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The shortage of RNs is really hurting the sector

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It’s an ongoing problem that was difficult to deal with before Covid 19 hit but has been exacerbated now with the lockdowns and mass vaccination programme that is currently underway. It appears that no health care organisation is immune from being affected, albeit to a lesser degree in some places.  As you see, I’ve also been affected with having to cancel all Clinical Updates due to lack of participants. While it is not as dire for me as for facilities, it’s having an impact across the board.

While no one can blame nurses from leaving lower paid jobs for those that are paying more, it’s till disheartening to see. I’m left wondering how this could be avoided because a lot of research around why employees leave their jobs is rarely because of money. You’ll see in this video, that no one mentioned low pay as a reason to leave their job. 

While many do leave for higher wages, there’s still enough evidence to suggest that if a person is happy in their work, they like the culture, and their colleagues, are supported by management, receive recognition for the work they do are better motivators for a person to accept lower pay than leave to chase the mighty dollar.

While receiving higher wages does give short term gain, it may not offer the same amount of satisfaction as their previous workplace. There is still multiple reasons for this but sometimes more money does not necessarily help the person in their day to day life.  

So, what is the cost of choosing more money over happiness and job satisfaction? 

Well, to the individual it may increase their stress levels. Their inner critic may also be reminding them that you left a job they loved for money which has not actually compensated them for that loss. It could make the person sad, regret the decision they made and often as a consequence end up spending the extra money they earned on other ways to try and make them happy.

If you are thinking of leaving your current job, that you love, then take a look at this video.

The new job, with extra money, may not be all it makes out to be. While your current employer may not be able to pay your money, there may be other ways in which your employer can reward you. So, if you get a job offer for more money, before you just jump ship and take the offer, have a talk to your employer. See what they can come up with for you to stay because if you are a valuable employee, they would rather keep you than lose you. Any employer knows that to lose a good employee will cost them up to 3 times your wage/salary to replace you up to 12 months to get the new person up to the level you are at now.

So, my question to you is what are the real benefit to you to leave your current job, apart from money? Do this exercise and you may well change your mind about the extra dollars. 

Why is nursing not able to keep its graduates in the profession?

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This month I want to focus on why nursing is no longer attracting people to remain in the industry. Well, I believe the publicity nurses are receiving may not be doing them any favours. Why? Well, why would you go into a career that is telling you it is underpaid, over worked and burnt out and while all of this is true, it is hardly a good advertisement for a good career option is it? 

All we hear in the news and on Facebook is all the negative things around nursing. There is nothing that tells people about the good things a career in nursing offers. The job satisfaction of seeing people get well, the amazing progress health science is making in health of all, how rewarding it is to be thanked for the loving care you have given them, the gratitude of those receiving care…. The list can go on.

I know I am a bit of a Pollyanna but there are so many good things about being a nurse. However, if we read facebook forums listen to the media and unions that is not the message that is getting out. Maybe if we started focusing on all the great things a career in nursing can offer, then maybe not only will people be attracted to profession but will also change the energy that is currently infesting the industry. The more people that find the positives about nursing, the more people will be available to fill the gaps in numbers and want to stay nursing.

Nursing has so many options. They are not all in the public sector where most of the negative comments seem to be coming from.  However, I do believe that an extended period of public sector nursing does give nurses the skills to branch out into other areas. 

I talk to a lot of people around the country for Care Training Online. At times they have empty beds and their owners put pressure on them to get them filled, and I understand how important it is to keep the business running. What I tell them, is what you focus on, the energy will follow. So, if you are focusing on the empty beds being empty then they will remain so, but if you focus on getting them filled, then they begin to fill. Doing nothing and expecting people to come to you, just doesn’t work.  Negative energy creates negative outcomes. You would be surprised how many people begin to fill their beds after they get to understand this principle. 

The thing is, you must never give up talking up your facility or your profession. Yes, I know at times, it can get you down and you don’t feel like you’re making any progress but you just keep pushing on it will eventually change.  I wouldn’t have a business if I didn’t keep calling people and talking to them about Care Training Online. New manager and owners come and go all the time. If I don’t keep up talking to your potential customers, they don’t know what is available for them.- they won’t know they have something that may be a better option for them.. 

