Nothing to celebrate here!
It is getting harder and harder to celebrate being a Nurse.
I don’t know about you but life just feels Meh ( if that’s still a term) at the moment. Everything feels off and it is getting harder and harder to find the little joys in life with so much going on in the world right now. Yesterday was the culmination of Nurses’ week celebrations culminating with celebration of International Nurses’ Day which ironically ( for us Black Nurses) falls on Florence Nightingales birthday! There is a lot to unpack there but that is a rant for another day even though it could be argued that it does fit in with the sentiments i am about to express which is that it is getting harder and harder to find anything to celebrate about Nursing or being a Nurse more so a Black Nurse.
Nurses, who are the backbone of healthcare services all over the world and beyond are tired and feeling under constant assault. We are undervalued, underpaid,overworked and no one seems to want to hear our voices or opinions on how our livelihoods and those of our patients can be improved. Nursing is under assault and it is worldwide. Systems everywhere are out to get us and no one feels that pinch more acutely than us Black Nurses and i am tired and frankly do not feel like celebrating anything nursing at the moment. I know that for those of you have been brought up to believe that Nursing is give-all-no-complaint-noble-godly-self sacrificing vocation, this might seem as a ungrateful thing to say but unfortunately it is the reality.
Racism still has its foot on our necks despite report after report highlighting the far reaching consequences of the effects of racism on Black Nurses and although everyone acts surprised and expresses their displeasure the status quo is truly and firmly maintained or worse. It's like perpetrators and their over lords get more oxygen to double down and dream of more ways to heap misery. Cut pay, overwork them,remove any form of family support or any support for that matter, while making them jump all manner of hoops that they would be forgiven for thinking they were working in a circus. So no, there is nothing to celebrate here. Nursing is under attack and Black Nurses are bearing a huge chunk of this full on assault! I for one do not have the energy nor the required bandwith to celebrate. So until things change and the over lords start valuing nursing and the important part Black Nurses play in propping up healthcare systems worldwide and paying us our worth, there will be no celebrations.
Clocking Off: How I learnt not to take work home!
Black Woman working on a Laptop
As a Black Woman, I am well aware of the double edged sword( Black & Woman) of having to work twice as hard as everyone else on top of having to constantly assess and reassess your work because if anything would go wrong, you would most likely be the first to be blamed. I am also acutely aware of the racial trauma we endure and the need to be constantly hyper-vigilante in all spaces we occupy, which just adds to our racial injury.
The COVID-19 global pandemic has forever changed how we work and the workplace culture that accompanies our jobs, so to speak. In the midst of a forced shutdown, companies and employers were forced to bring in changes that many have been asking for years that most employers have mostly paid lip service to! Working from home became “THE THING” and the era of employer led as opposed to employee led flexible working came into place. Gone was the so-called rat race and all over the world employees were reflecting on what life meant to them and what changes they wanted to make. I for one was here for all of it.
Woman on Laptop and Smartphone
The world of clinical research is a fast paced one with specific timelines on collecting clinical data and reporting them. For example, more often than not, sponsors require data on SAEs to be reported to them within 24 hours of one being reported. As a clinical research nurse/study coordinator, participants had my work number and preferred to call me as opposed to the emergency number they were provided with at the start of the trials. It was great that i had such a close working relationship with our trial participants and that contributed to the smooth running of our trials but it also meant that i was almost always the first to learn about issues arising like an SAE!
That was how i found myself dealing with an SAE and the paperwork that followed, not to mention the numerous phone-calls to the sponsor on a Friday evening way after work, on my own unpaid time. Having a work phone and carrying it home with me, seemed like a great thing to do as a way of getting on top and planning my work but it also meant that it ate into my private home time and i could not really switch off. I literally carried work home with me everyday! No wonder i was constantly tired, feeling like i was being pulled from all sides, but, hey, wasn’t burnout a great marker that you were doing something right?
Black Woman reading a book.
Fast forward to a new job and I am going through all the IT set-up and but this time I have no work phone, so I would not have to carry work home with me and I could maintain that work like balance that I so craved and had etched out but I am also a work in progress, because in the middle of setting up emails and teams, I found myself synchronising my phone to my work emails and teams! Luckily I caught myself just in time to remind myself that I was already doing enough, giving my 100% at work and that work stayed at work!
But we all know that it takes years to unlearn traits that have been part of ones identity formed from societal pressures and perceptions. So I have to fight the daily urge to be on top of everything and synchronise my phone to work emails and teams and remind myself that when I leave work, I make sure I leave ‘work’ behind!
How do you maintain your work life balance? Drop us a comment.
The Wandering Nurse!
x
WHAT'S IN A NAME? When being Kenyan saved my Nursing job!
I would be lying if i said i have never really given much thought to my name(s), after all they are me, my identity even during the times i have rebelled against said names! My whole life has been defined by my names so it came as no surprise when my career was about to be defined by them, even i did not see in what way.
I have ( and I know, many other Black people/ Nurses) lived and worked in a world where my name determined whether I got a job interview, whether I got a job, whether I got promoted or paid equally as my peers! You get it! My name seemed to be a barrier, so when the opposite happened and it became my saving grace, I was very surprised to say the least.
Working for an agency or the nurse bank gives you the flexibility to choose your working hours as well as where it is you would like to work. You also get to work with different teams on different wards and develop working relationships (or not), and this knowledge is often filtered through the various agency/trust bank grapevines. Which wards/units and teams were okay and which to avoid. This meant that there were wards/units that always struggled to get their vacancies filled and the ward and duty managers got clever. They devised ways to get these vacancies filled, unbeknown to us by creating false vacancies within the popular wards/units thus taking away choice, safety nets and in some cases putting patient safety at risk.
I got caught up in these ‘work houdiniships’ on a couple of occasions and apart of causing a of angst and disorientation, they also caused pay disputes with regards to who was meant to sign the timesheets and whose budget the pay would come from! you ended up chasing payments weeks after you had completed your shift. So, i tried to avoid them as much as possible, but oneday i got caught up in one houdiniship from hell.
