Archive for the ‘MediRants’ Category

Manchester Airport is a Health Risk

I arrived at Manchester Airport yesterday morning with plenty of time for my flight; I’d never been there before so didn’t know what to expect. It’s quite a large place with lots going on, so I figured it’d be easy to kill the hour before my flight. I had already gone through the rigmarole of separating my washbag so that all my liquids were in separate clear plastic bags, and I had my stuff all ready for inspection at the security area. When I got near the front of the queue I noticed that they had a fairly full-on security gate: there was a turnstile which let you through the initial metal detector, and once you’ve been checked for metallic objects, you are then presented with two glass doors surrounded by illuminated arrows; you then go through the door which lights up. One door leads you to your recently x-rayed belongings, and behind the other lurks a backscatter x-ray scanner. At this time I don’t know if this is a random allocation or if it’s due to Big Brother. Maybe if I’d been one place ahead in the queue I wouldn’t be writing this blog post.

So my turn comes and I go through the turnstile, through the metal detector, and stand in front of the doors, awaiting my fate, and hoping that the right hand door would light up and show me my freedom. Alas. I walked through the left hand door, where a kindly gentleman instructed me to place my feet on the marked circles. I calmly explained that I would rather not. He asked me to stay where I was and went to get a security officer (I’m not certain of her job title). She was a very friendly and not at all threatening lady, who walked over armed with information leaflets on the backscatter machine. I told her that I work with radiation, have spent the previous three years studying it, and that I had plenty of information on how the machines work and the radiation implications. Her body language changed slightly at this and she told me fairly dejectedly that unfortunately there was no alternative, as Manchester Airport do not allow passengers to opt out of the backscatter scanner. She asked me to email the Department for Transport and have it out with them; she said that maybe if enough people made a fuss, something might change. I’ll be honest and admit that I was so relieved to be met with someone so reasonable: I have never been on the wrong side of the law, and certainly never on the wrong side of airport security and I didn’t have the guts to get in trouble with both on this occasion. The conversation was very polite and considered, but she explained that the only way to avoid the scanner would be to not get on the flight. If I had the money I would have probably opted to take the train, but I’m still an unwaged student. I asked if they had any paperwork they could give me to prove that I had been scanned, but they don’t, which seemed odd; all she could give me were some leaflets on the machine itself. Maybe it’s part of the anonymisation process or something.

So I assumed the position, reluctantly. All the while very aware that I was being stared at by other passengers, as the entire charade was being conducted in a glass box in front of the security queue. It was quite humiliating to be honest, I know that assumptions were probably being made about why I was causing a problem, but I really don’t care. What worries me, is that there are no signs on the backscatter machine denoting what it actually is. It’s just two large black boxes which you stand inbetween with your arms in the air. At no point is it explained to you what the machine actually does or is. Is this because if they did, more people would refuse to enter it?

I’m going to do some more research, but for now I’ll leave you with these links:

http://www.bbc.co.uk/news/uk-england-manchester-15766544

http://www.bbc.co.uk/news/health-13990434

http://scrapthescanners.wordpress.com/2011/11/20/disgrace-and-debacle-euro-scanners/

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2012: The End.

No, not the apocalypse (do people actually believe that shit?).

This year will be the end of one way of life and the beginning of another, in theory.

If everything goes to plan, my final exam will be this Wednesday. The following day I’ll be celebrating the end of exams plus Portsmouth SitP’s first birthday (clicky for more info).

The next major milestone comes in March, which is when my dissertation is due in, and I am absolutely terrified. Shortly after is my final clinical placement, and hopefully the last time I’ll be working in a hospital without being paid.

And then that’s it. Finished. No more lectures, exams or presentations. No more staying up til 3am writing essays (I really can relate to Douglas Adams’ feelings on deadlines).

Apparently some people feel scared upon leaving academia; I wonder if this is because they haven’t worked before as I suppose that can be quite daunting. The scariest thing for me was starting the process. Giving up my job was the most unpleasant part of the whole affair, and I’m not just talking about losing a regular salary, although that was quite galling. There’s a certain safety in doing something you know you’re capable of, and you don’t tend to get that when you’re starting from scratch.

