An excellent guest blog on the importance of sensitive and trusting nursing from US-based Melanie Bowen.

Chronic illness can be very difficult to endure for patients and their families. During times of greatest need, sufferers of life-threatening diseases require all the support they can get from healthcare providers, family and friends.
Since patients will spend most of their time accompanied by a nurse in a medical facility or in-home nurse while at home, the strength of the bond that forms between the two could be the key factor in determining recovery rate and potential.
Even if recovery is impossible, good support can bring calmness, acceptance, and closure to the afflicted.

Why is emotional support so crucial to the recovery of patients?

As human beings, we are emotional beings. Our fondness for one another is based on a combination of similarity, frequency of interaction, sentimental behaviour, and emotional and intimate connections. The more ‘proof’ that a person receives from another individual to show that they care, the more attached he or she becomes to the supporter.
Humans need to have confirmation and assurance of their relationships with others to feel secure. Without actions, words mean nothing.
Nurses who show genuine desire to help and befriend patients are the ones that do their jobs the best.

How can a strong relationship between nurse and patient affect recovery?

From liver failure and brain tumours to pleural mesothelioma and malignant melanoma, a close bond between caregiver and patient can speed up recovery time and improve the chances of survival regardless of how grim the circumstances.
First, a positive and honest relationship between a nurse and patient gives the patient happiness. Knowing that somebody trustworthy is always there to look out for them can be a very comforting thought that reduces massive amounts of stress and anxiety.
Fear of death cannot be avoided, but strong physical and emotional support can brush aside many of those constant worry that add to stress and anquish.
Additionally, many chronic patients do not have any family or friends to visit them during times when they need the most love. Caring nurses can replace those missing loved ones to provide the same important emotional support that helps the afflicted fight on despite the overwhelming odds.
Second, caring nurses have intimate knowledge of their patients. This is a huge advantage when providing medical assistance that lessens the strain and pain.
Take the example of 26-year-old breast cancer patient Theresa, whose nurse, Jessica, was her caregiver and also became her best friend. Having been by Theresa’s side for many years, Jessica knew Theresa’s medical history. She gave Theresa candy before the drugs that always initiated her gag reflex, to use a longer needle on her, and to check her bowels if a physician doesn’t request an enzyme test.
By contrast, patients who have to transition frequently between nurses don’t have the beneficial personal connection. New nurses aren’t familiar with how the patient has things done, and they don’t have the personal bond to make them care for the patient like a true friend.
Lack of knowledge about and lack genuine concern for a patient are two things that could hinder recovery progress and contribute to worsening health.
Finally, a significant personal bond between nurse and patient give nurses more reason to give their all in providing for the sick. After spending so much time together, the patient is no longer just a stranger but a good friend. As a true friend, a nurse will have personal reasons along with a career obligation to provide the best care possible.

Time to fess up…’Harry’ is Bern, aka Bernie or Bernard, Shaw. His funeral yesterday was a success if defined by the emotions expressed by those who attended.

Funerals will only be ‘successful’ if properly planned and that takes time and effort from those involved.  The funeral director, W Uden, did a good job, though commissioned by Bern’s sister Joy and his best friend Bill, so I can’t speak for them but everything was agreed and delivered according to plan.

They recommended an excellent humanist celebrant, Jeanne Rathbone, who put the ceremony in a humanist context, understood and related Bern’s positive characteristics and personality and outlined the key events in his life without diluting the tributes that followed. She was most sympathetic and respectful, especially when relating Joy’s reminiscences of their childhood together.

Jeanne also augmented the readings by reciting two appropriate poems, If I Should Go by Joyce Grenfell and How Long Is A Man’s Life? by Brian Patten.

West Norwood crem (see note at the end) doesn’t use the Wesley Music system for playing farewell tracks, so I recorded a CD  with the music for the ceremony.

The tracks were played absolutely on cue by the crematorium manager…Bernard came in to Space Intro/Fly Like An Eagle by the Steve Miller Band. My tribute – memories of our friendship and his unique qualities – ended by detailing some of the music we shared. This included Tom Waits, and so was played his tender, anguished version of Somewhere, from West Side Story.

Then Bill, a loyal and generous friend of Bernard, recalled two or three very humorous moments they shared when Bern stayed with him following his time in Frankfurt. We needed some laughter and Bill delivered.

