DSM-IV Code: Not Specified



Image: Duane Michals



Look at me,

really look at me,

look past my beauty,

see me,

see the inner me,

the ugly side

wherein resides

the me who gloats

as I pull off

the wings

of living

breathing things.

He loves me,

he loves me not,

he loves me.

My handsome one,

I detest your goodness,

despise its vulnerability. 

You will dance my dance.

Sing to my tune.  

I pick petals off the

most exquisite blooms.

He loves me,

he loves me not,

he loves me, loves me!

Anna :o]

With thanks to Tess at The Mag for the inspiration.

Evil Nurses, Care of The Elderly - or Lack of It.

Unless of course we are called to higher office sooner, as sure as eggs is eggs we will, well, all end up old, some of us very old and well past our sell by date, we may succumb to the old arthuritus (sic) and/or diabetes and/or heart disease - perhaps multiple comorbidities and our little grey cells may thin at the same rate as our greying hair.

It is well known that unless a relative of yours, old people are a burden on the state and indeed society itself and are not worthy of the title of human being, okay they might be human but their being here is, well, bothersome.

Never mind, the hope is that they will end up a hospital patient and then – God bless’m – the nurses can finish them off!  What more satisfying than leaving someone’s gran or granddad lying in their own excreta, starving to death or dying of thirst while you read Hello at the nurses station and discuss last nights date in sordid details!   And then there is always the LCP if all else fails!

But of course it is not that easy for when learning of this despicable care via that stalwart of the media The Daily Mail, suddenly the entire world and his brother are up in arms stating that nurses don’t care any more and “They were Angels when I was a lad!”  Suddenly everyone cares about the elderly while they ignore Mrs Miggins next door who is so damn lonely the only friends she has is her GP and that nice nurse who visits weekly to dress her wounds.  (Mrs Miggins sometimes accidentally on purpose pulls off the dressing so that nice nurse calls more often.)

Interesting then that this recent  RCN survey shows that these unfeeling nurses (caring for the elderly) report that due to unsafe staffing levels “that activity was left undone, or was done inadequately on their last shift due to lack of time.”  These activities include comforting/talking to patients (78%), falls prevention (45%), helping patients with food and/or drink (34%), helping the patients use the toilet or manage incontinence (33%), pain management (19%) and care of the dying (17%).  Please read the full list, the full survey yourself.

Read the whole thing and learn that although older people “who often have the most complex and intense needs…  …have a more dilute skill mix than other types of wards.”

Staff (nurse) ratios are thus: 

·        9.1 to 10.3 patients per RN on older people’s wards.

·        6.7 patients per RN on adult general/medical/surgical wards

·        4.2 patients per RN on children’s wards.

This survey mirrors findings of the RN4CAST survey which found:

·        High nurse BURNOUT and job dissatisfaction were common among nurses in Europe and the US.

·        On average, only 60% of patients were satisfied with their hospital care.

·        Those nurses reporting high levels of burnout (notably in Greece and England) also reported an intention to leave their current employment.

·        Each additional patient added to a nurse’s workload increased the odds of a nurse reporting poor or fair quality of care.

·        Patients were less satisfied with their hospital stay in those hospitals that had higher percentages of burn out ore dissatisfied nurses.

Dean Royles, director of NHS Employers, said: "Mandatory staffing levels can not guarantee safe care.

"We do not believe that imposing a crude system of staffing ratios is the right way to tackle poor care."

Well there you go – bloody typical – things will stay as they are!

It is a fact that these unfeeling nurses – alongside completing only tasks they can do such as meds, admissions, discharges, etc, - spend their time completing reams and reams of required (tick box) paperwork that is deemed more important than the tasks they are tick boxing.

It is also a fact that working under these conditions, these unsafe conditions, they are in breach of their Code of Conduct.  However there is always the safety net of the Nursing and Midwifery Council (NMC) who stand up for their subjects and demand change (not)!

“There are now almost 3,500 fewer nurses working in the NHS than in 2010 and the number of managers has also dropped, the NHS workforce census has shown.” ( Daily Telegraph).   So much for Cammers promise of protecting front line staff then folks!  Things will only get worse for granny now the HSCB is soon to be enshrined in law – you were warned!  (See Jobbing Doctor). 

