Hospitals
 

Now we all know that the NHS is taking a bashing and things are not good but has it realy reached this stage;

AN MRSA patient has walked out of hospital in disgust and is relying on private treatment to tackle the infection after losing faith in NHS doctors.
(Evening Telegraph)

I am not a fan of hospitals but when a patient does this then borrows the money to go private then should we not be worried? The private hospital beleives it is better equiped to deal with this illness which it could well be but should the NHS not have the same ability? Ok I know there are nursing staff look at this site and will proberly voice their opinion on the matter but as a profession does this not anger these nurses?

I have the benifit of private medical insurance through work so have no worries there but most people do not have this luxuary and would have to go NHS or find the money to go private. Is it not about time the NHS worried more about patients and there needs than govenment targets and
excess levels of management?

Sorry for the size but it has given me the willies. :(

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that patient has a point and i can understand his concern

i had mrsa when in hospital and although most of the nurses washed their hands after handleing me or anything i touched some of them simply went on as usual and didnt take any preventive measures from spreading the dissease

i found out after that my pregnant girlfriend at the time should not have been allowed to visit me and boy how i could have done with the peace and quiet

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Sensationalism......and selling papers is what this story is about.
MRSA has always been about. Many patients will already have the Staphylococcus bacteria on their skin.....where incidentally it does no harm. I worked at QPH up until my retirement 3 years ago. I know the hospital has a very conscientious 'Control of Infection' team.

The lady in question will certainly get better at Gisburne Park because they will isolate her in her own room.

Too many visitors, visiting hours that are too long.....visitors sitting and lying on beds.... not washing hands......all are implicated in the spread of MRSA. It is a problem that needs a multi-faceted approach......and the hospital may not be entirely to blame.

Hospitals need to test patients before they are admitted to see if they are carriers of MRSA.......of course this is only possible where the admission is a planned one.

Stories like this one just undermine the confidence of patients and staff alike.

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Well it seems that this is a thorny issue with some on both sides of the fence
but if theres smoke then there has to be fire.

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Well, I wouldn't be worried about going into QPH.....but I would take adequate precautions about my own cleanliness. Nurses advise patients to bath before surgery and some of them do not heed this advice. If you go into hospital and there are not adequate hand washing facilities then ask to see the Nurse in Charge. Patients are also encouraged to prompt nurses and doctors who do not appear to have cleansed their hands.....many nurses carry alcohol gel to do this and you may see it strapped to their pocket.

As I said in the previous post the problem is multi-faceted and needs a multi faceted approach to tackle it........I think they are looking at reverting back to the more regimented visiting times, and looking at ensuring that only two visitors are present at any one time, that visitors do not sit on the beds and that they know the reason for this rule.

When I was Ward Sister I would challenge visitors (in a courteous way) about too many visitors at one bed and about sitting on beds.... I would explain the reasons for what I was doing, but many many times I was sworn at and abused.

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i was told that mrsa will blow off somone as soon as they go outsid ethe hospital and that only people at risk are those who have open wounds etc

only going off what i was told by my consultant and he seems to be a pretty bright chap so i have no reason to doubt him

although his sewing leaves much to be desired lol

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A few months ago I was at the Western General in Glasgow and the advice did not come close to what you have. Wonder why I am cynical.

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And which on your list is not the hospitals fault?

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Hospitals are trying to combat the problem, but there are very weak holes in the system.

All wards at the Royal Infirmary in Manchester were only to be entered and left by patients/nursing staff and visitiors who had cleaned their hands with the alcholic gel. This didn't apply however to the porters, who we watched every day going from ward to ward delivering great big bags of supplies, without even a glance at the gel dispensers as they came and went. This was on a ward were people already had infections. The person we were visting developed MSRA.

Seemed daft to me, you either follow procedure or you don't.

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You choose Neil........ these changes have been driven by expectations of patients.
The patients are the consumers......and have you heard the saying 'the customer is always right'....? Patients wanted longer visiting hours...... they want everyone and their grandmother to visit, they don't want to be told not to sit on beds....... they bring food and leave litter lying in patient areas. Patients also bring their own MRSA in with them.....it is difficult to decide whether the bug was caught from someone else.... it is always assumed by the patient that this is the case......but some patients will be the carrier of their own bug.......on the skin it is harmless, but if it gets into an open wound, well that's when the problems begin. As I have said there is not just one answer to this problem.

