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Nurse receives heavy criticism for discussing patients case on Facebook

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A Nurse, in a final act of desperation, reached out to fellow healthcare professionals online in a bid to assist in the healing of a chronic wound.

The Nursing and Midwifery Council (NMC) offer nurses extensive guidance on their conduct online but it seems this case has delivered somewhat of an ethical dilemma for many.

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The Nurse involved claimed to have exhausted all other available options including tissue viability and a multitude of second opinions and only turned to a Facebook group for Nurses as a last resort.

The patient, who remains unidentified, was struggling with a leg wound that despite a multitude of treatments had failed to heal. Her Nurse reached out to colleagues online for help but was met with a mixture of comments with some saying she was “thinking outside the box” and others calling it “inappropriate”, a “breach of confidentiality” and “unprofessional”.

According to the Nurse involved the patient provided full, informed, consent for the discussion and the post contained no identifiable information simply an image of the wound, a short description of the issue and a call for help.

The post was later deleted by the community moderators.

Apps like Figure1 (iOS / Android) can provide a forum for healthcare professionals to seek help from the wider community.

What do you think? Was the nurse thinking “outside of the box”, providing holistic care and simply utilising the resources available to her or did she overstep her boundaries as a healthcare professional?

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Mobile Stroke Unit will see patients receive life-saving care faster than ever

This the first time a Mobile Stroke Unit, a concept developed by the University of the Saarland in Germany, has been tested in the UK.

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Southend University Hospital is undertaking the trial of a Mobile Stroke Unit which will see patients receive life-saving care faster than ever.

The Mobile Stroke Unit, which has an onboard CT scanner and blood-testing equipment, will be staffed by stroke and imaging experts who can diagnose and start treating patients with suspected stroke at the scene.

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This the first time a Mobile Stroke Unit, a concept developed by the University of the Saarland in Germany, has been tested in the UK.

Lead Stroke Consultant at Southend, Dr Paul Guyler explains its importance: “It’s widely known that ‘time is brain’ when it comes to stroke.  When a patient is suspected to have had a stroke a CT scan is essential to allow specialists to determine whether the patient has a blood clot in the brain, a bleed in the brain or something else. 

“The scan determines the diagnosis and what treatment happens next, and the Mobile Stroke Unit brings the scanner and the clinicians to the patient.”

Should a stroke be diagnosed, life-saving clot-busting medications can be administered to the patient quicker than ever before.

The Trust was offered the opportunity, to test the specialist ambulance in the community for a short period of time.  This was made possible because of the of the strong links between Consultant Interventional Neuroradiologist Professor Iris Grunwald, who works at the Trust and also holds the post of Director of Neuroscience at Anglia Ruskin University School of Medicine, and her colleagues at the University of the Saarland, Germany who are supplying the vehicle free of charge.

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The unit will be based at Southend to ensure safety and governance standards are met and Professor Grunwald has been working with the Trust’s stroke team to put plans into place.  Anglia Ruskin University and the team will be evaluating the information collected during the project. 

Professor Grunwald said: “We know that Mobile Stroke Units work in a densely populated city through trials carried out in Germany, Norway, Australia and the USA.

“The data and learning we gather during the period the vehicle is in use will be valuable in understanding the benefits and challenges of using a Mobile Stroke Unit in a more suburban or rural area, like we have across mid and south Essex.”

While the project is limited to a three-month period, the stroke team are looking to the future and hope that the information they gather over the 12 weeks will help inform plans to develop stroke services across mid and south Essex.

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Secondary Care

Protests continue at Alder Hey Children’s Hospital

The protesters, known as “Alfie’s Army”, are in support of Alfie being released from the care of Alder Hey Hospital and transferred to the facility in Italy.

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Protests have continued overnight at Alder Hey Children’s Hospital in London over the case of Alfie Evans.

Alder Hey Hospital are currently providing care for Alfie Evans, a 22-month-old, who has a degenerative neurological condition which has left him severely brain damaged.

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Alfie’s parents are currently looking at transferring Alfie to a hospital Rome where they claim his treatment for the unknown condition can continue.

The protesters, known as “Alfie’s Army”, are in support of Alfie being released from the care of Alder Hey Hospital and transferred to the facility in Italy.

But, Mr Justice Hayden ruled last night that Alfie cannot be removed from Alder Hey Children’s Hospital pending the hearing before a Court of Appeal decision on Monday.

