The story of Josė

It was Day 2 of our walk. We were coming near the end of a 22km trek and thoughts were of the town below us- Astorga. Now that the  walk had been effectively bet we were chatting about the afternoon and evening to come. We we’re passing the Cruceiro De Santo Toribio. We weren’t really paying that much attention. To our right an elderly Spanish gentleman leaning up against a white Seat car, about 4 yards to our right. He was struggling appeared to be hailing us over to him. I didn’t understand what he was saying except “help”. But he didn’t look distressed. Normally my first reaction to this sort of thing would be “This fella is looking for something”. Walk on walk on. 

But what ever it was I hesitated momentarily and decided to walk over to him. Sharon wasn’t far behind. Already I could hear her scold me gently in my mind for stopping for the baba. This wasn’t normally what Sha or I did on holidays. We don’t avoid people but we value the space from intense communication that work brings  to go to the level, while on holidays, where we can get by hansomely on a couple of auld grunts at each other during the day. 

Initially I hadn’t a breeze what the baba was saying. But through a mixture of Spanish, English and sign language I copped that he wanted me to hold a branch of a tree while he sawed it. 

Baba was stronger than I’d expected an the sawing took only about 5mins. We were about to walk away  when baba, without either of us fully realising what was happening, slowly and deliberately  took both our hands in his, starred us both in the eyes and said “You are young and you are wealthy” (at this point I thought he was angling for money). But by wealthy he meant young and in good health. Then baba said “When you get to the Compostella De Santigo tell St. James that Josė, as he jabbed the index finger of his right hand into his left chest wall, is well and that he still has a big heart”. With this a big broad smile broke across his face. 

Sharon and I both looked at each other and realised all bullshit aside that something a wee bit special had just happened. 

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Camino 2016 Day 2 – Picnics and Dragonflies 

It being our first day of walking  we were keen to get on the road and decided we couldn’t wait for the hotel breakfast which wasn’t available till 8am. Hotels and hostel gladly offer a picnic instead for early starters to take away with them. This tipically consists of a sandwich of cold meat, a bottle of water, fruit and a piece of sweet cake. With the picnic stashed away in the rucksack we headed off. 

It was great to be back walking again. Leon is a big city and it took us over an hour to shake of the urban sprawl. With all the pellegringos we saw on the train the day before we’d expected to see more out walking. It was only 7:30 am but we could already have missed the morning rush. It’s not  unusual for people to start before the crack of dawn. Mornings can be nippy initially but once that sun is up the temperatures rise quickly. Because your, in general, heading west all the time you have the sun on your back during the morning. It’s a lovely feeling. 

Good walkers will have studied the route for the following day. How long is it going to be? How high are we going? Will  we need our boots? Where are we staying tonight? I had meant to do all this on the train ride to Leon but I slept instead. As a result we just blissfully headed of walking thinking “sure we’ll follow the crowd”. Anyways long story short we nearly missed an important split in the Camino route just after the town of La Virgen Del Camino. Keeping right led to Villadangos and left to Mazarife along a more rustic route but more importantly to our accommodation for the night. With the wake up call taken on board we settled into our walk. It wasn’t long before we spotted a wee place to have our picnic. 

It was sparse enough fair but to us it was beautiful. Sitting in the early morning sun light with the thoughts a good days walking ahead. 

We arrived into Mazarife at about 1pm. A small quaint town. Our instructions were to go to the Tio Pepe Bar and ask them to ring our accommodation and ask them to come and collect us. But we spotted another wee bar with table out on the quiet village street. It was just outside the gates to the village church. Mass was on. Don’t know what time it started at but there was a constant trickle of people in and it the whole time. About 20 mins later mass away over and as far as we could see everyone who was at mass came out the gate and into the bar we were in. There was great chatter and laughter. The tapas were flying out of the place. Only a few were drinking alcohol. Usually a small beer or a wine.  It was mostly soft drinks however. It was obivious that everyone knew each other and probably each other’s business as well. What struck us was that off the maybe 60 people who came out of the church there was only one young family. The main age of the group was between 70-80 yrs with a scattering of 50-60 year olds. Here in rural northern Spain most of the young folk move away to the bigger cities for work or education. An elderly woman in a wheelchair was placed at the table next to us and when her daughter went inside to get some drinks she decided to engage us in conversation. It was gas. We didn’t know enough Spanish to say we didn’t know Spanish and she hadnt a word of English. But she was a friendly sort and we  had a conversation through bits and pieces of sign language, the odd “Si” and smiling politely and nodding heads knowingly. 