So, my message to you this month is GET OUT AND GET SEEN. Be the squeaky wheel that gets oiled and DON’T GIVE UP. I’ll conclude with one of Winston Churchill’s famous quotes:

“Success is not final, failure is not fatal, it is the courage to continue that counts.”

“If you’re going through hell, keep going.”

“Everyone has his day, and some days last longer than others. 

So never give up.  Success will come if you keep going and focus on the good things about nursing, about your facility about life.

The art of delegation and direction

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I’ve recently been contacted by a company who is reviewing their RN understanding of delegation and direction especially when working with unregulated staff. I thought I would discuss this topic today because it is something, Registered Nurses need to be mindful of and our responsibilities around this. I wonder how many of us have been on to the NZNC to review what our responsibilities are around delegation and direction?

The NZ Nursing Council describes delegation and direction as follows:

  • Delegation is the transfer of responsibility for the performance of an activity from one person to another with the former retaining accountability for the outcome.
  • Direction is the active process of guiding, monitoring and evaluating the nursing activities performed by another.

While it might be easy to delegate a responsibility, how do you really know the level of knowledge of the person you are delegating to? We are all good at assuming that a person knows, BUT how do we know? Have you monitored or evaluated the person to ensure they have the knowledge and skill to do the job because ultimately you are responsible for the care being delivered? This 3 min video explains it really well

The problem I see is with the amount of paperwork and the physical workload that is now the responsibility of the Registered Nurse. It can become very easy to delegate a job assuming the person knows what to do but lacking the time to monitor and evaluate the caregiver/support worker. 

I can see how easily this can happen as I constantly see on the ‘Facebook platform New Zealand Please Hear Our Voice’, the stress that nurses are under with their workload. Many people work long hours, do not take breaks and get burnt out, so how are you going to give direction to the person you are delegating the task too? It can be tricky.

Even if a person has a Level 2, 3 or 4 qualification, can you be assured they are competent at carrying out the delegated task? Unfortunately, you can’t. So how are you going to ensure the person has the specific training?

One way to get them to do targeted training for the task or tasks they are going to do, online. For instance, if you are dealing with someone in the community who has a tracheostomy, get them to show proof of understanding tracheostomies online. The same goes for any ostomy, including PEG feeding. I know for instance, that on Care Training Online, I have a training module that comprehensively covers these topics. It’s not an NZQA Unit Standard, it’s practical training and understanding of the topic.

So, targeted training is one thing but how are you going to monitor and evaluate their competence so that you are assured they know what they are doing. So here lies the problem. Unfortunately, there’s no other way but to actively assess them doing the job because ultimately, you, the Registered Nurse, is responsible for the care they are delivering.

It’s a very tricky situation but the one thing you must do at all costs, is protect not only your good name but your Practicing Certificate as well. You must not compromise yourself in any way. While I cannot tell you how to do this, as each organisation is different, I can tell you that you have to be proactive and find a suitable way for you to delegate and direct safely so you can be confident the person delegated is delivering safe care.

The importance of laughter

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How much do you laugh in a day?  If you are like me, not very much mainly because I live on my own.  Now if you are like me, it is not something you really think too much about.  You laugh when you are with people, but it is not so easy to go around your house laughing at nothing or at yourself.  People coming round would think you have really lost it if you were.

So why is laughter so important?  Well there are many benefits including it could actually save your life. Check this out:

So, does forced laughter work as well as laughing for a reason?  Well apparently yes it does because the brain cannot distinguish between forced laughter and real laughter. The results are the same.

Now I know that in care facilities there is often a lot of laughter. – well there was when I worked in them, but did you know you could involve the residents in active laughter like Yogic Laughter? Take a look at this: 

When I was up in India 11 year ago, I used to go for a walk around the town I was staying in.  I used to see this group of men in the park, running around in a circle doing various actions with their bodies and laughing. This made me really curious to find out what they were doing.  So I asked them. They told me “Laughing Yoga”. Well as it was all men, I cheekily asked if it was only for men? They replied “No! come and join in”.  So I did. By the time I left to come home, some of the wives had come joined in.

