12. Dr Terri Porrett - #FabNHSStuff - and so much more!

Today is #FabChange21 - the Fab Change 21 Festival -  and how better to celebrate this than to chat with Dr Terri Porrett, otherwise known as ’The Blonde.’  You can find out more about 'being blonde', and how it relates to quality improvement, during the podcast!

Gill Phillips will be running a 'Whose Shoes - Poet's Corner' as part of #FabChange21 - you can pitch up and join the day's activities here: FabChangeFestival 21 Programme (fabnhsstuff.net)

A specialty nurse, and Head of Education for the Ostomy division at Coloplast, Terri has huge experience. Today we are  talking about her fabulous work at Fab NHS Stuff.  And network weaving - Terri is a super connector!

Never one to take ‘no’ for an answer, I’m told that grit and determination are Terri’s middle names  - and possibly even belligerent  ;-)

Key lemon lightbulb:
NEVER start with a blank piece of paper, If you are planning a quality improvement, someone has always made some progress before you. Link up and find out what they are doing. #FabNHS Stuff can help!

And if you have done some work around quality improvement you’re proud of, share it with others. Again #FabNHS Stuff can help!

Why the Blonde? I think it contains a lot of lemon lightbulbs

Be proud of what you do

🍋 B- Big up what you do

🍋 L - Little things matter 

🍋 O - Opportunities to showcase what you do

🍋 N - Never underestimate The importance of what you do

🍋 D - Determined every day to make a difference 

🍋 E - Energise - pass your passion, your success on to your colleagues

These values define NHS Fab staff - Sharing the good stuff you do!

Huge  synergy with #WhoseShoes  pledges and our crusade against re-inventing the wheel. We need to encourage more people to put their successes on Fab NHS stuff!

We are going to set up a #MatExp campaign page. I’m not even sure whether our case studies are there, so we have some homework!

The Apollo nursing resources, mentioned by Terri.

Recommended further listening, if you enjoy Fab NHS Stuff:
Episode 6 - Joan Pons Laplana - devious ways to make fab stuff happen
Episode 7 - Carol Munt - Why sharing is SO important
Episode 8 - Rachael Wong - Don't be scared of creativity and innovation

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If you enjoy my podcast and find these conversations useful
please share your thoughts by leaving a review (Spotify or Apple are easiest to leave a review - navigate via 3 dots) and comment on your favourite episodes.

I tweet as @WhoseShoes and @WildCardWS and am on Instagram as @WildCardWS.

Please recommend 'Wild Card - Whose Shoes' to others who enjoy hearing passionate people talk about their experiences of improving health care.

Chapters

• 1:30 Born to be a nurse!
• 2:45 Proper support for people with colorectal cancer
• 4:13 Helping people live with a condition – not be defined by it
• 4:43 Head above the parapet – becoming unpopular!
• 6:00 Lemon lightbulb – there is always a way we can do things differently, don’t just moan!
• 6:45 Growing a specialist service by listening to patients and making a case
• 8:19 Personalising care for people from different cultures
• 9:42 Don’t take 'No' for an answer – find a different way!
• 10:40 Small things make a difference
• 10:58 Fascinating career journeys – being curious to learn about others
• 14:07 ‘The Mum Test’ - is it good enough for my family member?
• 15:24 Frontline staff are exhausted – others can help!
• 17:00 The Academy of Fab Stuff - sharing solutions to common problems
• 18:06 Equity of access to services
• 19:40 International learning with Cleveland Clinic
• 20:28 A nurse-led colorectal service. Making full use of our nursing skills!
• 22:27 Influencing people by learning the language that applies in their world (eg business, medical)
• 23:45 Specialist nurses - developing tools to help others shine (Apollo resources)
• 25:03 The origins of NHS Fab Stuff with Roy Lilley
• 26:38 Easy and inclusive - supporting people (everyone!) to share their improvement work
• 28:03 5000 good practice examples - eg reducing noise at night
• 30:06 Nursing is rewarding! Helping people live well with long-term conditions
• 31:20 Let’s set up a #MatExp Whose Shoes campaign page!!!!!
• 31:30 Whose Shoes pledges add up - let’s use Fab NHS stuff to capture the outcomes! 🍋💡🍋
• 32:10 Don’t struggle. If you get stuck, Terri can help connect you to others who can help!
• 33:40 It’s easy to collect … and find quality improvement ideas
• 34:10 So, grab a phone. #JFDI - make a little film or a voicemail !
• 34:25 #FabChange21 - 24/11/21 - New solutions coming thick and fast – join the action on Twitter!
• 34:49 A simple template - you don’t have to write War and Peace. You don’t have to write at all !
• 34:58 You don’t need positional power! We can all do this!
• 35:15 The little things are the big things
• 35:25 Be … B-L-O-N-D-E !
• 37:22 It is so energising to realise you can make a difference, Whose shoes pledges bring people alive! 🍋💡🍋
• 38:22 Let’s ALL be BLONDE 😃 A state of mind, not a hair colour! 💇‍♀️

