NHS, you temptress

I had to get phone numbers for my NHS employers for my pending NYC job. When I was on the Queen Elizabeth Hospital website the job vacancy tab was calling me….

Yes, I clicked on it and found a posting for a Lead Nurse, Infection Prevention and Control, band 8b. I was previously a Band 6 and would have been demoted to Band 5.

I feel like a slut for checking out the job description, person specification and application. It doesn’t pay as much as my NYC job but I could easily live in my little 2 bed semi detached house on the salary range.

This evening I got an email from my potential lover:

Dear tracy,

Recently you started to apply for the following vacancy on NHS Jobs:

Application reference:      AR-119-644-967
Job reference:              304-004512
Job title:                  Lead Nurse Infection Prevention and Control
Organisation:               University Hospitals Birmingham NHS Foundation Trust

Hold me back

Did you say healthcare?

I guess it’s been awhile since I laid out my traumatic patient care experiences on my blog, experiences that at times were so emotionally painful and shocking that I saw a counselor through my employer.  Experiences that cross two countries and healthcare systems.

After working about 50 hours this week preventing infections, talking to patients, nurse and doctors to determine how these infections can be prevented then developing the guidelines and education to make sure that happens. I still have homework I should be doing including a critical analysis of an ethnographic study of dementia patients in nursing homes and a paper/presentation outlining a recruitment/retention plan….

I was slightly dismayed to see a comment from this religious professional that began as his rant about how he couldn’t afford “Obamacare” on his salary. He (or one of his supporters) felt compelled to bring Cesear into the discussion…

This is the last word on this:

  1. It is not “Obama” care it is called the Affordable Care Act (ACA). It is a law. It has been upheld as constitutional by a panel of smarty pants judges you might be familiar with called The Supreme Court. It is not going away, it can and will be improved. Get used to it.
  2. No matter who you worship it is wrong…WRONG…to let anyone suffer because they do not have the ability to pay for healthcare.
  3. Let me repeat -it is NEVER okay, permissible or excusable to allow suffering based on ability to pay. ACA is a step towards more equitable access to healthcare in the US.

So then in my rare forays into twitter I ran across a gentleman who tweeted a broad sweeping generalization about how there is a long list of countries with better healthcare than the US. I am very familiar with this data, in fact the Quality person at my hospital uses it in her orientation presentation to say that we need to improve our outcomes. It measures core measures, outcomes to common conditions like heart failure, cancer etc and costs…..yes, costs. I responded to this tweet saying – then why do people come here for treatment? he said with an air of authority that they do not.

At first I thought maybe he was a doctor but no. He doesn’t seem to have any healthcare experience at all. He does have OBE after his name which gives a clue to a possible British connection. I’m sure he’s a competely honest and reasonable guy  (edited after reading his response) pompous ass-but honestly when if you have dedicated 20 years of your life working in healthcare, taking care of patients, watching them die, watching family members cry their hearts out and thankfully watching the vast majority of them regain their strength and go home…. I take it personally.

I am not defending the US healthcare system, it’s majorly fucked up. I moved to England to work for the NHS, looking for a system that ticked all the boxes including being free at the point of service. I was very disappointed. I found an extremely low paid, disgruntled workforce, limited access to relatively basic equipment and a very low threshold for witholding treatment.

If it’s my child, spouse, parent who needs a unique, specialized treatment that is not available in my hospital, city or country what difference does it make what some longitudinal, multi-center study shows??? I want my family member to have that treatment regardless of the cost!

I would illustrate the contrast between the two systems by describing 2 cases.

In England on a Saturday morning they brought in a patient who had been out drinking, he’s fallen, hit his head and bled into his brain. Unlikely to recover, they sent police to his apartment to try to contact next of kin, the police would not break in so no family were contacted. The doctor’s took the patient off the ventilator, re-positioned him on his side and told me to start a morphine infusion. The doctor came back a few hours later and saw the patient still alive and told me to turn up the morphine because they needed a bed.

In the US we recently had the case of the 13 year old girl who suffered an anoxic brain injury and despite brain death tests conclusively showing brain death her family insisted on keeping her artificially alive.

Both of these cases are revoltingly, sickeningly wrong. They are a gross manipulation of life.

Am I opinionated and judgmental?? Yes, absolutely. But I don’t have these conversations with my colleagues because there are millions of healthcare workers, heads down, in the trenches day in and day out taking care of patients in every country with whatever resources they have available to them.

I don’t try to tell a soldier what it’s like to be on a battlefield…I wish people who are not involved in healthcare would keep their opinions to themselves.

What’s that saying? Lead, Follow or get out of the way.

7 years and 183 days

that’s how long i’ve worked for the NHS. i haven’t counted the days….it was printed on my pension statement. not bad for someone who only came for a year.

i wanted to see how national health, socialzed medicine worked. i have seen it up close and personal-the good, the bad and the ugly. i’ll have to wait and see what i find back in chicago at a public hospital before i give my critique.

one sign of things to come is that i went in to my unit (tricked by my boss) and saw a sign for a meeting for band 6 nurses (me). it mentioned a skill mix review….i texted my other band 6 friends and asked if they are being demoted.

they seem to think that is what they will be told. of course it won’t be tomorrow or without some (polite) foot stomping and there will be pay protection for a year or three but…i believe it will happen.

and why? why would a hospital drop some of its most experienced, hardest working nurses down a pay scale???? because it needs to save £22 million and because there are no other jobs out there…

i really feel bad, i wish i could take them with me!!!

thursday on 2 at 10

that’s a reminder for me to watch a funny, well so realistic it’s funny for me show that’s going to be on thursday night on bbc2 at 10pm…here’s a few clips from last year…if you’re here in england you should watch it too!

just watching those clips makes me laugh!! the show is called “getting on” it’s about a geriatric ward in a NHS hospital starring jo brand

what is your nurse worth?

it’s been ages since i complained about how nurses are treated like “angels of mercy” rather than professionals, with degrees, specialized experience and high levels of responsibilities, that we are.

this story has been all over the news for the past 24 hours…

Top managers in England’s NHS trusts received average pay rises of nearly 7% in 2008-09, compared with less than 3% granted to nurses, a report says.