Hilary, Bern’s partner for an intense period many years ago and who, like many others, has stayed loyal and affectionate, read most sympathetically The Road Not Taken, by Robert Frost. This was chosen by Maggie, Bern’s widow who came over from Frankfurt to attend.

Maggie was deeply affected by the funeral and hugely grateful to all those who attended. She designed the excellent order of ceremony leaflets, using some great photos of Bernard.

The track played during the time for quiet contemplation was Meadow of Delight and Sadness from John Barry’s lovely The Beyondness of Things.  And as we watched the curtains close around Bernard for his final journey, The Joker by the Steve Miller Band played, understood and appreciated by everyone who had cried tears of laughter when Bern told a joke or acted out a ridiculous monologue.

Virtually all came back to The Rosendale to share memories, catch up on old friendships and listen to a playlist to which various friends contributed. The staff were helpful, the food excellent and the music system worked well. More important, it was good to meet members of Bern’s family who attended and whose memories of Bernard were so touching to hear.

Bernard, I’m glad to say, had a good funeral. Several people said he would have approved. On his behalf, then, thanks to everyone concerned. Continue to remember him well.

West Norwood Cemetery is an excellent example of a Victorian metropolitan lawn cemetery and has the finest collection of sepulchral monuments in the capital, including a dedicated Greek Orthodox necropolis. Lambeth Council built the crematorium on the top of the hill from which there’s a great view of London. I recommend it as a peaceful and interesting stroll.

Ed Miliband was given the opportunity to inspire potential Labour supporters on the Today programme when he was asked to sum up what his Party stood for.

His hugely underwhelming answer: “For people to get on and do better.”

This low point in an appalling interview was almost matched by his statement that by encouraging the people to take action, Labour will get the Government to change its policy “like it did when it dropped its idea to sell the forests.”

The ‘people’ did not get the Government to do a u-turn on this rather silly and marginal policy.  It was a small minority of the middle class who made a lot of noise, as Miliband knows.

With such an uncharismatic and hopeless leader, the Labour Party is likely to be in opposition for many years to come, and as someone who until the Iraq invasion was a Labour supporter, this disappoints me.

I’m also very disappointed that David Cameron is a warmonger. He was the NATO leader who first wanted a no-fly zone over Libya which within days resulted in the Allied air force being the air support arm of the rebels, and hugely destructive NATO missiles raining down on various Libyan targets.

He might think that if enough damage is done to Libya’s armed forces, they will refuse to fight for Gaddifi’s cause and NATO’s military action will have achieved its goal.

But as he observes the burning shells of the Libyan tanks, picked off in a sort of NATO turkey shoot, he should consider the terrible deaths of the Libyan tank crews, burnt alive in seconds if they survive the hundreds of pieces of red hot shrapnel screaming around their turrets. These, Mr Cameron, are someone’s sons, husbands, fathers, brothers.

And does he really think that no innocent civilians will be harmed by the ‘smart’ missiles fired from miles away to destroy compounds in built up areas of Tripoli?

At best the damage will be mental scars, at worst the explosive force and heat that burns the flesh off people, destroys the vital organs and causes the slow and painful deaths of men, women and children who live close to the targets of these vile weapons.  These, Mr Cameron, are families, just like yours.

As they suffer, they won’t be reassured by the knowledge that the destruction of their lives has the backing of the UN, or that your policy is to ‘save the lives of Libyans’. Their lives will be sheer agony and uncomprehending horror for which you are in large part responsible.

Yes, Mr Cameron, you probably will force Colonel Gaddifi from power, but at a completely unacceptable cost.

And of course you won’t be shamed by the opposition, because Ed Miliband supports your policy.

It’s not an Alternative Vote we should be wanting when we go to the ballot box in May, but an alternative political philosophy.

Emotionally I’m an interventionist rather than an isolationist.

When I see innocent people suffer whether at the hands of their rulers, victims of natural disasters, or subject to discrimination and bullying I donate to emergency appeals, support societal change and confront bullies.

But I still cannot see any justification for the west’s military intervention in Libya. Indeed I find it very odd that only a few months after we’re being fed the line that President Gaddafi had reinvented himself as one of the Middle East’s good guys, we are expected to support military action clearly designed to remove him from power.

Why no negotiation with Gaddafi and his diplomats before the precipitous rush into military action? It was that notable opponent of appeasement, Winston Churchill, who said that ‘jaw, jaw is better than war, war.’ There wasn’t much talking to Gaddafi before the war planes went in.

