Flipping Crazy

The cops in Devon & Cornwall have got a great plan for dealing with drunken slappers in Torbay.

They're going to make them slap even louder!

All we need now is an NHS presence outside the nightclubs offering a free liver transplant with every 15th Bacardi breezer.

Am I the only person who thinks that public money is being pissed up the wall?

All in a days work

My last patient before the weekend was a 40 year old mother of 4. She split up with her husband six months ago and has been struggling emotionally, socially and financially since then.
She had a night out with friends 4 weeks ago 'to cheeer her up'. She had a few drinks, a dance in the local club a kebab, a snog and then in time honoured tradition a one night stand with a young erect penis without a conscience.
She came to see me because she thought she might be pregnant again, as she has more experience than me, I took her word ( and 2 positive HCGs) for it.
We had a chat about her situation. Her husband ( soon to be ex) is already fixed up with a 25 year old chlamydia bandit - no support there then.
The donor, well she never even found out his name.
So having established a gravid state, her absolute inability to cope with another child in these cicumstances, and giving lots of words of advice and encouragement. FLMN makes the referral to the early pregnancy unit, for a termination, gives the lass as much moral support as I can and reassures her that all will be well in the end.
I had a card this week from the patient, nothing flash or extravagant, just a few words saying 'thanks for being a friend when I needed one'.
I earn a good wage in my job, have a degreee of respect from my colleagues and patients, but this, this knocks all that into a cocked hat.
I have a privileged job and I love it!

Judas

In the interests of improving my prescribing practice I recently bought a new book. A very 'useful, concise and practical introduction to the vast and complex subject of medical treatment', is how it is described in the blurb. I like the book, it is all that it says above, and I will keep it close at hand in my clinical practice. It goes on further to say that the book is 'useful for nurse practitioners' so that's me sorted then.
One of the authors, Hugh McGavock rang a bell in my dusty brain. Could it be this Hugh McGavock?. Mmmm. Probably is I think.
So, it's OK to have a pop at nurses who prescribe, and make totally outrageous and baseless statements about their practice. But on the other hand it's OK to make a few quid by pushing a book at them.
The balanced side of me says ' good old Hughie, he's realised that nurse prescribing is here to stay so he might as well further the cause with a helpful publication'. The cynic in me smells the faint whiff of hypocrisy and the tang of greed.
What do you think?
That notwithstanding, I recommend the book to all nurse prescribers.

All Change

Hi,
Sorry I've not posted for a while. If you were a regular visitor, you've probably enjoyed the rest.
I started a new job two months ago, I'm now working in a GP practice as a nurse practitioner again, and learning the ropes as best I can. Hence the gap in posting.
The job is great, supportive GPs and staff, couldn't wish for better.
As usual, the patients spring plenty of surprises on me, I'll keep you posted.

Money Wasting Tossers

Quiet day at work for a change today so plenty of time to surf the net and catch up with the news.

I came across this in several places.

Yet another unneeded, unwanted and costly government fuck up. You'd think they got their fingers burnt badly enough with the Millenium Dome and the spiralling cost of the Olympics.

Stupid, wasteful, ignorant, bullish tossers.

I voted for Blair in 1997, thought it would bring about a meaningful change.

Don't I feel like a mugged off cunt now?

Poor Judgement

I came across this sad and worrying case today.

I was particularly struck by the following:

'The nurse, Sue Lindsay, said she could not elicit any symptoms of psychosis in his voice and gave the 28-year-old a 24-hour crisis number to call.
Days later, on June 9 last year, degree student Mr Woodruffe, of St George's Street, Ipswich, jumped to his death off the Orwell bridge.'

I think that this is inexcusable. Making a decision on a patient's care, when they have obviously contacted you in crisis cannot be adequately performed over the 'phone. A face to face assessment is mandatory.

According the Mental Health Trust, guidelines were followed. Although they concede that they are now reviewing them - so that's OK then is it?

Fuck the guidelines, whatever happened to common sense and sound judgement?

Taking Responsibility

Dr Crippen draws our attention to the plight of Paul Gascoigne

Whilst working in A&E I've lost count of the number of times patients with drug/alcohol dependencey have presented in 'crisis'. Often with well meaning friends/family who are determined that this time he/she will 'kill the beast' and return to sobriety. I've also lost count of the number times I've walked out of the back door of the hospital and seen said 'convert' drinking, smoking or shooting up.

The main problem, in my opinion, is the medicalisation of these social/behavioural problems, I suspect it is often more about shifting blame/responsibility than it is about seeking treatment. Whilst Mavis' sentiments about Gazza's predicament is laudable. I can't help thinking that the lachrymose Geordie needs to buck up and take some responsibility for his lifestyle and it's inevitable result.