I don’t deny that crappy nurses exist as do crappy doctors, plumbers, electricians and whole (coalition) governments for that matter – but if we continue with this scapegoat (the nurse) crap – nothing will change and granny and granddad will continue to be left to stew in it.

Stand up and be counted – do something – complain about staffing ratios when you see poor care – please do something!  The odds are YOU will be old one day!

What say you?

Anna :o]

Urm - the cutting and pasting shows - didn't before I posted!

Pills for All Ills

Pills for All Ills

I feel like a walking prescription

Taking drugs of every description.

I take so many tablets I rattle

While fighting a continuous battle

To unsubscribe this prescribed addiction.

Body Surgery

A daft woman ran a campaign

To have her body removed from her brain, 

Her surgeon complied,

She not surprisingly died –

But she’s not in the position t’complain. 

Anna :o]

Madeleine Begun Kane who blogs superbly at Mad Kane's Humor Blog  is todays inspiration at dVerse~Poets Pub  – the form is of course limericks.  My two offerings are not new – but what the heck – I thought I would post them anyway!

Democracy is Dead.

Armed Police at Save the NHS protest - photo by heardinlondon

On Saturday several hundred people protested against the Health and Social Care Bill and gathered in front of the Ministry of Health.  Armed police were in attendance.  You might not know anything about this protest for it was not reported.  Why?

Visit the good Dr No and read For You, The Democracy is Over at Bad Medicine and also the good Julie and read The Death of Democracy at Campaigning for Health.

Tonight there will be 25 NHS Candlelit Vigils nationwide - I wonder if they will be reported?  I wonder if armed police and the riot squads will be in attendance?

Be afraid, very afraid - for democracy is dead.

Anna :o[

Subarachnoid Haemorrhage

Image: Uzengia Alexander Nedic

A lightening strike? 

A thunderclap? 

Pain exquisite

he stumbles

at the shock of it,

falls,

tumbles down

the grassy bank,

comes to a stop. 

Tries

to make sense of it,

looks for a storm,

a fallen branch,

feels head and neck

for gaping wound,

for blood,

finds none of it

He stands,

great toe tingles,

stands erect. 

Confused

he undresses (bottom half),

tries to press down toe

with other foot. 

None of it. 

It stands erect. 

He falls again

(the shock of it)

arms headlock

as if to quell

the pain of it.

He sees her in the white,

fuzzy, undefined,

unrecognised,

light dims

turns black.

She stands

atop the grassy bank,

waits for him,

impatient,

angry,

hurt. 

He has not come. 

Looks down,

does not see him

taking root

amongst the undergrowth. 

“He will not do this again!”

she seethes,

cries,

turns on her heels

and leaves.

Anna :o]

With thanks to Tess at The Mag for the inspiration.

I Just Know Things...



Image by Sarolta Ban

 “I just know things”
she had whispered softly,
thin cold hands
combed through his hair,
brushed escaping wisp
from sweat beaded forehead
 “And you must know that I really care?”

He had thought her
some famous psychic
able to read his troubled thoughts;
some shrink wise to his chaos,
knew he was fraught,
nearing madness…

She’d picked him up
at some drinking hell hole,
slumped over half-drunk whisky,
racked with emotion,
slurring he was steeped in badness,
that his God would forsake him…

“No Sir” she had interjected
“you have a soul worth saving,
let me take you home,
let me give you love and succour,
let make you whole again.”

Drink sodden
he had drunk her potion,
entered her thin cold body,
inhaled her cold dank breath,
died there alone
in that cold lonely *bedsit
embraced within the arms of death. 

Anna :o]

*A bedsit is a form of rented accommodation consisting of a single room and shared bathroom and kitchen, an American equivalent would be a SRO or rooming house.

With thanks to Tess at The Mag for the inspiration.

The Tutor

Not so deep

inside his psyche

exists the  

frightened little man;

defences up

he walls him in;

ego inflated.

