Saturday 22 November 2008
Dirty needles and disaffected nurses
Posted on Fri 1 Jun 2007, 13:15 in NHS
MRSA nasties..
North Staffs University Hospital has the highest MRSA rates in the country - during my father's recent stay for a hip replacement op it was easy to see why.
We’ve all heard about MRSA, Norovirus (winter vomiting) and Clostridium Dificile. Not yet hitting the headlines is the return of tuberculosis (TB) in its new and more deadly multi-drug-resistant (MDR) and extreme-drug-resistant (XDR) forms.
Vomiting and diarrhoea is one thing – an incurable TB infection which may infect the rest of your family is another.
With diseases like this around the corner, the hospital should take infection seriously - not just make the right noises and ignore the reality on the ground.
As in this page on the Trust's website.
Should you worry about this? Read the two stories below and decide whether you or your loved-ones should be exposed like this.
Example 1 - Dirty needles and disaffected nurses.
Imagine that you’re in bed 24hrs after having your hip replaced and squirming around the bed in pain. The hospital has kindly provided a self-administered morphine IV into the back of your hand – you’re hitting the feed button but the pain won’t go away.
After asking the nurse for help, she tells you to keep hitting the button, but it doesn’t seem to help. Two hours into this nightmare, you notice that the IV has actually dropped out of your hand and the feed tube is on the hospital floor - which explains why it wasn't feeding him morphine.
You summon a nurse to ask for their help in getting it sorted… the nurse promptly picks the end of the tube off the floor and moves to re-insert it straight into the IV on your hand.
This happened in the UHNS last week. The advantage of being awake and not dulled by the morphine meant that my dad spotted the crazy actions of the nurse and prevented him from sticking a dirty feed line into his vein.
What is even more criminal is that the nurse stumped off mumbling that he’d be back to sort it out, but one hour later just went off-shift and didn’t even communicate the problem to the next shift. My dad had to get a new nurse to clean and replace the tubes.
When your hip is replaced, they chisel, saw and hammer away at your bones through an 8” incision in your thigh. It’s going to hurt. The nurses generally are excellent carers – they work hard under little supervision and with insufficient resources. I don’t criticise the profession – I just want to know who is managing the nurse that gets away with blatantly ignoring infection controls and neglects a patient in this way?
Example 2 – Bad news travels fast..
Hospitals are unhealthy places. They are full of sick people. Diseases and infections can be found in most of them.
Stopping the spread of infection should be a priority, but at the NSUH there are gaping holes in their defences.
The hospital has an informal arrangement to allow a chap to tour wards and beds selling newspapers. He steps out of his car each day, lugs his pile of newspapers around from bed to bed, taking coins and notes from patients and returning their change with a smile and god knows what else.
No gowns or plastic overalls. No face mask. No hygienic hand gel on entering each ward (it would probably smudge the print!) I’m not an expert, but as a disease vector, this chap is an absolute gem.
I heard he retired the other day. After 30 years of delivering the local “Evening Sentinel” and an interesting cocktail of bacteria and virii.
I’m sure that the management team at UHNS are now preparing an epidemiological study to uncover the effects of withdrawing this particular vector on their infection rates. They should also look at the newspaper chap as he’s probably immune to everything after his low level exposure over the years.
To conclude on a serious note:
At UHNS the “Medical Director, Dr Pat Chipping, has overall responsibility for the prevention and control of infection..” and the hospitals “ Infection Control Team is made up of experienced nurses and consultant microbiologists who have developed special skills and knowledge in the prevention and control of infection.”
I invite Dr. chipping to comment on the following:-
The nurse with the casual hygiene methods is still loose on the wards and possibly neglecting or infecting people today.
The newspaper vendor may have retired, but has toured the wards unchecked for years. The hospital postman will continue the touring tradition and has been doing this for years – frequently, each day, from ward to ward carrying his payload – including the High Dependency Unit.
Before Dr Chipping responds with the PR about the use of plastic overalls and hand-gel I can tell her that neither the newspaper man, postal staff or porters bother with such things. The corporate bull about "special skills and knowledge in the prevention and control of infection" rings really very hollow.
Notes:-
North Staffs University Hospital MRSA figures can be found at http://www.dh.gov.uk/prod_consum_dh/idcplg?IdcService=GET_FILE&dID=10102&Rendition=Web
MDR-TB and XDR-TB are not yet prevalent in the UK, but one death due to XDR-TB has been reported in Italy. The disease is most common in poor countries, and poor communities within rich countries. It typically passes between people in crowded sleeping areas, though it is possible that sharing a long haul flight may be enough. The UK has seen a 10% rise in TB cases between 2004 and 2005 (source: New Scientist 24/3/07)
Tags
north staffordshire university h, mrsa, clostridium, tb, tuberculosis, xdr, mdr, infection, disease, nurse, dirty, needle, drug, resistance, hospital
Related stories
Popularity: 895
Sweebstar Nominations: 2
This sweebler's rating: 
Report this story to a moderator
Comments
We too went through the worry of whether to go ahead with the operation. What I left out of the above story was how I encouraged my dad to make sure he had blood tests prior to entering hospital - we were already envisioning an infection. My dad seriously contemplated parting with £10,000 to get the op done privately, but like your own father, he has paid tax and NI from when he left school to when he retired. This government has been misleading, willfully ingenuous and patronising in the extreme - but I see them only as part of the problem. Ministers are too short lived to really make a difference - they can always blame their predecesors and then instigate change to give themselves a honeymoon period until they hand over to the next incumbent.
