Secrets of your trade.

The default position in hospitals is to resuscitate

I wonder if you could help me to understand this a little better, @Enigmasaurus?

You explained that CPR often has poor outcomes both in % success and consequences, and I believe (?) there's an expectation that if a condition's "treatable" it should be attempted, but if even HCPs avoid CPR wouldn't it be better to view it as something to be used only if NOK insist - and maybe not even then?

I recall a very compassionate doctor talking with my ex when his dad was dying, explaining that while such-and-such could be done it really wasn't in FIL's interests. Fortunately my ex accepted his advice, but I got the impression that if he hadn't the doctor might well have pressed his view further, even to the point of refusal

Was it unreasonable of me to think this, or does that in fact happen?

I would add to that Fuschia the need to be able to keep sticking at setting the good example and not be disheartened at the bad that their parents may exhibit, detach from it and just do more and more of the good regardless! It might be the only good a child experiences. What a worthy 'job'-vocation

Enigmasaurus that was reading, and quite grim. All strength to you for sticking at it. What can we do to make things change for the better (and I will be raising cpr awareness for a start - I think drama plays a big part in all the miraculous rescue beliefs!)

Mountain well he's not done anyone any favours, least of all you! That's a horrible experience designed to knock your confidence. Have you complained about the lack of actual education they were funded for providing? I am really sorry and I hope you can get the right support for your career progression.

@Rightwayup You can foster at most stages of adult life as long as you are fit & able. The most important thing is to demonstrate an interest & experience of some sort with young people & children.

Read up around theories of Attachment, Trauma & the effects of abuse on children.

Also I would say try to develop a compassion for parents who lose their children: they might have been awful in some ways but you are likely to have to manage the child’s ongoing relationship with their birth family. Your judgement about them will only add to the stress & confusion for a child.

Be realistic and honest about your own abilities, weaknesses and values; be prepared to reflect and adapt. Embrace learning and development. Consider the impact of your childhood on how you might parent.
Good luck!

To the PP talking about BTEC’s.

I done a BTEC in secondary school in Applied Science, our teacher literally gave everybody answers for everything. Just told us to word it all in a different way. Every single student in my science class passed with a distinction*. Even students who hardly attended school or had work missing.

Having this qualification got me onto another BTEC Applied science in college. I got bad qualifications in school due to other reasons but because I had distinction*, the college let me on the course. Which I wasn’t clever enough for in the end so I ended up dropping out, because I wasn’t getting enough help, but I felt it was hard to ask for help when I’m supposed to have the highest mark you could get on BTEC.

Great idea for a thread OP, fascinating reading.

Another HCP working in elderly care.

Agree completely with all the DNACPR (do not attempt CPR) comments. The majority of the general public are grossly misinformed about the nature and success rates of CPR. Successful CPR after a cardiac arrest in hospital is nowhere near the 50% most people believe - it’s closer to 20, and around 10 if you’re over 65 (low single figures if elderly with an infection on board). A large proportion of these patients will not leave hospital. Those that do may not be neurologically the same as before their cardiac arrest. I would urge everyone to read about CPR and make their own mind up as to whether or not they wish to be resuscitated - quite a lot of people in the field would choose a DNACPR for themselves. The default position in hospitals is to resuscitate - to prevent it, there needs to be a discussion and a form signed.

In a similar vein - everyone who feels strongly about not having particular interventions performed later in life should look into getting a Lasting Power of Attorney to nominate an advocate in the event that you lose the ability to engage in discussions around your care. This only kicks in once capacity is lost. It needs to be specifically for health and welfare not finances (which is a separate document). Of note, the LPA means that your nominated person must be consulted when significant decisions need to be made. It does NOT mean that they can make a decision for you or that their view must prevail irrespective of anything else. You also cannot use an LPA or advanced directive/ living will to actively request / demand specific treatments in the future, it is only to refuse / decline interventions.

