What a Difference A Day Makes

What a Difference a day makes.

On the anniversary of the 7/7 bombings,

In the Commons, MPs paid tribute to the actions of NHS workers and members of the emergency services in the wake of the bombings.
Speaking during health questions in the chamber, shadow health secretary Andy Burnham described the actions of NHS staff on the day as “heroic”.
Health Secretary Jeremy Hunt praised the “extraordinary bravery” of the emergency services.

And then one day later

Public sector workers, including civil servants, teachers, nurses, police officers and members of the armed forces, face another four-year pay freeze as a result of today’s budget.

Thoughts on 10 years later

There is a reason why I tend to keep off the internet when the 7/7 bombings anniversary rolls around, it’s not because of any traumatic memories (I did nothing more than turn up to cover my colleagues who dealt with it all, while I had one ‘Maternataxi’ job).

My thoughts on the days around it can be found here

What makes me angry is that on the anniversary there is a big hoo-ha about how ‘London stood as one’, with no hate but just a determination to keep on living and muddling along as we did before the bombing.

And it’s true – we did.

But then the media realised that they would sell more papers, get more eyeballs, and have a bigger influence by villifying muslims. By causing hatred and fear. And now we end up with groups like the EDL and ‘Britain First’. Two organisations that came into being based on the lies that the media has spun.

So something that should have unified us has, instead, just divided us. And it seems it’s going to continue that way – all for the benefit of media mogals and shareholders.

SEO Scumminess

I checked my email – something I now only do two or three times a week and found this email.

Hello,
Thank you very much for getting everything wrapped up so quickly but unfortunately I cannot say the same for myself.
We are having some annoying payment issues and it has caused a pretty hefty back log, as it’s a bot running payments there is a queue, Once you are first in the queue you will be paid but until then I cannot really do much.
If you need to pull the article then fair enough but can you please keep hold of it to repost as the payment will certainly come at some point.
Regards

omnibuzzmedia

I think as a species we are becoming more and more adept at filtering spam, and I found it strange that this would be sent to me.

Then an hour later I got this.

Hello,

I am very sorry for my previous email, I have just realised I sent the complete wrong message, the intended message is below. (if you have received this message more than once please excuse me, my email system is bugging out)

Thank you for taking the time to read my email, I am contacting you today to enquire about the possibility of collaborating on a post for your website.

Just a few quick notes to point out we are working with a client and the article would need to have a link to their site in do-follow format which we can pay you for hosting.

If you would be open to something like this or would just like some more information please let me know and I will get back to you as soon as possible.

I look forward to your response.

Kind Regards

omnibuzzmedia

So basically it seems that they pushed the ‘Give Excuse As To Why We Aren’t Paying You’ button, before hitting the ‘Try To Get Someone To Shill For Us’ button.

So draw your own conclusions.

Lord Warner – A Challenge

Lord Warner has released a report stating that we should pay £10 ‘tax’ to use the NHS and that the NHS is ‘not cost effective’ despite all the evidence to the contrary. Both of these statements are frankly bollocks. However we have grown used to these lies and, as the media keeps pushing them, eventually they will be believed.

I looked up Lord Warner, he is the executive director along with a Suzanne Warner of ‘Sage Advice Ltd.’ A company that has no contact details, no website and no telephone number. At least none that I can find. This doesn’t mean that this ‘company’ is in any way dishonest, but as a simpleton in the ways of business I can’t see the reasoning behind it.

Of course, this, and Lord Warner’s previous job advising Apax Partners (a company that invests in private healthcare) might mean that he has some sort of vested interest in bringing about further privatisation of the NHS.

Sadly the newspapers only printed Lord Warner’s side of the story (i.e. Bullshit) and have not in any way highlighted these vested interests.

So, as I lay in bed trying to sleep but with sparking neurons of flaming anger keeping me awake I came up with an idea. It’s not a cunning idea, and Lord Warner would never agree to it, but it might be nice to dream.

You get a small, agile, hell – even amateur, filmmaker to stage an hour-long debate between Lord Warner and a defender of the NHS. They each have plenty time to prepare and can bring actual, real, evidence to defend their position – and this evidence is added to the debate, maybe even using whizzy computer graphics. Maybe there could be a referee who calls for the evidence to be brought out when one side or the other makes a statement and challenges the participants.