I had booked a shift on a ward that i knew very well as i had worked on this particular ward as a permanent staff member before and knew the staff and the layout well. I turned up for my shift, bright and early only to be told that they were fully staffed and did not need me and had not booked me! I called the trust bank to let them know what was happening and was told that yes i was indeed booked in for that ward but was meant to work elsewhere to go help with washes and be the healthcare assistant for the day. The ward i was to be sent to was one everyone avoided due to how rude the staff there were making it a very unpleasant ward to work on, hence why they struggled to fill any vacancies. I declined and stated that i would rather go back home as the whole essence of agency/bank work was the freedom and ability to be able to choose when and where you worked, a point that neither the trust bank call handler nor the duty manager took kindly to and i was threatened with referral to the Nursing and Midwifery Council (NMC) for breaking the patient safety code of conduct by leaving the hospital short staffed.
I left the ward after explaining the situation to the manager and matron and went home. On my way home, i received a call from the trust bank informing me that i had been suspended and all pending shifts cancelled pending an internal investigation, and that my return to working for the trust bank would be dependent on the outcome of the investigation. I was annoyed that they would do that and i was confident that nothing would come of the investigation as i had done nothing wrong! So i told her that while i felt it was unfair, their action, given that i was a full time bank worker, i would await the outcome of the investigation. I was then told to write a statement of events, which i did and emailed it to the head of the trust bank as requested.
Two weeks later i received an email from the head of the trust bank asking me to report to her office. Being summoned is never a pleasant experience but i was surprised this time. It was a friendly setting and a very relaxed chat. She said she wanted to meet me and talk to me face to face before she decided how the investigation was to proceed. She proceeded to ask me where i was from as my name reminded her of a brilliant Kenyan Doctor she had worked with years ago at a previous trust. We talked about all things Kenya and how while my name was similar to the Doctors, we were not related in anyway and that i had never met him, let alone met anyone with the same surname as mine professionally during my working career in the NHS.
She then asked me to narrate what happened on the day, which i did and i also told her how common these houdiniships were becoming especially when the duty manager was the same one who had been on shift on that day and how on many occasions, she had moved me to wards where i was way out of my depth, like surgical trauma and when i voiced concerns she had replied that i was a qualified nurse with a PIN. This is when, i was informed of the complaint the duty manager had written, claiming that she had requested me to go to a different ward to help cover due to a crash call and i had refused. It was the first time i was hearing of this false account of events. I told her that she could confirm with the ward manager who had taken the call and spoken to the duty manager and then relayed the message to me, that there was no crash call and that i would not have refused to go to that ward nor left if that was the case! I also got to hear of the letter of support from the ward manager and matron decrying the drastic measure that had been taken to suspend me.
She then told me she had wanted to look me in the eye when talking to me, as she could not believe that a Kenyan would behave in the way that the duty manager had described, because she had worked with Doctor Onyango and other Kenyans and they were all very good at their jobs, reliable,honest, hardworking and put patient safety above all else, so she could not believe that i had been negligent. She had also looked at my file and in the five plus years i worked for them and there had been no complaints made against me nor any caution on my file. She lifted my suspension but said she would keep a note on my file for two weeks and if no issues arose during the investigation, then my file would be wiped clean.
I later found out that the duty manager was sacked after complaints from other nurses about her attitude and false statements amongst other things. I would like to say that houdiniships are a thing of the past but that’s not the case, unfortunately and because the largest agency/bank workforce are from the Global Majority, they bear the brunt of vexatious complaints. I picked up a great assertive tip from (yes), a brilliant Kenyan Nurse for those times you find yourself in a houdiniship:
“State that your skills set do not apply on that ward that you are being moved to, however, if they are happy to guarantee a waiver in writing that they will take full responsibility for any clinical and safety shortcomings that could potentially or accidentally occur, then you are more than happy to work on the new ward!”
I still haven’t met this Doctor Onyango but if he ever reads this, i would like to say a big thank you/erokamano and also a very big thank you to all my fellow Kenyan Healthcare Workers out there.
x
Shamim aka The Wandering Nurse.
Are you Hustling backwards?!
Onwards to new adventures!
One of my favourite programmes on the BBC used to be ‘Wanted Down Under’. It followed families who wanted to relocate to Australia or New Zealand, from helping them find homes, jobs while also giving them a reality check via a comparison cost of living between the UK and their dream new life in a bid to find out if the dream was affordable. For some the better salary and cost of living afforded by moving made the dream a reality and for others it meant hustling backwards, with their dreams deferred or abandoned.
Making the decision to leave home and start a new and hopefully better life in a new place or country is something humans have been doing since time immemorial and it’s a decision that is never taken lightly. For some it is the lure of a better work life balance, affording them more family time or more time to indulge in life long hobbies or passions. For others it is the promise of a regular paycheck and the job security that comes with it, a way to support themselves and their families free from worry and stress of not knowing if they would be able to do so day after day. It is this latter reason that i would like to focus on, because more often than not, the lure of a regular paycheck and job security blinds us and we do not take into account the full picture of what the cost will be and if it is at all worth it.
How can i make sure that my take home pay will be sufficient?
In my book ‘ The Extreme Sport of Nursing While Black : A Survival Guide’ , I talk about the importance of negotiating your salary so that you get paid your worth as well as really scrutinising your contract for any issues before signing on the dotted line. While this is still sound advice, i would like to add another tip, especially for Nurses being recruited from abroad, and that is to carry out a cost of living calculation to find out if would be able to live comfortably with the money you would be paid, your take home pay.
The first step would be to find out what your take home pay would be after all deductions, do not be fooled by the salary figure quoted, as that is normally your gross and not net which is likely to be significantly lower! Remember to ask during the recruitment process and not after you have signed your employment contract! The Salary Calculator is a handy site that helps you calculate how much your take home pay would be approximately. You can customise to see your take home pay yearly, monthly, weekly or even daily. This would give you a rough idea of what you are actually being paid and from that you can then do your cost of living calculations.
Armed with this information and your calculations, you can then make an informed decision whether it is worth it to take that job and uproot yourself from all that you know, or if you can negotiate for a better pay or hold out for one or better still, if staying and diversifying your income portfolio would be best. Whatever decision you make, make it work for you and having the full picture salary wise is one step in that direction and towards a financially secure future.
Here’s to Hustling forwards, always!
The Wandering Nurse x
The Importance of Grieving!
I came across a post ( link at end of post) on my timeline on X ( formerly twitter), by a Kenyan Nurse in the U.K talking about her nursing experience in Kenya especially with the managers, which was mostly negative in terms of their support for anything progress related as compared to her experience at an NHS hospital on a ICU unit, where the leadership encouraged progress and supported it. According to her, this latter experience cured her fear and insecurities around sharing her nursing career goals and dreams. From the replies to her post, it seems that she is not alone in having this fear of nurse managers in Kenya. While i can understand where she is coming from and i am happy that she found healing and a positive leadership style at this NHS ICU, unfortunately this is not the case all over, especially from the point of view and experiences of alot of Black Nurses working across NHS hospitals and even beyond.