When I first started nursing, children under the age of 12 were not allowed to visit except in exceptional circumstances (such as if a family member was dying - even then it was discouraged) this was because it was known that there was a risk that they would bring infection into hospital......and even worse, pick up something while they were visiting.
It is widely known that hospital bugs can be virulent......but as I have said before, in this post and in others......I would not worry about going into QPH.

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Alcohol gel is no more as affective as washing your hands PROPERLY. people are under the Impression that this WONDERFUL gel will rid all problems............................ Well I think not.
Just please be aware that this Gel is not better than washing your hands. Yes I have used the gel at work, but AFTER I have washed my hands very, very, very, well first.

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Agreed I cheat at work and use IPA wipes after washing my hands but they stink to high heaven.

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Margaret is right about the visiting and I believe the infection control team are looking at it now. We get daily abuse from visitors, especially when they are asked to leave or wash their hands. The nurses who carry gels are well aware that the gels only work after hand washing.

According to one of the staff on the medical wards the LET are targeting them, they have been sending reporters in masquerading as visitors who are then upsetting their elderly patients. They have been trying to access the ward at all hours of day and night and are becoming a pain in the neck for staff and patients alike. One of the things with the NHS is that the wards are so short staffed that the nurses/midwives do not have time to police the visitors. If we were to be policing the visiting then we would be neglecting the patients...

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I saw that when we were there. Big queues of people waiting to go into the ward to visit the new mum's and babies. Also big gatherings of people inside the ward waiting as well. On several occasions security were present to ask people to leave the ward. I wont be racist so I will let you guess who was abusing the rules.

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Neil its being honest not racist they would be exactly the same if the position was reversed.

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No they would be racist and get away with it.

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The sad thing is Neil, is that you're right. We did try open visiting on the Maternity unit several years ago (at the request of the mums). Within a few months new mums were requesting that visiting be restricted again because they were tired of having to entertain all day, then be up half the night with the baby.

On maternity especially, we do realise that people get excited about having a new baby in the family. However, people are only in hospital for 1 day now if everything is normal. They are only in for 3-4 days following a Caesarian if the recovery is normal, Therefore there is no need for hundreds of visitors to be piling into the hospital. They should be waiting until the woman goes home and visiting her there. Babies don't change that much in the first few days so they're not missing anything by waiting.

Incidentally, I have yet to see a visitor actually wash their hands before handling a new baby, despite being asked and despite there being notices all over the wards now. The worst offenders, I am sad to say, are the mother-in-laws.....

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Who said mother in laws know best?

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Thanks a lot for nothing, just occasionally I am right.

I always said they are the root of all evil.

The hospital have rules about numbers around a bed etc. It was nice to see security at least trying to stick to it. At visiting times it was like a circus on the maternity wards. Fortunately my wife was in a side ward becasue of complications ;)

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It is awful being a parent in hospital though, and not seeing your chidren for long periods of time. Yes the system shouldn't be abused, but it is awful stuck in them plaes on your own.

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The kids ran riot and you were pulling your hair out and looking foer ear defenders.

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The LET have always jumped on every hospital story.......they frequently misquote and misrepresent.....or tell the story in such a way as to reflect badly on the hospital staff.
They are a bit like those ambulance chasing lawyers in that respect......rather than report about the good things that are happening they report the deficiencies in a sensationalistic way. Don't get me wrong, I do think that if there ARe deficiencies then they should be reported, but in a mature and balanced manner, noting what attempts are being made to redress the situation. Fat chance with the LET!

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If it wasnt for the LET we might have fewer discussions than we do. They are great for a topic for pingpong. :D

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While that is true, it causes panic in folk who are due to be admitted......and that can't be good.

I worked within the NHS for almost 29years......the skin on my hands is wrecked from the handwashing, the use of latex gloves and strong detergents......but I wouldn't have it any other way.

The other thing that works in favour of MRSA is the bigger turnover of patients......this has again been driven by political targets. I know some days on the ward that I worked on we could have as many as 3 different patients in one bed over a 24 hour period....not all at the same time you understand. that is three lots of visitors for each patient too.

Patients also move around the hospital much more......they stand at the hospital doors smoking.....drips and sometimes surgical drains on show for all to see..... they might just as well get on a bus and have a ride around town. They go into the dining room where they sit down in a seat that may just have been vacated by one of the building workers in their working clothes.......and if you try to explain to them that this is not a good practice from the control of infection viewpoint, you get a mouthful of effing and jeffing...... no-one seems to respect the fact that the nurses don't get a big thrill out of telling patients what they should not do when it is for their own good. There need to be some radical changes to how patients AND visitors conduct themselves. I am sure that Lettie will corroborate a lot of what I have said in these posts......she is still on the sharp end!