Despite media reports we are not trying to kill elderly people because we want their beds. Nor do we euthanise or give excess medications to cause death. However it is not possible (or always desirable) to prolong life - sometimes it simply delays and prolongs the dying process. If you’re ever in the unfortunate position of having an elderly loved one admitted to hospital, please be realisitic in your expectations and engage openly with healthcare professionals when they try to talk about death. Ignoring that it is happening helps no-one, least of all your relative.

The number of elderly patients admitted to hospital who have no visitors or only have visitors who come to talk about money / the will (yes, it does happen), is heartbreaking.

Ash cash is for cremation forms which are performed as an additional duty and therefore not part of a doctor’s contracted duty or pay. In any case, they are likely to disappear soon with contract negotiations.

Medicine as a career in the NHS is fast becoming unappealing. Last year only 30% of very junior doctors entered into specialty specific training. A larger proportion of juniors are choosing not to enter training posts, practice medicine abroad or leave the profession completely than ever before, even amongst those who are relatively senior.

The (new) junior doctors contract discriminates against women, particularly those who have children / work part-time, as found by the government in it’s own equality impact assessment.

I have over 10 years post graduate experience in medicine. I am still called a ‘junior’ doctor.

I’m sure I’ll think of more!

At the end of filming a modern production the costumes are put on sale for cast and crew to buy, or sold to one of the theatrical costume hire houses. Anything left is donated to charity. The only items that are binned are underwear and socks.

Great minds puzzled ! I hadn't read yours I don't know why your message wasn't showing when I was composing mine (behind the scenes)!

Same to Hermione too, a notice that goes up regularly to announce and all the goodies from skip would be cleared! Or a call to local charities to collect, especially as its all new....refuges will always come get furniture and all manner of things needed always, especially for DC.

Thanks @Rockradio I will try to remember when my time for one comes.

I am more worried to hear about how to make them less painful...is that a thing, is there a way to?

Geneandfred thanks for a peek behind the [theatre] scenes! Very enlightening look at human nature some of it; you could write a book? Or, offer private dance lessons?

The box is really nothing special but the ticket price is! I hate the cold

Everything bought for a Production office ... goes in a skip at the end of the Production

But surely that doesn't make any sense, Hermione? I get that the staff might not have time to clear it all, but surely a charity could bring one of their vans along to do it?

GeneandFred many thanks for your "behind the scenes" piece about ship entertainment. I'm very fond of cruising and have always admired the sheer professionalism of the theatre shows, so it was great to learn a bit more about how it's done

Is that a secret?

When you go to watch a show and you are talking about someone on stage by covering your mouth with your hand and whispering into your friends ear, we can see you and the covering the mouth action makes it obvious you are talking about us.

Making a comment about a show to your partner - is that really a thing?

Surely it could also be just saying - shall we go for a coffee after the show?!

@Rockradio

Don’t ask them what?

Another college tutor one - sometimes we are relieved when a student drops out (because they are usually pretty hard work) but we're never happy about it.

I know that I and my colleagues all believe the best place for the type of student who tends to drop out is in college, not in a low-skilled job or hanging round the streets. We'll usually do everything possible to keep them in college at least until the end of the course. Even with difficult, not especially likeable students who leave, we do think about them afterwards and hope they've gone on to do well.

@Unescorted thank you, your kind words made his day (and possibly Wendy's )

@geneandfred - have you considered doing any teaching? Not necessarily dance - I know how awful it can be to do that when you were a professional (DH was west end musician and hates teaching music) but things like dance fitness classes? I've heard of a number of instructors who have a dance/theatre background and they seem to love it. There's an element of performance to it, keeps you fit etc without having to walk around being nice to parents of obnoxious 6 year olds... Also, a lot of teachers move around within a broad area rather than working at one gym, which keeps it interesting.

@IfOurEyesSawSouls I'm sorry but I don't understand your comment to me. I haven't posted anything about mental health just a couple of things about teaching.