Square, angular

'Chiselled from some

metamorphic rock'

(he muses)

jaw juts forward;

he gives emphasis

to every uttered word,

each morsel offered

as a tasty crumb

of wisdom

to be shared

vainglorious.

His students wait,

impatient

as he pauses yet again,

sits,

adopts his Rodin pose,

his thinking stance,

scratches

at his salt and pepper head,

dandruff flakes extracted,

he rolls twixt thumb and finger,

creates tiny oily balls,

flicks into waiting pocket

lest they contain

some random thought,

some stroke of genius

leached out,

secreted accidentally.

Class done,

'Young minds broadened'

(he muses)

he wanders

head bowed, shoulders slouched

as if carrying the burden

of his intellect

(self-perceived),

hands firmly clasped

behind waiting back,

through corridor and cloister.

The young ones,

see through his affect,

his pseudo-intellect

and titter ignominiously. 

He flinches,

hurt

and not so deep inside

his psyche

exists the

frightened little man,

defences down,
wall tumbled,

ego deflated.

Anna :o]

(Please note that the above is not an attack on the teaching profession only memories of one particular tutor!)

Thanks to the good folk at Open Link Night ~ Week 33 (hosted and posted by Hedgewitch) at dVerse Poets Pub.

Vision



Detail of the Schreyer-Landauer epitaph



Feathers, wedges, pitches,

rough shape stone.

beauty to define;

percussion lifts the veil,

reveals his vision;

the masons’ stroke

with every

successive sweep

projects relief,

elevates his dream

to final glory.

Victoria C. Slottos’ challenge at dVerse poets is to write an ekphrastic poem using a sculpture for inspiration.  Although I paint and draw I have never sculpted, so research was needed and my hope is that sculpting tools and methods of sculpting used in my little effort were actually used during the lifetime of Adam Kraft (born c. 1455-6, Nuremberg,  Bavaria [Germany] – died 1508/9), a sculptor of the Nuremberg school. 

Below is a self portrait (1490s) of Adam which is sited at St. Lorenz Church, Nuremberg.  How gifted he was!

Attributions: Adams self portrait courtesy of Wikipedia

Detail of the Schreyer-Landauer epitaph at St. Sebaldus Church, Nuremburg courtesy of  Allie Caulfields' photostream at flickr.

Anna :o]

An Ordinary Man



image: epic mahoney



Life complicates

with every twist and turn,

with every secret

held close

to anxious chest.

He dismounts,

parks up,

enters the box,

wishes the light

more dimmed,

lest he be observed

by prying eyes.

No indiscretions he,

an ordinary man he

remains amazed

at her choice

of him. 

No wealth,

no great intellect,

the only thing

he has to offer

is himself.

He thinks of his wife,

the ready scowl,

the nagging tongue. 

God, once he did love her so,

yet familiarity

bred contempt

and rent apart

the very fabric

that made them one.

He picks up the phone,

dials,

heart flutters

lest she not respond,

she does, whispers

“I love you!”

He straddles the bike;

elation

fades to heaviness. 

She will be waiting,

her diatribe of bitter words

will spill like shards of glass,

will cut him deep.   

She sees him,

no lover her,

no “I love you!”

her bitter words

stab at his heart. 

He picks up the knife;

blind with rage

penetrates her flesh,

muttering

“Well my love,

till death us do part!”

With thanks to Tess at The Mag for the inspiration.

Anna :o]

The Sham Of e-petitions

Oh I have lost count of how many times I have clicked on to Dr Kailash Chands e-petition and marvelled at the daily increase (in thousands) of those who have signed.  Initially I truly believed that the general public genuinely had a voice and could elicit change, that when the magic total of 100,000 was reached, the subject of the petition would be debated in Parliament.

Then I read the ‘small print’ and realised I was a trusting fool.

The website states “e-petitions is an easy way for you to influence government policy in the UK.”  However this is strictly not true as plainly stated in ‘How e-petitions work’ - “If you collect 100,000 signatures, your e-petition COULD be debated in the House of Commons.”  Just could be, that’s all.