Without little idea of the consequences the west has intervened in a civil war.

It hasn’t started too well. A US jet crash landed in the desert, some Libyan rebels went to rescue the crew and were shot at injured by another US plane.

The inability to distinguish between friend and foe dooms any military action to failure.

The rebels are currently the group on whose side we are intervening, but what happens when they take revenge on the communities and tribes that are loyal to Gaddafi?  Our forces will be in a state of confusion because the political goals of the various governments taking part in this fiasco are ill defined and incoherent.

Why also does the west seem to be so keen to kill innocent Muslims? Images of Libyans killed and maimed by western armed forces, families grief stricken at mass funerals, will without doubt radicalise Muslims in all parts of the world, and we know the terrible consequences of that.

I have a horrible feeling that the western leaders have not learnt from recent mistakes. Libya, like Afghanistan, is a cauldron of factions and tribes whose loyalty is far less to a national leader than to local or provincial government.

The lessons from our failure in Iraq have also been ignored. We have no exit strategy and no plans on how to deal with the power vacuum caused by Gaddifi’s overthrow, and these were overlooked in our haste to destroy Saddam Hussain.

Do our leaders know their history? Libya, created as a country less than 100 years ago, is really the sticking together of two different areas, one with its roots in Greek history, the other with Roman antecedents and 500 kilometres of desert in between. Our intervention might well result in two countries where there is now one, presumably not a regionally destablising outcome we favour.

Am I missing something? If so, please let me know.

I felt distinctly worried by David Cameron’s announcement that the UK and its allies (the US) are planning a no-flight zone in Libya to hasten the downfall of President Gaddafi.

To intervene in another country to affect regime change is against international law. Shooting down the aircraft of another country is an act of war. It will lead to more deaths, more funerals of loved ones here and in Libya.

Haven’t we learnt from our doomed intervention in Iraq and Afghanistan that we should not interfere in the affairs of other countries?

Because of the strategic importance of the middle east and the arab countries of North Africa, the world’s media are covering the story in droves. And as a consequence, western populations are seeing the brutal murders of peaceful protesters by tyrannical dictators such as Mubarak and Gaddafi. Understandably, the public’s sympathy are with these innocent people.

Playing to the public gallery, David Cameron thinks that his popularity will increase if he flexes some military muscle and imposes a no-flight zone.

Think again, please Mr Cameron. Explain what gives you the right to judge good and evil on the international stage.

The North Korean regime is starving its people to death. Mr Mugabe killed and tortured his opponents for over a decade, and people are still being beaten up by his thugs. The Burmese junta is a wicked and cruel dictatorship that has killed thousands of people who want democracy in their country.  These are just some of the countries in which rulers are cruel and despotic beyond imagination, and beyond the coverage of the world’s media.

I’m afraid to say that Mr Cameron’s desire for military intervention is to bolster his popularity, and it frightens me.  He must resist taking measures that are illegal to placate media pressure and uninformed public opinion.  It’s called leadership, Mr Cameron, just as much as is the image of a strong man ordering fighter aircraft to shoot down other aircraft.

Similarly it was media pressure that forced the British government to go to the huge cost and effort of rescuing and evacuating British workers in Libya. Surely this is the responsibility of their employers, the oil companies making huge profits by extracting this valuable commodity from the Libyan desert.

Surely they can afford to have planes on standby to evacuate their workers when, as their risk assessment experts will have recognised, the regimes in Tripoli, Cairo, Tunis and, dare one say it, Riyadh, begin to topple.  Or are they too busy looking at ways to avoid paying tax to the UK government?

I doubt very much they will be handed the bill for the military planes and vessels used to evacuate their staff, so they win both ways. Lots of profit, not much tax to pay and when things go wrong, the bill is paid for by the taxpayer.

Just because the Sun and the Daily Mail cry out for action is no reason to break international law, engage in deadly military activities and cost the country millions of pounds it can’t afford. We would do better for the government to take on tax avoiding corporates rather than dictatorships in foreign parts.

A close friend of mine questioned the future of My Last Song.

“Why,” he asked, “would anyone want to visit a website that makes you think about deaths and funerals?”

“Because if you don’t think about it until it’s too late, it really is too late,” I answered.  ”Death is inevitable so plan for it in advance. My Last Song helps and supports people to plan so that things are better when the dreadful time comes.”

How so?  If your loved ones don’t have the information needed for a death certificate, how are they going to get it when you’re dead?