What Nurse Cate had done was significant and in those series of tweets ( or Xers), she had demonstrated that she had grieved her past job experiences and resulting traums, healed from the traumas and celebrated her victory in her journey towards her nursing career. In her podcast episode( link at end of post) titled ‘How long can you grieve a job’, Dr Monica Cox talks about how much we can lose from our jobs, in terms of how we enter our workspaces full of high hopes and great expectations to grow and thrive, only for the opposite to happen, and we end up leaving, full of disappointment and disenfranchisement. She talks about how these loses are profound for People of Colour (POC) and those from maginalised communities, and how grieving for those loses ( job satisfaction, promotions, safe working places etc) is important to both mental and physical wellbeing, and is something that should be encouraged and acknowledged.
I was reminded how as Black Nurses, we come into nursing full of hopes and expectations to grow and thrive in our workplaces. We enter the workplace in all innocence, giving our all and, more often than not twice as everyone else, shrinking ourselves to fit into places, institutions and structures that are hell bent on drowning our voices and keep us out. We are forced out of jobs and with it out of our careers, growth, seeing through our work and projects we started. We do not get to bear the fruits of our labour, for the workplace is structured to reward hardwork with progress in relation to climbing ladders, one we do not get to do. It is not by accident that we make up the largest agency workforce, because leaving our jobs and working on our own terms is the only way we can survive, provide and protect our peace. We carry with us all of this trauma of loss, loss of identity, loss of self and loss of security. We carry on best we can and rarely do we stop, take stalk and grieve, to heal.
According to Dr. Cox, we need to grieve our work losses and also celebrate the victories no matter how small. When we allow ourselves to grieve, we start on the healing path. Just remember the saying ‘ grief is not linear’ , there is no timeline. Grieve the loss of a stable workplace but also celebrate the reclamation of your peace, working on your terms and protecting your peace.
Tell me what you think. Is grieving for your job important?
The Wandering Nurse X
Building Wealth: Black Nurses Edition.
In my last building wealth as Black Nurses blog post, i talked about the importance of having financial security that can enable us Black nurses to live and retire comfortably and i also recommended books that one could read to get some inspiration towards starting that journey towards financial freedom.
At that time, i had just finished reading Professional trouble maker( for the 5th time) and had bought Rachel Rodgers’ We should all be millionaires after listening to her story on the professional troublemaker podcast( i truly recommend subscribing and listening to this podcast. It is full of gems and inspiring stories galore!).
We should all be millionaires was an eye opener, not because it was the first time i was reading a book that was geared towards black women like me, but because it was jam packed with myth bursting, lie slaying facts about the lies we, as women, more so black women have been sold about money and our subsequent relationship with it and the systems that have been built to keep the status quo. I was truly floored!
While i learnt a lot from the book, i was also keenly aware that it was mainly aimed at Sistas living in America and that most of the advice given would be near impossible to implement here in the U.K, especially as a Black woman. The whole system is set up in a way that is designed to keep you in your place class wise and race wise. I mean, how dare you try rise above your station and make something of yourself! That’s why most Black artists and business people, move to the U.S.A from the U.K to make it. But that is not to say all is lost!
As i tend to see all things through a Nursing lens, i thought of how i could combine all the knowledge from the books i had read, including consulting , and see how i could come up with ways to help Nurses, especially Nurses in Kenya, scale up their income away from the traditional bedside nursing, and after much brainstorming, i can say i have found a few, which i will be sharing within our groups.
If you would be interested, join our mailing list below to receive the log in link for the Zoom meeting where i will share the various ways you can use your Nursing/ Professional License to scale up your income and hopefully build a successful business and realise financial freedom and stability.
How do we build wealth and financial security as Black Female Nurses?
Tweet by David Ring RN
I have stopped reading any reports that come out about racism at work and society because as a Black Woman, I live it everyday and no report or survey is going to tell me what i and other Black people do not already know. Reports and surveys without actual change and actions do nothing but perpetuate the racial trauma we already experience. So when i saw the above tweet highlighting an NMC report about Black African Nurses, i was not surprised, because again, it is something i have talked about and written about. I chucked it up to another casualty of racism and how it frames our careers and lives as Black Nurses.
As days went by, this tweet stuck with me and i reflected on the ways racism and the status quo goes on to affect every aspect of our lives as Black Nurses. Nursing is a predominantly female profession and so it stands to reason that those most affected by the statistics reported by the NMC report would be Black female nurses. Nursing is a career and a career implies progression, climbing the ladder or whatever it is you want to call it! But is it just a job and not a career when your gender and race are barriers to your progression?
Countless studies and reports have shown that women earn far much less than their male counterparts in all parts of society( google can be your friend if you want to read all about it), not to mention the time off and part time working that women have to take on, if they want to start and raise a family. This gap in payment also translates to pensions thus affecting women’s retirement. As Black female nurses we get to fight on two fronts, the gender pay gap and the ethnicity pay gap, add the lack of career progression into the mix then you start to get the stark and bleak picture that this all paints for our futures!
I have not worked in the care home sector, so really can not speak to work and career progressions within that sector but i’m sure it holds the same prospects for Black Nurses as in any other sector: cheap labour and barriers to progression. As for the agency sector, it holds no progression whatsoever but provides that work flexibility that doesn’t exist with a substantive post, without the job security( but then again is job security a luxury afforded to us Black Nurses?)! More often than not, we sacrifice our dreams and hopes for that fulfilling career as a nurse( and i’m not talking about job satisfactionhere), and buckle down and work the hand that we have been dealt, as we have our immediate and extended families depending on us both here and abroad( back home), as well as the ever present bills and everyday living costs.
How do we ensure that we secure ourselves financially in the present and for the future? That we have something to show for all our hard work and that we can retire and live comfortably with our health both physical and mental, intact? That we can build or start to build that generational wealth? That we can leave our children better off? While the nursing path career now has more choices than just bedside nursing, we as Black Nurses, especially female nurses, have to find a way to diversify like some of our white colleagues who have taken to providing beauty treatments like botox or like Doctors and other Allied health professionals who can open a private practice We can not just rely on that one income stream from working for a care home or agency. How do we make our nursing NMC PIN work for us?