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I wholeheartedly agree with Margaret although I don't say that I'm on the sharp end (what I do say still begins with 'sh' though) :D We have had the MRSA discussion on here before and it is due to a combination of factors.
Private cleaning services, too few cleaners for too many clinical areas.
Not screening patients before planned operations (although that wouldn't be possible for emergencies)
The vast amount of visitors and general disrespect of the building (spitting and peeing in the lifts etc.) Yes......They do this!!!!!
Poor handwashing practices..... Doctors have been shown to be the worst culprits. It seems the higher up you get, the more naturally sterile you become :D Sparks can vouch that my hands are a real mess from the constant handwashing, this is a problem which will never be cured as long as I still work there, and they are damn sore.

Lastly meeting targets and provision of new services takes staff away from clinical areas. We are treating more patients than ever, yet, beds have been cut, staff numbers are low in all areas (especially acute areas). If you are constantly rushed off you feet with emergencies, routine stuff, policing visitors, paperwork and telephone enquiries, how on Earth can you manage to do the cleaning up as well. On a 22 bedded maternity ward, there may only be 2 midwives working on one shift, with no support staff. That is looking after 22 mums and 22 babies. There are not enough hours in the day.

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LETTIE QUOTE > (spitting and peeing in the lifts etc.) Yes......They do this!!!!! Doctors have been shown to be the worst culprits. < QOUTE


Surely this is wrong?? ...................................lmao.

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Oooh Slinky!!!! You naughty girl.:rofl38:

With a misquote like that, you should work for LET..:D

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Sorry lettie, i couldn't resist that one.............................;) :D

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Im not old enough to remember, but I have heard talk of Matrons in charge of wards, those of you that do remember what was the differance between a matron and a sister?, and would the re-introduction of these Matrons help? also why cant they just toughen up the rules,1 hour a day visiting in normal wards, anyone seriously ill or dying could have different rules, but somebody in for a "routine op", 1 hour a day, I know I would be glad of the peace and quiet, introduce wi-fi to the wards and even better, online visit via webcam lolhttp://www.accringtonweb.com/forum/i...ons/icon14.gif

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You just wanna see those nurses dont ya Dazza????:eek::)

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pay per view lol

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One way to increease funds for NHS i'suppose LOL

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maybe we should email Patricia Hewitt with our suggestions lol

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The management structure when Matrons were in charge was VASTLY different......the Government have brought in what they call 'Modern Matrons'......this is just a bit of window dressing because the general population think that hospitals were run better when Matrons were in place.......so the government decreed that Matrons should return, but in truth they have very little in the way of real power.

Everything Lettie says is true...... and a lot of the fault lies with political tinkering that doesn't address the real problems.......changes in the Education system of training Nurses.......there used to be droves of students on the wards......and believe me a lot of the work those students did was cleaning....... and you did it with a good heart and you did it well because the next patient to use whatever it was you were cleaning could be one of your own family. Students are educated in Universities now and do not want to know about the menial tasks....... they might be menial but they are important.

I can recall being a student and we were never anything other than busy......if not with patients then we were allocated a tin of Chemico and sent to the sluice to clean and shine the stainless steel bedpans.....and sputum pots......OK today those are made of paper and are much more hygienic.....but what I'm getting at is that the problems within the NHS are down to lack of manpower where the patients are.......to few people with too much to do......too much paperwork and red tape.......too many targets set by people who don't know what they are talking about........all the high powered managers in the world will not improve the situation...........and these are the folk who are getting the chunky paypackets......not the nurses. And this all brought about by political spin.

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[QUOTE=Margaret Pilkington]The management structure when Matrons were in charge was VASTLY different......the Government have brought in what they call 'Modern Matrons'......this is just a bit of window dressing because the general population think that hospitals were run better when Matrons were in place.......QUOTE]

but did they make a differance that was my question as I said I am to young to have an opinion and you obviously know what your on about, so in your opinion did matrons make the differance?http://www.accringtonweb.com/forum/i...cons/icon7.gif

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Say one thing for this thread I have learned something from Margret and lettie and that is scary. All that info at the hospital get rid of it and ask the old hands (not meant as an insult ladies) :)

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I am also too young to remember Matron. She had already been replaced by managers when I started in 1987. Matron used to run the practical side of the hospital. She would do inspections on the wards and was in charge of most things including things like laundry and cleaning. The ward sister ran her own ward and was answerable to matron. If matron thought that a ward was dirty, she would shut it down, give everybody a kick in the pants and get it cleaned up.