This film then goes up online where anyone can see it and we try to get newspapers (who really should be the people doing this sort of thing) to publicise it.

Every soundbite has to have evidence to back it up, there is no ‘playing to the crowd’, there is only truth.

Not that this sort of thing would ever be allowed – because Warner, (sorry, forgot the ‘Lord’ and tug of the forelock) already has all the power and this sort of truth finding would only have the risk of him seceding power to someone opposed to him. While the defender of the NHS has nothing to lose (except, y’know, the NHS) Lord Warner would have everything to lose by taking part in such a radical idea as a search for the actual real truth.

So, silly idea, but at least it gets this idea out of my head and onto the screen so that I can hopefully get some sleep.

That Forcefeeding Video

I’m going to state right now that for most cases I am completely against force-feeding. There are issues of capacity and sacrifice and so on that would take a post of its own to describe, and that is not what I’m writing about here.
 
It’s the Yasiin Bey video showing him undergoing the procedure for the force-feeding of a prisoner at Guantanamo bay. It was created to highlight the evil of force-feeding.  

Here it is.

 
I have serious issues with this video.

 
Here is another video showing the exact same procedure.

(Here is a video on how to insert one into an eight month old child)

The procedure shown is the insertion of a nasogastric (NG) tube. I have placed more NG tubes than I can remember and I have never seen a reaction as strong as that shown in the first video. It certainly isn’t very pleasant to have a NG tube inserted as it tickles the back of the throat that makes you want to gag (or swallow), but it is not this apparent torture that is being shown.

 
An NG tube is inserted in hospitals for a number of reasons, sometimes for surgery, sometimes because a patient cannot swallow.

 
In the first video Yasiin Bey isn’t given water to drink during the procedure, but in many of my patient’s I also couldn’t give them anything to drink to ease the passing of the tube as these patients would have no gag reflex and so giving them water could result in them inhaling rather than swallowing the water. Inhaling water can have side effects that include death.

 
Yasiin Bey is also shown to be resisting, while the person in the second video is complying with instructions. Many of the patients that I passed an NG tube into had some form of confusion, either due to a stroke, due to dementia or due to a multitude of other causes . In some cases I would be passing a tube into the stomach of someone against their will because they had tried to commit suicide and were under a Mental Health Section.

 
Even in these cases I never saw a reaction as strong as that of Yasiin Bey.

 
Note also in the video that at one point Yasiin Bey’s hands and head are restrained, but later on they they are free – all to show how the medical staff have to use physical force to hold him down which makes it look even more brutal.

Once an NG tube is in place you can leave it in. So it is not something that necessarily needs to be done twice a day although in this case they may remove the tube in order to stop the prisoner from hanging themselves with it, or for some other operational issue.

 
This video is bad for two reasons. First – it makes a medical procedure which is carried out in hospitals up and down the country in the order of probably hundreds of times a day look like torture. As I note, it’s not pleasant, but it certainly isn’t torture.

 
The second reason is that this video is, in my mind, a lie. The discomfort is exaggerated, the physical restraint is unnecessary, and it is filmed to be as ‘shocking’ as possible.

 
Similar to what Islamaphobes do this is ‘othering’ the enemy. The people inserting the tube aren’t human, they don’t have faces – they are just shown as unremitting medical automatons. How is this different to how Islamaphobes only show the fully veiled woman or the bearded terrorist?

This video is the equivalent of an anti-vaccine campaigner, thrashing, fainting and drooling after a ‘flu jab. And we would challenge that video as being untruthful. We need to do the same here.

We need to be better than this – the Islamaphobes and warmongers can and do lie, they hide things, they distort and deny. Those of us on the side of peace need to avoid stooping to this level. We need to be better than this, because every time our opposing number can catch us in a lie our support will drop, we’ll be targeted by the media (just look at how the news is now about Snowden himself and not about how the NSA and others spying on us), and what is worse is we’ll lose the support of those who are most likely to be swayed by truth.

 
Truth sets us free, propaganda keeps us in chains – and in my opinion this is propaganda.

Damn Brain And Insomnia

I needed to write this down as it was rattling around my head stopping me from sleeping. Please excuse the formatting.

V/O ‘Thiamine and vitamin B. I’m sure that there are people out there who take only these two medications and who aren’t alcoholics. But I’m yet to meet one.’

