To think sometimes you can’t win with the NHS

[Merryoldgoat]

I’m NOT bashing HCPs at ALL.

It’s the conflicting information we get given. It makes us feel confused and utterly defeated at difficult times anyway.

Photos are from a leaflet from the hospital my son was admitted to with croup (steamy room may help) and the NHS web guide to dealing with croup (don’t put in a steamy room).

When I was admitted for my ELCS the midwife asked if I’d shaved. I said no and she got irritated until I showed her the pre-admission notes from the same hospital advising no shaving.

When pregnant the literature from my GP and NHS website had completely opposite information about eating nuts in pregnancy.

When admitted for an operation under GA pre-op assessment asked if I’d eaten or drunk in the last 12 hours. Said I’d had water. Again they started to tell me off until I produced the letter FROM HIM advising me to drink some water prior to admission.

It just leaves me feeling like a twat.

Maybe I’m having a bad week. Very unwell son, autism diagnosis for him and a hard week at work has exhausted me.

I think it’s worth pointing out that advice and guidelines are changing constantly these days. To keep up to date takes a lot more time/ money/ effort than a few online modules once a year. Most HCPs work in specialised areas these days and really need to be going on regular courses and to conferences. Trouble is there’s no money for that (unless you are a Dr and get sponsorship). And it would mean study leave which almost always get cancelled because of staffing shortages.
It’s no wonder a lot of HCPs are behind the times, medicine is changing all the time. Keeping up with and implementing latest practice means serious commitment from employers.

Yep
The amount of contradictory info I've been given from GPs, Nurses and Consultants is shocking.
One that sticks in my mind was when ds was around 7.
Asthma clinic nurse was vile, she bitched at me all triumphant as the spacer DS was using was "the wrong one" and I was "putting him at risk".
She demanded to know why I was using it, so I told her I had been told to use that one.
She looks at me in the manner someone looks at someone who they feel is a bit hard of thinking, and says "I very much doubt that, Mum, who was this inept person?"
She used "mum" in that way some nurses and HVs/midwives do to be condescending, as if the only thing you are now is a vessel.

I had great enjoyment in saying the inept person was her, at the last medication review, where she had complained I was using one not suitable for his age.

She just said "oh well I doubt that, anyway off you go"

Then there was the asthma nurse at a more recent doctors (we moved counties). Asked me questions about how DS is, how I manage as a single parent-Im not and never have been a single parent, she decided this was the case because my surname is different to DS.
Then she asked about lots of things and I answered, including how we manage to not disturb DD or have sleep as he can be hit worse at night due to his illnesses.

Answered fully. I said sometimes it doesn't help when the GP doesn't honour prescriptions given by consultants and the consultant had actually asked me to flag this as a serious issue. I said sometimes it can be hard looking after him, we didn't mind and had ways of dealing with it effectively but we felt the lack of support was sometimes disappointing, hence why we had a workable routine worked out.

She then sat making notes.
Clearly had fuck all to comment on. But got the arse over the comment about lack of support and the consultant's comment.

Turns round and says "well, I'm very concerned. I feel you don't care about (DS) all you seem to care about is the effect his illness has on you. I'm so concerned I will be contacting SS to offer the support you say we don't offer."

It was totally done to be a bitch. I had answered the questions she had put to me, which were mainly on how I deal with it, how it effects the family etc.

DS was 11 and he said, before I could "my mum and dad are excellent at looking after me, she answered what you asked. Please don't upset my Mum".
She called him rude and said "are you going to allow him to say that to me". I told her yes actually he beat me to it and was far more polite than I would've been.

I actually spoke to the receptionist and explained why I was so upset, she immediately made a note and nothing came of the nurses threats. Within 6 months she had left the surgery "by mutual agreement" according to their website

You say you are not bashing HCPs...but you are a bit and you know what, that's okay sometimes. Because like in all professions there are the excellent, mediocre and down right incompetent ones.

We need to stop all this deification of HCPs and have honest conversations about how lack of funding and resources in NHS sometimes results in substandard or awful care.

@MissyB1

I think it’s worth pointing out that advice and guidelines are changing constantly these days. To keep up to date takes a lot more time/ money/ effort than a few online modules once a year. Most HCPs work in specialised areas these days and really need to be going on regular courses and to conferences. Trouble is there’s no money for that (unless you are a Dr and get sponsorship). And it would mean study leave which almost always get cancelled because of staffing shortages. It’s no wonder a lot of HCPs are behind the times, medicine is changing all the time. Keeping up with and implementing latest practice means serious commitment from employers.

This is exactly it. When I started as a nurse there was funding and time off for study to keep staff up to date and improve knowledge. Now you’re lucky to even get the time off. I’ve paid myself to go to conferences in my annual leave but can’t do this for every area of my practice as my field is broad. I can’t afford to do this with rising professional fees and lack of pay rises so I keep up to date in the evenings. Oh and the cholesterol test, there’s a fasting and non-fasting test so you do still need to fast for some.

