NOBODY expects the Spanish Inquisition! Our chief weapon is surprise…surprise and fear…fear and surprise…. Our two weapons are fear and surprise…and ruthless efficiency…. Our three weapons are fear, surprise, and ruthless efficiency…and an almost fanatical devotion to the Pope…. Our four…no… Amongst our weapons…. Amongst our weaponry…are such elements as fear, surprise…. I’ll come in again.
Oooh, sorry I went a little Monty (not the full monty you’ll be glad to hear, but just a little monty)…and what in heaven’s name has bought this about…. Well we have just been inspected, by the CQC….
For those outside the British Empire I shall explain….The CQC stands for the
Cruel Quality Critique sorry that’s the Checking for Quality Crimes, no, no, urm it’s the Care Quality Commission, that’s the one.
Basically for years general practice has been allowed to doss along, minding its own business, up until the point the police identify that we’re giving morphine to all our patients. Now however the CQC has been introduced to inspect surgeries to ensure we actually know what we are doing, don’t have more maggots than patients and that all the patients are happy for reasons other than morphine addiction.
The CQC first came about in hospitals a few years ago, causing uproar from staff, who pointed out that they were now spending nursing hours filling in forms to keep the CQC happy and not actually having time to keep the patients happy. It caused so many problems, nursing break downs, and time off sick with stress they thought it was a good idea to introduce to primary care too!
It’s not quite the Spanish Inquisition – the element of surprises comes with a 48 hour warning. That’s about enough time to remove maggots from the surgery and remember to put your name badge on, but not enough time to fill everyone’s clinic with the nice patients who think we’re great, so on interviewing they all say nice things. I suppose it is more of a witch hunt, they have been commissioned to find problems – so find problems they must, or else they will be made extinct and have to find another irritating admin post in a sidewards management shuffle…we know how these things go.
So the night before the inspection I was not stressing – I know our practice is fab. I also know that as with the witch hunter general of old – the CQC inspectors know they have to find fault otherwise they’ll be out of a job, so I had a low-grade anxious feeling. I was visualising a Men-in-Black-esq team of crack professional invading the surgery, quizzing patients, inspecting the back of the radiators for dust, ensuring that we didn’t have pillow cases that could be harbouring life threatening viruses and performing rectal swabs on any soft toys….
On the day of the inspection rather than a witch hunting crack team, there was in fact one witch, hunting.
A solitary hump-backed lady, with clipboard in hand. Nonetheless – she gave us a working over. we had role plays to do, patients were interviewed, the practice manager even had to take her to the boiler room!!! (ooooo- errrrr!)
As predicted we passed with very little intervention required. Our Practice Manager has a list of intriguing jobs to do to prove we weren’t perfect and that we did in fact needed inspecting.
All the Practice Manager has to do is to supply all patients with sterile balaclavas in the waiting room to ensure confidentiality. Then install soap dispensers above and below the current soap dispensers, so you can wash your hands before you touch the soap dispenser and after you’ve touch the soap dispenser. Then he needs to take the doors off the toilet so nobody has to touch the door as this may be an infection control risk. Obviously it doesn’t matter if someone sees you having a pee, as your balaclava will protect your identity. Or something like that. Thank god we passed!
So for those of you with inspections yet to occur, don’t panic…. unless you are crap!Read Full Post | Make a Comment ( 2 so far )
It’s that time of year again when I like to destroy a perfectly good seasonal song…. so here we go again… thought with all the snow we’re having it was time to pick on winter wonderland!
Chesty coughs, are you listening?
In the waiting room, snot is glistening
A hideous sight,
We’ve been coughing all night.
Sneezing in a winter wonderland.
Slipping down, went the old bird,
Fractured Hip… How absurd?,
In hospital for too long,
Sleeping in the NHS corridor.
This makes the clinician frown
We’ll say: “No man”,
But you can have them…
Last night, we had a hall for hire,
All got drunk, filled with desire
Now to face unafraid,
The mistakes that we’ve made,
Shame in the staff party wonderland.
In reception we can build a snot-man
from all the snotty tissue left around
Until a new super virus is found.
When surgery closes it’s thrilling,
Though in out-of-hours we could make a killing
Working in a winter wonderland.
