NURSES.

The quality of care offered by the NHS has been placed under a magnifying glass over the past few months. Constantly being in the news it led me to question, why? One of the most let's say 'obvious' answers is of course under staffing. This was most definitely found to be the case with the Mid-staff's scandal where the Francis report had stated that "A chronic shortage of staff, particularly nursing staff, was largely responsible for the substandard care,". A lack of nursing staff = more demands on existing nurses = more stress and pressure = more adverse affects on individual attitudes = bad quality of care. This is what was found from the stories stemming from the Liverpool Care Pathway - where patients were often denied food and water due to a number of staff not being correctly educated on the LCP.

It has been predicted that there will be a serious shortage of nurses and midwives by 2016 and this will lead to obvious problems with care offered by the NHS, something the NHS will undoubtedly have to face. One of the biggest reasons for the shortage is thought to be the loss of our UK nurses to other countries. For instance, the US offers a starting salary of around £40,000 compared to the (around) £21,000 offered by the UK, not forgetting the year of experience they are required to also have. This has led the NHS to bring nurses and midwives from abroad, leaving them with almost the same problem.

For me, I have seen first hand the role of a nurse from my voluntary work and my view has developed as I've learned more about their duties. The role of a nurse is so broad and diverse as they need to be able to administer medication, offer emotional support and guidance, educate the family and the patient on the illness as well as making sure all the needs of the patient are met. Nurses truly are the definition of 'front line staff'. Where doctors have the responsibility of seeing through the patient from the diagnosis to the treatment and making decisions on the treatment provided it is the nurses that gets to care for the patients on a more individual level.

It's disheartening to see what has happened to the profession over the years and the issue is of high importance to be addressed. Hopefully, when this happens we'll start to see an improvement on the quality of care offered. :)

READ this if you'd like to know more. Let me know what you think.
http://www.theguardian.com/healthcare-network/2013/aug/20/need-graduate-nurses-nhs

A&E Bailout?

A&E. The headline for the majority of the health news that has been circulating the BBC for quite some time now. Accident and Emergency departments are open 24/7, 7 days a week, 365 days a year, and specialise in just that - accidents and emergencies. However, as we've all been hearing for months now, this is simply just not the case and this is leading to A&E departments being almost on the bring of collapse.

Why are they struggling so much you ask? Well it all comes down to three main reasons:

1: Lack of out of hours services 
Back in 2004, Tony Blair's Government made a deal with GPs to reduce their working hours and allow them to no longer be on call for weekends and evenings all in exchange for £6000 of their salary. This has been described as the root to the cause of A&E disintegrating by Health Secretary Jeremy Hunt. He believes that the current GP contract is 'fundamentally flawed' as responsibility of out of hours services has been removed from the hands of GPs. Many GPs are outraged and annoyed at the constant blame they receive as many of them currently feel 'overworked' and feel that a lot of unnecessary pressure is being placed on them. They also agree that their is a flaw in NHS 111. This is a helpline you can call when your family doctor is not available and so advice is given to you on what you should do next. GPs believe that the system is flawed, as the resulting next step is often advice to visit A&E.

2: The Ageing population
People are living longer. A great statement yes? Well, it does come with its own problems. People are living longer but they as they grow older they are more vulnerable to disease, and more severe diseases at that. It is presently thought the the elderly with complex conditions are now the greatest challenge. Many of them are said to arrive by ambulance and often have to have an extended stay. Which poses another problem - space and beds. David Cameron is proposing that what we should do is concentrate on building the relationship between A&E departments, GP practices and social care departments so that the elderly may receive more help from their local communities.

3. Staff Shortages
With the increase in demands by patients it is clear that staff shortages are a definite problem in need of desperate attention. This is all results in critical cases being handed over to junior doctors who may not be competent enough to deal with the patients thus endangering their safety. This battle between increase in demand, and decrease in supply seems as a fundamental issue at the root of the cause.

The solution to fixing the problem that is A&E waiting services is proving hard to find. However, a 'bailout' as been announced for specific struggling A&E units. This is just a short term solution to a long time problem of course, and many are aware of this.

What are your views on this? Comment/e-mail me, I'd love to know.

Food for thought:
http://www.bbc.co.uk/news/health-23612539#?utm_source=twitterfeed&utm_medium=twitter
http://www.telegraph.co.uk/health/healthnews/10192661/Crisis-in-AandE-as-hospitals-grapple-with-staff-shortages.html
http://fullfact.org/articles/factsheet_crisis_accident_emergency_care-29078

The Liverpool Care Pathway, what's happening?

