Hospital infections...

[Sooty Stoo]

Originally Posted by stevechesh

I thought we all had certain levels of MRSA living up our noses anyway, so stop picking them!

Does anyone remember a Dutch scientist saying everyone should pick their nose and chew it? Apparantly it increases resistance to germs etc.

Anyone want to try it?

[rustferret]

I worked in the medical industrie until 2002 and covered hospitals in UK ond over seas. I found standards for better in other Europea countries, and in England I had a black list of hospitals that should I be misfortunate enough to need treatment I would refuse to go.

I'm not going to start reciting horrer stories but nearly 3 years ago my ex went in for a histerectomy (by the way shes an ex theatre nurse) she contracted RMSA and at the werst time she had a hole in her abdomen so deep you could see the linning of her stomack.

She went through so much pain and was off work for over a year, and although back to work she is still not free of it and is now having problems with her hip as a result. At one point I had to prepaire our children for the worst and that they might loose their mother ......I was sure they would.

She has tried to sue the hospital but like every one else that has tried this she has failed as it is not possible to prove it was contracted in the hospital.

Its descracefull the state of UK hospitals and the way this government fails to have the balls to sort it.

Rustferret

[captainnemo]

There was the old saying about eating a peck of dirt before you die...how did we ever survive in the days before everything was shrink-wrapped and had a best before date....why is blue cheese so good when the blue bits are essentially bad?

Who else reckons the use-by dates on many of the things you buy are more advisory than mandatory? I've used dairy stuff that was well past the date and routinely find that Greek yoghourt is OK for several days. If it smells edible it quite often is, that's one of the reasons we have a sense of smell, not just to get excited by musk and jasmine!!

What does puzzle me is why things that used to have shelf life, such as root vegetables, now appear to deteriorate before your eyes. Carrots grow whiskers quicker than I can, parsnips go from cream to mud colour in the blink of an eye. And why exactly do supermarkets have to shrink-wrap things like bananas and cucumbers....that sort of come ready wrapped naturally.

With regard to the nurses who got dragged into the debate, most of us accept that most nurses perform well, better than well as often as not but they are only part of the solution and unless all parts of the machine work together there are likely to be problems. The media tends not to record good news, the regular successes of a unit are always going to be eclipsed by the occasional failure. It may not be fair but neither are many expectations. And the uncomfortable reality would appear to be that UK infection control is not up to European standards.

[Richard Mason]

Originally Posted by captainnemo

There was the old saying about eating a peck of dirt before you die...how did we ever survive in the days before everything was shrink-wrapped and had a best before date....

Well the truth is, a lot of us didn't. People died from communicable diseases all the time, only then, they called food poisoning "ptomaine sickness" or something like that.

Also, have a think about what you ate 35 years ago; our shopping basket was basically raw vegetables, raw meat, sugar, flour, margarine. These were prepared & cooked to hell and back by mother (bless her) and served still piping hot to the ravenous family - no more than 30 mins between preparation & consumption. We ate out maybe once a year and our idera of takeaway food was fish & chips, prepared & cooked fresh and eaten within minutes.

In those days, nothing had a use by/sell by date because it didn't need to - it's only since we started eating mass produced convenience foods, with long shelf lives and now, more & more, preservative free, that the risk of disease outbreaks from food have become magnified to the present extent. It might all seem like bullsh!t to you, but when you've interviewed a traumatised would-be mother who recently lost her unborn child from a bout of Listeriosis resulting from eating a blended smoked-salmon and cream cheese dip, just past it's sell by date, you'd realise that actually, it isn't.

As for shrink-wrapped veg, there's no requirement for that; it's something that retailers do because their marketers are convinced that the dumb customer will show a preference.

Originally Posted by captainnemo

Who else reckons the use-by dates on many of the things you buy are more advisory than mandatory? I've used dairy stuff that was well past the date and routinely find that Greek yoghourt is OK for several days. If it smells edible it quite often is, that's one of the reasons we have a sense of smell, not just to get excited by musk and jasmine!!

Sounds like you've got it all worked it out. That's good, it means I can retire without worrying now.

Use by dates are mandatory and relate to potential health risk, best before dates are advisory and relate to aesthetic issues only . The thing you have to be careful with, especially when you put a population of 60,000,000 into the equation, some of whom may have compromised immunity as a result of pre-existing medical conditions, or age, (like our unlucky neonate above) are the occasions when it smells or looks ok........... but actually it isn't ok. That's why people get food poisoning, it seems fine but is actually quite dangerous; so much so, that one of the commonest causes of food poisonings, Staph. aureous toxin actually received consideration in the 50s and 60s as a biological warfare agent.