Any person in the UK can petition the government electronically and any petition that reaches 100,000 is referred to the House of Commons Backbench Business Committee (BBC), who reviews the petition and decides whether it merits debate in Parliament.  (However a petition does not necessarily have to reach the 100,000 total if the Committee feels its subject merits debate.)

If a petition reaches 100,000 it does not automatically follow that it will be debated as it may be felt the subject does not merit debate, there is not time available to schedule the debate or no MP wishes to debate it.

With regards to Dr Chands e-petition Labour MP Natascha Engel (chairwoman of the BBC) states in this article in The Huffington Post “the amount of time allocated by the government meant it was increasingly difficult to schedule debates on contentious issues such as NHS reform.”

She also states that she can only schedule debates with cross-party support necessitating Liberal Democrats and/or Tory MPs to back the Drop the Health Bill petition.

So regrettably it would appear that the petition will/might not be debated and that the electorates’ voices will be ignored.

Is this surprising from a government that does not invite critics of its reforms to its meeting?

Anna :o[

Rome Is Burning

There has been a wonderful surge of signatures to Dr Kailash Chands’ e-petition “Drop the Health Bill” and indeed it has more than surpassed the 100,000 mark (130,789 at the time of writing) required to allow debate in the House of Commons.

But will it be debated?

Click on FAQs and read that “If the subject of the e-petition is currently going through legal proceedings, it may be inappropriate for a debate to be held."

As Cameron and Lansley are determined to ignore the concerns of the BMA, 19 Royal Medical Colleges, Institute of Healthcare Management, Royal Colleges of Nurses and Midwifes, NHS Consultants’ Association, GMB, Unite and Unison unions, Faculty of Public Health, Patients Association, Institute of Healthcare Management, Medical, Management and Nursing Journals, Chartered Society of Physiotherapists, etc. and push ahead with this much hated bill – why would they take notice of an e-petition?

If our wonderful government are intent in ignoring the very people who work within the NHS what more can we do?

If you have not signed the e-petition please do so and Facebook and tweet it!  Email your ‘contacts’ and ask them to do the same.  (The greater the number - the less likely the e-petition will be ignored.)

Email your MP – ask him/her what they intend to do (remember they were elected by you to represent you) on 22nd February when a debate is to be held to vote on the release of the risk register.   (Unison have made it easy - just follow instructions on page.  You don't have to be a member of Unison to do so - I'm not)

Details on the risk register from Unisons' pages:

“The government has so far refused to release the so-called “risk register" behind its controversial Health Bill, despite the independent Information Commissioner telling them to do so.

Speculation suggests that the register contains damning information about the risks of the government's NHS overhaul, particularly around the cost of its plans and the ability of GPs to take on massive new responsibilities.

It takes just two minutes to make a difference

The debate on 22 February is a chance for MPs to vote for the government to release the risk register now, so that the public will have a better idea of what is in store for the NHS and our politicians will be better informed when considering the Health Bill in Parliament.

Ask your MP to support the motion that the risk register should be published.”

If you care about your NHS, please ask your MP to support the motion and again email your ‘contacts’ and ask them if they will do the same.

Email  No 10 direct  and inform Dave of your concerns. It of course is highly probable that he will not read it – but if enough of us write he will certainly be aware of the volume of mail received and the general publics’ unrest, fear, hatred of the HSCB. (Again ask your contacts to do so too.)

Dave’s pride has become more important to him than the wishes of US, the GENERAL PUBLIC, THE ELECTORATE. We live in a DEMOCRACY; we have a RIGHT to VOICE our OPINIONS.

Please don’t just sit there while Rome burns, do something now before it is too late!

Cheers!

Anna :o]

Update on the e-petition!

I checked the number of signatures on the e-petition this morning and the total was 69,000+.

Went to bed, got up and read this article in Pulse, checked the petition to find 92,300 signatures.

What does that say to you Lansley?   To me it says an awful lot of docs have signed today!

I am indeed a happy bunny!

Keep signing folks!  (Just checked when creating this link - now 94,142!  Yippee!)

Anna :o]

Time Is Running Out!

JD provides a list here of those for and against the Health and Social Care Bill (HSCB) and he notes in his ‘Against’ column that “Most of the population (if they knew it)” would be.