Transcript

Gill Phillips  00:00

My name is Gill Phillips and I'm the creator of Whose Shoes, a popular approach to co-production. I was named as an #HSJ100 Wild Card, and want to help give a voice to others talking about their ideas and experiences. I'll be chatting with people from all sorts of different perspectives, walking in their shoes. If you are interested in the future of health care, and like to hear what other people think, or perhaps even contribute at some point, Whose Shoes Wild Card is for you.

Gill Phillips  00:46

So today I have the huge pleasure of talking to Dr. Terri Porrett, otherwise known as t’he blonde.’ I'm sure Teri will tell us more about that as we go. A specialist nurse, and Head of Education for the Ostomy division at Coloplast Terri has huge experience. And today we'll be talking about her fabulous work at Fab NHS Stuff. Never one to take no for an answer. I'm told that grit and determination are your middle names Terri and possibly even belligerent.

Terri Porrett  01:17

Absolutely.

Gill Phillips  01:18

All in all, a perfect Wild Card. So thank you for joining us, Terri, welcome. And can you tell us a bit more about yourself and what's important to you?

Terri Porrett    01:27

Well, thank you, Gill. And it's such a pleasure to be here.. So, as Gill said, my name's Terri Porrett. I am a nurse. And I was one of these young people that growing up at the age of five announced to everybody that I was going to be a nurse, I had no idea actually what nursing was about other than what you see on the tele and cartoons of nurses and things. But actually, I've never, ever regretted that decision to go to nursing school, I was meant to be a nurse, I, you know, I feel that's why I'm here. That doesn't mean I'm the best nurse in the whole world. But it means that this is what I think I was put here to do. I think we all make a difference in our own ways. And I was meant to be a nurse. I started by training at the London Hospital in Whitechapel. And I have to say, on the first day in nursing school, when a rather scary matron was talking to us about what nursing entails. And she was talking about night duty. And I sat there and suddenly thought, really, you have to do nights, which shows you how much I had considered what the role would entail. But I loved every minute of my training. And actually, as a student nurse, one of the very early wards that I worked on was a colorectal ward. And I saw people who were having surgery for their bowel cancer, and they were having a stoma, and then they were leaving hospital, and there was nothing. And there was no support for them. The ward sister ran a clinic on the ward. And if they had a problem, they'd come up and she had like a little broom cupboard with bits and pieces in it. And I thought, oh my word, we must be able to do this better when I qualify, I want to do this. And when I qualified, I worked on a variety of colorectal gastrointestinal wards. I even worked in the operating theatres, the colorectal theatres, because I thought, if I'm going to support people having that, I need to actually understand the operations. So I did all of that as a staff nurse. And my aim was to be a ward sister at St. Mark's hospital, I hadn't really thought past being a ward sister, because that was the pinnacle of the kind of nursing career in my eyes at that stage. And so Mark's hospital was the specialist hospital for for the country for complex bowel problems. And I became sister Allingham at St. Mark's hospital. And for the first year or so I thought, yeah, this is this. I loved every minute of it. I loved being a ward sister, the team kind of working, the planning, getting to know your staff and changing the provision of services to patients. And then the more I understood about stoma care, the more I understood that actually everything that we do in hospital is gret. But a person who's 18 and is going to really live the rest of their life with a stoma spends 1% of their life with a stoma in hospital, the other 99% is in the community. And how do we actually ensure that people can live the life they want to lead with with a stoma and they're not defined by the stoma, but the stoma allows them to do what they want to do. So I put in a proposal to the nurse director at St. Mark saying I think we should have a second stoma care nurse here because actually, when she goes on holiday, we all kind of try and cover as ward sisters. But there's only one of her and this is really, really important. And she came up to see me and she said that's a really good idea. Would you like to do that? Because it was then the NEMB216  course. It was nine weeks. Would you like to do it? And as the ward sister would you like to cover and come out of the ward for the periods of annual leave or sickness and cover this service? And I said yeah, of