look at these, from @jululupostbox “We are converted! Great for making contacts, accessing information, contributing to discussions” and “Really enjoyed Faculty Twitter week! As Paula said – its like being at a permanent conference!” or @pjohnsonPaula “can’t believe how much info you can access by tweeting!”  and if you have more time check out the timeline on #brookeshls.

And if you don’t already – get Tweeting!

Leadership…and hormones….


On my other, more personal blog, I wrote briefly a little while ago about getting older and sharing some experiences with a couple of colleagues on Twitter. Since that conversation I joined with a group of other women – health care professionals, academics – to contribute to the Evidently Cochrane blog site for its week-long look at Menopause and the evidence and resources that are available to women experiencing it. I had a particularly bad menopause, and I agreed to write about my experience for the blog and you can read that here.

The responses to that blog have been interesting. Responses from readers of the blog have been overwhelmingly positive and welcoming, and quite often, grateful. One or two have been of the churlish ‘Menopause? It’s normal, get over it’ comments, I assume from women who had a ‘normal’ or ‘better than normal’ menopause and sailed through it. Lucky them and yah boo to their lack of empathy and understanding. But as I said, just one or two.

Responses from colleagues and friends to me writing the blog have been much more mixed. I had lots of encouragement, again lots of gratitude and congratulation for taking the risk, claims of bravery etc. but I also had responses ranging from exclamations of incredulity that I would want to discuss openly this very personal (taboo?) experience, to accusations of foolhardiness and a presumption that I might damage my reputation (what??). When I drew attention to the blog and to ‘Menopause Week’ with some colleagues there was quite a bit of embarrassed silence and nervous laughter. They were, as I said, interesting responses and probably related to the fact that very few women discuss menopause openly and even fewer talk about it in mixed gender company.

And that brings me back to the title of this blog. If you want to influence something, or change something, or get something into the mainstream so that it is explored and examined, then one of the first things you need to do is to start talking about it. Normalise it, break the taboo, bring it into the open. And sometimes that’s about taking a risk, using personal disclosure, finding common experience, starting the conversation and then committing to sustaining it – even if there is some discomfort. My menopause gave me a leadership opportunity. It’s probably the only positive thing about it and I embrace it! 🙂