After putting up that last post I got to wondering how the situation arose and who ultimately is to blame. The triage nurse has operated within her defined role, and abided by the protocol provided. Technically she has done nothing wrong, but has abetted a system that sanctions inadequate care.
So who wrote the fucking protocol? Sadly I think it likely that it was done by one of our own. We have in the medical profession plenty of grovelling arse licking yes men, willing to throw their principles in the bin for self advancement and financial gain. Men cast in this mould. We all know that medicine can not be adequately practised by tick box and protocol, but some will overlook this for selfish motives.
I have used this phrase before and make no apology for using it again. The only difference between some doctors, and prostitutes, is that there are some things prostitutes will not do for money.
All manner of 'make-do' will continue proliferate as the NHS fragments.
ReplyDeleteIf not dodgy triage nurses, then overseas locums not entirely familiar with diamorphine dosing.
http://www.guardian.co.uk/society/2009/may/21/diamorphine-dose-nhs-review
I have stated elsewhere that Protocol is there NOT to protect the patient but the Serco staff and ultimately Serco.
ReplyDeleteIn Child Psychiatry, I have stated that Child protection procedure is there to protect the Social Workers! Why else did more children died since Maria Colwell.
And these protocols work in the reverse and prevent you from doing what is sensible because it's not what policy says.
ReplyDeleteAn example from my field of haematology:
It is standard practice to only give Kell negative units of blood to women with childbearing potential. That's because if they produce an anti-Kell antibody there is a high risk of haemolytic disease of the newborn. This has been translated by many laboratories to mean all females under 60 years of age receive Kell negative blood. Kell negative units have therefore become quite precious.
I was dealing with a post operative haemorrhage following a hysterectomy on a woman who was 42. She was post hysterectomy by the time I was asked for the blood. I over-rode the computer's suggestion of giving Kell neg as she clearly does not have childbearing potential - thoughts of Life of Brian has now popped into my head about the foetus gestating in a cardboard box - anyhow, I digress. I felt it was in everybody's best interests to preserve our stocks of Kell neg rather than give them to a woman with no uterus.
I was formally disciplined for failing to abide to protocol...
Appalled, but not surprised.
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