systemic failure: the naming of health professionals

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Fiction & Falsehood
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systemic failure: the naming of health professionals

Postby Fiction & Falsehood » Tue Mar 19, 2013 9:40 am

(in the case of a preventable death)

the best thing about punkbox is that i can get on my soapas with my ill informed and emotional opinions.

i think this is a pile of carrot cakes, naming a triage nurse, but withholding the name of the registrar?

stinks, rotten, gutless, cowardly fuckin bullshit, health professionals dont deserve to be offered as sacrificial lambs to protect a fucking bureaucrat that kills people with their selfimportant ignorance.

shit reeks of cronyism, makes me want to get drunk, take a pipe cutter to a row of coin operated parking meters and challenge your whole concept of authority and freedom.
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Re: systemic failure: the naming of health professionals

Postby dustbinflowers » Tue Mar 19, 2013 1:06 pm

could you post a link so we know what you are talking about?
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Re: systemic failure: the naming of health professionals

Postby Little Miss Twoshoes » Tue Mar 19, 2013 1:23 pm

dustbinflowers wrote:could you post a link so we know what you are talking about?
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Re: systemic failure: the naming of health professionals

Postby akaxo » Tue Mar 19, 2013 1:27 pm

taking a stab in the dark... http://www.stuff.co.nz/national/health/ ... th-workers

and yeah agree with the initial post's sentiment pretty much
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Re: systemic failure: the naming of health professionals

Postby Fiction & Falsehood » Tue Mar 19, 2013 4:18 pm

yeh thats it, i heard about it on the radio where a advocate for the health workers pointed out that the people named bear no responsibility and that there are people not named who do.
the problem for me isnt whether or not they can be named, which is a pretty complex issue, but the fact that some people are named just cos they were on duty at the time, people that may not have even had any contact with the patient(nobody is sure), and that those in charge of the system that failed are not just hiding behind it, but are pointing the blame at others to protect themselves, and that is emergency doctors and nurses who really have enough shit on their plates and dont deserve this at all.
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Re: systemic failure: the naming of health professionals

Postby MuscleMan » Tue Mar 19, 2013 6:21 pm

"The coroner found the individuals were not at fault but rather it was a systemic failure that led to Gravatt's death.

The length of time it took for Gravatt to be seen by a doctor - his meningitis was not diagnosed for more than four hours - was ruled a systemic failure rather than the fault of any one person."

So the coroner ruled it was poor systems and infrastructure that led to his death (because he had to wait 4hrs), rather than the doctor who saw him when it was too late? Is there no responsibility at all for the nurses to run precursory diagnosis? (or did it take 4hrs to see a nurse?)

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Re: systemic failure: the naming of health professionals

Postby xsfat » Tue Mar 19, 2013 8:14 pm

Put this into perspective - it occurred during the H1N1 (swine flu) outbreak, which killed 49 people, sent 1122 people to hospital
and 102 were so sick that they needed intensive care unit treatment. 18% of the population had evidence of infection.
You add this onto the seasonal additional workloads that occur around winter, and you can imagine how stretched the public health system became.

In most cases, transparency should prevail. But naming blameless health professionals in high profile cases can seriously affect their retention in the public health system.
Most of them already share their time between private and public practice. This type of unwarranted attention distracts them from their core duties.
Bear in mind we already have Coronial inquests and the Health and Diability Commissioners that provide specialist scrutiny over the provision of health services.
naming a triage nurse, but withholding the name of the registrar?

Pretty sure the Coroner's suppression order was set aside for all named individuals. Also, a registrar is a doctor, not a 'bureaucrat'.

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Re: systemic failure: the naming of health professionals

Postby MuscleMan » Tue Mar 19, 2013 9:23 pm

Fuck being the person that had to explain that to mum & dad without being bombarded with grief ridden abuse.

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Re: systemic failure: the naming of health professionals

Postby Tartanperil » Tue Mar 19, 2013 11:50 pm

Pretty shite. Thought the media also need to take some blame. This is just crap tabloid style reporting opening with "The medical professionals involved in the meningitis death of a medical student can finally be named after almost three years." For a start framing their role as "meningitis death" and not "meningitis treatment" is bs.