Well that’s that job done for this year. Have a smasher of a christmas period, and remember to go careful out there!!Read Full Post | Make a Comment ( None so far )
I’m sure somewhere in the deep dark vault that is the “It shouldn’t happen…” archive there is a post getting its knickers in a knot about whether wine and chocolate are good for you or not.
The more intelligent of my readers…
…are probably well aware that rich dark chocolate can improve blood pressure and has other cardiovascular advantages. Now however research has found that chocolate also decrease the risk of heart failure. Personally it seems highly likely to me, if I don’t get chocolate I get total body failure and a broken heart…surely it’s the same thing. Those poor researchers spending time finding out something that we all already knew made us feel better.
Closer inspection is obviously going to reveal that we should only eat small amounts…oh hang on it says…”moderate habitual chocolate intake”. Ooooh, “moderate”. Cool, that’s nicely subjective. One lorry load is moderately less than two lorry loads…
For those of you who are perhaps a little unfamiliar with the term “Heart failure”. It’s one of the diagnosis that sounds a little more acutely severe than it actually is. “Failure!” Oh my god, If you get brake failure then they completely stop working and you end up dead….(although confusingly if your brakes fail you keep going!) So heart failure sounds pretty much like death. Fear not if you don’t like chocolate*. It’s not quite that drastic (it’s not great but not immediate death either).
The symptoms are of heart failure are: Shortness of breath on exertion, swollen ankles, lethargy, nausea and often weight gain… interestingly this is the same symptoms you get if you eat too much chocolate. Perhaps the research just identified that if people eat lots of chocolate it’s difficult to spot heart failure from chocolate over dose.
Oh well. I’ll take the risks… back in that next lorry load for me.
*if you don’t like chocolate please seek psychiatric help immediately there is clearly something wrong with you!Read Full Post | Make a Comment ( 7 so far )
It’s crunch time…the H1N1 jabs are here.
We were one of the last places to receive the first batch. Patients and staff are approaching me, asking whether they should have one or not. My instinct is to shirk the issue and hide under my couch, but alas I can not do that.
Everyone asks me all the questions, and I can give the answers to all but one….”Are you going to have the jab?” So lets answer that now….
I virtually hang out with a few conspiracy theorists who tell me that the jab is a government ploy, or that the jab itself has been rushed through the testing stage. I know the 1976 jabs were blamed for neuro problems including Guillain Barre, see below…
but convincing evidence is difficult to find. The coincidence factor is always a concern.
Every year I hear : “I had my flu jab, and the next day…<add any random common presenting feature here>…my hair turned blue!
I argue with myself….I’m perfectly healthy (physically, mental health is debatable….I mean I blog therefore I must be a tad nutty!)
So why should I have the jab??? Well….
In 1991 I did a research project looking at the effect of the Measles, Mumps and Rubella vaccine (MMR) and specifically looking at the WHO target of complete UK eradication of the three childhood diseases. My research found that indeed the three nasties would be eradicated by the year 2000 as planned…. it didn’t happen of course as some twit Andrew Wakefield in 1998 decided the vaccine caused autism… which was later disproved ad nauseum, none-the-less the damage was done and the diseases were not eradicated. So I am quite pro- immunisation and aware of the detrimental effects of negative press.
The H1N1 vaccines are much the same as any other flu jab, just one aspect of it has changed, surely the risks must be fairly minimal.
Perhaps a microbiologist opinion might be worth having….
Then I argue back with myself… It’s just another upper respiratory tract infection, mild flu symptoms in the vast majority of cases, why bother getting stabbed.
Then the good angel appears on the other shoulder…if I get piggy flu and feel just a bit sick, I can still pass the bugs on to someone else who may not cope with it as well, that may be an immune suppressed patient or one of my precious kids, and that wins the case.
I get the jab and I get some brain altering weird extra head growing side effect…well that is rotten luck. Cash in on the critical illness cover, pay the mortgage off.
I don’t get the jab, I pass the bugs to my nearest and dearest and they get really ill… and it’s my fault, the mortgage doesn’t get paid off early.
Yes I’m a cynical nurse, but I’m a dad first.
