Monday, 31 March 2008

Infamy, infamy, the doc's got it in for me!

Two of my recent posts have both amused and infuriated the 'daddy' of medical blogs. The friendly, benevolent, nurse practitioner loving Dr Crippen.
Thanks John, my site traffic has gone astronomical, at least into double figures. The BBC have contacted me asking if they can mis-quote, mis-represent and lie about me and the Guardian wonders if they can mis-spell me. I've been offered a book deal by OK! magazine.
Perhaps we should collaborate on other ventures? Do you fancy working as a salaried dogsbody in the new nurse-led polyclinic Kharzi is going to let me have for my birthday? Send in your CV if you're interested.

Sunday, 30 March 2008

That's no way to address a lady

Now I'm not a political animal, and American politics doesn't really inspire me but....

Anybody got a picture of Gordon with incompetent twat writ large behind his head?

Saturday, 29 March 2008

Taking the piss - again.

Several medical bloggers have commented on this case:

Dr John Francis GRAY
From : 28 April 2008 To : 2 May 2008
Category : Fitness to Practise Hearings
Info :
Fitness to Practise Panel Planned dates: 28 April to 2 May 2008St James’s Building, 79 Oxford Street, Manchester, M1 6FQ The Fitness to Practise Panel will meet at St James’s Building, 79 Oxford Street, Manchester, M1 6FQ to consider a new case of impairment by reason of misconduct.

Name: Dr John Francis Gray

GMC Reference Number: 2277073

Area of practice: Lancashire

The Panel will inquire into the allegation that between about January 2004 and May 2006, whilst Dr Gray was working as a GP, he provided pre-signed blank prescriptions and pre-signed blank Med.3 sickness certificates for use by a Nurse Practitioner when he knew that she was not qualified or registered to do so.It is further alleged that during absences from his GP surgery, Dr Gray allowed a Nurse Practitioner to provide medical and emergency cover in the absence of a locum GP when he knew that she was not medically qualified or registered to so. Dr Gray’s conduct is alleged to be inappropriate, improper and not in the bests interests of his patients.In accordance with Rule 41(2) of the General Medical Council (Fitness to Practise) Rules 2004, the Panel may decide to exclude the public from the proceedings or any part of the proceedings, where they consider that the circumstances of the case outweigh the public interest in holding the hearing in public.

The usual nurse bashers have had a dig, Dr Crippen, Ferret Fancier, and the usual bollocks is spouted about quacktitioners. It amazes me that both of them seem to think that this a good excuse to have a pop at nurses again.

So let me see if I get this straight. A doctor fucks up, behaves outrageously, and according to his medical brethren it's all the nurses' fault.

Seem to have heard that one many times before.

Wednesday, 26 March 2008

Have some self-respect!

I've just got back from a trip to the corner-shop.

Outside the shop, where there were several people gathered, including small children, a chap was having a loud argument on his mobile phone - clearly audible to all.

'Oh for fucks sake, you are a whining bitch, I fucking hate you, get some fucking self-respect!' He hollered into his phone.

I'm loving the irony.

Friday, 14 March 2008

Painkillers Revisited

I'm beginning to think that there is no such thing as common sense any longer. Easier access to heath care, via Walk-In Centres, Minor Injuries Units, NHSD, Out of Hours centres and soon enhanced access to GPs (i.e. making the poor sods work even longer hours than they already do!) has made the public lazy, feckless and thoughtless.

In my sphere of practice (Unscheduled care/Out of Hours) I'm ideally place to witness this phenomenon. I never cease to be amazed at the breathtaking way in which people treat the health service and how poor their own coping strategies are.

For example, painkillers - sorry to bang on about this, I've visited this area before, but...well...just... AAARRRGGHHHH!!!!! What the Fuck! Why? Why oh why? Why don't people give their kids painkillers, or take some themselves.

Recently, I saw a four year old boy with a six day old knee injury. I saw him at 10pm, yes 10pm! On a school night! He had a painful knee, it had been painful for 5 days and nights. Mum wanted it checked out because they're going on holiday at six o'clock tomorrow morning and it might be serious.

So that's how you make a holiday packing list then is it?

  • Underclothes
  • Shorts
  • T shirts
  • Wash bag
  • Warm sweater for the evenings
  • Mosquito repellant
  • Swimming costume
  • Totally unnecessary visit to the urgent care centre because I'm useless twat as a parent
  • False teeth
  • Dick Francis
Mum said 'he's been crying himself to sleep every night because his knee hurts' - as if that was supposed to impress me. I asked which painkiller he had been taking and how often he had taken it. 'Oh well, you know, with children you're never sure are you? You never know if they're really in pain do you?'