Who invented Laughter Yoga? Well it was actually a doctor in India by medical Dr. Madan Kataria. He became “interested in growing body of scientific evidence showing that laughter is extremely beneficial to mental and physical health. He decided that more laughter was needed to improve health and cope with the stress of modern living and started a quest to find ways that laughter could be prescribed to patients and people who needed it.” You can find out more here.

So why is laugher so good for you? I know I said there are health benefits but what are they. Well, its like medicine so take a look at what it can do for your health. 

Physical Benefits

  • Boost’s immunity
  • Lowers stress hormones.
  • Decreases pain.
  • Relaxes muscles.
  • Prevent heart disease.

Mental Benefits

  • Adds joy and zest to life.
  • Ease’s anxiety and tension
  • Relieves stress.
  • Improves mood.
  • Strengthens resilience.

Social benefits

  • Strengthens relationships.
  • Attracts others to us.
  • Enhances teamwork.
  • Helps defuse conflict.
  • Promotes group bonding.

See more.

So, if the above is not a good reason for having more laugher in your life, then I don’t know what is. There are also Laughter Yoga clubs around the country. You can find one in your area here. If there isn’t one in your area, then start one up with a group of friends. You can meet in the park, in someone house, in a hall or start one up in your facility.

Don’t underestimate the benefits of laughter. Norman Cousins famous book “The Anatomy of Illness” written in 1979 is a well-known book about how he cured himself of  Ankylosing Spondylitis, a very painful collagen disease.  So, get to it. Start laughing Today and restore your health and vitality. Something very much needed by so many today. You can see more on laughter in the Titbit sections

The Power of Resilience

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This month I want to talk about resilience and the power it gives to you to bring happiness and joy into your life. 

Whether we like it or not, no one ever has a charmed life free from adversity. The way each person copes with adversity is different. There is no right way to handle a crisis you are faced with. There is only your way.

We also need to understand that what one person frames as tragedy or disaster, may be framed and inconsequential by another.  It is not up to us to judge another person’s crisis and the meaning it has to them. What is important is the tools that a person has to navigate the crisis to come out the other side intact; feeling alive, willing and wanting to face life or get back on the journey ahead of them.

So how do we learn resilience, the skill to rise above tragedy or adversity? Well, there is only one way and that is to experience these tough times in our life. Some people have to learn these experiences as a child through loss of a parent, abuse, living in a war zone or live through an earthquake.  Some people don’t experience adversity till they are a teenager or an adult.  One thing is for sure, every living person will experience a time or many times in their life where they have to find a way through torment or terror. 

So, what are some tools people can use to get through? You will find some tools in the TED talks section below, and there are many more to be found on the internet,  but I would like to share some of the tools that I use to get me through the tough times.

Firstly, watch what your internal dialogue is. What are you telling yourself?  When my marriage broke up, my self esteem was at rock bottom. I had 3 children to care for and I did not expect my now ex-husband to leave.  I thought there was something wrong with me and I didn’t have any skills to help me so I had to devise my own.  The internet was not the wealth of information it is now so I had to develop my own. I distinctly remember standing in front of the mirror telling myself I was beautiful and giving myself some encouragement. This turned out to be a wonderful affirmation for myself to get through.

Secondly, when I would wake up in the early hours of the morning in despair, I would get out a journal and write down my feelings. I found that I could take control of my life by writing it down, using the strongest language I could muster, using words that I wouldn’t normally use in everyday life. When I had got it all out of my head, I would find I could go back to sleep. So, talk about it. Let out your feelings by writing or talking to a close friend or counsellor but don’t keep it inside you.

Another tool I used was to see myself in the future or my situation in the future. I would see myself as happy and whole and enjoying life. I was managing my life on my own really well and I didn’t need that other person to be there to get me through. In fact, what I found was myself, that had been lost in my marriage. I felt free.

Now none of these outcomes materialized overnight. It was a long process.  I learnt heaps about myself, that I didn’t know. Perhaps the most significant one was I could be happy and whole without a partner.

So, these three tools, I have consistently used through out my life for I’m afraid that was not the only time I had to face adversity. There were others that followed but I got through them. 

We have all been through trauma with the pandemic. Some more than others. This video has some very important points on getting though the pandemic.  Use these tools to help your children. Teach them resilience and they can have the tools for life.

