Common sense is just catching up with me

Ideas I've had which no one thought anything of because when I mentioned them, I was and still am a nobody. It's just frustrating to see that they're being implemented now.

Idea number:

1. Hospitals employing own cleaning staff. Just read the BBC news and Scotland is employing over 600 new hospital employed cleaners, not contractors, to clean out their hospitals. I'm sick of cleaning equipment being locked away from me. I had a cleaner who said she doesn't clean up body fluids (vomit in this case) but wouldn't give me her mop or give me access to the locked cleaning cupboard. I wasn't trained enough.

2. Employing some male staff to work in the Psych ward every shift (I once worked in a place where often I was the only male on shift). I was called sexist. A year after I left they employed a couple of huge men to work as the muscle in the place. This only happened after a female member of staff was placed in a headlock and dragged down the corridor while none of the female staff, all of whom had been trained in restraint, could not stop him.

3. We always had difficulty finding out which patients could do what in the psych ward. ie which patients could leave the ward with supervision, which could not leave at all, and which patients were sectioned under the law. My suggestion was to have on the office whiteboard, next to each patients name, their legal status, their leave status, plus any special requirements if they can leave the ward. I was told this was not very confidential. One year after I left, this was in place and it made life much easier when trying to find out which, especially at short notice, who could leave the ward, especially for excursions for the patients.

I've had more great ideas, the above list is just off the top of my head. One big idea which I feel is critical to saving the NHS is this:

Making it a legal requirement to have at least one registered nurse per 6 patients, with the exception being night shift of course. I've regularly had up to twelve, sometimes 16 patients with a healthcare assistant, all in a busy surgical ward. Patients die because of this, it can't be helped.

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What I'd really like to say

As I opened the mornings emails a groan escaped my lips. There were three emails, two from Russia, one from the States. I knew none of them were going to be pleasant.

The first email - I am disgusted that the school would send my child to a place with third world conditions. My son will see a dermatologist urgently or there will be consequences.

The son happened to be on a school camping trip. He'd been bitten rather badly by either the mosquitoes or the sleeping bag he had used was full of bed bugs. The problem had resolved, the bites fading. Nothing a dermatologist could do.

The second email - I am writing to you because of the substandard care my daughter received. My daughter now needs surgery because you didn't bother to x-ray her. She has a fractured tail bone...

The daughter had self discharged from hospital, she said she wasn't in pain. And who the hell operates on a broken tail bone anyway?

The third email - I want to know how you can let children leave campus and get so drunk they end up in hospital...

The boy was celebrating his 18th birthday and his parents had given permission for him to leave campus and go to the city. They said he would be staying with his uncle. The hospital never called the uncle. They called me. I never saw the uncle because he never bloody existed.


What I wished I could say

The first email, the bedbugs - Dear Parents, do not threaten me or tell me what to do, ever. Your son got bitten by some bugs. This is what happens when you go camping. The bugs could have come from his sleeping bag, which you bought for him, or from some rather voracious mosquitoes. The bites have healed fine. A dermatologist would be of no benefit, other than to make you look desperate to blame someone for something that really is nobody's fault.

The second email - Dear Parents, Have you forgotten that it was your daughter that discharged herself from hospital because she was sick of waiting for an x-ray. Have you also forgotten that I recommended she stay, but she insisted she was fine and in no pain. I have never seen someone who actually has broken their tail bone be pain free and sitting fine in an upright position. I have also never seen someone have an operation for a broken tail bone, but this would not be the first time I've heard of absurd treatments from Russian doctors, although I am aware that with $20 US dollars you can get a doctor to write what you want from over there.

On another note, I hope the behavior witnessed by myself and the other nursing staff in the emergency room where your daughter was admitted was not typical. She was rude, abusive, obnoxious and generally appeared to be a spoilt, selfish, nasty little minx. I wonder where she gets this from

The third email - Dear parents, How can we expect to be held responsible when you say they are staying with relatives and take them away from campus. And since I haven't seen any sign of this uncle who was supposed to be looking after your son, and since it was I that got out of bed at 2 o'clock on sunday morning to drive two hours to the city to see your son, you should be on your knees thanking me. But you're probably feeling guilty for lying about this uncle, and I know you're lying because your son has admitted there never was an uncle. And now you're looking for someone to blame. Well take a look in the mirror.

