I spent the weekend hospitalised. Not fun at the best of times, but unfortunately, this isn’t exactly the best of times. Before you medivac, fearing a bout of introspective morbidity or existential angst, snap out of it! This post is about how fucking shit the NHS is becoming.
Look, I don’t understand the NHS, I don’t understand how the funding works, I don’t understand the government, the Trusts, the Foundations, the whatever-the-how-you-funds. All I understand is that more stuff has got worse over the years than better. Despite more money. Despite more nurses. Despite more doctors.
I know this because I have used the NHS a lot. I have been a life-long, hard-core customer. I am well placed to report on its strengths and weaknesses, certainly in London.
I also know that the NHS is merde compared to France’s system and Scheiße compared to the German system. The former, because of stories like these and the latter because my sister spent around 16 years of her adult life there and experienced both sides first hand. She now lives in England and is now beginning to miss a lot about Germany.
Friday night I started to feel ill. I knew I’d be sick. I try and fight it, breathe through it, but I just know I’ll chuck. I’m not like those alcoholics who think its fun to throw up, that it proves one’s manhood, or more and disgracefully more nowadays, one’s womanhood.
Retching reminds me of being a minute or two away from dying. One involuntary heave to projectile-expunge a quart of spirits from your gullet whilst under the mildly-anaesthetising influence is one thing, but vomiting hour after hour, day after day until eventually, you are in a coma induced by diabetic ketoacidosis, having lost most of your muscle and fat, having no muscles left to retch with and having been reduced to a skeleton is completely another.
That was my first experience of vomiting. Aged 7. December 1973.
When my local GP failed to recognise diabetes, despite several examinations and a month of disease progression to the eventual coma. (My mother never forgave him)
All I remember is the out of body experience, watching my prone body from my bedroom doorway on the bed, and my drunken father, equally prone, on temporary night-watch duty, asleep. My mum, having been awake for five nights, heard something in her dream, or a noise from within me like a banshee, she could never tell which – all she knew was DANGER – and she bolted upright, grabbed my limp body, rand down stairs and made the call to 999.
Dr. Lidell, an Australian doctor, at the (now closed, natch) Paddington Green Children’s Hospital, who I only remember because my mum repeated his name in prayers of thanks often enough to burn him into my memory, smelt ketones on my breath and diagnosed diabetes in about, oh, three paces across the room and one inhalation. I was put on a drip and after a day or three, I don’t remember, I regained consciousness, slowly, to a new world.
Ninety years without slumbering,
Tick, tock, tick, tock,
His life seconds numbering,
Tick, tock, tick, tockIt stopped short
Never to go again,
When the old man died.
After the diagnosis and the stay in hospital, I knew a few things: Hospitals were very, very clean places, most nurses were good, almost as many doctors were great and they all worked bloody hard. And most of them cared! They had smiles on their faces and cared. And this image persisted for many years and many admissions.
Oh, I also knew that I didn’t like vomiting, because it meant dying.
Fast forward almost exactly 33 years to the day, and I was vomiting endlessly. Over 30 times. Eventually, the vomiting was so frequent and debilitating, that I couldn’t breathe and was vomiting out of my nose and mouth and choking. Then, because I’m on stroke-busting medication, and my blood is thinner and there is little coagulation going on, a vessel or two in my throat burst and I was coughing up blood. I won’t talk about the other end of the alimentary canal. You’ve had enough detail.
In the old days, when a diabetic became this ill, because of the huge risk of DKA (Diabetic Ketoacidosis, remember?), a doctor would come over immediately, day or night, and if you were not getting enough fluids, you would be admitted to hospital. Now, there are no night doctors. Now, there is NHS direct. A wonderful, call-centre oriented call-back service where you get to speak to a doctor after two or more hours if you’re lucky, and a nurse probably an hour before that. A fucking helpline where like every other broken system in this broken country, you have to repeat your symptoms and details over a trillion times to every numpty and they all get their own versions of it.
It’s at times like this you think that the national database might not be such a bad idea, if it replaced humans who make such bad systems and those that implement them. More seriously, I wouldn’t mind my medical history being available to someone on demand, but from a chip I broadcast at will, encrypted, or something like that, over a cellphone perhaps. I only say this because my medical details now occupy more than a page of A4, make it A3 actually, and my hospital file makes War and Peace look like toilet reading. And I’m talking a piss. Yes, talking, not taking.
So after hours of this, we eventually called an ambulance as we had been instructed. It was I don’t know, about 5 or 6 in the morning by now.
OK, we didn’t call one. I was vomiting from my nose and asking my wife to call one. I don’t know what I sounded like, but it wouldn’t have been pleasant. That’s the downside of having an en-suite, it gives you the opportunity for fucking up twice as much tile space and hearing two types of reverberation on your porcelain-bus-driving masterpieces.
The ambulance arrived after an hour. Probably not the end of the world. Then from arriving at our flat to getting us to St. Mary’s took another hour. The NHS is about waiting. Lots of waiting. I would have hated to have been my wife.
I’m light on the detail here because I was so out of it and reliant on my wife’s time-line. Thankfully, she does memory very well indeed.
