David Lock

A couple of years ago I developed a foot wound which got infected and I ended up in hospital for 3 months with Sepsis whilst they wondered whether they should chop my foot off Anyway it eventually healed but I have regular checks to see if all is well.


Went yesterday to see a guy I hadn't seen before (I'd moved) who said that a fresh bleeding wound had opened up right underneath my foot. He summoned a nurse and said it had to be cleaned and dressed immediately. Nurse refused as I wasn't "her" patient. Eventually I was seen by another party who dressed the wound and booked me back next week. The risk is infection getting hold and because of the location I cannot have a look myself.


But it happens that my daughter and current b/f, a hospital doctor, are coming to see me tomorrow so I said to my daughter great, b/f could do a quick check on wound. Reply was not a chance as he was not allowed to check as I was not registered as one of his patients. I was very angry about this and did comment that b/f might just have the competence to see if a wound was infected or not.


So has common sense disappeared? What about the Hippocratic Oath?


I'm just too old fashioned for this PC world

dpb

Would you not have accompanying fever and can you look in a mirror




( I cant imagine he wouldn't actually offer an opinion , just not to the authorities )

steve05wrx

Hi,
My wife is an A&E consultant and she is very cautious about giving any medical advice to friends and family - as it can come back to haunt her if advice given is not followed and something subsequently goes wrong.
We live in such a blame society that people are too quick to sue you over what - in the past, would just have been put down to experience.
Where there's a blame - there's a claim!
Cheers
Steve

joz8968

iTrader: (13)

Yep, yet another great American import. Cheers, Uncle Sam.

ALi-B

iTrader: (1)

Sad to say but I know a fair few people that work or have worked in the NHS mostly nurses, care workers physios etc. All of them have a jaded view of the day to day operations. And a lot of departments operate a culture so affirmed at proportioning blame on to floor level workers that there is a ingrained fear that means they are constantly having to watch their back in a highly pressured environment where skilled or compassionate staff end up being punished for the oversights or incompetence by staff or higher management staff.

My gran was in hospital over January (passed away now) and obviously this is a period where they are very overstretched and understaffed. Being an old person it was very easy for her to get ignored or written off as a cabbage waiting for God, therefore invisible to the shift worker just there for the wage. FYI; One month prior she was fully Independant; cared for herself and lived in a upstairs flat with no need for a stair lift despite her COPD. It was quickly noticed by us she wasn't eating not because she couldn't or wouldn't, but because she wasn't given assistance (she has no teeth -at home she had a blender ) and food taken away uneaten, leaving someone who was very weak with a severe infection without any proper meals. Staff didn't seem to acknowledge our concerns.

A friend of mine is a physio who works on the floor below her ward, so out of concern and her seeing her rapidly declining condition would visit my gran on her breaks and help her with her food. Knowing my friend is never one to make a point go unnoticed, this would have rubbed at least one member of staff on that ward up the wrong way.

The result? She was reported for it and management staff "had words" with her for treating a patient that wasn't hers.

That's just a minor story. I have plenty more; I know two former physiactric nurses that effectively were bullied by a manager into quitting. The only reason they lasted as long as they did was their passion for caring, but the managerial and procedural dogma and blame apportioning by higher level staff with the cliques that result left them with almost PSTD like issues; If you were not part of that ward manager's clique he made your life hell. I could go for pages here on this one.

You maybe against privatisation and hold the opinion that everyone should have totally free healthcare, but as it stands now as a public body there is little incentive to reform this ingrained culture barring negative media in the press: Which is dealth with by closing ranks to the public. Refusing to treat people who are not their patient or whilst outside of work is the net result of this environment.

Don't blame the nurses, they just want to keep their job and not be held account by the bullying culture that operates should they slip up.

Remember the nurse that committed suicide due to a hoax phone call from a radio station? It is without doubt she was treated by upper level workers in a manner that would be considered as severe and persistent bullying in any other situation. But at that hospital they all closed ranks, the faceless responsible for her mental torment still work there and still operate there.

You will never end this without the dismantlement of the NHS. I don't have the complete answer, but what I know is, it cannot be free any more for minor ailments as it's draining far too much resources from the care of the severely ill that is being persistently failed. We will all pay for this in end.

David Lock

I fully understand that but feel that the pendulum has swung too much the wrong way.


I'm not expecting this medic to do anything more aside from check if wound has become infected. I am physically unable to remove the dressing and replace with a clean one.


So turning your arguments on its head. Say the wound was now infected it would be wrong to leave it alone. The last time this happened I nearly lost my life because of sepsis and was close to losing my foot. If it is infected I would start taking the antibiotics that helped last time (I have several boxes left) and give myself a fighting chance. All this "I might be sued for looking" is bollox to me I'm afraid. So if I was walking past your house and was badly bitten by the neighbourhood dog would you good lady just say sorry I can't help in case I get it wrong?


Ali - that's a sad but interesting tale.