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Re: systemic failure: the naming of health professionals

Postby Red_switch » Wed Mar 20, 2013 9:08 am

Triage nurses can, in my experience, fuck shit up monumentally. I think you'll find that at least some ed doctors would agree when pressed.

But that is potentially a source of such systemic failure, leaving it to them to make the call...
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Re: systemic failure: the naming of health professionals

Postby Lamb » Wed Mar 27, 2013 9:26 pm

I don't understand.. AT ALL.. the merits behind naming (and effectively shaming, whether that be the intention or not) the staff involved.. when it's been deemed the system at fault - not these individuals is bloody disgusting and such a slippery slope to go down.. with nothing being gained.

Makes me SO angry.

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Re: systemic failure: the naming of health professionals

Postby Lamb » Wed Mar 27, 2013 9:27 pm

Red_switch wrote:Triage nurses can, in my experience, fuck shit up monumentally. I think you'll find that at least some ed doctors would agree when pressed.


Elaborate plz?

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Re: systemic failure: the naming of health professionals

Postby Dick Dynamite » Wed Mar 27, 2013 9:34 pm

His uncle is a brain surgeon and the nurses ruined his life.

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Re: systemic failure: the naming of health professionals

Postby Lamb » Wed Mar 27, 2013 9:42 pm

Uncle practised lobotomy on him at home? LOLWUT

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Re: systemic failure: the naming of health professionals

Postby General Mutante » Wed Mar 27, 2013 10:45 pm

It was his dad's uncle's mate. Get it right.
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Re: systemic failure: the naming of health professionals

Postby Red_switch » Thu Mar 28, 2013 9:04 am

Lamb wrote:
Red_switch wrote:Triage nurses can, in my experience, fuck shit up monumentally. I think you'll find that at least some ed doctors would agree when pressed.


Elaborate plz?


First off, I'm not having a go at individual triage nurses or anything here, and it really probably comes back to systemic failure, but in my experience it seems that having one, maybe two triage nurses looking after an ed waiting room full of broken people and basket cases, there is a lot of room for error.

A few situations that spring to mind:
1. With a decently broken nose, and severe concussion (trying to do the acc paperwork was a laugh), I once spent about 2 hours waiting to get into ed. All the while bleeding like something that bleeds fucking heaps and doesn't stop. Triage nurse tells me at one point to go to the public toilet in the foyer and get some paper hand towels to clean blood up off the floor. On the way back I manage to collapse, which is finally my ticket in. Doctor was not stoked about the situation. Not super serious, but more so than it needed to be.

2. Had a pretty comical mountainbike crash which resulted in broken and bruised ribs, and bleeding/bruising of various inside bits. Didn't go to hospital initially, but my flatmate got the shits later that night when I couldn't really breathe properly and took me down to ed. Triage nurse wasn't convinced because she couldn't see any external bleeding or bruising. Sweet as lady, but clearly I can't breathe properly here. Sit down and wait a while (a couple of hours or so), there's only one other person in the waiting room. After a while a doctor happens to walk through, notices me sitting there doing what I can to breathe, and bails me through into ed quick smart.

3. The Mrs's old man had a bit of an accident a couple of years back that resulted in a potentially (but thankfully not) serious head injury, detached retina (cunt of a thing to do by all accounts), and a few other complications. Again, triage nurse didn't think it was too big of a deal, an hour or two later when he got into ed the doctors lost their shit, and he had to be transferred by helicopter to Dunedin. They said they could have had him all sorted out pretty quickly and safely if they'd seen him as soon as he arrived, but he deteriorated a lot in the waiting room. There were all sorts of implications with that, and formal follow up as well, though I don't know exactly what the final outcome of that was.

That's my experience in 3 different cases at two different hospitals in NZ. I've not had that much exposure to the public health system, and I've heard much worse.

To me it seems that the burden of that pre-assessment carried out by the triage staff is a heavy one, and there often seems to be a lack of those frontline staff, and not always a lot of objective decision making. It's a critical link in the chain, and it needs to be robust to avoid what can be a life and death situation, as some people have unfortunately discovered.
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Re: systemic failure: the naming of health professionals

Postby Lamb » Thu Mar 28, 2013 10:57 am

(On my phone so going to be a shitty reply)

Like... 80 PLUS percent of what ED sees comes in from behind the waiting room, so just because you deemed it a quiet time doesn't mean it actually was.