So, if times are tough for you right now, know that it will pass. It will not last forever. If you have financial worries, know that money does keep coming in. Sure, it may not be the amount of disposable income you would like, but it does still keep coming in. If your teenager is acting out, see them as happy, well-functioning people in the future. See yourself having fun with them, enjoying your time with them. Remember, this is not about them, this is about you getting through. You have no influence on other people, only yourself and how you get through your life experience. 

I hope the tips I have shared here are helpful to get you through a tough time and know life is to enjoyed not endured.

The Power of One Person

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If you ever thought that as one person you couldn’t make a difference then just look at what has happened in Auckland now. Because of one person, Auckland now faces another forced lockdown. How this could have gone so terribly wrong, beats me. While English as a Second Language may be a contributing factor, how does Get a test and self-isolate translate to get a test and go to the gym beats me. Let this be a lesson to us all.

Apathy is not unusual. I have heard many people say things like, “I cant do anything to change something” or “what is the point of voting, they don’t listen to me anyway”. Well take note, you can change something and your vote does count. One person has just locked down a whole city of 1.7 million people and restricted and disadvantaged yet another 3.5 million other people around the country. 

Let this be a lesson to us all. As a single person, we can make a difference.  While it may take a little longer to make that difference, and your motivation may be quite different (not that I am suggesting there was any motivation behind our latest community case not following the rules), and it might take a little longer to make a change, you as one person can and do make a difference. Still skeptical? Then check out this webpage.

So, what are some examples where one person has had a significant impact – and I’m not singling out good impact from bad. I’m just giving you some examples.

Maurice Hilleman has been claimed the greatest microbiologist of all times.  From humble beginnings, he went on to develop over 40 vaccines. Where would we today, without his ground breaking science. He used to say, every one should make a contribution in their lifetime, no matter how small.  Check out “The man behind the Science”.

Alexander Fleming who discovered the power of penicillin. He wasn’t able to bring it market on his own, because it was very unstable. But with two others, Howard Florey, an Australian Pharmacologist and Pathologist and Ernest Chain, a German- born biochemist. They managed to make this unstable product, stable. Just look at how many lives have been saved by them. Yes, we now are seeing the downside of over-use of antibiotics, we must not forget the good they do and the countless lives that have been saved. See more here.

And what abut Nils Bohlin, a Swedish mechanical engineer who invented the three-point seat belt. Look how many lives he has saved. Now all cars have to have seatbelts, which have been improved over time, and are now compulsory to be worn. View more.

While the above are a sample of the good people have done, let’s not forget that not everyone uses their power and influence for good. Just take Adolf Hitler. He was able to convince a whole country on his doctrine. He used his power and influence that caused the destruction of Jewish people and killing over 6 million people in World War 2. We all know how devastating that was. For more on Adolf Hitler. So, if you ever thought you couldn’t make a difference on your own, think again. The above are just a small sample of how people can change a world for good or bad. 

What’s happened to society values?

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I know I’ve been on a bit of a tangent these last few months, but this last week has caused me to question what has happened to society values. 

Firstly, last week, I accidentally left my wallet on a counter in a shop. Now in the past in NZ, you would have been reminded that you had left your wallet by either the shop keeper (if they noticed) or a customer. In fact, that is what I would do today anyway.

However, this didn’t happen last week in my case. One of the 2 people behind me, picked it up and some hours later, took it up to the local supermarket and spent my cash – somewhere around 150.00. They then left my wallet somewhere near the supermarket where some law-abiding citizen handed it in to check out supervisor.

Now it just so happens a friend of mine is the duty manager at the supermarket, and when I told her that I would be unable to meet the next day as I had to replace my cards, she told me a wallet had been handed in. After my call, she checked for a name and sure enough it was mine. It was handed in at around 7pm. Now, I was at the supermarket that day at 13:58 to be exact (thanks to my Covid tracker diary). I used my wallet after that time, there is no way I was there at 7pm. 

Another incident was where my daughter had asked me to pick up some groceries at another supermarket. She gave me her card to use as pay wave to pay for them. I got these items and returned the card to my pocket, so I thought, but it must have slid over the top and onto the floor at the check out. I realised this a short time later so returned to the supermarket to see if it had been handed in. Your right – no, it hadn’t.

