15th December, 1972Vol. 2. No. 28.

Editorial Comment

The Gazette, issued by Cranage Hall H.M.C., is now in its seventh monthly edition. November Editorial was "... what a struggle each one has been. Apart from a few regular subscribers and an occasional - and often anonymous - contribution, material for publication just is not forthcoming." We know the feeling.

The Editorial comments on the criticism that the Gazette is too official and heavy by remarking that,

"...if all the information we receive is from the Official side the Gazette will continue to be too officia1."

It's cold comfort for the Gazette, but we'd like half their problems.

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£. p  
Sewing Room Stall20 21 
Children's Stall2 08 
Men's Stall10 42 
Flower Stall7 08 
Household Stall4 00 
White Elephant Stall11 00 
Jewellery Stall14 39 
Ladies'14 37 
Refreshment Stall4 10½
Lucky Dip Stall2 70 
Total90 35½
Less Expenses £3.54 
Sewing Room Patients' Party £5.00 
81 81½
Additional Sales18½
£ 82 00 
To League of Friends£ 62 00 
To Patients' Fishing Club£ 20 00 

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We are pleased to record that F9up ladies are delighted with their two new budgies and cage and, through Miss J. Lock, wish to thank everyone concerned. There appears to be some suspicion that they are of different sexes. Perhaps Mr. Moon can give advice?


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In-Service Training Course held at the Royal College of Nursing, Birmingham

Course members represented 28 other hospitals, including Royal Military Hospitals and Royal Naval Hospitals, and a member from the World Health Organisation.

The course was very well organised and very enlightening.

We were divided into groups and had three projects, these included arranging programmes suitable for In-Service Training in the general field, psychiatric and mentally subnormal fields.

Existing programmes were exchanged and ideas were forthcoming.

Administrative problems and frustration levels were experienced in many hospitals.

General shortage of staff throughout the country was one of the problems discussed, it was found to be enlightening that Winwick Hospital are not alone in voicing their frustration levels and staff shortages.

Two hospitals have an In-Service programme for night staff.

The speakers gave very impressive and informative lectures on organising and planning ability.

The selection techniques of nursing candidates for commencement of nursing careers was discussed.


Principles of Planning and In-Service Training.

Monday, A.M.
November 13th

Mr Davis, Lecturer of Education and Training

Stressed the importance of technique of teaching as secondary to process learning. It was felt that need of achievement came first, recognition and responsibility and then advancement.

Monday. P.M.

Mr. Thomas, Lecturer on Adult Attitudes to Education Learning and Teaching;

The main topic was Adult teaching, aims - direct discussion, class involvement and feed back of materials taught.

Importance of success in learning listed as follows:

1)Motivation of learning - (reinforcement)
2)Self achievement in learning.
3)Individual activity.
4)Guided discovery (presentation of materials).
5)Programmed learning, which was a combination of all the above.

Mr. Astbury - Principles of teaching and demonstration

1)Learner - must be interested and motivated - must be interaction from group. (Full use of 5 senses), he did stress 2 of the senses.
a) Cognitive - hearing
b) Perception - seeing
2)Teacher - lectures with conviction.
3)Learning process.
4)Learning situation.
1)Learner - must be interested and motivated - must be interaction from group. (Full use of 5 senses), he did stress 2 of the senses.
a) Cognitive - hearing
b) Perception - seeing.
2)Teacher - lectures with conviction.
3)Learning process.
4)Learning situation.

Learning Processes

1)Dynamic process.
2)Knowledge of subject.
3)Preparation, certain areas of expertise.
4)Presentation of material. Awareness of learners needs.
4)Testing - opportunity to find out how effective learning has been.

Tuesday A.M.

Miss Reid, Principal of the College

Gave general discussion of Programme Planning and course organisation; emphasis was on visual aids.

Tuesday P.M.

Miss Adams

Briefing for and follow up.

a)Emphasis was on briefing and debriefing of staff attending courses.
b)Preparation of In-Service Training programme which was a group projects (for N/A's, emphasis on content and organisation.

Discussion on who should organise In-Service Training programmes.

Wednesday A.M.

Follow up and presentation of projects.
Emphasis on follow up.
Who was responsible for training of Nursing Assistants?
What guidance should be given to staff who teach "on the job"?
What briefing should be given to speakers invited to take part in induction/on going programmes for Nursing Assistants?
Refer to programmes in your own hospitals.

Wednesday P.M.

Mr J. Munro-Fraser

Interviewing and selection techniques.
Selection techniques.

Job description, specification of personal qualities and specification of vocabulary qualities and personal character. Tape recordings were given as examples.

Thursday A.M.

Further projects for job description of In-Service Training Officer. With emphasis on responsibility for organisation, planning, co-ordination of some teaching should be prepared to fill in for any speaker/demonstrator unable to fill commitments, otherwise teachers should be from as wide a range of disciplines as possible depending on subject matter.

Thursday P.M.

Mr Finn

The Joint Board of Clinical Nursing Studies.

Research advancement of nursing studies and education in the nursing field. They are there to advise, set up surveys throughout the country. 47 specialised courses in progress at present and there are 347 hospitals.

