MHU Transfers

First off, a big 'thank you' to everyone who wished me a happy birthday yesterday. You are all very kind. Also a big thank you for keeping the comments in 'Two In Two Nights' so civil. The internet is often used as a place for willy-waving and I am proud that my readers are so atypical of this.

One of our more regular jobs is to the Newham Mental Health Unit (MHU). It is one of the more bizarre side effects of the way that the NHS is structured in that while the MHU shares a physical site with Newham hospital, they are completely different trusts.

As each trust has it's own portering staff, if a patient needs to be moved from the MHU to A&E… they call an ambulance.

So we get calls to patients who need to be moved a grand total of 400 yards down the road. I've worked in hospitals where you would need to wheel patients on trollies for longer distances just to get them to the wards. Unfortunately neither Trust will take responsibility for wheeling patients between the two buildings.

It doesn't help that I'm not enamoured of the medical care of people in the MHU…

Sometimes we will be called for something as simple as a chest infection, or that the patient needs blood tests or an x-ray. Sometimes you will go to something that sounds 'genuine', but which ends up being something simple.

Take for example the last time I went there. The patient was a young girl and her diagnosis was 'Pulmonary Embolism', now this is a serious and life-threatening illness, it is a clot on the lungs which causes severe difficulty in breathing and shock.

This patient however had none of the risk factors or symptoms for this. She was shaking like a person with Parkinsons disease but her vital signs were all normal. Without turning this post into a list of symptoms found and not found she had nothing that suggested an embolism. She had also been in this state for a couple of days.

It looked to me like a toxic amount of one of her anti-psychotics.

Oh well, 400 yards later and she was safely in A&E where they quickly ruled out an embolism and sent her back to the MHU with one of the private contract ambulances. I'd be interested to see how much that trip cost the hospital.

The cause of her illness?

A higher than normal level of anti-psychotic in her blood.

16 thoughts on “MHU Transfers”

  1. Hot DAMN, that makes my blood boil 🙁 Poor girl!Having seen first-hand the conditions that some patients in MHUs have to endure though this doesn't surprise me. After all, us nutters aren't really human are we……….gah too cynical, sorry………it just upsets me to see how patients are treated sometimes (or mistreated in some circumstances). Ah well, at least she wasn't having a pulminary embolism for real, with the staff dismissing it as slightly too much anti-psychotic medication……The point you made about how civil the 2in2nights comments were – that's one I'd like to second! No matter how defensive I or another might get, one thing I've noticed since I started reading your blog is how little “willy-waving” there is!!! It kind of answers a question I was going to ask you – “How do you regulate the comments section here?” – I guess most of the answer is “I don't really need to….” I hope it stays that way, I truly do.

  2. Funnily enough I think the same thing happens at H'Don. I think the ambulances are used as a way of keeping the patients ” secure” , can't see why the MHUs can't have their own transport if that's all they are worried about.

  3. Im sorry but your comment about the staff “dismissing it as slightly to much anti psychotic” is wrong they didnt dismiss it they carried out checks to confirm this. As an emt myself we are constantly given duff info or no info at all. We can only act on what we see that is until the NHS issue us with crystal balls !

  4. Apologies – I didn't mean the emt's dismissed, I meant that at least the situation didn't turn out to be a real pulminary embolism with the MHU staff dismissing it and not calling fro an ambulance at all. I have every regard for the professionalism of emt's and I hope this explains what I was trying to say and whom I was really criticising! You guys do a simply amazing job – duff info notwithstanding of course. Kind regards, /j

  5. Slightly tangentially, we are told that if a medical emergency/serious accident occurs in the hospital but not in a clinical area, we are to dial 999. The theory is apparently that you guys know how to get patients to A&E and all the equipment therein – if we were to run into the nearest ward and get them to call eg crash team they wouldn't have the necessary facilities at their disposal in a corridor or wherever. Have you ever had to actually do this?Scientist.

  6. theres a similar situation in SE london – kings and the maudsley are opposite each other with A&E right across the road from the maudsley practically waving distance apart but they still have to use ambulances to transfer (if there's room there!).Complete tangent, but Tom do you find you (or your colleagues) have to do lots of transfers of pt's (esp children) out and around to different hospitals due to bed shortages?? Seem to have to do it alot where I work and wonder if its the case in most areas.Nearly finished book and is v good x

  7. Medical care in a psychiatric unit? No, sorry, never heard of that one ;)Its something that needs drastic action.. as well as psychiatric care whilst in a medical hospital. Small, tiny changes are happening, but its something that needs a complete change of thinking to happen, and I fear that is a long way in the future.

  8. TRUE, medical care on a psych unit does not really happen. It is also very difficult to get any medications needed for physical illness. A care worker/nurse (I'm not sure which she was) told me that she was not qualified to give me my HRT!!! What will she do if and when she starts taking it, will she be able to give it to herself? Last time my husband was an in-patient it took several days for his essentail heart meds to be sorted out, he could hardly stand up and was told not to behave like that. I said that the problem was his heart and he neede his meds. They did get sorted out then. I may be being very cynical but I sometimes suspect that things only get done properly when there is a risk for which the staff may be culpable. There are however, SOME good psych staff.

  9. I was just going to say the same thing! Both ways…RGNs not so hot on Psych. conditions and RMNs not so hot on medical stuff. I have worked in both (as a different professional) and find that psych illness is seen as 'bad behaviour' by general staff and medical troubles seen as 'somatising' by psych. staff. My advice to any patients in that position?…have a word with one of the professions who are actually trained or experienced in both…like a junior doctor who will have recent experience in both fields, or an occupational therapist. There are others of course, but these two are the easiest to find in either type of hospital. They may not be able to cure the problem without help, but they sure will recognise symptoms and know when to refer on to the experts for treatment. I did just this earlier today with someone who was 'somatising' but in fact showed all the signs of having rampant urinary tract infection.

  10. It may seem amazing, but, psych illness is also sometimes seen as bad behaviour by psych staff! The same person who couldn't handle my HRT told me off for bad behaviour when I got very upset about it. I was SO upset because I was ill and needed competent people to help me. My normal, wellish, self wouldn't have behaved like that. Fortunately my GP is excellent. As with every aspect of the health service things can't improve until adequate investment is made, including investment in staff training and development. I read somewhere very recently that the improvements in medical technology mean that by the end of the century the costs of healthcare which is reasonably up to date will exceed the GDP! What hope is there?

  11. OTs rule, hahaBut how often do they find themselves being the liason point with common sense between other professionals? Is this their job, haha, i sometimes wonder.


  12. Well, I think it *is* part of the job. OTs (Occupational Therapists), being Monday to Friday people tend to be some of the few points of continuity in Ward Rounds etc when the shift work that Nurses have to do means that the same Nurse is rarely in these meetings 2 weeks running. Junior docs. also carry the continuity because they never go home! We all have a role in communicating well but it is possible that because OTs are used to having to liaise with absolutely everyone to do their work, they become habitual conduits between professions. The glue in the team perhaps?

  13. I have come to the conclusion that, yes, OT's rock! Though, I was once referred to one who chain smoked throughout the appointment.. and this under 5 years ago!!But all the OT's I work with in MH Trust I work in are fantastic – but maybe thats because they tend to work towards “recovery”, which is an idea I am a huge fan of!

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