Posted by: Witch Doctor | April 12, 2012

Patients in a nocturnal pickle

witchround

When we witches think of Richard Branson, trains, planes, commercial space travel and hot air balloons spring to mind.

When we think of Holly Branson, we think of doctors and her entrepreneurial father.

When we think of them both together we think about The Entrepreneurial Genes that they both likely carry.

Now, it so happens that we witches have something in common with the Branson family — we all carry the entrepreneurial genes too. However, those of us who are witches as well as doctors never let this gene surface when we practice medicine because it can sometimes creep into “The Money Making Gene” or even into its big cousin “The Selfish Gene,” So we think entrepreneurism and doctoring are not very compatible although some entrepreneurial doctors who are not witches may disagree.

Last night during the witching hour all of this started off a hot debate in the coven.

One of witches brought out a print-out from the BBC news.

Just imagine for a moment that you are a patient tucked up in a hospital bed and you are sound asleep in your quiet and peaceful single room. You are recovering from surgery or an episode of heart failure or something serious enough to have you admitted to hospital in the first place (not an easy feat nowadays). Suddenly, during The Witching Hour, a night nurse or some kind of nocturnal administrator shakes you gently (or not so gently) to waken you up from your reverie.

They want you to go home.

They want you to go home in the middle of the night because they are short of beds.

OVERNIGHT DISCHARGES FROM NHS HOSPITALS TO BE EXAMINED

“The government is investigating after figures emerged suggesting that hospital patients in England have been discharged overnight to free up beds.
The Times newspaper discovered, via Freedom of Information requests, that 100 NHS trusts sent 239,233 patients home last year between 23:00 and 06:00.”

The Times article is behind a paywall:

SCANDAL AS NHS PATIENTS THROWN OUT IN THE DARK

“Hundreds of thousands of patients are being sent home from hospital in the middle of the night to relieve pressure on NHS beds, research by The Times reveals.
Patient campaigners say the elderly are often the worst affected as they are abruptly sent home to empty houses without proper planning”

Now, during The Witching Hour we all discussed how we could provide a service to these patients – a service that would be well outwith the capability of Richard Branson and Virgin Health.

We would run a Broomstick Taxi Service to take these patients home during the darkness and keep them safe. A witch would go into the house with each patient, make them a cup of tea or hot chocolate, fill a hot water bottle and tuck them up into their own comfy bed, after changing the bed linen if necessary if they have been in hospital a long time.

We would even go a step further. When called upon by The Night Nurse or The Nocturnal Administrator responsible for discharging the patient during the unholy witching hour, a fully trained witch doctor would go and see the patient personally to determine whether he /she was fit to be discharged during the night. If we deemed the patient was unfit for such a disturbance we would inform The Night Nurse and / or Nocturnal Administrator. We would tell them that the patient should not be transported during The Unholy Witching Hour. If The Night Nurse /Nocturnal Administrator did not comply with our advice, we would wave The Book of Spells in front of them. If they still refused to comply with our witching advice, in the twinkling of an eye they would be turned into cockroaches until dawn.

We feel this is an excellent, professional witching – doctor service that only we can offer. Integrated Care intertwingling with Patient Choice.

Patients would be offered the choice of a broomstick with a medically qualified witch-minder, a taxi, a train , a plane, a space ship or a hot air balloon.

They would, of course, all choose The Broomstick and Richard Branson’stransport systems wouldn’t get a look in.

Virgin wouldn’t touch our means of transport with a barge-pole. Broomsticks are scary things without an accompanying witch.

Unless……

Unless……

It might scupper our plans if Holly Branson is a triple whammy – a doctor, an entrepreneur, and a witch.

She may be the first two, but we don’t think she is the latter.

Do we My Black Cat?


Responses

  1. Just imagine for a moment that you are a patient tucked up in a hospital bed and you are sound asleep in your quiet and peaceful single room. You are recovering from surgery or an episode of heart failure or something serious enough to have you admitted to hospital in the first place (not an easy feat nowadays). Suddenly, during The Witching Hour, a night nurse or some kind of nocturnal administrator shakes you gently (or not so gently) to waken you up from your reverie.

    They want you to go home.
    ———

    But that’s the idea WD, if docs like you were in ‘full’ charge, this would never happen! Certainly, this would never be allowed to happen with Branson in charge either, ‘not good for the business’, you see. Businesses are run on their reputation, and presentation, hence, can not cope or survive on a headline like that, they’d certainly fold with behaviour like that. Remember the ‘care of the elderly group who had to fold, en mass?’, it’s the same principal. And why is this allowed to happen is because nothing ever gets punished in the public sector, and I can remember loads, MTAS for one!

