Wednesday, January 24, 2007

A new champion

Well, if not, then a new contender.

All fired up with pre-ICU fervour, given that I have only a few weeks to get up to speed on hospital medicine after a year of mainly addiction stuff, I have been trawling the medical news.

And amidst the interesting (discussion of how the most popular anti-depressants increase the risk of hip fractures in the elderly), the truly-horrible-even-though-we-know-this-shit-already (the finding that surgeons with little or no experience performing "off-pump" heart bypasses are more likely to perform this operation on black than on white patients), and the thought-so ("Cynical distrust, depression, and chronic stress... linked with elevated levels of inflammatory markers and thus higher risk of cardiovascular disease"), comes this month's contender for the golden Sherlock.

"Adequate Hospital Nursing Care Improves 30-Day Survival for Acute Medical Patients", which should really confuse all those people who've been backing inadequate nursing care as the secret to survival for the acutely unwell in hospital.

Published by one Dr Laurie Barclay this month in the Journal of Advanced Nursing.

Now you have to feel a certain amount of sympathy for the author, because this paper is clearly meant to function more as part of a polemic rather than as anything telling anyone what they didn't already know. Reading this you get the idea that Dr Barclay is probably sick of sending people up to the ICU and finding them dead a few days later and having those who do the budgeting look simultaneously appalled, confused and shifty when told of this. And now s/he has proof, for those for whom proof is needed, that nurses help keep people alive.

So,this month's winner, but not for the usual reasons.

Anyway, must reply to comments, will post again soon.
Thanks for listening,


Blogger Dr Dork said...

Hi John

Just found your very interesting blog, and have spent a while reading from one end to the other.

Very interesting, insightful. Thank you for sharing your journey.

Kind regards

12:17 AM  
Blogger Juanita J. Sanchez said...

How refreshing! My fellow nurses receiving recognition improving the 30-day survival rate. It's nice to know that adequate nursing care is (sometimes) appreciated. Those who survive usually appreciate it.

12:58 AM  
Blogger Midwife with a Knife said...

I've been lurking on your blog for a while. I think it's been very brave for you to share everything that's gone on. And I'm glad you're feeling better and out of the hospital.

I just had to comment on the nursing issue. We have a serious shortage of nurses in the U.S.A. (I don't know if you have the same problem in Australia). The nurses where I work are particularly underpaid and under appreciated. Thank you for sharing this article. I hope that papers like this will help in the fight for better funding for nurses.

5:31 AM  
Blogger Bronze John said...

Hail Dr,
Thanks for reading - although I always feel a bit nervous thinking there are fellow doctors reading this. Please ignore any technical stuff I get wrong.

Thanks again,

10:28 PM  
Blogger Bronze John said...

Hail Juanita,
One time I will write about how many times nurses saved my life (and by extension, a hell of a lot of other people's lives) in my first clinical rotation. IT was up on the third floor of Florey, and I ... actually, I will write about it.

Thanks for reading,

10:30 PM  
Blogger Bronze John said...

Dear Midwife,
For a start, that's one brilliant name. Thanks for reading.

The nursing situation is the same here. A few years back when you rang the Royal and were put on hold you would hear harpsichord music. Nowadays it's someone saying "Are you an enrolled or registered nurse? The Royal, the city's premier hospital, is always looking..." and so on.

I don't know as much as other people do why this is the case. I do know, just by looking around, that the average age of nurses is getting older, that the next generation is not coming through. And in a way it makes perfect secnse - when you can get paid more and work less being an economics graduate, who would choose the health care professions? It makes perfect sense for all of those people to chose commerce.

Until someone gets sick, of course...

Thanks again,

10:35 PM  
Blogger Midwife with a Knife said...


Your example is well chosen. One of my brothers is an economist (he does fancy electricity rate structures modeling that I on't understand), and his goal is to make a lot of money and work as little as possible!

12:55 AM  

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