please, please turn yer brains on and be clean in hospitals!

[Tahrey1043]

Standard totally off-topic three-page rant procedure. I suggest you go find a book or something instead unless you enjoy reading full page articles from the guardian or independent. No need to reply unless you feel as strongly as i do and have also had just about e-f***ing-nough and need to soapbox.

Hell we could turn this into a general moan thread with a change of topic line.....

==========


Sorry to whinge* but after a bloody awful day tuesday that ive just come down from (stuck in work til 7.15pm, etc), i have to pass comment.

There's an awful lot of BS talked in the papers and on telly about MRSA.

Some pertinent facts of the matter boil down to***:

It is a minor mutant, of a common skin bacteria present on about 2/3rds of the population, that happens to be resistive to one of our most common antibiotics. It's perfectly fine when on your outside, just when it gets on the inside of a patient who is already immunocompromised, it spells trouble. Staphylococcus Aureus is a common HAI (hospital acquired infection) that's usually treated with Meth... Methy... some antibiotic beginning with M - i think you can guess how the rest of the bug's name came about.
These patients can be very effectively treated with other antibiotics if it is recognised as MRSA (or, one of a family of similar bugs, such as VRE) - the hoo ha is that they have to be carefully barrier nursed, to stop this more troublesome strain of a common infection spreading outwards from their isolation room and becoming a more commonly carried type than it's usual low natural occurrence, which would render one of our best antibiotics totally useless.

The barrier nursing itself is quite simple and follows the usual basic rules of hygeine and quarantine as found with all infections. Treat the patient's room as a place that has a 100% coverage of excrement, basically. If you wear gloves, overshoes, and an apron, and are careful what you touch and to safely dispose of the protective materials in a burn-bag at the exit, followed by a proper scrub wash, everything is fine - the MRSA has no way to transmit. Similarly, simple rules along these same guidelines govern the code of practice in other departments where a lot of patients may share the same space - lay down protective materials that are changed between each appointment, and for "problem" patients, make extra provision - gloves and apron, contipads on the bed, full clean-down when they leave etc. And regular, careful waste disposal and most importantly - hand washing with use of santitation spray.

Unfortunately, the life of nurses, cleaners, and a myriad array of support staff - who have these rules banged into them and have to follow them for fear of losing their low paid jobs - is made a lot harder, and their reputation degraded, by the actions of two self important and disgustingly careless groups, and the consequences/media blowup that follows ----- Doctors (!), and Patient's Visitors. (The patients themselves are usually either very good, as they similarly have the rules drilled into them and are wary of cocking up their treatment, or have no choice in the matter if they are being nursed)

Little can be done about the doctors other than threatening to strike them off, as they will quite casually stroll into canteens wearing blood spattered scrubs and be quite offended when ordered to, for the love of pete, get out of here and change into clean clothes, or bring a round of coffees into a nuclear medicine scanning room where there are patients full of multi-megabequerel doses and a nasty dose of the flu. Professional action is being taken, but it's slow.
(We are still complaining about, and getting nowhere with, the literally indecipherable handwriting some doctors also display - 50 or more years since it became a running joke. Except in real life, it's deadly serious.)

What's more grating is the people that most complain about how disgusting it is that our hospitals are allowed to get into such a state, are those that are the biggest risk factor: Visitors, accompanying relatives and helpers. They wear their outdoor gear into barrier nursing areas. Don't wash their sometimes obviously grubby hands. Cough and sneeze all over the place even whilst the staff are paranoid of even doing so into a tissue. Touch and feel all kinds of different surfaces that ten different people have been fondling even that day. Ignore restrictions on close contact with radioactive or infectious patients. And the thought of putting on protective gear in risk situations never crosses their minds, even if they themselves may well be a walking hive of MRSA (staph A lives on the nose - one scratch of the schnozz with a grubby hand, a stray gamma ray or five, and you have a budding methylicillin**-resistive colony on your finger).

In short, the general standard of hygeine amongst a large slice of the population is nothing short of shocking, and (besides careless, and admittedly overworked doctors) THATS why we have a problem. Not inadequate cleaning - though its certainly a contribution factor in some cases, MRSA still crops up even in places where the work of the domestic staff is exemplary, such as Queen Liz wards or the kids hospital - but just all the sh*t people track in with them and between various points, never thinking for a moment they might be causing any harm.

You may well be that visitor in the future. For the love of all that is holy, take a moment to consider you are going into a very high risk environment where you are surrounded by people with much weakened immune systems (NOT the common "I'll catch something" - they'll catch something from you), and where the sick and infectious either congregate in public areas, or use shared facilities such as diagnosis and treatment rooms, wards and isolation rooms. Particularly in the last two or three cases there, many surfaces, mainly those touched or affected by the patient, could be hives of germs. The staff will clean after you've left, but until then, conduct safe practice. You don't have to scrub up - just wash your hands before entering, and exiting, will remove a good 90% of the risk.


