bad nhs direct advice?

[bridewolf]

i rang nhs direct to get some advice on my IgE allergic son.

after brief chat to nurse he asked if i had ever tried homeopathy to cure his allergies.

i was pretty shocked, has anyone else ever got this sort of advice from nhs direct?

and becstarlisea- NHS Direct couldn't possibly diagnose measles over the phone. it is an emergency out of hours service which primarily assesses the seriousness of symptoms. we don't diagnose ANYBODY. they would rule out meningitis and then refer on or give self care advice. and it's not a flowchart system, they use algorithm and clinical knowledge/experience.

ImSoNotTelling - I'm not sure what your disagreeing with - I'm saying that their is a perfectly understandable tendency and desire for medics to actually do something. And I'm saying that this is not always the best solution - and you seem to agree with that.

I am disagreeing with your statement that "Medics are always going to want to do something"

I disagree that medics always want to do something - in many cases there is nothing to do and the medics are perfectly happy to leave it to take its course/see how it develops. Which is as it should be.

I also disagee with the statement that because medics "always want to do something" that "In the absence of evidence based medicine, that becomes 'what works in my experience'".

I do not expect medics, if they don't know a tried and tested medical solution, to dish out advice like "put a cold marmite compress on it" on the basis that their granny used to swear by it. I expect them to research further, do some more tests, refer on to someone more expert etc etc. I don't expect them to make random pronouncements just so that they're "doing something" at all.

It was a homeopath that diagnosed my milk allergy when I was 10 - 8 years of horrible eczema was gone in a couple of months. I am profoundly grateful to this day.

Arguably he didn't need homeopathic knowledge to achieve this, just an open mind and the willingness to discover the root of the problem rather than just slap cram on it but it was more than my GP and several dermatologists ever managed.

If your son was in the middle of an allergic reaction then you are NBU to resent the suggestion. If it was a more general inquiry then I think it is quite a valid suggestion (unless you were asking what to do in case of anaphylaxis) which you are free to ignore.

What you expect them to do and what they actually do are to different things.

I'm not saying that all medics do this all the time. I'm saying that this is a tendancy - so over the set of all opportunities to intervene there will be a bias to taking action. This is not a Medical trait - it's a human one.

This is why " they are trying to turn medics away from treating some things in favour of 'wait and see' "

Researching further, more tests, second opinions etc . all seems good evidence based practice to me ;)

It seems unrealistic to me to suggest that Medics will do this in all circumstances, rather than fall back on something they know to have worked in the past. Medical staff aren't perfect, and we shouldn't expect them to be.

ooj, there's no need to go to extremes. Nothing wrong with evidence based medicine as a concept, but there is plenty wrong with treating it as the be-all and end-all. It should be used sensibly, recognising that lots of medicine simply isn't evidence based at the moment. Partly because there ain't enough research to cover every possible condition and patient and intervention, and partly because people are different and complicated and real patients in real GP surgeries or hospitals aren't exactly the same as the very defined and carefully selected population enrolled on a drug trial.

Edam - I agree. I'm not suggesting that if there is no defined course that you should do nothing.

To go back to the original Homeopathy point though - I think it's understandable, that a Medic, faced with something they can't help with might recommend something like Homeopathy out of a desire to help the patient. Either out of a belief in Homeopathy itself, due to some of the beneficial side effects or just to make themselves and/or the patient feel less powerless.

there is a lot we do not understand about homeopathy though, why in some cases stuff seems to work and we do not understand why, and say "ah, the placebo efect"

would you for eg think it was mad to chew on a lump of willow bark,if you were in pain, or boil it into a tea-like drink? the native american indians and chinese used this 1000s of yrs ago - and from willow bark WE have now derived aspirin, so they were not totally "barking" if you will pardon the pun

I have mistrusted advice on NHS direct ever since one of their advice workers confidently informed me Herpes simplex is a bacterial infection not a virus

they actually said that DD - or misdiagnosed symptoms of HS as a bacterial infection?

Homeopathy can't be compared to the use of beneficial plants in medicine. There's scientific evidence which shows that digitalis can and does benefit many heart patients.
There's no such thing with homeopathy, there's no logic. It goes against everything we know about science.