An Incomes Data Services report into boardroom pay at more than 380 trusts found chief executives earned seven times more than the average nurse.

Senior managers in NHS trusts typically earned £147,500, the report said.

The NHS Confederation said trusts needed top managers to help them through financial challenges.

can anyone tell me why a chief executive deserves a 7% increase when nurses got less than 3%????

this really put me over the edge~~~

The highest-paid chief executive was at Guy’s and St Thomas’ NHS Foundation Trust in London, with £270,000, the report said.

A spokesman for Guy’s and St Thomas’ said: “The pay of our chief executive, Ron Kerr, reflects the experience, expertise and responsibility that the role demands, and we are delighted to have a chief executive of his calibre to lead the organisation.

“Guy’s and St Thomas’ is one of the largest, most complex and successful NHS Foundation Trusts in the country.”

£270,000 per year??? that’s around $400,000….

my random hypoxic ( low oxygen from hyperventilating) thoughts about that are~~

  • does this person really expect the rest of the employees at this hospital to think that if he only got 3% like them that he would’ve walked??
  • does this person actually say to their spouse “this measly salary of £270k just is not enough to make ends meet…i need to look for a new job!” ?
  • does this person ever stop and think about the “little people” the ones who actually do the work that makes him look good?

let’s play a substitution game with the next statment that attepmts to justify this outrageous salary

“The pay of our chief executive, Ron Kerr, reflects the experience, expertise and responsibility that the role demands, and we are delighted to have a chief executive of his calibre to lead the organisation.

insert tracy a. critical care nurse….or any one of the thousands of nurses, who by the way have a starting salary in the NHS of £20,000/year

the pay of our nurse, tracy a, reflects the experience, expertise and responsibility that the role demands, and we are delighted to have a nurse of her calibre to take care of really sick patients.

why doesn’t anyone ever say that? well, actually they do say that every once in a while….usually in conjunction with telling me that i am only getting a 3% pay raise….or that i will have more work to do, with less staff on crappier shifts….

isn’t that a mixed message?? this chap can have his ridiculously high salary justified but the rest of us are only there because  ~~we have hearts of gold? we want to save the world one patient at a time? we idolize florence nightengale?

we shouldn’t have aspirations for a bigger house, a new car, a few sunny holidays to wash away the images of working in critical care…

did i mention this is a public sector job? the NHS is a government employer? there is a recession on last i heard….and an election…

merry christmas to you too, gordon

this is what we get, we NHS employees~~from the prime minister~~for christmas…forget the £10 voucher we used to get~~


it’s nice and touching and even inspiring but it does not go far enough in addressing the dissatisfaction that permeates the NHS. i have never experienced such blatant expressions of entitlement and desire to milk the system….a close second to the air force but at least then we were all losers with no other option…

regardless, i still go to work and give my best…using my clinical skills and my heart.

merry christmas to all those unlucky enough to be in the hospital during the holidays…i’ll be there with you!!

coming back to life

i have to say that i have been hit with my fair share of tough viruses since i have been here. i think it’s a combination of viruses that i may never have been exposed to on top of the fact that nurses are constantly fighting off stuff…so when something does find a vulnerable spot….like my throat…it really takes hold.

i’m feeling much better today, been up and about a little, mostly due to the ginger ale, apple juice and lots of ice cocktail from yesterday….

thanks to cleo i was roused from my bed at 0620 when she knocked over a 1/4 glass of my overnight drink by parking her rather ample ass on my bedside table and overturning everything!

i went to the GP, rather the NP (nurse practioner) and gave her all my symptoms in a timeline that made it easy for her to just listen to my chest and look in my ears and write a script for amoxicillin….total time 8 minutes!!! success for the NHS!!!

sad to say this has been all over the news today

Failing hospital ’caused deaths’

A tribute wall to the people who died at Stafford Hospital

Mr Johnson blamed management failure for poor patient treatment

A hospital’s “appalling” emergency care resulted in patients dying needlessly, the NHS watchdog has said.

About 400 more people died at Stafford Hospital between 2005 and 2008 than would be expected, the Healthcare Commission said.

It said there were deficiencies at “virtually every stage” of emergency care and managers pursued targets to the detriment of patient care.

Health Secretary Alan Johnson has apologised and launched an inquiry.

One of the worst examples of care cited in the watchdog’s report was the use of receptionists to carry out initial checks on patients.

It said that:

  • Unqualified receptionists carried out initial checks on patients arriving at the accident and emergency department
  • Heart monitors were turned off in the emergency assessment unit because nurses did not know how to use them
  • There were not enough nurses to provide proper care
  • The trust’s management board did not routinely discuss the quality of care
  • Patients were “dumped” into a ward near A&E without nursing care so the four-hour A&E waiting time could be met
  • There was often no experienced surgeon in the hospital during the night

the stories these families were telling were pretty frightening, people who have spent their whole lives paying into the NHS deserve better than this…