I have worked in a few hospitals- Rose cottage is definitely a place in many hospitals, and "may she rest in peace" a standard in notes. Doctors no longer write code for patients "FLK" for funny looking kid etc, and if they do, then they should be reprimanded - record keeping is on the agenda for most places, and only recognised medical code "ECG" or CPR etc is allowed. Many doctors in their letters will write "I had the pleasure of meeting this delightful lady/ child..." - this isn't necessarily code for anything, just being polite, and even if the child is a nightmare, they will still try and use a nice term.
5/6am is the prime time for a heart attack - blood pressure rises quickly when getting up, increase in adrenaline and the stickiness of a type of blood cell in the early morning all increase the risk - we used to know it was a heart attack when the red phone rang in resus at that time to tell us about an emergency on the way in, especially on a Monday morning!
"Ash cash" was the fee paid to drs to sign a cremation form, not death certificate.
In the old system, there used to be a place/ bedroom for the oncall dr to get some rest in a long night/ weekend oncall, these rooms have now mostly gone.
We don't get offended by patients/ families who are obviously stressed but do get fed up with those being rude without reason. We also talk to other staff/ teams, so will know about the patient who has made multiple complaints for very little reason.
We are constantly battling against lack of resources- sometimes only complaints directly from patients will work when we have been raising our concerns for a long time, so please complain to PALS if you feel lack of appointments/ long waiting lists are significantly affecting your care.

Professional dancer here, West end, theatre tours and cruise ship credits.

When you go to watch a show and you are talking about someone on stage by covering your mouth with your hand and whispering into your friends ear, we can see you and the covering the mouth action makes it obvious you are talking about us.

If you use your phone in the theatre it is incredibly distracting for everyone. And it's rude.

Same with talking. Because we are generally in front of the speakers or depending on where the speakers are placed we can hear you.

If you are waiting for photos at the stage door be nice and wait your turn. Technically that is when we are off work and we are all rushing to get out last train home. Apart from the celeb cast members who usually have a driver.

I made more money working on cruise ships than I did working in West end.

The shows are of a higher standard on some cruise ships that west end.

Usually the show team that work on ships have been rehearsing for 1 to 2 months before they are on board at the ships studio usually in the states. Then they join the ship on the last 2 weeks of current cast contracts and start the install process which takes place of an evening time starting work at around 11pm at night till 6 in the morning. This is for tech runs, to get new cast used to the stage, prepare flying equipment, costume fittings etc. So when you are in bed of a night in your cabin there is a whole production going on in the theatre.

Dancing is incredibly hard work and not great pay. You really do need the passion to get through it.

I'm now retired at the age of 35 and have no pension or security other than my own house... Which years at sea paid for. Lol. I find it hard to find a new career after literally having the best job in the world for 15 years. The high I used to get from being onstage was something else and I think I'm still chasing it. Plus dancing is a lifestyle choice. I've literally moved across the world for work before. I'm so bored now staying in 1 place.

Also to work on ships that we don't have passenger status on we have to complete a course called STCW95 which is a basic firefighting, water, crowd management, first aid course. Basically when I worked on a ship I was in charge of a muster station which lead to the lifeboats. Its so much responsibility for a then 22 year old dancer. I know how to inflate life rafts, apply cpr, prepare a lifeboat for disembarking etc. Some passengers were extremely rude to me until they knew my position and they would be coming to my muster station in an emergency.

Loads of things happen on cruise ships that passengers don't know about. We had a full on fire on crew deck thanks to a washing machine that caught on fire. It was dealt with quickly and efficiently and no passenger ever knew.

Cruise ship doctors rip you off. Ours used to charge £200 for a sea sickness tablet that was a vitamin tablet.

As crew, we have a half price bar and our parties are so much fun. Honestly. Crew has a ball.

Dancing is not glamorous. It is sweaty, aching, tiring and fast paced. Dancers usually perform with at least 1 or 2 injuries. We can't afford to take time off for injuries to heal. We will usually be in physio of a day before our shows in the evening.

We can complete costume changes in 30 seconds.

Theatre touring life is hard work. Cramped tour vans, different beds every night, no home comforts, your diet is awful, no ability to cook, it's a lot of moving round.

God I miss it so much!