When we arrived, I was put in a cubicle at around 8:30a.m. and we were seen by the nurse by 9, but it was 10 before I was put on a drip and given anti-nausea drugs. The doctor finally arrived at 11:20 and took my blood to test for DKA at 11:30. They had checked my urine earlier and found a huge amount of ketones in, despite my blood sugar not being massively high. This is suggestive of enormous dehydration in a diabetic, and is of course, incredibly dangerous. I was given the saline way, way too late, but I was at least seen by a doctor within the four hour New Labour target. It didn’t take the doc to put me on saline though.
The doctor was nice enough, but he was absolutely bushed. He took the blood from my left arm and then promptly dropped the loaded hypo into my lower leg. You know how big the needles for IV blood withdrawal are. Well, thankfully, my peripheral neuropathy meant I felt very little pain indeed. The doctor was embarrassed, but I laughed it off. I remember that.
Another doctor saw me at mid-day. She asked me the same questions I’d been asked a million times – and thankfully – having learned our lesson – we came prepared – a neatly typed summary of my condition and recent complications on 4 pieces of A4 were handed over to her to photocopy. She then uttered the words no heterosexual man wants to hear in front of his wife. “I want to have a look in your bottom”. Sure. Go right ahead.
I was finally moved into the Clinical Decision Unit into a bed by 1p.m. (I’m having to get all of these times from my wife, I was out of it). There was no bed-table at any of the beds, no drip-stands and precious little nursing. My saline had run dry for over two hours during which time my wife repeatedly requested a replacement pack. This was finally administered only because my wife asked the nurse when the doctor was present. The nurses didn’t look overworked by anything other than computer work and gossip. The only people the ward seemed to be short of were doctors.
I had been advised to eat so that I could take some insulin. (No way). Nothing to eat arrived for hours.
Later that night, I finally found the energy to get up to take a pee. With an IV hanging out of my arm at my elbow, I grabbed the saline pack off the oxygen chamber onto which it had been jury-rigged, then was told that the toilets were filthy. I waited, and eventually managed the feat of pissing without soaking the back-revealing gown you get at hospitals.
I asked for a drip-stand and there were none. It’s not like these things are stolen, is it? So why can’t a hospital like St. Mary’s, one of the biggest in London and certainly the most famous, afford these bloody things? If you think this is funny, and it kind of is, I’d like you just to imagine, if you’re male, taking a piss, standing up (because if you sat, you wouldn’t have the strength to get up again), with a gown that falls over your flyhole, a saline pack held aloft with your left hand and a catheter going into the vein in your right. It’s a delicate coordination exercise, that’s for sure. A drip stand would have helped enormously.
Earlier, when my wife had gone to ask the nurses at the station for some water for me, after saying “excuse me” twice, she had to wait over 20 seconds before any of the five nursing staff would even acknowledge her. What were they doing? They were having a chat, moaning about patients. Elderly ones specifically – and about how they could “help themselves”. Well, if you pay peanuts, what calibre of nurse will you attract? And why would you blame them for going to the private sector? The good ones who stay are saints.
Back to the nurses-round-the-fire. One of the male nurses had his feet up against a wall, whilst reclined against his chair. This was no meeting. This was modern rudeness. It would never have been tolerated a couple of decades back.
Dinner was absolutely fucking shit. Worse than any I’ve ever had. Worse was to follow. You want to know what dinner was, right? Cottage pie. Mashed potato. Dead broccoli. Pale, watered-down simulacrums of them. With yellow gas-light murk smeared uniformly over the whole plate.
Breakfast was one weetabix and a cup of tea. That’s it. One fucking weetabix. Still, that day, that was all that I was going to manage. I was still ill, but I just had to get out. All the while I was thinking “what if someone who really needs this bed is waiting out there?”
More staff were rude than I ever remember (and I am always, always incredibly polite to NHS staff, no matter what they do). The Polish girl serving our breakfast was the worst. Four patients in our section, I’m the only brown guy. I have the best manners, and yet I’m the only one who gets talked at brusquely, got no “sir”, got no “you’re welcome” and got my breakfast practically chucked at me. Still, I’m a guest, so I don’t complain.
Then of course, there are no longer any blankets by default for the beds, they have to be requested. We had to wait over an hour and a half for one and this was then thrown on me by the nurse, half-folded. She went back to the phone and continued her chat with her friend.
And can you say “mixed wards”? I had to do my injection late on the Saturday night, and wanted just 30 seconds of privacy to do it. The curtains were drawn back on me by three different people on four occasions in less than a minute whilst I sat there with my cock out. Talk about a lack of dignity. Meanwhile, the poor lady to my side had her boil-infested arse on display as she walked around with her open-backed gown on. Mercifully, her son warned her after a while and this was corrected. I wanted to puke. Not for the first time, I should add, that day.
On the other hand, visiting hours are clearly shown to be between 3pm and 8pm and these were roundly ignored. And everybody was quite happily using a mobile phone, brazenly and default-Nokia-themed-ringtone-loudly. I felt like such a kid, keeping mine hidden at all times, on silent at all times and conly communicating by text when I started to feel more awake later that evening. And the nurses apparently had a good telephone manner and were patient. They didn’t do much, but I didn’t sense impatience, just indifference.
