Patients dying needlessly

ethan said:
Doctors are paid enough and are trained enough to be professional enough not to gamble with people's lives so needlessly. As far as i am concerned it is more to do with competence than anything else and what you are suggesting is intollerable.
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No matter the job, no matter the pay, mistakes *will* be made. There is no job where the stakes are higher than in the medical profesion so anything that can minimise errors is more than welcome. But don't pretend that Doctors and nurses are somehow more than human.
 
It doesn't matter how much you pay someone, mistakes will still happen. you would be very silly to believe otherwise.

also gambling is something they have to do day to day with unknowns. how ever its either take the gamble win and save a life or don't then there is no chance for life.

I'd take the gamble.
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Nobody is believing that. For the most part we are not dealing with unknowns but a total lack of including disregard for a profession.

No matter the job, no matter the pay, mistakes *will* be made. There is no job where the stakes are higher than in the medical profesion so anything that can minimise errors is more than welcome. But don't pretend that Doctors and nurses are somehow more than human
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I'm not pretending anything?
 
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Hikari Kisugi said:
Medical training to whom, sorry that what I was asking, what or who do you train?
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Ditto...wth is a medical trainer?

The paper in question has a low, and in my opinion unrealistic, threshold for determining a death as 'preventable'. It's written with a somewhat alarmist slant. Bear in mind that the NHS staffs humans, and has limited resources.

For example:
"A woman in her 80s who died because doctors took 18 days to diagnose inflammatory bowel disease."
Extremely rare for a first diagnosis of IBD to be made in an 80year old, and with the far more common GI symptoms that 80yr olds suffer from that have similar investigation results, it could easily be understandable.
:: A man in his 60s who suffered a heart attack after an unnecessary procedure for a misdiagnosed cancer.
Sometimes cancers are misdiagnosed despite best efforts. It's a simple limitation of medical knowledge, and a limitation of current investigation technology.
:: A middle aged man who died from a surgical infection because medical staff failed to notice he wasn't responding to antibiotics.
Often patients appear to show some recovery when given the right antibiotics, but quickly decline. If staff were taking regular observations, then there's not really a reasonable way to ascertain a lack of response.

If you replay those scenarios, and many more, they could easily end up with the same result.

Sadly the case of Kane Gorny was a **** up of epic proportions, and caused by busy nurses failing to take a patient seriously, and doctors having too many jobs to do respond to a non-urgent request to see a patient.
 
dowie said:
fairly sure most don't - European working time regs etc...
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Junior doctors are limited to 48 hours (or at least that was the target back in 2009, they used to work and average of 58 hours).

The only regulation I can recall at the moment is that doctors have to have 11 hours (continuous) rest out of every 24 and ensure that once a week they have 24 continuous hours off as well. They're not allowed to opt out of these regulations, suggesting some would work more if they could. 13 hours a day, 6 times a week is 78 hours...
 
int said:
Junior doctors are limited to 48 hours (or at least that was the target back in 2009, they used to work and average of 58 hours).
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What this actually results in, is junior doctors only being paid for the first 48hours they work. In practice (depending on rotation) they work a lot more for no overtime pay. 'Banding' seems to mainly depend on unsociable hours, and even the highest banded F1 jobs are supposed to be limited to EU working time directives.

The only regulation I can recall at the moment is that doctors have to have 11 hours (continuous) rest out of every 24 and ensure that once a week they have 24 continuous hours off as well. They're not allowed to opt out of these regulations, suggesting some would work more if they could. 13 hours a day, 6 times a week is 78 hours...
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Acute Medicine in the JR, Oxford, is one of the busier F1 jobs in the country. You work at least 8am to 6pm on weekdays and usually 9-5pm on one of the weekend days. But more commonly, if you have a busy team, you'll be in the hospital well past 7 on most weekdays. A weekend 'take' means you work 8am to 8pm over the weekend, followed by 24hours off. It's supposed to be even busier in the Central London hospitals. Surprisingly enough, it's also the rotation where lots of mistakes get made, and where some totally unnecessary deaths happen.
 
ethan said:
Yes I am a medical trainer and a director of a company which pays particular attention to the prevention of (medical) mistakes bearing in mind we are only talking about basic mistakes in the op's post.
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You don't sound to have a medical background. Are you registered with the GMC?

Mistakes are innevitable and the only thing we can do is to understand what lead to them and if they can be prevented WITH the available resources.
 
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Sounds like the guy who's first-aid trained at the office and makes it sound like he's some sort of healer/paramedic/master of the medical.
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Yeah that's right. If ever I could be arsed to respond to a comment like that.

