Dirty hospitals, nothing else.

C- Difficile began showing up in hospitals in Montreal a couple of years back. As the article notes, seniors are the ones that seem to get the brunt of it. This little bug may be responsible for the death of two thousand people, just in Montreal alone.
It's not that hospitals are dirty, it's that viruses know how to figure out how to get through all the antibiotics that we use or misuse, for that matter.

I hate being pedantic but C. difficile is not a virus, it is a spore forming bacteria.
Its resistance to antibiotics is due to selective evolution; kill 99.999% of the bacteria and the remaining resistant .001% breed. The mutation that bestows resistance is passed on and, as they reproduce asexually and quickly, become the dominant form (what more proof of Darwin's brilliance do we need?). That is why you need to finish your antibiotics when you are given them-don't self-select for tougher bacteria.
Weakened and aged individuals have lowered immune systems and cannot fight off the infection as easily. Nosocomial infections are the bane of hospitals. Using regular soap, not the selective bacteriacidal stuff, and the judicious use of antibiotics will help restore the natural order of things. Regular soap reduces the total amount of bacteria by chemical and mechanical action thus keeping the normal ratio of genotypes in the flora present.

I agree with Faye #1. Dirty hospitals are still a problem; and some of them are very dirty indeed.

It seems to me that there are two ways to combat the problem of hospital acquired infections. Firstly, bring back matrons; with the power to run hospitals properly. They can easily be paid for by getting rid of the excess of administrators (we currently have more administrators than we do hospital beds). Secondly, the New Labour numpties would serve the public better if they stopped wasting money on rubbish and paid for a decent cleaning service in the hospitals. However, this is unlikely to happen, at least till May.

Excessive Populations within species trigger pandemic diseases that nature designs as thinning mechanisms.

Sewage disposal inventions have allowed humans to delay the thinnings but time is almost up.

The silver lining, to the dark cloud, is that Industrial Pollution is also a function of excessive population. Once the population is thinned, the pollution will also thin down although it will still need a lot of greening.

If you had the above information and worked for the gov't, which age group would you target?

A very good reason for staying out of hospital indeed.

Here we go again. I was at the ERI just a few days ago and saw 3 patients and numerous nurses and other staff outside smoking. The wind was blowing dust around which I can only imagine worked it's way into the dressing gowns, robes and nurses uniforms and hair. When will the madness STOP! I can't believe patients are allowed out of the hospital to smoke. Their patients for goodness sake, now might be a good time to prohibit their smoking to begin with. They wear robes and slippers outside, the slippers for sure bring dirt and muck back into their wards. Smoking is a bad idea any way but in this case it drives people out into the open air to pick up and take back any germ floating around out there. So much for a sterile invironment to help fight off bugs such as this!

First thing to do IS FIRE THE HOSPITAL ADMINISTRATOR!!

These C.Difficile and other resistant 'bugs' are the result of SLOPPY HYGIENE. Somebody is failing to follow instructions. It's the Hospital administrators job to see that everything is done according to the regulations. The Administrator must take an hour off each day and get off his ass and carry out random inspections,(with the various union shop stewards and a camera man to record unsatisfactory situations) of the hospital, unit by unit to see that absolute cleanliness exists!! Get him down on his knees in the food prep.areas looking for filth that has been wet mopped under the equipment, an invitation to mice and roaches! Let him check in various 'BROOM CLOSETS' and clear out the crap that has collected. Let him watch and check to food handlers serving meals in the wards. How often after picking up crap off the floor do they go on serving without washing their hands. Let him check under patients beds for dust bunnies and other signs that the ward floors have not been washed and cleaned properly. Let him check that the blankets and linens are PROPERLY STERILIZED between patient use. And he should CUT DOWN DRASTICALLY the number of people who can enter wards. Every toilet must be cleaned and cleaned several times a day if need be!! The floor must be spotless.(As should all floors in wards and hallways.)

I could go on but I hope you get the idea!! The Administrator is well paid and he should do his job properly!!

The problem is our government's priorities. They will invest in nice shiny new Tridents and other weapons of death, while cutting services that save lives :)

How many times do we have to hear about MRSA.
Could the quangos,NHS bureaucracy, MPs,and MSPs all have a little thought to themseleves overuse of antibiotics and cleanliness we have heard the same thing for years!!!!!! What are you doing about it? Have you put the cleaning back into the hands of the hospitals or is it still cheaply outsourced. Antibiotics I am not a Doctor I have read what Doctors have said MRSA should have been on the decline by now. The Executive had a report on the state of the New Infirmary how clear do they need the picture painted. The solution is simple clean the hospitals using staff that are not being hired for minimum wage and low standards.OH and listen to the professionals that have told you for years about the build up of resistance to Antibiotics.

