Feeds:
Posts
Comments

So the report into Mid-Staffordshire NHS Trust is public, and it makes for grim reading for the public and a valediction for many coal-face, NHS workers. For anyone about to become an inpatient it must make them feel extremely nervous. When in hospital you are basically reliant on the care provided for you by the staff, so to read that patient deaths were caused by neglecting the basic standards and that patients were left unfed, unwashed and unmedicated, must be horrifying. At this point is it easy to dump all the blame on those who physically failed to provide care, in this case nurses, but hallelulah, the report then goes on to get to the crux of the matter by finding fault with the Trust Board and the Local Health Authority and then recognising that the Department of Health is ‘remote from the reality of the service at the front line’.
Here is the author of the report speaking at a press conference, he graphically enumerates the failings at Mid-Staffordshire, neglect that makes me shudder, failures in compassion and caring, a culture where patient care was obviously not the top priority. Some of this may well be down to a few front-line workers, to a culture within that institution that has been allowed to continue without investigation, and yes, there should have been investigation, many patients and their relatives had made complaints. Why would this situation been allowed to continue? Lack of leadership, I’m going to qualify that, lack of effective leadership but, being a clinical NHS worker, the words which leap out are ‘Insufficient staff to deliver effective patient care’, ‘a focus on reaching targets, achieving financial balance…. at a cost of delivering acceptable standards of care’.

For years I have been writing about staff shortages and paperwork but in The Safety of Services blog entry I highlighted the government and DoH as being culpable for many failings within the NHS. In fact, reading it now, 5 years after I wrote it as a response to a report from the King’s Fund, I am truly depressed to see how nothing has changed. Substitute NHS for Maternity Services and you have the skeleton of today’s report.

There is a tiny piece of self-satisfaction, knowing that I can sit at home, tapping away in my spare time and come up with an immature version of an official report but there is also huge sadness. It just goes to show that those who are a position to influence and drive positive change in the NHS never listen to front-line workers as what I write thousands voice.

 

 

A cutting comic

One of my favourite comedians is Dara O’Briain. I love his forthright take on issues and his ability to spin off on a fantasy tangent, so imagine my joy when I was watching recently and he began talking about antenatal classes, both NCT and NHS. My ears perked up in rediness for some insightful side-swipes at the presentations he had sat through. It started well, the tone of voice we (some of us) use and the way midwives voice their opinions about doctors being over involved (true). It was during this second observation that my ears pricked up and I started shouting at the TV, something that only usually happens during One Born Every Minute. Mr O’Briain began talking about how the facilitator of the class exhorted the attendees not to let ‘the doctor near them with a knife’, it may have been scissors, or it may have been to cut them, but basically ‘Don’t let a doctor do an episiotomy’. The person went on to say that it was better to tear rather than to be cut, and it was this aspect which Dara went on to disect, using the fact that his wife is a surgeon to support his jocular comments which were ridiculing this attitude.

Tears versus cuts. Research has shown that the use of episiotomy should be restricted, for various reasons, but the one I shall highlight here is healing. As the person presenting Mr and Mrs O’Briain’s classes said, ‘a tear generally heals better than a cut’, this is especially true with muscle. During a caesarean section the surgeons tear the muscle. Why do they perpetrate this violence? If you tear a muscle it generally separates in the direction of the fibres, the fibres can then knit together better following surgery. Move from the abdomen to the perineum and the same logic must apply, with an episiotomy you just cut in a straight line, with a tear it is more likely to follow the fibres, therefore the chances are that it will heal quicker and with less pain. My final thought on this is that an episiotomy ‘may produce a larger wound to heal than would have been produced without intervention‘.

Less pain, better healing and a smaller wound? I know which option I would choose.

