Ropey

Two cases, one I, sadly, have come to expect, the other was a bit more surprising.

In the first we find ourselves going to an elderly man who has fallen out of bed, normally a nice simple job that doesn't require much from us apart from a quick dusting off, a check to make sure that they aren't hurt and to make sure that this simple 'mechanical' fall isn't the start of something more serious.

Being the eagle-eyed medical professionals that we are, we notice that our patient has a lot of sores on his body – so we ask him about them.

He's been getting them for a while and the district nurses have been out to dress the sores on his legs for a few weeks now. The sores have since spread to his arms, but the nurses won't dress them as it's not in their care plan. He has been trying to dress them himself – with little success.

Once upon a time I did a nursing placement with a district nurse service, one of the things that you get very good at very quickly is the ability to dress leg wounds. You see so many ulcerated legs you start thinking that everyone over the age of sixty must have them.

You learn how to dress these wounds so that the dressing stays on, so that it is clean, and you make sure you use the best dressing for that particular type of wound.

I look at the dressings on the man's legs. These dressings are awful. They are secured (and I use that word loosely), not with medical tape, but with Sellotape. The bandages are the wrong sort of bandages so they are just falling off his legs. I wasn't too impressed with the underlying dressing either, the layer that is supposed to promote the healing of these sores.

I could maybe understand the dressings not being of high quality if the patient were the type to undo his dressings but he isn't. Couple this with the open sores on his arms that hadn't been dressed at all and I could only really say that this was a very poor example of nursing care.

So I did the only thing that I could, I took him to hospital so that his wounds could be treated properly, and then I filled in one of our 'vulnerable adult' forms, hopefully someone higher up the food chain will take notice of my concerns and do something about the terrible treatment of this patient.

—–

I'm used to poor care in the community, I expect better in hospitals.

We were called to transfer a patient with many broken bones from a ward in one hospital to another hospital, a fairly simple job although the journey would take over an hour. Little did I know we'd take about the same amount of time picking the patient up from the origin ward.

We arrived on the ward and found that our patient was quite a chirpy fellow, he was covered in plaster casts and had an external fixator through his pelvis. No problem, this wouldn't be a tricky transfer.

I asked the handover nurse what sort of pelvic fracture he had, while it's been some time since I studied orthopaedic treatment (in a non-emergency setting), I suspected that due to the presence of the fixator it would be a an 'open book' fracture.

The nurse told me that she didn't know, and handed the notes at me.

Non-plussed at this lack of knowledge about the patient that she was looking after I asked what else he'd broken.

“Dunno”, I was told by the nurse.

I gritted my teeth.

There was a strange contraption attached to the patient's leg – to be honest I wasn't sure what it was, so I asked the nurse.

I wasn't altogether surprised when she told me that she had no idea what the device was for.

It was about then I started to see red – as a nurse you need to know about your patients, you should definitely know what the various bits of equipment hanging off the patient are for and how to look after them. Imagine if this bit of kit needed to be removed once an hour – without knowing this you could put the patient at risk of serious harm.

If you get a patient arrive in your ward with something unusual you find out what it is and how to look after it, to do otherwise is, in my eyes, a basic failure of nursing ability.

The nurse noticed I was getting annoyed at her lack of knowledge and at her apparent apathy towards the care of her patient.

“It's not like I've lied to you”, she said referring to the machinery, “I could have said I knew what it was for”.

“That's not the point”, I replied, “the patient came down from ITU with it attached to them, you should have asked how to look after it when it was handed over to you – or you could have rung up ITU at any point during the day and asked them over the phone. It's hardly rocket science”.

She stomped off in a strop. I don't think that she understood the point I was trying to make.

I checked the notes that we'd been given – there wasn't a CD of the patent's x-rays in there.

“The orthopaedic nurse will have it”, I was told by another nurse, “she'll have gone home by now”.

“Can you not get another copy”, I asked.

“I don't know how”.

“Tell you what”, I offered, “bleep the Ortho SHO and get them to burn you a new copy, because otherwise the receiving hospital will think you are all idiots here”.

“Oh – that's a good idea”, she agreed.

So finally – after an hour at the hospital we were ready to move the patient onto our trolley. I looked at the patient's drug chart.

“He last had his painkillers seven hours ago”, I told the nurse.

“Yes?”, she said, “he's not in pain”.

“Ah, but just think”, I explained, “we are going to drag him from his bed across to our trolley, then wheel it through the hospital and into the back of an ambulance. We are then going to drive that ambulance over the horribly bumpy streets of London for an hour. Might he not benefit from a bit of pain relief before we head off?”

'Oh…. Yes”.

After an injection of what I wold consider a homeopathic dose of analgesia I then had to browbeat some of the nurses to help us move this immobile man across onto our trolley. I also had to teach them how to safely move someone who has half a tonne of metal holding them together .

So… I know that this isn't a specific orthopaedic ward – but all I was looking for was a bit of common sense, even for someone to realise that their current knowledge isn't good enough for this patient and ask for help. But, sadly, there wasn't any of that self-awareness that I'd hope to see in a sentient life-form, let alone a professional.