course. Well, that was my first introduction to actually not being popular because I saw that there was an issue. I put it in writing. But I was the newest ward sister at St. Mark’s. The ward sisters had been there for many, many years. And they'd talked and identified and as we do as nurses complained a bit Oh isn't it but we have to cover this because there aren't, but nobody had actually put it in writing. So look, I think this is an issue, I think we could do a better service for our patients. And then, of course, I was given the opportunities, which didn't make me that popular. But hey, that's life. So that was my first real kind of thinking that actually, as nurses, we can whinge quite a lot. And we can complain. We're human beings, we're tired, we get, you know, stressed by the situation. But if we're not prepared to suggest how we could make things better than just stop whinging, so either stop whingeing or make a suggestion of how we can improve this because there's always a way that we can do something differently. And that really has shaped the rest of my career. So I did this EMB 216 and became a stoma care nurse and was a ward sister and covered the service when the stoma care nurse was away. Absolutely loved it. At the time, the Homerton hospital was part of a foundation trust with St. Mark's and Bart's hospital, and they advertised for a nurse, clinical nurse specialists in stoma care to set up a service at the Homerton. So I said to my boss at St Mark’s,, I'd really like to go and do that. And it will give me the opportunity to do the community side of things and she said No, go,, go and do that. So I applied I got the job, I went to the Homerton . And I said to her, two years now I'll be back, I said to my senior, you know, I will come back with this and, and 20 years later, I was still at the Homerton, because I had had the opportunity to change how services were delivered for patients by listening to patients by involving patients, and by being able to grow the service. So when I started the Homerton team, it was me, a stoma care nurse. And when I left 20 years later, we had the bowel cancer screening practitioners,  I had the continence nurse specialists because obviously pelvic floor incontinence issues are across the board. I had an inflammatory bowel disease nurse, I had a research fellow had colorectal cancer centres, all grown because I could make a case to to the Trust board about why people with conditions that are often identified as being socially isolating, there's a huge amount of stigma associated with poo. I think it's the one of the last big taboos, we don't like to talk about it. And so 20 years later, I will still there. I have to say the Homerton was a fabulous place to work, a district general hospital hugely varied multicultural society, so many different languages, cultures, beliefs to incorporate into our care, I loved every single minute of it, and being challenged to go okay, well, we're delivering this service, and it's fantastic. But actually all the advice I give around diet and how to control our either faecal output if you have incontinence, or if you have a stoma, and I don't understand what a Turkish, or Kurdish diet is, I can't suggest the right vegetables I don't understand. So although I can do it for if you like within my culture, and my dietary kind of base, I can't do this for somebody else. But then being able to ring the Imam and have an hour with the Imam and the health advocates who then actually allowed us, took us shopping showed me vegetables that I'd seen, but I didn't even know their names, explained whether they were high or low in fibre. So I think we can make such a difference. If we're just prepared to go, this isn't perfect. But in these simple steps, I can begin to make it better. So I do think we have to have the courage of our convictions, which I think is where the grit and determination bit that you were talking about me comes in. Because if you have an idea, and somebody says no, I always believed that, that doesn't mean NEVER, it means I just haven't explained it well enough for that person to understand why. So it's my responsibility to position it differently. And within my team, we had two sayings in my team at the Homerton . So the first thing is we don't do failure. We might have limited degrees of success, but we don't do failure. Because failure is just going oh, that didn't work and forgetting about it, not learning from it and doing it differently. So we don't do failure. And actually we can always turn adversity to advantage. So that's that kind of was my yeah defines me as a nurse, I think just thinking you don't have to do a multi- centre international randomised control trial to make a difference. There are small things that you can do and test and incrementally you can, you can have as big an impact. 