Friday A.M.

Presentation of projects.

Friday P.M.

Mr Cale

"On the job training for Senior Managers".

Opening theme was nurses returning to an unreceptive atmosphere after attending RCN courses.

Management cannot be taught in the classroom.

Management is learnt by gaining acceptance in the teaching situation.

The closing item was the summing up of the course. It was found to be a very well planned and organised course, a host of information was given by speakers. The participants on the course exchanged some very valid points of their difficulties and frustrations in their own hospitals. It is hoped the guide lines that we have been given can be put into practice in our hospital in the not too distant future. We personally have gained a great deal of benefit from this course and have been given some insight into the aspect of teaching for induction nurses and orientation courses for S.E.N.s.

We would like to thank the Group Management Committee, Miss Coppack, Mr. Morris and Senior Nursing Officers, for their briefing prior to commencement of the course and we feel it would be beneficial for our nursing colleagues to attend further courses available. Thank you.

M. Lythgoe, Ward Sister
E. Potts, Charge Nurse

THE FOLLOWING is the content of NHS Reorganisation Staff Information Bulletin No. 1. This has, of course, been circulated but Bulletin No. 2 (a precis of which will be published next week) stimulated us to print it here.

1. This is the first of a series of bulletins which the Staff Advisory Committee will be issuing from time to time reporting progress being made on arrangements for the appointment and transfer to the new authorities of staff in the present employing authorities providing health services. It is for the information of all staff affected.

2. The Committee have received views on matters within their terms of reference from over 50 organisations and have had discussions with many of them.

3. All members of the Committee have visited varying types of existing employing authorities both in order to get to know as much about the services as is possible within the time limit and to meet staff affected. These visits emphasize the importance of keeping staff informed about reorganisation plans and for making arrangements for this to be done regularly.

4. Our immediate task concerns the arrangements for filling vacancies between now and l April 1974 and the procedures for filling some senior posts in the Regional Health and Area Health shadow authorities in the middle of 1973. At the same time we must keep an eye on the arrangements which will be made following the legislation, for transfer of the vast majority of staff to new employing authorities and satisfy ourselves that there is adequate machinery to deal with staff appeals on, for example, hardship grounds. Firm decisions have not been reached on these matters but are very actively under consideration.

5. The Committee have been much impressed by the comments which have been made that they should be involved closely in procedures for filling the senior posts for shadow authorities. They have therefore indicated to the Department of Health and Social Security that they are prepared to handle the arrangements and procedures for filling the senior posts, including the issuing of advertisements, receiving applications, appointment of assessors and preparation of shortlists. This offer has been accepted by the Department and work is now in hand to establish the machinery. It must be made clear, however, that the Committee will not be making appointments; the new employing authorities will be responsible for this aspect of reorganisation.

6. We intend having our own officers in the field early in the new year to assist all concerned. These officers will be part of the committee's secretariat.

7. We are maintaining very close contact with the Local Government Staff Advisory Committee for England, the NHS Staff Advisory Committee for Wales as well as with the NHS Staff-Commission in Scotland.

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There is no Social Therapy Review this week due to the uncertainties in that area.



On behalf of the Stepping Stones Club, I am pleased to announce that all the tickets for our Xmas Dance have now been sold, and take this opportunity to thank all those members of Winwick staff who bought them.

As our club is still in its infancy, having only 31 members, obviously we had to appeal to non-members to swell the ranks for this important event. I say 'important event' because we hope it will serve the threefold purpose of giving our members a good night out, helping us financially from the proceeds, and providing a certain amount of publicity for the club.

As for the dance itself, we have the ideal venue in the recently modernized St. Mary's Catholic Club, Warrington, where a late bar (1 a.m.) and chicken buffet have been arranged. Supporting us by their attendance on the night will be the deputy-Mayor of Warrington along with senior members of Winwick staff, and for the highlight of the evening, we have been successful in obtaining the services of one of the countries top up-and-coming groups -'The Summer Rain.'

This St. Helens based musical/comedy group competing against 200 other acts, recently won the 'Artiste of the Year' contest at Preston, and is in great demand by local concert secretaries. We have been fortunate in booking them.

Finally I wish to thank our own Secretary, Mr. J. Beck who, with his usual flair for organization has been responsible for most of the arrangements, and who, by virtue of his skill in the swift application of a 'half-nelson' has also managed to sell most of the tickets.

G. Scott
Stepping Stones Comm.


When a concerted activity - even if it involves only two people - is performed with collective dedication, creativity and a high standard of teamwork, this activity can be said to possess the quality of dynamism.

Of the three constituents of dynamism, creativity is far and away the most important. Without it, though containing an abundance of the other two, a group activity at best may be valueless and at worst destructive or malign.

Between the two extremes of dynamism and malignity, there is a well-trodden middle ground; and it is on this middle ground that most of us spend most of our working lives.

In the field of mental nursing, much of ground occupied by most of us throughout our professional career is the vast wasteland of custodialism.