For example, a 0.1% probability in any one year of something being seriously awry with our food (1 in a 1000) may seem like a low risk to you or me as individuals, (especially as we have a statistical probability of dying which averages out at around 1.25% in any given year anyway); but when you look at the same probability x 60,000,000 it soon equates to a lot of dead or sick people.

That is the nature of the problem with risk that regulatory authorities have to deal with - in those circumstances, home-spun wisdom doesn't add up to much.

[Steve S]

Originally Posted by Sooty Stoo

Does anyone remember a Dutch scientist saying everyone should pick their nose and chew it? Apparantly it increases resistance to germs etc.

Anyone want to try it?

No. I find the thought of eating your bogies quite revolting actually

Safe diving,
Steve

[Sooty Stoo]

That's not what you were saying the other night

[Steve S]

Originally Posted by Sooty Stoo

That's not what you were saying the other night

Safe diving,
Steve

[captainnemo]

In between the smiles and the bile and the professional insights a picture appears to be emerging....

It ain't just media hysterics, there are infection issues in our hospitals (the nature of the beast, in the same way there are violent and thieving individuals in our courts) and the health pros are affronted at any suggestion that they don't follow measures to combat these bugs. Evidently there is debate as to how effective such measures are and whether things were done better in the old days or whether rose-tinted specs aoutomatically come with 20/20 hindsight!!

Likewise food: apparently the golden age of wholesome nutritious stuff is a myth (though government statistics actually exist to suggest that the national diet during the last world war was actually surprisingly healthy) Maybe the 50s mum might have been overcooking some of the fresh food (frequently sourced locally on a near daily basis by the revolutionary method of walking up the High Street with a basket) The disappearance of so many local shops together with the concept of shopping daily for consumables has led to the development of supermarket 'convenience' foods....whose convenience exactly?

Sounds like the bottom line is nobody has all the answers because often the wrong questions are asked. Are we better off with rickets or type 2 diabetes, tuberculosis or ME, typhoid or MRSA? Obviously, 'none of the above' would be cool but people can be quite self-destructive and not everybody obsesses about what they eat, where it comes from and the level of exercise they do. Quite a lot of the people who put fish fingers and beans in front of the family do so in the belief that it's a decent meal (and there is not so much junk food, as a junk diet, usually caused by poverty) and under many circumstances it is.

Life doesn't have to be brutal and short, we can't do much about the longevity but the quality is in our own hands. Divers already have an advantage over many, we have a pastime that interests and unites us and allows us to see things that many never will....and occasionally disappointments, but hey, sh1t happens.

Some think that I deliberately set out to wind people up and to an extent that is quite true but only in the spirit of asking people to think. If we all posted the same anodyne, mutual congratulatory mush the forum would be a dull place. If Al Gore can get the Nobel Peace Prize for his intellectual exercise in mass delusion theory there is hope for all of us!!

[dlegros]

Originally Posted by captainnemo

With regard to the nurses who got dragged into the debate, most of us accept that most nurses perform well, better than well as often as not but they are only part of the solution and unless all parts of the machine work together there are likely to be problems. The media tends not to record good news, the regular successes of a unit are always going to be eclipsed by the occasional failure. It may not be fair but neither are many expectations. And the uncomfortable reality would appear to be that UK infection control is not up to European standards.

Well actually, you started the nurse-bashing (my emphasis)

Originally Posted by captainnemo

Consider the changes that have led to the current state of affairs. Nurses now wear their uniforms to travel, hospital laundry has been out-sourced and the nurses now see themselves as above the grubby business of cleaning bedpans and changing sheets. The old hierarchy of matron, sister nurse may have been archaic but it worked. The most important memory those of a certain age will retain of hospitals will always be the smell, soap and disinfectant.

To take some of your points:
Nurses wearing uniform to travel, I am lucky to work in one of only three departments in my hospital that has a (very small) changing area. I use it and do not wear my uniform to and from work. Most nurses in my trust do not have the choice.

Furthermore, the trust does not offer a laundry service for staff - meaning I have to take my worn uniform home to launder and it has taken me four years to convince Revenue and Customs that I have to do this to claim back my £70pa laundering expenses because the trust claimed it provided a laundry service. The uniforms I have are thread bare and falling apart and I am waiting (for an indeterminate period) for replacements.

