Would YOU put your life in the hands of a junior doctor?
The evil impact of bureaucracy on British medical care
Every day thousands of newly qualified junior doctors make decisions which could mean the difference between life or death and they’re often as terrified as the patient. And now EU rules cutting their working hours mean they’re losing out on valuable experience and knowledge gained from working alongside senior colleagues.
They’re also often left in sole charge of whole departments at night. Many have become disillusioned and are quitting the NHS before completing their two-year training. But what does all this mean when it comes to patient care?
We asked a junior doctor to share her diary with us. For obvious reasons, she’s done so anonymously, although the Mail knows her identity. Her account makes for alarming reading….
MY FIRST DAY AS A NEW DOCTOR
After a brief health and safety meeting where we’re told what different-coloured fire extinguishers do (will I ever remember?), I’m assigned a ward with 30 patients and four nurses. I’m in charge for the afternoon. I’m 25, I still can’t cook properly, but I’m responsible for 30 lives. It’s pretty terrifying.
My bleep goes off 20 seconds after I start. I ring the ward where the nurses are frantically searching for a doctor. A surge of adrenaline rushes through me. The harassed voice on the other end of the phone says: ‘We’ve got a patient here with a brain tumour and we think she’s septic (suffering from a life-threatening infection). Which antibiotics should she be on?’
I think an unspeakable word. Not only has this patient got one of the most serious conditions you can get, it’s at a life-threatening stage. And I certainly haven’t got a clue what medication she’s due.
Should you not ask someone more senior, I croak? There is no one else. I make my way to the ward and introduce myself to the patient. As I discover will often happen, the minute I get there, someone says: ‘It’s OK, the doctor’s here now’, as if I will offer some miracle cure.
I can’t tell them I haven’t the faintest idea what to do. The patient is already on a complex array of medication, and if I start prescribing more I could make the situation worse.
So I decide to not give her anything. She doesn’t look too ill at this stage and should make it through until someone more senior comes around. I later discover, to my huge relief, that the more senior doctor didn’t prescribe any antibiotics either.
But I’m angry at myself for not knowing what to do. What if that lady had gone rapidly downhill and died? I shudder to think what would have happened if this had been a night shift when it’s likely there would just be me and another junior doctor on duty.
I’ve already heard that night shifts are horrific. Before my time, junior doctors worked more day shifts and were often on call at night – in nearby hospital accommodation – if their patients got sick.
But because of new EU rules which state no one is allowed to work more than 48 hours a week, everyone works shifts – either day or night. As a result the one or two junior doctors working at night in a specialism can end up having to look after between 100 and 400 patients on their own, with no back-up.
And because we have to work either day or night, the number of day shifts we’ll work has fallen. That means we won’t work as often with senior staff such as consultants and registrars – the people who train us. So when we’re alone at night and having to make decisions about patient care, I won’t have as much knowledge. I’m terrified I’m going to make a mistake.
TRUST ME, DON’T FALL ILL AT NIGHT
One month into the job and my fingers are trembling as I dial the consultant’s phone number. It’s 3am. ‘I’ve got a STEMI (ST segment elevation myocardial infarction), can you come in please?’
There is a grunt and then the phone goes dead. I have just got a consultant out of bed in the middle of the night to save the life of a heart attack patient. Fair enough, you might think, as that’s his job. But there are different types of heart attacks and it’s vital as a doctor to be able to distinguish between them.
With a STEMI, if you can locate the blockage in the artery that’s causing the heart attack quickly and open it up with a stent (an artificial tube used to keep the arteries open), there’s less chance the patient will die or suffer serious consequences.
Missing one is considered one of the worst things a doctor can do. The stent technique can only be performed by a consultant cardiologist in a specialised lab.
At night this means opening up the lab and calling staff in from home. Therefore it’s pretty bad if you call a STEMI and turn out to be wrong. My friend was in charge one night when all the cardiac nurses said the scans definitely indicated a STEMI.