For my present purpose I will define custodialism as a medico-nursing treatment policy which limits its aims to making provision for the basic physical needs of the patient and takes no account of his psychological needs except insofar as these needs can be met by physical or chemico-physical forms of treatment.

In the vocabulary of those who claim to be progressive, custodialism is a pejorative word.

But in my opinion the hospital which provides a high standard of custodial care for all its patients deserves to be held in a higher regard than the pseudo-progressive institution which, because it devotes an undue share of its resources to its showpiece short-stay wards, can only provide a sub-standard level of care for its backwater long-stay areas.

Another pseudo-progressive approach which has even less to commend it is the one in which a sub-standard level of patient care is made to appear respectable by justifying it on the grounds that a greater degree of care would induce overdependency or would reinforce institutionalisation of the patient.

This sophism is most commonly resorted to by the therapist who is either too lazy to give adequate attention to his long-stay wards, or who is overwhelmed by a sense of hopelessness when faced with the difficulties and frustrations involved in the treatment of his long-stay patients.

In this latter case the more neurotic therapist often seeks a resolution of his guilt by a succession of useless experiments or cloud-cuckoo land projects which have little connection with the harsh realities of long-term mental illness.

The frenzied activity in which he indulges sometimes gives the false impression of being dynamic. This impression is more likely to be given if the activity presents an appearance of teamwork and enthusiasm.

Even when these qualities are actually present the activity lacks dynamism because true creativity the most important ingredient of dynamism, is absent.

Collective creativity has at least one quality in common with the individualistic creativity of the artist: namely, its rarity. In twenty years in the hospital service, I have yet to encounter it.

A list of the obstacles to collective creativity in the context of either a large or small mental hospital would require more space and energy than I have at my disposal at the moment.

I will tabulate a half dozen or so of these which are least mentioned in text-books:

1) the divisive snobbery of tuppence-halfpenny professions looking down on tuppenny ones and keeping them in their place.
2) the equally divisive inverted snobbery of tuppenny professions maintaining a permanent position of genuflection to tuppence-halfpenny ones.
3) individual and collective vested interest.
4) an authoritarian management philosophy which rejects creativity because it fears it.
5) the absence in the hospital field of the quality of total personal commitment which is a pre-requisite of dynamism.
6) the ease with which the lip-server and the sycophant can get access to the corridors of power.

No respectable textbook would contain the above six cynicisms - but then textbooks are not written by nurses who are busy nursing or by doctors busy with the problems of psychiatric chronicity.



We wondered if our Christmas issues could be enlivened by anecdotes of previous Winwick Christmases... like serving bread sauce with the Christmas Pud... and who remembers Father Christmas and his sleigh? If you have any Christmas stories or handy tips, then we'd like to hear from you.

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Would 'The Standard' in printing this letter please convey our sincere thanks to Mr. French and Hospital Management Committee for the use of the annexe for our Unit Party.

Our thanks to Mr. Bartholomew and his men for arranging the chairs, tables and general layout.

Mr. Stewart and gardens for Stage and excellent Floral arrangement at very short notice.

Mr. Dutch for printing the tickets.

Without these very kind people we could not have had a most enjoyable evening.

Many thanks and may we take this opportunity to wish them a Merry Christmas.

D. Hill, Unit 5,
Social committee.

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Following the move of the patients from Delph Hospital to the main building, the following re-allocation of wards to Nursing Officers has taken place:

F.1Up- Miss E. Pennington
M.1Up- Mr. W. Templeton
M.1D- Mrs. S. Barr

Mr. J. Beck will be the Nursing Officer in charge of Social Therapy, with effect from 11th December, 1972.

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We hear that several staff are ill in hospital, and our wishes for a quick return to health go to D. Rawsthorne, J. Lowe and J. Wright.


Felix Greene's series 'One Man's China' tonight (Friday) deals with Chinese medicine and pharmacology. No doubt it will include a description of Acupuncture, a subject which has aroused considerable interest in the Western medical world.


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At a special joint meeting of NUPE and COHSE members held in the hospital last Friday, a large majority of those present voted to join Wednesday's demonstration by Ancillary staff against the Government's pay freeze. Our latest information is that this decision will not now be implemented.


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Les Anderton, one of our drivers, was taken suddenly ill at work last Thursday afternoon. He died early on Saturday in Warrington General Hospital.

Les was a well liked man, as the large number of mourners at his funeral on Tuesday in the hospital C of E church bore out. We are sure we speak on behalf of the hospital when we offer Norma Anderton our deepest sympathy.


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Farewell to:

I. Turner - S.E.N.
A.J. Walsh - S.E.N.

Welcome to:

Miss S.A. James N/A
Miss D. Ward T.N.A. (Holiday employment)

Congratulations to Mr. David Bowles R.M.N. on promotion to Deputy Charge Nurse.

Attending Introductory Management Course, at Mabel Fletcher College for State Enrolled Nurses 11th December to 15th December 1972, Mrs J. Bauds.

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It would assist the Secretarial Department immensely if staff would read the instructions issued on the back of the application forms. We do not want money until the tickets are collected.

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