I can not pretend to have the answers as to how we can secure ourselves financially, i will leave that to the experts, but i hope this post starts a conversation, starts something, a spark, a desire to learn about wealth management, to have wealth, blessed wealth, to live comfortably , to not shy away from the notion that we are worthy, worthy to live a comfortable and financially secure life.
If you are looking for some direction or inspiration, then i would recommend reading ‘The Professional Troublemaker: The fear fighters manual’ https://amzn.to/3uHMLbYby Luvvie Ajayi Jones and also listening to the podcast as well. Another great book to read would be ‘The Power of Expertise’ https://amzn.to/3HJaQXVby Elle Pierson RN and ‘We should all be Millionaires’ https://amzn.to/3BqbFAWby Rachel Rodgers another one would be ‘Get Good with Money’ https://amzn.to/3W5XSHtby Tiffany Aliche. You can also follow their accounts on social media for hints and tips if reading is not your thing( you can get them in audio format as well!).
Here is to taking charge of our financial security and to a better future as Black (African) Nurses!
"CALLING IN BLACK": Affirming my humanity as a Black Woman at work.
“If you are silent about your pain, they will kill you and say you enjoyed it” - Zora Neale Hurston.
“10”! A high or low number, depending on how you look at it or the circumstances. It was a number i was proud of, a badge of honour of sorts, a vision and reality of how “strong”, “resilient”, “efficient” and “dependable” i was. I mean i was a put -your -head -and -work- kind of person, just get on with it. What i didn’t realise was that, perfect number 10 was killing me, taking it’s toll on me and was in some ways, rooted in racism! You see, for 15 years working as a qualified nurse, i had only taken 10 sick off days! i had a near perfect sickness record, but my mind and body were falling apart!( I write about this in a previous blog post: https://www.ayiechoodembiconsultancy.com/about-healthcare/racism-in-health-a-patient-safety-issue-navigating-healthcare-while-black-part-2
“Calling - in - Black” to work was journalist and social media satirist,Evelyn Ngugi’s way of affirming her humanity to herself by staying home from work to deal with the feelings of grief and it’s emotional toll after being overwhelmed by traumatic events around violence and trauma fueled by racism faced by Black/ African American persons in the U.S.A, according to Byers et al who wrote about her work in their paper: -Giving while grieving: Racism-related stress and psychological resilience in Black/African American registered nurses. Their paper looked at race related stress in the healthcare system and how Racism-related stress can affect nurses’ engagement, performance and practice. It is a great read and worthwhile read
Byers et al are not alone in looking at how racism affects the mental health of Black Nurses, according to a study conducted by Nursing Outlook, cited by Portia Wofford in her post : - Black Nurses’ Mental Health Matters, Black nurses perceived that they had low psychological resilience in stressful situations and were affected by both lived and vicarious racism. Portia also includes this quote below in her post which resonated deeply with me about my previous and current experiences within my workplace and how i now choose to respond to them.
According to psychotherapist Megan Watson, "Microaggressions and macroaggressions in the workplace, that stem from patients, colleges, supervisors, management, and the institution itself might be rooted in racist ideology and can put a heavy burden on the work that you do and ultimately impacts your burnout."
How does all this relate to me and my sickness record? Well after years of enduring pain and illness, showing up to work regardless of how i was feeling, because taking time off sick was (and is still) frowned upon, more so for us Black Nurses in the NHS, COVID19 happened and finally there were conversations happening around workload, racism, mental health and burnout especially around and about Black healthcare workers. For the first time, it was laid bare the unfair and uneven system and bias with regards to all four and more that had been placed on Black healthcare workers and the toll it had taken. Conversations around and about change were happening. Organisations promised to do better, be better, but words without actions are just that, words!
Fast forward to 2022, and i am working at a new organisation, a global one at that, with branches worldwide and nothing has changed. The racist ‘Strong Black Woman’ myth is still firmly in place. The myth that as a Black Woman/Nurse, you can do it all, you can manage the heavy workload without help at all and you will be more than fine, since you are a Black Woman and a strong one at that! It is coated in fake accolades, that tell you how efficient you are, how capable you are, how you just ‘get on’ with it, while more work is piled on and you dig in, carry on, because, as a Black Woman, you know you have to do the work or else you and your work will be called into question. You carry the load even as it breaks your back and mind. Do not be fooled by the accolades, the false praises that are slowly sending you to your grave, eating at your soul. Do not be fooled, no one is coming to save you!
So while, nothing seems to have changed, I have. It’s business as usual on the ‘trample on Black folks/Women’ street. So i am glad that i learned from my past mistakes, my betrayal of self and body. I learnt not to be taken in by the accolades. To see the situation for what it was, exploitation, rooted in racist ideologies. I learnt to listen to my soul and body. So next time the myth of the ‘Strong Black Woman’ came calling, and tried to break my body and soul, I listened to my soul and body and I Called in Black! I mean what is a perfect score worth, if you are not around to enjoy it because your body is totally broken or you are 6 feet under? Like Zora Neale Hurston said: “ If you are silent about your pain, they will kill you and say you enjoyed it!”
Do not suffer in silence, there are steps you can take to safeguard yourself:
Talk to your manager about your work conditions and if your manger is the problem, find out who your HR person and what your workplace policy is around raising grievances and complaints and escalate the issue. Write a letter/email highlighting the issues you face and who you have raised it with and when and what was the outcome. That way there is a record and not just a word of mouth scenario. See also https://www.gov.uk/raise-grievance-at-work of how it should work and what to expect.