The night passed relatively well. None of the nurses had a clue about my medication, which was just as well, I would never have trusted them with it. Fuck, if they had had to administer my insulin, my next visit would have been downstairs. To the morgue. So I tested my own blood sugar, took my own medications and took my own insulin.
Credit? One of the night-time nurses, a Nigerian, was brilliant. Nigerian nurses are invariably brilliant. My all time favourite nurse was a Nigerian, I wish I could remember her name, but she made me feel better as a child with her beautiful attitude. Healing is mostly that. Attitude. Many nurses with their glamour-shot-smiles miss that, whilst missing your eyes with their blank gazes. And thus the point. And one of the day nurses on my second day, a small, squashed face English girl, a bit round, a bit shy, a bit giggly, was absolutely wonderful. She was the only nurse out of the 8 I encountered who asked her patients how they felt. And she meant it. Great nursing is about human-facing-work. Not public-facing. And certainly not inward-facing, as it has become today. I sensed one of the nurses in particular was hugely concerned about how she came across to the doctor – and to the database.
I can’t make a judgement of the NHS based on this most recent experience, but I do know this. It doesn’t make me feel safe. It doesn’t make me feel looked after and it certainly doesn’t make me feel as if it cares. I don’t know what fucked it up, and I couldn’t offer solutions unless I knew more about it. I do know that directors take the cash, not the blame.
Doctors work their nuts off, make mistakes when they’re tired, have to under-charge in order not to make it look like they’re overworking (new Labour) and they’re the ones who have to deal with patients and their families on the front-lines of battlefields created by directors and managers who know nothing about the cold reality of turning a brain-tumour patient away from scheduled surgery because their place has been given to some drunk-driver in A&E, freshly scraped off the windscreen of his uninsured car. I was taught an expression by a young man who reported to me many years ago. “Shit rolls downhill”. And yet – doctors were once revered. Now, we the public – and their managers and directors – shit on them. Doctors. The healers. The savers of lives. No wonder so many leave medicine before they’ve found their place in consultancy.
Is it society? Does too much TV and too much google make us more knowledgeable and thus more argumentative? Or do we just know enough to be dangerously misinformed? Or is it that our respect for so-called-authority has dwindled down to fuck-all? Well Britain, as ye soweth, so shall ye reap.
At best, this system, once a jewel of this wonderful country, is now just a Notional Health Service.
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As I read the article I am stunned by the writing quality and angered by the content. The anger is that I pay for private medical insurance – and the NHS suffers as a result. And yet, of course, I am glad I do. Especially after reading this.
Staff that have had management practices beaten into them and job satifaction drained out are in every public service. We have seen the rise of this new worker, the servant of management targets, who idolise the robotic (mainly female) ministers on the New Labour front bench. But its so much worse from front line carers.
If I’ve read a better article this year, I can’t remember it.
What an eye-opening post on what the NHS is and more appropriately what the NHS is isn’t. I am horrified at the conditions you describe and the terrible experience you fought through so bravely (again).
I am glad that your narration is sprinkled with your unique sense of humour. It is like a spoonful of sugar that helps one swallow the bitter taste of the NHS experience.
Wish you all the best Shahid on a very speedy recovery. Rest up, eat well, and get yourself back to form. I’ll do my bit meanwhile and shall keep sending my prayers in your direction.
Best to your wife. Her strength and support is admirable to say the least.
PS. I love the new look of the blog – clean, serene and stylish.
Sorry to hear you’ve been having such a bad time; I really enjoy your blog both for the writing quality and the content, and wish you a swift recovery.
The database system you described – where all your medical details/history are recorded, but that you, the patient, and not the government, control who sees it and when – sounds very like the french carte vitale system.
Both my parents and my stepmother have spent much of their working lives at the NHS and would be disappointed but not surprised at the time you’re having. The current system was supposed to incorporate the benefits of private-sector-style competition, but was so badly thought through that it makes things more innefficient.
There is – and arguably can be – no public service equivalent of the simple, monetary measures of performance that exist in for-profit companies. Hospitals compete on “targets” that are so specific that (1) they have little direct effect on patient care levels, and (2) they are easily “fiddled” through dodgy bookkeeping.
One could argue that competition of any kind is out of place in the public sector, but fighting over who can show the shortest waiting list – or whatever the most politically important target of the month happens to be – creates hospitals with bloated and often corrupt management structures, and a culture of resentment and helplessness in the staff.
Good luck, Mr Suspect, for a speedy recovery, and best wishes for your treatment in the new year!
I (along with so many others) really enjoy your blog, so keep up the wonderful work.
JG
It doesn’t surprise me. The care facet of the NHS, just as in all the caring services, has been deprofessionalised. You are more likely to be looked after by an ‘NVQ trained’ carer than a Nurse, perhaps the most easily faked qualification ever to be conceived in the history of the world. It also reflects the hideous shift in culture which Blair has overseen, which has made middle class fuck-offism a necessity to social survival, unless you want something from someone, and then you can do the ‘social skills’ bit. NHS shit? It’s this country that sucks, mate. Thanks to Tony uber-Thatcher.
http://www.canada.com/nationalpost/news/story.html?id=a042812e-492c-4f07-8245-8a598ab5d1bf&k=63970
Thanks for this eye-opening perspective on the NHS from the patients’ side. I only wish more patients would take the time to have their say but most of them have been so conditioned into accepting the authority of the State Health System (thank you Holby Central) that they can’t be bothered and think they’re ungrateful for trying to make it better.