When the exhausted consultant turned up and discovered it wasn’t, they were nowhere to be seen. The consultant was not happy. I was lucky that my first STEMI was very clear cut.
But it raises another issue: nights and weekends aren’t good times to be admitted to hospital as there’s just a skeleton staff. Of course they will do their utmost to keep you alive, and perform emergency surgery if you need it, but if you’re not at death’s door then they’ll wait for their daytime colleagues.
And at night it’s just a junior doctor – usually someone a year more advanced than me – who will decide if a patient is admitted or not. I’m not sure many people realise that the decisions are made by someone who hasn’t even been working for two years – there are also no consultants in the hospital at night unless they are called in, which is rare.
Often the decisions aren’t clear-cut, but there are few, if any, people around to seek advice from. It’s not the kind of scenario I’d want a member of my family to be in.
I ACTUALLY SAVED SOMEONE’S LIFE
My first dramatic, life-or-death day. A gentleman in his 60s was admitted today vomiting litres of blood. I was first on the scene and it was pretty daunting. There was blood everywhere, his blood pressure was dangerously low and he was drifting in and out of consciousness.
He could have died at any moment so I knew I had to act fast. I quickly gave him fluids, arranged blood tests and organised an emergency procedure to examine the inside of his throat.
His wife and daughters – who were my age – were hysterical and kept asking me over and over if he was going to die. I was frantically trying to stabilise him and didn’t want to tell them yet that it wasn’t looking good.
With every second that went by I kept willing the gentleman to hold on and make it – it would have been so awful for him to die like this, covered in blood and in front of his family.
To my utter relief, the consultant arrived soon afterwards and began investigating the cause of the bleeding. The patient’s needs were now way out of my league, so I had plenty of time to sit with his wife and daughters and explain what was happening.
They were so grateful. A senior colleague once told me having the time to talk to the family is one of the best things about being a junior doctor, and I agree. Better still, I was later told my actions probably saved the gentleman’s life. He survived emergency surgery and went home with his wife and daughters a fortnight later. I got my first hug on the job.
ON OCCASION, I’M THE ONLY ‘EXPERT’ HERE
I’m now in my second year as a junior doctor which means I’m in charge at night and work is more stressful than ever as I now decide who is admitted to the hospital or not.
This means on top of dealing with seriously ill patients on my wards, I have to assess which A&E patients need to be admitted. Night shifts produce the almost comical phone calls from GPs and out-of-hours doctors who want advice.
When the person is a GP who qualified in 1968 and who therefore has 40 years’ more experience than me, it does seem rather ridiculous.
Sometimes they ask for the ear nose and throat department, for example. I tell them that at 2am on a Sunday morning, I am the ENT department. They sound disappointed, but still send the patient in anyway, even though it’s me who’ll end up seeing them.
SHABBY CARE? BLAME THE EU
A patient was due for major surgery this morning, and last night needed a vital injection to stop his blood from clotting. It had to be given at a certain time to make sure it worked.
Had I qualified even just a few years back, I would have been working all last night and could have kept an eye on him or done it myself. But according to the new EU working rules, I have to go two and a half hours before his injection is due, so I asked one of the nurses to give to him.
Even though it wasn’t the end of her shift, she said no, because she was going home soon. So I begged her to ask the next nurse on to do it, to which she responded: ‘Yeah, yeah.’
I arrive this morning to discover the jab hasn’t been done. I’m furious. I catch the nurse trying to give the patient the jab now – I can’t believe what I’m seeing; if he has it just hours before the op, he’ll bleed to death on the table, so I grab the needle.
Because of her, the patient’s operation has to be delayed. But the consultant screams at me. There is no point answering back. I see the nurse again, but I avoid her. It’s frustrating because there are so many good nurses and healthcare assistants who do their job properly and actually take junior doctors under their wing. I’m also furious that I wasn’t allowed to stay late myself, and give my patient the injection. Blame the EU.
