All posts by Brian Kellett

Ambulance or Nurse?

The Independant have an interesting story where, due to the shortage of ambulances the plan is to send community nurses first for patients over the age of 65 who have had a fall.

This is a bad idea.

But first, as a quick update on my career, I went from nursing into the ambulance service, and then returned to nursing. At the moment community nursing. So I’ve done both of the roles that the article is talking about.

The ambulance role is very much different from community nursing. When a community nurse sees a patient, it is not in an emergency situation. If you have a leg ulcer, or cancer, or a surgical wound that’s not healing as it should, then the community nurse is ideally placed to see to your needs. However if you have fallen and either can’t get up by yourself, or have broken your hip, then what you need is an ambulance.
This isn’t to say that comunity nurses don’t already keep people from going into hospital. Community Treatment Teams (CTTs as they are known in my patch, your acronym may vary) work hard to stop people with chroninc and acute conditions from needing to visit A&E. Unfortunately trauma is something entirely different to the heart failure, asthmatic and palliative patients that these teams see.
An ambulance crew are trained to deal with these acute traumatic incidents. Community nurses are not (as an aside there was some research about how nurses are really bad at first aid. And they are bad).

The plan is for a nurse to give a painkiller, including morphine, and then wait for the ambulance. At least I assume they are supposed to wait. I know I’m not going to give Doris with her fractured hip 10mg of morphine and then leave her on the floor. A big problem with this is that, as a community nurse, my day is already packed with patients (and as the government wants to kick more patients into the community, that will only increase). It is more common than not that I work through my lunchbreak, just in order to do the bare minimum for my patients. Community nurses do not have the time to play at ambulances.

What happens if the nurse overestimates the amount of morphine to give the patient, they’ll need a BVM, and training in how to use it and naloxone and how to give it, maybe some other drugs to counter potential bradycardia. And remember, a nurse doesn’t then have the option to load the patient into the back of an ambulance and whizz off to hospital. They’ve got to sit there.

And then who is going to supply the morphine, where will it be kept? Morphine is a Controlled Substance and needs to be kept in a special locked cupboard inside another locked cupboard. Who is going to provide a stock of morphine just in case it’s needed.

And then there is…

…but you get my point.

This is, yet again, an example of short-term thinking to patch up huge holes in the NHS that have been caused by successive governments. Both the ambulance services and the community nursing trusts need more money, and odd blue-sky thinking by people who are several steps removed from actually meeting patients is not the way.

Post-Bingo NHS

I took a look at my blog the other day. ‘Last post Jan 18 2016’, so nearly a year spent noodling around on Twitter rather than actually writing anything. I’d started a new job and that needed a fair bit of my attention, then there were games to play and food to eat and things to build. Then before you know it you’ve stopped writing and replaced it with reusing other people’s writing by ‘retweeting’ it.

Urgh.

No one reads blogs anymore, or so goes the common consensus, but when I use twitter I’m often redirected to a website, a blog or a whatever you call a Tumblr thing.

I also wasn’t angry. Well, that’s a bit of a lie. I first started writing because I was angry about things and writing about it got it off my chest. I’m still angry but I came to realise that not many people cared about the things I cared about, and so my writing didn’t exactly save the NHS, fix the planet or stop tech people from doing really dumb things.

But, maybe I do have it in me to write again. There are more and more stupid things happening, and while you may mutter about ‘echo chambers’ and ‘shouting into the void’, perhaps there might be a bit of value in starting to write again.

(If you are curious about the title, ‘bingo fuel’ is a term for the amount of fuel you need to land a plane safely. I’ve got a horrible fear that the NHS is past that point and is truely doomed. I hope for everyone’s sake that I’m wrong)

No Fear of Death

In my last post I was asked in a comment why I don’t fear death, what brought me to that attitude towards it.

I would guess that due to the amount of death, ‘near death’, and ‘about to die’ that I have seen due to my work it has driven me to think about it a bit more than a ‘normal’ person would.