I don't know – sometimes I feel like returning to nursing so I can stalk the wards with my 'Big Stick o' Learning' gently tapping people on the head until they realise that NHS shouldn't be a watchword for slapdash care.

Or is it just me, is this acceptable care these days? Should I stop being so harsh on other people, expecting them to do at least as well as I would think I could do? Am I just judging these others as being incompetent while blind to my own inadequacies? Would I really prefer a return to 'old fashioned' matrons who would tear you off a strip in public, thus humiliating you and making the lesson stick in your head – or are the 'modern matron' with their clipboard and 'softly, softly' approach in fear of 'stressing out' an employee the way forward?

I dunno – I just drive a van.

—–

The Peter Principle is the principle that “In a Hierarchy Every Employee Tends to Rise to His Level of Incompetence.”, something that seems particularly apt in the NHS. However, I sense that this works in all forms of life and work. Consider this my Monday Question – What is the worst sort of incompetence you have come across lately.

Commentors who just post 'The Government' will be mocked for their stating of the obvious and their lack of imagination.

Go on, have a moan…

60 thoughts on “Ropey”

  1. Barclays/Woolwich. Messed up my new mortgage and overcharged me over 1000. Blamed everyone (advisor, branch, etc), but as no-one would accept responsibility for error, said I had to pay. Then said no error had ocurred, and I had to prove it to them. Eventually after nearly 6 months of me complaining they agreed to waive the overcharge, but so far have not sent me an amended statement. Then offerred derisory 'goodwill gesture'. Now referred to ombudsman!!! I told them I would tell as many people as possible not to touch them with a bargepole, and that is what I am doing! Be warned!!!

  2. Must be the nurses at a nursing home who could not understand that the patient's dehydration had anything to do with their care, that this was their responsibility, or that this was something they should have discovered before calling the patient's gp.

  3. There's so many, I don't know where to start!If I want an urgent appointment with a GP, I need to see the nurse first to get me a same-day appointment, which I guess is fair enough for a lot of people who perhaps don't need to see a GP, but is frustrating for me when I only go when it's something I can't fix myself. The nurses are always excellent and very thorough, but most of the time I've tried everything they suggest (having a mother that's an ex-nurse helps!) so all they can do is agree with me and pass me onto the GPs. The GPs are another matter. In the last 10 times I've been to see a GP, I think I've only seen the same one twice. It's rare that you get one that actually listens to what you're saying and even rarer that you get one that says “this is what it is, this is what we can do” they're often rather unsure about anything and some have even resorted to Google in front of me for fairly common problems!

    Another bit of (dangerous) muppetry is the last operation that I had. I've had a fair few over the years for various knee problems, so I know what's “supposed” to happen. This last one was a general anaesthetic, but only a day case so thankfully I didn't have to stay long. I was on a mixed ward (not comfortable for a female who knows that the next time they wake up it will be difficult to move either leg, let alone walk!). I came round from the general anaesthetic and I didn't get my blood pressure or how I was feeling or anything checked at all. I had no nurse call button within reach (not useful for someone unable to move!) and there didn't seem to be any nurses coming through to check on anybody to even call out to. The curtain to my cubicle was open to world (again, not comfortable for me) and there was a lot of yelling from other patients which was quite disturbing. Was most thankful when parents appeared to take me home!

    Another thing is my Grandma being taken into hospital after various falls (breaking hip and wrist on seperate occasions). One A&E was great. They were busy and couldn't get her through the system that quickly, but kept her updated and took into consideration the fact that she is diabetic with how they treated her. Another hospital was horrendous. They were also busy but nobody had any time to explain to a scared, hard-of-hearing 93 year old anything that was going on. It was only after my parents arrived at the hospital an hour later (that was the time it took them to get there after being notified) that anything got told to her and even then she was last in line to even the drunks that just need to sleep it off.

    On a more positive note, every ambulance crew she's had has been absolutely lovely. Very caring and vary patient with explaining to her what's going on.

  4. I've been reading this blog for just over a year now, and have only now decided to comment…The worst level of incompetence I can remember witnessing is this: My brother and I, last summer, bought 5 ice creams from a local ice-cream shop. We asked the girl behind the counter if we could get something to hold them all, as my brother was driving…

    Now, 5 Ice-cream cones, 2 guys, one driving…

    “I'll get you a bag. =)”

    “a bag? for ice cream cones?”

    “well… yeah… it'll hold them.”

    BAH!

  5. 2 incidents in the NHS:My father in law was admitted following a stroke. He lost the use of his arms. When we visited, he was bruised (nothing in the notes) dehydrated (water jug and tumbler untouched on the bedside cabinet) hungry (sandwiches from previous day untouched). When my mother in law complained, she was told “Shut up, you're upsetting people”. This hospital permits visiting at mealtimes; apparently if you don't get visitors you don't eat.

    I was admitted for appendectomy. The post-op antibiotics were administered by a nurse who could be smelt from ten feet away, using a syringe carried in her hand with the needle uncovered. no venflon flush, just jab it in and push. To this day the veins in the back of my left hand won't take a needle.