Gill Phillips  10:58

Thanks Terri I think it's really fascinating. And it makes so much sense in terms of what I know about you. It's so interesting to hear people's personal stories and what's led them to what people see of you today. And just as you're talking, I mean, inevitably, various sort of things are resonating with me a couple of them personal actually. So I remember the #MatExp workshop that we did at Homerton with very warm feelings, I remember the chief exec coming in towards the end, and there wasn't a seat for her. And she stood up.

Terri Porrett  11:31

Was that Nancy?   

Gill Phillips  11:32

No, it was… is it Tracy? 

Terri Porrett  11:35

Yes, yeah, yeah.

Gill Phillips  11:38

And I think Joan was head of Midwifery, and it sort of bringing back memories, but I've just remembered this long, narrow room, it wasn't an ideal room, there was a little girl helping Anna with the pens, the conversations were just absolutely buzzing, and I think the exec team meeting or something, had finished during our workshop, and they'd all come in to see what was happening. And I think they look quite shocked, actually, that there were so many people and you know, you couldn't just come in and see it, you had to just join in with what was happening. So that was Homerton. And that was, I can see that that was a special, very multicultural, all the things that you've said, and I've just had that picture. And the other one, which is a crazy sort of memory that I had forgotten, I even remembered as in my early career, I did a Diploma in Management Studies. And part of it involved me going around the shops, Asian shops in Leicester, learning about the different vegetables, and long, thin things, and all sorts of things. And just all of what you've just said around diet and culture, and I just found it fascinating and so much fun to learn, things that I just hadn't got a clue about. And I think, you know, people need to be more open than they to learning about different cultures. And it's so interesting. And in terms of nursing, and what you do to actually understand people's cultures is just critical isn't it?

Terri Porrett  13:04

A     bsolutely , you can't deliver individual person centred care if you don't understand how that person lives, their beliefs, their diet, their family, as situations, you know, patriarchal matriarchal kind of societies, you have to understand that, and I suppose it's difficult, we all we understand our personal culture, because that's how we've been brought up. So you, we haven't had to learn it. But actually, you have to physically make that decision to be as comfortable with other people's culture or beliefs as as your own. Because otherwise you can't deliver the same care that you would to somebody from from your background. And I think the the way I've always tried to do that, obviously, I used to talk to my mom and dad and shock them terribly as a student nurse, right? And explain over dinner, all of things I was doing and injecting and all this kind of thing. And my dad said to me, so how, you know, if you get asked to do something, when when you're a student, or so you don't really know how to do it or if you are a staff nurse, how do you deal with that? And I remember saying to him dad, all I can do is say to the person, actually, I am not the person to do this, I you know, I haven't got this. If it's not good enough for my mom or dad or my brother, then I can't do it. I will always try my correct thing. What I'm about to do, or the service I'm about to offer, is this good enough for a member of my family? And if the answer is no, then I need to do something to change that, that service or to change my skill level in being able to deliver. So that's always been my guide and I can remember him saying to me, that must be quite tiring having to think like that the whole time. And I went well, Nursing is a safety critical profession. And so you have to think like that.

Gill Phillips  15:05

But it's so simple, isn't it? You know, that shouldn't be difficult to think because, you know, would it be good enough for my mom and I loved the way that sort of caught on in health care. I remember Andrea Sutcliffe and her ‘the mum test’. A bit like ‘Hello, my name is’ it's just so simple, but makes such a difference to people. And one or two of the other things she was saying there, Terri? So I've just been talking, as I think I mentioned to you,  to Racha el Grimaldi from cardmedic. And you know, we were talking about cultural issues and also mentioned Sunita from Chelsea and Westminster hospital, who's doing personalised discharge letters now for people. Now those would be the sorts of things wouldn't they in turn have, you know, if you were talking about diet, what you could realistically eat, rather than just a standard letter? It's not rocket science, is it?