If family members don’t know your funeral wishes, how can they avoid the stress of wondering what you would have wanted? Some families tear themselves apart when arguing over the type – and cost – of the funeral.

Planning a funeral in advance can save a lot of money. You can take out an inflation proofed funeral plan, or you can think about what part of the arrangements you really need, which can be done by the family, and where costs can be reduced.

And, planned properly, the funeral can be a positive, celebratory and unique event that becomes a treasured memory. Unfortunately, all too often, funerals are rushed, inappropriate services that don’t match the lifestyle or views of the departed. In many ways a traditional funeral is a Victorian religious ritual completely out of place in the 21^st century.

You may even see the benefits of planning a farewell event before the death, so that family, friends, ex-colleagues, neighbours old and new can get together for a party at which you are the centre of attraction, giving your final messages.

Or you can ensure the reception is the sort of event you want to be remembered by…music, dancing, speeches, jokes, great food and drink.

It couldn’t be easier to organise. All the information is available on the website, and then you store in your Lifebox your wishes, the music you want played, the ceremony you want…as well as the other personal details your next of kin and executors will need. Simple…and crucial.

We only have one life, and only one death. My Last Song can’t help to make life memorable, but it can make the ending rather special.

Saturday’s Radio Four Today programme included a piece about the shortage of burial land in our cities, citing the example of south east London where cemeteries, including the wonderful but scandalously neglected  Nunhead cemetery, have little or no space.

Today presenter Evan Davies suggested to Dr Julie Rugg who chairs the cemetery research group at the University of York that natural burial grounds offered the solution as they had enough capacity, were outside built up areas and were environmentally friendly.

Dr Rugg replied that natural burial grounds were difficult and expensive to reach particularly for older relatives.  She had come across people in London who needed to use five buses to visit the graves of their loved ones situated in these often remote locations.

She has a point, although such issues haven’t stopped the 30 per cent year on year rise in the number of people being buried in natural woodland sites.

Rosie Inman-Cook, who runs the Association of Natural Burial Grounds, believes the 240 natural burial grounds in the UK “should meet the demand for the foreseeable future.”

Even so, we should take seriously Dr Rugg’s opinion. While from the viewpoint of the reasonably fit and affluent, natural burial has many environmental advantages, to a less well off old person getting to a woodland burial to attend the interment and thereafter visiting the location, presents real disadvantages.

Dr Rugg’s suggested solution was the reuse of the space already taken by a body in our urban cemeteries after it had been there for about 100 years.

While I can see the sense of this, my main worry is the loss of the wonderful gravestones that are such a pleasure when walking in the impressive civic graveyards that our Victorian forebears situated in what was then the outer areas of our towns and cities.

I also think people will not want to bury their loved ones in a space that was previously occupied by an earlier grave.

It seems to me that our age will see its dead being put in fields and woods where they enhance the environment and where there is less pressure on space.

This will present problems, but these can be overcome if families and friends help those more disadvantaged to get to natural burial sites. Maybe that is something that the Big Society can address.

Attending a talk today on the importance of metaphor in our use of language, I thought about the daft names motor manufacturers give their cars.

Three German quality car manufacturers, Mercedes, BMW and Audi, are exempt from this criticism as they have decided to use a numbering system that allows you to know where a particular model fits into the range.  Sensible and logical…unlike the silliness that Porche faces with cars called Boxster which is a dreadfully confused mix of what might be a noun or a verb but is neither, Cayenne, which is a red pepper, and something called the Panamera, another non-word.

The other German manufacturer to get into trouble with names is VW. Golf and Polo were fine as they are international sports, though what makes polo less impressive or expensive than golf is not clear.  Then, in a curious denial of logic, they introduced a smaller hatch back and instead of staying with male dominated and ‘clubby’ sports – Tennis or Squash would have completed the sporty triumverate – they called the wretched car Rabbit.

Peugeot epitomises Gallic logic with its numbering system. If it starts with a 1 it’s small, 2 is a bit bigger and so on until you get to the top of the range which has a 5 at the beginning.

But what’s this? They have now introduced a range called the Tepee, one of which is the Expert Tepee Long.  Which ever way you order these three words, it’s nonsense.

But it’s the Japanese car makers that have the biggest problem with names as their models have to be translated from a rather specific language – Japanese – to words that can be pronounced, if not understood, in those countries where they have their biggest markets. So the sequence of the letters of many models has a Western linguistic feel, but are meaningless. Hence the Toyota Avensis, Prius, Aygo and Auris.