The NHS was set up after World War Two with the aim of ‘repairing’ young men and women who were incapacitated by some unfortunate illness or accident and then ‘sending them back into action’, to continue to be productive. I’m sure the resemblance beween the mission statements of the early NHS and the armed forces isn’t wasted on you! (“patients and their families on the front-lines of battlefields”).
Trouble is, the ‘war’ has changed direction over the past 60 years. A combination of fewer people being looked after by their families, reductions in government spending and a willingness to score political points with the statists by expanding the envelope of state health care (sex changes, fertility treatment, mother baby workshops etc.) have caused such ‘mission creep’ that the NHS is fighting a completely different war from the one it was originally conscripted for.
In short, we’re saddled with a hideously uneconomical anachronism that’s sinking faster than Ehud Olmert in the Palestinian opinion polls and nobody’s going to do anything about it. For the record, my grandfather was killed by malpractice in an NHS hospital caused by poor hygiene and incompetent nursing. We have yet to have any form of redress and I don’t thnk we’ll ever get it. I for one hope and pray I will never need to stay in a state hospital.
Thanks again for the great article. Best wishes to you and your family for the holiday season
PS Sorry to hear about the Polish nurse. Please believe me that not all of them are so bad! Then again, some of them really are bitches though…
Brilliant blog, well written. I recently had a short hospital stay. It was nothing like the bad experience you had, but I was surprised at how unconcerned some of the nursing staff were. The loud, all night, chatter from the nearby nurses station made it difficult to sleep, and no-one came round to check on any of the patients. An old lady needed help using the commode. One of the nurses finally obliged, but you could hear the impatience in her voice when the old lady (she was in her 90s) was a bit slow to comply with intructions. I still want to believe in the NHS, but I fear for its future.
All good luck for the future.
Dear God,
That is so depressing!
John
Thanks. Glad someone noticed. Hope you are feeling better.
Ps. it is getting worse not better…… but noone listens to the doctors
Thankfully in some parts of Ulster as yet, this affliction hasn’t yet taken total root. I was hospitalised for a month in a Belfast rheumatology ward (MPH for those who know it), and have to say it was a hugely enjoyable, restful and relaxing time. The staff for the most part were superb and one nurse whom I knew from previous admissions even went out of her way to provide me with a CD player and soothing music when I was crawling my brain in agony one day, and Aromastones to help me sleep when she heard that I wasn’t getting much due to my pain. Most of the other Belfast wards are similarly blessed with superb staff okay, BUT we certainly still are being heavily hit by NHS incompetence and management overloading where two of our main casualty units can never find beds and like most others then end up with dozens of trolley waits. I posted elsewhere how I firmly believe this Government’s intention is to run the NHS into the ground for some weird reason – perhaps so that they can then come up with some new wonderful strategy to ‘save’ it which will require them to be put back into power yet again!! PLEASE, please, please don’t let that happen again. While you may not have a lot of better options over there politically, Labour is absolutely definitely NOT the party to solve the crises they’ve created in our nation. Sadly we don’t get a chance to have that say here stuck as we are with our own brand of inept politicans who equally like destroying things so they can then turn round and get prizes for having done so!! Enjoyed your post – nicely descriptive and informative
Get well soon mate. Other than that all I can say is I’m glad I live in France and I shall make a mental note not to fall ill on my trips back to England
What an appalling experience. I spent last weekend in hospital watching my son re-hydrate on a drip and was really pleased with the care he (and I) received from the French nurses. They were busy, but his drip was carefully monitored, there was a bed for me, the place was clean, he had a single room with en suite loo, and the food was decent.
I know the French system is set to implode because its deficit is monumental, but it seems to be holding together for the moment. My ex-h is a doc, however, and he told me that attitudes towards doctors are not what they were. The Socialist governments over a period of years have destroyed public respect for ‘over-paid, privileged’ baddy docs, and you get people claiming that they pay doctors’ wages, as though they were the cleaner.
France also trains fewer doctors, but brings in cheaper foreign ones, mostly from north Africa, to be exploited with lower wages and longer hours.
There’s a lot of crap happening beneath the shiny French hospital veneer.
You had a shocking time and in a way I hope that people with chronic illness like yourself might have some sort of priority. After all it is not as if diabetes is a mystery to medics.
That said, I wonder when this incident happened. Was it at the dog-end of a shift when the staff had had hours of being abused and assaulted by drunks?
Could it be that the system is creaky and beset with arbitrary targets that benefit nobody but politicians?
However, I think you are probably about right – other European countries seem to manage their services better.
Interesting blog by the way..this is my first visit. You seem to be rather apopleptic about Jews, but no more than I am about Muslims, so I suppose we are quits.
Hello Sus,
Well-written blog. As a fellow type-1 diabetic, I’m interested as to what caused your DKA? I thought DKA was down to not having any available insulin at all?