Modern matrons have nowhere near that kind of power, they are nurse managers retitled to include the word matron in order to try and reassure the public. Their main job these days is to juggle with the staff numbers to try and staff the shifts on the wards. Some of them do get involved with the patient care but that is because they sometimes have no choice. There are too few staff on shifts to adequately do all of the jobs, so they sometimes have to muck in. They try to work to their targets, ie, how much money can we save this year??? They listen to the staff complaining and take their grievences higher, but never get anywhere.

I would not have a modern matron job for all the tea in China. It's not worth the flack. When you've trained as a nurse or midwife, gained experience and risen through the ranks, to be constantly moaned at by your colleagues, it must be a hell of a job. Believe me the staff moans are justified. If any one of you found yourself doing an 11 hour night shift and had no tea break because it was too busy and there was nobody there to cover you, would you not moan?

These working conditions are a daily occurrence within the NHS. Nursing staff are tired and demoralised so therefore there are high levels of sickness amongst staff, which adds to the problem.

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There is too much red tape and rules that have no benifit for the patient especially if staff are running round after a set of targets. Govenment seems determined to bury everyone under paperwork and then has the gaul to moan because targets arent met. Yet these people are the problem so if the Hattie Jakeus matron returns lets send a few to parliment to orginise them.

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Thanks Lettie, very eloquently put.
Oh, and by the way......I don't remember Matrons either, but I did work with nurses who did and the tales they told would make your hair curl......there was one Matron at Queens Park who used to be accompanied on her rounds by a little white highland terrier called JOCK.......cross my heart!

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And these matrons made sure the wards were clean. Very hygenic, a dog with p***y paws walking around.

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It WAS a long time ago Neil.......and that particular Matron ruled with a rod of iron....or so I'm told........the nurses who knew her would poop their pants if they were sent for by her.
And I'm told that if you broke a thermometer you would have to take it to Matron and she would make sure that you were docked a shilling from your meagre earnings. Those were the good old, bad old days.

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If I ruled the world..... these are the measures that I would implement to combat the spread of MRSA.

VISITING......would be strictly limited. Patients would be given 2 visiting cards for their visitors to use. These cards would have magnetic strips on them and would open the ward doors only at certain times. At all other times anyone coming to the ward would have to use the intercom system......this would have the beneficial spin off of allowing the staff to know exactly who was in their ward area.
No children under the age of 12 years would be allowed to visit....unless the patient was a close relative who was considered to be on deaths door.
Parents would have open visiting on childrens ward......but other relatives would have to stick to the regimented visiting times...and then only 2 visitors per bed.
There would be a visitors waiting area attached to each ward.
Patients would be discouraged from visiting the restaurant, and would only leave the ward for diagnostic procedures.....X-rays, scans etc.

Ward Cleanliness.......domestic cleaners would be allocated permanently to their own wards. This ensures the continuity in the cleaning process.
Two people would be employed on each ward to clean all equipment.....trolleys, drip stands, commodes, locker tops and surfaces......with hot soapy water....this would be done every day regardless of whether the equipment had been used or not....and these would not be ordinary cleaners......they would be part of the Control of Infection Team.....and their uniforms would identify them as such.
Carpets would be removed from ward areas.
The rolling process of laundering drapes and screens would have to be documented and audited regularly.
Wards would be closed in rotation for 'Fogging'...... this is a steam cleaning process with detergent in the steam.
All the ventilation systems would have to be checked for bacteria on a monthly basis......who is to say that the bacteria is not being spread through the air conditioning.

Other Measures.
Routine surgical admissions would either be checked at Pre-operative assessment clinic to make sure they are not a carrier of this organism......if this was to be too costly/would swamp lab services, then alternatively patients could be prescribed a weeks course of Aquasept Wash ......this to be used in accordance with instructions in the week prior to their admission.
Emergency admissions quarantined until swabs proved that they were not carrying the organism.
Foot operated door mechanisms.......door knobs are known to be vectors in the spread of infection.
Patients know to have MRSA.....barrier nursed......full gowns like they used to be covering the whole of the nurses uniform.......not the silly plastic aprons......are the bugs just going to land on the plastic apron.....I don't think so!