…and “Yes” Deborah, that’s just a government ploy to get us all jabbed, but it’s a good one!
and “No” Sister, you don’t have to make any jokes about just having a small prick, my sleeve is up, just get on with it!
OW!Read Full Post | Make a Comment ( 3 so far )
So over my few weeks off I hear a story on the news, that makes me stop and scratch my head a little…
(and no I didn’t get splinters).
Now perhaps I’m missing the point, perhaps I’m being controversial and am going to get slated for the following post, but it seems to me I am not the one missing the point, and from what I hear and read about the subject the more I seem to be the only one who thinks it’s laughable. Anyhow, lets look at the story….
The BBC website entitled their article :
No! Not crimes against heroines!
Now if you don’t fancy reading the article here are the basics of it…
100 drug addicts are given either FREE methadone or FREE diamorphine (AKA medical class heroin), and then assessed to see how much they were getting in trouble with the Police, how much they were using street drugs and how much they were spending on drugs…
Guess what…the pilot scheme showed that:
“One of the heroin addicts on the programme, a 34-year-old man called John, had been addicted for eight years when the trials began. He fed his habit by dealing.
“My life was just a shambles… waking up, chasing money, chasing drugs,” he said.
But John said the scheme had transformed his life “100 per cent” and he now had a part-time job.”
Well of course his life has been transformed, some nice clinic is supplying his drugs so he does not have to worry about it.
I’ve been thinking more about this kind of initiative, I commute to work, and that’s not very environmentally friendly, so perhaps the government can do some research on the benefits to the environment by paying me the same wage to stay at home and get someone else to do my job… I bet the results show I use less fuel by not driving to work!
Now before I crack into this little post, I would clearly like to clarify something… I am actually quite keen on Americans. I mean I’d have to say that because a fair chunk of my readers are from “across the pond” and some of my favourite bloggers are Americans, but despite the stereotype I like them!
Anyhow…the reason I’m heading down this road is that the debate about the American health care system, seems to have turned into a bit of NHS bashing exercise. This is partly due to a British Conservative politician going on American TV and having a moan about the NHS. I was going to ignore it…I’m not too interested in blogging on politics really and try to keep the blog more for light relief on a rare coffee break. However I found amusement in the ongoing debate following an editorial from the “Investor’s Business Daily” which stated:
“People such as scientist Stephen Hawking wouldn’t have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.”
Stephen Hawkin as I am sure you know has an American accent via a computerised voice-box. He is however a BRITISH physicist and after being used as an example against the NHS he stated:
“I wouldn’t be here today if it were not for the NHS,” and pointed out: “I have received a large amount of high-quality treatment without which I would not have survived.”
Not only does this make the editorial team at the “Investor’s Business Daily” look like a bunch of idiots, it also does nothing to quash the American stereotype of being slightly insular…It’s a stereotype and not my opinion, although having a “World Series” for a sport that most of the world has no interest in also seems to be a bit of a bummer!
Next you’ll be telling me you though that grumpy Doctor House was American….oh please!!!
“House old boy…is that you?”
I digress! People complain about the NHS it’s true, but people complain about health care from any provider. I have worked within the NHS and been on the receiving end of NHS care at a life and death level on two occasions, and I love it (I love the NHS that is, not particular in love with life and death situations themselves). Sure it’s not perfect, but as the biggest employer in the country there is always going to be a few imperfections, maybe even in some cases a bit of a postcode lottery, but apart from a few variations the NHS provides a good standard of care for everyone, regardless of your financial package and insurance policies.
Whether or not Obama is going to win this battle, or even whether it is the right thing for America, well I have no idea. Either way it’s a big country and I’m sure they are big enough to look after themselves without having a go at the NHS and without the unnecessary opinions of our politicians. Here endeth the sermon…
Just one more thing…my mate is raising money for Cancer Research, by swimming in the fricking cold September waters. She is a bit of a contributer on this blog and could do with some support, so if you want to donate a few quid to a good cause and a friend of mine…then click here… Donating isn’t means tested and won’t effect your long term health care…(although it might mean Rachel gets Pneumonia and needs NHS treatment!) Ta!Read Full Post | Make a Comment ( 7 so far )
Bored with swine flu? Increased war zone fatalities not decreasing population adequately? Need something new to worry about? Why worry about new killer bugs when you can worry about good old fashioned BLACK DEATH!?!!
