The National Health Service is celebrating 70 years by July 5 2018. The NHS was established July 5 1948 by then Health Secretary Aneurin Bevan at Manchester Park General Hospital now known as Trafford General Hospital. Looking back at 70 years ago, doctors, nurses and pharmacist came together to save lives and since then there has been an improved staffing level and Allied Healthcare Professionals to many fields in the healthcare sector. NHS has invested in staffing, education, technology, surgery, medication, research, to mention a few. The NHS have come a long way and and keeping strong to survive and continue to cater for all people despite the size of population, age, diversity and innovation therefore the need to find financial assistance to support the NHS has become unavoidable if NHS is to live on and not privatised.
The NHS is one of the biggest organisation in the world with good understanding of patient care and the biggest employer around the globe this means we all can expect to live longer and enhancing quality of life. Today the NHS is struggling to recruit staff and retain them. Each NHS hospital has an issue to address and these issues also affect the Community Care, clearly there is a problem with the NHS.
The people of United Kingdom knows the value of the NHS and have agreed according to the BBC World News and King Fund Opinion Poll to higher tax, to redeem their NHS. No matter of how much we are being taxed to save our National Healthcare it will worth it in the end for us and for the next generation to come, and the people will always benefit more from the state hospitals compare to the compulsory private hospital, medical insurance and cash payment should NHS be privatised.
In many Countries the NHS system does exit with cash payment compare to the UK where cash payment is not needed to those who live in the Country and that’s why people all over the world come to the United Kingdom for free treatment of which the government have put in so much effort to ensure visitors pay for their treatment to deliver good management of tax payers money. Healthcare system in the UK is not free, many people assume the Care System is free, here in the UK taxes are paid toward healthcare system while other Countries make payment through medical insurance or straight from their pockets and if you don’t directly make payment there would be no treatment while in the NHS you don’t have to make any payment upfront before receiving treatment, you walk in and you receive treatment irrespective of level of treatment this is because the cost of the treatment has been deducted from individual tax and that’s one of the the fundamental reason why UK taxation is of the highest in the world. Collective tax payment from the working individual makes life easier for everyone and to receive an optimistic treatment when fall ill or injured. This is a good functioning system to save lives and respect for humanity.
It is not surprising that the people of United Kingdom have taking the right decision and chosen wisely by agreeing to an increment in tax rather letting the NHS slip off their hands and end up with medical insurance system which does not come cheap and individual pay as you go.
Good health brings all prosperity according to Philosopher and Psychologist that said “Health is Wealth” this is basically true, it is better to remain healthy than being ill. Illness is something anyone should avoid by all means however there are other factors that affect health such as genetic, congenital and environment whereby being ill is likely inevitable. All effort should be made to live a healthy lifestyle, visit your General Practitioner (GP) as early as possible if you notice or detect any abnormality in your health and well-being. Early diagnosis lead to early intervention and early intervention lead to early recovery and healthier life.
Urgent care in the National Health Service (NHS) can be discouraging but they are doing their best to treat everyone. Guess waiting time would worth waiting for in the end. Many people often get put off by waiting time but what’s more important than your health. The waiting time could have been spent elsewhere anyway, either in bed, at work, shops, pubs or travelling, all these places are part of choices. Urgent Care is not a choice though individual can argue this but what’s more important than good health. If you are not feeling too well how can other interests be achieved, therefore “4 hours” waiting time is an investment to your health. Be patient, the Healthcare Professionals are human trying to help in whichever way they could. Health is Wealth.
When it comes to acute healthcare need it becomes a necessity rather a choice and at this point prioritisation would take place to enhance immediate treatment by the healthcare professionals. Acute Care can be classified as secondary health care where a patient receives active treatment, although this can be for a short term treatment for a severe injury or an illness. In Medicine urgent care can simply be classified as any medical condition, recovery from post operative and not involving chronic conditions.
The emergency departments within the NHS treat and care for all people irrespective of age, gender, religion, beliefs, sex, ethnicity, disability, offenders, all people are welcome to Accident and Emergency Units. This Hospital department treat and care for people with a serious injury or life-threatening condition. Medical staff will normally assess your ill-health to determine a care plan for you. This department is responsible for immediate care and to carry out various medical assessment, transfer individual to Acute Medical Unit or Wards for further treatment. Some individual can benefit from straight transfer to Theatre for immediate operation by the surgeons whom can be Neurosurgeons for evacuation of possible epidural hematoma, subdural hematoma, subarachnoid hemorrhage, intracerebral hemorrhage among others. Other surgeons who are likely to treat you are orthopaedic, cardiac, gastrointestinal, lungs, vascular, plastic surgeons and many more. Another group of individual might need a transfer to Intensive Care Unit, or be discharged home if medical condition can be stabilised within Accident and Emergency Unit.