When I was learning how to use Linux for the first time, I did so at my own pace, and when it all got a bit much I’d retreat to the safety of Active Directory, something I could configure in my sleep (and frequently did so) which bumped my confidence back up.

There’s not been much in the way of safety or familiarity over the past 2 and a bit years; all of it (with the minor exception of the teeny bit of quantum physics in the first year) has been brand new to me, even down to certain aspects of essay writing (I put my name on the first essay I submitted, not knowing that this was an instant fail- oops!) so it’s been something of a journey.

The “working in a hospital” bit which comes next doesn’t worry me so much; from what I’ve seen, all newly quals start their first jobs like rabbits on a motorway, terrified about their first on-call or theatre case so I’m sure I’ll fit right in. The actual act of getting a job is pretty unnerving though. I had my first rejection last week for my “dream job” at King’s College Hospital. I didn’t expect to even be considered, but still. Sucks.

Anyway, I’m rambling. Back to revision.

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Inter-Professional Spurning

On Friday I finished the practical aspect of a degree module called “Inter-Professional Learning” (IPL). For two weeks every academic year, healthcare students from Southampton and Portsmouth University are bundled together into groups of 10 and given a project to do. IPL “strives to improve communication and working relationships between professionals, and helps them deliver high quality services in increasingly challenging times.” The idea being that if doctors, nurses, podiatrists, radiographers etc work together before they qualify, it will hopefully enable them to work together even more smoothly throughout their careers.

Unfortunately my experience of IPL has taught me very little about other healthcare professions (except pharmacists, which I’ll come to later) and in most cases it has reinforced some stereotypes that I know aren’t true.

For example, all of the medical students I have worked with on IPL have been incredibly self important and made it very clear that they had much better things to do (as if the rest of the group desperately wanted to be there) and in a few cases they even went as far as not bothering to show up. The male med student in the first year showed up on day 1 and day 14, and spent the time in between playing rugby somewhere in Europe.

Until this year, all of the social work students in my group have been paranoid and defensive, an attitude which can’t have been helped by the introductory lecture we had at the beginning of the first IPL which basically reminded everyone that people always blame social workers when a child is hurt or killed. I’m sure this was meant to be helpful, but it put my group’s social work student into a really foul and indignant mood.

The nurse from IPL1 was an alt-med nutter who insisted that humans don’t need vaccines as homeopathy is a much more effective and safe method of protecting yourself. Terrifying.

So yes, I am cynical about the effectiveness of IPL in its mission to improve communication and attitudes within a multi-disciplinary team. Especially bearing in mind I had the best IPL-like experience anyone could wish for whilst living in the Pokhara house; working, resting and playing with healthcare professionals from all over the world. I learnt more about what nurses and doctors do in that month that I have done over the duration of my entire degree so far. I was hugely impressed by their knowledge, and I really enjoyed our dinner conversations about the day we’d just had.

Last year on IPL2 I did actually learn a fair bit about pharmacy, but it had nothing to do with IPL itself. It was in the car journeys to the placement site, where the pharmacist and I had many really interesting conversations about the legal side to the profession, as well as discussing the vast amount of mathematical prowess required.

I follow a few medics on Twitter; some are students, some are long-qualified, and some have only just registered with the GMC. They all regularly provide me with really interesting information about their profession and healthcare in general, and there’s even a Twitter journal club where papers are reviewed and critiqued by anyone with an interest.

I have never felt compelled to stay in touch with any IPL group member once the sessions have finished, but this weekend I’m driving over 500 miles for a reunion with my Pokhara housemates (those on this side of the Atlantic anyway).

I suppose what I’m saying is that healthcare workers and students need to be personally interested in engaging with each other, as no amount of forced role-playing or ice breaking sessions will achieve a truly cohesive working environment. It is a sad fact of life that some people are content to go through their lives with the bare minimum of effort and interest, and I guess that’s why IPL has to exist. But at least those people will never become public health bores like me.

:-/

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Blood, Sweat and Wee.