What! Shut the fuck up! Not sure if he's in pain! Oh for fucks sake!
You tell me in one breath he cries himself to sleep because it hurts, in the next you're telling me you don't know if he's in pain. And, to make it worse, you haven't given him any painkillers.

At this point in a consultation I begin to quietly, internally, weep.

Friday, 7 March 2008

Rude Bastard

I was taking a history from a patient ( I refuse to call them clients because I get fuck all cash from them) today. During our chat his mobile phone rang. Now this doesn't usually trouble me so much as it is either ignored, or a quick 'hello - I'll call you back' and then we carry on.


This chap decided that a little natter with someone on the other end of the line was a better use of his time than telling me about his problem. On reflection, he was probably right because there was not much wrong with him and I soon sent him packing. But this is not the point. Am I alone in thinking this the height of rudeness?

In my clinic we don't insist on patients turning off their mobile phones - probably because most of the kit is too old to be affected by errant emissions anyway. We do however expect a bit of common courtesy.

Unrealistic expectations

I saw a lady recently with a painful foot - it was painful when she woke up. Doesn't remember injuring it, but; 'would like an Xray please in case I broke it rolling over in my sleep'!

Now I don't know about you, but since I had my kids I've been a fairly light sleeper and tend to wake at the slightest sound. Before the advent of nippers I would sleep like a log and be virtually unwakeable. However, if I injured myself during the night, I'm sure I would wake up - probably screaming in pain!

In order to break a bone in one's foot, it is acknowledged that significant force must be applied to the foot. It doesn't just happen when you roll over in the night.

So unless someone drove a car over your foot whilst you were sleeping, a maniac came into your room and twatted your foot with a sledge hammer, or you indulge in skydiving whilst asleep. It is highly unlikely that you have a broken bone in your foot. So an Xray is not indicated, is it?

Oh, and some bastard painkillers might help as well!

Thursday, 6 March 2008

For Crying Out Loud!

I've had a fucker of a day!

Why do patients never listen to what we tell them. I have reviewed two soft tissue injuries today, both of which were seen in the past week and advised that STIs take a while to heal. Both of them came back expecting an Xray for their migratory, transient symptoms. Neither were Xrayed, both were cross, as their friend, relative, postman, hairdresser thought they needed an Xray. Neither had followed STI advice given on their previous attendance.

Then, a nurse friend of a patient thought that she needed an Xray for a nose injury and told her to come and see us 'to get it Xrayed', cue one pissed off patient when I patiently explained that we don't Xray acute nose injuries.

There seems to be a belief that an Xray has some curative properties, sure if you've got a tumour in your head, frying it might make a difference. But for muscle strain, ligament injury or a sore nose; nada, rien, fuck all use.

Then I see another patient with a two week old injury that he hadn't bothered to see anyone about until now- potentially quite disabling. Decides that a fracture clinic appointment for the following day isn't convenient and probably won't bother to attend, by this point I'm past caring. So bollocks to him!

Off now for a drink, and some normalcy with Mrs Fat and the little Fatties.
Back to more of the same tomorrow - deep joy!

Tuesday, 4 March 2008

Bigging up Nurse Practitioners

As an NP, part of me thinks I should be really pleased to receive news like this.
Another part of me makes me think....are we being used as pawns in a larger game?

Although I disagree with much of what Crippen and some of his pals say about NPs; they rarely present a balanced view, preferring rabid hyperbole instead. Some of what they say is food for thought.

NPs cannot manage patient care in isolation, sure a diabetic nurse working in primary care can probably manage a caseload of diabetic patients, but can he/she provide the full package? I would stick my head above the parapet and say no.

At the risk of being flamed by some of my NP colleagues, I propose maintaining the status quo: Nurse Practitioners and GPs working as a team the better to better provide patient care, utilising the strengths of each team member.
The them and us debate, which now appears to be politically led, is damaging our professional relationships. The medical and nursing professions need to move on from this and work collaboratively to defend primay care from 'Grim' Gordon, 'Grinning Al' Johnson and the other numpties stripping our NHS of its' assets.

Together we stand, divided we fall.

What do you think?

Sunday, 2 March 2008

Shagging Nurses

First we're all promiscuous sluts, with dirty finger nails as well .
Coming from an ex-junkie, that's a fucking compliment - cheeky twat.

Now we're busy knobbing the punters.

Someone, somewhere is getting Fat Lazy Male Nurses' portion. Perhaps I should re-invent myself as Grubby Promiscuous Drunken Nurse, I might stand a chance of getting a knee trembler!