  6. surprisingly (maybe?) the restaurant businessMyself being a lowly cashier, I noticed a pipe was leaking right above the server station, directly onto wine glasses and the counter for dressings. I pointed it out to a server, only to get a “not my problem.” Same with the cooks who wouldn't get a bucket. No, it was me who had to find and inform the owner, who chewed me out as though I personally chose to ruin his day by putting a leak there

  7. What is the worst sort of incompetence you have come across lately. Honestly, do you really think it is incompetence or just that common sense is being bred out of people? I've encountered both as of late, with the lack of common sense people outnumbering the incompetent. At least in my corner of the world. Opinions?

  8. Tom, I'm never going to be on the professional side of that particular fence, and as a potential patient, no!, I don't think you're being the tiniest bit harsh.

  9. Empire building – four departments all doing similar and mutually comprehensible things, not only not communicating but actively playing politics against each other – not good for the business let alone the customer!On a health related note : stroke unit not having a clue about diabetes, especially given adult onset diabetes (now also child onset thanks to lifestyle) being a multiplying factor to the risk of having a stroke.

    & having to tell umpteen GPs that the medication for one health complaint (now banned due to coronary side effects) is contraindicated for anyone at risk of using adrenaline (allergy). Sorts the wheat from the chaff, though!

  10. ED nurse about to push 4mg of Adrenaline IV instead of Nebulised, to a 13 year old anaphylaxis patient before being stopped by an Intensive Care Paramedic.Then the ED Doctor banning the Intensive Care Paramedic (and all our crews) from their resus rooms because he'd reported them to the 'Incident Management' area “too many times”.

  11. In the medical field…The doctor who prescribed 4g of paracetamol four times daily. I understand having the nurses write out your paperwork but please just have a quick skim before you sign it and discharge a patient with those instructions… thankfully no harm done.. this time.

  12. Incompetence……….2 blokes from Currys were paid 80 to come and install a tv: 1) they forgot the drill. 2) they trod mud all over a beige carpet when they came in. 3) they brought in and unpacked the wrong tv. 4) after re-packing the tv and bringing the correct one in, they trod more mud all over the carpet (then sounded surprised when I told them and asked them to wipe their feet). 5) they attached the bracket incorrectly on the tv 6) they marked out on the wall, in felt tip, completely wrong and after drilling the first hole (in the wrong place) said they couldn't put the bloody tv up anyway because 'it's the wrong sort of wall'. The only exterior wall there is. Hmmmmm. Cowboys.

  13. It wasn't lately -it was back when Morrisons was still Safeway, and it was hardly life threatening, -but I think it's too funny not to share.A friend of mine was shopping there and went to use the toilets, which she found to be in a dreadful state. The only loo roll was spread about the room rather than on rolls and the whole place was just a mess.

    So she went to the 'customer service' desk, and said “I'm just letting you know, the ladies toilets are in a real mess”.

    Whereupon the 'customer service' advisor got on the phone to a colleague with the immortal words…

    “I've got a customer here moaning about the toilets”.

    She was rather lucky my friend is only 4'11″ and the desk was too high for her to vault over…

  14. The worst incompetence for me was something similar – a one and a half hour transfer from a rural hospital to a district hospital. The nurses knew the man's name and tea preferences, but didn't have a clue what was wrong with him other than he occasionally has “funny turns” or why he was going to the district. I had to ask four times before getting any notes to take with him – the second request got me a letter that turned out to be discharge paperwork from his nursing home which they thought was everything I and the receiving hospital would need…Anyways, you're on the look out for a new job, yes? Why not go back to nursing. You'd make a fantastic charge nurse, gently showing the nursing staff how to do it right…

  15. 'I dunno – I just drive a van.'Er, actually, no, Tom. You do a huge lot more than that. One enormous thing that you do is that you raise the awareness of thousands of people, including people outside the NHS such as myself. Today's post is a valuable contribution to the education of 'the masses' and also a reminder to 'the management' that they are being watched.

  16. A company I once worked with were given 3m by the parent company to 'sort out their production'. They spent 1m on new machinery but didn't measure it first and they found only half of the said machinery would fit in the space allocated. So they left the other half still in its crates. Six months later they closed down the department. They have been offered 1500 scrap for the metal.The result of this 3m spend was pay cuts, closures and redundancies. The company closes down at the end of this month.The staff will shortly be unemployed and with limited skills, not much to look forward too. The management are all moving on to other companies – as directors.

  17. I don't think you want to go back to nursing right now. Have you read Militant Medical Nurse's blog lately? I've shed tears for her over what she puts up with.

  18. A year ago I left our local council where I was responsible for the website. Web and stuff came under the control of “Corporate Communications” – a section that handled (unsuprisingly) the entire organiastions press & media.They didn't have a television. Or acess to one. Or any desire to have acess to one.