Ask about your organisations Occupational Health Policy. Occupational health can help establish a safe working environment for you by providing a range of services which could include recommendations around safe work loads and safe working spaces with correct equipment. You can read more at: https://www.acas.org.uk/using-occupational-health-at-work
Further reading/resources:
Harder, better, faster, stronger? Work intensity and ‘good work’ in the United Kingdom https://onlinelibrary.wiley.com/doi/full/10.1111/irj.12364
RCN Nursing Whilst Black Podcast Series: https://www.rcn.org.uk/About-us/Diversity-and-inclusion/Nursing-whilst-black
Celebrating Black Nurses’ Impact on UK Healthcare: https://www.florence.co.uk/posts/black-nurses
New anti-racism resource for NHS nursing and midwifery professionals: https://www.nmc.org.uk/news/news-and-updates/new-anti-racism-resource-for-nhs-nursing-and-midwifery-professionals/
Combatting racial discrimination against minority ethnic nurses, midwives and nursing associates: https://www.england.nhs.uk/long-read/combatting-racial-discrimination-against-minority-ethnic-nurses-midwives-and-nursing-associates/
A Point of View: Calling in Black: https://www.theinclusionsolution.me/a-point-of-view-calling-in-black/
Black Fatigue by Mary-Frances Winters: https://www.amazon.com/Black-Fatigue-Racism-Erodes-Spirit/dp/1523091304/ref=sr_1_1?dchild=1&keywords=black+fatigue&qid=1592415015&sr=8-1 https://www.wintersgroup.com/black-fatigue-is-available-now/?__hstc=201086513.b0b4ad3e2d6f8cb2ac5c1fbd0bfcdd30.1667634858234.1667634858234.1667634858234.1&__hssc=201086513.2.1667634858236&__hsfp=638492305
Calling in Black by Nicholle Ramsey: https://www.amazon.co.uk/calling-black-Nicholle-Ramsey/dp/173607461X
A QUICK & HANDY GUIDE TO SETTLING IN THE U.K: FOR KENYAN NURSES!
Part 1: LOOKING AFTER YOURSELF - Physically & Mentally.
After months and weeks of frantic preparation, you have finally made it to the U.K to begin the next chapter in your Nursing journey. Congratulations on making it this and best wishes in all your endeavours.
The Covid-19 Pandemic has shown us now more than ever that ‘health is wealth’ and by health i mean overall health( physical and mental). Moving to the U.K might not seem like a big change in terms of things like jet lag etc because there isn’t such a huge time difference like with other countries e.g USA and also being that Kenya was former British Colony, some things are familiar, but it is a big change weather wise, culturally, food wise, socially and even accommodation. Once the excitement of moving to a new place dies down and everyone gets back to the daily grind, it can all seem overwhelming causing anxiety and loneliness in some cases.
That is why looking after yourself and knowing what to look out for and where to get help/ resources when needed is so important. When i first came to the UK, the only serious illness that i had ever experienced was Malaria. So months later i was in bed not able to get up, whole body aches and pains, sore throat and running nose. I genuinely felt like i was dying and having no family or friends around to lean or look after me only made it worse. I was staying at a hostel at the time, where meals were served at set times downstairs in the canteen. I managed to drag myself on day 2 of being ill downstairs and the security guy at the desk took one look at me and said ‘ i see you have finally got the welcome FLU’! He asked if i had any supplies, i had no clue what he was talking about? it was summer, how did i have the flu? He helped me get some food, got me some Lemsip, tins of soup and multivitamins. He then went on to explain to me what he meant by the ‘welcome FLU’! He was from South Africa and over the years he had noticed that those who migrated to the UK, got this one bout of very strong flu within weeks or months of them migrating. I know it is not scientifically backed but then i started noticing the trend amongst friends and colleagues who had migrated as well. So i pass on this tale to you as a forewarning to be prepared and have some supplies, just in case you get hit with this ‘Welcome FLU’. Thanks to him and his rescue pack i was on the mend and back to work.
You can buy your much needed rescue supplies from any pharmacy over the counter or from most supermarkets, but i would recommend BOOTS: https://www.boots.com/ over all the others like Superdrug, Lloyds or Supermarket pharmacies. My tried and tested reasons being:
Their points/ rewards system is the best out of all of them like Superdrug, Holland&Barrett and signing up for their points card is a great way to save money, earn points which you can use to pay for products.
Their own brand products are just a good sometimes if not better than branded ones.
They have a wide variety of products and lines from baby stuff, cosmetics, skincare and alot more especially at their bigger stores, so you can do all your toiletry shopping as well as pick up essential medicines all in one go and have i mentioned while earning rewards. it a win - win for me.
They also offer a wide range of other services depending on store.
So if you have not already done so, get yourself a boots card and thank me later!
You may have come with your friends as a group or have family here in the UK which is great as having loved ones nearby can be a blessing when adjusting to new settings and scenarios. Technology has also made it easy for us to stay connected to those who are far away. Sometimes due to work commitments or time differences it may not be possible to stay in touch with friends and family that you have left behind as much as you would like to or even at all.
You are not alone and there are support networks you can plug into. Most NHS Trusts provide some sort of counselling/ therapy services for staff that you can self refer to or call if you feel overwhelmed and need help, be it work or home related. I am not sure about provisions in other settings like Care Homes or Private Hospitals.
Others that might be interest and are worth noting down/joining are:
KENYA NURSES/MIDWIVES- UK( KENMA UK) : http://knmuk.org/ They aim to bring together all UK Kenyan nurses and midwives for common good and to help collaborate with like-minded organisations across the world.
Equality 4 Balck Nurses: A great organisation that can support you when you are experiencing racism or discrimination at work. They also have a weekly zoom session that you can join as and when for support. https://www.equality4blacknurses.com/
Part 2: LOOKING AFTER YOURSELF - Money Saving/Work/Food/Shopping Tips
You would have to be on another planet, if you are not feeling the pinch or have been affected in someway or another with the global cost of living crisis! Lets just say that even before the Covid-19 pandemic and the war in Ukraine, nursing pay has not been that great and that we have been feeling the economic downturn shift for a while now.
I remember going shopping for food or anything and converting the cost into Kenya Shillings and almost fainting. I still do it even now, 20 something years later! I refuse to buy an avocado for £1! You’ve got to draw the line somewhere. As a Nurse working within the NHS or Social Care sector, you can get discounts across many high-street stores by just showing your Work ID badge, or via your local NHS Staff discount pages that your has managed to negotiate on your behalf as part of their staff benefits, or you can sign up for Discount Cards, that you can use to get money off your shopping, phone deals, home gadgets and much more. Some come with an initial fee to join, but are worth it in the long run. Two that i can think of are:
Blue Light Card: For just £4.99, members of the Blue Light community can register for 2-years access to more than 15,000 discounts from large national retailers to local businesses across categories such as holidays, cars, days out, fashion, gifts, insurance, phones, and many more. https://www.bluelightcard.co.uk/index.php
COSTCO: Great for if you prefer to shop in bulk. https://www.costco.co.uk/
FOOD
If you like eating out and are craving that Kenyan feel to going out, then you are in luck if you are in London, mainly East London, as most Kenyan Restaurants/ Eateries are based there.
If you happen to be based in Swindon then Masai Choma House on 131 Ferndale Road is your place. Other places can be found via Google or word of mouth but remember not all those that use our Kenyan Heritage actually cater for them.