Terri Porrett  15:54

No. But let's be fair, the situation that most health and care practitioners health and social care have gone through in the last 18 months, the emotional trauma stresses of them living and working through the pandemic, I cannot be kind of over over realised the impact, the draining impact, people are exhausted. So, I think more and more it becomes people who are not at the forefront, if you like of frontline care delivery, to step up and go, How can I help you do this, you you have using your mental capacity and energy to deliver services? How can I help you do the bits around the edges that you can't do. And I think that's what I'm endeavouring to do in my day job with Coloplast. So deliver educational tools and resources to support specialist nurses. Were also with the Academy of FAB Stuff, which you alluded to at the beginning, which is a platform where people can share solutions to common problems. And it's based on the theory of positive deviance. So in health and social care, the majority of the problems that we all experience are the same, there might be slight local variations or nuances. But actually, some of the challenges it's affecting the whole of the NHS in England, Scotland, Northern Ireland and Wales. So rather than this, ‘ if it wasn't invented here’ mentality of having to research and pilot and what, let's hear from people who've had that problem, what their solution was, and instead of starting with a blank piece of paper, start with their solution, and then tweak it to work and test out within your environment. Just don't start with a blank piece of paper, because that's the difficult thing. So I think, yeah, it's really important to share. So this became really apparent to me when I was at the Homerton . So when we were developing this, this team of specialists, nurses, I actually wrote this paper to the chief executive at the time and said, Look, if you are unfortunate enough to have bowel cancer diagnosed and you need to have a stoma, you get stuck with a stoma care nurse specialist who sees you the whole way through your journey of life with cancer, your cancer treatment pathway, because you have a stoma, you've got that person to ring up, you've got the advice, you've got somebody to, to kind of broker your care, dovetail your repeat scans with other appointments, you've got a specialist nurse, if you're unfortunate enough to have bowel cancer diagnosed, have surgery and are fortunate enough to have your bowel sewn back together again, in then it’s : Bye! note, there were no colorectal cancer nurse specialists. So you just and I wrote and said look, we talked about equity of access to services. This can't be right, this this can't be right. And we need to develop a colorectal cancer nurse role. And then everybody should have the same follow up following their surgery as they go through their really often quite extensive chemo radiation, radiation treatment, they they need that support. We can do nurse led clinics, we can do their follow ups. And the answer came back yet come come and talk to us in the board. Tell us a little bit more about this because this is you. So I went and I spoke and I explained why why I thought this could be a nurse led service complementing and working with our medical colleagues, but this could be nurse led. And the following day, got a letter in writing saying, right, do it you need to we'll agree you the funding for another stoma care nurse because you will step away from stoma care and you're going to develop this role.

Terri Porrett  20:09

And I thought well, okay, that's great. And then I looked around and there were very, very few because the it wasn't, you know, the norm then so I actually went to the US and had a placement at the Cleveland Clinic in Fort Lauderdale. From there, came back wrote it wrote all the protocols, you know, about nurses doing things like a sigmoidoscopy and oh, you're doing technical tasks. No, I'm examining this. I'm going to examine the person and then plan their care from that. It's a tool. It's not a kind of a big deal that a nurse is doing something that a doctor normally did, it's how I use that skill to change the service that the patient's going to be offered. And we put our put everything together in a in a kind of like a book. So all the guidelines, all the training protocols, because there weren't any nationally, and the Royal College of Nursing and the Association of ColoProctology kind of used it as an exemplar, and nurses used to contact me. So we're going to be colorectal nurses. If you've got anything you can share. Yeah, I've got a whole what everything? Yeah, look, I was fortunate I was supported to do this for a year, you're in post now. So let's not don't spend hours writing these policies, adapt them. I used to just send them, just share with everybody. Because why go? Yeah, we've got them, but they're ours. So you've got to write your own. Why, why would you do that?

Gill Phillips  21:39

And  it's so helpful. I mean, do you think that culture, obviously, fab NHS stuff has played a massive part of this, and I know the podcast I did with Carol Munt, we were kind of tearing our hair out a bit that people don't share more, and then an obvious and very natural shout out for Fab NHS stuff. But do you think the norm is now that people will look not to a blank piece of paper, but to look around and see what's already out there and to share with each other?