A lot is going on when you first arrive at Accident and Emergency Unit and Urgent Care Centre. Everyone is busy including the clients who are waiting to be seen, there is pressure everywhere. The healthcare professionals are good in their vocation and job despite the pressure, they are able to deliver empathy, compassion, high standard of care while resilience emotions to allow them carry out quality of care that is needed for you. The staff are professionals they take in all accusation, insults, abuse and yet treat you with compassion and kindness, they are strong, everyday they go back to the field. I guess all people should be grateful to the NHS and the staff as we all know the private hospitals and places where immediate payment is required before treatment can be costly yet there would be a waiting time however might be minimal due to low number of clients. Many Countries pay out of pocket for their own healthcare cost, some have medical insurance. These other places equally pay taxes to their government. In the UK taxes and National Insurance are paid and at a high rate however, when you arrive at the Hospital there is no cash payment before you can be seen by a medical practitioner. In some other places no payment no treatment.
I guess patience is a virtue. Waiting time does not mean everybody must wait for “4 hours” everyday, this can change very quickly to less than 4 hours depending on individual assessment and treatment of those that went in before you and how many individual registered to be seen on this day. Care is not to be rushed and if rushed vital aspect of assessment could be missed leading to poor outcome. Be patient and tolerant, despite the number of individual registered to be seen everyone will surely be seen. Health is Wealth and it worth waiting for!
Psychosocial behaviour of some drivers on the major roads can be terrifying. All drivers seems to forget just one most important thing on the roads while driving which comes under philosophy of life, your life – your health keep them safe. It can be said that psychosocial characteristics of individual can influence the factors that surround psychological behavioural status and social environment.
Most drivers lack patience and in return intimidate other road users unknown to them. The fact remains that your driving reflects who you are and your psychological state. You may argue to say l am late to work or to school and some other places, examining these arguments yes it is true that you are late but the question is this: If a trap cut a rat can the rat continue the journey? Of course NOT! Be patient, drive with peace of mind and show good example on the road. Respect the law of the land and that of the road. If 30mph is required respect that, there is no need going as far as 40mph instead of 30mph and driving along bus lane to beat the drivers that are humbly obeying the law, what does that say about anyone who disobeys the law and freighting other road users?
psychosocial is defined as a state of mental, emotional, spiritual and social well-being and looking into clinical implications of psychosocial, these area of clinical explanation is big however we can mention a few without going into details. Post-Traumatic Stress, Road Traffic Accidents, Points on your Driving Licence, Injuries, mental trauma, compensations, Insurance Claims, traumatic brain injury and multiple fractures to mention a few without touching the worse scenario. Admission to Intensive Care Unit needing respiratory support.
Remember you are responsible for your own life and that of other road users. You left your home and wish to return safely therefore be careful with your driving habit. There is nothing wrong in being patient, after-all no matter how much rush and driving irrationally, the traffic light will still go ahead to stop you, so why the rush? Drive like a gentleman and women drive with respect.
If you are running late for whatever reason contact your workplace informing them that you will be late approximately how minutes and if that is not possible then do that on arrival and apologise for being late and unable to call because you were driving and respecting the law that says do not use your mobile phone while driving. And if it is an emergency such as wife in labour still don’t drive in a rough manner or panic. Driving under pressure can cause more harm than good, think of the safety of your passengers and other road users. Everyday is not the same therefore take each day as it comes. The Government loves you, Your family loves you, Your personal Guidance loves you and you love yourself. A Word is enough for the Wise drive carefully and respectfully. The philosopher and Psychologist including Sociologist once agreed upon one thing ‘Prevention is better than Cure’. The truth is bitter but it has to be told for the sake of everyone! See It! Anticipate! Avoid!
