Today is Remembrance Day. At the eleventh hour of the eleventh day of the eleventh month, we remember those who shall grow not old, those who age shall not weary, for they died in the service of their country.
Today we also learned of yet more health service failings, of suffering and death; of lessons unlearnt, and lamentable failures, among older patients undergoing surgery; older patients, a few of whom no doubt fought in Flanders and other fields, and lived, only to be deserted in their late hour of need by the country they had served.
Such findings offend not only the Military Covenant; they are also part of a wider picture of health service failings. From babies dying in Bristol on altars of arrogance, through ignored excess deaths in Stafford, to the death march of the Diamorphine Queen in Gosport, the NHS has its own share of blood on its hands.
And yet, as we remember all those who died in Flanders and other fields, we all too often forget those who suffer and die not at the hands of war, but who suffer and die closer to home, in the theatres and wards of our hospitals.
There are those who prefer a white poppy of peace to the blood red poppy of Flanders field. Perhaps, Dr No sometimes wonders, we need a black poppy, to remember all those who suffer and die unnecessarily at the hands of the NHS.
A brave post Dr No, and one that I think will be ignored by some in a hospital setting – as it makes uneasy reading.
In the healthcare professions, there are those that do care and those than don’t – hopefully, the former being much greater than the latter. For those who observe bad practice and are driven by their conscience to do something about it, the road they take (in whistleblowing) is fraught with difficulty; it is often the whistleblower who is scapegoated and ostracised. Because of this, some in nursing accept bad practice as they recognise the futility in fighting it, and in doing, gradually become immune to it and no longer see it as such.
Like all in nursing, I have recently received ‘Raising and escalating concerns’ from the NMC. It is a fine booklet – but is it worth its salt(?), as in the past, nurses who have whistleblown have not received backing or support from their professional body.
One of the Key points in ‘Stages for raising and escalating concerns’ is to refer to your employer’s whistleblowing policy. This is perhaps where, the guidance falls flat on its head, for I know than some (many?) hospitals have a ‘gagging clause’ written into the employees contract. The same applies in many care home chains.
So what do we do? For me, it will always be to whistleblow as I would rather lose my job than have someones death on my conscience. And yes, I have whistleblown twice and been squeezed out of employment on one of these occasions.
Unneccesary deaths are never acceptable, although it would appear that they are. It is sad that you consider a need for a black poppy, but until things change, I will wear a symbolic black poppy in my mind.
There will always be human error and tragedies surrounding medical care. The last thing a witch would want to be involved in is a witch-hunt…… But maybe, just maybe, some suffering and loss of life are so blatantly avoidable that, when Remembrance Sunday is past, The Black Poppy should be allowed to shed its petals and mature till the seeds are ready to to be shed where they are needed around the blogosphere. This night coloured flower might turn out to be more effective than whistle-blowing, and safer.
The high mortality following surgery is indeed scandalous, and an indictment of our NHS system. Those who wish to defend the NHS do need to explain why after 70 years we have this state of affairs. If we fail to address the issue then there will be calls for change, though whether they will be the right change who knows?
Similar scandals happen in other countries, such as the excess mortality in the 2003 heatwave in French Hospitals, and I have heard similar tales from the USA.
One problem is that junior surgeons are not very interested in the post-op care and forget that they are doctors, not just carpenters with an interest. I did a house job some years ago taking #NOF patients from the Orthopods onto a Geriatric unit for rehab. Even in my first year qualified, I was appalled at how heart failure was out of control, PE’s rampant, electrolytes chaotic, confusion uninvestigated. These patients are tough to Nurse, and female orthopaedics and medical wards particularly hard to staff, as Nurse Anne on Militant Medical Nurse has so thouroughly documented. 30 years on nothing seems to have changed, though if my juniors are not on the ball they are rapidly hauled over the coals. I can’t change attitudes everywhere but in my little corner of Borsetshire I do my best.