Aside from case 3.. That sounds pretty standard... (Although I would potentially be a bit concerned about number 2.. Would want to know a bit more info.. But don't know what kind of assessment on you that they did that you might not understand took place.)

And re: doctors losing their shit at nurses... That's generally more indicative of them being a-holes than nurses fucking up. And as you said the doctor was walking through the room... He might have been on break and just came back (with all other bays full etc...) you don't know...

If you really feel you're that much of a risk -phone an ambulance!
As you mentioned each time you were hanging out at home and walked in... This indicates to me... Comparatively you may not have been that unwell.
Waiting a couple of hours or so to be seen in an NZ ed is standard... And shit a couple of hours? You should be greatful! That's not long at all...

Triage is a necessary part of the ED... And but having more staff do that it would take people out of the back... Where the actual treatment is going on and I'm willing to bet would cause a lot more poorer outcomes! For sure sometimes triage get it wrong... But still that process increases outcomes for most...

A lot of the time people's ill feelings towards the ED... Wait times and triage stems largely from not understanding the process... Or how in fact there is a lot more critical going on through the back.

(I do not work in ED... And am currently not employed by a DHB in Nz.. But have worked for 3different DHBs in Nz and AUS.)

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Re: systemic failure: the naming of health professionals

Postby Lamb » Thu Mar 28, 2013 11:04 am

And sorry.. maybe they did fuck up in all of your cases and you had shitty nurses.... I don't know.. I don't know the specifics surrounding each event - as I'm sure you don't either.

But I just get sick to shit of people ragging on nurses when the system (or a patients lack of understanding) is at fault and we bust our asses to do literally whatever we can for the patients...... yet still some how end up with the blame.

Classic example: Man with appendicitis is cancelled one day (pfft one day.. fuck go to aussie I had patients cancelled 9-10 days in a row) for surgery... and loses his shit... I explain to him the way the acute theater list works (Everyone is given an acuity, like triage and should something more urgent come in.... the lower acuity get bumped, again like triage)..... His response was to yell and scream at me... and say how urgent his surgery is.. and sure to him it is.... the man is uncomfortable.. and his world centers around him.. like all of ours do......... but unfortunately in the system your bloody nose.. or appendix... isn't that important in the grand scheme of things and you can afford to wait another day while they operate on the severe trauma out the back.

(again, I am not employed by a DHB - and this is based on my experience previously)

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Re: systemic failure: the naming of health professionals

Postby Red_switch » Thu Mar 28, 2013 11:23 am

Lamb wrote:(On my phone so going to be a shitty reply)

Like... 80 PLUS percent of what ED sees comes in from behind the waiting room, so just because you deemed it a quiet time doesn't mean it actually was.

Aside from case 3.. That sounds pretty standard... (Although I would potentially be a bit concerned about number 2.. Would want to know a bit more info.. But don't know what kind of assessment on you that they did that you might not understand took place.)

The nurse literally looked me up and down, then told me to sit down and wait. That was it.

And re: doctors losing their shit at nurses... That's generally more indicative of them being a-holes than nurses fucking up. And as you said the doctor was walking through the room... He might have been on break and just came back (with all other bays full etc...) you don't know...

If you really feel you're that much of a risk -phone an ambulance!
As you mentioned each time you were hanging out at home and walked in... This indicates to me... Comparatively you may not have been that unwell.
Waiting a couple of hours or so to be seen in an NZ ed is standard... And shit a couple of hours? You should be greatful! That's not long at all...[/quote]
I wouldn't say walked in, the broken nose/concussion, I was half carried in (fuckin out of it - as I mentioned, on my way back from the toilet where I'd been sent to get paper towels to clean the pool of blood up off the floor, I blacked out and collapsed). The other time I hobbled in and could barely talk when I spoke to the triage nurse.

Triage is a necessary part of the ED... And but having more staff do that it would take people out of the back... Where the actual treatment is going on and I'm willing to bet would cause a lot more poorer outcomes! For sure sometimes triage get it wrong... But still that process increases outcomes for most...

I don't disagree with this, to me it seems like the triage staff need to be better equipped/supported, and maybe better trained to make very quick but reasonably accurate assessments so that already sparse resources can be allocated appropriately. That said, I'm not familiar with the type/level of training triage nurses might have relative to other nursing roles. Whenever I've been into ed personally, there's been maybe one admin person doing the paperwork side of things, and one triage nurse. I'm probably with you in that I think we need to make these peoples lives easier! If we add extra staff and their workload might be cut by, I dunno, 40% most of the time, I don't see a problem with that if it means that at 100% per staff member they can better cope with all but the very worst of times (I'm thinking busy Saturday night, they should be able to cope with that, but it's ridiculous to expect there would be no strain following, say, a large natural disaster).

A lot of the time people's ill feelings towards the ED... Wait times and triage stems largely from not understanding the process... Or how in fact there is a lot more critical going on through the back.

(I do not work in ED... And am currently not employed by a DHB in Nz.. But have worked for 3different DHBs in Nz and AUS.)

I understand that eh, and one thing that is now in the back of my mind (especially after going through a few different first aid/pre ambo care courses), is that if the situation is slightly serious, call the ambo. I think kiwis tend to downplay situations, and sort of casually rock into ed through the front door a few hours later when they realise that "oops, that's worse than I thought", which does obviously bump them down the priority list. But at the same time, I am aware of how thinly stretched the ambulance service is (at least in this neck of the woods). 30 minute + waits are not uncommon, way faster to just drive, at least that way if the shit hits the fan you're already in the building.

Nursing is like any field, there are great people, and not so great people. Most nurse I've come across have been fantastic, and obviously very passionate about what they do. Others have made me think hmmm really?

The couple of minor surgeries I've had, I found the nursing staff to be really good, but that's obviously in a very different environment to ed.
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Re: systemic failure: the naming of health professionals

Postby Red_switch » Thu Mar 28, 2013 11:25 am

Lamb wrote:And sorry.. maybe they did fuck up in all of your cases and you had shitty nurses.... I don't know.. I don't know the specifics surrounding each event - as I'm sure you don't either.

But I just get sick to shit of people ragging on nurses when the system (or a patients lack of understanding) is at fault and we bust our asses to do literally whatever we can for the patients...... yet still some how end up with the blame.

Classic example: Man with appendicitis is cancelled one day (pfft one day.. fuck go to aussie I had patients cancelled 9-10 days in a row) for surgery... and loses his shit... I explain to him the way the acute theater list works (Everyone is given an acuity, like triage and should something more urgent come in.... the lower acuity get bumped, again like triage)..... His response was to yell and scream at me... and say how urgent his surgery is.. and sure to him it is.... the man is uncomfortable.. and his world centers around him.. like all of ours do......... but unfortunately in the system your bloody nose.. or appendix... isn't that important in the grand scheme of things and you can afford to wait another day while they operate on the severe trauma out the back.

(again, I am not employed by a DHB - and this is based on my experience previously)


I've a family friend who died from appendicitis. Everyone else I know who has had it has received attention pretty quickly.
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Re: systemic failure: the naming of health professionals

Postby Lamb » Thu Mar 28, 2013 11:41 am

Red_switch wrote:I've a family friend who died from appendicitis. Everyone else I know who has had it has received attention pretty quickly.


Yep not saying it's not serious - just again trying to explain the way the system works.
Patient is seen in ED (probably after a few hours..) they determine how serious it is... if it's super serious gets sent straight to OT... if not you get sent to a surgical ward... where in a perfect world you have your OT that day.... unfortunately this is not always the case... and people can wait a good couple of days for their surgery as that is essentially their triage rating... and as mentioned before they're bumped according to that... they're monitored closely whilst on the ward... and if their condition changes they're taken sooner.. if they stay stable.. they are not - unless the OT list allows.


I think it would be helpful if the public understood the way the system worked a bit better. Although I have to say peoples attitudes towards the system and staff in NZ are much better than in Australia where the people tended to have a far greater sense of entitlement.

As for the rest of your points - as I mentioned in a previous post.. I don't know the full story of what went on - was just offering another view point as to what may have potentially caused any of that, but if you feel that you weren't treated with a good level of care definitely lodge a complaint. http://www.hdc.org.nz/complaints/making ... laint-form

The thing about complaints is that it highlights an area of shortcoming for the system and if enough are lodged will highlight a need to assess a certain area and then potentially allocate more funding.. or training to this area.

