On This Day....

... in 1990 the World Health Organisation passed a resolution to remove Homosexuality from it's list of mental illnesses.

The World Health Organization's ICD-9 (1977) listed homosexuality as a mental illness, and in 1990, a resolution was adopted to remove it in the ICD-10 (1993).

Wikipedia

The ICD-10 then carried the note-

Sexual orientation by itself is not to be regarded as a disorder.

OINK!

My 2 favourite things right now are:

1. Telling people I'm signed off
   and
2. Making fun of Swine Flu

Yea I know number 2 isn't very grown up but to be honest it is Scotland's biggest joke right now.
It's kinda coming to a big nothing. The two people who were the UK's first cases have sold their stories to the newspapers. And the government has produced the most patronising leaflet since the one about disaster preparedness.

The jokes are doing the rounds as well.... We have the one about breaking out in 'rashers'. Of course you can insert almost any 'oink'ment joke as appropriate. Oh and my current personal favourite has to be any poor sod with hay fever, a cold or an asthmatic/COPD/smokers' cough being let loose on a bus or train. Fastest way to get the annoying person sitting beside you to move.

Worst part is I could have saved them millions on the whole message thing. You know; wash your hands, use a tissue, bin the tissue............
We had a strangely similar message going about nearly 70 years ago.......

Confessions of a Nurse

Anyone in the UK catch the Dispatches documentary - Confessions of a Nurse?
Please tell me you did. Much of it is true, least from what I heard from around the web and throughout my course.
Disturbing.

Patient care

• 42 per cent of nurses and midwives interviewed say they have either been in or witnessed situations where patients have been put in unnecessary danger
• Over half (57 per cent) of the A&E nurses interviewed say they have witnessed situations where patents lives have been put in unnecessary danger
• Almost half (53 per cent) say they have seen colleagues perform medical tasks that they are not qualified to do
• 44 per cent of the nurses and midwives we polled say they don’t always stick to the rules
• Over a third (37 per cent) think that patient care in the NHS has become worse in the past five years

Impact of understaffing and long hours

• Half (51 per cent) of all the nurses and midwives interviewed say that they are exhausted most of the time
• 29 per cent say long hours and exhaustion prevent them from doing their jobs properly
• 83 per cent of the midwives surveyed say they have been in situations where they have had too many patients to look after properly
• 70 per cent say understaffing prevents them from doing their jobs properly
• One third (33 per cent) say they would leave nursing and midwifery if they could

Behaviour of nurses

• 43 per cent say they have seen other nurses shout at patients (13 per cent admit they have themselves shouted at patients)
• 44 per cent of nurses and midwives interviewed admit to calling in sick when not really ill
• 40 per cent admit to browsing the internet when they should be working
• 36 per cent admit to coming to work with a hangover and unable to concentrate on the job properly

We can't care properly for our patients if we are under staffed. There are no great revelations to be had there. Not for those in the NHS anyway.
Bet you the patients will be scared now.
Go watch it on 4od if you can....

Yesterday Was Far Better

Never had a day like it... Being told that I'll pass if I keep doing my job that way I am! SCORE!

I love my placement. Placement is now past the halfway point and it flies past. Course working only 3 days out of 7 does make it feel like that. I also feel rather lazy. The eagle eyed might have noticed that I've not done a whole lot of swimming recently. Yea I need to get out more on that front. It might have something to do with the minor factor that I got a monthly pass so the motivation has gone out of it. You know what I mean. All those gym memberships that run for a year but only see a single month of visits.

Anyway I have a range of news stories that have filtered past the news feeds in recent days.

The paramedic who was attacked by yobs throwing fireworks while the woman, who was suffering a heart attack, lay dying. What is the obsession with attacking the emergency services? I really don't get it.

There's an inquest currently happening into the deaths of 10 elderly patients at a single hospital. What got me was the recollection of one patient's son who was told that his mother was there to die. that not the kindest way of breaking something. Even worse he believed that she was there to rehab after a stroke. So why is a woman in rehab dying? Who really knows. However all 10 patients were under the care of the same doctor; who is now under suspicion for over prescribing sedation.