LCP.
I came to terms with this procedure not so along ago. I was on a shift at a local hospice where I volunteer at and during the handover with nurses I was told that a patient, let's call them 'X', was put on 'LCP'. Now, I'm going to admit that I had never heard of this 'LCP' before this time and I was instantly curious to find out what it actually entailed. So I asked. The reply was: 'LCP is for end of life care, when the patient is nearing the last few hours or days of their life'. The answer wasn't very detailed so I decided to look into it more myself.

Now, LCP was proposed by the Royal Liverpool Hospital and the Marie Curie hospice during the late 1990's. Let's get this straight, LCP is not a treatment but is merely a sort of process in which specific care is brought to the patients when their time of death approaches. The proposed idea was to enable the patient to have all their needs, be it spiritual, psychological and physical met by the senior doctor in charge of their care.

Problems started to arise when it became difficult to tell when a patient was nearing the end of their life. How could doctors tell? It was simply a guessing game.

I liked the idea of the LCP. I liked the idea of it being used as a 'framework' for good practice. I liked the idea that health care professionals would talk through plans with the patient and their families carefully and ensure that their needs would be met. I liked the idea that good communication between the health care team and the patient & their family would be a vital and key part of the proposed idea. Most of all, I liked the idea that the LCP was reserved as a last resort, a resort to which should be looked at when the entire team had reached a consensus that the patient was nearing death.

However (yes there is always an 'however') what I didn't like at all was the fact that these principles and guidelines set by the LCP were not being met. From the stories plastered all over the news lately I've grown to question weather the LCP is the way forward. They've been disturbing stories from patients families who have said that nurses would often deny the patient a drink and so patients would often go days without having their thirst quenched. This is simply inhumane and unlawful.

It's a shame that the LCP and their guidelines haven't been met by everyone as I think if it was applied properly it would be a very successful way to care for end of life.

From the concerns that have been raised by numerous different patients the health minister, Norman Lamb, has announced that the LCP will be phased out over the next 6-12 months. Instead, a individual and tailored end of life approach set by a senior doctor will be introduced, carried out and reviewed through its implementation.

It's a real shame that the previous guidelines were not met.

Let me know what you think. Comment, e-mail go for it.

Some more info for you below:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212706/100715_letter_to_trusts.pdf
 http://www.mariecurie.org.uk/Documents/HEALTHCARE-PROFESSIONALS/Innovation/Liverpool-Care-Pathway_FAQ-23-August-2012.pdf
http://www.bbc.co.uk/news/health-23315865
http://www.dailymail.co.uk/news/article-2364029/How-Liverpool-Care-Pathway-used-excuse-appalling-care.html
http://www.bbc.co.uk/news/health-23301360

''Martin''

The big 'S'.


SUICIDE. Or specifically in this case, assisted suicide.


Such a controversial topic, there are many opinions and many factors to consider. Now, I am only referring to assisted suicide in the case where a health professional aids a terminally ill patient in speeding up their death. Here in England this is of course illegal.


The big question on everyone's mind nowadays is not the arguments for or against assisted suicide, but it's the arguments for or against the law on this being interfered with due to special cases. One of the biggest 'grey' areas surrounding this matter is the ability of these patients and their families to travel to places such as Switzerland (where assisted suicide is legal) without being prosecuted.


Let's talk about ''Martin''. Now ''Martin'' is a man who suffers from the locked-in syndrome. This is a syndrome that strips a person from their ability to move their limbs so movement sometimes is limited to simple eye movement and/or limited speech. Essentially you are 'locked' in your body, and in the case of England you are forced to stay that way until death creeps up upon you naturally. A heart-breaking condition.


Now ''Martin'' is a man who would have liked to have the power to chose when to end his life and would have gone to any means to do so, even if it meant travelling abroad to Switzerland, Dignitas (assisted suicide centre). As I said before the law states that assisted side is illegal, however the question is how does it affect family members who somewhat aid these patients in travelling to such places? To sort this out ''Martin'' did in fact 'manage to persuade two of three appeal court judges that the law on assisted suicide needs further clarification'. The Supreme Court is now being looked at for final clarity surrounding this topic.


One of the most powerful statements I have heard on this topic is 'This is not about denying people the right to take their own lives, but about making legal the act of taking someone else's'.

This is a new way of looking at it and it's made me thing of the criteria of a murderer. Now in the eyes of the law euthanasia provided by a doctor e.g. active euthanasia (for instance deliberately injecting a patient with lethal drugs) is seen as manslaughter.

So my question to you is, is assisted suicide then manslaughter?

Is relieving your mother/father/daughter etc from endless pain and suffering by helping them in ending their life manslaughter?


Let me know what you all think. Comment below or e-mail me. Thanks for reading!

Food for thought:

http://www.bbc.co.uk/news/health-23520391

http://www.theguardian.com/society/2009/nov/18/assisted-suicide-dignitas-house

http://www.bbc.co.uk/news/health-22198464