And so begins my last week of working on the Isle of Wight, and I’m actually going to miss it. This placement in particular has been really good, I feel like I’ve learnt so much, and because of it, I’ve been made to feel like one of the team, which is fantastic.

But there have also been downsides: today had a couple of rather memorable ones.

The first one was really unpleasant and will probably stay with me for a while. A 90ish year old female patient (who I shall call Betty) was referred to the department for a lumbar spine x-ray. A message came through with her referral form telling us that she must be examined whilst lying down due to her mobility issues. We thought “fair enough, she’s in her 90s, no problem” and called her into the room. Her carer pushed her wheelchair over to the imaging table and we went through her details. Confirming her mobility issues, her carer agreed that she might be more comfortable lying down, but would be in pain anyway die to numerous previous fractures and her general frail state. Betty lay on the table on her side with her arm underneath her ribs so instead of getting her onto her back, we decided to attempt the lateral first, as she was obviously in a lot of pain. I asked her to move her arm forwards so it was clear of her spine, and when she moved it she screamed in pain. Both myself and the radiographer I was working with were really unhappy with continuing the examination this way, so we decided to ignore the earlier “advice” and perform the examination with the patient on her feet.

I helped Betty to sit up, and when she gave me her hand I noticed that the sleeve of her blouse was covered in fresh blood. I assumed that maybe a scab had been knocked off or something, but upon closer investigation, it turned out that her skin was so fragile that it had torn when she moved her arm. There was a three inch haematoma and open wound on her right elbow and it was bleeding a fair amount. We quickly continued with the x-ray whilst a colleague contacted A&E to get someone to apply a dressing to the wound.

Betty was much happier standing and the x-rays came out really well, although they clearly demonstrated her osteoporotic state. Personally I don’t agree with putting someone of her age and condition through such an examination; obviously the risks of the radiation aren’t a factor, but the pain and indignity are, and I really do doubt that the results of the x-rays will affect her treatment- it’s not like she’s going to be asked to lay off the skydiving for a few weeks so her back can heal.

After seeing her over to A&E, we filled out an incident form as is required following a patient suffering an injury whilst in our care. Whilst doing this, complaints started coming in about a leak in the waiting area, and sure enough, there was a torrent of water cascading down from the ceiling in the corner by the window. A few inco-pads were thrown down to absorb the water, but they couldn’t hold back the tide, and all they did was draw attention to the colour of the water. As suspected, it turned out that a sewage pipe in the ceiling had cracked, therefore making the flood slightly more unpleasant. Regardless of this, patients were still merrily walking through it, ignoring the warnings and traipsing it through the waiting room. One mother even walked past the cones that were used to block the area off and guided her son pretty much underneath the flow of effluent.

So I decided to take action and used some clinical waste bin-bags to set up a cordon, and mopped up the footprints and puddles in the waiting area. All the while dodging the waterfall which appeared every time someone upstairs flushed the toilet.

Luckily, shortly after lunch the estates department stopped the leak and arranged a clean-up. Let’s hope the smell is gone by tomorrow.

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Meanwhile, back in the UK…

The residents of Cosham are bitching about the possibility of having their evening television viewing interrupted by the air ambulance. Yes, that’s right, some of the residents who choose to live next to a massive hospital are complaining about not being to watch Big Brother uninterrupted. Oh and apparently the downdraught knocks over their patio furniture too. Boo fucking hoo.

Currently, the air ambulance can only operate between 8am-6pm and a planning application has been sent in to make the service 24 hour, but some local residents regard their television viewing as more important than saving lives.

I’m assuming that in registering their complaints that they are also registering their ineligibility for airlift in the event of a serious illness or injury? Of course not.

If you live in the Portsmouth area and want to let the council know your opinion, the planning application can be found here or on the Portsmouth City Council website under Planning, and search for “helipad”.

Without wishing to labour the point too much, in countries like Nepal, if you are seriously injured and cannot afford the bus fare to hospital or don’t have anyone who can take you, you will die.  If you’re lucky enough to get back to your home, you will die there, if not, it’ll be an agonising, public death with no medical attention whatsoever.

Come on England, get your fucking act together.

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