Now I know we’re not a ‘medical blog’, but somethings a-stir lately amongst the medics.
That Neil Bacon fellow (essentially an inadequate doctor who pretends he was a renal specialist but decided to go for the dot.com fortune instead with doctors.net.uk) has started something most annoying to the medical fraternity. I won’t link to any of it (except Shrink’s post on the subject and 360 degree feedback - but only cos he’s an honorary nurse*). You know where the rest of it is.
So what’s up? Well in a nutshell he’s started a ‘rating’ site for doctors (Bacon - not Shrink) - with anonymous submissions from.. well, anyone. It’s a bit crass - actually it’s extremely crass - and I sympathise with the medics - (in the same way they might sympathise over nurses pay).
But wait! Cue the cavalry bounding over the hill - Sir Liam Donaldson, Chief Medical Officer has another idea.
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The
Healthcare Commission has produced this
report into Acute Mental Health In-patient Care. There’s a HCC press release
here.
While the Telegraph highlights:
Thousands of mental health patients go missing from wards
The sectioned patients either escaped from wards, went missing during authorised leave or failed to return to hospital when they should have, a critical report by the Healthcare Commission found.
During six months in 2007, patients detained under the Mental Health Act went missing on 2,745 occasions for a total of 8,870 nights
The Independent writes specifically about how unsafe such wards are.
Despite increased spending of £1.2bn in real terms on adult mental health services since 2002, one in four of England’s 10,000 mental hospital beds is in a trust rated as “weak”, which, says the commission, “does not meet the minimum requirements and reasonable expectations of patients and public”.
There was previous discussion (originally discussing the waste of the ology and iatry in mental health) which developed into suggesting we should be focusing more on the actual wards rather than splitting neurons; but I’m not about to revive it.
So, back to the report. What does it tell us? Apparently it reports that:
Overall, eight trusts were rated as “excellent” (accounting for 843 beds – 9%), 20 as “good” (2,808 beds – 28%), 30 as “fair” (3,985 beds – 40%) and 11 as “weak” (2,249 beds – 23%).
Hmm… so what does this mean?
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Here is something we can all get into a self righteous lather over. I am not sure if Iris Robinson is a British MP or a member of the Northern Ireland assembly her husband, Peter Robinson, is the leader of the DUP and First Minister, but Iris is reported by Hansard as saying;
“There can be no viler act, apart from homosexuality and sodomy, than sexually abusing innocent children.”
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A little over a week, the great Doc Crippen pleasured us with
this guest post.
Within the commentary of this discourse, I believe it was firmly and established that this offer of…
I will bet you all a virtual pint that more than 75% of newly qualified nurses are under 25.
…was irrefutably and evidentially proven to be in err by Gallowgate and seconded by Zarathustra with this:
- Gallowgate said…
According to the now defunct NMAS (Nursing and Midwifery Admissions Service) website: In 2007, 15226 of accepted applicants were 25 and under and 10260 were 26 and over.
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Okay, the tone of debates seems to have, shall we say, lowered a bit lately, so I’m going to make a little statement about rules of the site.
First off, I have made the decision that quotes from or links to BNP websites are not permitted on this site. I know that some of you object to this on free-speech grounds. The likes of the BNP are free to speak elsewhere on other websites, as far as I’m concerned. Anyway, I’m not going to debate the matter further. The decision is made and that’s it.
Second, some of the debates have at times descended into personal attacks. That’s not acceptable. By all means be as forthright as you like in debating ideas and issues, but don’t lower yourselves to insults or abuse. Attack the ideas, not the individual. As a rough guide:
Acceptable: “That suggestion is blitheringly idiotic”
Not Acceptable: “You are a blithering idiot”
If a comments thread is starting to turn into a slanging match, I will simply close the thread. Repeat offenders will be given a warning, then a temporary ban if they persist, and then if necessary a permanent ban.
There is no comments thread for this post because this is not a matter for debate. It’s simply a statement of how it is.
Listening to “
You and Yours’” Radio 4’s consumer affairs programme, on the way into work today I was following the debate on the proposed government changes to the
benefits system. The government plans to shake up the benefits system by encouraging some of the long term unemployed to do voluntary work in return for receiving state benefits. Also included in the Government green paper are plans to scrap invalidity benefit and replace it with an enhanced benefit with stricter medical criteria administered by someone other than the individuals GP (Invalidity nurse practitioner?). Those not qualifying for the new benefit will be moved to a new employment support allowance scheme by 2013 which it is hoped by ministers will be regarded as a temporary benefit by all but the most disabled
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In today’s news, surgeons at Imperial College Healthcare Trust will get
bonuses for not killing their patients.
My response to this is the same as my view of the compassion index and the Productive Ward scheme. Which is that by and large doctors, nurses and other healthcare professionals don’t need an endless slew of top-down schemes of incentives, monitoring and reorganising. What they need is to be granted the freedom to do their job.