Lazyitis

Nearly every night I think ‘I must blog’, and every night I get carried away with something else. Tonight I shall put fingers to keyboard though, after all  I started blogging to maintain an on-line diary, to recount my journey into Grandparenthood. I was amazed when I started receiving comments, I was amazed but I was also gratified. I used to blog freely about my family, but I drew my horns in when a reader took huge issue about a piece I had written and told me that she had discovered who I was and that she was going to notify my employers, and the NMC about my Blog. I was horrified. I was fairly sure that the NMC would not have complaint with me, after all I didn’t break confidentiality or bring the profession into disrepute  however, once my anonymity was compromised then confidentiality issues may have arisen. My employers, they may not have been too happy about my ‘musings’ as they sometimes referred to employment topics and local employment topics at that. I could have been in serious trouble. I closed down my blog for a couple of months, deleted the writing she found offensive and held my breath. Months later, when I had heard nothing, I started writing again. Momentum was suffered though and I had lost the ‘discipline’ of regular blogging. I am going to make a New Years resolution, blog at least once a week.

I’m still a midwife. Recently I received a ‘promotion’, really it is just an official recognition of a role I have been helping with for over a year, but it does give me a new job title. Over the last 18 months I have also assumed two other roles within the maternity services, one clinical and very few hours, the other non-clinical but together they take me up to full-time hours, and more. I am approaching retirement age but, due to my husbands pension having become negligible since G Brown did something, don’t know what but it made Hubby’s pension pot leak a huge amount, and my state pension age running away from me at breakneck speed, I can see that I shall have to put in the elbow grease for a few years yet. Midwives and childbirth have been much in the news over the past few months and, with Will and Kate announcing her pregnancy, I expect procreation will remain in the spotlight.

My family are all well. 16 of us now and all spending Christmas Day together. Hectic week ahead but culminating in a fabulous, chaotic, noisy but joyous celebration and, of course, Ruby’s first Christmas

Ruby Rose

Ruby Rose

Hello!

It’s been a long, long time since I last blogged. Many reasons for this including two new jobs, one new Grand-daughter and work being absolutely manic. The two new jobs are both midwifery related, but non-clinical and I’m still a community midwife, so my hours have now doubled! The latest addition to our family was born in May, quite the most traumatic of all the grand-children’s births, but at least the outcome was a live Mum and baby. Have to look on the positive side. The work that has been manic? Community. There have been more and more changes to how we are able to provide care and the end result has been that 4 midwives, out of a team of 8, have left. 1 handed in her notice one day and went off sick the next, and has stayed off sick for the entire 3 months of her notice period. They are all younger midwives with years left before retirement, 2 have left the profession entirely, unable to face the prospect of continuing and being unable to provide the quality of care they would like to. Drastic action, and really leaving the women and their colleagues in the lurch, but these midwives were not only disillusioned but also incredibly stressed.

The family are all well. The Grandchildren are all growing-up and are all such individuals, even the twins. I still look after the twin boys and their sister after school 2 days a week, but now it’s for only one day a week during the school holidays. Lots of juggling commitments and using annual leave is involved but really worth it to be part of their growing-up.

I’m off now. One more day at work and then 5 days off. I’m so looking forward to it. No getting up at ungodly hours; no dreading the phone ringing in the middle of the night; no piles of paperwork and no realising every morning that there are not enough working hours in a day to complete all the work.

Have you heard of this? Please, please sign it.

Recruit 5000 more NHS Midwives, an e petition to HM Government.

What with One Born Every Minute and Call the Midwife, midwives do appear to be very popular at the moment. Call it a busman’s holiday but I do watch both programmes. With OBEM I find myself shouting at the TV, ‘Get her off the bed’ being the popular refrain, but then occasionally there is a wonderful example of how well a woman’s body works and how supportive a midwife can be. Call the Midwife is just a lovely drama. Yes, there are many details which are not quite accurate but who cares when you are taken back to a much simpler time and midwives are depicted being ‘with woman’ rather than ‘with paperwork’. I have to admit to shedding the odd tear at the end of every episode but it did gladden the heart.

