Covid – My blog is calling (Week one, through a doctor/dad/outsider’s lens)

Fear of doing the wrong thing is a fundamental of quality improvement. If you are afraid to act because people might call you out or think you stupid, you won’t do anything, and the quality won’t improve. It won’t necessarily deteriorate either, yet, in times of radical change, that is worse.

Broken sleep & Coronavirus (Bruce Lee, the philosophy of time and space and this week)

Getting rid of the routine allows people to focus on what is important. (Bruce Lee said this in the 60’s – ‘Hack away the un-essential’)

Pishers, Michael Rosen, viral illness and the Passover story (timely I know, as it is Easter soon)

Well, talking with my family when I had the distinct need to panic buy and hoard face-masks and rubber gloves the other day, (I didn’t); not only is this deeply rooted in the brains of every one of us, it is (at least I believe) amplified in some groups.

This is black-belt medicine (areas of uncertainty in health and social care)

Ever been breathless at three in the morning? Do you have any strategies to sort yourself out, particularly when to begin you have a bad chest?

Why an ECHO focusing on human rights in relation to dementia and frailty?

…designed for maximum efficiency of staff and outcomes, not necessarily for the comfort or dignity of patients – we erect a thin curtain between beds and pretend it is sound-proof, for example.

Metrodome Part 2 – agitation in Alzheimer’s disease. (Words and the complex nature of a problem)

You will note this is the opposite of ‘There is no bus to Upton, you are 93, you have dementia, you are in hospital’ approach, which is likely only to worsen the anxiety.

Too negative, too positive, or should I just be quiet? (thoughts on the experiences of people living with dementia in the UK)

Ensure independence, autonomy and the right care and support for people living with dementia (and, yes, older people in general) and the NHS will be fine.

Catch-22, doctors, leaders and the NHS (healthcare, military and other absurdities)

What struck me was the similarity between bad leadership as described in the 256th US Army Air Squadron and… you guessed it, the NHS.

(Admittedly there are no bombing runs in most UK hospitals)

Doctor, my husband will see you now. Home visits, and why we should fight for them.

For today, I hope to keep popping out, spending quality time with patients, understanding what is important to them, their preferences, hopes, fears and aspirations, and supporting them to stay outside acute care.

What will happen tomorrow if Labour don’t win the election

I don’t usually go-in for prediction. Sure, I think about the future, speculate on what might be, but jumping ahead 48 hours isn’t my usual thing. Tick, tock. It feels like one of those death clocks counting down. Measuring the minutes until everything is over. What happens? I don’t want to think about how IContinue reading “What will happen tomorrow if Labour don’t win the election”

GPs ending home visits – what the heck?!

Many are the result of an acute deterioration in the health of an older person, who, terrified of being admitted to hospital calls their GP. Many patients do not want to be admitted; they want to stay at home and recover.

Why I have been depressed for the past nine years (and how to save the NHS)

..when you see society deteriorating, when there is so much potential for improvement, that is surely depressing; when you see vibrant doctors and nurses forced into early retirement because the work has become too much, that is bad; when you know that people have and will die because of cuts, what could be worse?

Hospital

You see, The Plan says that more will be invested into community care, yet, the cumbersome nature of the NHS, again, the upside-down system of health and social care has resulted in lots or organisation and reorganisation but little transformational thought, little concept of how we can do things differently.

Manor Field Blog Number 19 COPD

It is never good to start something with an obscure medical acronym; ‘Chronic Obstructive Pulmonary Disease’ is however a bit of a mouthful and I suspect for many, even those who have the condition it doesn’t explain much more.

Medically Fit – 2020

Maybe we should call it ‘hospital check-out’, to get away from the nonsense of fitness, when many of the people described are actually quite sick and are often even dying, it is just that their death need not require a bed on a hospital ward.

Anticoagulation and possible head injuries in care home residents

Consequently, significant numbers of very frail and older people are transferred to local Emergency Departments following either trivial head injuries or when a head injury is only suspected but not witnessed.

General Practitioner and General Physician

A patient with a headache is more likely to receive paracetamol from a GP, a CT scan from a General Physician and an MRI from the specialist.

Who is more effective?

My Job

Mostly, my approach is to consider that we, that is the community services (those outside the acute hospital) can and do support a far broader range of patients than people realise and, when working well together, can care for a significant proportion of the people who otherwise arrive at the door of A&E.

In the darkness we wait.

I have a patient Who cannot read or write.   I have not yet Determined the reasons why; Whether circumstance situation or something else.   Nevertheless, He struggles with many activities that you or I would find Straightforward.   When I was explaining to him the other day About the dosing of Paracetamol, I realisedContinue reading “In the darkness we wait.”

London to Glasgow (cardiologists and frailty)

First, I wanted to mention Neprilysin (and its inhibitor) as it seems to me to be such a cunning piece of high-tech science it should reach this blog. Then I’ll get to the cardiologists!

G. falls over and possibly bangs his head

He was treated with antibiotics and returned to the care home 48 hours later. During his stay he fell twice on the ward; there was an incident with a member of staff which led to him receiving intramuscular Lorazepam.