    Apparently they couldn't see why this might be useful or relevant to thier work. Presumably they were waiting to see if TV caught on. As you can imagine, “new media” was even harder…

  19. As a student radiographer on placement recently I was at a large local hospital which had had an entire new hospital build in the grounds courtesy of the governments PFI initiative.The link radiographer, a somewhat old-school woman, was also in charge of the logistics of moving the entire department over to the new building as well has her usual duties as a reporting radiographer. This left very little time for her to actually look after us as students. I'm aware that the jobs she did were very demanding on her time but as some of my colleagues had never been in department before a little hand holding might not have gone amiss, certainly to start with. All in all the impression I came away with was that we were at best and inconvenience and at worst an impediment to the running of the department, I think I prefered it when students were used as slave labour.

    I can't blame her for doing her job but whoever it was down to, to organise our pastoral care while out of university should really have checked that the members of staff who were responsible for us actually had time to be responsible for us.

  20. Some of the learning-disabled people I support live in a 'care' home staffed almost exclusively by residents of Numptyshire. One chap had been routinely coming to our day service without things he needed eg money, gloves in cold weather, a change of clothes. My informal requests for improvement were ignored. Then one day the chap was brought in soaked in his own urine: he is incontinent and his conveen had come off, allowing urine to soak his trousers and wheelchair seat. The wibbling hippy who brought him in said “I think it's Rice Crispies” despite the overpowering smell of ammonia. A search of our chap's bag turned up, again, no spare clothes so we sent the hippy back to base for them. An hour later the berk still hadn't returned so I phoned the home's manager. She apologised. I replied that it's not me she should be apologising to.I'm seriously considering phoning CSCI anonymously about this shower.

  21. For truly epic incompetence you cannot beat the welfare system.They don't seem to understand they are dealing with people's lives – or that by definition they are the safety net for people who usually have no other resources to see them through whatever crisis (job loss, marital breakup, unexpected single parenthood, disability or illness) has led them to claim welfare in the first place.

    My last Disability Living Allowance claim, it took *nine months* from the date of my claim for them to turn me down and me to get an appeal set up – for the appeal panel to take one look at my evidence and actually ask the DWP representative, in front of me, why on earth such an obvious case had been rejected. I got the 2,000+ they should have been paying me over those nine months in a lump sum, which was lovely and all, but I didn't *need* a lump sum of cash – I'd *needed* a little bit of regular cash to, you know, live off for the previous nine months…

    Incapacity Benefit was no better. When I got my job, I phoned them to tell them to cease my claim and I also told them in writing. They continued paying money straight into my bank account for another month. I finally persuaded them to stop it but they wouldn't/couldn't tell me how to pay the extra money back. Then five months later, along came the nasty letter threatening me with legal action if I did not immediately repay the money that I had unlawfully “claimed” but to which I was not entitled… thankfully I'd kept it aside and could pay the whole lot back immediately and avoid additional aggro.

    Tax Credits have to be the winner though. They sent me nasty letters for three years, demanding immediate payment of several hundred pounds, threatening baliffs and legal action and so on, before finally agreeing that they'd made a cockup and I didn't owe them any money. That particular example of incompetence is the largest part of the reason why I don't now claim the Tax Credits our country says I am entitled to as a disabled worker.

    A troll on my blog spent a while taunting me that I seemed to think the DWP and Tax Credits were out to get me. The trouble is, they're not. My experiences with them are 100% normal, representative and par for the course.

  22. On my last hospital admission I had to outly from day 7 post 4th laparotomy on the Gynae ward (having been thrown off the amazing colorectal ward). The nurse looking had non-existant bleep skills (she did ask me if I was going to bleep the team?!!!). She bleeped once (the wrong team) and then did nothing.I sat on the ward for two days before I started to loose my rag and threatend to crawl down to my consultants clinic and remind them I was still there. At this point someone thought that maybe they might ring the ward I'd come from and tell them that no one had been to see me. Cue a steady stream of very apologetic Drs: the FY1, the FY2 and then the Reg all uttering the imortal line “we thought you'd gone home”, err no, not likely when I still have a drain in! Cos I wasnt in the same bed on the Monday they “assumed” or were told (two conflicting stories) that I had gone home… God love the NHS!

  23. I recently visited my other half's very old, very batty grandmother in her ruralshire nursing home. Beautiful building, beautiful grounds, very good security, execrably poor “nurses”.As seems to be the norm for nursing homes, all the inhabitants were sitting in chairs in a room together with no form of activity and no attention from the nurses, who seemed intent on ignoring their customers as much as possible.

    One poor lady clearly had a problem. She sat in her chair and made plaintive sounds, but couldn't form words. Every time a nurse whooshed past the lady reached for her, tugged at her cushion, made more plaintive sounds, and had the aura of a person in serious need of assistance.

    When we approached her and asked if we could help, the patient next to her told us to ignore her because she was always noisy, but we felt disinclined to do so, and bagged a nurse on her behalf the next time she passed. The nurse actually ignored us and continued on her way.