Me as a midwife? I’ve settled into my new role and have now reached a point where I can really enjoy it and as a result of this new found enthusiasm I have taken on another role until they have recruited a permanent body. It is only an extra 5 hours so, during term time, it’s not too problematic. Not sure how I will fare in school holidays but with a little juggling it should be okay. Community is as demanding as ever. Not the women, a pregnant woman or new Mum varies little. Okay, so they have far higher expectations than say 10 years ago, but most do acknowledge that it’s not the workforce’s fault that demand currently outstrips resources and so will take gripes higher up the ‘food chain’.

The family are all well, now. Louis had pneumonia, overlooked by the GP and, as she was also suffering with the flu bug, happy that Lou was not causing her any trouble and reassured by the GP’s assurances that it was a virus, by his Mother. Fortuitously I went round to administer TLC and take Lou off her hands and realised that her son was entirely non-rousable not just sleeping. Thankfully 2 days in hospital quickly saw him fit, well and full of beans. Son, who has an ileostomy, caught Norovirus from his youngest and ended up in hospital with severe dehydration. 5 litres of fluid later and he was well, although whilst monitoring him they found a ‘cardiac anomaly’, plus he has been told that the next part of his bowel surgery is urgent and he is dithering about having it done as their next baby is due in 10 weeks. The timing is rubbish, as it was when he had the initial operation, but hopefully he has learned from his previous procrastination, accepted that delay did no one any good in the long run, and will have a constructive discussion with the surgeon on Tuesday.

Note to self; make time to blog, it’s good for the psyche.  

For some unknown reason I had imagined that as the years passed I would find myself myself slowing down and having more ‘me’ time. I don’t know where I got that idea from but I was really way off the mark, my life now is full of commitments. When I increased my work hours I knew that my life was going to need to be strictly organised and that I would need to be religious in using a planner to ensure that all my duties slotted into place. What I hadn’t allowed for was Hubby doing his back in so badly that he couldn’t help out when the going got tough, in fact he became yet another commitment. Anyway, so what with juggling 2 jobs; 1 incapacitated husband; household tasks; gardening and 7 grandchildren I have found little time to blog.

Today, today has been declared an ‘I have no intention of doing anything that I don’t want to do’ day. Yes, I will be working on 2 databases but that is my choice, sort of, because if I don’t get on with them I will look a right idiot on Monday when I have to present the results of an audit. They are work but there is not enough time to do them during work hours and staying late at work would not help with the production of these beasties because, if you are seen then people feel they have to interupt you, plus it prompts them to dump more c**p at your door. Strange mentality in the NHS, perhaps everywhere, I don’t know. If I noticed someone having to work late, and over their hours, to complete a job then I would acknowledge that they had too much work. I may not be able to substantially reduce it, but I would definitely not go giving them more to do, where I work the opposite appears to be the case.

Work. The cut-backs continue, the unhappiness of the midwives and the women increases. We have just passed through a huge baby influx and it appears we should be back to normal levels until December when there is another little blip. May/June next year are bumper months which was unfortunate as the booking of these women co-incided with the bumper crop of newborns, making a double whammy for community midwives. I’ve had a couple of exciting call-outs requiring me to accompany women on blue-light transfers. In both cases the women were not in danger but the transfers were in the rush hour so 2’s and blues were used to reduce delay. One woman had rocked up at the wrong place in quite advanced labour and had received no antenatal care at all, was newly arrived from an African country and spoke no English. The other had turned up at a clinic, having taken her own discharge from hospital 2 days previously, and her blood pressure was through the roof. With the first lady I saw very little of the journey as halfway to the obstetric unit she started to make the sounds you associate with pushing so I was kneeling on the floor next to her trying to convince her with body language that she should breathe, breathe. I was also sliding up and down the ambulance as it braked for which I bore the bruises for quite some time, but which did make her laugh between contractions. As I was safely strapped in with the second transfer I had a wonderful view of the ‘Moses’ effect i.e two streams of traffic parting to allow the ambulance through. I also witnessed how stupid some drivers are, one even trying to outrun the ambulance, the paramedic told me that is not unusual. Unbelievable!