When it comes to food shopping, it is worth shopping around but time to do that is rarely available so my go to supermarkets are: Lidl and Aldi. They are pocket friendly and most of their stuff are own brand and actually taste way better than the branded stuff! In fact buying Supermarket own branded stuff not only saves you money most times, they actually taste better most times ( Think Panadol/Paracetamol).
For Spices and stuff like Maize meal and Chapati flour or even greens and fruits, then its cheaper and better to buy them from your local South Asian store which are mostly branded as Halal stores as opposed to the World foods section that have now popped up in most major supermarkets. I tend to get my Meat/chicken and fish from there as well.
PHONE/SIM CARD PROVIDERS
Calling home( Kenya) used to be a problem, one had to buy a calling card or use access codes to call home. Calling home has never been easier especially with apps like Whatsapp, Facebook Messenger etc, the only problem is that they require the party that you are calling to be online and we all know how expensive bundles in Kenya can be. While you can roam with your Kenyan numbers and use them to call home, you will need a local UK number for day to day use. If roaming, i find that Safaricom is cheaper that the rest.
Most service providers conduct a credit check before you sign up for a monthly/ post paid deal. If a pay monthly deal is not your thing then there are great pay as you go Sim only deals out there. remember to check coverage in your area, you do not want to get a deal where you can only use in certain spots! If you want a UK line that you can also use to call Kenya on then my go to one is LYCA: https://www.lycamobile.co.uk/en/rates/#/international , it has great low rates when calling Kenya and also free Lyca-Lyca calls.
Whatever provider you are looking for, do not forget to check what savings you can make using your Blue Light Card. Usually you can save more on top of discounts already provided by your selected provider.
CLOTHES & OTHER STUFF.
I am not much of a clothes shopping person as most of my time is spent either in my work uniform or in my pyjamas once i am home, so i would be utterly useless at telling you where you can get the latest fashions etc. I also hate shopping so i tend to go to one store and that is it and for 20 or so years Primark has served me well, especially when it comes to essentials needed for work and new items and for other stuff like coats and jackets or seasonal wear, Charity or thrift shops are my go to places. But those are just my preferences.
The UK is a place where you can have four seasons in one day! I have also discovered that an Umbrella is much of a hindrance than help when it is raining as it rarely rains without wind or in a straight fashion! rather, as one friend put it ‘ it rains in a diagonal way’ and half the time you spend trying to stop the umbrella from flying away! Investing in a couple of waterproof good coats is essential. A thick one for winter, a slightly lighter one for Autumn and Spring and a general light rain coat for summer. I would also add a fleece sweater for work, if your work place does not provide one. They are much more comfortable and less bulky to wear when at work.
It would also be a good idea to buy some leggings or thermals that you can wear under your uniform, especially during the cold months as you have to bear below elbow when in a clinical setting, so wearing a sweater on the ward is a no-no. I tend to buy the long sleeved basic tshirts and leggings at Primark, not forgetting a couple of long thick socks.
You will quickly find out how expensive anything Black hairdressing is with varying quality at every turn, so if you have that friend who knows how to braid, plait or style hair then keep them close or else you better learn fast how to look after your own hair and how to make a hairstyle last that bit longer. All things Black hair are a tad expensive and hard to find unless you are in a town that has a Black Hair Store. If you happen to find one in your town, ask them if they have an in house hairdressing place. Most of them do. You can also find a limited amount of Black Hair Products in Boots, Superdrug, Amazon, online stores and some select supermarkets.
These are just some tips that i hope will help. I know it is not at all exhaustive but i hope it can be start into getting you settled. If there is anything else you would like me to touch or expound on, please let me know. Please share with friends or anyone who you think would benefit.
Wishing you all the best in all your current and future endeavours.
WHAT IS BLOCKING YOUR CAREER PROGRESSION?
“The days when NHS staff can progress at equal level is the day NHS can say they are truly inclusive and equal. If newly graduated nurses can reach to Band 8 within 3 years and non-clinical support staff to Band 6 but ethnic minority staff have to wait atleast minimum 10-20 years”. Mushtag
@mskahin1 (Twitter)
The above tweet from Mushtag was as usual a ‘pause for thought’ read and it reminded me of something a couple of Nurses from an ethnic minority background told me when i asked them why they had not applied for the Band 7 post in their department? Their answer was sad, but not shocking and was one i had heard several times, including from myself- They did not want the added stress and lack of support that came with moving up and that they were comfortable where they were, not happy or content but comfortable. A put your invisible head down and get on with the work, kind of situation. Get your pay and maintain the status quo!
As a Black Nurse, i understood this all too well. When opportunities seem like traps, not because you are not qualified, (in fact you are most likely overqualified, given that we always have to put in twice the work!). But because, you have witnessed those before you, who worked hard, climbed the ladder only to find that there is no support whatsoever at the top. That you would be expected to take on much more and often for much less. That the brick walls you will encounter will knock you so hard that you will end up being a shell of the person you once were and that finally you will pay heavily with your health, only to realise that even in sickness/illness, we are still not the same!
At one former workplace, Black Nurses were terrified of promotions. They told me that it was because they had witnessed their colleagues being sacked right after being promoted. To them a promotion to either Ward Sister or Manager = a P45. There was this one ward that seemed to have problems and no manager had ever survived once they were moved to that ward, most had to be redeployed elsewhere. So when one of the Black senior Nurses on our ward, after years of applying, got given the post of ward sister and moved to that ward, instead of celebrating her promotion, all the Black Nurses were sad, a mourning of sorts, because they were sure she was on her way out. That is how messed up this whole situation was.
This whole situation is also reflected in the Ethnicity Pay Gap as is evident in the research paper below ⬇️ . One may say, that Agenda for Change(AFC) has eliminated inequality and the pay gap or that within the NHS it is not common for there to be pay gaps amongst Nurses due to banding. But even within those banding, there are different pay-points and your moving up a pay-point is dependent on your managers assessment during your PDR, also on what progresses you have made. If you have not been given those opportunities to better yourself, to improve your practice, access to training which is not just the run of the mill mandatory training! If you have not been afforded those opportunities but instead have had your workload increased, as a warped way of rewarding your hard work, that you have proved that you can handle more responsibility, but without the correct pay, then a pay gap ensues and inequality is at play, do not be fooled.
Research Nursing as a career option.
