I notice this is the NHS. So many smart, very well educated folks on the front line who are confined by the guideline-imperative. The need to follow a set of, often out dated, tick box exercises in the name of standardisation and risk avoidance which reduce the work to an unthinking automaton. All the care and noticing get squeezed out leaving the individual feeling no meaning or agency in their work. No wonder so many GPs, doctors and nurses are leaving the profession early. The story of nursing staff unwilling to lift a patient in a ward resulting in an ambulance having to be called to take the patient a few hundred yards to A&E for a check up and X-ray. This meant the patient sat on the loo floor (after a fall) for hours. It’s not that the nursing staff didn’t care, they were fearful of breaching the protocol which could mean they are reported for a disciplinary review. These protocols give leaders an unsafe perception of good care and safety been provided. Ticking the box does not mean the right thing is done, often quick the opposite. It de-humanises the interaction in a profession that is all about care. This needs light shining on it so it can be tackled rather than remaining in the shadows.
Just as moving Outside the Walls requires a different mindset, so does understanding how we fit into a long tail world. When Chris Anderson introduced the idea in 2006, I thought it was an idea whose time had come. It was the early days of the internet, before smart phones. Everything look bright and hopeful for the future. But along the way, the reality that we live in a world of globally centralized institutions has made it harder, not impossible, for the long tail to become a reality.
We are at a historic juncture in modern history, where the sustainability of large, centralized institutions of governance and finance is in question. The power of smart phone technology has made forming networks of collaborative relationships a reality. The challenge is the access to products, manufacturers, and distributors who can serve a long tail business and its customers.
I notice this is the NHS. So many smart, very well educated folks on the front line who are confined by the guideline-imperative. The need to follow a set of, often out dated, tick box exercises in the name of standardisation and risk avoidance which reduce the work to an unthinking automaton. All the care and noticing get squeezed out leaving the individual feeling no meaning or agency in their work. No wonder so many GPs, doctors and nurses are leaving the profession early. The story of nursing staff unwilling to lift a patient in a ward resulting in an ambulance having to be called to take the patient a few hundred yards to A&E for a check up and X-ray. This meant the patient sat on the loo floor (after a fall) for hours. It’s not that the nursing staff didn’t care, they were fearful of breaching the protocol which could mean they are reported for a disciplinary review. These protocols give leaders an unsafe perception of good care and safety been provided. Ticking the box does not mean the right thing is done, often quick the opposite. It de-humanises the interaction in a profession that is all about care. This needs light shining on it so it can be tackled rather than remaining in the shadows.
Just as moving Outside the Walls requires a different mindset, so does understanding how we fit into a long tail world. When Chris Anderson introduced the idea in 2006, I thought it was an idea whose time had come. It was the early days of the internet, before smart phones. Everything look bright and hopeful for the future. But along the way, the reality that we live in a world of globally centralized institutions has made it harder, not impossible, for the long tail to become a reality.
We are at a historic juncture in modern history, where the sustainability of large, centralized institutions of governance and finance is in question. The power of smart phone technology has made forming networks of collaborative relationships a reality. The challenge is the access to products, manufacturers, and distributors who can serve a long tail business and its customers.