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Care Homes & Brushing Influenza under the Carpet

Tom Lennard

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Care Homes & Brushing Influenza under the Carpet

Last October it was reported in the Guardian that the total number of care homes had fallen from 18,068 in September 2010 to 16,614 in July 2016.

Meanwhile, in early 2017 there are reports of care homes closing around the country, two from East Yorkshire facing closure[1], as well as Devon[2] and Wales.[3] The former Lib Dem Care Minister Norman Lamb has launched a cross-party campaign to solve the crisis in health and social care [4], and in addition an urgent letter was sent to the government from Independent Age, including signatories from the Royal College of Nursing and Royal College of GPs, both expressing similar sentiments.

In and of itself this is concerning enough. Care homes closing will no doubt create a further burden on healthcare services. But not discussed are the number of care home influenza cases. Every week Public Health England produce a report of the cases of influenza for the previous week. Last week (up to January 19th) it can be seen that of 122 new acute respiratory outbreaks in the community (essentially flu), 94 were from care homes.[5] Whilst this figure can enlighten us very little as to why influenza loves a care home, it can be suggested that the collapse of so many of these institutions will do the infamous, and sometimes deadly illness, some favours. Firstly, infected but asymptomatic residents rushed to another care home, or back to family or concerned parties, will possibly infect other people. Secondly, there is a likelihood of these people entering the healthcare service and infecting others. Thirdly, the whole process of closing a care home will no doubt unsettle the virus, and due to its survival of 24 hours outside of the host, it will be able to transfer much more in its immediate environment.[6]

To turn to those unfortunate enough to go through the upheaval of having a care home close – the combination of respiratory illness alongside the stress of the unfamiliar may be too much for them. Influenza may end up isolating or separating them from those who are close. Thus a spate of care home closures doesn’t only present a challenge for the healthcare and social care systems, but combined with a true epidemic or pandemic, could add to the devastation wrought. Jeremy Hunt congratulated the high uptake of flu vaccinations this year on Twitter.[7] But as any nurse, or other healthcare professional will tell you, stopping something from happening in the first place is better than hoping that pharmaceuticals and a robust immune system will fight it off. If anything the Health Secretary’s heartfelt messages and “thank yous” during his tenure attempt to mask his administration’s poor regard for long term health and social care planning. Influenza is an old and familiar opponent, and hard to stop. But by letting services waste away, the government endangers the health of nurses and other healthcare professionals.

[1]    http://www.hulldailymail.co.uk/call-for-action-to-stop-more-sudden-closures-of-east-yorkshire-care-home/story-30031066-detail/story.html
[2]    http://www.exeterexpressandecho.co.uk/christmas-woe-for-staff-and-residents-as-two-exeter-care-homes-face-closure/story-30001369-detail/story.html
[3]    http://www.dailypost.co.uk/news/north-wales-news/colwyn-bay-care-home-shut-12017529
[4]    http://www.normanlamb.org.uk/norman_lamb_launches_cross_party_nhs_and_care_campaign
[5]    https://www.gov.uk/government/statistics/weekly-national-flu-reports
[6]    http://www.nhs.uk/chq/pages/how-long-do-bacteria-and-viruses-live-outside-the-body.aspx
[7]    https://twitter.com/Jeremy_Hunt/status/823934903591063552
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Adam Kay’s Letter to the Secretary of State for Health

Matt B

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Adam Kay's Letter to the Secretary of State for Health

Adam Kay, a former Doctor, publishes an open letter to the Secretary of State for Health calling for him to walk a mile in the shoes of a junior doctor.

In his new book, ‘This is Going to Hurt: Secret Diaries of a Junior Doctor,’ the former obstetrics and gynaecology doctor writes candidly about his experiences as a junior doctor and the effect working in medicine has on both his personal and professional life.

