There is still plenty of bread, flour and beans in the UK.
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.
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’)
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.
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?
Sometimes eight or nine relatives would pack into these airless spaces to spend the last hours and minutes with their mum or dad;
Anyway, death is out there.
…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.
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.
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.
dim lights that cast no shadow in the bedroom
Man or woman
I gave this guy, who to me appeared to be of Greek or Turkish origin himself (with the assumption that I would answer him, ‘From Ankara…’) the response I used last week
How long do his dreams last as he, Tightly tucked away survives the winter?
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)
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.
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”
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.
..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?
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.
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.
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.
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.
Great and awful events have happened throughout history sans likes and tweets.
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?
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.
By the end,
The BBC said tens of thousands,
The Independent a million.
It can’t be that hard to estimate.
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.”
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!
I will not go into more detail about this but suffice it to say, this is congruent with my values and probably my purpose.
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.
‘The out of hours doctor says he has an infection…’
We humans are so incredibly expert at communication that we often forget about its importance, a little like breathing – which in a similar vein, is only an issue when you can’t.