AH YES…The scare mongery media have got bored….(although I think if the government were in trouble about something, this would have more attention…)
The BBC reports a second death from pneumonic plague….DOOOOOOOOOOOOOM!!!!! The report states that “…it is caused by the same bacteria that occur in bubonic plague – the Black Death that killed an estimated 25 million people in Europe during the Middle Ages”.
OMG…..what shall we do?? How about a nice digestive and a cup of camimile tea…. and look at the facts…
People infected with the plague usually experience flu-like symptoms, including fever and nausea, after an incubation period of three to seven days. If treated early with antibiotics, plague is curable….. oh my god it’s curable….oh how dull….
OK lets work harder….everyone is bored with invisible bacteria…lets go for a more visible threat…how about “Ladybird flu”? It’s a killer cross between a bird flu (avian flu) and the variant of the worst flu known to man….yes….Man flu! It is transmitted by “killer” ladybirds.
Symptoms of Ladybird flu are….urm….fever, and your skin turns red (probably due to the fever) and then you develop black spots… oh crud, someones already got those symptoms for diagnostic purposes…
Damn you Rocky Mountain spotted fever and of course Anthrax…
OK, so the new symptoms are that after you developed the red skin and black spots, you get severe back ache and then your back splits open and wings emerge from your back…and start repeating tongue twisters.Flew or Flu?
A flea and a fly flew up in a flue.
Said the flea, “Let us fly!”
Said the fly, “Let us flee!”
So they flew through a flaw in the flue….hmmm, not sure anyone is going to buy this one….
Lets just find another historic disease and spin it for the media… don’t want the public to start feeling they might be healthy again…lets say…hmmm Smallpox….actually no lets not, that is actually quite fricking scary!
How about….”Highly contagious weeping sores rife amongst children and can be spread to adults and across species“… Good…. Lets add a bit of science….”caused by staphylococcus bacterium“…. oh yeah sounds good. OK, OK, it’s just impetigo and the death rate is close to non existent….and easily treated with antibiotics….not so good…..
We need something not treatable with antibiotics to get the media really interested and scare the general populous…. I know the media will love this one….
“Disease which may quickly spread around the whole population” that is “Untreatable with antibiotics”, that “Guidelines state that treatment is not recommended”…. Warts or verruca’s not really that scary sounding though…
How about a sexually transmitted parasite that increases in size inside your abdomen and then pushes it’s way out through sexual organs and spends then next few decades causing havoc and costing tax payers thousands of pounds? Yeah, pregnancy…not that scary really (well pretty terrifying, but people are aware…)
Why am I wasting my time trying to think of something to scare everyone? I’ll just wait a week or so, the media will think up some health scare to sell papers or the politicians will have something to hide so they’ll distract us.
Before I close, I must draw thy attention to my blog mum…she has just celebrated her 4th blogiversary and produced a cracking addition for Grand Rounds. Keep up the good work Kim!!
Read Full Post | Make a Comment ( 1 so far )
Whoa….someone stop the ride….
I’ve been hellishly busy of recent, and I am just typing up a quickie! So where have I been…here and there is the answer, meeting, greeting and patient bleatings, but for the most part I’ve been bringing in the cash for the surgery by meeting government targets. I was given two weeks to do a years work that someone forgot about until the last minute and then went ” Quick get Max to sort it…” and actually I feel I did quite well! Maybe I should sign up for next years Apprentice.
So what have I missed the opportunity to blog about during this time.
Well Swine flu cases have increased, but the media has lost interest, mostly due to another pig related story….
or perhaps it is just that Swine flu is less of a concern since the release of…….
But due to my lack of time to blog, I’ve finally given up the resistance to Twittering! So just in case anyone was worried I had dropped off the planet or finally given up blogging, I can pop in and post a few words up in the top right corner and keep everything a little fresh!
