Get you in the end

http://www.youtube.com/watch?v=_N0w2rORwSc

I have just finished my rotation in surgery - general surgery, but specifically colorectal. I have also done "surgical take" - where patients come in with usually bellyache but pretty much anything that could be a surgical problem. This happens in the "Surgical Assessment Unit". There is a room there, for seeing patients initally. This room contains a bed, a sink, a table, three boxes of assorted sized gloves, and a box full of bottles of KY jelly. Many people who come in with abdominal pain - in fact, almost all - should have a rectal examination and this is the place it's done. Regulars to the SAU know the room. One such man - with a colitis that keeps him returning - I've seen a few times over the four months. He makes a joke of it each time. "After all this, I'll have to buy you dinner sometime."

Swine Flu abounds

http://www.telegraph.co.uk/health/swine-flu/5990603/Girl_dies_of_meningitis_after_swine_flu_diagnosis.html

So, a little girl has died, after swine flu was diagnosed, by a paramedic. She, in fact, had meningococcal septicaemia.

Yes, meningitis is missed sometimes, and it's awful every time. But, from what I have read, this little girl was not given much of a chance to be properly assessed.

Children will still get meningitis despite the pig death. Shouldn't they be assessed and treated in the same way they always did? Is this going to happen again? The SWINE LINE - non medical people prescribing medication after someone ticks some boxes on a computer detailing non specific symptoms - seems to indicate that it would be suprising if it does not.

Surgery

I started surgery on Thursday at 7am. So of the last 108 hours, I have been at the hospital, working not sleeping, for almost 70 of them. I counted.

EWTD my arse! Tee hee! I'm not a fan of reducing doctor's hours really - we need the training, especially in things like surgery - but why the huge pretence? My hospital hires locums for the weeks that we are being "monitored" and then suddenly stops hiring them when the clipboards have left. If we give in a form saying we have gone over hours we are called into an office and told to change it to say every minute extra we spent is of our own accord for learning purposes as "we are not being told to stay". They don't seem to realise, or care, that it's actually jobs for patients that we are filling our time up with. If we don't do them, the patient might as well be at home. Why bother with all of these silly forms and hours monitoring? What's the point of all the deception?

Melanie Phillips ...

... makes me spit blood.



http://www.dailymail.co.uk/debate/article-1160511/MELANIE-PHILLIPS-Doctors-struck-denying-patients-right-die-What-sinister-distortion-medical-ethics.html



Dear God. Is she taking the piss? It's like she is desperate for something to say against doctors, but the best she can come up with is the fact that doctors have been told to comply with their patients wishes when it comes to withdrawing treatment? There are so many problems with the NHS and healthcare and doctors that she could talk about and bring people's attention to. But oh no, she goes for doctors listening to patients wishes about the end of their lives and complying with them. What she says does not even make sense. She says



"It has always been an important medical principle that no patient should be forced to have treatment against their will. Patients have always had the right to refuse treatment, whatever the consequences to their own lives."



And then in the same breath to say "the terrible truth is that doctors will now be struck off and may be sent to prison for refusing to kill their patients. How on earth did this country arrive at such a monstrous situation? And how can the medical profession go along with such a betrayal of its deepest ethical principles?"

I'm only a baby in the medicine world. But already I know that sometimes letting a patient die peacefully, especially when the patient in sound mind has said that that is what they would have wanted, is sometimes the ethical, humane, human thing to do.

Sigh

Sorry, bit of a rant.

Working on the gynaecology wards. We have such a major bed crisis that operations have actually had to be cancelled. This is because the hospital cannot get its head around the fact that if it doesn't have as many beds as patients, there will be problems.

Very expensive suit comes striding up to me brandishing some notes.

Her: "XXXX, directorate managar. Why hasn't this patient gone home?"

Me: (thinking she had the wrong patient or something) "Becuase she had a hysterectomy yesterday afternoon."

Her: "So she can go home."

Me: "No. She can't. She had a hysterectomy yesterday afternoon."

Her: "FINE - can she go tomorrow?"

Me: "I really don't think she'll be ready tomorrow, patients usually stay for at least two full days after an abdominal hysterectomy, usually more."

Her: "Well nothing's going to delay her discharge. Don't you know the hospital's in a bed crisis?"

Me: Smiling politely but wondering what she is going to acheive with the note waving.