Oh and this is not the first time your son has been in trouble for drinking, although it certainly is the worst. He says he's been drinking at home since the age of fourteen. I don't want to judge, but feel I must say that this is illegal.

I won't bother telling what I really wrote as that is too boring, too damn politically correct and cover your ass.

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Missed Fractures

"Don't you question the doctor?" asked Bryce. I took several slow breaths before replying as I was becoming more agitated with every word Bryce said. "No Bryce, we never advocate for the patients. We let the doctor do as he wants" I replied. "You what?" Bryce exclaimed. Caught off guard by my comment Bryce seemed to miss the sarcasm in my voice. Bryce is the head of the complaints department. I don't know how he got the position, especially as he is not a doctor or a nurse, although he did once work as an assistant in a lawyer's office.

"Bryce, we always advocate for our patients, but if the doctor says the x-ray is fine, then I tend to take his word for it. I'm not an x-ray specialist" I said.
"Well, the family are complaining because they say Miss Putin now needs surgery because the doctor missed the fracture on the x-ray. You were right there, you saw the x-ray" Bryce said.
"Are you saying it's my fault then? That I should have seen the fracture that even the most senior doctor on duty didn't pick up?" Bryce shook his head, "No, no, that's not what I mean" Bryce said almost apologetically.

"Bryce, why am I even here? This is between you and the doctor who saw the x-ray" I said. "But you were there, you saw everything. This was your patient" he said. "Well, if you want my opinion, well, here's how I see it. First, the patient apparently has a tiny break in the tail bone. She wasn't in that much pain. She wanted to go home. You don't do surgery for a broken tail bone. Oh, and this happened six months ago and we don't have the x-ray to confirm that there really is fracture that has been missed" I paused for breath. "When you put this whole thing together, this sounds like a load of shit."

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I"m to dumb to understand that diagnosis

"Fuck off" said Peter. I moved suddenly, catching Peter off guard. I grabbed the front of his shirt and slammed him against the wall. "Don't ever speak to me like that again Peter, or you'll be real sorry" I snarled. "You can't do that to me. I'm a patient. You're fucked" he managed to gasp. I replied by slamming his head against the wall, "Let's find out if you're right, eh."

The phone began ringing. I woke from my daydream. I reached over and answered the phone.

We do have a patient called Peter. The doctor thinks he has a Personality Disorder. I don't understand this diagnosis. To me he's the bastard who got caught drug dealing in the paediatric ward just after his wife had given birth. He's also the only patient who does tell me to "Fuck off" on a regular basis.

He's never been admitted to a psychiatric ward before, but after being caught by the Police he tried to kill himself. Ten paracetamol is not enough to kill, but his liver has got to be suffering. I'm sure he knew it wouldn't kill, but he probably didn't know he'd damage his liver.

Maybe I'm insensitive. Maybe unprofessional. But I'm allowed to dream.

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Defibrillator Battles

One heart attack down, another dozen to go I reckon.
Everyone smokes here, the maintainence guys are mostly over 50, or even 60 year old. They smoke about 30 cigarettes a day, and have a pretty decent amount of alcohol. Hell when I arrive at work in the morning to open the health center, the hall is full of the smell of cigarette smoke drifting up from the basement workshop.

The head of business has told me he's not keen on spending money on some defibrillators. "Well, there's legal issues involved" he said and "It's not just as simple as going out and buying a defibrillator." I shook my head at this "It is that simple. We buy it, then I show the staff how to use it. They're desgined so that even young children can use them. You switch it on and follow the instructions, which usually are "Push the button"

Anyway, to be thorough, I offered to have the school send me on a course to officially train others ie lay people like the teachers and maintainence guys, on how to work the damn thing.

Too much money apparently.

I wonder what happens when the next staff member drops dead. We had our first heart attack last week. Fortunately he survived, but no thanks to the health center.

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