Panel – Overhead shot of a dishevelled man sprawled out in a very untidy room

V/O ‘The interesting thing about alcoholics is they don’t normally drink themselves into unconsciousness, which is why I’m concerned that the man laying on the floor in front of me, whose only medications are thiamine and vitamin B, isn’t moving.’

V/O ‘The medication isn’t my only clue he’s an alcoholic.’

Panel call outs – An empty bottle of Tennants Super. Nicotine stained fingers. Fag burns on the carpet. The shirt buttoned up lop-sided. Dried urine stains on the trousers.

V/O ‘And then I see the thing that is going to make this a very long night indeed’.

Panel call out – Two sealed up fang marks to the neck.

On conspiracies

I’m not a fan of conspiracy theories, while there is often a certain elegance to them I have been on this planet far too long to believe that great secrets can be kept. Humans are dreadfully inefficient creatures and a conspiracy needs a more perfect operation than can be handled by bunches of jumped up primates.

What I do see however is A leading to B which leads to C.

On Monday I wrote about the explosion in the use of private ambulances (and a good comment was left, one I shall revisit later), in that post I linked to my piece about the cutting of London ambulance staff by one sixth. A few days later, after the news story had been featured on the BBC, it was announced that London ambulance would be recruiting more staff.

Obviously I was interested, and as I keep an eye on such things, I looked as to who the LAS was looking to recruit. Their only job vacancies at the moment are for ‘Ambulance Support Staff’.

Ambulance support staff are not trained to the same standard as what the public would call ‘Paramedics’, and the plan is to team up one paramedic with a ‘support staff’. So when you call an ambulance only one of the people present will be trained to deal with your medical emergency. The other will essentially be a driver and equipment carrier.

It goes without saying that when there is a serious job, for example a ‘proper’ car accident, then you need all the hands you can get, and in the future you will arrive on a scene and half the people wearing green will be undertrained and underpaid staff.

Needless to say ambulance support staff are paid less than the person that they are sitting next to for twelve hours of the day.

So instead of the old ‘one day drive, one day look after the patient’ that we had always had, the paramedic will be looking after patients for twelve hours a day constantly with no break and no support. Given the unique pressures of ambulance work this is not in the best interests of the health of the paramedic.

Money will be saved, patients will initially not know the difference and paramedics will burn out even faster. These burnouts will be replaced by ‘apprentice paramedics’ who will also be cheaper than those who have been in the job for a longer period of time. What impact do you think that losing all your experienced members of staff will have on morale and, more importantly, patient care?

So we have a cutting of staff, followed by increasing private contractors and now followed by recruiting more staff. These staff are to be paid less than the staff originally lost. And apparently this will have no impact on patient care. The expensive staff will burn out quicker and be replaced by cheaper staff and this will mean patient care will fall.

This is similar to the government’s plan of student nurses working for a year as a HCA – it’s a blatant way of getting free (or certainly very cheap) health care assistants.

A leads to B which leads to C.

Private Ambulances

An apparent increase in the use of private ambulances in the NHS is a risk to patient safety, Labour has warned.
It says freedom of information requests show spending on private vehicles by three English ambulance services rose by millions over two years.

This is amusing to me as it was Labour who started the privatisation of the ambulance service whne they were in power. I remember the LAS losing a lot of patient transport contracts as private companies could ‘do it better and cheaper’. At one hospital I remember the private ambulance company lost their contract because none of their staff had been through criminal record checks…

I had reason to need an ambulance to transport a patient to hospital as an urgent case a little while ago. We booked the private ambulance to do the job and thought that was that. Later that day I had a phone call from the company saying that they wouldn’t do the job as it wasn’t booked with 24 hours notice. I told them that they should go ahead and book it for the next day, to which they replied that they still needed twenty four hours notice – I explained that they were actually getting twenty-six hours notice.

In the end we decided that as the patient needed to be in hospital we should use the LAS urgent service.
I was waiting at the house so that the crew could gain entry and was less than surprised to see a private ambulance turn up.

The figures showed an increase in spending of (in London) more then £3.8m, from less than £400,000, in 2010/2011, to £4.2m, in 2012/2013.