BADGER Health Information staff only check verified websites, they dont bloody Google! They give evidence based research information only. If you ask about MMR, they will give you FACTS not opinions. Then leave you to make a choice. Would you honestly base your childs health care on what you dredge up on Google?

As one of the NURSES there I use 15 years (including A&E) experience to make a reasoned assessment based on symptoms - I dont follow blindly what my computer says, but allow it to prompt some questions as I know it is very carefully researched by medics. (I agree, the thread around the willy one is ridiculous, and I never ask it!) There are always some idiots in every organisation, but the fact that we take thousands of calls every single week means we must be doing something right.

I personally would not leave a baby with a high temp and screaming for 3 hours at home but advise an urgent gp appt, or even A&E depending on other symptoms. I certainly dont diagnose but I do risk assess and give advice.

There have been rumours of getting rid of all the nurses and using call handlers with no medical training. They WILL follow flowcharts, which is why ambulance crew friends complain bitterly that people with toothache have ambulances called for them (heart attacks have referred jaw pain). If that is ever the case I would advise everyone I know not to touch the service with a barge pole.

do you really think that will happen BMUS? i work part time at NHS24 and call handlers are now using call streaming which means they ask more safety questions to help route the call more 'accurately' but it's still very different from actually assessing patients... i'm trained to advise and refer chest pains/minor ailments/medication enquiries/district nurse referrals but i doubt many of the call handlers would be comfortable with any more responsibility as they become personally responsible if anything goes to court (as has happened to a colleague).

I recently had a tampon 'scare' - I called NHS direct about leaving a tampon in too long. It turned out I had removed it, so no worries. However! NHS Direct advised me to 'insert a new tampon. If it goes in fully and easily, there's not another one in your fanjo. If there's resistance, an old tampon is in there'. I took their advice for two minutes and then thought 'holy fuck that's dangerous!' and whipped it out.

Let's just stick to GPs!

mmm yeah dangerous

did you expect them to run round to your house and retrieve it for you? door to door fanny maintenance.

jesus.

blinks I don't understand your post.

Are you saying that vivia was wrong to call NHS Direct for that problem?

I expect the OP was worried about toxic shock syndrome, and a lot of women can fit two tampons in their vagina. So she could have stuffed another one up, had it go in fine, take it out happy that all was well, then die.

Please can you explain what you meant about "dangerous " and expecting them to retrieve it and so on?

hello, my son had a previous reaction that resulted in a dash to hospital.

however at home ,even with steriods and antihistamine, he had allergy symptoms returning, not enough at the time for me to worry about epi pen and hosptial, but enough for me to want to talk to someone and get some support.
i also wanted to see if there was a way to get him more comfortable with his lip swelling.

(things are ok now and we have it sorted with his immunologist)

so just made a quick call resurance, after a few sleepless nights , a mummy needs a bit of that!

wasnt happy with the suggestion to try homeopathy, for ige allergies its not gonna work, and seems a dangerous idea to me.

Homeopathy isn't going to work for anything, unless you can find a problem cured by sugar, water and big dollop of bullshit.

pooexplosion - quote of the week there

I called NHS last weekend about myself. After I spoke to the call handler for about 5 minnutes she said 'are you conscious and breathing at the moment' !!

imsonottelling?

a cold marmite compress!!

laughing at that one........a cold compress was suggested, which i thought was a ok idea.

however, the marmite idea, is such a no no for my lad.......would have ended everything vvery, very quickly!

Hmm marmite is out, that's a shame...

Have you considered a poultice with grass picked while the moon is full?

ROFL @ waitingforbedtime!

maybe it was a comment on your conversational skills...

imsonottelling.

my gran used to put bread and hot water on boils............i got one on my knee once, spent whole day with a slice of soggy mothers pride on my knee, boiling hot.

it worked. but then so would have TCP

grass picked naked in full moon, in feb?

Bread poultices actually have a semblence of logic about them, there is a scientific reason why it might work. Surprisingly quite a few old wives tales/ home remedies have some medical validity.