Clean bed pans? Most hospitals have been using single-use disposable card bed pans for about 5-10 years.

Originally Posted by captainnemo

Unfair to blame hospital visitors. I was in hospital during the 60s and they had visitors back then.....but curiously there was not much in the way of hospital acquired infection...certainly not to the extend that dozens could die in an outbreak while the chief exec gets a pat on the back for 'good work'.

MRSA and Clostridium Difficile (as well as VRSA and Acinetobacter) were not prevalent in the 60s simply because we hadn't been abusing as many antibiotics in as many ways as we now have been since then.

Originally Posted by captainnemo

It is probably true that there is plenty of MRSA and the like out in the community but we aren't addressing the possibility of people keeling over in the wide world, we're looking at people in hospital, where you normally go to get less unwell....

MRSA has a prevalence of around 30-40% in the community, but it is unheard of because it does not tend to affect otherwise healthy individuals. You should go to hospital because you are unwell, whilst your immune system is otherwise occupied, or your other natural defences (such as your skin) are compromised, MRSA can then move in and cease to become a colonising organism and become and infecting organism.

Decowarrior, the most common reason for not moving an infected patient is that the hospital (and I mean every available bed space) already has someone in it.

We had two known C. Diff patients in my department last week, barrier precautions were easy to institute as our cubicles are single spaces. More than once we had to stop visitors from walking out wearing aprons and gloves despite repeated instructions on how barrier precautions work. Unfortunately there were no side (or isolation) rooms available - because they were full of patients with C. Diff and Acinetobacter.
We then had cubicles out of action for in excess of two hours whilst we waited for "deep cleaning" - in a department with between 200 and 300 attendances daily - with up to 40% of those being potentially unidentified MRSA carriers, plus their relatives, friends, etc.

Nurses have been routinely dumped on by the Government (below-inflation pay-rise means I'm around £400-600 pa worse off than last year; agenda for change now has me at a pay-point that effectively means I don't get paid for 2 months out of every year!), the press (TV and papers), our managers and the public.

The "modern" NHS is a business, I no longer have patients, I have customers, I actually have to do "customer service" training. The Government is concerned with meeting targets, not quality of service targets, but speed of service targets (4h ED waits, 18mo surgery waits).

If you have all the answers, undertake the training, work your arse off for similar money to a bin-man (whilst routinely making literally life and death decisons, as well as facing abuse and violence on a near daily basis), work up to point where you can implement your fantastic ideas then we'll all applaud you.

The alcohol gel is not a panacea - it is wholly ineffective against C. Diff and I have seen it used as a weapon by patients (squirted into your eyes it is an effective incapacitant) and drunk by alcoholics - but it looks good!

A recent report on hand-washing (in a popular paper) stated that a ward nurse should wash their hands an average of 23 times per hour.

Current hand-washing guidelines state that it should take 2-3 minutes to wash your hands correctly - so for 46-69 minutes out of every 60 we should be washing our hands???

Is the NHS full of angels? NO! It is full of people, just the like the rest of you. We are over-worked, under-resourced and under-valued; yet we still do the job because we try to make people's lives that little better/easier/comfortable.

[/RANT]

[captainnemo]

Actually, if you look at my posts in this thread I have been quite complimentary to nurses and nursing, the criticism has been directed towards the NHS adminstrators and hospital management. The actual health professionals who have posted seem to have the same theme, they do the best they can with the insufficient resources they are given (and the growing sense of frustration is evident)

I agree with you that you are dumped on by all sides but perhaps it would be useful if more nurses exposed the practices they are required to implement. When you talk about 'customers' in hospital that crystallises the type of management that has led to the current situation. When I went to hospital in the past I was never a 'customer'....or did I miss the list of offers at the checkout?

Perhaps nurses should organise some sort of guerilla campaign to expose the lies and spin of the adminstration of their hospitals? Public opinion reacts to photographs and recorded conversations and these days mobile phone technology and other digital gadgets make that sort of thing pretty doable.

A few weeks ago a TV stunt organised a bunch of MRSA affected people to descend on a number of hospitals and demonstrate the cleaning standards. It wasn't comfortable viewing. As to the alcohol gel thing, I agree it was a typical daft gimmick but what happened to disposable surgical gloves? Every garage I use has generally got a supply of plastic gloves for diesel pumps....difficult to see even the most inventive alkie getting a buzz off some gloves or incapacitating the ward staff with one....