I'll hop off now


David

steve05wrx

Hi,
It's even worse where we currently live - in the UAE, if my wife witnesses an accident right in front of her - she is forbidden by law from treating any injured people that she sees, when off duty! Luckily we have not come across any situations, yet - as this will be very tricky for her to handle.
Once we were at the British Embassy in Dubai for a function and somebody collapsed - she readily helped in this situation until the paramedics arrived - as we were on "British soil".
In the UK, she would often help when out and about and coming across medical emergencies and RTAs.
We have also had many situations when flying on planes and the call goes out for a doctor. Being an A&E consultant - the crew really love her when she helps out! The captain is often pleased when she manages to stabilize a patient and avoids having the plane divert - as this costs the airline up to £100,000 - and its her call whether to divert or not!
One time we were on the HSS boat from Holyhead to Dublin and the doctor call came out. My wife was then taken to the bridge by a member of the crew and a "paramedic" followed them. Once they arrived at the bridge they were greeted by the captain - who then asked for ID, before he would discuss the patient (who was a seriously ill crew member). Whilst they were checking my wife's credentials - the "paramedic" disappeared!!
Cheers
Steve

David Lock

Thanks Steve and Mrs Steve seems to have the right attitude. Not sure how UAE law overrides a Doctor's allegiance to the Hippocratic oath I'll check that she is on any plane in the unlikely event that I fly anywhere


atb, David

neil-h

Easy, UAE law is legally binding where as the Hippocratic oath is purely ideological. So at the end of the day it's down to the moral standing of the individual question. That being said a lot of countries have what's known as a Good Samaritan law, which protects individuals who provide first aid as long as their actions aren't negligent/inetentiaonal misconduct.

steve05wrx

Hi,
Yes you are right - they are talking about a Good Samaritan law here - but at the moment it's a "last person to touch them is responsible" sort of situation and that would be an issue if somebody died following first aid treatment by a passer by.
Medical negligence cases get very messy here - if a patient or relative complains against a doctor - there have been cases when the police arrive at the hospital to arrest the doctor!
Cheers
Steve

dpb

http://news.bbc.co.uk/1/hi/health/7654432.stm

steve05wrx

Yes and what's really amazing is that Assad took that oath and look what he has done to his fellow countrymen in Syria!

steve05wrx

Here is the discussion on Good Samaritan law in UAE

http://gulfnews.com/news/uae/general...-uae-1.1265898

dpb

Does it all stem from the physician - poisoner position

john banks

GMC have clamped down heavily on doctors attending to family or informally. It is all apparently about accountability, record keeping, indemnity, professional standards etc.

Dingdongler

It's quite simple. The GMC warns us against treating our own family and friends...and for good reason. In addition your daughter's bf is not employed or idemnified by the hospital that is treating you.



Despite saying all that the reality is that the bf should have a look and if he's worried he should approach the doctors looking after you. As professional courtesy they will listen to him

pimmo2000

iTrader: (6)

Out of interest, if he looked and said it was fine and in a week you needed your foot removing because he missed the signs and you listened to him, how would you feel?

David Lock

Because that just wouldn't happen. I would expect a medic with 8 years experience to say if a small wound was showing signs of infection and a suggestion that I immediately start taking appropriate antibiotics or the wound look OK but I should get it checked in a day or so.


It really isn't rocket science to see if a wound is showing signs of infection and I could do it myself if I could get to the damn thing. The factors are colour, smell and possibly heat around the area. Plus anything else that looks suspicious. David

john banks

I have 19 years of experience, but reckon that call is not necessarily as simple as it sounds David. Some people with much less or no experience think it is, but they haven't seen how an apparently simple call can be very wrong.

I'd push you back to the team looking after you.

pimmo2000

iTrader: (6)

I'll leave the comment above to make my point

David Lock

OK John, I completely accept what you say. And I am going back to the team next week. I just thought it might be helpful if someone had a quick look in the meantime to see if it seemed to be behaving itself and pop a clean dressing on. I do know that these things can change quite quickly but do not claim in any way to be experienced! I can say that over a year I had a variety of District Nurses treating my original wound and there were 2 out of the 6 or more that visited me that really had a clue. As the origins of this are diabetes related I am also angry with my GP who refuses to let me have any blood/sugar self testing kit (finger ***** and test strips). Because I am old I am treated like an idiot and I don't like it


In a way my original thoughts remain. If I came to see you you would be prevented from examining me because I wasn't "your" patient. This seems ridiculous. I naively assume that someone with 19 years experience would have the skills to comment on the state of a small wound.


Don't worry though I am not planning to visit


David

dpb

don't think theyre too accurate the self testing kits

David Lock

No but they are better than nothing and after using them for a decade you get a pretty good idea of what your blood/sugar level is doing. And the testing is what every Consultant. Doctor and Diabetic Specialist has strongly advised for the last 15 years. This testing regime is also supported by Diabetes UK. The daily results give an indication only which should be confirmed by a blood test (HbA1c) every few months.


David

steve05wrx

Hi,
You can buy blood sugar monitors and test strips from any pharmacy - they don't need to be supplied on prescription.
If you really want one - go and get one.
Cheers
Steve

David Lock

I have ordered a new monitor from manufacturers and spoken to pharmacy about strips. Just annoyed that GP won't help !


David

john banks

If you came to see me when I had your records and was indemnified to do so, I would be happy to treat. If you asked me informally for an opinion outwith these circumstances, I would have to decline.

Both that, and the decision whether or not to supply blood glucose testing strips for people not at risk of hypoglycaemia are now not any longer at the discretion of individual practitioners.

If you have something that cannot wait until your review appointment, your usual route of access in most parts of the UK is to contact your GP, or if thought to merit it when they are closed, the out of hours service. Or perhaps there is a standing arrangement with the hospital department looking after you, or if unwell with risk of sepsis, A/E.

I hope your troubles are resolved soon.