Everyone has their own ideas about what constitutes being totally fucked, by which I mean that level of gubbedness that is unsalvageable and not worth even trying. There are various ways of thinking about it, you can do a P-possum, check their base excess and pH, look at them from the end of the bed, but one thing is sure. There is rarely a return to health from being totally fucked. It can be depressing.
Bighospital is totally fucked just now….
We have 8 nurses off sick on my ward alone; 5 with either flu or vomiting and 3 with stress and this situation is repeated everywhere.
We have no beds for elective operating as we are full of unwell medical patients. We do physically have beds, but we have no staff to open them.
We have an A&E that is full and overflowing with staff at the ends of their tethers. Patients are being told they have inappropriately attended and should have waited 2 hours to speak to NHS 24 and then 6 hours for a GP to come.
We have trainees (entitled and snowflakey in a way I never was) being taken off on call and moved to elective operating lists in case they complain in their GMC survey and we lose them entirely. Newsflash to anyone who thinks like this: this isn’t school, you get a salary, start delivering some value for money.
We have some consultants who won’t do anything that isn’t in their job plan and obstruct and hinder attempts to improve service. “I’m a consultant surgeon, nobody can tell me what to do”…you’re a salaried employee, not a deity.
We have managers who can’t manage. Leaders who can’t lead.
Bullying, misogyny and bitching are endemic.
Patients on the ward are sometimes not washed or fed because nurses are filling in endless paperwork and “magic stickers”* for every problem that must be completed or some nurse manager will explode.
I can’t get the elderly and dependent patients out of Bighospital because there are no carers to look after them in the community. They remain there, pathetic and heartbreakingly vulnerable, not having been home for weeks. These people haven’t seen the sunshine or felt the wind on their face, and they bear it politely and impassively in a way I could not.
We are beyond fucked. It is the same everywhere, I’m not sure it can be fixed and I suspect that our conservative government doesn’t care if it dies.
*magic stickers are Bighospital’s response to all problems. For any target or goal or other utterly unnecessary nonsense that trained nurses and doctors do anyway there is a sticker. For example; a doctor is asked to review a patient with a low blood pressure. The patient is 17 and weighs 50kg and is asleep, her BP is 80/50mmHg. It was similar to this when she was awake. This is normal, but the nurse has to mention it to the doctor. A year ago we could say “that’s fine. Thanks, I’m ok with that” now the junior must complete a fucking sticker and a complete assessment and stick it in the notes.