I am certain he is correct.

So why don’t they/we know?  I think Richard Bloggers’ excellent post “Why Patients Are Not Objecting To The Health Bill” is well worth a read.  Please read it all!

He writes:  “NHS patients treat the NHS like mains-supplied water. When you need it, it is there. Turn the tap on, and the water flows. Go to your doctor and get treated. You don't have to think how either is provided. You don't think about how it is funded. (Even people on metered water don't think: flushing this toilet will cost me 1p.) You know it is there and you use it when you need it.

And that is exactly how it should be.

But it will change under the Health and Social Care Bill.”

And indeed it will.

For further information of how the HSCB will affect YOU, please read “Frequently asked questions on the Health and Social Care Bill” and focus on

Q7:  I had the impression that the reform was all about putting GPs in charge, which sounds like a good idea.  Isn’t this the case?

A:     No. Through their involvement in Clinical Commissioning Groups (CCGs), GPs will be acquiring new financial and legal responsibilities for balancing budgets and deciding whose care can be paid for and whose cannot, but they may well see a reduction in their professional autonomy rather than an increase.  Specialist services will be provided for most patients through the Any Qualified Provider (AQP) process (identical to Any Willing Provider process used for commercial procurement in the EU and the USA).  GPs initially believed that they would be able to help their patients navigate the system and arrange optimal care.  However it turns out that any provision through AQP must be administered under competition laws, it is the rule of the patient alone to choose a provider.  Because the GP is part of the system, it would distort competition between providers if GPs advised patients of which to choose – so they won’t be allowed to.   Thus GPs will only gain workload and risk, and patients will be deprived of GPs know-how on which providers will be the most suitable.

So your care outside your GP practice will be in the hands of ANY Qualified Provider and not that of a specialist your GP knows and trusts.  How will YOU know who to choose?

Would you send your child to ANY school or attempt to secure a place at a school that offered good education?  Would you buy ANY car or one that you knew was roadworthy?    Would you buy ANY house or one that you wanted to live in as it suited your needs?  (Carry on the possibilities here your good self!)

Dr Kailash Chand is behind an e-petition to have the HSCB scrapped.    It has 63,237 signatures at the time of writing and needs 100,000 before 16/05/12 to force a debate in Parliament.   If you care about the NHS, please sign it – there is much to lose if you don’t.

Please email all you know and ask them to sign the petition and also forward “The frequently asked questions on the Health and Social Care Bill” too.

Cheers!

Anna :o]

Addendum:  e-petition signatures at 11H05 today (Sunday) is 64,467!  A thousand plus since yesterday!  Keep signing folks and we will easily make 100,000!  Don't forget to ask all you know to sign it, tweet it, whatever they can!  Yay!

Aleksandr Nikolayevich Bakulev

A grave, Novodevichy Cemetery, Moscow

A peasant boy

not content

to bow to circumstance,

no plough guided

by his steady hand

but that of scalpel blade,

Incision made

he opens up his mind

to medicine.

Art and science;

skills honed

on the scars of battlefield,

he becomes the surgeon.

The thoracic cavity,

a privilege to see within

what lies

beneath the human skin,

sternum sawn apart,

a pioneer,

he removes a growth,

repairs a heart.

The surgeon

not content

to bow to circumstance,

in death thrusts

forth his hands

grasps at the heart,

the heart of medicine.

Anna :o]

Tess’s prompt is that of a grave at Novodevichy Cemetery, Moscow.  Research led me to the knowledge that Novodevichy is a very prestigious place to be buried in and that the grave is that of Aleksandr Bakulev.

I knew nothing of him so researched and discovered he was an eminent Russian surgeon and that the Bakulev Scientific Centre of Cardiovascular Surgery was founded by him.

Unfortunately it is difficult to find much about Aleksandr as all entries found were either the same or abridged versions of his life history described at the Russia-InfoCentre – that is apart from a brief description given at Wikipedia – you can click on via Novodevichy Cemetery.

Nevertheless – despite the brief history – his genius is obvious.

With thanks to Tess at The Mag for the inspiration.

Anna :o]