Unfortunately I spent a lot of time visiting at various hospitals last year and I was appalled by the lack of cleanliness and any simple regime to keep wards clean.

Simple things show there is little effort/concern about cleanliness - like plant pots of dead and dying plants lined up along corridors for visitors to knock over. Piles of equipment, books, papers etc in wards and corridors making it impossible to clean floors. Dirt on windowsills and in stairwells - which I wrote my name in. No attempt to enforce that visitors wash hands before entering wards.

Simple changes would surely make a difference. e.g. security guards to allow people in only after they have washed their hands; stopping people bringing in plant pots; storing equipment/files properly. Many council swimming pools only allow people into changing rooms if they put plastic covers on their shoes - so why not hospitals.

The evidence is clear that hospitals are doing little in practice to combat these infections. While there are many good people in the health service who go above and beyond there are as many jobs-worths as well. I agree with an early comment that putting someone in charge of a ward, a.k.a. a matron, is the most obvious way to enforce a cleanliness regime. It isn’t rocket science.

If any politician or administrator were to visit a hospital in secret they would see how little attention is being paid to this.

Guga has hit the nail on the head, bring back matrons, raise standards of cleanliness( I don't believe I had to say that). I have heard too many horror stories about cost cutting in Hospitals in the UK. Matrons will bring hospitals back up to the standards we should expect in this age. Get rid of the armies of pen pushers, spend what it takes to combat infection. The first thing that hits you over here, when you walk into a hospital , is just how clean it looks and smells, needless to say we have nothing like the problems we have in Scotland, and that is with a population of 80 million !!!.

Can someone explain to me what I'm supposed to say to my wife?

Her father died of MRSA after going into hospital with a broken hip (although for some reason it was never mentioned on his death certificate. I wonder why?). In November her mother went into the New Edinburgh Royal Infirmary to have her gall bladder removed and then died of C difficile before Christmas.

Do we feel let down? Yes
Do we want compensation? No
Do we feel that anything has been learnt from either of these needless deaths? No

Nobody from the NHS or the government will have even given a thought to what are two unrelated deaths to them. But to my wife they are not unrelated, they were her parents who died because people did not follow proceedures to stop the transfer of infections. What happened to a duty of care?

Unfortunately, during a period of grief you don't have the energy to fight a battle you know you won't win and therefore the government and the NHS will get away with it.

Thanks for the article, unfortunately for us it just brings back sad memories but hopefully it may help someone else.

#8
Sounds fine, but how would your camera toting teams avoid trailing the very bugs into the wards you want cleared?

I agree that clean wards and kitchens are the minimum acceptable standard but how would you recognise a C. difficile or MRSA bug, that had been missed, on your patrol?

Remember Scotland's most serious food poisoning outbreak, John Barr's award winning butcher shop in Wishaw was spotless when they infected and maimed hundreds with incurable E Coli 0251 and killed 21.

Relying on the most poorly paid, trained and regarded members of staff to ensure food and patient hygiene is one area I'd be concerned about, particularly when often those who should be setting the example are often quite cavalier in this respect themselves.

Isn't there also an issue with simply the number of old hospitals in this country? I am not an expert in this area but I would think that older Victorian era buildings were never designed to be cleaned in the way that is needed to keep these kind of things at bay.

Calling and installing 'Matrons' is irrelevant today - as the stature, expertise and authority of the real Matron of yesterday no longer exists nor could they function in today's nightmare of non-professional management trivia and interference, patient's rights, lightening fast turnover and premature discharge of patients, open visiting, transient agency staff, management's obliteration of the professionals sense of duty, loyalty, commitment and good will and the completely useless volume and relevance of idiotic, but enforced, paper-work diverting the professionals from clinical practice.
People are dirty, they always have been, and linked to either their own lazy habits or the reticence or inability of nursing to insist on thorough daily bathing and washing hands after toilet and before meals (like we used to do with Sister breathing down our nursing AND the patients necks!) the fundamental starting point of personal hygeine is a lost cause.
The days when the simple geography of Florence Nightingale wards enabled logical organisation, implementation and monitoring of clinical care has fallen foul of the deceit of 'privacy' in new 'race-track' ward design where patients (mixed sex) are packed into tiny airless wardlets where they remain invisible to the ward staff but ripe for their own or resident bug to exploit the perfect warm, dirty and dark agar culture of the patient.
ALL visitors (relatives, porters, physios, radiographers and staff from elsewhere in the hospital etc.) did not enter the main ward where the patients were, until permission from the senior nurse on duty was received to do so. Visitors were restricted to time and number. Sister had eyes on the back of HER head. Matron knew the permanent nursing and medical staff by name. Cleaners cleaned with pride and devotion. Porters portered with humour and humanity. Auxillary nurses cleaned and maintained the ward equipment to a sparkling degree rather than todays' poor habit (not their