Nursing has evolved over the years and has opened up many career paths, one of them being research nursing. While nurses have always helped in research in one way or another, it is only in recent times that the role of nurses in research both as clinical researchers in their own right as well as helping run clinical studies as research nurses, has truly been recognised and feted, but there is still a long way to go in dispelling the myths that surround Nursing and Research and also Research Nursing. If you have heard of ‘evidence based practice’, wondered why CPR changed from 15:2 compressions/ breaths to 30:2, or why manual handling has changed over time amongst other things , then you have engaged with research.
Who is a Research Nurse and what do they do?
“ A research nurse is a registered nurse who plays an important role in delivering clinical research which in turn improves treatment pathways and patient care” - RCN.ORG
“ Research Nurses bring studies to life” - Lisa Berry, Senior Research Nurse.
According to the Royal College of Nursing(RCN), a career in research nursing offers nurses the opportunity to use core skills, contributing to the development of new evidence and improving patient care.
“Clinical research is essential- It is the only evidence-based method of deciding whether a new approach to treatment or care is better than the current standard, and is essential to diagnose, treat, prevent, and cure disease” - RCN.ORG
I first came across research nursing while working alongside research nurses as a student nurse, working as a clinical trials assistant in a clinical trials unit, working with healthy volunteers, testing new drugs and devices. Years later after qualifying i worked as a research nurse, a role that was very different from ward based nursing but still utilised the clinical and nursing skills gained whilst working on the wards. There is this disconnect between ward based nurses and research nurses, a misunderstanding amongst nurses that research nurses do not really do much and are not really ‘Nurses’. The roles, while different all require use of nursing and clinical skills. The national body that is responsible for research in the U.K, the National Institute for Health Research ( NIHR) is trying to bridge this gap with their ‘Clinical research is everyone’s future’ which aims to embed a research culture across the whole of the NHS by encouraging a research positive culture and encouraging all NHS staff to be research aware and active. Some NHS trusts with Research and Development (R&D) departments have short/ week long clinical placements as part of the student nurse pathway which is a great way for students to be exposed to the practical side of clinical research.
As a research nurse you work within a wider team as well as autonomously within Good Clinical Practice(GCP) guidelines and your duties include but are not limited to:
Acting as a patients advocate while supporting them through their treatment as part of a clinical trial.
recruiting patients to clinical trials.
Sample collection and processing
Data collection and submission.
Coordinating clinical studies from initiation, management to completion.
Preparing trial documents, submitting trial documents for regulatory approval.
Managing a team.
How to become a Research Nurse.
It is not possible at the moment to come into research nursing as a newly qualified nurse. Some clinical experience is needed, but there are ways you can still get a so called foot in:
Find out if your Trust has a research and development department or your local research network and what research studies are being run in your hospital/ ward and how you can help the research team. You could be the ward/ department research link nurse.
If you work soley for a nursing agency, you could find out if they have contracts with private research companies where you could do some shifts ( training is always provided).
Do your Good Clinical Practice ( GCP) training. Training opportunities can be found on the NIHR website or via your local /regional Clinical Research Network (CRN)
The above will work in your favour when you decide to apply for a permanent research post. These can be found on the NHS jobs website or other job search sites like indeed . Just search for Research Nurse. You can also apply to work as a research nurse for Clinical Research Organisations ( CRO) , G.P practices and Charities like British heart Foundation, Cancer Research just to name a few.
Things worth noting.
Every research study is unique and has a protocol that determines how the study will be conducted. Detailed study specific training is normally provided before each and every study. Research specific training is provided by the trusts local research and development department or the local clinical research network (CRN) or the research organisation that you work for. If in doubt, always ask. There is always a team of people willing to help.
Research and the research network still has a diversity problem in terms of workforce and in patient/ participant recruitment. This is an area that the NIHR are trying to rectify with their key priority of: Promoting equality, diversity and inclusion in research.
“We are committed to equality, diversity and inclusion in everything we do. Diverse people and communities shape our research, and we strive to make opportunities to participate in research an integral part of everyone’s experience of health and social care services. We develop researchers from multiple disciplines, specialisms, geographies and backgrounds, and work to address barriers to career progression arising from characteristics such as sex, race or disability” - NIHR
As earlier indicated, research nurses work within a wider team but also autonomously , which means at times working alone in terms of patient/ participant recruitment, data collection and input, arranging patient visits and all study related actions that do not require the Principal investigator (PI). This can at times be challenging in terms of getting time off or annual leave. So with this in mind, make sure when you are interviewing for a research nursing post or before you sign any job offer contracts, you:
ask what support network is in place to help with studies.
How many studies would you be expected to manage and if an intensity tool is used to access each study.
who you have as back up for your studies if you are the only one in post and not part of a team especially if it is a speciality specific role, who can cover your studies when you are off or on annual leave.
The current Covid-19 pandemic has helped to highlight the importance of research and the important role research nurses play. The research nurse role is diverse and broad, and everyday is different with patient advocacy at the very heart. You can learn more from the links below.
Useful Links/ Further Reading:
What was your first encounter of racism? Talking Racism with Getrude of World Class Nurse.
As part of Black History Month in the U.K, I talked racism in life in general and in Nursing with World Class Nurse- Getrude on her platform. We also talked about what help is out there for Black Nurses in terms of support.
We also talked abit about my book, it’s inspiration and how it can help Black Nurses. I will be donating a couple of books to World Class Nurse as well.
Click on the link below ⬇️⬇️ to listen to the talk.
https://youtu.be/CPLF0MpgH2o
What's New? Flexible Working and the NHS.
There has been a lot of talk about flexible working in the media, especially now that we have a stressed and burnt-out workforce in the NHS , not to mention staff shortages. The pandemic has also shown the importance of work-life balance and people’s perspective as to what is important in their life has also shifted. A more balanced life is now more than ever appealing than the rat race we were all sold. So it came as no surprise when an email from work had an article about the new changes to flexible working procedures. Apparently as a Nurse, you can now make unlimited flexible working hours requests right from day one on your job ( Personally i would rather have it ironed out during recruitment/interview stage and have it written down in my contract before commencing employment).
As you may be aware, Section 33 of the NHS Terms & Conditions Handbook changed to reflect a change in approach to flexible working. This reflects the commitment in the NHS People Plan to support our colleagues to achieve a healthy work-life balance, to aid staff retention as well as attracting new and diverse talent to the organisation. Research shows that there is an increasing demand for flexible working from colleagues across all age ranges and genders.