SOMETIMES RELATIVES ARE ENEMY NO 1
Tonight I get called to A&E to assess an elderly lady who fell at home. She’s on her own because her family live miles away. She’s terrified because it’s Saturday night and there’s a drunk guy on one side of her cubicle and someone having an asthma attack on the other.
Despite this, she’s one of the sweetest ladies I have ever met – constantly apologising for causing more work for us. Unfortunately, her slip on the bathroom floor has fractured her hip.
When I tell her this, she begins to cry. It’s awful – she’s someone’s granny and it seems so wrong that she’s here alone. When she calms down, she explains one of her neighbours broke her hip last year. That woman never walked properly again and her family put her into a home. The problem is this lady’s son thinks she should give up her flat, too.
She fears her accident will give him the perfect excuse – and she’s right. Many patients this lady’s age never fully recover from a fall. Even after months of rehabilitation, they are likely to have lost some mobility, which can make the difference between coping at home or not.
She’s determined this won’t happen to her. I admit her and wish her luck – and I really mean it. A few months later I was on the orthopaedics ward – where this lady had gradually been recovering – and heard a commotion.
The lady in question was arguing with her son, who had come to visit. She was so cross with him for trying to put her in a home, she hauled herself out of her chair and proceeded to climb up two flights of stairs, while her son watched open-mouthed.
I looked over and thought: ‘Good for you!’ The fact the lady had recovered so well was first due to the amazing work of the physio- therapists. But I think her fighting spirit and determination also helped.
DON’T BLAME JUNIOR DOCTORS FOR QUITTING
After nearly two years I’m slowly getting less worried about every decision I make – I guess that’s experience. I could even say I am starting to enjoy my work.
However, many of my friends are so unhappy they’re either going to work abroad or quitting medicine altogether. Those who are particularly frustrated are the surgical trainees. They hate the 48-hour week restriction, as it’s now taking them three years rather than two to become a registrar (the level before a consultant) and they fear the quality of training is falling, too.
More than a few are considering moving to Australia, New Zealand or South Africa, where there aren’t strict regulations on working hours, meaning they can progress faster – and some already have.
But, for now, I’m going to stick it out; stress and all. I’ve managed to get through what can only be the worst two years of my career, I’ve gained experience, so things can only get better…
Sad and angry, the millions of British women who dream of more babies: Thwarted by cash worries
Another consequence of blundering Left-inspired economic policies
Millions of women are being left ‘sad, devastated or angry’ after failing to have the number of children they dreamed of, a survey has found. Only one in 25 imagined having just one child when they grew up, but for nearly a third this becomes reality.
More than a quarter would like one more child than they have at present and a further one in ten would like two or more – but just 23 per cent believe this will happen.
The main reason for the ‘baby gap’ is financial constraints, with 45 per cent blaming household budgets. Just over a third of women reluctantly hold back on repeating pregnancy because they fear they would not be able to give enough attention to their existing children, either because their families already take up too much of their time or because of work pressures. More than a quarter say their plans for more children have been thwarted because of a reluctant partner.
One in five women revealed they were ‘sad’ at the size of their family, while one in eight were ‘jealous’ of others with more children. Three per cent described themselves as ‘angry’ and two per cent as ‘devastated’.
If the proportion of women interviewed who wanted to have more children was applied nationally, it would mean an extra 3.6million babies – swelling the current population of 61million by around 6 per cent. Instead, families have been shrinking in the UK, with the average number of children in each household standing at 1.3. In recent decades the figure was typically around 2.4.
Marital therapist and author Andrew G Marshall, who arranged the online survey of 2,304 woman with the BabyCentre website, warned this ‘fertility crisis’ had divided women into two camps – those with children and those without – and diverted attention from mothers who ‘ache for children they never had’.