After resting up and soaking up the atmosphere with the locals for about three quarters of an hour we made our way across the road to the Tio Pepe Bar to arrange our transport. It was going to be 20 mins so we decided to sit out the back in the beer garden, have a beer and await our chariot. We got a shaded spot and watched a man, a pellegringo, in his 50s, tall, and with a bald crown wash his clothes in an outdoor sink. As is we got chatting to him. He was David a chatolic priest from North Dakota on a 3 month sebatical walking all of the St. James’s Way. 

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Camino 2016 Day 1 – Getting there. 

Day 1 was all about getting to Leon where we had decided we’d pick up the Camino again. It was a 6:10 am flight out of Dublin to Madrid. Landed there, their time at about 10am, and then jumped on the Metro to Chamartin Railway Station to await the train to Leon which didn’t pull out till 14:40. The Spanish to public transport well. Everything arrived and left as it should do. One thought though. The driver of the inter – terminal shuttle bus had a bit of trouble getting the bus airborn. He nearly got all four wheels off the ground on a number of occasions but thankfully we arrived safely at Terminal 4 to take the metro to Chamartin. 

The time passed quickly. There was a mixture of pelegringos both coming and going on their way around the station. We caught snippets of the excited conversation of those on their way as well as those sharing their experience of being there and back with anyone who cared to listen. Modern technology is a wonder full thing. We had a movie downloaded on the iPad which helped while away the time. 

The train ride from Mardrid to Leon was uneventful. As expected the train arrived on time. We got a taxi from the train station to the hotel. I won’t hide this. We aren’t doing this on the cheap cheap. We have all our accommodation pre booked  and out luggage is transported from hotel to hotel. Our hotel for the first night was just off the Plazza San Martino. The Colegiata Hotel is an old converted monastery. The rooms were clean and there was some of the original stone work from the monastery  around the windows. 

Reception area in the hotel. 

So starved and thirsty after a day’s travelling we hit the sunshine of Leon at about 6pm. It became apparent quickly that there was very few resturants open. There were lots of cafes selling coffees and icecreams and they were packed with locals. There was an alrighty din of conversation at each street corner and a real buzz about the town. This didn’t help the fact that we were hungry and were beginning to think that we might miss the opportunity to get a decent meal under our shirts. As it turns out we were way too early looking for food. Most resturants in Leon on a Saturday don’t open till 8:30pm or 9. So with that knowledge in mind we had a slow beer in the Plazza San Martino and then, absolutely ravenous, at 8:30pm we headed for a Resturant we’d spotted earlier. Unfortunately there were no tables outside in the Plazza but they served us the same menu in the more formal resturant at the back of the building. Hunger is a great sauce and I suppose that is being slightly disingenuous to the place as the food was actually lovely. 

Chickpeas with prawns. It was delicious. 

Medallions of pork

The fish. Think is was sea bass. 

The town was only getting started as we finished our meal and headed for the hotel full and exhausted. Apparently deserted streets we’d walked only an hour ago were transformed into a series of lively bars with the locals standing outside  nonchalantly having a beer or wine and of course tapas. There was a great sense of excitement as we’d experienced in  Burgos and Pampaloma last year so we decided very sensibly to head for the cot. 

The cot had this above it. Not being the most religious person in the world I wasn’t sure if I’d go up in flames or not. 

So ended Day1 of our #Camino Would I survive the night under the crucifix? 

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Gandhi’s wisdom and wit 

When Mahatma Gandhi was studying law at the University College of London, a professor by the name of Peters disliked him intensely and always displayed animosity towards him. And because Gandhi never lowered his head when addressing him, as he expected, there were always “arguments” and confrontations. 