WRT hospital care, I’m glad to say my experience doesn’t reflect yours at all, yet. 3 years ago, I was rushed to hospital in abdominal pain via ambulance (midnight on a Sunday), and they diagnosed the diabetes there. Then followed a week or so on an insulin pump with a load of other lines going into me as they tried to restore electrolytes and hydration. I can’t really fault the treatment I received. Whilst the toilets wern’t spotless, they were clean. Those antiseptic gel hand cleaners were all over the place.
It *was* rather undignified though, there wasn’t a lot of privacy. That said, there was only one occasion that I was concious of where the curtains were opened before a nurse or whoever had poked their head round first to see what state I was in.
A truly horrible experience of health care. However, I can’t help wondering if your experience would have been the same if you had been lucky enough to have been admitted to another hospital? I work in the NHS and I understand the need for targets which were brought in to do 2 things. (1) raise the standards across NHS (2) Improve patient experience of health care. However, this has not happenend.
I have read so many times doctors say “they don’t listen to doctors” as if doctors have all the answers. If you talk to nurses they also say “they don’t listen to nurses”…and I am sure all other health professionals if asked would say the same thing…nobody listens to us. Therefore who are “THEY” listening to? I do know that patiens and carers have been listened to. Its patients who had complained that they are kept waiting for far too long in A&E depts before being seen. Its patients who have reported that they are not listened to by doctors and its patients who have described how they want the NHS to change. So many of the targets that have been imposed on the NHS have been driven by patients and carers. So what has gone wrong in the NHS if these ‘improvement targets’ are patient led?
Is it a case of rsistance to change by ‘some professionals’ as some politicians claim? in my experience as a nurse there is some truth in this. But it is also a case of too many cnages imposed at the same time…expecting NHS culture i.e our professional culture to change over night. It does not of course excuse bad practice and ignorance professional and personal behaviours that you so describe.
What an absolutely dreadful experience.
I left nursing in the NHS after 25 years. My colleagues were gradually being replaced by the nurses you describe. Nowadays many caring, sensitive and hard working people find themselves ineligible for modern nurse training which is a very academic course. Nursing has proudly became a university science, cold and theoretical. I believe it is an art, a natural talent. You can’t teach someone to have a caring nature, it’s something you’re born with.
It’s not about pay. It’s about management.
Everyone from the nurses to the patients has been hoodwinked into believing that the problems of the NHS are about money, in part because the management, the unions, the doctors have all said so. They have become “victims” where everything is the fault of patients for eating too much, the government for not paying them enough.
The attitude when you go to a hospital is all wrong. From the receptionist who barely raises a smile, to the Unison notices on the wall, to the nurses who are “too busy”, yet seem to find plenty of time to hang around the nurses station. This operation isn’t about you – it’s about them. Be bloody grateful for it.
Tesco treat complaints over a corked bottle of cheap merlot with more seriousness than the NHS treats a complaint over a health visitor not turning up (and not phoning to tell us).
Until we have the power to fire our hospitals, to put the managers of them out of a job, and see an owners assets lose their shirt on investing in the wrong people, we will not see an improvement.
Ah the famous Mary’s hospital treatment I went there because I thought I’d done my back and neck in
They strapped me to the bed and in a hard neck brace after two hours waiting with no painkillers and then asked me if I wanted painkillers and water when i patently couldnt get them down being strapped to the trolley like that
It was a horrific experience the locum a&e doctor was nice but pretty distracted and I almost breached their fabulous target
I hated the experience and vowed not to go there again and was thankful to get out of that place at the end.
Its true that the NHS has become shite and if you pay peanuts you get monkeys..
Even when I had an operation in another hospital in London 6 years ago I had been rather shocked that there were only three people on at night and that there was only one qualified on at night.
When my jaw got fractured by some young teenagers and I got taken to hospital the only time I got decent pain relief was in the ambulance to the hospital and the ambulance transferring me to the next one
Why only in the ambulances? Because I asked for and got Entonox and because I’ve done obs and gynae and delivered babies know exactly how to get the best benefit from it and whilst it makes you drunker than a skunk really does relieve pain when you’ve been beaten up and kicked about
The A&E departments kept me waiting for pain relief even though I was dripping blood on the floor and another Hospital in London decided that my jaw would heal naturally even though I couldnt close it properly. My parents naturally took me home to Yorkshire booked me in to see an oral surgeon and then I got a five hour operation to wire my jaw and to reduce it properly and I was on pureed food for three to four weeks but my hospital stay was fabulous up there. They realised how much pain I was in and put me on a decent dose of painkillers and made me feel better.
I dread falling ill as I know how shite the NHS has become and I work in it too.
No one has the time the place is always understaffed and if you raise your voice to make a complaint well you get chucked out.. its fabulous but the managers are doing nothing bean counting and getting a nice fat paycheque
The managers need to be culled and soon or there’ll be no NHS left to manage.
Jesus H Christ! I am in rural Scotland and we have a different system due to devolution, but I recognise too many of the outrageous scenarios you portray. Your experience reinforces my own view that the government don’t care diddly squat about the current situation in our hospitals, medical training and nursing care.
I am so glad that I don’t live in England.
Regards,
Sisiphus
It isn’t about money. Nurses where paid less years ago but where taught basics – like the fact that talking to your patients was important, spending time with them etc. Now nurses are too busy trying to be nurse consultants etc and the basics have been lost.