Terri Porrett  22:07

I think it's getting better. Yes. I still think that there is a degree of Oh, that was done. At St. Elsewhere. And here, it's and whatever, we're much, but so we'll see, we'll do our own, you know,. So I do think there is that there is still that, but it's much less. And that leads me to so to how FAB happened. So okay, I had through through my role at Coloplast, I started working with Professor Alison Leary, she wasn't Prof then. And we wanted to develop a resource for specialist nurses to help them demonstrate their value, because I'd got quite far with how to write a business plan and how to write an annual report. Because I'd asked my brother who was in business, how to do this. So at the Homerton , when I wanted to grow, grow my service, grow my team, I had to use the language of business. That's, you know, I had to be bilingual. You know, when I want to talk to doctors, if I want to change their practice, I need my paper published in a medical journal, because I want to change their practice. I have to do a randomised control trial, because they'll listened to that. I'll learn the language necessary, so that the people who I want to listen to me who I want to not say, No, I've got to present it to them in a way that they can easily say, Yes, I think that's my job. Rather than say, why don't they understand why? Because you're not explaining well enough, you, you need to tell people what you do. So especially as nurses, we go on these courses, and I'm a clinical expert. Nobody teaches me how to write a job plan. Nobody teaches me how to write an annual report or a business case or do a service summary. Nobody helps me with the language that I use, because in nursing, we have such passive language at times, because our language of how we describe what we do, by the nature of nursing arose from religious orders, you know, so we have, I j’ust’ did this. Or I ‘only’ … ‘basic’ nursing care, there's nothing basic about it it’s the foundations on which all other care is built. So our language is dreadful, but we don't we don't help us to develop in that way. So Alison Leary and I've worked together to build this standalone website, we worked in conjunction with Ulster University. And so it's a website called the Apollo nursing resource. And any any nurse from any speciality can go on to it, learn how to do a job plan, learn how to do an annual report, how to analyse activity within this service, and it's free for for anybody. 

Terri Porrett  25:03

It just so happened that Roy Lilley, the health writer and commentator saw on Twitter, I must have tweeted about this Apollo nursing resource and he went and had a look at it. And he obviously thought, Oh, this is really good. And he wrote about it in part of an e- letter that he wrote. And on the day that he wrote about it, he nearly broke the website because so many people went to it to have a look, which obviously was fantastic. Fantastic. Yeah. And then he tweeted, he direct messaged me on Twitter and said, Look, I have seen your Apollo website you and Alison I think it's fantastic. I've got an idea. I'd like to do some things similar but for the healthcare in general. So, would you come and have a chat with me about it? So we met. And I have to say I was a little scared, because you know, he has quite a personality through his letter, I'd never met him before. And within 15 minutes, we were killing ourselves laughing, actually, because he has a fantastic sense of humour. But he was so so focused on l- ook in health care, lots of problems happen in lots of places, but there's no central place, no repository, where people can go to learn from the problems other people have had and how they can solve them. Do you think you could help me make this happen? And I thought, well, that sounds like a really good idea. And so yeah, definitely. So worthwhile. He said, What shall we call it? The academy? Yeah, the Academy of fabulous stuff. Because my whole premise was, as I talked to you back at the beginning was I didn't want this to appear too …. And I don't mean academic, I didn't want the label or the name of the website to put people off thinking that actually they had something to contribute to this website. I wanted it to be for everybody, not only for audit leads or research leads or QI facilitators, I wanted everybody to feel that this was a place they could go, have a look and browse for solutions, but to also share their work. So we've had work shared by porters, who've shared  … I've emailed them and said, Okay, this is great. I love these three bullet points, I think you're talking about a, b, and c, and I've scoped it out and work because they've never, they've never published anything before. It’s my job to make. It So what message do you need to get across to people of what you did, I'll help you make, make that so. So we have from realistically all, all walks of health and social care, employment, volunteers, visitors, service users all contribute to the Academy of FAB stuff. And it's got over 5000 shares. So 5000 pieces of work where people have had an issue, and they found a solution. And it can be a small thing, like one of the one of the most impactful things was a community nursing hospital where a ward sister, a community nursing hospital, found that on the patient feedback, noise at night was a big thing. And people couldn't sleep. And so she didn't fill in a, you know, loads of forms. She just said, You know what I've been given, I've got this money I'm going to and she researched it, I'm going to buy all of the slow closing bins. And she replaced all of the all of the bins on the ward with these slow closing ones that don't make a noise so you can let it go. And it doesn't go clanging at two o'clock in the morning. And, and she made these sleep packs she bought, he can buy very cheaply, the kind of eye masks and the foam ear things that you get on an aeroplane. And for people that were light sleepers, she offered them these sleep packs. And the next patient survey came out and the complaints about not being able to sleep at night had gone from being like seven out of 10 respondents complained about noise at night to nobody complaining about noise.