Right off I go…people to see, places to go, illness to diagnose, paper work to do, courses to study, phone calls to make, emails to respond to that I’ve ignored for the past fortnight…hmmmmm, perhaps I should get a job as a nurse or something rather that an office worker…oh hang on, my mistake, I AM A NURSE!!Read Full Post | Make a Comment ( None so far )
Well I don’t think on this occasion I need to post a news link to the story I’m discussing… Swine flu! (unless you have been cave dwelling of course).
Swine fever has hit! Yes, I said Swine fever and not swine flu. It’s not the illness that amuses me, it’s the media hype and general “excitement” surrounding it!
The news has been nicely winding the public into a frenzied state. The ITN news this week was highlighting countries that had been affected. Even if there was only one case the whole country turned red in their exciting graphics, until it looked like all of the America’s were about to loose their whole population, 1/2 of Europe had been wiped out and of course Scotland!
Then the presenter (in the same…”oh my god you’re all going to die…but I’ll be OK because I’m a celebrity” voice) showed a graphic of the WHO alert moving from 3 to 4, as if it was happening at the very moment he talked about it, suggesting things are getting worse by the second.
FOR GOD SAKE!!!! Everybody relax. Yes some people may die from it…like they do every year from influenza’s, but most people may get a bit of a headache and feel crap for a few days. The government are concerned as we are in a recession and if a pandemic hits hard it will increase health spending and damage infrastructure – i.e lorry drivers, supermarket staff and public sector workers will be temporarily in short supply due to them having a few sickies, which will be an inconvenience and cause stress.
It’s as simple as that….unless you want to hear my conspiracy theories…
Are you sure??
Every generation has to do something to polish off a chunk of the population to stop over crowding. A world war usually does the trick. Old Bush n’ Blair tried to get a headcount going by irritating the Middle East, but the population wasn’t culled enough. So they put a plan together…
They set the cogs in motion and ensured they were both out of power when it set in. Just 3 month’s after Bush ducks out of the White House it all kicks off!
This strain of Swine flu is a combination of 4 other flu viruses…. How did they get together? Flubook? Met at a party? Much more likely they were mixed in a secret lab somewhere!
Bush ensured it all kicked off in Mexico, hopeful that the poor Mexican’s will perish and the American’s can move in. Let’s face it they are running out of space to build MacDonalds over there!
Don’t believe me?? Who do you trust more? Bush or Max???
OK I just made that up…good fun though. The whole Swine flu thing is just a hoax to get people to stop focusing on the current financial mess and get the reporters to focus on something else.
It’s obvious really. Swines…AKA “pigs”
Flu as in “Flew”, past tense of “to fly”
… “Pigs might fly” expression suggesting that something’ll never happen.
If pigs fly will the price of Bacon go up???
Oh! How I’ll look back on this next month and laugh…in my side room between doses of my antiviral medication…
…and if you want to get hooked and find the latest cases look here… thanks to the Twittering Jacob Spencer for this!!Read Full Post | Make a Comment ( 4 so far )
A fantastic story in this weeks news about a 28 year old Russian man called Artyom Sidorkin. Who presented to Doctors with chest pains, he was sent for X-ray. The X-ray showed a large shadow and Doctors told Mr Sidorkin that they feared he had lung cancer.
Presumably with a previously healthy young man with a lung shadow, they wasted no time taking him to surgery, on opening him up they found…he didn’t have cancer. So what was causing the shadow??? A 5cm fir tree! I’m not teasing! It’s in the papers and the news.
Watch carefully I’ll be asking questions afterwards.
OK so you’ve seen the report, here are your questions….
1: How many people where required to remove the small fir tree??
One? Two? or Tree fellers?
2: Did they get the thoracic surgeon to operate, or did they call a tree surgeon?
3: If it had grown bigger would they have to tear him limb from limb or just operate on his trunk?
Enough puns questions, I’ll leaf it there for today!
…and now for something completely different….for anyone who’s ever loved a doctor! (I’ve only ever dated a Doctor’s daughter…trivial but no punch line!!)
I tried to put Julie Andrews in here, but it wouldn’t let me imbed her (oo-er) so you’ll have to settle for the rather wacky Janet Klein (I’ll be returning her to Nurse Ratcheds care).Read Full Post | Make a Comment ( None so far )
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