Dedication:
This one goes out to the very well intentioned lady who was just a little short of sight in the minds eye that made me tear my hair out tuesday - once she, and her nearly-crippled-by-MS husband had left the dept. She was my inspiration for the whole post.

NO LOVE, sez I, YOU SHOULDNT TOUCH THAT PAPER THATS SOAKING WET WITH YOUR ILL, INCONTINENT, RADIOACTIVELY DOSED HUSBAND'S URINE, THANK YOU EVER SO MUCH FOR OFFERING, ITS VERY KIND, BUT I'LL DEAL WITH IT MYSELF ONCE YOU'RE GONE, WITH GLOVES, BLEACH, AND DECONTAMINATION FLUID, AS ITS DEFINATELY HIGHLY RADIOACTIVE AND MAY WELL BE FULL OF CONTAGION....

and then, shortly, in my mind... "look you stupid tart, i just told you it was potentially infectious and definately active, and i was happy to clean it up with the right safety gear as that's what i'm trained and paid for - why in the world did you ten seconds later grab a big handful of that p*ss-soaked paper and carry it, dripping onto the floor which i've already decontaminated from him wetting himself earlier, over to the bin marked NON CLINICAL WASTE ONLY and stuff it right down in there with all the other dirty tissues and stuff, only to return to his wheelchair and grab the handles without washing or even wiping-off your bloody hands? how's this sick gent supposed to last another six months in your care with standards of cleanliness like that?"

This is the stuff that we have to deal with. This is why those Conservative posters are a load of bunk. They have the right idea but are solidly naive on what it takes to achieve their goal. Given the capacity for patients and visitors to make a huge god damn mess, it is VERY difficult to keep a hospital clean, much more so to keep it clinically clean and safe.

(what's worse is, not long before, she'd asked for some plastic sheeting to stop him getting the seat of the wheelchair wet...)

It's the same thing as speed limits. You can cut out a whole swathe of risks with brute force tactics, becoming more and more insensibly restrictive each time with ever reducing cost-benefit ratios, until you've got trackers in every car and a 20mph speed limit right out of the 1910s - or a huge cleaning team on the go who, in truth, will now spend a lot of their time sitting around drinking tea as there's little they can actually do without getting in the way of the actual therapy - or you can encourage people to keep a safe gap, and not exceed a speed that allows them to stop within the distance they can see to be safe whatever the speed; and to impress upon everyone entering the hospital the utter requirement for PERSONAL cleanliness, rather than the impersonal type that comes with a cleaner passing by doing their (once, twice, four-times...) daily job and then disappearing, with the whole hygeine thing then leaving your mind.

Sorry about the length but I hope someone, somewhere draws the incessant (not rambly for once, but repetitive) message out of this, and maybe washes their hands after seeing poor, sick, MRSA suffering auntie joan in her private bed bad down the general when they otherwise wouldnt, potentially sparing us another epidemic scare.

Now to cut and paste this anywhere i can.


* not really. it's gotta be done.
** something like that. if you're bothered, google for it. i didn't because i was on a roll, like bacon and ketchup
*** only in the sense of boiling a cup of rice....

PS If you like, and know/care nothing about hospitals, you can pretend this is a rant against all the cocking wastes of oxygen that were on the road today and yesterday. Particularly today. Hows a girl supposed to get thru her test if her tutor seemingly reccommends slowing to 15mph a quarter mile from the approaching T-junction, and then sitting there for a good minute indicating left whilst the road she's joining is --- rarely and flukily! --- utterly, completely free of traffic? Unlike the one directly behind. Arse. All she's going to learn is the humiliation and self-esteem damage of a hundred horns.
That instructor, and the nob in the corsa who accelerated FULL THROTTLE to 47mph from each stop or slowish corner.... and stayed there. On a busy A road. Here's looking at you, numpty. You made me late for my appointment AND gave me the w*nker sign when i finally overtook (long-ish straight empty bit of road), my engine screaming, as you spotted me and suddenly caned your own throttle, tailgating me up to 70+ and flashing your lights for a while. That's two black marks just there. Get another one before the end of the week and you've got a ticket to heck in the post. Oops... you were driving a corsa. That makes three.
Ditto the wibbly in the punto. There's these wonderful little reflective strips they have on the sides of cars now... i think theyre called mirrors... look into them next time you fancy cruising at 41mph on similar roads with a mile long queue behind you.
Just three of about 20. It's a bumper week... often i can get thru it with only 1 or 2 minor ones.