    Finally the poor lady's trauma came to a head: She'd needed the toilet, and finally caved in to the pressure and done so right where she sat, in a room surrounded by strangers. Suddenly a nurse paid attention – hefting her out of her seat in a very heavy-handed fashion, wiping down the seat rather than helping the customer to a more private location, and dumping her back down with a cushion under her while she was still soaked through.

    It's sickening enough that we dump our elderly off onto others to “care” for on our behalf. It's even more outrageous when someone whose job includes the title or implication “carer” simply doesn't. Just what persuades these people to become nurses, carers, social workers or doctors when they simply do not care?

  24. What is the worst sort of incompetence you have come across latelyFGW due to engineering works the train was terminated early and then a bus service and then another train. okay fine yet the 2nd train was the 1st train they ran it empty between two stops as the guard was not available.

    Cancelling Red nose day stuff at work because it was not one of our nominated charities.

    contractors who dig up the roads without permission and the council doesn't do anything.

  25. The local council tax dept. who 'discovered' I owed them some money from several years ago. I queried whether I owed them the money and asked that records be checked, only to be told that because computerised records had changed three times & they could not supply the information “as it's a different system”. Usual threats of bailiffs, court action, etc. When I asked why it took them so long to discover this & request payment I was told “We didn't know where you were living”, despite paying council tax via direct debit over the past seven years. The joy is that my mortgage company phoned me last week to state I owed some money from six years ago. WTF….they apologised but are unable to explain how this happened.

  26. IT SectorMy motherboard fried a while back, being impatient I took it down to the local PC repair place. I had used them before for a burnt PSU so I was expecting half decent service. I told them exactly what was wrong, I even pointed out the Motherboard on the shelf that it needed to be replaced with.I was quoted 85, fair enough, left the PC there and went off to enjoy the rest of my day. I return the next day to pick it up, the first thing I notice is that the bill is 135 intead of the 85 quoted to me the day previously, I pay 85 cash and 50 cheque and take the PC back home. First thing I notice is that the DVD Rom isn't working, I open up the case and they had completely cocked it up. The had put in the wrong motherboard, forgotten to reconnect the IDE Cable for the DVD Rom, forgotten to plug the graphics card back in to the power supply and (dangerously) forgotten to reapply more thermal paste on the chip when they switched motherboards. Needless to say I cancelled the cheque. A couple of days later (having fixed all of the cockups they had made), I got a nasty phonecall about the cheque I had cancelled, I explained to them that I had given them the money that I had been quoted, and they'd done a god awful job on the repair by causing problems without fixing anything. I got threatened with police action etc, obvious rubbish. A lawyer friend of mine was kind enough to write a legal letter to them explaining everything that they had done wrong and that if they didn't drop all accusations then I'd sue them in to the ground. Needless to say I didn't hear from them again.

  27. Us on the desk saw a rather interesting example of incompetence last night! I suspect I would get in trouble if I wrote about it though.

  28. Being a student nurse myself I understand what your saying. I tend to annoy people because am I of the rare breed that asks “WHY?!” and “Whats that do?”. Im shocked that no-one knew what the equipment was. I have done a placement on Ortho and there are so many types of tractions, fixations and casts that it is overwhelming but it dont take 5 mins to ask someone.

  29. A certain person (you'll know who I mean) got accepted on a paramedic degree course last March. She commenced this course last September and has still not had occy health clearance and now she's got to fill in another pre-employment form grrrrrr

  30. Same here – this isn't about being harsh about, I dunno, someone's synchronised swimming skills – this is people's LIVES we're talking about.I'm all for matrons and the old system, at least people knew where the buck stopped.

  31. I agree-you and other ambulance crews have saved loads of people's lives, so no, you doon't just drive a van. I know a lot of van drivers, and they don't do nearly as much for the world as you do.

  32. I'll spare you incompetence stories.Is this ultimately something to do with the nice culture of praising pupils all the time, banning winning at sports day so in the end no-one learns to be self critical but assumes that everything they do is just great, perfect even.My definition of a professional is someone who learns, all the time, who after every job asks how it went, could they do better.Doesn't matter if you are the cleaner or the consultant, if you don't learn from what you do you are not a professional.

  33. Couldn't've put it better myself.There are so many cultures around the world which pay lip service to the notion of doing your best, no matter what your job.

    Perhaps it's just we perfectionists who are outnumbered 😉

  34. The standard of nursing doesnt look like its likely to improve either. I'm a student nurse and frankly I wouldnt trust half of my peers to make a cup of tea, let alone care for someone important to me. Although that might just be a numbers thing, there are close to 500 student nurses in my year, there are some really good ones in there too. I'm not sure if the entry requirements are too low, the assignments are too easy or if by the end of your first year of training the cynicism and apathy of our mentors start rubbing off on the more impressionable students.

  35. I work for a firm that make boilers, on their technical advice line. We tell engineers (from everywhere – even BG) how to fix our boilers. The number of engineers that call us and when we ask them to test x,y and z, sound shocked and say “I don't have a multimeter/manometer”, or some don't even have tools on them at all.. Basic stuff for gas engineers!The worst one was a lady who had a conservatory fitted by some cowboy builders… The builders realised that the boiler flue came out the side wall and simply built the conservatory round it. She rang us saying that whenever she or her family was in there, they got headaches and felt sick. We had to tell her to get outside fast and not to use the boiler again!

