thrown out of the window

Absolutely!i was a victim myself and i was apalled at the non challence displayed,i dont want to go into details but where are the checks Nhs hospitals are forever boasting about?

Hi again Penny,
re your:

To provide the BEST CARE and SUPPORT they can for their PATIENT or CLIENT and remember that everyone of them is an individual.

I've sent in some comments for the Liverpool Care Pathway review, and one of my comments was that calling it a 'pathway' is too prescriptive, because it is really only 'a prompt to provide proper INDIVIDUALISED care' - thinking of the LCP 'as a thing', or of 'a pathway', tends in my view to deflect 'thinking' away from 'what would THIS PARTICULAR PATIENT want doing ?'.

This week in the news we are talking once again about how nurses are failing to provide adequate levels of care for their patients.
If we at the stage of reminding nurses that their job involves providing all aspects of basic care for the people they are looking after then sadly it seems there is the need to be prescriptive.
I have always objected to seeing care plans put in place that are STANDARD for a certain condition or care need but sometimes it ensures that nothing is forgotten, and of course it saves time, something everyone is always complaining they do not have enough of.
As regards the process of dying every person has a right to die in the way he or she wants and any health professional involved in the process has a duty to ensure that as far as is possible and obviously within the confines of the law that their wishes are carried out.
Sadly there seems to be a need to be prescriptive and until we have sorted out the basics once again it would seem more prudent to follow a well signposted path that just an empty track.

Penny Green

'I have always objected to seeing care plans put in place that are STANDARD for a certain condition or care need' ... Sadly there seems to be a need to be prescriptive and until we have sorted out the basics once again it would seem more prudent to follow a well signposted path that just an empty track.'

This is a valid debate - but care, and indeed each intervention, is supposed to be considered at the time, on an individual basis.

Peter Carter is quoted in The Times today on page 12, and he apaprently said (extract):

Dr Carter, whose organisation represents 400,000 nurses, midwives and support workers, said: "Will there be another Mid Staffs? Yes, sadly there will be. There are 1.2 million people employed in the NHS and there is a hospital in every town. It would be foolish to say everything in the garden is roses.
"Mid Staffs cannot be an isolated incident. The fact is, the service is under huge strain. Trusts are not thinking intelligently about how they deliver care and are simply cutting the numbers of frontline staff. Our members have a personal and professional responsibility to raise concerns."

...

Dr Carter told The Times: "The vast majority of patients still get good care, but that is no consolation to those who don't. Mid Staffs has got this massive profile now, but there have been many others like it ... Bristol Royal Infirmary, Basildon, Alder Hey. The report into Maidstone and Tunbridge Wells [where hundreds of patients died after an outbreak of the superbug C-difficile] is painful to read. On the wards there were beds that were eight inches apart ... what the hell were the managers doing, but also what was going on with the nursing culture? There was a culture of bullying and intimidation.

"If the board had spent time walking the wards, talking to patients and staff, just doing their jobs, they may have saved hundreds of lives."

I (Mike) asked a senior hospital manager who posts on the Nursing Times website recently "Do the senior managers, walk around the wards ?" and her answer was something like "Sadly, not unless there is a photo opportunity".

LOTS OF BASICS TO SORT OUT - non ?!