If we want to see change in the NHS, then accountability is the key - the career directors, managers and heads of department. It's these people that are more than aware of the issues, but have to protect their own interests and pensions by keeping quiet. They know the wards are short staffed, that corners get cut, and that the hospitals would not be able to cope with a major epidemic.
It ued to be that hospitals would object strenuously to targets - I think we are now in a post-target era, where the management have found ways to deliver against targets which satisfies their political masters, and in the process absolves them of any repsonsibility for the real results. Ticking the box against a target means good PR, get's their bonuses paid, but leaves neglect and poor service on the ground.
If the managers on the ground are held to public account, they will soon start to behave differently. If we use forums like this to name and shame, I think the behaviour in management meetings will be different - i.e. they know we're watching and that their actions may become public.
I decided to name the hospital in my piece above, in future I will name wards and individuals if the information is available.
Maybe it's just a pipe-dream, but I could imagine a web site like this packed with real stories, names and events - which can not be denied or buried amongst NHS statistics.
I have contrasting examples on hospital infections and cleanliness. One is when my grandad was in Hull Royal Infirmary a few years ago and had knocked over his bedpan of urine. When we went to visit we asked how long the floor had been left like that, he replied a couple of hours.
Thankfully the hospital has since changed its cleaning contractor.
But anyone who thinks infections are a recent thing and can be fought just by nurses washing their hands is wrong. MRSA was first identified in the early 1980s, but people have caught infections since the first operations. And things like MRSA are brought in from the outside, they just spread quicker in an enclosed place where there are people whose immune systems are already weak.
I agree that infection is nothing new, but what we face today is a range of infections that are increasingly immune to antibiotics. TB is back and certain strains are now untreatable - you will die.
The problem I see with the NHS is that we see grand statements and optimistic targets, but on the ground, there is little discipline or resource to actually deliver the results.
If nurses are run ragged, and clinical managers are driven by administrative and financial constraints, then their objectives are going to be different to my objectives as a patient.
My objective is to go in, receive treatment as painlessly and efficiently as posible, and to emerge better than when I went in i.e. cured and uninfected by other diseases.
I don't see how a minimal clinical staff, supported by low wage contractors will be able to deliver this.
I would challenge any health minister who would give a straight answer to explain how this could work.
I do not believe that the hospital business managers and the hospital clinical staff share the same objectives.
It would be interesting to hear from someone inside the NHS about how the two sides work together.
RESPONSE from the hospital to original story.
From: Chipping, Pat [mailto:Pat.Chipping@uhns.nhs.uk]
Sent: 14 May 2007 17:46
To: xxx
Subject: RE: Concerns regarding infection control
Dear Mr F
Thank you for drawing these matters to my attention. Clearly both of these are important issues. Without knowing details of the ward on which your father was nursed I cannot take further action regarding the clear lapse that occurred with the IV morphine drip – if you or your father provide me with further details we can address this.
Nobody should be exempt from using the alcohol gel when entering wards and between patients. I don’t believe there is a necessity for any further precaution than this. I am going to draw this matter to the attention of the Professional Heads of Nursing to cascade to their ward managers and re-enforce the point that all members of staff and the public should be observing hand hygiene precautions.
Pat Chipping
Let's see how things develop at UHNS.
Please log on to your Sweeble account to post comments.
Both of these stories are deeply disturbing but sadly not surprising.
I write after watching Tony Blair boast about cutting hospital waiting lists during his departure speech yesterday. Maybe this is so but I wonder how many patients have opted out of procedures all together because of the fear of contracting a fatal infection due to sloppy care.
Several years ago my own dad seriously considered bailing out of a hernia operation, which he was told he would need sooner or later, because he was genuinly scared of contracting MRSA. My dad is an intelligent man and not easily swayed by hard-hitting headlines.
He also continues to work into his seventies and has more than paid his dues through taxes and National Insurance contributions. It made my blood boil to see him have to take time to make a decision about going into a hospital - a place which used to be known as a sanctuary of cleanliness.
These stories, like many others, demonstrate his fears were far from unfounded.
The fatcats who are running our NHS - yes OUR NHS - need to be held properly accountable for anything less than first-rate care.
Report this comment to a moderator