Lastly there was a study done on wither religion makes a difference on patients wanting resuscitation at the end of life. Can't really comment on this personally because I've not really seen it happen first hand. I know for a fact that families have a huge part to play in the resus status of patients. Maybe they should and maybe they shouldn't. Who really knows? A lot of the fight comes from the person themselves and their inner strength. So does that imply that those who are not as religious have less inner strength? Is this evidence to back up some of the claims that religious speakers make?

And in the culture section of today's news announcement I need to get my ass over to Edinburgh. A Turner exhibition starts next week! A selection of his Italian works and his paint box and pallet. Hows cool is that?

Right I'm off to enjoy what may be the best weather Scotland will see all year!

Struck Off for Being Religious?

OK we have a nurse who is religious. That's just fine the writer of this piece is a nurse who is gay. You can be what ever you want to be. I don't plan on getting struck of for my sexuality any time soon. That alone shouldn't be a problem, equality and diversity and all that.
Course it's not that simple. She has offered to pray for her patient (The Beeb's report cos it might be more impartial). The patient questioned her actions (which she has a right to do) and of course it has been taken further.
I'm in 2 minds over this because on one hand we have a caring nurse and spirituality is part of the activities of living. On the other we have a clear breach of the Code of conduct.
They've got her over a barrel, so to speak, on 2 points.
"You must demonstrate a personal and professional commitment to equality and diversity" - We care for so many different people that really you shouldn't even make assumptions about them.
"You must not use your professional status to promote causes that are not related to health" - Now here she was promoting something unrelated to health.
That's 2 strikes.... and for anyone trying to string up the sister that had to escalate the situation -
"You must listen to the people in your care and respond to their concerns and preferences"

The Code is what we live our lives by. You break it, you pay the consequences. I understand why the PCT have had to take action. Maybe I realise better than some how pushing my beliefs on anyone else could hurt.

Oddly enough I love the anonymity of the professional façade. I love that I can put away the bits of my life that aren't necessary for me to do my job. But that's the part so many people have a problem with.

EDIT: Updated 08/02/2009.
The PCT have lifted the suspension and allowed her back to work. I don't think this will be the end of it and we'll see the out come from the MNC hearing in the months to come.

Stand Back I Saw This on Casualty!

Imagine the scene....
You're walking through the local shopping centre when a middle aged man in true theatrical fashion clutches at his chest and falls to the ground. His skin is pale and clammy. His lips are turning blue. All fingers are pointing to something delightful involving his heart. His wife is screaming and bystanders are throwing their 2 cents into the ring when someone comes forward...

At this point I'd be thinking thank goodness someone in that crowd as done CPR at some point. Er no... this helpful person is going to be helping this poor ill man on the basis of knowledge acquired from medical dramas.
Sorry I've done more CPR courses than I care to count and I would still be hesitant (slightly) in rushing in to help. But apparently 1 in 5 would have a go even if they are not trained. 77% aren't.
"First aid is easy if you know what to do" Well thanks St Johns Ambulance. They think you should at least try even if you haven't a scooby. Now if this was another country I could mention that bystander could get sued for not knowing what they're doing. Heck it's happening here too. It's a false confidence that could actually put someone's life at greater risk.

"Stand back I was this on Holby City / Casualty / ER / M*A*S*H / House / Crossing Jordan / Gray's Anatomy / other medical drama!" Ain't really gonna cut the mustard. Keep your precordial thumps to yourself. Assuming you know what that is...

WTF?

OK well we have a 3 year old with a smoking habit and his mother dragged up in front of court. The kid was filmed by his mother's friend because she was worried about him. Apparently the film clip shows him lighting a butt with a lighter and inhaling. Now come on if that was a kid showing off by coping then her would have been coughing, or better still wouldn't have gotten a lighter to work. I know I was 5 when my dad taught me about matches and lighters. He's a smoker and if lighters and matches were going to litter the house then I better be able to do it without setting fire to the place.
That kid had skill that no other 3 year old would (or should) have. The kid had done it before. Ergo the kid had a habit.