However, on the bright side there are still good nurses and doctors out there. I trained as a nurse but left to become a teacher (I must be mad!). Recently, I’ve been in hospital quite a bit and can only praise the staff at Walton Neuro in Liverpool for their care. On the negative side I remember being in another hospital in Liverpool, lying awake at 3.30 in the morning, with pains in my chest due to my asthma and taking my inhalers like crazy while staff nurses walked in and out and ignored me!!!!
We need to get back to the basics that used to be taught and forget about trying to be more than just nurses.
You are right that it is not about money. Neither is it about just nurses. Much can be said about medical staff, social workers, OTs and psychologists too. However it is also not about training being transfered to Universities either. You train monkeys which is where we were 25 years ago…do as I tell and don’t think to questions mentality and attitude prevailed. Yes 25 years ago when I did my training it was at a local hospital, being trained by staff who had no idea why or what they were doing but did it anyway. I am not convinced or seen an comvincing evidence that training is the cause of all evil in our NHS. What we are seeing in staff of today is the same attitude that we see in general member of the public. Go to a restaurant or the post office or the supermarket and you will see the same attitudes on display in some staff of those organisations. Go to another such faciltity and you may well see a different set of behaviours are more prominent. Neither is it fair to blame the managers. As in every organisation there are different levels of management…which level of managers are we blaiming here. Even among medical staff there are different levels of managment i.e. the Medical Director who is also a Board Member, the Clinical Directors etc. There always has been management even in the ‘good old days’ and this will always remain as such. So what has changed?
Health care has changed. Members of the public are more aware of their rights and their expectation of services have increased. Demand for services have increased without the services changing the way it has provided services. We have more specialism both in general medicine and in mental health. So we keep providing more services with the same number of staff or near enough the same number of staff. We shut services to provide new services that the public demand but we dont educate (not train) staff to work in these new services. One day they are working in an acute ward the next they are working in some new ‘speciality’. We create new job titles but staff continue to do what they have always done before and I mean all staff not just nurses.
We have been told repeatedly by Blair and co. that they have increased recruitment…they never tell us how many have left the NHS in that time. let me ask those of you who had bad experiences with the ‘NHS’, did you complain asnd pursue it to the end?
To all of you who left thoughtful and kind comments, thank you.
Some specific responses follow:
Once again, thanks to everyone who left such kind messages of support both for my condition and for my writing. I appreciate it and am humbled.
It seems to me that you are oversensitive to criticism, and like your fellow Islamists, you can dish it out but you cannot take it.
It’s a shame because this blog is interesting.
And here is my reply to you on my blog (it’s called free speech)
http://wrinkledweasel.blogspot.com/2006/12/suspect-paki.html
Dear wrinkled weasel. I’m sorry if you were upset by my terseness. You said I was apoplectic about Jews. I am not. I pointed you towards my rules as a short-cut, because I don’t have the time to respond to every comment in detail, much as I’d love to. You will note that I had the courtesy not to delete you, despite the rules, and that I responded to you, even though I had not responded to other posters who were very kind towards me.
I am delighted to have you here, and you are within your rights to criticse me, it’s not against my posting rules! As long as you don’t get personal or particularly vicious. (I note that you called me a wanker on your blog – you are within your rights to use such terms about me – I’ve been called far worse!) – but I reserve the right not to engage. On your blog, you were also concerned that I wouldn’t publish your comments, but all of your comments have come through unedited.
You used the term “Islamist”. There is no such thing. I am a Muslim. The term “Islamist” is an invention and it is derogatory. As for being sensitive to criticism, I’m afraid that is a generalisation and not true in this case. Note my tagline. I am indivisibly a Londoner and a Muslim. I do not separate myself from other Londoners. I believe in that which unites us, and I prefer not to dwell (too much) on that which divides us.
I do hope you will stay and continue to contribute, even if you hold completely contrary views to me and I apologise in advance for not being able to respond in detail to your comments.
Interesting and terrifying experience which I have to agree with.
My mother was dying a horrible death at a hospital in Enfield and thank God I was by her side. My mother was always a sick person spending many years in and out of hospitals so, from the age of four, I was in awe of nurses. So well educated, clean, efficient, caring, mainly from the West Indies and Ireland. Many with posh accents at the University College Hospital in London
where I was born. I was determined to be a nurse but things did not quite work out at 16 so at the age of 47 I graduated as a nurse in Florida.
Let me tell you that being in hospital in the USA is like a holiday camp compared to the NHS today. When I arrived at my dying mother’s bedside, the thought that hit me was “this is Third World Care”. Well because I was a bitch, knew what I was talking about and at one point told them I would meet them in the morning with my attorney, I got things done my way with enough comfort medication and care that would never have happened if I wasn’t on their backs all the time. The first thing I noticed was an infiltrated subq site on her leg two minutes after arriving from the airport.
The nurses were a joke and their attitudes dangerous. The two Ward Sisters were marvellous though. One was moving to the USA in two months having taking all her exams in London. There was a code called while I was there, and as all the nurses were agency, the Ward sister who wasn’t working that day, only interviewing for a replacement sister, had to get involved because no-one knew where any supplies or emergency meds were.