Initially, the trust said that protests were “peaceful” but have since released a statement outlining that a small number of supporters ‘negatively impacted’ on other patients, families and staff at Alder Hey.

A spokesperson for Alder Hey Children’s NHS Foundation Trust said; “We do understand that this is a very distressing time for Alfie’s parents and realise that there is a great deal of public interest in this matter.

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“Alfie’s clinical condition is truly heart rending, but at each stage of the legal process which has to be followed in such cases, the courts have agreed with the treating team and the independent expert advisors instructed by the Trust and the family that Alfie’s condition is irreversible and untreatable.

“All treatable conditions have been diagnosed. All the experts agree that it will not assist Alfie to subject him to further tests in order to identify a diagnosis.

“As part of that process his parents are making further appropriate representations to the Court of Appeal to present their views.

“Last night Mr Justice Hayden ordered that Alfie cannot be removed from Alder Hey Children’s Hospital pending the hearing before the Court of Appeal on Monday.

“We trust that the public and supporters of Alfie’s parents will respect that decision and allow the staff caring for Alfie and all other children and families at Alder Hey to continue their duties without interference and disturbance.

“Unfortunately, the action taken last night and the behaviour of a small minority of supporters impacted very negatively on other patients, families and staff at Alder Hey.

“We would therefore be grateful if all respect and consideration is shown to all our staff, patients and families at the hospital.

“Our priority continues to provide Alfie and all our other children with the best care possible.”

Earlier in the week, the trust made the following statement after the protests caused “significant disruption” to its service;  “the hospital experienced significant disruption, due to a large protest concerning one of our patients.

“We wish to pay tribute to our amazing staff, who worked tirelessly under extremely difficult conditions to manage the implications of this disruption.

“Alder Hey is a special place with highly skilled staff who dedicate their lives to caring for and looking after thousands of sick and ill children every year.

“Our priority will always be to protect and look after the welfare of all patients and staff and to continue to provide outstanding care to our patients and families, which we know is recognised by colleagues across the NHS and in the wider public beyond.”

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Hospital doctor embodies everything good about the NHS

The innovative surgery has never been performed in the UK before and involved four consultants.

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The Consultant Surgeon stole the hearts of millions of viewers as he fought to ensure a patient’s life-changing surgery went ahead.

Dilip Srinivasan, Consultant Maxillofacial Surgeon and Clinical Director at Nottingham University Hospitals NHS Trusts stole the hearts of millions of views after revealing his refreshingly down-to-earth approach to patient care.

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During the episode, Mr Srinivasan is due to perform life-changing surgery on Val Blunden, who’s entire jaw was destroyed by mouth cancer several years earlier, but an instruction from the Department of Health to cancel all such surgeries puts her surgery at risk of being cancelled.

The innovative surgery has never been performed in the UK before and involved four consultants.

Explaining the surgery Mr Srinivasian said; “We had to use a different type of technique. What we have done in Nottingham is grow the bone by a distraction.

“What that technique is when you break a bone, for the bone to heal it [requires] first the soft bone – before the bone becomes hard – being stretched to make the bone longer.

“That’s the technique that we have used. We have done this in a few operations before, But what we have not done is on a patient missing bone, skin and muscles.

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“All three missing I have not come across anyone in the UK who has done it or in world literature.”

When informed that Val’s surgery was on the list to be cancelled Mr Srinivasan worked alongside general managers, Jo Fort and David Dalby to ensure the surgery went ahead.

During filming, Mr Srinivasan was asked why he pushed so hard to ensure the surgery went ahead Mr Srinivasan replied; “Urgency, you are talking from whose perspective? If you can’t go out of your house, you can’t eat, you can’t talk, it is urgent”. 

Filmmakers questioned Mr Srinivasan on why is thought the surgery was necessary; “It doesn’t sound very urgent?”. “It doesn’t matter what she is, what she is now is the question. What she is now is someone who is suffering” replied Mr Srinivasan.

Since filming Val’s jaw was grown by 9cm and she continues to do well.

A spokesperson for Nottingham University Hospitals NHS Trust said; “Thank you for featuring the work of Dilip and our Maxillofacial team. We have had a great response both to them and to Val and her family, and the progress she is making. Since January we have unfortunately had to cancel 800 routine operations, but we hope that Hospital is showing how we have worked as a team to make difficult choices in the best interests of our patients.”

You can catch up on ‘Hospital’ on BBC iPlayer.

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