The problem is so great in some cases that it can lead to the collapse of relationships. Almost one in 30 women admitted they were so determined to expand their family they would stop using contraception without telling their partner. ‘I discovered, almost by chance, how couples can be haunted – even broken – by the children they never had,’ said Mr Marshall.
‘While counselling a couple with one daughter I asked, on a moment’s intuition, if they’d have liked a larger family. Suddenly, all the repressed pain came tumbling out – tears, recrimination, anger.
‘Though it wasn’t an issue they’d raised themselves, talking about it proved a turning point for their counselling, so I started asking all my couples about family size. For most it was a source of contention, for many an open wound.’
He added there were two points at which disputes between couples about their number of children was most likely to lead to a split. ‘The first is when the desire for another baby peaks – generally 18 months to three years after the birth of the previous child – when the age difference would not be too big,’ he said.
‘The second point is reaching 40 and starting to reassess the first half of your life. I often counsel people who thought they’d come to terms with fewer children but are hit with a searing regret – just when it’s too late.’
The survey, published in Psychologies magazine, found just under a fifth of mothers have three children yet 32 per cent want to have a third child.
Only 6 per cent have four children but 16 per cent want this size of family. Most people, 54 per cent, said they were resigned to waiting for grandchildren to fill the gap in their lives. Just over a third said the their partners would change their minds.
Louise Chunn, editor of Psychologies, said: ‘The focus today has reverted to being a really good old-school mother but the reality is that having that kind of family is very expensive and time-consuming compared to when people grew up in those kinds of families. ‘Financial restraints during the recession and pressures of work for modern mothers mean the situation is not likely to improve in the near future.’
Britain goes halal… but no-one tells the public
A Mail on Sunday investigation – which will alarm anyone concerned about animal cruelty – has revealed that schools, hospitals, pubs and famous sporting venues such as Ascot and Twickenham are controversially serving up meat slaughtered in accordance with strict Islamic law to unwitting members of the public.
All the beef, chicken and lamb sold to fans at Wembley has secretly been prepared in accordance with sharia law, while Cheltenham College, which boasts of its ‘strong Christian ethos’, is one of several top public schools which also serves halal chicken to pupils without informing them.
Even Britain’s biggest hotel and restaurant group Whitbread, which owns the Beefeater and Brewers Fayre chains, among many others, has admitted that more than three-quarters of its poultry is halal.
Animal welfare campaigners have long called for a ban on the traditional Islamic way of preparing meat – which involves killing animals by drawing a knife across their throats, without stunning them first – saying it is cruel and causes unnecessary pain.
Sharia law expressly forbids knocking the animal out with a bolt gun, as is usual in British slaughterhouses. Instead, it must be sentient when its throat is cut, and the blood allowed to drip from the carcass while a religious phrase in praise of Allah is recited.
The extent of halal meat consumption, even in areas of Britain with a very small Muslim population, was revealed as the Pope, on his first visit to Britain, expressed fears that the country was not doing enough to preserve traditional Christian values and customs.
In a strongly worded speech to Parliament, he said: ‘There are those who argue that the public celebration of festivals such as Christmas should be discouraged, in the questionable belief that it might somehow offend those of other religions or none.’
But it is animal rights groups which have been most vociferous in their opposition to halal slaughter. Campaign organisation Viva!, whose supporters include Heather Mills and Joanna Lumley, said in a statement: ‘Other practices which may be undertaken for religious reasons, such as polygamy or the stoning of adulterers, are not permitted in the UK.
‘Religious freedom does not override other moral considerations and the suffering caused by this form of slaughter is so severe that it cannot be allowed to prevent action to be taken. Consumers can do their bit by boycotting places that persist in selling meat from unstunned animals.’
An RSPCA spokesman added: ‘The public have a right to know how their meat is produced. Many people are extremely concerned about animal welfare. What The Mail on Sunday has discovered shows that people are not being kept informed. The key to a more humane death for these animals is that they are stunned before slaughter.’
