Gosport hospital deaths: Independent panel findings due
Discussion
Gosport hospital deaths: Independent panel findings due
https://www.bbc.co.uk/news/uk-england-hampshire-44...
Just seen this on the news. Staggering story, like a film; deaths, cover-ups, enquires.
Sad story for all families involved.
https://www.bbc.co.uk/news/uk-england-hampshire-44...
Just seen this on the news. Staggering story, like a film; deaths, cover-ups, enquires.
Sad story for all families involved.
My grandmother was definitely "helped" by her GP. She was in a huge amount of pain, and my Mother clearly remembers the conversation about morphine when the doctor said "I can give her more, but it will almost certainly kill her", the family nodded, and the doctor went back in to administer what was needed.
I am far more worried by the idea that someone won't be able to do this for me, than the idea that they might.
I am far more worried by the idea that someone won't be able to do this for me, than the idea that they might.
rxe said:
My grandmother was definitely "helped" by her GP. She was in a huge amount of pain, and my Mother clearly remembers the conversation about morphine when the doctor said "I can give her more, but it will almost certainly kill her", the family nodded, and the doctor went back in to administer what was needed.
Although it's probably a little off topic We experienced exactly the same with my father-in-law, he had secondary terminal cancer in various places including a large non operable brain tumour. He had come home to die as was his wishes, the nurse and doctor agreed they could give him something to help him and we looked at them and fully understood what they meant.It's unfair that you can have a suffering pet put to sleep but not a suffering family member.
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hstewie said:
hstewie said: Reading between the lines it sounds as if there may have been a little more going on than hastening what might have happened naturally or relieving pain.
You are not kidding! I'm no Lib-Dem supporter but full marks to the local MP Stephen Lloyd of Eastbourne who had been pushing this for many years after a constituent brought it to his notice. Could be as many a 600+ patients.crankedup said:
ITV lunchtime news stating that some of the patients given opioids were in the hospital for relatively minor issues, broken limb was exampled. Surely not another Dr Shipman ?
Dr Jane Barton.https://www.telegraph.co.uk/news/2018/06/17/retire...
Edited by dandarez on Wednesday 20th June 13:47
bhstewie said:
hstewie said: Reading between the lines it sounds as if there may have been a little more going on than hastening what might have happened naturally or relieving pain.
I have a good friend who is a GP (for the avoidance of doubt, not connected with my grandmother in any way). This person is a realist, and curses the likes of Harold Shipman, and now, will curse whoever is guilty in this case. What will come out of this is a load of new regulation about painkillers and doctors dragged before the GMC when someone thinks they have got it wrong. Result - doctors will be less willing to do what end of life patients need to have done for them.rxe said:
I have a good friend who is a GP (for the avoidance of doubt, not connected with my grandmother in any way). This person is a realist, and curses the likes of Harold Shipman, and now, will curse whoever is guilty in this case. What will come out of this is a load of new regulation about painkillers and doctors dragged before the GMC when someone thinks they have got it wrong. Result - doctors will be less willing to do what end of life patients need to have done for them.
I'd wait and see if the people concerned here were end of life or not.End of life is one thing, this doesn't sound as if that's where it ends though.
bhstewie said:
hstewie said:rxe said:
I have a good friend who is a GP (for the avoidance of doubt, not connected with my grandmother in any way). This person is a realist, and curses the likes of Harold Shipman, and now, will curse whoever is guilty in this case. What will come out of this is a load of new regulation about painkillers and doctors dragged before the GMC when someone thinks they have got it wrong. Result - doctors will be less willing to do what end of life patients need to have done for them.
I'd wait and see if the people concerned here were end of life or not.End of life is one thing, this doesn't sound as if that's where it ends though.
Reading the report on the BBC, and as someone who's been operated on at Stafford hospital, there was a passage that rang very true to my own experience, (this after the Stafford enquiry) which seems to get to the heart of the problem:
I also find the ease with which senior staff dodge any responsibility for issues frankly disgusting.
BBC said:
Peter Carter, the former general secretary of the Royal College of Nursing, has talked about the NHS being a series of "microclimates", where good care can exist next to bad.[/]b
He visited Stafford Hospital before the horror of what happened came to light. He was shown around wards, but not the ones that were at the centre of the subsequent inquiry. Afterwards he praised the care he saw.
It can make identifying problems very difficult. It requires those on the inside - staff or patients - to blow the whistle.
https://www.bbc.co.uk/news/health-44550913He visited Stafford Hospital before the horror of what happened came to light. He was shown around wards, but not the ones that were at the centre of the subsequent inquiry. Afterwards he praised the care he saw.
It can make identifying problems very difficult. It requires those on the inside - staff or patients - to blow the whistle.
I also find the ease with which senior staff dodge any responsibility for issues frankly disgusting.