    As for docs becoming entrepreneurs, I hope they do, very soon too, or else, what do you think will become of all they juniors who will qualify within the next few years to no consultant posts at the end of that longest and hardest of roads they have to endure?! Already loads are in this predicament, it breaks my heart too! Some think ‘immigrate’, I think maybe innovate, for those with an entrepreneurial spirit … and btw, compassion is born with you WD, I would trust you whether you worked in the public or private sectors.

  2. Here is a link;

    http://www.telegraph.co.uk/health/healthnews/9177635/Glut-of-NHS-doctors-by-2020-report-warns.html

  3. I remember a situation like this, when I’d taken my mum up to hospital with a suspected stroke. The (very) junior doctor suggested sending her home, although he was decent enough to look shame faced about it. Fortunately I’ve inherited a ‘paintstripper’ look from my mum , which I put to good use at that point. He went away and found a bed. Mum ended up there for a week. I did feel for the doctor, because it was a situation he didn’t want to be in, but it was just ridiculous given the severity of her condition.

  4. These are curious figures, but not yet clear what they mean. It seems that these Trusts discharged about 2400 patients each during these hours, or about 7 patients every night.

    Some hospitals classify deaths as discharges, but i suspect that most of these are patients being “admitted” to assessment units. In the good old days we used to keep patients awaiting investigations in an observation room in emergency, now the same room is used for the same purpose but designated a ward assessment unit. This way we do not breach the four hour wait for the emergency dept, but fiddling those figures has caused us to have odd looking figures for nocturnal discharges. If a figure is needed then it is worth cheating at…

  5. Sam, I do wish I had your confidence that the commercialisation of Healthcare will avoid situations such as this and many more. What I have seen unfold gradually over the years is the detrimental influence of attempting to bring the philosophy of commerce into the NHS. There have been some successes but more often the enthusiasm of staff has been stifled and standards driven down. Closing beds, introducing bed managers, mixing wards, relocating or even forgetting the whereabouts of patients, dumbing down, and many other detrimental initiatives were at least partly the result of a culture transfer from the non-medical private sector. At the same time resources were put into futile activities that often went round in circles. Things were far from perfect before but much has worsened since I was a very junior doctor. If, for example, a patient had been raised from their bed and sent home in the middle of the night then it would have been a disciplinary matter for those involved. Perhaps some would regard it nowadays as “using your initiative”

    Granted, as Dr Phil says, some or perhaps a lot of the figures quoted may be spurious. But why collect stats that are spurious? It costs money to document these activities and often results in dishonest gaming of the system.

    As you are probably aware Sam, I believe we need more, rather than less, doctors who will take full responsibility for the individual patients in their care. A private sector funded by taxation won’t want to pay for that perceiving that it is an expensive way of doing things. In some circumstances it is possible it may not be.

    Julie,

    I have experience in my own family too of patients being inappropriately sent home or hanging around an A and E Department for hours when an intelligent dolphin would have had the wit to see they needed immediate admission and tucked up in a comfortable ward bed. Sometimes I get the feeling that the junior doctors are working in a culture of “don’t admit patients to this hospital because the beds are too precious and don’t refer them to an outpatient clinic either or the waiting times will rocket” It is quite an onus to put on junior doctors and must be quite stressful for some.

  6. “I do wish I had your confidence that the commercialisation of Healthcare will avoid situations such as this and many more.”

    What’s different from before this time is that it’s a whole package of reorganisation and not just one aspect of involving a greater role of the private sector. Meaning, hopefully, Gps involvement with the likes of KPMG will marry well with foundation trusts as well as those ‘other’ providers, and since each of those whill have a ‘personal’ interest, financial or otherwise, they will all strive to cooperate out of own need first, or they’ll face the consequences. This in turn will ‘hopefully’ benefit the patients. As for staff, it works the same way as each of those groups will need ‘good’ staff, then training, remuniration and conditions will have to improve or all those providers will suffer too. Will this vision succeed, I sincerely hope so, because if it does, then it’s way better than the status quo. Is there risk? Definately, but what is in life that is without? … so best be practical since it is upon us, and strive to make it work too, since it is in our interest that it does.

    I know what you mean to say though, but times do change WD, and so we need to move with it too. The whole globe is changing, and our leaders are trying so hard, I can feel it. The problem is, how can they make us accept? You see, if we do, doors open to new opportunities too … as always

    … and it was you WD who first noticed it too!


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