[Babe RuthLess]

"why in the world did you ten seconds later grab a big handful of that p*ss-soaked paper and carry it, dripping onto the floor which i've already decontaminated from him wetting himself earlier, over to the bin marked NON CLINICAL WASTE ONLY and stuff it right down in there with all the other dirty tissues and stuff, only to return to his wheelchair and grab the handles without washing or even wiping-off your bloody hands?"

Man, that's disgusting.

We have a real problem though, if people do that sort of thing... Imagine the sacrifice it must be for her to simply wash her hands.

[GroovyCarrot]

If I were you, I'd rewrite that without the reference to what you were actually thinking about the urine woman, send a copy of it to labour, lib dems and the conservatives, along with all the major newspapers, and hope that someone somewhere reads it. Send it signed for if necessary to ensure that it gets to someone.. the problem is, unless you have actually experienced something first hand, it's very, very difficult to know how things work and how to behave. I went to visit a friend of mine in hospital a while ago who has leukemia and was on chemotherapy, so had basically no immune responses at all.. group of three of us went to visit him, nurse outside his room told us to squib our hands with alcohol spray and left us to it, never mind what we might be carrying anywhere other than our hands, no scrubbing of anything, no mention of whether any of us had infectious diseases, just a quick squib of disinfectant on the hands. Very hard to know what to do if that's all you're told you need to do to enter the room.

Btw, I'd be very tempted to floor the brake pedal next time a moron in a corsa tailgates you after you overtake. Priceless expression when they realise how stupid they're being and back off..

[polopowah]

i get the impression that your be voting conservative? because of the spiralling mrsa cases. But imo conservatives are all talk and no do, so i'll be voting labour, after all we did go to war to liberate miliions of iraqies and we as a nation have never been better off! (apart from fuel costs and immigration) slowly im going off topic!
mrsa has been rife in hospitals since the mid 80's it just has not been publicised and blown out of proportion as it has in recent months, after all how severe is this case compared to Hiv and hepB.

-Ben-

[SiDaBa]

, it's very, very difficult to know how things work and how to behave. I went to visit a friend of mine in hospital a while ago who has leukemia and was on chemotherapy, so had basically no immune responses at all.. group of three of us went to visit him, nurse outside his room told us to squib our hands with alcohol spray and left us to it, never mind what we might be carrying anywhere other than our hands, no scrubbing of anything, no mention of whether any of us had infectious diseases, just a quick squib of disinfectant on the hands. Very hard to know what to do if that's all you're told you need to do to enter the room.

Fair point but at the same time it has to be put across that it's also very much the visitors responsibility and common sense not to go anywhere if they are contageous of anything.

At the same time i do understand that things are picked up and passwed on with out actually it effecting you.

Any how I am all for the cleanliness of hospitals as i have been through numerous infection control training etc being that i work in hospitals etc.

[Tahrey1043]

hmmm i think i should have put a contrasting viewpoint - of how some people are very good, such as a reverse situation where a young man looking after his sick mother in the same way was actually taking better care of the hygeine situation than i was (and i was very grateful for it, because there comes a point - like with the paid cleaning staff - where you can't make things any more sanitary because you won't have time left to do the actual job)....... rather peed off at the time

i dont know which way i'll be voting in six days time, but i'm intending to somehow get hold of an opinion poll in my local area and go with whichever party is considered by it to be strongest against labour, as this is traditionally a reasonably strong cons area with a good liberal presence and i fancy not changing that - someone's got to keep a balance. i'm not automatically voting conservative because of what they say about MRSA, in fact, the exact opposite - it's not "how difficult?" to keep a hospital clean... it IS difficult, and often it's not the domestic staff's fault*. That poster is a gross oversimplification and i hope it's not indicative of their policy, merely a slight hiccup on the route from manifesto to snappy ten-word soundbite. more cleaners would be nice (we're short one of a two-person team in my dept, but who we have does a sterling job) but thats not the be all and end all - education on good practice would be far more helpful.

To be perfectly honest the cons and the libs are an unknown quantity and could be very bad for the country (or liberals bad for this area... etc), but their policies currently appear worse than labour - and they have the advantage of not having a disgusting track record of bad things happening - often on purpose - and then being either completely buried, or being spun into oblivion until some people are bludgeoned into thinking e.g. a war in iraq (rather than a single SBS mission to cap saddam..) was a good thing, or the conservatives are somehow exactly the same party as they were when maggie thatch was in power TWENTY years ago - labour isnt, the liberals aren't....

