NHS: Get real!

I am REALLY annoyed. I really am pissed off and really need to let off steam. I am fed up with the sheer fuckwittery which seems to be the ruling factor in the society which we live in. Petty crimes get 50 odd years it seams while murder gets you a few hours community service. I am fed up with the brainless nerks which populate this world. Ok so nobody reads this blog but it keeps me sane. I am fed up with the way in which I am forced onto a diploma course as I cannot afford a degree pathway and then cannot afford the diploma pathways and then the bank plays wanker with me and refuses to actually give me a loan and this means I am now buggered finically and some smug cunt has all the control and yet I must be bloody perfect all the fucking time. I will seriously murder the next twat who winds me up as I am really annoyed at the whole great fucked up perverted set of pseudo morals which Twat Blair and Patsy fuckwit and the bunch of brain dead retards which the dithering simpletons AKA the government the general public let into power (AGAIN: I HOPE YOU DIE SCREAMING YOU FUCKING BUNCH OF CUNTS!!!!) let in as the government. I would not trust those idiots to look after a plant, never mind the country, and I am boiling over with rage and I really don’t care anymore. I really doubt I will even bother getting and RGN status never mind a bloody interview as lets be honest, a 22 years old heterosexual male with a girlfriend is not likely to get the job as some 27 year old female who has a BSc but not enough knowledge to lace my bloody shoes will get the post while I am left skint. Oh sure, they may have a degree but remember here they do no more work then me in terms of their writing, they do it simply together in one assignment. I really am fed up. I am so sick of the way I go around saving lives ( NB: YES I FUCKING WAS THE ONE DOING CPR ON THE ARREST CASES WHEN THEY STARTED BREATHING/HAVING A RETURN TO A CARDIAC OUTPUT) yet I am viewed below the morons without the first clue of how to treat people, or the mouthy twats who have not clue save how to yell every bugger else down. I learned more reading the sodding green book then three years university study. I really feel I have never had that one defining moment that sets me appart that I can hold up and say "that was my moment".

Yet again I am left pissed off in the extremes. You work your bollocks off and some twat who cant do the fucking job as good as me ends up in a better position because of money and having not had a second year death. In the immortal words of daffy duck, I demand that you shoot me now!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

One passport to heaven please!

It was once in something I read (not cited because i'm lazy) about a Nurse who dies [after all, we are not immortal-Ed] and there wasa short piece of writing about the said nurse going to heaven and being asked what she did. On replying that she had worked for the NHS, St. Peter's reply is: "Come on in then, you've had you share of hell".

Student Nurse is deeply worried that he will be left unemployed at the end of all this. I would really like to qualify and work in the critical care area, and work on the arrest team and become up to the level of Charge Nurse following many courses. One thing that seems so unfair is the way that people cannot often reach their true calling, or have a job which they like. As a rule I dont watch medical TV shows (I cite the time my former girlfriend got mad at me for lauching objects toward the TV when she was watching Casualty. The last time I checked, using ambulance trolleys as battering rams to open the A&E doors with a suspected C-Spine fracture is not recommended protocol, neither is opening said doors while wearing sterile gloves. One I do watch however, is the US show Scrubs. I have to find it amusing as there is one character in it (Dr Doug Murphy-Johnny Kastl) who is portrayed as a nervous, incompetant doctor. In an episode titled "My malpractical decision" (S4 ep13), While a malpractice attourney visits the hospital, the chief of medicine orders Murphy to the morge, where he, along with the second main character look at a few corpses.
Elliot: Doug, I'm sorry, but...I don't think you're cut out for being a doctor.
Doug: Wow....
Pathologist: I cannot figure out how this guy died.
Doug: I'm betting he took a paracentesis needle to the aorta.
Pathologist: Have you seen this before?
Doug: Seen it? Upstairs they call that a "Doug"!
Elliot: You got any others you can't figure out?
They stand over a body...
Doug: Doctor prescribed overdosage of Fentanyl.
And another body...
Doug: Dissected left main during a cardiac catheterization.
Doug feels around inside another body...
Doug: We look under Mr. Pancreas and...there it is.
He pulls out a lost rubber glove.
Elliot: Huh!
Pathologist: He's the best I've ever seen. Mind if we steal him from you?
Elliot: I can live with it.
Doug: Well, my work here is done.
He strips off his gloves and drops them into the open cavity.

Now yes, I know, this is only a TV show, but really makes you think though that a) NEVER NEVER NEVER be as bad as him, and b) How come if he could become a great pathologist, I think I am unlikey to get any nursing job.

(Scrubs script came from here)

Going away

Wayhayy!!!
Study up, study hard, and take two days away...ahh yes, sun, sea and...OK, Yorkshire to be precises. I'm a student though, give me a break!

Answer to a question

Ever get the feeling this is the type of thing we will see happen with the NHS?

...and so it goes on, day after day, year in, year out, slime in this ear, slime in that ear, don't you ever yearn for change?