  36. IT director of large, IT-based bluechip company calls us IT support dudes to fix his computer because “it's not working”. We arrive a few minutes later to find he's gone out to lunch, telling his secretary nothing about the problem.Once we'd convinced her that we were allowed to look at her boss' machine to fix it, we found the drive was full. We did standard cleaning stuff, emptying the wastebasket, compacting rarely-used folders, and so on. We left a few minutes later, with plenty of space now free on his machine. We then sent him an email letting him know we'd been, and that his problems should be resolved.

    After a couple of hours, the IT director stormed into our office, waving a print-out of the email we'd sent. “You've deleted all my files!” he railed.

    Well, he was the IT director: clearly he was right, and we mucked up somehow, so we ran over to his desk to try to figure out what we'd done wrong.

    Turned out, he used his wastebasket as an “archive” folder.

    We thought maybe it was because he felt it was quicker than drag-drop moving the files. But no, it was because he didn't know how to create a folder. We shouldn't have expected more from the kind of “IT Director” that got his secretary to print out his emails…

  37. Not one I went to but at a 'nursing' home my mentor went to the carers believed a woman was still concious and breathing as her eyes were open.Also the 'carer' who left a man lying on his own urine stained carpet where he had been all night. She then left and it took for his friend to come over for an ambualnce to be called so that he could be helped.

  38. I've just read your post -More On How I Deal With Patients

    by Reynolds on Fri 19 May 2006 08:10 AM BST

    It seems that this week is turning into a bit of a confession about how I sometimes deal with patients.

    I was sent to a twelve year old whose hand had been burnt.

    I'm in the 4th year at school, and in the 1st year we had a boy who, on seeing that the chemicals in the lab were stored in little, shot-sized containers(especially the dangerous ones) decided to 'play hard' in front of his friends. You can guess what happened next.

    While pretending to drink shots from those little, tempting containers he accidently threw a tub-full of harmfull chemical into his mouth and swallowed it. Clever boy. Unfortunately I wasn't there when the ambulance arrived to take him to hospital as I heard the story from the other half of the school who were there (why do I always miss anything interesting?) but I understand they weren't very impressed. Neither were his parents. Or his classmates. Or the chemistry teacher who had to sit with him in the hospital for half the night. Aaah, the wonders of intelligence.

  39. As a fairly recently qualified nurse (6 years) I was disgusted at the amount of training that we had (or lack of i should say) but it does not mean that we are all retards or lacking in common sense. I say bring back proper training instead of crappy EBL scenario's and make us learn stuff on the wards rather than being used as cheap labour. I know that There will be comments on how basic nursing care is important and i agree. However every thing else is important too. I get more satisfaction washing someone than anything else, but i have left and gone into community cardiac nursing so I can offer good 1:1 care to all my patients rather than average care or below average care to my patients.

  40. The government.More specifically the job centers run by them. The way they seem to run goes something like this:

    Deal with someone

    Put their documents aside

    Cancel the claim when you cant remember where you put them.

    The bit that annoys me isn't the incompetence, its the blaming the other guy that ensues.

    That said, I'd better get job searching – Lest I lose my claim again!

  41. It gets worse.A colleague of mine was at an unnamed supermarket when someone collapsed. He ran to other customer service desk and told the guy there to phone 999, the attendant ignored him and continued to chatter with the other guy already on the phone.

    He had to hang it up to make the attendant actually do anything.

  42. I used to work for the DWP and believe me, they treat their staff no better than their customers. If that is they still actually have any staff left at the sharp end (ie the people who do the actual work) because numbers were falling fast during my time there.I think minimum 90% of the problems in the public sector are down to staffing shortages, it's endemic.

  43. Actually I have just read a blinding example on here…http://www.dailymail.co.uk/news/article-1162484/Workers-plunged-deaths-untrained-colleague-loosened-bolts-crane

    Key phrases are …

    “Two workmen plunged to their deaths after a colleague with little training mistakenly loosened the bolts of the 118ft crane they were working on, a court heard today.” and

    “Mr Smith's task was to begin loosening the bolts of the crane's tower, despite him being 'wholly untrained' in the process and with 'no clear understanding' of the risks involved.

    He had not been shown a risk assessment form or a method statement before beginning the job”

  44. The only thought that gives me any sort of consolation in stories like this, being only a few years away from probably needing nursing care myself, is that one day these incompetents may similarly be old, deaf, confused and frightened……and at the mercy of incompetents like themselves. If there's any justice….