The surprise was where this information was located, Section 33 of the NHS Terms and Conditions Handbook! This admittedly was the first time i was hearing of such a handbook and i had so many questions not to mention i was curious as to where one would find this Handbook. What was it about? Who had written it? and why had i never heard of it? So read the highlights of the changes as laid out in the email, which to me did not look like change at all but much of the same as before in terms of requesting flexible working and the person who had to approve it but at least there now was what looked like a clear stage to follow, a formal procedure consisting of 4 stages ( as per this trust ) and what actions and outcomes were expected or not and how they would be handled. I was still sceptical as to how or if it will work especially for my fellow Black Nurses as management still pretty much remained the same.
The key changes include:
· A stronger focus on creatively exploring ways to support flexible working wherever possible, whilst still supporting high quality, effective service delivery.
· The right for all employees to request flexible working from the first day of their employment regardless of the reason for the request, or the role/band or grade/area the individual is employed in.
· No limit on the number of flexible working requests that can be made in a 12 month period.
· A focus on normalising flexible working conversations through regular and informal discussions at induction, PDR, 1:1s and team meetings. The purpose of this is to explore the individual’s needs and wishes and what options might be available to help employees think about whether they want to make a request.
I did a quick google search, where would we be without google! and i found this Handbook on a website that said NHS Employers. Now this was another revelation, who were NHS Employers and if they were that important and dealt with matters NHS workforce related, how come i had never heard of them? The more i read the more perturbed and angry i got as had i known about them then my work situation in terms of flexible working requests might have turned out differently. Who are NHS EMPLOYERS and why should you know about them? They are a government agency, part of the NHS Confederation and from the looks of it a very big deal. I would call them the mother of all NHS HR.
NHS Employers is an organisation which acts on behalf of NHS trusts in the National Health Service in England and Wales. It was formed in 2004, is part of the NHS Confederation, and negotiates contracts with healthcare staff on behalf of the government.
“We are the employers’ organisation for the NHS in England. We support workforce leaders and represent employers and systems to develop a sustainable workforce and be the best employers they can be. We are part of the NHS Confederation.”
I scanned my old contracts to find any mention of them, yes we all knew about the NHS Constitution but not of this Handbook that held the answers to all things work related for the NHS. The ultimate NHS HR Bible. The reason i was looking was because this information would have been of tremendous use to me almost two years ago when i needed flexible working hours or what i now know is called an employment break ( NHS T&C section 34) in terms of taking time off but no one not even my then manager knew who or where to turn to. I wondered both loudly and privately about senior managers often consultants who were on sabbaticals and how they got those and what the process was? I even discussed this with my then manager as having this information would have influenced how i went about making the choice of caring for my Dad and work. So i am annoyed that nowhere in my contract not even on the HR page of the trust on the intranet was it mentioned that an employee could find this information in the NHS Terms and Condition Handbook! More alarming is that my then manager had no clue, while this was meant to be part of leadership knowledge so to speak. The only place i could find ant mention of them was under matters of pay as below.
“ARRANGEMENTS FOR DETERMINING PAY AND CONDITIONS OF SERVICE This appointment is subject to the National Terms and Conditions of Service that are agreed by the NHS Staff Council (and Agenda for Change: NHS Terms and Conditions of Service). A copy of the Terms and Conditions of Service is available from your Manager or on the Trust intranet.”
Anyway my time has passed now and whatever decisions good or bad have long been made but i would be remiss in my duties if i did not mention the Handbook and the importance of being thoroughly acquainted with every aspect and detail of it just like i advised in the Extreme Sport of Nursing While Black: An unofficial survival guide book under ‘wolf in sheep’s clothing aka HR’. Please have a read as it may be the answer to the questions you have been asking and might help you in making that work-life decision.
NHS Terms & Conditions Handbook: https://www.nhsemployers.org/publications/tchandbook
NHS Employers: https://www.nhsemployers.org/
Now you know!
Racism, Nursing and the NHS
Racism,Nursing and the NHS
The Extreme Sport of Nursing While Black: The Unofficial Survival Guide, started off as me passing on the do’s and dont’s to my daughter who was thinking of working for the NHS and like every other thing her race came into play. She is in the band of what i call the ‘triple threat’ i.e Woman, Black and Muslim. Unfortunately she, like many of us before her would have to do thrice the work, constantly prove herself in all that she does. I was determined to at least equip her with the weapons she would need as yes it is a war out there. At the same time there was also a lot of issues around racism and nursing on social media and this is how the book or booklet idea was born of using my experiences working as a nurse as examples of the things that are likely to trip you up as a black nurse on the NHS and how to avoid them, hence making work a tad more bearable while the NHS and other health organisations catch up to racism within themselves and work towards finding lasting solutions to eradicating it within and without themselves. For far too long, the onus of fixing the racism problems that plague the world had been left at our doors, we, the very victims. it was time the script was flipped.
It is crazy that Black people are still making firsts in 2021 worldwide and in the NHS. You would be forgiven for thinking that Black people only recently arrived in the U.K as opposed to having been part of the NHS since it's inception! How is it that out of the 223 NHS trusts only two have chief excutives from BME background , one being black? According to NHS providers.org: https://nhsproviders.org/inclusive-leadership this under representation of BME’s is repeated across NHS boards country wide, and even though they note that the number of senior BME’s is increasing, i wonder how many of them are Black? The NMC does not escape this affliction, looking at their 16 senior representatives.
How is it that those who are at the snowy white peaks of power within the NHS did not notice or question why the peak was so white? It all well and good that they are questioning this now but how is it that they did not notice this anomaly while rising up? How did they not question why their black colleagues were hardly getting out of the band 5 starting block, while they were sprinting towards positions of power? How did they not notice the email exchanges alerting them to new career progression options or the fact that some had job vacancy adverts tailored to their specific needs, just short of actually naming them? How did it escape them that they were disproportionately referring BME staff to their regulators for fitness to practice? Did they not notice or did they not want to notice?
How are we as BME healthcare staff and more importantly as Black healthcare staff now trust that these same people who most likely scaled to the snowy peaks of power on the back of our blood, sweat and tears all over sudden have been on their road to Damascus and have now realised that we as Black healthcare workers are equally as qualified if not over qualified and are quite capable to sit at and take command of the table? The proof will be in the pudding or so the saying goes because we Black people are not going anywhere! So while you all are busy trying to find ways to ‘invite’ us to the table, a table which we really don't need an invite to as we are not guests and have never been,you will come to realise, hopefully when it is not too late that We own the table!