For anybody who might be interested here is a list of never events that occurred within the associated dates 2011. a never event is simply a mistake or event that should never have occurred following practice guidlines.

1.Wrong site surgery
2.Wrong implant/prosthesis
3.Retained foreign object post-operation
4.Wrongly prepared high-risk injectable medication
5.Maladministration of potassium-containing solution
6.Wrong route administration of chemotherapy
7.Wrong route administration of oral/enteral treatment
8.Intravenous administration of epidural medication
9.Maladministration of Insulin
10.Overdose of midazolam during conscious sedation
11.Opioid overdose of an opioid-naïve patient
12.Inappropriate administration of daily oral methotrexate
13.Suicide using non-collapsible rails
14.Escape of a transferred prisoner
15.Falls from unrestricted window
16.Entrapment in bedrails
17.Transfusion of ABO-incompatible blood components
18.Transplantation of ABO or HLA-incompatible organs
19.Misplaced naso- or oro-gastric tubes
20.Wrong gas administered
21.Failure to monitor and respond to oxygen saturation
22.Air embolism
23.Misidentification of patients
24.Severe scalding of patients
25.Maternal death due to post partum haemorrhage after elective Caesarean section
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Not that it matters a medical trainer in this context (as if people couldn't have googled) is somebody who takes responsibility within a company or organisation for Policy and guidance implementation concerning awareness and planning activities relating to
identifying never event occurrences. It can consist of being in a team of assorted professionals looking after a patient with whom a never event is thought to have occurred. It involves having supervisory roles within line management structure
and risk management as well as being part of any investigation team. I am not a physician though my area(s) of management and experience include palliative and dementia. Not that any of this should have mattered.
 
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ethan said:
Not that it matters a medical trainer in this context...is somebody who takes responsibility within a company or organisation for Policy and guidance implementation concerning awareness and planning activities relating to identifying never event occurrences. It can consist of being in a team of assorted professionals looking after a patient with whom a never event is thought to have occurred. It involves having supervisory roles within line management structure and risk management as well as being part of any investigation team.
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There's more waffle there than in a Belgian cake shop.
 
Corporate ********. Risk assessment and management for short lol
Quite worrying some of the things on the list.
 
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ethan said:
Yeah that's right. If ever I could be arsed to respond to a comment like that.

For anybody who might be interested here is a list of never events that occurred within the associated dates 2011. a never event is simply a mistake or event that should never have occurred following practice guidlines.



Not that it matters a medical trainer in this context (as if people couldn't have googled) is somebody who takes responsibility within a company or organisation for Policy and guidance implementation concerning awareness and planning activities relating to
identifying never event occurrences. It can consist of being in a team of assorted professionals looking after a patient with whom a never event is thought to have occurred. It involves having supervisory roles within line management structure
and risk management as well as being part of any investigation team. I am not a physician though my area(s) of management and experience include palliative and dementia. Not that any of this should have mattered.
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Where did these 'never' events take place?
Was this within the basis of the Op, or within your own sphere of managment?
Care home manager?
 
joxang said:
What this actually results in, is junior doctors only being paid for the first 48hours they work. In practice (depending on rotation) they work a lot more for no overtime pay. 'Banding' seems to mainly depend on unsociable hours, and even the highest banded F1 jobs are supposed to be limited to EU working time directives.



Acute Medicine in the JR, Oxford, is one of the busier F1 jobs in the country. You work at least 8am to 6pm on weekdays and usually 9-5pm on one of the weekend days. But more commonly, if you have a busy team, you'll be in the hospital well past 7 on most weekdays. A weekend 'take' means you work 8am to 8pm over the weekend, followed by 24hours off. It's supposed to be even busier in the Central London hospitals. Surprisingly enough, it's also the rotation where lots of mistakes get made, and where some totally unnecessary deaths happen.
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Thanks for the clarification, it's been a while since I've looked up the regulations, I think I was interested to find out after one of my friends started medicine at university.
 
ethan said:
Not that it matters a medical trainer in this context (as if people couldn't have googled) is somebody who takes responsibility within a company or organisation for Policy and guidance implementation concerning awareness and planning activities relating to
identifying never event occurrences. It can consist of being in a team of assorted professionals looking after a patient with whom a never event is thought to have occurred. It involves having supervisory roles within line management structure
and risk management as well as being part of any investigation team. I am not a physician though my area(s) of management and experience include palliative and dementia. Not that any of this should have mattered.
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This is exactly one of the many roles that physicians undertake as part of their managerial duties and I cannot see the need for an additional layer (not to mention cost) of management. As long as this is a complement of your "main" job I cannot see any problem, but employing more managers instead of more nurses or doctors will not improve the quality of care.
 
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