MMR Problems....Again

For those of you who havent already heard about this. Dr Andrew Wakefield is the Canadian trained British physician who published a report in 1998 'proving' a link between the Measles Mumps and Rhubella triple vaccine and various bowel disorders and even autism. His 'results' are now being questioned, and not just by those of us who know enough to identify shoddy research when we see it. Almost miraculously his research is now being questioned by the vox populi. The optimist in me wants to believe this indicates a massive step forward in the general intelligence of the masses.

The first issue with this chaps research I wish to raise is that he recieved fifty thousand pounds(a substantial amount even for a doctor) from a legal agency supporting patents of children with health conditions they would like to link to the MMR vaccine. I cant think of any reasons he would take the money that would allow him to remain unbias(an essential stance for any level of research). Interestingly the article makes a fairly small point of it. He also tried to patent a potential alternative to the MMR vaccine, had this gone through he would have been a very wealthy man, however success in this matter required the standing MMR vaccine to be discredited.

However the largest issue from my perspective is that this man presented his findings as fact when there was insufficient evidence to even found a credible theory, infact there was overwhelming contradictory evidence. As a result the number of parents vaccinating their children went from around 91% before his report to 70% following it. As a result there has been a massive resurgance of mumps(which can be fatal). I admit its largely the patents fault for not vaccinating their children but what choice did they have when the 'experts' told them it was too dangerous. I also dont understand why this increase has gone unreported by the media when so much fuss has been made over a few cases of swine flu. In my honest opinion I feel this 'doctor' and his colleagues should be charged with manslaughter.

Great Shift

I had a wonderful shift as a bank healthcare assistant on an emergency medical assessment unit(EMAU) today. This shift has come in the middle of a series of horrifically busy and understaffed shifts. Today we were busy(the busiest ward in the hospital) and understaffed as well. The key difference was who I was working with. My recent bad shifts have been working with people who panic, they get stressed and it paralyses them. I honestly found someone crying at the fact our linin cupboard had run out of organge pajamas so she would have to dress her patients in the green or pink ones. When one person on a shift gets overly stressed the rest of staff on that shift feel it and get stressed too. Fortunately working on A&E has taught me how to stay calm when others are freaking out however eventually it does get to me too.

Todays shift was busy, I had fourteen patients to myself as did the other three healthcare assistants(its a big ward). However I spent more time on this shift laughing than any other time in my recent memory. We kept each other calm and focused. There was one point where another HCA was feeling a bit shakey about being told to take the obs of a patient she knew was close to death(I recently posted on a similar matter). I uttered something along the lines of "Our job is to play the game, and if we get really really good at it we can change some of the smaller rules". It was just an off the cuff and hopefully supportive sentiment which had the desired effect however it wasnt until I had said it that I realised it was true. The best incentive for ambition in healthcare is the ability to tweek the minor rules regarding patient care(the big rules will never be dictated by anyone with a clinical education).

I'm currently aching but still smiling, Today wasnt just about the much needed money for me, I really enjoyed my shift.

The Bell Tolls

Her bones are clearly visible through her yellow tinted skin. She has a cannula in each arm both have tissued, her veins having shut down hours before. Her last set of observations tell me her systolic blood pressure was sixty-seven, barely compatible with life. She has been on the liverpool care pathway for two days. She is Dying.

Despite all this my patient was incredibly lucid. She was aware of what was going on around her and could answer all of our questions appropriately. This is why, when I was asked to take a set of observations on her I refused. She is on the pathway for the dying with twenty-four hours left on it all of her previous vital observations and physical observations suggest it will be much sooner than that. I refuse to tug a blood pressure cuff onto her arm, inflate it to a painful level and drag it off again when the results will be of no use to anyone. I still cant believe the nurse asked me to do that to my patient.

Standard Shift

I step onto the ward at 0645, typically early. I stand staring down the long corridor leading to the nurses station. Doors to the right leading to small two or four bed bays, doors on the left leading to isoluation cubicles. I close my eyes the same as I do every time I start a shift listening for the indicators of the kind of shift I have ahead of me, somewhere down the corridor I hear the loud, shrill screaming of a ninety year old dementia patient on a loop screaming for her mother. Down towards the nurses station where all the six bed bays are I hear numerous buzzers going and the sounds of staff members actively trying to prioritise tasks. The smell which once was very prominent to me now barely noticable that of thirty unwell patients. All this speaks of the end of their busy night shift and the begining of a fairly standard early shift.

Eight hours later I am stood in the same place looking back down the same corridor, sweat still obvious on my skin, my head throbbing and my hands shaking because I havent had anything to drink since the start of my shift and I havent eaten in almost twenty-four hours. My knees and back also throb, my bodies way of complaining at the unnatural positions I have to adpot in order to do my job. A smile creeps across my face as I realise despite all this I have achieved a lot today, my patients are all clean, well fed and settled. I take a deep breath, aching and maloderous I go home.

Growing Up

Recently I have been mulling over fond memories of my later childhood. Spending whole nights playing various computer games with my friends, exchanging witticisms over irc. Sunny summer days spent sitting on the grass in a nearby towns park just relaxing. I used know exactly when my favourite authors next book was due out.

Now my life is all sixty hour weeks, assignments, wedding plans, mortgage payments. As far as my favourite author goes even if he hadnt died I'm certain I wouldnt be able to name any of his recent books. As for my friends, I see very few people from those days. I suppose this is just what growing up is and I am certain there are stresses and problems from those times that I am not remembering.

There is nothing in my life currently I would want to be without, I am in a really good place. However I wouldnt mind a touch of the carefree days of youth entering my life again just for a while.

Snow

I had promised myself I wouldnt blog on the tedious matter of the snow. However it is directly effecting my work so its hard to avoid.

Personally I love the snow, I have a degenerative eye condition called retinitis pigmentosa(RP) which makes me as good as blind at night. However the is now this nice reflective white stuff everywhere meaning I can safely walk around at night now(and I love night time). Also as I have size 14(UK) feet and always wear my magnum boots I have no problems with slipping.

Professionally I am concerned about the strain this is putting on the local hospitals. The larger of the two local acute hospitals was completely out of beds for several days recently forcing ambulances to divert to a much smaller and already strained hospital(where I work). My hospital has reopened a ward to try and take some the strain. This ward is entirely staffed on a day to day basis by bank staff, there are no permanent staff on this ward at all. I have got plenty of shifts booked there as a healthcare assistant (the money is good) however it cant be good for patient care to have different staff on every shift throughout their admission.

A&E departments are swamped by fractures(mostly elderly) and the ambulance service is overwhelmed by people who are perfectly able to get to their gp's office but have decided that an ambulance is a much warmer way to get a paracetamol prescription for their headache.I honestly believe these people should be fined, I am certain that the income generated by these fines would pay for a lot more paramedics, nurses and even a doctor or two.