The question of basic hygiene is obvious. However, it may be useful to add something to the essential comment by 3# Scullion.

I'm no medic, but a few years ago I attended a short course of a few weeks on basic medicine in connection with my own work. The course was given by a university professor of medicine.

When we came to the end of the course on bacteriology, our lecturer stopped and issued a warning: antibiotics had been misused and we had now reached a stage when even the most potent cocktails were often failing. It took a long time to produce new generations of antibiotics - I don't recall the precise timescale mentioned, but it was over ten years - and for the time being we had only so many antibiotics in use.

He then warned us to avoid hospitals in every way possible, unless it is absolutely necessary to enter one, because these are the breeding grounds for the most virulent antibiotic-resistant strains of bacteria. Obviously, if you've no choice, you go to hospital. But, said our lecturer, if - for instance - you're suffering from depression, don't let yourself be hospitalised; what with lowered immune defences, you'd risk catching a nasty bug and becoming dangerously ill or dying...

I'm over sixty and have watched - in horror and, at first, disbelief - the absurd and almost universal abuse of antibiotics throughout my lifetime: and now we're seeing the results of massive preventative use in livestock production, dishing out prescriptions every time people catch colds, self-medication in much of the world (but under no control), etc. etc.; then, the spread of antibiotic-resistant TB with the help of crass regimes in Eurasia (in particular China and the USSR and its successors). And, as Scullion said, the effects of Darwinian natural selection, aided and abetted by our abuses of what began as a miracle-medicine.

Human stupidity is incurable, and these problems are among its side effects.

[16] SonofHamish: Utter and complete nonsense. You're talking out the back of your head.

You can clean anything to an adequate standard if you use the right techniques; the age of it makes no difference provided that it has been maintained properly.

The problem, as Louisa [15] eloquently points out, is the cheapening of standards as a result of universal adoption of the bean counter mentality. Until this idiocy is swept aside, and those that control the budgets realise that they are dealing with non-renewable entities (human lives) we will continue to suffer the filthiest facilities in Europe. Is this a measure of how seriously we take our own wellbeing?

#13. Cameron1875
If my own mother's case is anything to go by, the hospitals just bury their mistakes and get rid of the evidence.

She was misdiagnosed, for 14 years, with iron deficiency by her GP when she actually was suffering from coleiac disease.
The mistake only came to light after my father was told she'd been given one week to live with 'liver cancer'.

Ironically her life was saved when an unrelated minor operation went wrong and she'd been left haemorrhaging until the last moment, damaging her heart, unnoticed, post-op on a trolley left in a corridor.

The blood transfusion to save her life was contaminated with Hepatitis C from an American donor.

This was kept secret until a chance remark from a nurse reading her notes let it slip, a hospital consultant passing overheard, also made the coleiac diagnosis, saving her life.

For the medical tribunal my mother requested her medical notes from her GP but was refused.
Apparently he was stunned to see her still alive.
When pressed, he simply ripped out the incriminating sections and destroyed the evidence in front of her.

To add insult to injury the chairman of the tribunal had been this GPs best man at his wedding and the GP skipped the country to South Africa to avoid being called as a witness.

Instead of compensation for my mother and measures being taken to make sure the same mistakes could not happen again, the doctors closed ranks and got rid of the evidence against them.

Because of these years of misdiagnosed illness, and time off work, my mother did not qualify for her state pension and now, in her late sixties, has to work as a lollipop woman to make ends meet.

During this 14 years, she suffered with cronic diarrhea, faded to skin and bone, and was given just days to live before the mistake was realised, she was a hospital auxilliary preparing patients' meals in the kitchens.