One day Mr Peters was having lunch at the University dining room when Gandhi came along with his tray and sat next to him. The professor said,”Mr Gandhi, you do not understand. A pig and a bird do not sit together to eat. “Gandhi looked at him as a parent would a rude child and calmly replied, “You do not worry, professor. I’ll fly away,” and he went and sat at another table. 

Peters, red with rage, decided to take revenge on the next test paper, but Gandhi responded brilliantly to all questions. 
Unhappy and frustrated, Mr Peters asked him the following question: “Mr Gandhi, if you were walking down the street and found a package, and within was a bag of wisdom and another bag with a lot of money, which one would you take?” 

Without hesitating, Gandhi responded, “The one with the money, of course.” Mr Peters, smiling sarcastically, said, “I, in your place, would have taken the wisdom.” Gandhi shrugged indifferently and responded, “Each one takes what he doesn’t have.” 

Mr Peters, by this time, was fit to be tied. So great was his anger that he wrote on Gandhi’s exam sheet the word “idiot” and handed it back to him. Gandhi took the exam sheet and sat down at his desk. A few minutes later, Gandhi got up, went to the professor and said to him in a dignified but sarcastically polite tone, “Mr Peters, you autographed the sheet, but you did not give me a grade. 

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But which one of them is it? #governmenttalks

The reasonable man adapts himself to the world; the unreasonable one persists in trying to adapt the world to himself. Therefore, all progress depends on the unreasonable man.
George Bernard Shaw. 

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The Paradox of our time. 

 A Message by George Carlin: 
The paradox of our time in history is that we have taller buildings but shorter tempers. 

Wider Freeways , but narrower viewpoints. 

We spend more, but have less.

We buy more, but enjoy less. 

We have bigger houses and smaller families.

More conveniences, but less time. 

We have more degrees but less sense.

 More knowledge, but less judgment.

More experts, yet more problems.

More medicine, but less wellness. 

We drink too much, smoke too much, spend too recklessly, laugh too little, drive too fast, get too angry, stay up too late, get up too tired, read too little, watch TV too much, and pray too seldom. 
We have multiplied our possessions, but reduced our values. 

We talk too much, love too seldom, and hate too often. 
We’ve learned how to make a living, but not a life. 

We’ve added years to life not life to years. 

We’ve been all the way to the moon and back, but have trouble crossing the street to meet a new neighbor. 

We conquered outer space but not inner space. 

We’ve done larger things, but not better things. 
We’ve cleaned up the air, but polluted the soul. 

We’ve conquered the atom, but not our prejudice. 

We write more, but learn less. 

We plan more, but accomplish less. 

We’ve learned to rush, but not to wait. 

We build more computers to hold more information, to produce more copies than ever, but we communicate less and less. 
These are the times of fast foods and slow digestion, big men and small character, steep profits and shallow relationships. 

These are the days of two incomes but more divorce, fancier houses, but broken homes. 

These are days of quick trips, disposable diapers, throwaway morality, one night stands, overweight bodies, and pills that do everything from cheer, to quiet, to kill. 

It is a time when there is much in the showroom window and nothing in the stockroom. 

A time when technology can bring this letter to you, and a time when you can choose either to share this insight, or to just hit delete… 

Remember; spend some time with your loved ones, because they are not going to be around forever. 
Remember, say a kind word to someone who looks up to you in awe, because that little person soon will grow up and leave your side. 
Remember, to give a warm hug to the one next to you, because that is the only treasure you can give with your heart and it doesn’t cost a cent. 
Remember, to say, ‘I love you’ to your partner and your loved ones, but most of all mean it. A kiss and an embrace will mend hurt when it comes from deep inside of you. 
Remember to hold hands and cherish the moment for someday that person will not be there again.. 
Give time to love, give time to speak! And give time to share the precious thoughts in your mind. 

Life is not measured by the number of breaths we take, but by the moments that take our breath away.

 George Carlin 

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The ontology of nursing. My thoughts.