Health is wealth and health is something everyone should take very seriously. Eat well and drink well and when talking about drinking well we mean water, juices, hot drinks, chocolate drinks and possibly normal limit of red wine. Eat less processed food and if affordable organic food might be the best. Ill health can be very expensive and limiting too therefore take good care of yourself by ensuring that you are stress free, have a good sleep, relaxation and meditation could be very helpful in keeping body and mind at peace. When feeling a bit ill visit your GP on time, it is better if your GP says it is nothing rather too late. Early diagnosis leads to early intervention and early intervention leads to early recovery. Health is one of the greatest gift for both the rich and the poor therefore appreciate your health. Like we made mention earlier health can be extremely expensive in terms of physiological changes and financially.
Your next holiday can be next form of relaxation and time for healthy exercises. You can visit Windsor UK where you will have the opportunity for good food in local restaurant, The Great Long Walk for morning exercise, tourist venues to visit and good hotels and Bed & Breakfast.
Exposure to various forms of stress is a common daily occurrence in the lives of most individuals, with both positive and negative effects on brain function. The impact of stress is strongly influenced by the type and duration. In its acute state, stress may be a necessary adaptive mechanism for survival and with only transient changes within the brain. Severe and or prolonged stress can cause overactivation and dysregulation of the hypothalamic pituitary adrenal axis thus inflicting detrimental changes in the brain structure and function. Chronic stress is often considered a negative modulator of the cognitive functions including the learning and memory processes. Exposure to long-lasting stress diminishes health and increases vulnerability to mental disorders. In conclusion, stress exacerbates functional changes associated with various brain disorders. Eradicate stress as soon as identified and seek immediate help where necessary to avoid complications of stress. Read more about the symptoms of stress and this knowledge will help you to identify and understand the ill health that surrounds stress.
It may be interesting to discuss here the Philosophy of Nursing Care and the Intervention needed in all nature of care. What does it mean the philosophy of care, this is an individual spiritual gift of good personality and characteristics to deliver nurtured care to patients of all age. The tool of philosophy is a guidance to help you walk and work in the right perspertives of care and to follow the right path toward achieving Wisdom of care, effective communication, fashion of loving care, compassionate care, interpersonal skills, tolerance, dedication and achieving happy ending at the end of each shift. This philosophy equally will help you to manage conflicts among colleagues and service users. Wisdom of Care is one of the best charisma to have that will make you become one of the best of Nurses on earth. Once you possess the gift of philosophy care, Nursing becomes bearable, admirerable, happy vocation, satisfactory and unending compassion. The care you provide to your patients would be exceptionally deemed as first class, you will be seeing as an angel because the fashion in which you deliver your care would be pure and at the highest standard directly straight from your heart.
Personally my nature of nursing is fully indulged around philosophy of good care leading to commitment to the public and private services and the ability of willingness, determination and passion to help those in need of care at some point in life. Nursing is difficult to describe, this type of inner loving care mimic motherly care, can a mother explain all the care given to her child? I do know this is a special calling that has a passionate fashion and samaritan above just a job but rather a vocation.
Nursing is more than treating an illness it focused on delivering quality patient care that is individualised to meet the need of each patient at one time. At Saint Alexandra Healthcare Services our philosophy of nursing incorporate the knowledge of Intensive Care Nursing, while collaborating this with relational compassionate caring that respets the dignity of every patient. Patient’s values are honoured and our crucial aspect of nursing is inter-professioal relationship with our Allied Professional and medical team collaborating efforts to promote quality patient care.
Our philosophy of nursing extends to our community of which health promotion is something we continually strieve to achieve, creating awareness and maintaining home care services. Health is Wealth allow SaintAlex to look after you.
Oral care is one of the fundamental basic Nursing Care to maintain personal hygeine both in hospital setting and home care for all patient. Oral health is a good step to understand your health status, and any possibility of bacteria in your mouth which can affect the rest of your body causing psychological and pathophysiological changes to your health. Many organ systems in our body can be affected if oral care is poorly handled. The mouth can be affected though most bacteria can be harmless, however, the body has natural defense against bacteria which can prevent penetration of bacteria into our blood system if care is taking to maintain good health and good immume system. Daily brushing and flossing is recommended by the Dentist to keep bacteria under control. However, poor oral hygiene can reach the level of acquiring oral infection causing tooth decay, gum disease, pain and offensive breadth.
Physiologically, oral infection and inflammation caused by periodontitis can have severe role to play in some diseases such as Cardiovasuclar, HIV (AIDS), Osteoporosis, Dementia, Mental illness, Mental Health, Diabetes, Alzheimer. Some other conditions that might be linked to oral health include eating disorders, rheumatoid arthritis, head and neck cancers, and Sjogren’s syndrome.