The two things that influence my thoughts about death would be my atheism, and my grasp, tenuous as it may be at some times, of logic.

Firstly, my atheism, means that I have no fear of a Heaven, or Hell, no Limbo (and sadly no Valhalla). So I don’t think that there is anything after death. You die, and you stop. Stop thinking, stop feeling, stop worrying about work, or family, or why the cat keeps scratching your sofa.

And if I stop thinking, then there is no consciousness, and therefore no experiencing of anything, including time.

So when I am dead, that’s it – I won’t feel anything because I won’t exist anymore. When I sleep I have no experience of time, no feelings of pain, no nothing. I don’t worry about if I am going to wake up because my conscious mind ceases to exist for the time I’m asleep.

(I know that with the different phases of sleep and with dreams the analogy breaks down somewhat, but I think the general point is made).

So, logically, why should I be scared of death? Even if I die in a horrible and painful fashion, I’ll not remember any of it, because I will no longer exist. So ultimately it won’t matter how I die, because even with a long drawn out death it will end eventually.

And I don’t plan on having a long, drawn out death. If I become terminally ill then I shall scream for the really good medications, and when I’m fed up of that – well, there are ways out of the situation.

As I have no sense of self before I was concieved, I will have no sense of self once I have ceased to exist. All of which, in my mind, is comforting, that no matter how bad things get, in the end all worries, all pain, will cease.

Of course, if I’m wrong? Well won’t I look foolish as Anubis weighs my heart against a feather.

But that’s a bridge I’ll worry about when I reach it.

Nightmares Don’t Work On Me

I’m not massively scared of anything. In part because I’ve seen a lot of bad stuff, in part because once you are not scared of dying a lot of fear goes away.

So when my brain wants to try and scare me with a nightmare it has to get a bit ‘creative’.

So it tries to frustrate me – Last night I dreamt that there was an older Star Wars ‘sequel’, it made no plot sense, the lightsabers were plastic toys doused in lighter fuel, and David Cameron had a guest role.
Bad enough, but my dream went further, the creators of the film had managed to hijack IMDB, so when I looked up the film (in order to avoid any other films the director had made) it loaded malware onto my computer.
And then every time I tried to delete it, it would reinstall.

Nightmare.

New Year Resolution

Normally I don’t care for New Year resolutions, in my view one day is much like another. This is something that is also reinforced by shift work – I barely had any idea what day it was, let alone the date. Heck sometimes I didn’t know my own name.
So, one day is very much the same as another one, so why wait for a special date to make a change in your life.
However, this year feels different, in part I think it’s because I’m not in work (I am technically,but it’s… ‘complicated’), so it seems to make sense to mark a certain date, especially with things that have been whirling around my head for quite some time.

Also, if I write them down I’m sort of honour bound to follow them. I may well explain some of them in more detail at a later date.

1) Blog more – As in blog at all. I used to love blogging, then I sort of fell out of the habit of it. Partly because of the reason for resolution 2. Planning on writing something a few times a week, luckily hardly anyone will see it as my days of being a world famous sexy internet ambulance god are far behind me.

2) Play less MMOs – These are a terrible timesink and at my age I’m starting to foresee myself on my deathbed cursing the hours spent playing yet another endless treadmill.

3) Sort out my diet – I successfully stopped being a fully tubby bastard and am now only half a tubby bastard, which wasn’t that hard, but now I have an addition reason to sort out the rubbish that I eat.

4) Get TRUTH BASTARDS done and out into the world – This is a project I’ve been noodling around for a number of years, but never sat down and cracked on with it. Hopefully following Resolution 2 will mean I actually get something into a presentable state.

5) Stop tiptoeing around fuck nuggets – No longer am I going to let complete idiots annoy me/hold me back/make me angry – instead I’m going to either ‘sort them out’ (as we say in my part of the world), or just ignore them completely.

I think will do – I don’t want to be too energetic or enthusiastic. I am English after all.

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.