Work, job number 2. The job is thought provoking and challenging, however my dealings with HR and payroll have been even more thought-proking and challenging. After 3 months of being relaxed about not being paid, no contract etc. I lost my calm, laid back demenour and went for the throat. I have recollections of uttering such blasphemies as ‘grievance’, ‘union’ and then the ultimate ‘I’m stressed’. It does seem to have worked in that I received lots of back pay 2 weeks ago, I eagerly await the 24th of this month. Who is behind this bungle? A totally US manager, even more US than my other manager, in fact so US that my community manager is now beginning to take on the mantle of the most amazing manager, ever.

Home. Well Hubby had to be carried off the golf course after resurrecting his old back problem. He was in agony and was unable to feel anything down one leg, from his buttock to his little toe. G.P? Anti-inflammatories, this was a phone-call trige because there were no appointments and it wasn’t considered urgent. 4 appointments later, when I dutifully waited outside, and 7 weeks later, I marched into the consulting room with my drop-footed, unable to walk properly husband and waited until the G.P had told my husband it ‘would take time’, and ‘at your age’ (58) whilst staring intently at his computer screen, not even shifting his gaze when husband demonstrated the extent of his ‘dead’ leg, then I waded in. ‘What’s the diagnosis then?’ Still not looking away from the screen the doc responded with ‘Well, it’s possibly the same as he had before’. ‘Sure of that are you? Are you not concerned that previously the symptoms were not as severe but that he did require surgery?’ Oh yes, then I had his attention. A withering look was sent in my direction. ‘We could try physio, but it would possibly be a waste of time’. ‘It may well be a waste of time but now we are at the point where this is having a detremental effect on our lives. My husband has his own business and is unable to work. He can do nothing, not even pick up his grandchildren. So far you have done nothing, not even attempt a definitive diagnosis. I am thinking MRI to rule out a problem which, rather than resolve, could get worse.’ Over to the G.P, ‘Well the wait for an MRI is about 6 weeks and it may be better by then.’ I am surprised that he didn’t push the emergency button at that point because I erupted. A verbatum transcript is impossible, mainly because anger and indignation took over, but the essence was that if they hadn’t waited so ******long already he would now be having his MRI and physio and we would know what we were dealing with and, just because you are only just out of short trousers, don’t regard anyone who has grey hair as too old to spend money on. Now pension ages have been changed everyone else, except NICE and NHS choices, thinks we have at least 10 years of productivity ahead of us, so don’t dare write my husband off. Hubby now has his physio and MRI appointment.

The grandchildren are all well, and growing but of them are growing quite as quickly as grandchild number 8, who is currently nestled in DIL’s womb and scheduled to appear at the beginning of May. Yes, another one. See below for how the others have grown.

 

Well. My update is complete. My databases call. Firework night looms and Christmas lurks.

Recruit 5000 more NHS midwives in England

Responsible department: Department of Health

More babies were born in England in 2010 than in any year since 1972, whilst births to women aged 30 or older were at their highest since 1946. The NHS is desperately short of midwives, and the shortage affects every region of England. We need urgent action from the Government, including a target to recruit the equivalent of 5000 more full-time midwives. Care for women but especially babies at the very start of life should be shielded from the cuts.

This is an e petition to H M Government. I would have worded it differently, but there again I am a simple being who would just go to the heart of the problem. The whole world, literally, interprets the current staffing issue within the maternity services as being down to a shortage of  trained midwives but that isn’t the situation, there are plenty of us. The issue is the employment of midwives, and the crux of the matter is funding. The Trusts are having to budget so harshly that coal-face staff numbers are being trimmed to below the quick, and not just midwives, other professionals as well. We do need to recruit more midwives but to do this we need to improve the funding, be shielded from the cuts yes, but also improve the monies available to the maternity services, not for paper-shuffling exercises but to employ more midwives.

Anyway, here’s the link, it can’t do any harm so please sign  the e petition here.

 

Follow

Get every new post delivered to your Inbox.

Join 34 other followers