Socrates was critical of those who lived their lives without examination (Rudebush, 2009). Within the context of practicing in a contemporary healthcare setting nursing is compelled to avoid such criticism. It is imperative that nurses reflect on and are succinct about the fundamental nature of what they do (Willis, 2008) and the impact that has in the modern healthcare arena. If we cannot identify this then we will hand control of our present and our future over to others (Clarke and Lang, 1992). To enable this process we need to examine the sum of the parts that form the precepts at the very core of our existence. Present-day nursing has gone through many stages in its development. Austin (2011, p. 161) contends that in all that time nursing’s commitment to those in its care has not changed and that ‘Nursing is grounded in faithfulness, in constancy and loyalty to patients, families, communities’. The Royal College of Nursing (2014) defines nursing as ‘The use of clinical judgement in the provision of care to enable people to improve, maintain, or recover health, to cope with health problems and to achieve the best possible quality of life, whatever their disease or disability until death’. 

Nursing is not practiced in a void. It has been shaped by society and in turn it has helped to shape society (Donahue, 1985). Two examples of determining factors shaping nursing today are an ageing population and the increased prevalence of chronic diseases. Frequent hospital admissions and complex treatments make chronic diseases a major issue for healthcare (O’Shea et al., 2013). The recent downturn in the global economy has resulted in a drive for cost containment. The way we provide healthcare is being changed as conformity to pre-scripted practices is favoured over clinical judgement risking the potential to inherently change the essence of the nurse-patient relationship (Austin, 2011).   

We live in an era of economic polarization, armed conflicts, environmental problems, corruption, injustice and changing communication patterns (Dali Lama, 2012). The roles played by nurses and the scope of nursing practice needs to engage with these issues in a meaningful way to maintain its social mandate while at the same time maintaining the values of the profession (Risjord, 2010). The permutation of the common good and the dignity of the individual affords nursing a unique philosophical basis from which to develop its own theories and specialist knowledge enhancing its meaningful contribution to society (Mc Curry, 2009). 

Nursing theories are coherent approaches to describe, explain, predict and prescript nursing care (Meleis, 2012) and it is necessary that we use them to underpin our practice (Willis et al., 2008). Early metaparadigms included the person, environment, health and nursing as central concepts to nursing (Fawcett, 1984). Theorists such as Parse (1992) contend that nursing should not be a central concept as it is in fact the whole. Intellectual discourse around nursing theory has centred on distilling the central concepts. Newman (2008) advises incorporating knowledge from other disciplines. Bohm (1980) warns against the idea of an all encompassing nursing theory and suggests the strength of nursing theory lies in their diversity. More recently a unitary- transformative approach in which the person is considered as a whole and the relationship is regarded as the central aspect of nursing theory has emerged as the imperative in the discourse around nursing theories (Newman et al., 1991). 

Grace (2002, p. 67) reports that ‘Practicing according to a well-established theoretical framework generally results in more consistent and better care than does practice without such guides’. Chambers (1998) feels that nursing theories can be too aloof and may result in the exploitation of nursing. Mc Crae (2011) is concerned about theories constructed on empirical evidence only and cites Attree’s (2001) concerns about scientific methods being unsuitable to explore important nursing qualities such as sympathy and compassion. This is what Cody (2013, p. 8) refers to as the Praxis of nursing and talks about nurses using ‘reasoning relevant to their situation’. Future nursing research needs to reflect issues relevant to current practice, use a variety of research methodologies and add to how we already help patients reach their potential (Willis et al., 2008). Nursing theory should remain the construct that directs nurses in their practice with patients and is the starting point for a give-and-take relationship between nursing theories and nursing practice (Fawcett, 1992). 

Nursing theories are integral when we come to talk about nursing as a professional discipline. Newman (1991, p. 1) states that ‘A discipline is distinguished by a domain of inquiry that represents a shared belief among its members regarding its reason for being’. Nursing as a discipline is inclusive of all the many purposes nurse fulfil, includes the theories developed to explain it, research findings generated by it about it and functions as an entity to promote the discipline (Meleis, 2012). Nursing as a professional discipline is bound by a code of ethics, has a registration process, has power and authority over training and education, is accountable to the public and provides a knowledgeable service to society (Bohan, 2015). Nursing as a professional discipline is defined by a number of characteristics that accumulate to afford it distinction. 