Gill Phillips  29:31

That's amazing.

Terri Porrett  29:32

And she shared about the slow closing bins. We tweeted about it. She was inundated. It's one of the most successful… it's a tiny thing.

Gill Phillips  29:31

That everyone can relate to.

Terri Porrett  29:32

But many people... Oh, really it was a bin - it’s not like it was… you know, you haven't cured cancer. No. But for every single patient on that Ward, that is a big deal. And if you put all of these little things together, it really changes the person's experience of living with their with their illness, because people have often said to me, okay, Terri, you're a nurse, you did your masters, you did your PhD. Don't you wish she'd been a doctor? No, I, I've always wanted I wanted to be a nurse. I'm meant to be a nurse. You know, cure things? Well, very few things can we cure. We can treat things, but my nursing interventions can treat things and make things better. And once we're so hung up on trying to cure things, we're missing the point for the 95% of people that are having to live with diabetes, live with chronic obstructive ailments, live with renal failure. can't cure it. How can I make it the best possible and that's what I can do as a nurse. And it's these little things that really make that. So, so important, I think, because that improves quality of life.

Gill Phillips  30:56

And I think that that's just so amazing. That like last minute or so needs to be captured on its own in terms of, you know, why would you be a nurse rather than a doctor, it's been so like, eye opening for me in a way, you know, just to sort of hear that, and then 99% of your life, that you're just living your life with whatever condition you've got, doing the best you can do. The other thing that's been a massive kind of light bulb for me is, you know, as a small business with Whose Shoes, we find it difficult to capture and follow up all the different outcomes. And we're doing, Flo, and I are doing a report for the RCOG at the moment. And we need to include the outcomes, and we've got books of actual case studies from our bigger projects. And I need to check they need to be on Fab NHS stuff, I think they are. But what we do at all of our workshops is encourage individuals to make pledges. And we should be saying, as a regular thing, you know, whatever you do, as a result of this, even if it's only a little little thing, and the way you describe the work with the porters, and so on, you know, Terri can help you if necessary, just capture that snippet. It doesn't need to be a massive project does it?

Terri Porrett  32:07

No Absolutely. Or you can be halfway through a change, and you've got stuck, and you don't know what to do next., We will tweet, we'll put you in touch with people that have been there so don't. So it's not even, it's even if you haven't finished, and you've got stuck, ask because there'll be somebody else who got stuck and has found a solution. So let's put you together,

Gill Phillips  32:31

We need to do a little mini project. Now I think just to point some of these amazing people, like say Sarah Jane Pedler. in Cornwall, they've done Whose Shoes workshops each year around big topics, all of them have collected pledges, all of them have collected outcomes. That's the sort of thing that should be fed through. They do just amazing work. 

Terri Porrett  32:53

Absolutely Gill. And I can make you a campaign page, all of this can go in one central place. So all we need to do it. So when we want to refer people to this one page, one campaign page, and they will find everything with this hashtag on that one page, we can even sort it. It's so simple to do. So fab change day, this annual event started off six or seven years ago now maybe even longer. I think

Gill Phillips  33:23

I think I've been involved in all of them!