A spokesman for Twickenham, which sells only halal chicken despite not advertising the fact, insisted that the lack of transparency ‘had never been an issue’ and said: ‘Our consideration is more for those who want halal, to ensure they get it.’
Other institutions secretly serving up meat that is halal – or ‘permissible’ – include Mid-Staffordshire NHS Foundation Trust and one of London’s biggest NHS Trusts, Guy’s and St Thomas’. A spokesman for the London hospitals admitted: ‘The only way people using the canteen would know they were eating halal chicken would be if they asked a member of staff directly.’
Whitbread, which also owns Table Table restaurants, Costa Coffee shops and Premier Inn hotels, admitted last night that 80 per cent of the chicken it served comes from halal poultry suppliers, including some in Muslim-dominated Turkey. A Whitbread spokesman said: ‘We don’t specify halal as a requirement in our procurement. We base our decision on quality and price. ‘It just turns out that we source that amount of chicken from suppliers that happen to be halal.
‘It is not mentioned on any of our menus because we don’t think there is customer demand for that information. But if people started asking, then we would definitely provide it.’
Rival operator Mitchells & Butlers, which owns the Harvester, Browns and Toby Carvery restaurant chains as well as pub chains All Bar One and O’Neill’s, was even more opaque about the source of its meats. A spokesman said it had a ‘broad range of suppliers’ but declined to say how many were halal-certified.
Ascot racecourse said it was easier to store and cook only one type of meat. ‘All our chicken is halal. This is not advertised as the menus are kept as simple as possible,’ said a spokesman.
A Football Association spokesman confirmed: ‘All the beef, chicken and lamb sold at Wembley Stadium is halal which means a large proportion of the meat on offer to our customers falls into this category.’ Pork, which is forbidden to Muslims, is also served at the stadium.
Britain’s Muslim community is exempt from regulations that require animals to be stunned before death, as is kosher meat prepared for the Jewish market.
Conservative MP Andrew Rosindell, secretary of the Associate Parliamentary Group for Animal Welfare, said: ‘I don’t object to people of different religious groups being catered for but it’s not something that should be imposed on everybody else.
‘The vast majority of people in this country would not want meat of this origin. The outlets have a duty to let their customers know because some will object very strongly, not least because of the animal welfare implications of halal.’
Keith Porteous Wood, executive director of the National Secular Society, said: ‘We suspected that meat killed by the halal and kosher methods was being used for general consumption but we never imagined it was so widespread. It is disgraceful that people aren’t being told if the food they are being served is from meat that has not been stunned prior to slaughter.’
British Pro-life campaigners say their freedom of speech has been denied after being arrested
“Two ‘pro-life’ activists claim their freedom of speech has been suppressed after they were arrested for holding a banner depicting an aborted foetus. The campaigners, Andy Stephenson, 35, and Kathryn Sloane, 19, say they were simply peacefully protesting outside an abortion clinic when police stepped in.
Staff in the clinic had called for help claiming patients arriving for appointments were traumatised and upset by the pair’s 7ft by 5ft banner, which showed an embryo aborted at eight weeks.
When officers ask Mr Stephenson and Miss Sloane to take down their banner, they did so – but immediately replaced it with a near-identical banner of a ten-week-old foetus.
At that point the duo were arrested and taken to a police station until the early hours of the morning. In a month’s time they will be told if they face prosecution for causing ‘harassment, alarm or distress’.
Mr Stephenson, who lives in Worthing, West Sussex, with his wife, daughter and baby son Quinn, went on: ‘We’re seeing success already in what we do, with people changing their minds about abortion.
Director of the Christian Legal Centre Andrea Williams, who is supporting the campaigning duo, said: ‘This is a test case for their democratic right to reveal what abortion really is like.
‘In the 21st century it is not appropriate to silence and to censor those who speak out against abortion, even if the manner in which they do so is not how many would choose.’