Then we have a nurse who was struck off the register for killing her husband with an axe. Actually the WTF stems from the fact that she is now wanting to be put back on the register. I understand the background of domestic abuse and that he had done something like fathering a child with his niece or her niece or something. But really would you want a nurse who has a past conviction like that? We are never supposed to judge our patients but I know for a fact that they would judge us and her name is all over the BBC website's stories. I assume that the NMC will stand by their decision. It's all up to the high courts to make a decision. The NMC's on shaky enough ground with the public and it members without dragging this through the press too.

Ranting and Idiots

Honestly how much intelligence does it take to become a member of parliament these days? Graham Stringer, MP for Blackley in Manchester, (Labour party by the way) has called dyslexia 'fiction'. Made up to cover for poor teaching methods and costing the taxpayer thousands.

Well thanks for that! In his column on Manchester Confidential he extols the virtues of synthetic phonics and assumes that better teaching will cure all illiteracy, like it did in the East Dumbartonshire example. Yes we shouldn't have the same high levels of illiteracy that we do and that maybe more flexible teaching practices would help. It might have helped me or, you know, maybe not.

I don’t know about anybody else but I want my doctors, and for that matter, engineers, teachers, dentists and police officers to be able to read and write.

Hey Graham, look, I'm dyslexic and (your worst fear it seems) nearly a qualified nurse. I can read and write but there's far more to it than my garbage spelling. OK here's the thing to get a degree or diploma or pass the entrance exams you kind of have to be able to read and write. In fact it's kind of hard to get into college or uni without being able to do that.

He went ape about the med student that took the BMA to task about not 'written' exams but multiple choice. See he couldn't even get that right. She likes written exams and essays. I hate them. Easy mistake to make. I even moaned about that then. This isn't even a very original rant for this blog.

The British Dyslexia Association puts it far better than I can...

Mr Stringer needs to realise that dyslexia is not just about reading. Although, being able to read is often problematical for those with dyslexia it also sits alongside a range of other processing skills including organisation, sequencing, retrieval of information, short-term memory, spelling, writing and numbers.

See! See! He also states that dyslexia doesn't seem to appear in the likes of South Korea or Nicaragua. It probably is there of course they don't have one of the most difficult languages to learn and speak as their first language. English is difficult. Look at how many words sound the same but a pronounced differently or vice versa. I would like to see him live one day with my brain.

The problem is of course that I can say all this but my brain has never been 'normal'. It's not like a stroke or heart attack where there is a tangible difference between 'before' and 'after'. I've always been this way. Sometimes I can spot the difference between me and other people, it's awkward especially when they notice the difference. This is why I'm so good these days at compensating. And they wonder why I've learned not to care about doing over time when I've not finished something I said I was going to do.

I'm going to have to take a coffee break..... I'm still mad at this eejit.

Norovirus

Lets make this really simple huh? If you have had vomiting and diarrhoea, and if it stopped less than 48 hours ago, then don't come NEAR your local hospital! Got that?
According to the BBC 3 million people came down with the bug. There are currently 13 trusts in England alone that are reporting outbreaks! Although I think it's more than that now and that isn't including Scotland and Wales.
So for the sake of the immunocompromised, the very old, the very young, and the staff DO NOT bring it in with you when you come visit! Got that? Good.

And while we are on the subject of D&V... Enough of X-Factor Christmas hits already! I don't watch these shows, if only because I really don't have the time, but why must we suffer this crap year after year? Has Britain got no taste in music? Apparently not.

Sometimes You Just Get Days Like That

Today was hell.... An interesting hell but hell none the less.
So many discharges = lots of admits to fill the empty beds.
Patient going 'off' in medical, who needed surgery, and no they don't talk to each other.
Cannula going weird at the sight of a bag of FFP.
So yea..... Having a busy day.
Still got the headache that started the minute I walked through the door. Apparently I'm not the only one having an off day, Chinese Girl Gets Kiss of Deaf. Wow kissing causing deafness.... bring on the hearing aid.