In the open letter to The Secretary of State for Health, he said;

“Roger Fisher was a professor of law at Harvard University, who suggested back in 1981 that they should implant the American nuclear codes in the heart of a volunteer. If the President wanted to press the big red button and kill hundreds of thousands of innocent people, then first he’d have to take a butcher’s knife and dig it out of the volunteer’s chest himself; so that he realizes what death actually means first-hand, and understands the implications of his actions. Because the President would never press the button if he had to do that.

“Similarly, you and your successor and their successors for ever more should have to work some shifts alongside junior doctors. Not the thing you already do, where a chief executive shows you round a brand-new ward that’s gleaming like a space station. No: palliate a cancer patient; watch a trauma victim have their leg amputated; deliver a dead baby. Because I defy any human being, even you, to know what the job really entails and question a single doctor’s motivation. If you knew, you would be applauding them, you’d be proud of them, you’d be humbled by them, and you’d be eternally grateful for everything they do.

“The way you treat junior doctors demonstrably doesn’t work. I strongly suggest you seek a second opinion.

If you’re interested in reading more, you can buy a copy of his book on Amazon or book tickets for his ongoing tour.

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The Junior Doctors Survival Guide written by Nurses

Matt B

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The Junior Doctors Survival Guide written by Nurses

Well done. Congratulations. You’ve survived medical school and made it ‘on to the shop floor’, this is where the real test begins.

Your first few weeks as a Junior Doctor are going to be difficult and jam-packed; a new hospital, new colleagues, new patients, and a new hospital system to figure out.

Here are ten tips that will stand you in good stead for your first day, week, month, year and beyond. This is your Junior Doctors Survival Guide as written by Nurses;

  • Respect the nurses. You can come to us for advice and guidance – we will have you back – but please don’t take us for granted. We have an abundance of knowledge about our patients, the hospital and how to make stuff happen.
  • Each member of the team is important. Doctors, nurses, porters, physiotherapists, domestics, estates, plumbers – the hospital simply couldn’t function without them.
  • Don’t be a smart arse. We know and understand you have worked hard through medical school and congratulations on becoming a Doctor, but now it’s time to get to work.
  • Have a sense of humor. Make sure your able to have a laugh and a joke but be careful not to cross the line.
  • Master cannulation. I don’t just mean know how to put a cannula in – develop the skill and master it – it will stand you in good stead for the future.
  • Eat and drink. The list of jobs is, and always will be, almost endless. Make sure you take your breaks; eat, drink and chat to your fellow colleagues.
  • Show emotion. I’m not going to lie to you, it’s going to be hard – medical school hasn’t prepared you for the first few months of life as a Doctor. If you’re having an especially tough day talk to someone about it. Don’t beat yourself up for having a little cry – it happens to the best of us.
  • Don’t just look at the numbers. We spend 12 hours a day with our patient, we will come to you when “something just isn’t right”, we don’t know what, we can’t put our finger on it. But, we know our patients.
  • Your first death is hard. Expected or not, nothing can prepare you for the death of your first patient. We have all been through this. See- show emotion and How to Deal with the Death of a patient
  • Tidy up after yourself. Nothing and I mean nothing, annoys the ward staff more than a Doctor who thinks the staff are there to clean up after them. Tidy away your sharps, notes and coffee cup.
  • Ask for help. Your seniors are there to support you – it’s literally their job. Don’t be afraid to escalate patients or situations to them and never put yourself in a situation where you have no backup.
  • Admit when you simply don’t know. Making up an answer to a question can have serious consequences. If you don’t know. Say, but find out.
  • Try to go home on time. Look through your list – find out what can wait until tomorrow. Your downtime and social life are important too (check out our list of NHS Discounts for downtime ideas). You work to live not live to work.
  • The hospital at night is scary. There are fewer doctors, nurses and seniors around to support you. Call for help early and escalate appropriately.

Remember, you are part of our team. Our job is to work together in the interests of patient care. We will try to look after you, make you tea when you’re sad and, rest assured, we will tell you when you’re being an idiot.

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