I had similar to this. I went into hospital last year for a simple procedure as a day patient. The admissions letter said nothing about fasting and advised to drink. Got to the hospital and got told off as I had had some water. Can't win and had to hang around for a further 4 hours or something.

I do understand about changing guidelines but surely the literature given out should match the NHS website? And there a consultant should know what’s in a letter sent from his department? And a midwife know what the hospital age works arcades about pre-cs shaving?

I’m not really saying they’re wrong as I don’t know - just that the advice is conflicting so you feel like a moron.

If I’d taken DS to hospital, they’d said ‘have you tried a steamy room?’ And I’d said ‘but the website says you shouldn’t’ who’s right? I don’t care in a way as I just want him treated but I feel like my sanity is called into question sometimes.

We need to stop all this deification of HCPs and have honest conversations about how lack of funding and resources in NHS sometimes results in substandard or awful care.

I find the patchiness odd.

I have frequently been disbelieved at work as I’ve managed to get appointments same day but people living across town can’t see anyone for two weeks.

The patchiness is because each GP surgery (unless part of a group) manages itself how it wishes. I always manage to get same day appointments yet the other local surgery is terrible and you wait 3 weeks.
The croup, steam used to be recommended but no longer is. Again the fact sheet from the hospital needs updating but either hasn’t been or has been by someone who hasn’t looked up the recent research. We don’t give out fact sheets, just direct to the NHS site.

Basically it’s NHS by name but not by nature. There is nothing national about it other than the name and some directives. It’s all to do with the privatisation and outsourcing. It’s broken.

The problem with the fact sheets is that they are prepared by central resourcing - not the hospital.

Then sent out in a bundle to be put in waiting rooms/corridors etc so patients can help themselves.

It’s unlikely the staff even have time to read them to be honest.

The web is possibly the best pace to look as it (should!) be immediately updated on whatever current best practice is.

It is infuriating when you get looked at like an idiot for following their advice though.

it happened to me when I broke my leg, they missed the fracture and told me it was ligament damage so to just keep exercising as normal.

3 weeks later when my leg was swollen like an elephant and I couldn’t walk I went back and got roundly told off for not following the drs advice to rest and use crutches...I was so glad I’d got the same person with me for the second visit as the first because we both put that dr straight on what I’d been told.

I had such a hard time healing my perineum after birth. Got told to use a sitz bath, don't use a sitz bath, use a shower, don't shower, don't get it wet, use water when peeing, sit on a ring, don't sit on a ring, use lavender oil, just use clean water.

They told me to take all painkillers at once (paracetamol and ibuprofen), then to stagger them, then I got told off for staggering them! The consultant told me they would prescribe me tramadol, then when I got admitted to the ward the prescription midwife said the doctor wouldn't have said that, because they didn't stock it and I must be lying.

After a third infection I begged the doctor (consultant) to tell me how to heal it, she said, 'Oh, well, some midwives say you can put manuka honey on it'. FFS I was looking for medical advice from a consultant gynaecologist, not an old wives tale. As if I was going to slather honey on my infected perineum. Give me some antibiotics if that's the solution!!!

The constant back and forth on advice was really confusing and exasperating and it felt like I couldn't get anything right.

YANBU

NOT having a copy of your exams and your medical file always drives me nuts.

You end up meeting various professionals who have no idea of your background and medical history. Your summary is nowhere near as accurate as a full medical report.

You should be given everything and up to you to take it on appointments. Should you forget, no difference with the current situation when the information doesn't follow and is not shared.

It's a complete mystery, you would have thought every medical facility could access your unic medical record and add to it!

I had the shaving thing for the ELCS too! Leaflet said don't shave and when was on the table being prepped the doctor was like "oh, you haven't shaved?!". I was lying there with a team of professionals looking at my crotch and one of them asked "should I try to find some clippers?" while I was desperately repeating "but the leaflet said!!"

@Biffbaff

I had such a hard time healing my perineum after birth. Got told to use a sitz bath, don't use a sitz bath, use a shower, don't shower, don't get it wet, use water when peeing, sit on a ring, don't sit on a ring, use lavender oil, just use clean water.

They told me to take all painkillers at once (paracetamol and ibuprofen), then to stagger them, then I got told off for staggering them! The consultant told me they would prescribe me tramadol, then when I got admitted to the ward the prescription midwife said the doctor wouldn't have said that, because they didn't stock it and I must be lying.

After a third infection I begged the doctor (consultant) to tell me how to heal it, she said, 'Oh, well, some midwives say you can put manuka honey on it'. FFS I was looking for medical advice from a consultant gynaecologist, not an old wives tale. As if I was going to slather honey on my infected perineum. Give me some antibiotics if that's the solution!!!

The constant back and forth on advice was really confusing and exasperating and it felt like I couldn't get anything right.