The news that despite the Royal College of Nursing (RCN) at the beginning of conference having its figures of Nursing post reductions scoffed by the government, the fact is there is a large problem with the nursing staffing and the effect on patients.

There are problems with all jobs, and certainly even the private sector has its problems. However, if the checkout operator accidentally charges me 15p more for a broccoli, there is no real disaster, however, if I were to give a patient 15ml too much of a drug, there could be a patients life at stake.

Many point and bemoan the posts being cut. I am fortunate that I can still (sort of) have the time free to study for a different job when I qualify. I quite fancy the Ambulance service, but need a different driving exam to get appropriate licence. I could take access to Medicine and study that...but then you read of the MMC fiasco and think again. I could do law...but I have a conscience. I did have the finance to examine while working in business management...but frankly did not like it. I could join the armed forces, but thanks to my medical conditions would be excused on medical grounds. Which is the issue here. I chose Nursing as I am very knowledgeable and competent with health and anatomy and physiology, and actually WANT to get of my backside and do some work (Yes, I know I may seem to those who meet me to seem cynical but you also know just how good I was with patients and there was that time it was recorded I was more knowledgeable then what was expected of me at the time- and that's not blowing my own trumpet, that people, was recorded officially on a dialogue sheet from the university!).

We have seen this before with the NHS. Job cuts, staffing shortage, wards close, beds short, over and over again. I am tired of reading of ministers burying their head in the sand and using political unspeak to worm out from giving a straight answer. Is it just me who years for change from this cycle of disaster?

Stranded in suburbia gives a glimpse of utopia

Having spent the past few days with my better half, I realised that a few days away from the daily slog can really do wonders for the soul, and make you feel a little less angry with the world. Easter was quite nice, I feel very happy with the world in general this evening.

But why? Well, I am ahead with most of my work, the reading list I have is being worked through, a few more photo's of old ambulances from Scotland have been emailed to me so that's another article written up, and even my old historic vehicle while still refusing to start now no longer seems to phase me.

Over at the Dr Rant blog, even the ever present threat of the MMC fiasco and the deeper troubles of the NHS seems almost again to be quelled in the blogs standing as the bastion against some of the more anarchic medical opinion.

Amazing. From screeching through the streets in ambulances, to pacing the floor of the hospital, against all this, Student Nurse feels all charged up and ready to return to the grind. Maybe the romantic [.sic] walks through leafy suburban bliss at sunset with my girlfriend has made me happy, perhaps realising just how much I know from all the years of study finally starting to pay off has provided a valuable ego boost. Or the overall reason? All the above, plus not having to return for two more weeks and a weekend away next Friday to boot.
Ahhh, happiness for a few hours. That's a rarity!

Doubt: In the battle between you and the world, bet on the world

In some ways, the above photo sums up my current feelings of my progress through nursing.

So, lets recap. I'm overdrawn, have two broken down vehicles (ones my car, another a historic vehicle), a long list of essays currently being worked on, two presentations to do, reading/literature searching for the aformentioned assignments, trying to find time with my girlfriend, saving for a weekend away in 2 weeks time, and always having bad news with the NHS been seen on a weekly basis which will afftect my chances of gaining employment.

Good Friday? Whats good about it?

Insomnia makes Student Nurse think: "Why, a culture of cynicisim may not be a bad thing now you mention it!"

I have no problems with the NHS as an idea, nor of its aims. It was responsible for the 23 operations I had on my hands, feet and mouth. That was the reason I wanted to be either a Doctor, a Nurse or a Paramedic. But what bothers me is the way that in the past few years the focus of the NHS has shifted from providing care which is intended for the benefit of patients, but for the finance of the NHS. The trust deficits have run into millions. One wonders where all this money has gone. If a trust has over-spent by £20 million providing patient care then this is fully justified. However, the biggest bug student nurse has on the issue is why the shortfall was not a) noticed sooner or b) Planned for in budgeting. Did the trust leave at 5pm one Friday all ship shape and on return at 9am the following Monday suddenly think "Crikey, £30 million in the red!". When the idea of foundation hospitals was initiated, I personally considered the financial penalties for low performing trusts rather odd. Should it not be that those who are struggling be given the extra funding to put toward investment in services to improve the outcome and service for patients while the better performing trusts be given an increase in line with inflation to maintain the standards which they operate at, but be given reward by placing of regional units and first choice of a new facility to be developed (with the attendant increase in finance to meet such investment and expansion). By having the questioning of any changes which have changes which hide ulterior motives, clinicians are best place to have a say on these changes and to ensure that the safety and the service which we offer are for the greater good for both the trust and the patients.