At one point her case knocked the Spice Girls Of

17 - jennifer ....I have to agree with your underlying point that it is in the professionals hands to do something effective.
Someone said to me a couple of years ago:- "In our day it was the bad nurse that stood out - now it appears that it is the good nurse that stands out"?
However, I rather think that there are plenty of potential good nurses around but they have been restricted and demoralised in their desire to function professionally as it would stray from their job description according to which letter of the alphabet (D,E,F,G,H) their rank prohibits. If all Registered Nurses functioned according to relevant Scots Law and the primary legal expectation within their Code of Professional Practice and the requirements of Professional Registration and Accountability (no mention of the alphabet in these formal and official documents!) instead of some second rate, marginal, management invented tick-list of their 'job description' inhibitions - we might see a competent professional renaissance that could take the NHS forward in terms of quality, pride, effectiveness and genuine patient satisfaction.

We are all getting too weak to resist these bugs as a result of a sanitised lifestyle. We should concentrate more in allowing a few bugs and bacteria into our bodys in order to make them stronger rather than this utterly futile strategy.

Thankfully the folk who just get on with life are probably immune to this MRSA caper ... a). Because they don't bother the NHS with petty problems or unecessary ops b). They get their sleeves rolled up and don't mind a bit of muck - it's good for you!

Folk die of stuff - it's a sad fact but pretty much unavoidable at the end of day. We should stop fussing about the occasional death ... as much as I am an outspoken critic of the NHS the fact remains, despite the fact it costs too much and deliveres too little that more folk live, or die decently, than would otherwise be the case without it there.

... the more you mollycoddle life the weaker life becomes ... in more ways than one ...

#22. Voldemort
So presumably you'll be volunteering you and your family to stop fussing and let them die of 'stuff'?

I work in a hospital, in housekeeping. How much of a ward's surfaces do you expect me to wipe down in my 8 hour shift?

I get paid a decent wage (about twice the minimum wage) for my 30+ years of experience. I know what I am doing. However, on my ward, I am THE housekeeper ... if I don't do something, it will be waiting for me when I come back tomorrow. (There are casuals who work weekends; finally, I don't).

Our supervisers are rarely seen, and by rarely I mean once a season, maybe. They check the main hospital rigorously, but I work in another building.

See, the greatest slice of a hospital budget is for wages. Do you think I am overpaid? Think: you want to pay me enough to prevent a constant turnover of workers - who will all have to be trained (do you know how to properly clean for c.dificile? I do) - and pay me for my experience and knowledge.
But can you afford to pay someone like me so you have the staff and staff time to wipe every surface on the ward every day? Of course you don't. I have time to hit up high traffic areas, do the toilets and empty the garbage. Any disruption in my schedule puts me behind in my work, so don't spill blood or other body fluids on the floor, please - the protocol for this REALLY eats into my time.

Think about it: hospitals have a high percentage of patients and visitors who don't even wash their hands after using the toilets - and don't tell me I am exaggerating, as I am the one who doesn't have to fill up the paper towel dispenser!! This is one of the ways in which c.difficile gets around:)

Are YOU sure you washed your hands enough times today? Scrub your hands with soap while you mentally recite the ABC song - that's how long you should scrub, incidentally - or else look in the mirror at one of those who spread the c.difficile bug :)

#3. Scullion, Canada / 2:51am 3 Jan 2007

Good intelligence.

Is there scope to reduce the prescription of Antibiotics by doctors? Is there a way to monitor and correct the bacterial imbalance?

The article says "C difficile" is present in 5% of the population - I presume without major problem.

#21 Louisa
You're right, there are a lot of potentially good nurses around. Trouble is they're not intellectually bright enough to get a degree. 30 years ago they would have started on the wards as soon as they left school and would have made brilliant nurses. But some prat decided to turn nursing into a graduate profession and now they all want to be pseudo-doctors and real nursing which involves caring for the sick and emptying bedpans and giving blanket baths and getting covered in vomit occasionally is beneath them.
So underpaid skivvies now dump patients' food out of reach and refuse to clean wards properly and well guess what, we get dead people!

For those of you talking of viruses and antibiotics, viruses do not respond to antibiotics!

I am a former health worker, and C. diff was a major problem on the elderly wards 7 years ago. The biggest problem was not one of cleaning, it was the simple lack of isolation facilities combined with patient confidentiality which would not allow staff to place some sort of warning signal on the notes of a patient suffering from an infectious condition brought about by MRSA or C. diff.