Terri Porrett  33:26

Where the NHS started off pledging how what can I do as an individual to change things, are still running.. And for the last two or three years fab has hosted this and been the repository for people to put either their pledges or their outcomes.  This year. We're trying to make it really, really simple as you say. So you don't have to share, you don't have to type stuff in to the website. If you want to share a voice note, or you want to share a film on your telephone explaining what your problem was, and how you solved it within your ward or department and upload it. I'll put all the pretty bits around it and upload it to the website. So for fab change day, people can send voice memos, they can send films, not YouTube mega, NHS England stand, Comms standard films,

Gill Phillips  34:19

Just grab  a phone and do it fun #JFDI

Terri Porrett  34:22

And I’ll put the title and we'll embed it on the page. And on fab change day we will be tweeting every five minutes there will be a tweet to a new piece of work that people are sharing on new solutions.

Gill Phillips  34:36

That’s extraordinary!

Terri Porrett  34:36

And to make it as easy as possible, we've made a template so if you do want to do a little poster, and you've never done one before, we've got the kind of what was your problem? What did you do about it? What were the challenging bits? What would you like to tell other people, we've made a really simple template but people can upload their own PowerPoint presentations, their own posters if they've done them already. So just trying to make it simple. You don't have to have ‘leader’ you don't have to have ‘QI lead research, lead quality and development lead’ on your badge. We all can do this. And if we share it then that just means that our little thing is amplified across the country as other people learn from it and it becomes a really really big thing. And as you know Gill, we've always said the little things are the big things.

Gill Phillips  35:25

Isn't that the ‘L’ in blonde? We never got back to blonde!

Terri Porrett  35:30

Blonde, big it up. Tell people about what you're doing. Your managers are not telepathic. Tell them what you and your service does. L: little things are the big things. Don't be put off thinking this isn't a randomised control trial or I haven’t followed the Prince project methodology for planning it out doesn't matter. It doesn't matter. Little things make a big difference. Don't be embarrassed about and take any opportunity. That's the Oh in blonde to talk about what you do. You talking about your services you advocating for patients, as nurses, we love to say we're patients advocates. So talk up about the challenges for them. The areas of your service that you could improve, to improve things for patients. The N  in blonde is never, ever, ever give up. Don't give up. No doesn't mean never. Find another way, find another way to communicate why it's important you do this.At  the Homerton I asked for something. It took three annual reports, multiple multiple conversations before there was a lightbulb moment and they went you need these two people to … Yes! and then I got them , three years. If I'd given up, that change for patients wouldn't have happened but never ever give up. So B L O N  D determined we've already explained that. D on't give up and E: energise by sharing you will energise others you will energise your team who will be proud that you shared their work and you will energise your colleagues working throughout the NHS and social care who right now with what everybody has been through with the pandemic, they need your energy. So be blonde!

Gill Phillips  37:21

Be blonde! Yeah. And that ‘energise’ is so strong and when we get round to doing our pledges at the end of our workshops, I can't believe the way the room lights up as people share, that they actually realise that they individually can do something, they're not waiting for, like ‘the top three things on your ‘table and all this rubbish. It's like you are passionate  about something. What can you do about it and people are owning it. It is brilliant. So Terri,  let's put this episode out on Fab Change

Terri Porrett  37:50

Fab Change date. Yeah, November the 24th. Wow, that would be amazing. If you can!

Gill Phillips  37:54

That would be amazing. Let's do that on the day. And I think there's a lot of messages here that people can really take and run with. So, Terri, that has been amazing. Thank you so much.

Terri Porrett  38:04

Well, thank you. It's been a wonderful opportunity and nothing gives me more pleasure than talking about the amazing work that people do on the Academy of FAB stuff and their humility and pride in sharing so that others can benefit, so thank you for allowing me to share that

Gill Phillips  38:22

and your passion shines through. It really does. We need more blondes, let's all be blonde.

Terri Porrett  38:28

But don't forget it's a state of mind, not a hair colour.

Gill Phillips  38:32

I’ll remember that!

Terri Porrett  38:33

OK, thanks Gill.

Gill Phillips  38:35

Thank you.

Gill Phillips    38:36

I hope you have enjoyed this episode. If so, please Subscribe now to hear more of these fascinating conversations on your favorite podcast platform. And please leave a review. I tweet as @WhoseShoes, thank you for being on this journey with me. And let's hope that together we can make a difference.