Lord Warner has released a report stating that we should pay £10 ‘tax’ to use the NHS and that the NHS is ‘not cost effective’ despite all the evidence to the contrary. Both of these statements are frankly bollocks. However we have grown used to these lies and, as the media keeps pushing them, eventually they will be believed.

I looked up Lord Warner, he is the executive director along with a Suzanne Warner of ‘Sage Advice Ltd.’ A company that has no contact details, no website and no telephone number. At least none that I can find. This doesn’t mean that this ‘company’ is in any way dishonest, but as a simpleton in the ways of business I can’t see the reasoning behind it.

Of course, this, and Lord Warner’s previous job advising Apax Partners (a company that invests in private healthcare) might mean that he has some sort of vested interest in bringing about further privatisation of the NHS.

Sadly the newspapers only printed Lord Warner’s side of the story (i.e. Bullshit) and have not in any way...

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I’m going to state right now that for most cases I am completely against force-feeding. There are issues of capacity and sacrifice and so on that would take a post of its own to describe, and that is not what I’m writing about here.   It’s the Yasiin Bey video showing him undergoing the procedure for the force-feeding of a prisoner at Guantanamo bay. It was created to highlight the evil of force-feeding.  

Here it is.

  I have serious issues with this video.

  Here is another video showing the exact same procedure.

(Here is a video on how to insert one into an eight month old child)

The procedure shown is the insertion of a nasogastric (NG) tube. I have placed more NG tubes than I can remember and I have never seen a reaction as strong as that shown in the first video. It certainly isn’t very pleasant to have a NG tube inserted as it tickles the back of the throat that makes you want to gag (or swallow), but it is not this apparent torture that is being shown.

  An NG tube is inserted in hospitals for a number of...

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I needed to write this down as it was rattling around my head stopping me from sleeping. Please excuse the formatting.

V/O 'Thiamine and vitamin B. I'm sure that there are people out there who take only these two medications and who aren't alcoholics. But I'm yet to meet one.'

Panel - Overhead shot of a dishevelled man sprawled out in a very untidy room

V/O 'The interesting thing about alcoholics is they don't normally drink themselves into unconsciousness, which is why I'm concerned that the man laying on the floor in front of me, whose only medications are thiamine and vitamin B, isn't moving.'

V/O 'The medication isn't my only clue he's an alcoholic.'

Panel call outs - An empty bottle of Tennants Super. Nicotine stained fingers. Fag burns on the carpet. The shirt buttoned up lop-sided. Dried urine stains on the trousers.

V/O 'And then I see the thing that is going to make this a very long night indeed'.

Panel call out - Two sealed up fang marks to the neck.

I’m not a fan of conspiracy theories, while there is often a certain elegance to them I have been on this planet far too long to believe that great secrets can be kept. Humans are dreadfully inefficient creatures and a conspiracy needs a more perfect operation than can be handled by bunches of jumped up primates.

What I do see however is A leading to B which leads to C.

On Monday I wrote about the explosion in the use of private ambulances (and a good comment was left, one I shall revisit later), in that post I linked to my piece about the cutting of London ambulance staff by one sixth. A few days later, after the news story had been featured on the BBC, it was announced that London ambulance would be recruiting more staff.

Obviously I was interested, and as I keep an eye on such things, I looked as to who the LAS was looking to recruit. Their only job vacancies at the moment are for ‘Ambulance Support Staff’.

Ambulance support staff are not trained to the same standard as what the public would call ‘Paramedics’, and the plan...

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An apparent increase in the use of private ambulances in the NHS is a risk to patient safety, Labour has warned. It says freedom of information requests show spending on private vehicles by three English ambulance services rose by millions over two years.

This is amusing to me as it was Labour who started the privatisation of the ambulance service whne they were in power. I remember the LAS losing a lot of patient transport contracts as private companies could ‘do it better and cheaper’. At one hospital I remember the private ambulance company lost their contract because none of their staff had been through criminal record checks…

I had reason to need an ambulance to transport a patient to hospital as an urgent case a little while ago. We booked the private ambulance to do the job and thought that was that. Later that day I had a phone call from the company saying that they wouldn’t do the job as it wasn’t booked with 24 hours notice. I told them that they should go ahead and book it for the next day, to which they...