  45. I've just read Nurse Anne's Militant blog on mealtimes. Now I know that when my dad goes into hospital, I shall ask the staff if I need to be there to feed him. Relatives cluttering up the space can't be good, but neither is a ratio of 1-8 or 10 patients (on a good day, seemingly), with that one trying to deal with meals for people who can't feed themselves, medical emergencies, or simple things like bed-pans and commodes all at the same time. In some cuntries I believe relatives go into hospitals to take their sick ones meals. In some cases – where special dietary conditions do not need to be met – might this not be a bad idea here? I know we've 'paid' for the NHS, but more and more it looks like we're paying the administrators and supervisors who have relatively cushy numbers and are no practical use down at the sharp end than we are for those who we really need to staff the NHS: efficient and responsible nurses in numbers which allow them to ~be~ sufficient and responsible.

  46. 2 examples I've seen.The first was the construction worker who, instead of moving the raisable platform the half foot higher he needed, climbed up on the safety rail to do his work. This was even despite the rain that would have made the rail slick.The second is outside the large police station in a rough area. There is a braille sign outside the station, but due to the high possibility of vandalism, the sign has been covered over with a perspex sheet to protect it from damage.

  47. “What is the worst sort of incompetence you have come across lately.”The management of Stafford Hospital.

  48. Yes, don't say that again, Tom. After all it is a (mostly) white van and we know what kind of reputation that would give you.

  49. I came across a complete lack of competance recently. I was on the A&E ward, where an elderly lady was in a bed waiting to go up to a medical ward. All I was told was that she'd had a fall and they were going to investigate why she'd fallen. It was a night shift, this patient had came in during the day and had spent the night on this ward. When she woke up the following morning, nearing the end of my shift, she started moaning and wailing, much like any old person with dementia. She was ignored by some of the nurses, but I went over and started talking to her. She started complaining of hip pain. I had a look at the notes and there was nothing wrote about this lady's hip, I asked how long she'd been in pain, to which she replied 'Since I got here'. We sent her to x-ray to find she had a fractured neck of femur. This was roughly 16 hours after her admission. Bearing in mind that any fracture to the hip or femur must have an x-ray within the first hour of coming in, and I was told recently that if an elderly patient has a fractured NOF it must be operated on within 48 hours, otherwise it is fairly likely that they will die.I believe what had happened was that she was quite deaf (as I'd discovered when I'd asked her what was wrong), and so whenever she was spoken to during her stay in the emergency department she didn't reply because she didn't hear what had been said to her. It was probably thought that since she didn't answer their questions she was demented and wasn't able to communicate. She can't have had an adequate secondary survey, and I highly doubt she received adequate pain relief.

    While she was having her x-rays, the nurses started scribbling something down in the notes in attempt to cover themselves. This poor patient would have seen plenty of nurses and doctors and it was completely missed. A group effort in incompetance.

  50. As a fairly regular consumer of the NHS on and off for the last 40 years I've seen more than my fair share of numpties.Had a hernia repair done when I was 7, getting dressed after day surgery to go home, we noticed that the skin incision hadn't been fully closed as if they were going to put a drain in and then forgot or changed their minds. Ended up closing it with steristrips.

    Had an SHO at a very good hospital (now closed despite being a regional centre of excellence and offering great value or money) take a cast off my leg so I could have the sutures removed and the foot reset under GA the next day. He managed to get the saw so hot it started the Velband under the POP smouldering and burnt my knee with it, then whilst cutting the Velband layer off used the sharp/blunt scissors the wrong way round and sliced into the side of my foot. He seemed totally bemused as to where the blood was coming from and seemed to assume that I'd just started spontaneously bleeding.

    One HO took a history and got my age, gender, key diagnosis and the leg I'd had amputated all wrong, despite me telling it all to him. I tried to complain and the ward sister said it was a doctor issue and I had to speak to the senior registrar so I asked for him to be bleeped and I was told that they were only allowed to bleep that team once a day and they'd already done that. Luckily the Consultant Microbiologist I'd been seeing once a fortnight for the previous 6 months was also the Clinical Director of the trust and I had his card with me so I called him and needless to say he wasn't pleased at all. The HO had to redo a rotation and have better supervision and the locum head of the team didn't get his contract renewed but I'm sure he's still out there somewhere.

    One weekend a reg from a different team was doing rounds and asked me if I was up and about and I said it was very difficult at which point he called me lazy and explained that if I didn't get my backside out of bed I was going to end up being in hospital for a long long time. It was then I pointed out that I had had a fairly recent lower leg amputation and was on IV fluids and the board my hand was bandaged to made it tricky to hold crutches. He defended himself by asking how he was to know and, sarcasm getting the better of me, I suggested he use the basic medical skills of observation and reading. He later complained about my attitude to my consultant who corrected him in such a way that the whole ward heard it.

    As for feeding I've seen it assumed that patients aren't hungry so many times because they can't feed themselves that I always intervene. I've even missed my own meal (no great loss) to feed another patient when I've been on understaffed wards as I knew I'd be getting visitors who could get me food later. I try to stick any complaint in at the appropriate level as if it's policy and resourcing that the problem, I know it's easier for me as an educated outsider to try an influence a lot of the time than as an insider. Of course crap 'professionals' will get it off me too. I feel as an experienced user who knows the system and how care 'should' be there's almost a moral obligation to ensure those without a voice in the system get heard.