When I was still working in the hospital I was surprised that, when I went outside the A&E doors (normally looking for a member of staff who’d gone outside for a crafty cigarette), I would often see more private emergency ambulances than LAS ones.

As for the increase in private ambulances – could it have anything to do with something I wrote about previously – the decimation of the LAS?

While I am ideologically against the privatisation of the NHS (and the evidence would seem to back me up), the more practical concerns with respect to private ambulance services are, how well are they trained and kitted? Do they have clinical updates, CRB checks? Who does their staf training? What are the legal issues of them driving on blue lights and claiming the excemptions that the NHS services claim? In the effort to cut costs (and thereby increase profits for shareholders and owners) are they compromising patient safety?

I know that private ambulance services are monitored by the CQC, but we know how well staffed and effective they are.

The quality of the work of ambulance services are hard to track, it’s why the main gauge of ‘efficiency’ is ‘how fast did they get there’ – so I wonder how well the private services are being monitored.

My guess would be ‘not very well’.

My Nemesis In My New Job

I have been in this new job for about six weeks now and I have already come across the thing that gives me the biggest headache.

It’s faff.

For those who are unaware, ‘faff’ is the accretion of stuff that protrudes into our dimension after being summoned by excessive paperwork, awkward workflows and all those little things that go wrong and ruin your day.

Let me explain further – let’s say that I have to see a patient in order to dress a leg wound. Now, because of the rules every patient must have a prescription for the thing that I’m going to wrap around their leg, be that a clever hi-tech dressing impregnated with nano-particles, or a simple bandage. This is fine if the patient has a nice big box of the dressings in their front room.

Often they don’t.

So, for one pharmacy I can phone them up and they can order more, for the other two that we use I have to go back to base and order more using the victorian technology of a fax machine. Of course the nurse before me should have noticed that supplies were running low and would have done this previously.

This does not always happen.

It should also be obvious which pharmacy ‘owns’ the patient, but again, if a patient moves then the pharmacy that would logically be theirs, isn’t.

What this means is that I spend two hours running around (some would say ‘faffing around’) in order to scare up some dressings to use. And this is a simple example.

What it means is that a nice easy day turns into a nightmare as I faff about phoning referrals, chasing ambulances, robbing Peter to pay Paul and doing all those other things that are required in order to make sure that the patient gets the right care.

It’s not always incompetence which leads to the gathering of faff – sometimes it’s the pathways which we use. For the example above, why aren’t dressings automatically ordered? Surely we have the technology?

I think some of my workmates have seen that I’m starting to stomp around a bit grinding my teeth and muttering (who am I kidding, moaning) ‘why can’t things be better?’

My plan is to start trying to change things. Let’s see how it goes.

(Also – high degrees of faff from Squarespace v.6. I think I need to go back to v.5 which actually let me do things inside my blog posts)

TV On The Job

I was supposed to be writing more for this blog but a few things got in my way, mum going into and then coming out of hospital, new job, depression and being tired all the damn time. I’m going to try and make a bit more of an effort, not least because I’m supposed to be writing three things as well as this blog…


As I go from house to house visiting patients I catch a lot of snippets of TV. It is interesting to see what this tells me about my ‘client group’ (as is the correct term for patient now – it might be ‘stakeholder’ or some such, I’m afraid I lost track about three terminology changes ago).

The TV programmes that are being watched seem to fall into one of four things.

1) Jeremy Kyle.

2) Repeats of Catchphrase

3) A Bollywood/Asian soap channel

4) A Imaan preaching intercut with Asian political news.

I honestly do my best to not listen to Jeremy Kyle – I think about his show in the same way I would think about bear baiting if I lived in medieval times, its just an evil show. Catchphrase is pretty easy to ignore as he always seems to be talking to the contestants rather than getting on with playing the game. My favourite is the Bollywood/ Asian soap – it’s normally utterly insane. The other day I think someone had been bitten by a snake which had made them revert to childhood – at least that’s what it looked like to me, I’ve not much clue about what they are saying. Finally the Iman preaching is a pretty relaxing background noise unless you get one who likes shouting at the camera. The bonus of this channel is that I can now tell you what each Pakistani political party is now polling at.

Some patients will turn the TV off, others will keep it on and to be honest as long as I can hear what the patient client is saying, then I’m not much fussed.

What Random Acts of Reality turned into