Edited by Digga on Wednesday 20th June 15:40
dandarez said:
crankedup said:
ITV lunchtime news stating that some of the patients given opioids were in the hospital for relatively minor issues, broken limb was exampled. Surely not another Dr Shipman ?
Dr Jane Barton.https://www.telegraph.co.uk/news/2018/06/17/retire...
Edited by dandarez on Wednesday 20th June 13:47
rxe said:
bhstewie said:
hstewie said: Reading between the lines it sounds as if there may have been a little more going on than hastening what might have happened naturally or relieving pain.
I have a good friend who is a GP (for the avoidance of doubt, not connected with my grandmother in any way). This person is a realist, and curses the likes of Harold Shipman, and now, will curse whoever is guilty in this case. What will come out of this is a load of new regulation about painkillers and doctors dragged before the GMC when someone thinks they have got it wrong. Result - doctors will be less willing to do what end of life patients need to have done for them.crankedup said:
ITV lunchtime news stating that some of the patients given opioids were in the hospital for relatively minor issues, broken limb was exampled. Surely not another Dr Shipman ?
It certainly seems to have alarming parallels with Shipman, otherwise healthy old people seeking help with the typical consequences of old age ending up leaving hospital in a bag after a once-in-a-lifetime trip on BP quality smack. The effective gagging of people raising concerns about this is disturbing, killing the messenger is a culture alive and well in the NHS; I will be interested to see what Private Eye has to say about it.It'll be the usual combination:
- the view that old people are undeserving and a waste of NHS resources
- medics with a high opinion of themselves
- less senior staff cowed by those above them
- the system protecting itself
- other people outside automatically protecting the holy NHS
Even now when we have pretty solid evidence of hundreds of deaths I don't exactly see the system leaping into action to deal with this.
Evil witch deserves a needle herself, along with everyone else that enabled this to happen.
- the view that old people are undeserving and a waste of NHS resources
- medics with a high opinion of themselves
- less senior staff cowed by those above them
- the system protecting itself
- other people outside automatically protecting the holy NHS
Even now when we have pretty solid evidence of hundreds of deaths I don't exactly see the system leaping into action to deal with this.
Evil witch deserves a needle herself, along with everyone else that enabled this to happen.
ok i'm a medic and this is probably going to get me mugged, but let me tell you of my experience
I qualified pre shipman, it is hard to explain how much impact shipman had on end of life care
At medical school we were never taught about it, it was something you came across on your shadow jobs, or in my case, doing a locum before i started my medical house job.
I was on call, got called to a ward, mr smith is in pain, i look at his drug chart, he's on a huge amount of morphine already. The number 1 side effect they did teach us about opiates was respiratory depression and hence how careful you had to be. The nurse is telling me to write up more morphine, i'm naturally reluctant, she goes on about how some professor says you can't go into respiratory depression while in pain, i point out he's not here to write it up, i was genuinely worried I was going to kill someone and get struck off before my career had even started.
So i called my SHO, who I knew from medical school, he apparently told his colleagues that he thought his new house officer was flapping, but anyway came along to help, his explanation was this, he said "look mr smith has cancer, mr smith is in pain, we are going to give mr smith all the opiates he needs until he is no longer in pain, if that causes him to stop breathing, then that's a happy coincidence" and that weirdly in a medical way made sense.
As a house officer both the time i worked on a palliative care unit and other jobs, we used diamorphine pumps for those we could not cure and were going to die, i still remember how to write them up, diamorphine 50mg in 50ml sub cutaneous titrate to patient comfort. Did we euthanise people, well we certainly sped up their passing, but they were comfortable, not in pain and had a peaceful death. The alternative doesn't bear thinking about, the guy with the tumour in his neck that we couldn't stop bleeding, just a steady drip drip of blood, we set up the diamorph pump, put something to collect the blood and over 3 days he slowly bled to death, but he never suffered, i can still remember going to see him twice a day, the smell of blood making his room smell like a butchers shop, I can close my eyes and i'm there, it was 25 years ago, we carry these patients with us for life, like our mistakes.
The interesting bit was the lines were subcutaneous, something we rarely use rather then intra venous, i never knew why until i asked one of the palliative care nurses who explained we did it so if the family tried to push the whole syringe in, we could reverse it. The fact we did it tells you, when we had given it intravenous, this had happened often enough for the entire NHS to change. None of us want to see our relatives suffer or their deaths be prolonged.