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I have been in this new job for about six weeks now and I have already come across the thing that gives me the biggest headache.

It’s faff.

For those who are unaware, ‘faff’ is the accretion of stuff that protrudes into our dimension after being summoned by excessive paperwork, awkward workflows and all those little things that go wrong and ruin your day.

Let me explain further - let’s say that I have to see a patient in order to dress a leg wound. Now, because of the rules every patient must have a prescription for the thing that I’m going to wrap around their leg, be that a clever hi-tech dressing impregnated with nano-particles, or a simple bandage. This is fine if the patient has a nice big box of the dressings in their front room.

Often they don’t.

So, for one pharmacy I can phone them up and they can order more, for the other two that we use I have to go back to base and order more using the victorian technology of a fax machine. Of course the nurse before me should have noticed that supplies were running low...

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I was supposed to be writing more for this blog but a few things got in my way, mum going into and then coming out of hospital, new job, depression and being tired all the damn time. I’m going to try and make a bit more of an effort, not least because I’m supposed to be writing three things as well as this blog…

As I go from house to house visiting patients I catch a lot of snippets of TV. It is interesting to see what this tells me about my ‘client group’ (as is the correct term for patient now - it might be ‘stakeholder’ or some such, I’m afraid I lost track about three terminology changes ago).

The TV programmes that are being watched seem to fall into one of four things.

1) Jeremy Kyle.

2) Repeats of Catchphrase

3) A Bollywood/Asian soap channel

4) A Imaan preaching intercut with Asian political news.

I honestly do my best to not listen to Jeremy Kyle - I think about his show in the same way I would think about bear baiting if I lived in medieval times, its just an evil show. Catchphrase is pretty easy to ignore as he...

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The interrogator sat opposite the interviewee, his machinery sat on the table between them. He checked his screens with care, watching the pupil dilation of the woman he was addressing.

“Miss Jones”, he said, “You are walking in the desert and you come across a tortoise that is laying on it’s back in the baking sun. What do you do?”

“I pick it up and turn it over - poor thing”, she replied.

The interrogator made a few notes and asked her his follow up question, “And once you have completed your training and gained your degree?”

“Easy - fuck it, let it die”.

The interrogator stood and reached across the table to shake her hand, “Congratulations, welcome to nurse training”

The government has said that there is a problem with compassion in nursing, that nurses don’t ‘care’ enough. So today they released their plan on making nurses work as Healthcare assistants (HCAs) for up to a year before they start their training. Apparently this will teach prospective nurses how to care for people - something that I seem to remember...

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I’ve been trying to put into words the exact reason why I have left the acute services (A&E, Ambulance, Urgent Care) to move into the slower paced world of community care. After fifteen years of acute services you might think that it is because I have some degree of ‘burn out’, and maybe that is part of it. Perhaps it’s because I am getting older and more worn out and so the ‘easier’ work of a community nurse appeals to me.

I was visiting a member of the In-health team today and she asked me that question, why I am going from a band 7 job to a band 5, and why the sudden change of career.

The answer that I came up with while sitting in her office is perhaps the closest I’ve come to putting my finger on the truth. I told her that while in acute services, I may well be fixing people on the day, in this new job I would be able to help them for much longer and in a deeper fashion.

If you come to me with a broken arm I’ll assess you, x-ray your arm, give you painkillers, put you in a plaster and arrange the follow up...

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When I worked in the Urgent Care Centre I would often have student nurses spending their shift with me. Unfortunately for them I have many views and no shortage of desire to share these views with anyone within earshot. I’d also try to fit in some teaching if there was the time.

Over *mumble* years of nursing and ambulance work I formulated a few basics laws of nursing that I would inflict on as many students as I could catch. I never did get around to writing them down. Until now. 

Kellett’s Laws Of Nursing

1) Do Not Bullshit

If someone asks you to do something to a patient and you either do not understand or do not know how to do it then tell the person asking you. Do not under any circumstances ‘have a go’ and hope that it works out for the best. This is how you kill patients. For example if I send you to do an ECG (heart tracing) and you do it wrong I could end up sending them home without knowing that they are having a heart attack. I know it’s embarrassing to tell someone you don’t know how to do something - but...

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