But when this system begins to fail, there is a huge impact. I remember back when I was more involved as an ambulance attendant the old agency agreement which was held with the former county ambulance service. My regular mate was once activated as an emergency team and the ambulance pressed into service for the NHS. On arriving in A&E, he overheard a county Paramedic mention about "Cheap work while we are on overtime ban". It was very clear, the agency agreement intended for when county was swamped was being used as cover for industrial action. It was swiftly terminated. The forth-coming weeks was busy and the service swamped, and it resulted in a death of a patient. I have never forgotten that event.
Now though, this has grown to record levels. I am a third year and should be ecstatic over the prospect of finishing university, planning for a lifelong career, looking forward to my graduation day when my family can see me gain my "cap and gown", and take another step down life’s great road and plan for what the future holds for me and my girlfriend (also a student nurse, on the child pathway). Instead however, I fear that I will be left with no job and fail to gain employment as a Nurse, have studied for 3 years for nothing but my certificate to show or face having to leave my area to find a job and leave all which I hold very dear: Family, friends, my dear girlfriend, have the headache of finding a home for my historic vehicle, change the address for correspondence for an organisation which I am a committee officer/Editor for, and have to pay for accommodation for the initial weeks (with what money though as I am heavy on the overdraft as it is). I understand that some trusts have to find ways of balancing the books but this really is not a healthy culture to have with staff. I am doubtful that I will gain employment which I am passionate about. In all placements had a great rapport with staff and patients, shown a high level of knowledge of both medical and nursing knowledge/theory, passed essays and have done well with that. I admit, I referred on a research essay, this was when I was going through a rough time and knew I would not pass the essay becuase of the situation, but that is an exception (I got nearly 70% for assessment at the end of year one, and despite the horrendous second year got slightly lower at a range of 50%-60% for essays). I am now pulling out all the proverbial stops to increase on second year and build on the sucess which came at the end and re-build my confidence, but this is the one dark cloud on the horizon: Job freezes.

Unless all health and medical professions work together, there is ever chance that students who have the potential to be good novice nurses, junior doctors, physiotherapists, Occupational therapists or Radiographers in the upcomming 18 months will be left unemployed. Unless the full reason for change is ever explained (and I mean without political unspeak), I cant help but think that thinking cynically may lead to the true reasoning behind changes.

Quiet day, busy working

Not much to write for today, have been looking over the essay for submission in June and am hoping to get the essays and presentations worked toward as much as possible before Student Nurse and his girlfriend take a weekend break at the end of our time off. Anyone with Clinical decision frameworks please make yourself known, have been on the DoH website and trawling journals so have had my own reading list.

short term loss, long term error

With Student Nurse reading more tales of students being left without a Nursing job on qualifying, he began to think about the future which he has to consider. There are a number of factors which are causing such problems, and you can read plenty of that subject in the media. But Student Nurse began thinking of the future when considering compounded errors. Much how a mistake at the beginning of a long equation will have disastrous consequences on the final figure arrived at, he wonders of the ramifications which today’s losses to the nursing workforce will have. At the moment, a quick scan over the classified in Nursing Standard shows positions vacant for the senior positions for senior Staff Nurses, Sisters/Charge Nurse. This is very nice for the lucky people who can go for such a position. Then the Band 5, D grade jobs...3 possible positions for a Registered General Nurse (RGN).

This is not intended to be a rant on the current status for newly qualified nurses, but a consideration for the future. Consider for a moment the Nursing echelons like a long pipe and the staff water flowing through it. Newly qualified staff come directly from the tap, and the senior posts are the end. As you progress through the ranks, the further you travel along the pipe. However, imagine there was a kink in that pipe. New water cannot flow in as high a quantity as it could. For a while, this only affects a small area, but as the effect of the lack of water kicks in, the greater the systemic loss can be felt. Eventually this will be transmitted to the end, and the flow stopped. If this happens to the extent that there are excessive shortness of newly qualified RGN's, when considering the facts that students face bleak prospects coupled with the prospects of large number of retirements to set in within the upcoming years, and add the extraneous variable of barring foreign recruitment student nurse has reached a very worrying fact: Unless there is a change to the recruitment soon, there will not be enough Nurses to fill the posts and a reduced number of experienced staff.

People need money and will not wait forever to get a job in their field, and newly graduated students will soon look to other fields to work if nursing cannot provide. Few who leave may come back. The college student may also feel the pinch from the cut in training posts, assuming they even choose to apply for nursing and not another course. Some have said to Student Nurse to go abroad. He would like New Zealand or Canada as places to emigrate to, but he reminds them of the one fact companies who advertise for overseas jobs state: 2 years post registration experience essential. Trusts may need their books balancing, but wards still require nurses. Form filling may look nice, but it will not help a patient to know that despite there being no nurses to administer their pain medication, all the forms have been filled in so everything is hunky-dory.

Will this system ever change? Well, consider this: the UK went into Iraq despite unprecedented levels of public opposition to the war. Despite the howls of protest, nurses look set to have a staggered 1.9% pay rise. How much chance will getting a few thousand extra nurses by 2014 have?