I'm a District nurse and we use honey in wound care every day. Research has shown it is effective at reducing infection as it can stop bacteria from multiplying. It comes in a tube so can be squirted on, or in knitted guaze type form. Its all sterile and manufactured for wound care.I have been offered a tube of honey by a patients relative to put on a wound that they've bought off the supermarket shelf which obviously I declined.

@Tiredmum100 That's interesting that you use that day to day. I'm definitely not disputing the antibiotic properties of honey. The kind made for wound care sounds fantastic! If she'd offered me it like that I probably would have gone along with it. I just wanted more from the consultant that day than a recommendation she clearly didn't want to put her own name to. I ended up buying manuka honey and eating it out of desperation for the immunity boost!

I Generally good experience with consistency of approach in the NHS. Just one exception- I have a rare condition that causes nose bleeds. There are a few ways to treat but never cautery. I saw a Specialist ENT Registrar for routine check - he said if I just waited he would cauterise it before I left. I don’t expect all doctors even in the specialty to know about my illness- I do expect them to read the notes or do basic research.

If I had been a few years younger I probably would have let him do it and presume the advice had changed. This time I just said when the consultant authorises it. It most definitely has not changed.

I agree and I am a HCP

I'm a midwife and the shaving before c/s confusion drives me nuts - I hope I would never make a woman feel bad for feeling the same! The only evidence is not to traditionally shave due to resulting micro cuts being an infection risk but they never have the clipper heads at work any more plus now we have improved dressings that stay on for up to a week and work best on hairless skin so no-one knows what to do for the best. Ideal would be to trim closely 2 days before I think but hardly practical!

Its not just your NHS someone above mentioned the Australian system which can be just as bad. My last pregnancy an example. I get HG so for my third pregnancy I ask for medication really early GP told me not to think myself into being sick. Previous pregnancy an immune issue had caused low platelets in baby so I'm referred to high risk stream. High risk stream get some blood test results decide last baby was an anomaly back to standard stream. However I've missed the intake procedure so I have no idea I'm supposed to be testing my urine and giving them the result. I get in trouble for not doing this. BP is high, get told that because im fat. I've just lost 10kg because of the hg. Dr tells me this is a good thing. See a different Dr a week later get sent to monitoring because my bp was high. Very quiet baby so ended up in monitoring a few times. Results not good enough so get told to drink a glass of cold water. Later on get told by a dr that drinking cold water shouldn't be done. The whole pregnancy was like that it was lucky it was my third and I knew roughly what should be happening and was bolshy enough to challenge a few things. Like that the baby's platelets be tested at birth (they were lower then previous child)

Oh I should add the best drs and midwives I have had ever in Australia are all British,

My dd did a lot of classical ballet classes as a teenager. Like 15 hours advanced intensive training a week, with a view to a professional career.

One day she was running home from school in a hurry and tripped over the kerb. She came home limping and in pain. This was someone who was well-used to having sore and painful feet from all the dance training and wearing pointe shoes, so I knew she wasn't making a fuss about nothing. The following day it was worse so I took her to the GP, explained that she was a committed dancer training at a high level, aiming to train professionally, and had auditions and performances coming up. Could he please check her foot to make sure there was no serious damage, because early intervention was vital. Due to the location of the pain I was concerned there might be a fracture, which I told him. Foot injuries in dancers training vocationally can be disastrous, and need urgent treatment. Dancing with an undiagnosed injury and causing further damage could mean the end of a potential career.

He had a quick look, said there's nothing wrong, take some paracetamol and rest it. Come back in a fortnight if it's no better. And you have a lot of hard skin on your feet which shouldn't be there and you need to get rid of it. Put loads of lotion on to soften it.

He really hadn't listened to a word at all. I'd spent 5 minutes emphasising the fact that she was an elite national-level dancer, and all he can say is that she needed to get rid of the hard skin on her feet. Of course she's got hard skin on her feet - she's a bloody dancer. Total waste of time seeing him at all.

Took her to A&E, told them she was a dancer and they were all over it immediately, x-rays from several angles, the works. They were incredibly good and went out of their way to help. They even called down their top orthopaedic chap to double-check the x-rays for her, to make absolutely sure there was no break, which fortunately there wasn't.

But that GP - honestly, he couldn't have cared less.

My sons surgeon and consultant have opposite opinions about his health conditions. Really useful for me that is.

Frustrating isn't it? And the hospital didn't tell my dd to go away and take paracetamol like the GP did. They gave her crutches.

It's weird more isn't centralised and a lot is done at trust level. I had similar during pregnancy, the midwife printing off some advice sheet made by the trust, it contradicted what was on the website. I asked at my next appointment as it was important, and she said how would I know which is right .

I take Metformin for pcos. In my first pregnancy, the midwife told me to continue taking them, the Dr told me to stop and the NHS website said taking them might reduce the risk of miscarriage. I took them!

This pregnancy, in the booking letter for my scan there were additional sheets of paper (like how to get there, did I need a translator, etc.) And one said I could bring my partner and another said I couldn't in the same envelope!!