On an up side tomorrow is Day Without a Gay. I would call in to placement gay but I think Sister would have a small problem with that. Not the gay bit just the calling in for a day off bit. My windows vista sidebar magic 8 ball says 'go for it' but I think I'll be getting up in 4 hours anyway.

Other and Better Things

Well the Large Hadron Collider came online without a hitch. Protons are running around in circles in France / Switzerland. It's also producing pictures...

Tonight was the first time I had to explain to 7 year olds why today is important and why it should be remembered. It's hard to get a 7 year old to understand why these people that they have never met, in a place they have never been to, about an event they will only see in pictures but it's possible. I do it every year for Remembrance Sunday and somehow it's actually more difficult to get them to understand something I never saw or will truly understand myself.

Actually I could use some advice. Anyone worked with a kid who is nervy and unable to be around large groups of other children? What do you do with them? How would you help include them? She wants to be there, it's just that she can't handle it.

THE END OF THE WORLD IS COMING!!!!

Actually it's not but that got your attention right?

CERN's Large Hadron Collider (LHC) is to be fired up this morning.... some time.... All they will be doing is sending tiny protons round in a circle to make sure it works. We're not even at the 'sending 2 beams in opposite directions so they will smash into each other' stage yet.

Some people are freaked out by the thought of this unknown 'will it create a giant black hole that will swallow the Earth'. It's not going to create a giant black hole. Besides if it grew instantly and swallowed the Earth would we actually notice? Well no, not even twitter works that fast.

And if the world does end this morning... I'll be stuck in a lecture..... What a rubbish way to go!

Warning: Studies May Harm Health

I like medical studies. I kind of have to since these are what powers my day to day tasks. They show me why things have to be done a certain way or how to avoid infection or make patients feel better. This so far will no harm your health but 'buyer beware' the docs have been at it again.

Lets start with a famous example. Once upon a time there was a combination vaccine for Measles, Mumps and Rubella, they smartly called it the MMR. Then after a study was done the press went a little bit nutty, blew it all out of proportion and linked this jab to Autism. Which has meant that equally nutty parents are not vaccinating their children. Sorry it's at this point I would like to quote House MD...

Young Mother: Her whole face just got swollenlike this overnight.
House: Mmhmm. No fever, glands normal, missing her vaccination dates.
Young Mother: We’re not vaccinating.
[Baby giggles and coos]
Young Mother: [Takes a toy frog and starts to make frog sounds] Gribbit, gribbit, gribbit. [Giggles]
[Baby smiles and giggles too]
House: Think they don’t work?
Young Mother: I think some multinational pharmaceutical company wants me to think they work. Pad their bottom line.
House: Mmmm. May I? [He takes the frog and starts to do the gribbit noise with the baby]
Young Mother: [Whispered] Sure.
House: Gribbit, gribbit, gribbit. [The baby laughs] All natural no dies. That’s a good business: all-natural children’s toys. Those toy companies, they don’t arbitrarily mark up their frogs. They don’t lie about how much they spend in research and development. The worst a toy company can be accused of is making a really boring frog.
[Young Mother laughs and so does House. The baby giggles again]
House: Gribbit, gribbit, gribbit. You know another really good business? Teeny tiny baby coffins. You can get them in frog green or fire engine red. Really. The antibodies in yummy mummy only protect the kid for 6 months, which is why these companies think they can gouge you. They think that you’ll spend whatever they ask to keep your kid alive. Want to change things? Prove them wrong. A few hundred parents like you decide they’d rather let their kid die then cough up 40 bucks for a vaccination, believe me, prices will drop REALLY fast. Gribbit, gribbit, gribbit, gribbit, gribbit.
Young Mother: Tell me what she has.
House: A cold.

I would love to have put up the clip of that exchange (it's much better on film) but no one on You Tube has done it as far as I can see. I recommend you watch Season 1: Episode 2: Paternity. But I do concur with his assessment of people who refuse vaccinations.

So to the point I came across this baffling piece of research, Ear Infections 'Link' to Obesity. So is this the magical link that will cure childhood / adulthood obesity simply by stopping ear infections. Er... no I think not. This is starting to sound rather like the simplified outcome of the MMR study - "12 children with autism who also had the MMR jab... oh look MMR caused their autism". So because I had several ear infections when I was a child that's the reason I'm fat? Least I'm not blaming it on my genes.