In contrast some medication can reduce saliva flow and saliva washes away food and neutralises acid that is produced by bacteria in the mouth. Pain killers, diurectic and antidepressants can reduce saliva flow, it is essential to visit your dentist on time, early intervention in medicine leads to early recovery. While you can, visit your Dentist and acknowledge your appointments.
Personal Care: Saint Alexandra Nurses take this aspect of care very seriously. Oral care enhances refreshment of the mouth, but most especially it nourishes and refreshes the body and mind leading to a sound positive pschological state. Brushing out teeth daily as we were told by the Dentist to brush twice a day, however, some people with certain types of job are likely to brush their teeth after every meal. Our patients are critically ill and some are ventilated and in need of a good oral care to prevent Ventilator and Endotracheal Tube acquired infection while tracheostomy care becomes equally extremely important, some are elderly and need support to achieve this aspect of activities of daily living, whle some are too ill receiving palliative care.
Oral care is an essential part of Nursing Care adding to over-all Personal Care. We cherish our patients cleanliness, we give total personal care, we are able to wash your hair, dry and style, cut the gentman’s hair, eye lids, eyes brows, hair in the nose and ears, shaving, brush your teeth and offer mouth wash and lip balm, keeping your mouth moisture and fresh. We also get fully involve in your activities of daily living, we can wash your feet, massage and oil them giving you total skin care. We will feed you to your satisfaction no hurry at all, we will keep you company and read your favourite books to you, be your new best friend giving you bundle of generous care because you deserve it!
Care is beautiful once it comes from the inner-most heart. It is a privilleage to be able to care for others. We have passion in doing this at Saint Alexandra as Care is Life to Us!
Accepting help might mean loosing privacy and independence to the new life changing routines. As a result, your loved one might feel frightened and vulnerable, and may also be angry that he or she needs help or feeling guilty of becoming a burden to the family and friends.
Professional caregivers include home health visiting nurses, rehabilitation therapists and healthcare social workers. The therapies comprise physical therapy, speech and language pathology and occupational therapy services. Professional caregivers deliver services at the elder patient’s home to help them develop independence with activities of daily living in a convenient and comfortable setting while allowing families to be closely involved in the rehabilitation process. This is what Saint Alexandra Healthcare does best!
Working in intensive care unit can be very daunting without acquiring constant knowledge. In Intensive care unit, there are many factors to consider especially emergency cases both expected and unexpected. At any time patient condition can deteriorate and this can be challenging.
ICU patients can be subdivided into three levels, Level3, Level2 and Level1. Level 3 group of patients are Critically very ill as well as most Level2, the group2 patients are not intubated and Level one’s are the step-down patients awaiting to be discharged to the ward. Each level of care require knowledge and understanding of care management and process to avoid lapses. However, these group of patients can slowly or quickly deteriorate especially those in Level2 category and Level1 if omissions or delayed treatment should occur clinically. These patients in group2 and group1 can revert into Level 3 or 2 even worse can lose the patient all to-together if appropriate attention is not given. Contributing factors include missed observations such as Neurology, Respiratory, Cardiac instability, Renal dysfunction, post surgery care, vital signs, skin assessment, blood gas analysis, laboratory results, warning signs to mention a few. Inadequate knowledge and lack of critical care observation skills can cause more harm than good the Philosophers stated that “Prevention is better cure”.
Advance Nursing Knowledge is required and that’s why its important to attend Conferences to learn from the experts. The Intensive Care Professor Physicians and Consultants, Dr’s, Nurses, Dietician, Physiotherapist, Pharmacist and guest speakers from all over the world are usually present given evidence based teaching and research outcome on (ICU) medical and Nursing care.
Discussion on compensated and decompensated organ phase based on multiple-organ sysdrome are front-line topics. Neurological circumstances, cardiac cases, respiratory failure, Ventilaton, teaching on individual system and diagnosis, Pharmalogical awareness, Nutrition, complications and management of system by system. Having attended these conferences l gained improvement on thorough observations and assessment and to inform the Charge Nurse and Doctors on time of any changes in patients even if it is nothing “A stitch in time saves Nile”. Give drugs to patient on time as prescribed, understanding the consequences of backlog and effects on patients. If a drug is prescribed 2 hourly such as Nimodipine or 4hourly for example, and 2pm is given at 3pm or 4pm the late administration will affect the rest of the hours overall leading to ommision at some point, this type of care is unprofessional and would have a negative effect on patient’s recovery phase physiologically. I understand we can be extremely busy however, drugs comes as priority. It is crucial to comply with drug chart prescribed time and to give the drugs as of when due unless unable for some clinical reasons such as patient not fit for oral in this circumstrance report to Charge Nurse and Doctor should they wish to prescribe Intravenous route instead. As a Nurse its important to advocate for all patients in every situation.
Attending Conferences has really improved my confidence, understanding and efficiency in practice. I am able to pass on the knowledge to my Nursing Students, Medical Students, colleagues and stand up for good practice. It is good to practice effectively and preserve patient safety. This is the most reason ICU patients should have one-one care or 2:1 ratio while promoting Prioritising People and to effectively promote professionalism and Trust.
Drug infusions is drawn by a Registered Nurse and be used within own shift only. Most often Nurses draw-up drug infusion for the next shift and the incoming staff think this is great.
Preparing drug infusion for the next shift can be very dangerous. It is not advisable to use an infusion not present when it was drawn up as errors could have occured during dilution or wrong drug all together. Take for instance Noradrenaline could have been prepared in 50mls of 5% Dextrose and nicely labelled however, due to busy schedule of the Unit the Nurse may have forgotten to add the Noradrenaline to the infussion and the next shift uses this infusion what happens then? The patient blood pressure starts to drop and eveyone thinks why is the patient’s blood pressure dropping doctor will say go higher on the Noradrenaline and eventually prescribe fluid start dose but little would anyone knows that there is no Noradrenaline added to the infusion syringe. l have come across such incident whereby you just have to prepare a new infusion and connect to patient thereafter blood pressure and mean arterial pressure improve nicely to the parameter set by the Physician, or Neurologist, and Neurosurgeon and good perfusion observed. Failure of Noradrenaline can be detected when it failed to work what about other infusions.
Having attended the European Society of Intensive Care Medicine (ESICM) Conferences, it was said not to use a drawn up infusion that has been prepared by a colleague in your absent evidence based practice suggest safety of the patient is priority, staff, Unit and the Trust in question.
Personally do not use a drawn up infusion neither draw up one for the next shift. If an infusion is coming to an end towards the start of next shift, l will prepare the infusion connect to the patient, start the infusion and handover. This is to avoid a delay in treatment following clinical time judgement.
Drug infusion can be drawn-up shift by shift by so doing will not compromise patients safety, avoid drug error, and cost effective. Throwing away drawn-up infusions due to uncertainty becomes unnecessary wastage. Hospitals should implement actions to avoid drawn up infusions for the next shift or staff. This is not about lack of trust but it is all about safety measures for all.
European Society of Intensive Care Medicine 2015
Intensive Care Unit can be very remarkable my patient was looked after for two days in a row and was discharged to the ward. Handover was given to the ward Nurse and thereafter returned to the Intensive Care Unit to look after my other patient. At the end of my shift just about to go home met with discharged patient’s sister at the corridor the lady told me her brother is sick and have sent for me so l went to the ward.
I assessed him and realised he has declined medical advice to have only sips of water after major pelvic exenteration, he has been drinking and even had a small amount of soup and this has caused nausea and vomiting as the bowels are yet to function actively. The abdomen was distended and firm tapping like a drum.
Pelvic exenteration is a radical surgical treatment that removes all organs from a person’s pelvic cavity. The urinary bladder, urethra, rectum, and anus are removed. The procedure leaves the person with a permanent colostomy and urinary diversion.
I spoke with my colleagues on the ward and looked for the ward doctor to inform them of my assessment. The doctor came with me straight away and assessed the patient agreed a replacement of the Nasal Gastric Tube (Free Drainage) is needed.
I inserted the NG and aspirated over 470mls at one time and stayed with patient for another 45 minutes and aspirated the NG again and this gentleman is now feeling better and abdomen is less distended. Going to see this patient on the ward has prevented the possibility of readmission to Intensive care Unit.
Patient and family happy and smiling, bedside teaching given to patient and family not to exceed sips of water as Surgeons have advised and to wait until Surgeons approve eating and drinking.
Patient agreed to follow Surgeons directives and was much better which made me happy too. Patient said thank you Anita you’re one in a Million.
The fact that patient has been discharged from the ICU does not mean compassion should not be shown to patients wherever they are admitted or homecare going extra mile is what Saint Alexandra does best!