Nurses to wear uniform in hospital only.....proper change facilities and time to change given.
If a uniform is contaminated then the nurse should change into a clean one immediately.......a central store of uniforms should be kept for such occasions.
Handwashing.....everyone, staff and visitors to wash their hands and DRY them properly......hand that are not properly dry might just as well never have been washed.
If a ward has an apparently high rate of infections then the staff should be required to give swabs.....if these prove positive then the staff go off duty until they are cleared.....when I first started in nursing this was one of the role of Occupational Health Dept.

All of these measures would come at a cost......and some will observe that it will reduce the ability of the hospital to meet its targets......and therefore may be seen as impractical, but how important is it that this bug is beaten...?

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Just out of interest, the standard procedure in Dutch & German hospitals is that upon a patients vacation or discharge, the entire hospital bed plus adjacent clinical equipment |(ventilators, etc) are taken away for sterilization and cleaning and 'fresh' beds & equipment are brought in from stock.

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When patients are discharged the bed and the locker and the chart holders are washed with detergent and dried before being made up with fresh linen.
This does not happen in all hospitals........some hospitals only wash down the bed frame and the mattress if there has been a spillage of body fluids.

Electrical equipment is decontaminated before servicing or repair.

I don't know if there are any checks on the ventilation system, but it stands to reason that if the ventilation system is linked from all the wards, then there must be a possibility of bacteria finding their way into the system and being spread in this manner - unless there are some ventilation engineers out there who can tell me any different. Viruses do not survive outside the body, but bacteria can be airborne.
The single bedded wards in some areas have some kind of 'reverse air flow' that is supposed to stop the spread of infection by this route......though I am not sure how this works.

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I don't know how the ventilation systems work either Margaret but I would certainly second all of your suggestions. It will always be physically impossible to protect everybody from every bacteria. Nobody can control the bugs which are floating around outside. It would be brilliant if we had some sort of control over them in hospitals. As you said though, it would be expensive, inconvenient, would require planning and would cock up some of the government targets. Those inconveniences do not matter to me and would not matter to the general public if they were told how important those measures were to protect them.

I bet they would matter to the government though. In my opinion they have brought this on themselves by trying to run healthcare on a shoestring and employing too many chiefs and not enough indians....:D

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Crikey I thought a little banter would come from this thread but instead its education and a first hand front line report. For what has been said the nurses aint paid enough for the grief they get from management and the public. To think the govenment thinks they can sort the NHS well to that I answer "if they can fix the NHS then I am the nxt King of a free Scotland" ie 2 chances a cat in hells chance and no chance.

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Whew....! that's a relief......I logged on thinking that I would be shot to bits over my suggestions.......but they make sense to me. It will take some REAL radical changes to get to grips with the situation and to bolster the confidence of the general public......but they NEED to see action......and they need to see it NOW.

These things cannot be done on a shoestring, but they can be done.

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There are bits kicking around on the news that some NHS trusts are in financial trouble and are freezing staff higherings. Why dont the rid themselves of overpaid underworked business suited target loving beaurocrats and get some more hard working angels in. You could get quite a few nurses for the pay packet of some executives and we could put the care of patients back were it belongs ie the doctors and nurses. Maybe then we can get back a health service that is not treated as a loss making business!!!

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Yes, it appears that one third of all hospitals are going to have to close facilities to try to balance their budgets.....what about targets that the government are so keen on.....well, they won't be met that is for sure and waiting times for operations are bound to rise.
Market forces in the Health service do not work....people are not tins of beans!

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Many targets and government initiatives require extra money. In order to meet the government requirements experienced nurses and midwives are often taken from frontline work to help set up new services, but they are not replaced. This leaves wards and departments very short staffed. Usually the money to provide new services is nowhere near enough and most hospitals are running on very tight budgets. This government are patting themselves on the back, saying that they have provided so many thousands of extra nurses. Those numbers of registered nurses in this country are very misleading. They include nurses who are still on the register but retired or recently emigrated. They also do not differentiate between who is full time and who is part time. The majority of my colleagues are part time and it is extremely difficult to cover shifts when 5 out of 7 people in your team are only working 20 hours a week....

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Lettie that sounds more like a warzone than a hospital service how on earth do you maintain your standards in them conditions? It still seems to me to be badly run and the nurses and doctors are suffering as well. If it was me the international sighn of up yours would be aimed at the buffons who think everything is rosie
Can you be sure they are not sneaking into the drugs while use are being worked into the ground?