Rog Posted July 26, 2004 Author Posted July 26, 2004 A really big thanks to everyone who’s sent wishes for a return to health for the memsahib and a bit of an update for anyone who’s interested but first to address the post by FMCR where he writes --- Have the medical staff at the new Hospital got a fear of facing legal action if they get the diagnossis wrong at the first attempt, which sometimes happen. Cleaning staff at the hostpital are not allowed to disturb or move patients while cleaning, so how can they do a good job, Nursing staff wont do any cleaning as its not in their contracts, so how can they keep the wards clean. The only way would be to have spare wards, as one is given a full clean out they could then move the patients into the clean ward, this would have to be done daily, but cant be, so whats the answer. An action for misdiagnosis is unlikely to get to court let alone succeed unless as a result of such misdiagnosis the patient receives treatment that proves injurious in some way. OK – telling someone they have cancer and then after they have sold off all their possessions, told their boss what they thing of him, done the sex-cruise to the Philippines and picked up a dose so severe medical science will name the strain after them, and then having them find they didn’t have cancer after all might warrant legal action but we’re not dealing with such extremes here and in any case that’s Sods Law in action, part two of which states that ’You can’t legislate against every eventuality’. What is the determining factor in diagnosis where the problem is not immediately obvious is cost. Each department is a ‘cost centre’ in its own right and one way of monitoring efficiency of a part of any organisation is to compare actual costs with predicted costs. The fact that hard cash doesn’t actually change hands is incidental. To illustrate this point in an NHS Trust Hospital it is the general rule that if (say) the A & E department send a patient to have a CAT scan the A & E dept are ‘charged’ for the service of the CAT dept. In the case of a CAT scan the sum is considerable – several hundred pounds. On the other hand an X-Ray, or a blood test to detect the number of white cells in a sample, amounts to only a few pounds. It is precisely to minimise the operating costs of departments that the inevitable takes place and the expensive options are only taken when they are either really needed in the opinion of the doctor and / or he feels able to defend his decision against some local administrator or more senior doctor in the dept. questioning his action, something that is quite common place apparently. What is being missed is the principle that controlling costs in this way may give the illusion of efficiency but when viewed in a wider context it results in a gross inefficiency. This is not ‘rocket science’ but something that has been recognised in industry for a number of years now. Now if a the patient was seen as a cost centre things would at least improve. If the patients was brought into the equation and pain and discomfort were to be costed then different practices would follow. Suppose for example that one hour of agonising pain was to be charged to the A&E department at £1000, or an hour wait for treatment following triage was to incur a ‘cost’ of £25, I would just bet that there are quite a few practices that would change and bloody quickly too. Once again there wouldn’t be any actual money changing hands, i.e. the patient wouldn’t get cash in hand, but the hit on the operating cost of the department and so its perceived efficiency, would motivate more than a few into action. Cleaning. To imply that because cleaners must not move patients and that nurses don’t ‘do’ cleaning ‘cos it’s not in their contracts, so things must be as they are is simply astounding – and unacceptable. There is no reason whatsoever, other than cost, why a when a bed is vacated it and the surrounding area should not be thoroughly cleaned – cleaned with ‘soap and water’ for a start. I have watched the ‘cleaning’ staff at work and I just hope they are not typical of the general situation in our NHS hospitals though I suspect that they are. While waiting with Clair in the A & E treatment area I watched a succession ofd patients go into and out of cubicles and the bed coverings never get changed once other than when one patient was bled profusely onto the sheet and another one vomited on theirs. Cleaning of wards by simply pushing a dirty ‘bumper’ around part of a ward floor is not cleaning it in my book. Polishing it. Perhaps, but cleaning? No. The same with corridors. No washing and rinsing here – just a dirty mop being wiped around. They (the cleaners and their managers) seem to think that by simply wetting a surface it somehow becomes clean, there’s not even any bactericide used – just plain water. It’s bloody shameful. In the past many people used to talk about ‘that hospital smell’ It was the smell of disinfectant. That’s a good word to ponder on is ‘disinfectant’ Split it --- ‘diss’ and ‘infectant’. Something that prevents infection. Today it’s seldom if ever used and so--- surprise surprise – people get infections. FMCR asks ‘What’s the answer?’ --- the answer is to get the people who are employee to do a job to actually DO the job that they’re employed to do, not re-define the job into what they can get away with. Abandoning the contracting out of ‘cleaning’ and bringing it and therefore the cleaners ‘in house’ would be a damned good start. You get far more ‘buy-in’ when you all work for the same boss especially when it’ll be his ‘cock on the block’ if things go wrong. That way everybody has a common interest and more to the point, involvement. Additionally the need to recognise that when a job is removed from an organisation or when responsibility is taken away from a person, you can’t just forget about it what it was that person was responsible for. People so often say ‘Bring back the matron’ or ‘The ward sister can’t say anything to the cleaners anymore’ but there’s no real need to bring back the matron, nor to just allow the ward sister to be able to direct the cleaning staff, (though she and in fact any nurse should have the authority to do so) but appoint someone in each ward to pick up the bits of responsibility such as direction of cleaning and housekeeping that was once something that the ward sister and the matron used to do. If there was a need for something, and there was someone who filled that need, taking away that person or taking the responsibility away from that someone who formally had it and not allocating it to someone else is bloody stupid. It results in the need being unfulfilled and look at the filth and unhygienic conditions that now exist in our hospitals as proof of the validity of that statement. The solution is so obvious the fact that it has not been done would make a cat laugh. But to more important things. Clair has had her operation and (hopefully) will be released from hospital today. I won’t go into it being far too bloody soon as the state of the hospital is such that I see the balance of risk being in favour of getting her out ASAP before something happens such as an infection – there is MRSA on every ward in the hospital at present. The nursing and other clinical staff have for the most part been excellent insofar as the internal procedures allowed them to be. The food is disgusting but here again that is only to be expected. My own thoughts are that it should be possible to have the option to purchase from an a’la carte menu in addition to the standard ‘free’ meals provided to allow more choice. Overall the experience has been horrifying. The message is that it is very clear that you MUST stand your ground as the people with whom you will come in contact are very restricted in the degrees of freedom that they have and although they may well want to do something they may not be able to as a result of cost based procedures. Don’t be fobbed off with officialdom and the ‘We always do it this way’ mind set though do remember you are dealing for the most part with experts and professionals. Don’t get nasty with clinical staff, but administrators are fair game, and if all else fails be prepared to involve your solicitor. What a disgusting state of affairs. Remember, we don’t have a ‘free’ health service. We pay through the nose for it and we are entitled to be treated accordingly.
When Skies Are Grey Posted July 26, 2004 Posted July 26, 2004 All these tales of medical woes certainly puts the bickering that sometimes goes on in here in to perspective. My best wishes to Rog, Minnie and all those involved......
FCMR Posted July 26, 2004 Posted July 26, 2004 Good luck Rog. Its ok telling us all on the forums who are only a small% of the population, your story should be heard by a larger % of the population. May I suggest that you contact Manx Radio and the local papers. A very interesting news item on TV this morning over the cleaning of Hospitals in the UK, head of the union for the cleaners said that in order to have any chance of keeping Hospitals clean would be to take a hard look a the way visting is done.
ans Posted July 26, 2004 Posted July 26, 2004 May I suggest that you contact Manx Radio and the local papers. Why? Rog lives in the UK, this is a UK hospital he's talking about.
FCMR Posted July 26, 2004 Posted July 26, 2004 I did not know. OK contact your local radio and newspaper
manxbird Posted August 3, 2004 Posted August 3, 2004 A cousin of mine yesterday had an appointment at Noble's for an exploratory operation. He was prepared for the op and undressed by 12.35. The nurse told him he would be seen in 20 minutes. He then lay in an empty room with no clothes on, and not having ate since 7.30 that morning, until 4pm. He then got fed up and left. He now has to wait another 5 or 6 weeks for another appointment for something that could possibly be life threatening. Surely someone during those 3 hours could have explained what was happening?
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