i'd rather make a cockup getting a new lot in whose far-less-spun policies backfire on us, than being idle and letting the same twats who've been giving it to us on the brown road for eight years carry on with their authoritarian little game. they have done some good things for this country and even for me personally, but i don't intend to be bribed by that stuff in order to accept the frankly alarming other conditions that come along with it. i'm going to play the ww2 card only because my history isn't strong enough to offer other examples - you know hitler solved his country's massive interest rate and unemployment problems, right? rebuilt a battered country and army, and won the peoples trust that way through a combination of doing good things and spinning the life out of everything else he did (and mussolini got the trains running on time, etc)..... but just look what else he did.

maybe we should vote Green... they have a snappy CG-and-franz-ferdinand aided election broadcast .... naw we fell for that with mr shiney teeth...

f**k how did this become an election thing, i didnt want that tack

i wouldnt have brake tested the corsa guy, he looked angry and ready to spark off (some people have the cutest reactions to realising they're not the fastest thing on the road and have been holding folk up... me, i already know i aint and try to keep a low profile if e.g. TTs are about) and i was in a genuine hurry. ended up more than 5 minutes tardy because of that nubbin and the learner girl already... i'd been making good time til i got off the m'way!

but i do tend to brake just a little harder and longer than is neccessary if i'm in a queue and someone's hanging off my bumper, as if that's going to get them anywhere quicker in wall to wall traffic. it's nice seeing conciousness return to their eyes when they finally figure out the reason they've almost caved their front end in is because they're so close, all i had to do was brake a couple percent harder (not exactly an emergency stop, now) and stop a couple metres further back from the vehicle in front than i might otherwise be.
that and gearing down in a similar situation on the motorway. it's a mile-long tailback behind an overtaking lorry. there's nothing to left of my car or the one behind other than another artic, who's unlikely to try cutting in between us. So what's the beef with being less than a length astern? a quick bit of 4th gear generally sorts it, then 3rd (..or 2nd) to recover back up to 55...

ah, twunts. you just can't avoid them. and often you can't avoid being one (according to my mum anyway ). just have to try your best.

* i'll admit my very most local hospital, which has been in the paper this week because of shockingly bad performances from the domestics - e.g. only dusting once a week, blood and urine left staining the floor for days on end - has historically had trouble... i've worked as a domestic there and i only once or twice actually saw anyone else doing the job rather than having a fag or a cup of char. training was limited to being told "clear the rubbish into this bag and dust the tables, use this funny shaped mop dry on the floor in a figure of 8, use this stuff on the toilet and chrome, leave it a minute then polish off with a paper towel, vacuum the carpeted bits with that knacked old henry if you have time, and mop/wipe the visibly dirty areas with one of these tablets in a half full bucket" and giving me a key to the store-room, before the super sloped off for another embassy no1. And it was often VERY dirty - scrubbing six month old water stains of unknown composition off the walls, removing a half inch of dust, etc. So it does need fixing some places, but as ever, the situation is nowehere near so chronic except where the media crews choose to descend.

[GroovyCarrot]

i wouldnt have brake tested the corsa guy, he looked angry and ready to spark off (some people have the cutest reactions to realising they're not the fastest thing on the road and have been holding folk up... me, i already know i aint and try to keep a low profile if e.g. TTs are about) and i was in a genuine hurry. ended up more than 5 minutes tardy because of that nubbin and the learner girl already... i'd been making good time til i got off the m'way!

but i do tend to brake just a little harder and longer than is neccessary if i'm in a queue and someone's hanging off my bumper, as if that's going to get them anywhere quicker in wall to wall traffic. it's nice seeing conciousness return to their eyes when they finally figure out the reason they've almost caved their front end in is because they're so close, all i had to do was brake a couple percent harder (not exactly an emergency stop, now) and stop a couple metres further back from the vehicle in front than i might otherwise be.
that and gearing down in a similar situation on the motorway. it's a mile-long tailback behind an overtaking lorry. there's nothing to left of my car or the one behind other than another artic, who's unlikely to try cutting in between us. So what's the beef with being less than a length astern? a quick bit of 4th gear generally sorts it, then 3rd (..or 2nd) to recover back up to 55...

ah, twunts. you just can't avoid them. and often you can't avoid being one (according to my mum anyway ). just have to try your best.

Had a similar situation with a gravel lorry yesterday. Followed it plodding along around the lanes between my village and the local town, I was stuck behind it for about 10 minutes until the road widened and straightened and I went to pass it.. the bastard started accellerating from 45mph as I pulled out, by the time I got past I was touching 70 just to get back on the right side of the road before anything came around the corner at the end of the road. Unfortunately, a truck carrying a few tonnes of gravel is not the kind of thing to brake test in a polo, but if only the thing had been signwritten then his employers would have got a bloody earfull... just think of the amount of damage something as heavy as that could do at that kind of speed, let alone the danger of keeping another vehicle on the wrong side of the road for such a length of time..

[Tahrey1043]

thats probably the bugger who tore my town up a few months back.... hmm.