Well it's less likely than Clumsy Young Face Obesity Risk. Actually I can see the reasoning behind this. Think about it less coordinated children are less likely to enjoy school sports. Therefore more likely to avoid them in the future, increasing their chances of becoming overweight through lack of exercise. Brilliant huh? Wish I had written that could have made some money selling the results. I knew that sport wasn't for me when I was hit in the face by a basketball and everyone laughed. Didn't see it coming. Actually I'm quite a strong swimmer but when it comes to catching and throwing my skills stopped when the basketball hit my face.

You can't possibly follow every study done. I mean for everyone I've read that says X causes cancer there's another 4 saying A,B,C, and D all cause cancer too. You'd never leave the house, eat anything or touch a cleaning product. Least then I'd have more time to catch up with all the TV I watch. Unless there's a study that says TV causes some sort of debilitating illness... oh wait it does - Couch Potato-ism.

MCQ

I'm dyslexic and I prefer multiple choice to essays. This med student doesn't and is campaigning against the world's use of MCQ (Multiple Choice Questions). It got me so annoyed that I had to comment on it (so you might see some of this here and there too). I hate essays. When I was still in primary school I used to say 'Why write a page and get 10 mistakes when I can write half and get 5'. See even then I knew my limitations. This means I struggle to get to a word count. I can count on one had how many times I've gone over the word count without a struggle of some kind (twice by the way). If there had to be a choice then I would pick MCQ. Many of my 'normal' (I use that to mean their brains are not affected) friends hate MCQ tests though and would prefer essays. This is always where I thought the difference was.

Multiple choice happens in every day life in medicine. You disregard the things it cannot be to leave what it is. Also no one dyslexic can speak for all, everyone's dyslexia affects people differently. I've met people that struggle all day every day and have left school with a diagnosis of dyslexia and no qualifications. While I can function quite well in the course and work. Dyslexia is more than just reading and writing, it's about how the brain functions and it will never be a level playing field when it comes to exams. No matter the concessions.

Happy 60th?

The NHS turns 60 today. It's a bitter-sweet birthday with the public drawn between it being old and out of date or still necessary today.
Is it really needing to be put out to pasture? Is the NHS now just a joke?

I don't think it's dead already. Of course it is in no way what it used to be, but then nether is medicine.
When the NHS was started, no-one had considered the heart transplants or intensive care units. Massive hospitals offering neuro surgery in one building and plastic surgery and burns rehab in another.
In the same breath they couldn't have imagined wards full of patients suffering from infections they caught only because they happened in be in hospital with a weakened immune system.

Should we condemn the NHS to die by one of its own creations? No. For where would it leave us? With another bigger problem to solve.

Fly Solo Little Bird

OK.... usually I get called the 'wean' but hey I did fly solo because we ran out of bodies. Woot! I rock.
The results from the exams are out on Friday of next week.

And finally... The world's first pregnant man, Thomas Beatie, gave birth to a little girl. I'm happy for them. I keep quiet on this story because I nearly outed myself when I stepped into an argument about this. So facts? He is a man who was born a woman. Kept his reproductive organs in case he ever wanted to have a child and he did. Good for him and his wife. Now the world needs to back off.

Crazy Town Dead Ahead

"I need to get away I little early today."
"Why?"
"I... uh... have to pick up some medicine."
"For yourself?"
"No,... er.... my fish."
Thank goodness my clinic wrapped up early and then I got the one I took over cleaned up fast!
Yea, one of the fish has a fungus. Black moors are notorious for being susceptible to illness. Oddly enough I get laughed at for my 'children' as they have been referred too. A sickly Black Moor (Keppamaki), a Goldfish with half a tail lost in an accident (Nemo), a 'white' Goldfish that has lost it's colour (Truffle) and a one-eyed Comet who was born (er hatched would be more exact) that way (Blinky). I have a sick sense of humour with the names; sushi, a Disney character with a damaged fin, Truffle was brown when I got him and fish don't have eyelids.