Most clinicians want to do their jobs well, and are happy to get on and do it. Simply ensure that clinicians have a minimum of bureacracy to contend with, keep staffing levels above a safe minimum, and make the NHS disciplinary system a bit more robust so that we can effectively weed out those bad apples who don’t want to do the job. Make those changes, and it’ll make far more difference than somebody monitoring your smiles or sending you on a training course on how to tidy a cupboard.
Over at Kings College Hospital, nurses won’t be getting bonuses like the Imperial College surgeons if they do their jobs well. They get a biscuit.
Good nursie! Nursie beg! Nursie wanna bikkit?
It seems The Shrink has been shouting since 2.10am for a round-up. Therefore I need to do two things.
1. Arrange some zopiclone for The Shrink
2. Put together This Week in Mentalists.
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As some of you may have guessed by now I am currently reading a book on “Social construction” or social constructivism or constructionism by Ian Hacking called the “Social Construction of What?”. At the risk of boring certain members of the audience even further (audience what audience?). I want to give a resume of Chapter 5 (pp 100 – 125) entitled “Madness: Biological or Constructed” and maybe draw a few conclusions of my own.
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Tributes are being paid to nurses after practically the entire profession laughed its self to death following the publication of “Releasing time to care: The Productive Ward” released by the NHS Institute for Innovation and Improvement.
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The symptom of ‘lack of insight’ is often a component of major mental illness. Technically referred to as
anosognosia, it is the lack of insight that often results in the need for compulsory detention; supervision orders; enforceable medication and the ever-present psychiatric coercion.
Now there’s a whole heap of debate on coercion and understanding the difference between a patient electing an informed choice as opposed to one who simply doesn’t see themselves as ill. However, I have a niggling question about this state of denial that others may be able to shed considered thought or experience on.
In the case of someone who denies the existence of a mental illness, is it ever found to pervade to the denial of other illnesses, particularly new found medical ones?
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…as the assembled company of Mental Nurse examines the contents of its collective navel button, out in the real world, the All-Party Parliamentary Group on Mental Health has
reported the results of its survey, showing that almost a fifth of MPs have experienced mental health problems.
[They] also found that 86% thought being an MP was stressful…
…One in three of them said colleagues’ attitudes and the possibility of a hostile media reaction prevented openness about mental health issues.
Much the same was the case with gay MPs in previous years and while I don’t imagine it’s a huge amount better than it was, there have been some who have been prepared to be open about their sexual orientation. This has been an enormous help in informing the public debate on equality for gay people.
What’s needed is an MP who is prepared to go on the record about his mental health problems, in the same way as former Norwegian PM Kjell Magne Bondevik did when depression forced him to take a very public sick leave ten years ago. An MP who was prepared to do so would be a brave individual indeed, and one can imagine the reaction of the media to such an admission. But think of the good it could do for people with mental health problems.
Even though I know many
celebrate the difference of ‘madness’ I make no apology for the use of the term that others might find offensive.
I guess we have to call it something - and to be honest - I’m using it in belligerence to those who choose to call it by the names of the self-promulgating “sciences” - like psychiatry, neuropsychiatry, neuropsychology, psychology - because this then determines the issue is no longer a person; it is an “ology” or an “iatry” of the “psyche“.
I don’t particularly begrudge each one’s right to inclusion in the search for finding solutions to these debilitating mental health conditions; but I am totally racked off with the sense of pontificating exclusivity each one brings to the dilemma.
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An epitaph for the eighties? “There is no such thing as society”
“I think we’ve been through a period where too many people have been given to understand that if they have a problem, it’s the government’s job to cope with it.’I have a problem, I’ll get a grant.’ ‘I’m homeless, the government must house me.’ They’re casting their problem on society. And, you know, there is no such thing as society. There are individual men and women, and there are families. And no government can do anything except through people, and people must look to themselves first. It’s our duty to look after ourselves and then, also to look after our neighbour. People have got the entitlements too much in mind, without the obligations. There’s no such thing as entitlement, unless someone has first met an obligation.”
Prime minister Margaret Thatcher, talking to Women’s Own magazine, October 31 1987
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I thought it was well past due that I write a post for Mental Nurse, what will all the intellectual discussions going on, it was about time for a pile of waffle from myself. *ahem*
As you may or may not be aware, I am in my final year as a student and will be a qualified Mental Nurse by the end of September. I’m quite surprised at how the time seems to have gone quickly, although there have been plenty of times I wished it could have gone even faster. Particularly the due dates for course work, which always seemed to be such a long time away, with plenty of time to put off doing any work, and then it’s the last night and I’m up all night typing away, trying not to panic. (I don’t recommend this approach to current and future students)
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