Nursing now considers itself a human science with an emphasis on engaging with the human experience in health, illness and dying (Meleis, 2012). Because experiences are subjective and open to a myriad of influences nursing seeks to find out what effect they have on those under our care (Willis et al., 2008). Meleis (2012) argues that it is this exact interest that makes nursing a practice discipline. Mitchell and Coady (2002) argue that when nursing is practiced from a human science approach it can be considered both an art and a science. 

It was Leininger (1978) who first described caring as a central tenant to the discipline of nursing. Newman (2008) agreed but was concerned about the lack of clarity around the concept. Authors such as Condon (1992) welcomed the introduction of the concept and felt it presented an opportunity to move away from older archaic military and religious connotations associated with the discipline. Meleis (2012) welcomes the fact that caring carries more bearing in contemporary western society and Watson (1985) argues that caring is not a means to an end but an end in its self. Further discourse around the concept has prompted nursing scholars such as Cody (2013) to suggest that the remit of caring is explained in terms of brining the humanness to any health related activity. Meleis (2012) contends that nursing has always been health orientated with nurses, through their practice, helping individuals take charge of their own health. Newman (1991) suggests a blending of the two into a defining ideology that further helps identify the discipline of nursing.

Nursing is about the doing, the actual practice of nursing care. Nurses monitor, assist and empower individuals in illness and potential illness (Bottorff, 1991). We are concerned about what we do, why we do it and when we do it (Meleis, 2012). As a practice orientated discipline we gain twenty four hour, seven days a week engagement with our clients. We are in a prime position to get to really know those in our care (Jenny and Logan, 1992). Meleis (2012, p. 91) states that nurse patient relationships ‘…are characterised by continuity, intensity, and involvement in ways that other health care professionals do not experience’. The same author is concerned that inquiry around the practical aspects of nursing is being superseded by the pursuit of more theoretical knowledge and the effect this may have on nursing as a practice discipline (Meleis, 2012). 

Nursing as a discipline has a body of knowledge, a domain, which is particular to its self and which posse’s practical and theoretical considerations, too nurses (Meleis, 2012). Newman (1991) reports that concepts central to nursing have been the nurse, the patient, the situation, their purpose together and the patients health. Cowling et al., (2008) suggests adding the concepts of wholeness, consciousness and caring. Meleis (2012) uses the exaggerated scenario of space travel to reveal how the body of knowledge we consider as belonging to nursing may have to adapt to meet or client’s needs in the future – e.g. current knowledge around environment. Meleis (2012) lists seven concepts which she believes go to help define nursing’s body of knowledge. They are the nursing client, transitions, interaction, nursing process, environment, nursing therapeutics and health. Mc Namara (2011) claims that nursing has traditionally been bad at articulating its domain. Failure to do so can lead to the subordination of the discipline where nurses find themselves practicing to fill in short falls in healthcare systems (Latimer, 2000). Further delineation of nursing’s domain of knowledge will come about through research, practice, education and administration (Meleis, 2012). 

Sahlsten (2008) asserts that participation with patients is present when 1) there is an established relationship between nurse and patient, 2) there is some surrendering of power or control by the nurse, 3) there is shared information and 4) there is engagement together in intellectual and /or physical activity. Newman (1991, p. E17) expands the idea further and talks of the relationship being ‘… embedded in a concept of wholeness, evolving pattern, and transformation’. On the evidence presented in the previous paragraphs this author suggests that nursing is a participatory rich practice. For maximum participation nurses need to engage without preconceived ideas (Sahlsten, 2008). 

In conclusion the professional discipline of nursing can outline a very definitive practice orientated ontology. Is that ontology completed? Because of nursing’s very nature this author believes that it may not be. Nursing is and will continue to adapt to meet the needs of those in its care. If nurses can continue be clear about the disciplines ontological basis they will be afforded the privilege of engaging in practice that is rewarding for them and to the healthcare system they work in (Newman et al., 2008). 

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