Meanwhile in the 'real' world....


This was found to be offensive. What's the worst bit? That some parents (if they caught it when it was on, like only once and no where near kids tv because of the very high fat content) might have to explain to a child why one man may kiss another man? Have we not already realised that children get advertising far more than an adult does. That's why such products cannot be shown during children's programming any more. Stonewall is asking for an ethical campaign. For a boycott of Heinz products... So anyone need a kilo of ketchup? I bought it a week ago.

'Normal' Service

After a nice restful weekend, I'm returning to my ranting. There was a study done of lesbian and bisexual women and their perception of healthcare. (oh and yea it's gonna be one of those posts)

Thing is we've already discovered that the NHS is sometimes homophobic. Towards staff and patients.
Come on, you might not notice it but when you assume that someone is being stupid when they answer that they have sex but don't use contraception, it could be discrimination. I answer questions that way and so do most of the LGBT community.

People, that sucks! Why do we not consider the alternatives? I remember multiple lectures on respecting other cultures and religions. The importance of spirituality.

What about the importance of your partner being ignored when you are ill? Them being locked out of knowing how you are doing? Of being too scared to tell your doctor in case you end up getting second rate treatment?

Remember how I call this one of 'those posts'? Heck that was me making assumptions about what people want to read about. Giving them a chance to tune out before they read anything that would offend them.

What I did like was the recommendations...
1. Understand lesbian health needs:
Yea, I think we could do with some training on that. Even I can't tell you some of the answers, aside from that ALL women need smears.
2. Train staff:
To stop saying things that would offend...
3. Don't make assumptions:
I revert to the point I made earlier.
4. Explicit policies:
So we don't discriminate but they are useless if NO one acts on them.
5. Tell lesbians what they need to know:
Some proper health promotion in this area would be a good start.
6. Improve monitoring:

One in ten lesbian and bisexual women stated that when they did come out to a healthcare worker they were either ignored, or the healthcare worker continued to assume they were heterosexual.

Continued to assume? Now that scares me. By all means be offended, I'm used to it, but please I've told you already, I ain't for turning.
7. Increase visibility:
If the NHS wasn't so homophobic towards staff then maybe you'd find out who I am but I'll be the one not making assumptions.
8. Make confidentiality policies clear:
See 4!
9. Make complaints procedures clear:
And again see 4! One proper definitive policy that covers all the bases.
10. Develop tailored services:
Right the NHS is slightly skint so this could be hard to change but the other 9 would make a good start till the money thing is figured out.

Full study here!

*sniff*

I smell.
Well yes a day working will do that to you, but I smell of hospital. You know? Those big buildings full of sick people? Well they are rather successful at creating a stink and mine doesn't even have an incinerator.
I remember turning up for night shift and nearly throwing up at the stench dinner was giving off. Must have been cabbage or sprouts. Anyway it was rank.
My hands smell of the soap and alcohol gels. My uniform of coffee and old paper from the loads of medical records I've been carting about for the consultants, oh and hospec and sheets too.
Worse yet I've been given my own clinic to organise and run tomorrow. God love the patients.
News stories today....
An example of why I want to go into spinal injuries.
and
A comment from the Guardian by the editor of DIVA magazine. About how sexuality is anything but simple.

Off My Game

These exams have me off my game at the moment. For a start I read this yesterday.
The Pink News reported on a study apparently showing that the brains of homosexuals are different to heterosexuals. Excuse me? What? Is this another part of the search for the elusive gay gene? Anyone else think that someone will use this to create a useless test for babies? Find out if your child will be gay? How many would buy into that... Say it with me now, EUGENICS!
Still now the BBC is on to it.

"As far as I'm concerned there is no argument any more - if you are gay, you are born gay,"

2 more words - nae shit. I could I have saved them the radiation.

Moment of the Day - maintenance guy is pulling a toilet out of the cupboard. An honest to god toilet, what it was doing in there I still don't know.

"You know we have catheters so you don't have the carry that around with you."

I think I need a humour injection.