Now fortunately, no money was taken out by pay wave in either case as blocks had been put on the cards fairly quickly, so I guess we’re both lucky in that way.

My question is this? What’s happened to our society? Why is it when people find something that doesn’t belong to them, and the item is clearly labeled with the owners name, do they not hand it in to the shop or the police? Why do they think it is their right to take what they can from someone else or attempt to take what they can from a person they do not know. Is this now COOL behaviour?

The same goes for stealing from residents or patients in our care. Theft is theft – game set and match. Oh, how I wish to return to the wonderful honest values of New Zealanders. While I do know there are still some good old fashioned honest people in New Zealand and I am realistic to realise that there have always been people who are opportunist theives. However, for me, I would never even consider not telling someone they had left their wallet on the counter or hand in a found credit/debit card on the floor and I’m sure there are still people like me. I guess I have been unlucky to have struck 2 incidents in one week where opportunists do not think like me.

Who pays for your education?

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This can be a hotly debated topic. Is it you personally or should your employer pay for it?  Well, I guess it boils down to this – whose practicing certificate is it? Yours or your employers? 

So, what is your employer’s role around your practicing certificate?

Well, they need to make sure it is current and renewed each year.  The employer also has to check that the medical practitioner, physiotherapist or occupation therapist or any other allied health professional has a current practicing certificate too, not just yours.  Is your employer responsible for paying for the allied health professional’s educations?  No, they aren’t. The individual is responsible for ensuring they keep up to date with their education hours. 

So, the question is, does an allied health professional get anything more than you do to be able to come in and attend to residents or clients.  They get remunerated for it just like you. While it may not be a weekly wage, their services are still paid for by your employer, but your employer does not pay for them to go to educational updates.

So that comes down to you as a RN or EN. Who should pay for your education – you or your employer? I guess this is a question you have to ask yourself. Do you give anything more to your employer than an allied health professional? You may argue you do, but you see, your employer’s ability to provide the service is dependent not only on you, but also the caregivers and the allied health professions they contract in to service their clients or residents.

Why am I bringing this up again? Well, many RNs and ENs have an expectation that their employer will pay for their education hours, and if they won’t, they don’t attend. Now if your employer does pay for you to attend education updates in the form of paid days off, course fees etc, be grateful because they don’t have to. If you don’t have a current practicing certificate because your education hours are insufficient, that is your issue – you can’t practice.

So why then am I discussing this? Well, in some cases there is not much loyalty or gratitude paid to a generous employer. Loyalty is not something high on the values of some people. Money is and some people will think nothing of jumping ship to a get a higher paid position rather than give back to a generous employer. Your employer should expect something in return for being generous and giving you a day off and paying for your education. Do you give back to them or is your expectation that it is their responsibility to keep you employed when tomorrow you could hand in your notice and not look back.

When you next see an educational session you would like to attend, think first of how you can contribute to paying for it. Maybe you discuss a partnership with your employer? Maybe you take some annual leave or lieu days to attend so they are not paying both your wages and for someone to replace you. If they do want to pay for your fee to attend and your wages, then be grateful and show them some loyalty. Give back to them and be considerate to your employer. Work together because in the end, you are the one that keeps the knowledge you attain. Sure, your employer will benefit while you are there but if you leave, you walk out with that knowledge.  It is not left behind.

Now I am not saying which is right. I have been the recipient of having an employer pay for courses for me for which I was very grateful, but I have also been an employer who had to look at the budget to see if staff could be paid for to do course and this can be quite a dilemma. So spare a thought for your employer who is trying to balance the books and if they graciously pay for you to do training, be grateful and give back to them with your loyalty.

Food for thought isn’t it?

The power of giving back

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Last month I talked about being grateful for what we have. This month I am going to talk about the power of giving back or paying it forward.

So what has sparked this for me to want to write about it? Well last month I advertised on Face Book the library that is now available for professional development educations hours. One response came back with “About time nurses had protected education time and that it was paid for” 

Now I didn’t respond to it because I do not feel we need to get into a tit for tat, right wrong sort of debate in a public forum like Face Book as there are too many negative posts on there any way. 

However, my question is “Whose responsibility is your practicing certificate?” It is not the DHB or your employers. It is yours. If you don’t keep up with your professional development and fail the competencies for your practicing certificate, do you really think the DHB or your employer is going to enable you to keep working  No! They will look to replace you tomorrow. 