I am moving back to the UK with my Type I diabetes teenager and hope I will be able to avoid the NHS inpatient stays at all costs. Maybe that is why God made it possible for me to be a nurse, he knew about the NHS.
By the way, am not going to be a nurse in the UK, I am going back to my original job as legal secretary – I wonder why.
Seems I got you all wrong. I apologise.
For the record, I am and always have been anti the Blair/Bush aggression. Moreover I tend towards the “Blair is a War Criminal” end and have said so.
I am actually neutral about the Middle East. To be honest it is of no direct concern to me, though I do understand the terrible suffering both sides have experienced and I am informed enough to know that America and to some extent, Europe are to blame for it. Any anger I have is for the BBC who are biased against Israel and that is not their job.
I acknowledge that you have the perfect right to worship as you wish. Absolutely, no caveats. It’s just that we live in a country where my God is mocked and vilified on a daily basis and you kind of get used to it, on the basis that we leave God to judge and not ourselves.
As long as you partake in this great country on the basis that you are a law-abiding citizen, and a democrat, we do not really have a big problem.
I have edited my blog in the light of your comments.
I salute your integrity and equanimity.
You might find it interesting to look up Gammon’s Law.
> The term “Islamist†is an invention and it is derogatory.
All terms are inventions. Doesn’t mean they don’t mean anything.
The term “Islamist” refers to the political movement that believes that Islam should be a system of non-democratic worldwide government, not merely a religion. Like any other word, it may well have derogatory implications when it’s used by idiots who don’t know what it means, but I don’t see how it’s inherently any more derogatory than the name of any other political movement. For instance, the word “Tory” tends to be considered derogatory by left-wingers, but not by members of the Conservative Party, for obvious reasons. Similarly, you may well feel it’s derogatory to be called an Islamist if you aren’t actually one, but I fail to see why someone (and I suppose I should interject here that I really do just mean “someone”, not “you”) who really does want society to be forced to live under Shariah would take offense at being described as such. And, indeed, I did see a man interviewed on the news a couple of weeks ago who was happy and proud to be described as “Islamist”.
Anyway, best of luck with the “N”"H”S. My wife’s diabetic, and they’re killing her at the moment, too.
Oops. That should have been N”H”"S”. Obviously.
@Squander Two: It would be churlish and selfish for me to discuss nomenclature with you when your wife is ill. I wish her all the best, and you too. My prayers are with you both.
Heartening to see WW and yourself on better terms. As an NHS worker (thankfully not in the South East) I’d agree that some aspects of the NHS are getting worse, some are improving however.
I take exception to the fact that a patients treatment varies so much according to (especially) where they live, their age, sex, race, education and social standing. The homeless person should get treatment every bit as good as Tony Blair.
No ifs or buts.
Sorry to read how advanced your problems are Shahid, especially relative to your age. I’ve only just come across your blog. This may be a stupid question, but are you vegetarian?
Hi Neil – not a stupid question at all – I’m not veggie, but I tried it for a few years after discovering nephropathy. I took soy protein liberally and found that the kidney disease did not progress. Once my creatinine stabilised at just below optimal (around 140) I started eating meat again, but nowhere near as much as I used to, sticking to halal/kosher/organic.
I now eat fish twice a week, white meat twice a week and red meat once a week.
” I’m not veggie,” Good.
I realise you have to be mega watchful over your kidney function Shahid. As a general principle, I think meat eating or being an omnivore is what the human metabolism is best suited to, though on moral grounds, the way animals are treated is awful. Further (as a principle, rather than what I actually do) I reckon the high fat, moderate protein, low carbohydrate diet is, all things equal, the way to go as far as health goes.
Anyway, end of lecture!. This is your blog, not mine. Best wishes.
I’m a surgical trainee in the NHS and nothing you say surprises me.
The bottom line is that the system doesn’t give a damn about you. It certainly doesn’t reward nurses or doctors for the sheer mind numbing effort and strength of will it takes to do the job.
Most nurses I work with are just as you describe; rude, uncaring and arrogant. Why? Becasue they hate their jobs.
I’m so sorry you had this experience. I’m glad you were pissed off enough to write about it though.
Perhaps if you have the misfortune to have to go in again, your wife might take a camera with which to quietly snap some pics of the lounging staff? Or better yet, a video camera to capture the temporal dimension. Everyone has to sit down sometime, the question is, how much of their work shift is being spent chatting and lounging? If it is excessive they are stealing from the tax payer and endangering paitents. Since you have this bully pulpit, you could use it to raise awareness of the extent of the problem and to goad the workers into doing their jobs.
Hi Penny, I was going to take a picture of the jury-rigged saline pack holder (the oxygen chamber above the bed, about 20 sizes too big) but I was too weak. I hope there isn’t a next time, but of course, with my condition, there will be. I will try and remember your advice if I find the presence of mind at the time.
Hi Shahid,
I’m glad Neil picked up on what I was going to write about regarding vegetarianism, which has special implications for the diabetic (there is dramatically more carbohydrate in a vegetarian diet). I find it useful and manageable to limit starches. I go out of my way to avoid bread and pastry. It means I don’t have to inject so much insulin, and I can keep in the normal range without thinking quite as hard all the time. So my meals almost always have meat in them, and tomato is my “potato” or “rice”. I’ll have pasta provided it is “al dente” (lower GI so not as “fast”)
The reason I’m posting this is that I’m quite shocked that you are describing severe diabetic complications, and you’re so young.
