Performance Assessment

DSC_0046I can’t help mulling over the experience even after the end of my stay at Charing Cross hospitals. I am sure that some of the overhead in paperwork and staff is caused by the desire to measure and monitor the nurses’ performance.

Based on my own observations, here are a few suggestions to measure that easily and reliably.

Measure the minutes a nurse spends in the patients’ room and divide by the minutes spent chatting in the pantry or in the hallway.

Measure the average distance and average speed walked.

Consider the case of medicine which needs dissolving in water. Distinguish nurses who place the sachet of powder on the patient’s nightstand from those who actually fetch water and dissolve the powder, and again from those who also run to get a straw for stirring such that said powder actually dissolves.

Consider the case of a day old bandage with fluids beginning to seep through. Distinguish nurses who point-blank refuse to change the dressing following a close inspection from a 4 meter distance (not until it bleeds through) from those who change when asked, and again from those who change the dressing unasked and even offer spare dressing.

I experience the full range of the scale, and find the width of the gap astounding.

Here’s a flower for those who rank at the top of the range. They would know who they are if they’d read this.

Golden Mango Mystery

DSC_1005There’s no Golden Mango Season. Not this year, not where we live. In previous years, and for a few weeks only, the streets of London’s suburbia are lined with piles of boxes of the most delicious Golden Mango from countries like India, Pakistan, Afghanistan and Bangladesh.

I asked one of our local Afghani shopkeepers where the mangos were this year. He wasn’t sure but thought he heard rumours about bacteria or fungal infections preventing import into the European Union.

Even Google knows little, but I found this intersting commentary by Tahmima Anam in the New York Times, which sheds light on a number of things in relation to Golden Mangos, and their shortage. Apparently, the Golden Mangoes are rotting on the trucks and in the fields away after having been found sprayed with formalin, a strong solution of formaldehyde. According Wikipedia, the Bangladesh government issued a formalin control law in 2014.

Not sure how this applies to the mangoes of Pakistan and Afghanistan, but at least it explains the absence of Golden Mango from our streets to some extend. Maybe the Pakistani and Afghani are too busy fighting over beliefs or running for their lives.

[Edit]
Turns out that shipments of Indian mangoes (and other produce) are banned from import into Europe after fruit fly infection has been discovered.
[/Edit]

Fit Note? My Arse!

DSC_0802I didn’t need to see the doctor, but as last week’s feverish cold took its time, I took a moment to check the rules as to when I had to supply a sick note for work.

Fascinating fact #1: it’s 7 calendar days in the UK.

Fascinating fact #2: it’s not a sick note any more. It’s a fit note, supposedly confirming that you are fit to work or, as will be the case in almost all cases when a doctor signs such a document, it will confirm that you are not fit to work on medical grounds. Also known as sick.

I find that pretty annoying. Some political spin doctor thought it important to change the well-established name sick note into fit note. Something about the psychiatry of being positive, I guess. By the time this was discussed in all committees involved, by the time the decision was communicated with all parties and doctors involved across the country, plus the general public, by the time related documentation (and the new Fit To Work forms) was changed and printed, by that time, hundreds of thousands of pounds will have been spent on a change that makes no difference no whatsoever to nobody nowhere at no time.

 

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What’s Your Name?

another not-so-bright fellow One particular detail about my recent hospital visit fascinate me though. It goes like this:

Whenever health professional A hands over a patient to health professional B (which, as it turned out, happened quite a lot), they need to go through a ceremonial dance to confirm that A brings the correct patient, that the correct wristband is still attached to said patient, and that B then obtains the correct patient.

It seems a little over the top, but I am sure the ramifications of cutting off the wrong part of the wrong patient could be unpleasant. So, OK, I go along with it. Not that I have a choice anyhow, but you’d wonder with all that scrutiny applied, at least they could try to do it right? You wish:

Sir, are you Mr so-and-so?

Yes.

Sir, are you born on the such-and-such of year so-and-so?

Yes.

Sir, do you live in this-and-that street?

Yes.

There were times when they could have asked whether I am the Queen of Sheba and I’d have said yes. Everyone who ever read a mystery novel knows not to ask suggestive questions. How hard is it to ask

What’s your name, sir?

 

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A First, at Ripe Age

another chap of ripe age Funny that in all those many years, I never had surgery done, not as far as I remember anyhow. Well, now I have. The surgery was a low-risk thing and, as such, no cause for anxiety and worries, but it was very interesting to experience the whole thing.

First, the check-in to my day-case hospital treatment. I approached the receptionist, stating my name and claiming that I had a reservation for a room with sea view. Turns out they couldn’t deliver the sea view, but a nice long view overlooking a park and golf course, then the new Wembley stadium, with the London Skyline at the horizon (the docklands with Canary Wharf and the London Eye were clearly recognizable). So far so good.

Then, a long series of being fussed over. Temperature, pulse, weight, medical history, lunch menu choice, blood test, and similar jobs kept me entertained for a while, until I was laid down flat on my back, wheeled through the hospital, asked to breath deeply, and then be told everything was over.

(Followed, of course, by a a couple of hours of boredom until discharge.)

Fascinating.

 

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Health and Safety

Health and safety Health and safety was all I could wish for this lonely construction worker.

The high-visibility coat that he wore must have magic protective powers.

Click the image for a larger version. Unless you suffer from vertigo, or common sense fear for others taking stupid risks.

I went back later and checked that the guy was still alive. 

 

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A Pain in the Back

DSCF6611_JPG_595 NICE has now approved of acupuncture, to be subscribed on the NHS once traditional means (such as injections of various kinds) have failed to cure back pain. Other secondary methods of treatment include physiotherapy and some-such.

I am no doctor as you know, and I certainly acknowledge that many people suffer from genuine and chronic pain in the back.

I am, however, vaguely aware of the great British furniture, and thus suggest NICE should consider supplying good quality ergonomic desk chairs, firm sofas and very firm latex mattresses.

I’m pretty sure this could do wonders and avoid much of the pain, and the costly treatment required later.

Too bad they never come and ask me what to do.

 

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The Deodorant Paradox

dancer Hold on, let me get this right. In this tv commercial, you’re telling me that I should buy this all-new Dove deodorant. You say that it shows perfect performance as a deodorant -that is, to keep my underarm nice and dry.

At the same time, you say, this new concoction is your latest must have because it keeps that natural and vital moisture… ?!

I am puzzled.

 

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