  51. Anybody who's worked any length of time in ITUs gets used to the fact that a large proportion of the work consists of trying to pull consultants' chestnuts out of the fire, particularly surgeons.I recall one guy who had come in for a routine trouser graft, got totally over-heparinised, haemorrhaged to blazes and ended up on ITU with kidney failure; died.

    Another who was sent to the unit after a partial oesophagectomy with a 2″ catgut needle spang in the middle of his chest, as visible on X-ray. The surgeon had insisted on closing up even after having been told by scrub nurse and theatre sister that a needle was missing. Patient had to go back to theatre and be opened up again; not in the best of states with CA oesophagus, couldn't tolerate 2 doses of GA; died.

    Patient with severe Krohn's who was septic but still operated on; bowel was in such an ulcerated state that the surgeon couldn't close the wound. So he put moistened woolpads over the open wound and sent the guy to ITU like that. Died.

    I could go on, but it's too depressing. What is more, in such cases the surgeons just dump the patient on ITU and leave him/her to the anaesthetists and nurses. They don't come near their victim (I use the word advisedly) again.

  52. A consultant oncologist once called me over to a screen with some MRI slices on it, and asked me why the right of the patient was on the left of the screen and the left of the patient was on the right of the screen, and said “why isn't it the proper way round?”.

  53. We seem to have found ourselves living in a world where a nurse gets suspended for months for offering to pray for someone but dressing wounds with sellotape is acceptable.Maybe something to do with managers having started out in suits not workclothes.

  54. Well, compared to all the life-and-death stuff in the other comments, this is going to sound pretty trivial, but it's still infuriating and embarassing. I'm in VIP event catering, where I've worked during my uni holidays, and before that I worked for six months in a central London restaurant. This gives me a pretty decent amount of experience, but not so much that I expect to be better than the managers! One event, the boss had decided on a very complicated service procedure, and even when it blatantly didn't work (it took forty-five minutes to get a starter out), he didn't change it to the normal way of doing things that we've all done a million times before, but did it again for the main course!And then there are the chefs who just force us to go out with canapes or bowl food over and over again despite us telling them that the guests don't want it, to the point that the guests are getting angry with us (it's annoying to have your conversation interrupted ten times in five minutes) – just because they want to get home early.

    And then there are the staff who just don't have a clue or just can't be bothered – place settings laid with knives and forks on the wrong sides of the plate, or a napkin/glass/tablecloth with a stain or smudge on it, or a light left in the middle of the floor where anyone can trip over it, or a chair missing, or… You get the idea.

    Then there was Natwest – I opened an account so I could access their overdraft. In my meeting the employee asked how much I'd like for my overdraft. I said 1500, please. I then proceeded to write three cheques – and they bounced. And then they charged me twice for those bounced cheques. So that's six charges of 38, thanks very much. I went in and enquired about it, they said I hadn't “activated my overdraft”. I said that the employee had asked me about it, and didn't mention activation at all. They replied that there was no record of it at all. I pointed out that they still didn't have to charge me twice. They agreed to refund me half of the sum “as a goodwill gesture”. This has reminded me that I need to chase it up!

    Oh, and there was the A&E doctor who recently misdiagnosed a family friend's heart attack as indigestion and sent him home; unfortunately he died that night.

  55. The woman responsible for masters students in my department. She asked 3 times for a certificate I gave her before leaving the country, so I had to send her back the emails in which she had written that she had received the certificate…3 times, of course!And a friend of mine came from the US especially to deal with administrative stuff. Because of that woman, she couldn't do everything she needed, and I had to do it for her.

    Oh, and of course she's rude. She once called me and said: “Can I speak to S. [trying to pronounce my name] or whatever your name is?” She won't listen to anyone either. For some reason, she's relatively nice with me. I think I scared her. If I have another problem with her, I'll write to her boss, explaining why he should fire her.

  56. Having worked in and around a nursing home and been to visit or collect residents from most of the hospitals around the Manchester area, having watched 3 grandparents go in and out of hospital I can confidently say that nothing stupid happening in a hospital can ever surprise me. From unutterably filthy wards, long stays on a corridor and placing a bowl of food in front of a quadraplegic, expecting them to feed themselves to utter ignorance, wrong medication and lack of offering patients even basic courtesy, it all goes on in hospitals. If a nursing home was to be run the way some hospitals are run then there would be complaints to CSCI and the place would be shut down the second the visiting inspector arrived. Where else but hospital can you trip over a bag marked 'MRSA waste' in the corridor or quite literally starve to death? Where else can you go in with a minor leg infection and come out in a box, having run the gauntlet of a quite bewildering array of other infections that you wouldn't have caught at home. My dad has peripheral vascular disease and as a nurse and owner of the nursing home I worked in (so am even more frequent visitor of residents in hospital) he is so terrified of hospitals that he's spending the money he and my mum saved to have the surgery he needs done in a private hospital.

  57. thanks for the opportunity to comment but the reality is lel treatment of state hospital treatment and management of older people is cruel irresponsible

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