The problem with medicine is it's not black and white, the very dark grey is easy, but everyone has a different view, now in this case the GP (i'm guessing gosport was just a community hospital) seems to have been convinced she's right, the old school, don't question me kind of doctor, she was dealing with quite frail people all the time which i'm sure slowly moves you're goal posts as you see people who keep dying despite everything you're doing. It looks like she was too happy to set up the diamorphine. Then each case needs to be looked at and judged.If she is significantly outside what the profession would have done, then she needs to stand trial and we have a process for this. Be careful of jumping on the cases of "they only had" based on the families, what they mean is we were only aware of this being new, but you have to take into account all the other pre existing conditions including frailty. Patient recovery in the elderly can be hard predict and is multi factorial, the death rate for a fractured neck of femur for example in the elderly is 20-35% and doesn't seem to change no matter what you do- oh and that's not just the uk.
Following shipman, everyone was scared to use diamorphine, people died in pain. I hope this doesn't have the same effect because being on the other side, when my time comes, if there is nothing to be done for me, to die in an opiate haze is a lovely way to go
Now if you are acutely unwell and terminal, we keep you comfortable, that means we try and control your pain without shortening your life, this is not pain free- given the choice i know which i'd prefer.
ok let the tirade begin- but if you have a genuine question, i'll try and answer it
ps for those that don't know diamorphine is medical heroin, it's faster acting and needs a lower dose then morphine
pps ask any doctor who worked pre shipman, shipman was the tip of the iceberg, as a junior i've seen it and reported it, nothing changes
I qualified pre shipman, it is hard to explain how much impact shipman had on end of life care
At medical school we were never taught about it, it was something you came across on your shadow jobs, or in my case, doing a locum before i started my medical house job.
I was on call, got called to a ward, mr smith is in pain, i look at his drug chart, he's on a huge amount of morphine already. The number 1 side effect they did teach us about opiates was respiratory depression and hence how careful you had to be. The nurse is telling me to write up more morphine, i'm naturally reluctant, she goes on about how some professor says you can't go into respiratory depression while in pain, i point out he's not here to write it up, i was genuinely worried I was going to kill someone and get struck off before my career had even started.
So i called my SHO, who I knew from medical school, he apparently told his colleagues that he thought his new house officer was flapping, but anyway came along to help, his explanation was this, he said "look mr smith has cancer, mr smith is in pain, we are going to give mr smith all the opiates he needs until he is no longer in pain, if that causes him to stop breathing, then that's a happy coincidence" and that weirdly in a medical way made sense.
As a house officer both the time i worked on a palliative care unit and other jobs, we used diamorphine pumps for those we could not cure and were going to die, i still remember how to write them up, diamorphine 50mg in 50ml sub cutaneous titrate to patient comfort. Did we euthanise people, well we certainly sped up their passing, but they were comfortable, not in pain and had a peaceful death. The alternative doesn't bear thinking about, the guy with the tumour in his neck that we couldn't stop bleeding, just a steady drip drip of blood, we set up the diamorph pump, put something to collect the blood and over 3 days he slowly bled to death, but he never suffered, i can still remember going to see him twice a day, the smell of blood making his room smell like a butchers shop, I can close my eyes and i'm there, it was 25 years ago, we carry these patients with us for life, like our mistakes.
The interesting bit was the lines were subcutaneous, something we rarely use rather then intra venous, i never knew why until i asked one of the palliative care nurses who explained we did it so if the family tried to push the whole syringe in, we could reverse it. The fact we did it tells you, when we had given it intravenous, this had happened often enough for the entire NHS to change. None of us want to see our relatives suffer or their deaths be prolonged.
The problem with medicine is it's not black and white, the very dark grey is easy, but everyone has a different view, now in this case the GP (i'm guessing gosport was just a community hospital) seems to have been convinced she's right, the old school, don't question me kind of doctor, she was dealing with quite frail people all the time which i'm sure slowly moves you're goal posts as you see people who keep dying despite everything you're doing. It looks like she was too happy to set up the diamorphine. Then each case needs to be looked at and judged.If she is significantly outside what the profession would have done, then she needs to stand trial and we have a process for this. Be careful of jumping on the cases of "they only had" based on the families, what they mean is we were only aware of this being new, but you have to take into account all the other pre existing conditions including frailty. Patient recovery in the elderly can be hard predict and is multi factorial, the death rate for a fractured neck of femur for example in the elderly is 20-35% and doesn't seem to change no matter what you do- oh and that's not just the uk.
Following shipman, everyone was scared to use diamorphine, people died in pain. I hope this doesn't have the same effect because being on the other side, when my time comes, if there is nothing to be done for me, to die in an opiate haze is a lovely way to go
Now if you are acutely unwell and terminal, we keep you comfortable, that means we try and control your pain without shortening your life, this is not pain free- given the choice i know which i'd prefer.
ok let the tirade begin- but if you have a genuine question, i'll try and answer it
ps for those that don't know diamorphine is medical heroin, it's faster acting and needs a lower dose then morphine
pps ask any doctor who worked pre shipman, shipman was the tip of the iceberg, as a junior i've seen it and reported it, nothing changes
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