Do not think you are so precious and indispensable. Who every employs you owes you nothing? You owe it to yourself and your patients/residents/clients to keep up to date with current information AND pay for it yourself. You can look at it as paying it forward: being grateful that you have work because a lot of people don’t. Think more about what you can contribute rather than what you can take. What has happened to our community?  Is it no longer cool to give back?

This year, I have purchased for my grandchildren so cards Acts of Kindness or AOK.  These cards are about encouraging people to be kind. The first card I picked up said “Children love toys under the tree. Buy something for someone not as lucky as me.”  The next card I pulled was “Candy canes are a Christmas treat. Leave some for strangers now that would be neat.” The third care said “Ring someone for no reason at all. Tell them you love them on that call.”

Now it struck me that if we could foster some of this kindness in our workplace, then what a great place it would be. Instead of your employer thanking you, why don’t you thank them for a change.  Instead of your employer paying for you to work and train, why don’t you pay for your own training to thank your employer for giving you the opportunity to work. 

I know it is easy to think your employer has an infinite amount of money and can pay to keep you in work. The reality is they do not have a pot of gold available to pay for everything they would like. I am sure they would like to pay you more. I’m sure they would love to be able to give all the staff you need to make your job easier. I’m sure they would love to be able to pay for unlimited training to keep your skills up. But they don’t. 

Having a job is a privilege not a right.  Show some gratitude towards your employer and do something for them this Christmas. Show them you appreciate them: that they do not only help you put food on the table and roof over the head of your family. That you appreciate them giving you the opportunity to feel worthwhile and valued; that they give you a reason to get out of bed in the morning. That they give you a reason to smile each day and care.

Remember giving back doesn’t have to cost a lot of money.  It is the little things that count. 2020 has been a hard year for everyone so why not let’s make 2121 a year of giving and forgiving.  Of loving and appreciating everyone around you. Of spreading love, not gossip and falsehoods. 

May your Christmas be one of joy and giving. Of loving and laughter. Of joy and thankfulness. Till next year. Merry Christmas. 

Living in a grateful world

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As we’ve recently gone through a general election and two referendums, it is interesting to see the changes that are happening in the country. We certainly are getting more diversity in parliament which reflects the nature of New Zealand’s population so it will be interesting to see what happens in the future. While Labour and the Greens have worked out a deal, one cannot help but think that because Labour has a majority, how much influence the Greens will have. I guess we just have to wait and see what transpires over the next 3 years. 

As far as the End of life choice bill referendums is concerned, I wonder how many people actually like the idea of being able to make a choice but do not fully understand what it is for the health professionals who have to apply this law. While I believe the actual number of people who chose this option, when it comes to actually making a choice, few people will take it up. However, my thoughts go to the health professionals who have devoted their career to saving lives, to be put in a position of now having to actively facilitate a person’s death. 

As far as the Cannabis referendum went, I wonder that by not voting for Cannibas reform what the effects of this will be? I guess it’s just another wait and see isn’t it.

However, one thing I am grateful that for is that we truly live in a democracy where we have sensible and sane leaders at the top. When we look at the debacle that has been going on in the US, I am so pleased that we do not have any of that nonsense here.  I find it so amazing that people can actually vote for someone like Donald Trump who is so full of his own importance, makes up lies, contradicts himself, and tweets so many untruths that people actually revere him. It makes me wonder at the psyche of some people. I’m sure the fireworks are not over there yet. He’s like a screaming child, screaming and stamping his feet because he has been told to do something. 

So today, I am writing a list of what I am grateful for

  • That we truly live in a democracy where all people can have their say without violence
  • That on the most part, our politicians are honest
  • That we have a really stable country
  • That sense prevailed and we opted for short term pain for long term gain with Covid-19
  • Majority of New Zealanders are sensible and consider others
  • That we all have freedom

What are you grateful for and what are the benefits of being grateful:

Now we are not perfect by any means, but who is and what is perfect anyway.  However, if we compare ourselves with other countries, we are pretty lucky.  I can see why we are so attractive for people to want to live here.  So if you don’t think being grateful has a positive effect on you and your health, then listen to the research on this in this clip: