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XB9S Guide 60,817 Views

Joined: Sep 7, '06; Posts: 8,678 (25% Liked) ; Likes: 3,988

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  • May 9

    A great motivation for me to enter back into clinical side...thanks

  • May 9

    Thanks a lot....i m bothered because am out of bedside nursing for more than 10 yrs...thats what s my concern thinking if i could cope up with..but i am still very much interested in bed side work. Am sure ,with such encouraging words of you,i can do..

  • May 8

    Quote from Kyrshamarks
    Thats the thing...I have been here a hell of a lit linger than you have. I was one of the first 1000 members here when this started. I survived the great purge of 15 years ago when even the word Heather was enough to get you banned. I dont hve to prove myself to you or anyone else for that matter. I can have my personal held beliefs despite your demand for "science and evidence". So call me a troll if you want, see being a conservtive wirds dont hurt me.
    ...if you've resorted to asserting superiority based on the length of your membership on this board, I suspect you don't have any valid points to make.

    It's a shame. This topic is an important one and deserves a better OP.

  • May 8

    You young pups! I'm 58 and still on the floor!

  • May 7

    Quote from broughden
    Do you mind pointing me to a source on his EEG's?
    The only thing I have seen are normal news reports but according to the media, during the trial expert testimony said there were no brain waves present except during seizures.

    403 Forbidden
    In the uk, the brain stem must not be functioning for brain death to be diagnosed. This is tested with the apnea test (among other things) where on 2 separate occasions the patient is removed from the ventilator and observed for spontaneous respiratory function for 5 minutes. There must be no respiratory function. This may be different from the US definition of brain death. The court reports on this child are in the public domain and are easily searchable and contain information which describes how Alfie's brain stem was still functioning although there was some impairment.

    I only wanted to clarify this point as this forum is open to the public and I would not be surprised if it comes to the attention of "Alfie's Army". You may not be aware but in the UK this case has caused what can only be described as a colossal episode of mass hysteria. Individuals who have no link to Alfie or his family have taken up the call to arms almost. These people are persistent, and they absolutely believe that there was a conspiracy to murder Alfie. Emotions are running high and the situation on social media has been volatile. Anyone posting on social media supporting the courts and hospitals decisions regarding Alfie is attacked and hounded. There are facebook groups set up simply with the intention of trolling those who agreed with withdrawal of treatment. Healthcare professionals have had posts screenshotted and bounced between various Facebook groups. These people have been harassed and bullied. There have been reports of individuals tracking down people's places of work and reporting them to their bosses simply for expressing their opinion. Doctors and nurses have been called murderers, there are reports of nurses being spat on and the child's father attempted to accuse the doctors of murder in court.

    Often their argument was "well if he's brain dead, it can't hurt to try and it'll make his parents feel better". This is not accurate. I simply wanted to clear up any confusion and clarify the technical point of Alfie not being brain dead according to UK guidelines. I do agree that that little boy was "gone" and that withdrawal of treatment was the kindest thing that could happen for him.

  • May 7

    Quote from XB9S
    I have worked in the UK for 30 years the last15 in very senior positions. In that whole time I have never encountered your so called "death panel"

    We occasionally have disagreements between what families believe is in best interests and what the medical teams are advocating at which point we will hold a best interest meeting. At that meeting all interested parties are represented and all have the opportunity to input into that discussion. The views and beliefs of the family are very much considered and extremely important.

    If no agreement is reached and all options to reach that agreement are exhausted (and from my experience w try all options seeking second and even third opinions ) then the medical teams would involve the hospital adult or child safeguarding teams for support. A strategy meeting would be held with an independent reviewer and if this was not able to find a way forward then they would contact the hospital legal team to ask for guidance.

    The legal processes are independent of the hospital (and the government) and provide an impartial review of all of the information to support a decision which is in the best interest of the patient.

    Do we always get it right - no
    But this view that we have death panels is just not accurate.

    There are many flaws in our system, it's not perfect.
    We are underfunded, over stretched, many of us working in the NHS don't like the direction we are heading, driven by finance which sometimes feels at the detriment of quality. BUT most of us are passionate about our NHS because despite that the care we deliver in the main is excellent.

    If you want to demonise Universal Healthcare there are many other reasons you could look a and use but, this case is not one.
    Don't clutter up this discussion with facts.
    And for god's sake, what has your extensive experience with the UK health system have to do with anything?

  • May 7

    Quote from broughden
    I use the term repeatedly for two reasons. One because its the accurate descriptor for the condition. Two because maybe if I keep repeating it people will finally understand he wasnt going to recover. You seem to have some issue with my using the term, if so please just openly state it, because Im not sure what your point is in bringing it up.

    I have handled death. Unfortunately all to much. After five combat tours you come to realize the body over there is no longer your fallen team mate, its just a body, and they have moved on. When you have to worry about getting yourself and the rest of the team out of an ambush alive, what happens to a body becomes low priority. Do we leave our fallen comrades behind? Never. But your frame of reference has to adjust to higher priorities.

    Its evident that you and I are just going to have to agree to disagree. Will I show the proper respect for a deceased person in front of their family? Of course. Do I feel the need to do so on a nursing forum in the context of the present debate when people are arguing he needed to still be on life support? No.
    Feel free to get in the last word, and enjoy your Sunday night.
    I'm at work tonight, so rest assured I'm not staying up just to "get in the last word."

    Your context of handling death is certainly different than mine. I appreciate the fact that no fallen soldier is left behind, although I do wonder about the point of that if they are just "hunks of meat." While I can see that retrieving a body is not the priority in a combat situation, I don't see that that translates to bodies in general are not deserving of respect. But as you say, we will have to agree to disagree on that.

    I stand by my opinion that the descriptors you used were excessive. Maybe that's just me being too soft, or too female. But given that I am otherwise agreeing with your viewpoint *and* you are going into a female-dominated field, it's something for you to perhaps bear in mind. You could have made your point without dehumanizing.

    Thank you for your service.

  • May 6

    Quote from broughden
    So the tax payers should be responsible for artificially maintaining a corpse because the parents cannot handle the fact that their child is dead and unrecoverable?
    Sorry but no.

    It was a hunk of meat, there was no life left, Im not sure why that medical fact is so hard to understand for some people.
    Can we temper our zeal for realistic descriptions with a little common decency please. Those of us advocating for Alfie on this thread are trying to argue his humanity. Language like this is crude and unnecessary.

  • May 6

    Quote from XB9S
    No I believe the OP is a US nurse.

    Given the OP's profound and continued lack of understanding into basic human physiology, as evidenced by some of his posts in this thread, I question if they are a nurse at all.

    He has refused my request to explain to us all how a body with a cranial cavity full of water and lysed neurons was going to spontaneously recover, which he implied as possible.

  • May 6

    I keep thinking of that heartbreaking photo that was circulating after Alfie was extubated. His mother was holding him and someone -- presumably his father -- was propping up his arm to make it look like he was hugging her shoulder. The contrast between what his parents wanted to see in him and the reality of his closed eyes and slack body, to me, just encapsulates the fundamental problem with saying his parents were the best people to make decisions on his behalf.

  • May 6

    And before anyone wants to accuse me of being rude and nasty, I'm sick of reading opinions from people whose only experience of univerdal healthcare and medicine is what they read in the media.

    Because we all know how much the media likes to tell the truth.

    It seems that for many if the opinions formed based on media hysteria contradict the actual experience of those who have lived with, and worked in a single payer system, then actual experience takes a back seat to media hype.

    IF what some of you posit what goes on in a single payer scheme actually happens. That would make the nurses and doctors who work in the service some of the worst criminals in the world.

  • May 6

    Quote from tacticool
    . Socialized medicine equals death panels, plain and simple.

  • May 6

    Quote from tacticool
    The parents should be the ones to determine what's in the best interests of the baby; not you, not the government.

    I wonder if there's something about working in pediatrics, especially on the younger end of the spectrum, that makes it easier to see these children as people in their own right. Alfie did not exist as an extension of his parents. His ability to communicate, or lack thereof, notwithstanding, he was an individual, with his own rights to dignity, comfort, and peace. Being kept alive as a shell for the sake of his parents was not in his best interests, and this was not a determination that his parents were in a position to be able to make.

    And once again, just for the record -- the government had nothing to do with this decision.

  • Apr 29

    OK, against my better judgement I am going to chip in.

    NHS is NOT free, it is free at the point of use. Everyone pays a part of their salary for "National Insurance" this ensures you do not get a medical bill and also can give unemployment/disability/old age pension rights.

    The government had nothing to do with this it was a medical decision upheld by the courts see here for a timeline Timeline: key events in the legal battle over Alfie Evans | Society | The Guardian
    Their are NO death squads looking to dispatch ill people.

    Parents will always try their best for children - I do not blame them one little bit. I do blame the idiots who go by "Dr. Google" and know nothing about a very emotive issue.

    NHS is excellent at the life saving stuff but less so at the life enhancing stuff. You can wait for certain treatments - not good but if you want you can always go private or have private health insurance.

    USA spends more than twice what the UK spends on health care and has a lower life expectancy.

    To sum it all up, yes the NHS has problems but killing children is not one of them. We have a government that does not care about people and wants to dismantle the NHS. We have social media stating nonsense about things that people know nothing about because it is easier to get a reaction.

  • Apr 19

    Quote from Nrsing101
    I think you just mentioned the big difference between a registered nurse in the US and in the UK. Nursing in the UK is the like Licensed Practical Nurse in the USA. I know basic care is taught in nursing school but wiping patients's asses without mask??? SERIOUSLY?? you do not find anything wrong with that?

    I think it is just a matter of cultural difference. Nurses in the US are divided into RN, LPN, CNA, PCT. In the UK, YOU DO ALL THAT! Even kitchen stuffs...
    Outside of specific infection control precautions requiring a mask, why would anyone wear a mask to provide peri care? And, yes, there are different levels of education and certification/licensure in the US, but the RN is ultimately responsible for, and involved in, all nursing care, including baths and cleaning bottoms. RNs are changing and cleaning people every day in the hospital in which I work, and all over the US.