Hopefully the next Toyota recall will be to add some letters to these names to make proper words.

Which brings me to the Mitsubishi Starion.  The story goes that back in the 1980s the top guys at Mitsubishi were very pleased with the UK success of the small hatchback called the Colt. They decided to launch a larger saloon, and a meeting was held in London at which the UK marketing team was asked to present a name for this vehicle to their Japanese bosses.

“We propose,” they said, “to call the model the Stallion because as the Colt is a small horse, so the Stallion is a large and powerful horse. Our customers who want a bigger and more powerful car will want to buy a Stallion.”  There was a pregnant pause…then to everyone’s delight, the Mitsubishi main man smiled a big smile. “Ah yes,” he said, “I agree. It’s very good.  We will call the new car…the Starion!”

I chose several of my facebook friends because I like their views and comments, or they have similar business interests. Others because we share a liking for the same sort of music, arts and entertainment.

Why, though, do so many of them also want to tell me about what they ate for breakfast or bought at the supermarket or what their kids are doing? I’m not interested.

Why waste their time writing trivia, unless it’s a smokescreen hiding a darker, more unpleasant side of their lives.

It made me wonder what sort of Facebook page Hitler would have had.  It probably would have been fairly light on his work activities and containing quite a bit of trivia such as how much he loves children, walking his dogs, staying at his Bavarian estate, how he’s getting on with Eva Braun. No doubt a  few of his paintings.

He probably would have let us know the early career successes. ‘Invaded Czechoslovakia today…went remarkably well.’

Then a few weeks later: ‘Invaded Poland today, think it’s annoyed Britain…oh well, who cares.’

I expect lots of Germans would want to be his friends and like his posts.

Hitler’s facebook page could have saved a lot of lives if he had been honest. ‘Decided to start a republic that will rule the world for a thousand years. Part of the deal is to exterminate Jews, gays, gypsies and the disabled. Rest of the world will be subjugated to German rule. Now off to draw up detailed project chart with Goering.’

It wouldn’t have been long before a group ‘Stop Hitler before it’s too late!’ was up and running.  They might have been taken seriously. I would have signed the online petition.

It’s remarkable that a move to sell off our forests was ever considered likely to go ahead without arousing a great deal of public anger.

For the Government, the worst sort of anger – rational, well-informed, articulate, reasoned – and the worst sort of public – middle class, vocal and reasonable.

It shouldn’t have taken many focus groups or polling exercises to show that this was always going to be an unpopular proposal. It’s not clear what the political or economic advantages are to changing the management of our forests and woodlands.

The great British public, or rather the small but affluent and articulate elite that can afford the time and cost of driving deep into the countryside, enjoy strolling around the woodlands with children and dogs in tow.  They are aware that if organisations other than the Forestry Commission are responsible for the management of the woodlands, their pleasures will be at a higher cost and a reduced quality.

And while Jack and Josephine Upwardly-Mobile are happy to pocket bank bonuses and run PR businesses for ever greater profit, they don’t want commercial companies making money by chopping down the trees their Golden Retrievers pee against.

No, they and their ilk have a nice experience and now very much admire the way their playgrounds are managed by the Forestry Commission, the National Trust or English Heritage.  How dare the Government want to change this arrangement!

Neither Caroline Spellman nor Jim Paice, the government ministers saddled with the unhappy task of ‘selling’ the sell off of forests to this disapproving cohort have sounded very convincing.

La Spellman put forward a view she possibly thought would play well with this audience that local groups and charities should take over the management of their neighbouring forests from the large, impersonal Forestry Commission, under the localism element of the Big Society.

No they shouldn’t. Running a forest is a complex task and beyond the ability of a hard pressed local council or a group of well meaning local people who form a charity on the basis that they are more responsive to local need.

When questioned in the media, by unremittingly hostile interviewers, Spellman and Paice soon seek refuge in the ‘but nothing will change’ stance. To which the obvious response is why change it.

Like most of the country, including those who rarely if ever venture into the woods, I like the two words ‘Forestry Commission’. It sums up a body of experts, boffins, public administrators and a workforce motivated by love of trees, muddy boots, rare plants and furry animals and whose sense of commercialism doesn’t go further than selling nobbly carvings and bird feeding kits to kids called Rupert and Annabelle.

Leave well alone Mr Cameron.