The original moonbat admits he was wrong — grudgingly
He once claimed that Veganism was the only ethical behaviour — but is now promoting meat! Do I hear the rustle of currency somewhere in the background?
George Monbiot, the original Moonbat Liberal, confessed in a column in the Guardian that going vegan will not save the planet from global cooling, global warming or whatever they are calling it today.
From George Monbiot: “In the Guardian in 2002 I discussed the sharp rise in the number of the world’s livestock, and the connection between their consumption of grain and human malnutrition. After reviewing the figures, I concluded that veganism ‘is the only ethical response to what is arguably the world’s most urgent social justice issue.’
I still believe that the diversion of ever wider tracts of arable land from feeding people to feeding livestock is iniquitous and grotesque. So does the book I’m about to discuss. I no longer believe that the only ethical response is to stop eating meat.”
Then he went on to plug a book about meat.
There is another religion that recently reversed itself on meat. The Catholic church in the 1960s decided eating meat on non-Lenten Fridays was OK.
Then there is this bit from George Monbiot: “Feeding meat and bone meal to cows was insane. Feeding it to pigs, whose natural diet incorporates a fair bit of meat, makes sense, as long as it is rendered properly. The same goes for swill. Giving sterilized scraps to pigs solves two problems at once: waste disposal and the diversion of grain.
Instead we now dump or incinerate millions of tonnes of possible pig food and replace it with soya whose production trashes the Amazon. Waste food in the UK, Fairlie calculates, could make 800,000 tonnes of pork, or one sixth of our total meat consumption.”
You control what people eat, you control people. This has been done with every religion. Monbiot’s pagan Gaia religion is only the latest.
Apparently going Vegan was a deal breaker for many and so like Saint Paul kicking circumcision to the curb goes Monbiot’s vegetarianism.
Broccoli could provide potent pill to treat six million osteoarthritis sufferers
This is total speculation so far — another example of trying to show that anything unpleasant is good for you and anything popular is bad for you. It’s so predictable
Broccoli has been hailed by scientists as a ‘super food’ for joints which could cure millions of arthritis sufferers. The green vegetable is rich in the compound sulforaphane and initial research has suggested this may play a key role in protecting bones and joints and stop them from wasting away.
Scientists at the University of East Anglia have found the chemical blocks the enzymes that cause joint destruction in osteoarthritis, which is the most common form of arthritis. The team are now launching a new project that they hope will lead to a new broccoli-based treatment for Britain’s six million arthritis sufferers.
Professor Ian Clark said: ‘We all know broccoli is good for you but this is the first time it has been linked to a osteoarthritis. ‘We know there is a chemical, sulforaphane, in broccoli that can slow down cartilage destruction and we want to see if this can actually get into the joints and stop the progress of the condition.
‘The UK has an aging population and developing new strategies for combating age-related diseases such as osteoarthritis is vital – to improve the quality of life for sufferers but also to reduce the economic burden on society.’
Around 30 patients will be fed the cruciferous vegetable ahead of joint replacement operations. They will then be examined after their surgery to see if sulforaphane has successfully entered their joints. If the test is found to be effective then more patients will be recruited for a larger clinical trial.
Professor Clark said: ‘The results could mean we prevent many, many more needing to go for surgery because progress of the disease will either be slowed down or completely halted. It really is a breakthrough project.’ Currently, people suffering from arthritis can only choose between short-term pain relief or joint replacement operations.
Arthritis Research UK and the Diet and Health Research Industry Club (DRINC), is funding the £650,000 project.
Osteoarthritis is the leading cause of disability in the UK where it affects around six million people. It is a degenerative joint disease which gradually destroys the cartilage in the joints, particularly in the hands, feet, spine, hips and knees of older people.
Broccoli has previously been linked with reducing the risk of cancer and is regarded as a ‘super food’. However, there has not yet been a major study of its effects on joint health.