In my experience I do feel the NZ healthcare system does the best it can within the budget it's allocated.... there are nursing shortages everywhere and people working so much overtime - or in my experience actually doing the work of 1.5 people... frequently... and in something where you really need to just be so on to it.. and notice any subtle changes in your patients.. there is bound to be error, unfortunately. Which stems back to the point of the initial post... I don't know any of the stats.. but would say it's pretty fair to say a large number of fatal errors are in fact a systemic failure....


(all of the above being my own views.. I am not employed by a DHB.)

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Re: systemic failure: the naming of health professionals

Postby Fiction & Falsehood » Thu Mar 28, 2013 11:56 am

i had appendicitis. took hours before i got surgery, very crappy few hours, once i was finally at the hospital it all got fairly well taken care of tho.

ive waited hours and hours at the a&e, but thats the nature of the beast.

one complaint i have tho is when i had surgery for a boil this bloody nurse took my very expensive and brand new antiseptic cream and threw it away.
fuckhead.
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Re: systemic failure: the naming of health professionals

Postby Lamb » Thu Mar 28, 2013 12:04 pm

Fiction & Falsehood wrote:one complaint i have tho is when i had surgery for a boil this bloody nurse took my very expensive and brand new antiseptic cream and threw it away.
fuckhead.


Good!! Those things are more often than not harmful to your healing!!!

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Re: systemic failure: the naming of health professionals

Postby Fiction & Falsehood » Thu Mar 28, 2013 12:07 pm

she could have just said dont use it on this, which i wouldnt have needed to, as a district nurse came to my house and repacked the gaping hole in my groin :calavcalav:

but she decided to treat me like a retard and to take away my personal and expensive property and dispose of it without my permission and against my wishes, fuckhead.

many times since i wished i had that stuff to help with minor infections, you know, TO STOP THEM GETTING TO THE STAGE THAT REQUIRES FUCKING SURGERY FOR FUCKING CHRISTS DEAD DICK ON A STICKS SAKE
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Re: systemic failure: the naming of health professionals

Postby Lamb » Thu Mar 28, 2013 1:26 pm

Anger much?

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Re: systemic failure: the naming of health professionals

Postby nazi scum » Thu Mar 28, 2013 4:00 pm

the average wait at waikato hospital ED is 6 hours...

Meanwhile
"Foreigners owe the Waikato District Health Board almost $2 million in unpaid medical bills – with $330,000 to be written off as bad debts."

how many more doctors and nurses does $2million buy, for Kiwis, not fucken overstayers

Anger fucken heaps mate!
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Re: systemic failure: the naming of health professionals

Postby ghetto ninja » Thu Mar 28, 2013 4:08 pm

nazi scum wrote:the average wait at waikato hospital ED is 6 hours...

Meanwhile
"Foreigners owe the Waikato District Health Board almost $2 million in unpaid medical bills – with $330,000 to be written off as bad debts."

how many more doctors and nurses does $2million buy, for Kiwis, not fucken overstayers

Anger fucken heaps mate!

Fuck off Darren.
You got any idea of the figure thats unpaid for New Zealand citizens?
Its a lot fucking bigger than two million as is the amount thats written off as bad debt.

Ive noticed you can use a computer, is there any reason you cant do data entry as a job?
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Re: systemic failure: the naming of health professionals

Postby xsfat » Sat Mar 30, 2013 3:20 am

Wasn't there some idiot spouting shit on punkas a while ago, and he got all pissy when it was revealed he was working in a data entry type role at Waitemata DHB...
Then to top it off, I said I was working in the HR team there... didn't hear much from him after that...

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Re: systemic failure: the naming of health professionals

Postby ghetto ninja » Sat Mar 30, 2013 8:22 am

That was a guy who posted as Beredius.
Martyrdamn wrote:Said 'hey baby gurl' to about seven girls tonight,
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Re: systemic failure: the naming of health professionals

Postby Fiction & Falsehood » Sat Mar 30, 2013 9:05 am

oh christ yeh, that was great haha
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