A few of the complications are reversible. It is possible for neuropathy to recede. But this only happens if the blood sugars are kept in good control (4-7mmol) for a long time. And in the healing period, it causes the neuropathy to hurt more rather than less. But normal feeling does eventually return.
I do a basal/bolus insulin with DAFNE method and take a statin, a fibrate, and an ACE. The ACE can halt microalbumin in the urine. Mine showed zero microalbumin the last time I was tested. Is this the kind of thing you’re on? I am treated on the NHS, btw.
If you’d like to chat about this kind of thing off the blog, feel free to email me privately.
Thanks THX – I got retinopathy after only 9 years of type 1. I’ve now been diabetic for 33 years. Some diabetics as you know, don’t get complications for 60 years! I guess I wasn’t lucky.
My last HbA1c was 9.4%. Awful. I am on 40mg of Simvastatin, 300mg of Irbesartan (I switched to ACE2 after a persistent cough from standard ACE inhibitors). I’m also on 200mgx2 of dipyridamole and75mg of aspirin.
I’m a bad diabetic. I will swing from periods of exceptional control (low carbs, low GI, good HbA1c) to awful control (chocolate, no exercise, the rest…)
I know what to do, I just haven’t always practiced it. I’ve been a lot better about it recently, and I’d love it if the neuropathy were to recede, but my foot pulses are absent now, so that doesn’t bode well.
I’m currently recovering at home – albeit with a cold and for the first time, am more controlled thanks to twice-daily injections of Lantus. 24 units at night, 12 the following morning. The morning dose is a new feature of my control. I’m alarmed that I need so much more insulin. I’m also a little “full” around the waist, suffering from the dreaded “apple shape” – a relatively recent phenomenon for me – and being Asian too – really sets me up well for heart disease!
My email address is my first name followed by this domain name. Thanks for writing!
shahid,
I was surprised when you posted your doses of Lantus, they are moderate rather than high. Suggests to me that you still have a fair amount of your own insulin function and this has to be worth preserving if you can.
You and THX 1138 might find this post in Dr John Briffas blog interesting, he specifically mentions a lady with Type 1 who ” has got good, tight blood sugar control on minimal medication. How has she done it? Not by taking standard anti-diabetic advice, that’s for sure. In reality, this woman eats a diet that is essentially devoid of the very food diabetics are traditionally encouraged to base their diet on.” Her HbA1Cs are apparently normal. Stay well.
http://www.drbriffa.com/blog/2006/12/08/what-are-we-going-to-do-about-the-diabetes-timebomb/
Yes, they’re moderate, but climbing. I have about 30-60 units of Novorapid a day too.
When I’m good, I go low-carb and low-GI.
Thanks for the link.
It’s probably my receptor cells that are fine, the islets will all be non-functional. As my weight increases, it’s the receptors that will suffer, resistance goes up and of course, the dose requirements will increase.
I hate diabetes!
Novarapid too. Well i guess you have quite a lot of injected insulin then.
Try to be good, or at least better than I could probably be, at least you know what works best diet-wise unlike many diabetics. I’d like to think I could give a really low carb diet a good shot if i were in your shoes, but it must be bloody difficult in real life.
Hi Shahid,
All other things being equal, insulin resistance increases with age. Even in non-diabetics. Having a gut doesn’t help, though
Wow, 60u of rapid! that covers 900g of carb @ 1u/15g
My blood sugar goes up even when I have protein. It’s not fair.
Not fair, true, but apparently normal for everyone
http://www.whale.to/v/sandler11.html
Fig. d. Following the ingestion of proteins and fat the blood glucose level rises moderately. Since no sugar or starch is ingested no exogenous alpha-beta-glucose is available to inhibit the output of endogenou.s gamma-glucose from the liver. The blood sugar will thus consist of the gamma-glucose form exclusively. The rise in blood sugar after protein and fat is due to the rapid conversion of the digested protein and fat to gamma-glucose. A meal consisting of protein, fat, and carbohydrate foods containing no sugar or starch will also cause a moderate rise in blood sugar and with no inhibition of liver output of gamma-glucose. After such a meal there will be a rise in total body oxygen absorption.
Another addition to the position that humans don’t need carbohydrate as long as they eat fresh non processed food I guess
I wonder how many Eskimos (zero carbs) suffer Type 1 or Type 2 on their traditional diets? (My guess is vanishingly small to zero)
Eskimos? I found this site by googling, ( I already knew of the articles ) Seems to be a Christian bible site so why Eskimos diet is on there I don’t know. Anyway, it would appear that the Eskimos did not get Diabetes on their traditional diet, going by what Stefansson wrote at least. Though they didn’t seem to be particularly long lived, they didn’t get heart disease or dental problems either.
http://www.biblelife.org/stefansson1.htm
This site is quite interesting too, if you haven’t seen it before, re insulin response to different foods.
http://www.low-carbdiet.co.uk/insulin.htm
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