As the NHS proceed with their policy of "rationalising" health care facilities - which roughly translated means having all facilities valued by an estate agent and the most lucrative ones sold off - we are going to see more and more overcrowded hospitals with little or no isolation facilities. Watch out in the future for the sale of the Royal Victoria and the Sick Kids with their land in some of the more desireable areas of Edinburgh. The Astley will go too if they can find a loophole.

It is all about money. The WRVS do not have a canteen at the New Royal, instead we have Starbucks! The very idea of having so many non-health professionals working in a hospital environment, and the lack of understanding of infection control that accompanies them just beggars belief!

And who introduced bean-counters, outsourcing, downsizing - if it moves flog it! - and Stalinist centralisation?

Step forward Saint Margaret of Finchley, Medieval patron saint of holes in the road, high unemployment, micky-mouse training courses, and dirty hospitals.

23 #

You're darn right I'd volunteer if it set an example!

I ate muck when I was a kid, lived with the chickens and dogs, ate worms, crossed oceans, climbed mountains, have almost died of thirst but I don't get ill even when I am ill. Furthermore I don't complain if someone intentions were good.

As I said I'd rather have the NHS with a bit of MRSA than no NHS at all. MRSA is such a small problem - it will NEVER go away (it has always been there in one form or the other) and the occasional person will die from it - that and the occasional mishap on the operating table etc is a fair price to pay given the overall benefit.

I really hope we never submit to the 'victim' mentallity which so much of Britain has fallen to already.

"Life is not a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside, thoroughly used up, totally worn out, and loudly proclaiming, "WOW! What a ride!"'

(I wish I could claim credit for the quote - I think it came from Roz Savage)

You could get double deckered tomorrow stop worrying about MRSA 23#, accept the fact that folk die sometimes tragically - sod it, it happens - and get out and do something spectacular!

Just before Christmas I was in Ninewells in Dundee twice - in total for just over 3 weeks. The ward I stayed on was spotless, the nursing staff busy but dedicated and the cleaners ever present and proud of their work. At lot of this seemed to be driven by the culture set by the (slightly scary!) senior Charge Nurse.

I was told by one of the cleaning staff that they did not have a problem with MRSA etc on that particular ward because of these standards. the patients on the ward were a range of ages and included some elderly ladies from care homes.

So don't class all healthworkers the same - a lot of them are dedicated to their jobs and I for one cannot fault the care I recieved. The only time infection control procedures were not followed in full was when visitors arrived and chose to ignore the prominent notices asking them to comply with hand cleansing and not to sit on patients beds or chairs, and woe betide them if they were caught by the nursing staff. Patients and visitors have a large responsibility here too.

21 - Yada
Funny thing is - that when I started nursing in 1968, and most of my student nurse colleagues had plenty of Highers that would have allowed us to enter university as the nurse training in those days was considerably more demanding intellectually and practically. We constantly sat tough exams etc. both academic and practical that would make some of the soft non-life science pathophysiology guff that fills today's nursing degrees pale into insignificance!
I have since completed a range of post (nurse) registration degrees at a number of universities in life sciences etc. which again make some nursing diplomas, which can be expanded to ?degree level, look very superficial. I think part of the trouble is that today's student nurse from the very start is denied real clinical hands-on experience. Instead they 'observe' within their supernumerary role as onlooker. They perceive the ultimate goal in nursing as being non-clinical, hands-off patient care as the senior letters of the nursing alphabet are busy-busy in paper-work and 'delegating' to Nursing Assistants.
Women's lives have changed - and today I would never choose nursing but I would go to university and study medicine. We are therefore left with a present cohort of nursing students today, many of the type that, in my day, would not have ever entered nursing. I am being deliberately barbed to make an authentic point. I seriously thought that introducing a universal nursing degree education programme would attract back those who would previously have chosen nursing by so-called widening the entry gate. However the gate was NOT widened in the proper direction in my view, and the once proud profession of nursing has been flooded with many candidates whose life-style, ambition and capability does not match or address the patients needs.
Beware of the nurse who wants to be a 'pseudo doctor' as you describe - they cannot grasp or achieve the broad range of medical science and practi

Its about time that detection kits were issued to every household in the country, because these infections are not confined to hospitals; it has been known for a patient to bring them into a hospital.

32#

I hope you're not serious .. I'll have to consider turning you into an MRSA bacteria if you are!

wouldnt have happend on the wards my Aunt worked on, she was one of old school nurses that ran her ward with cleanliness and efficiency. I pray that I nor family or friends dont fall ill enough to warrant a hospital stay it doesnt bear thinking about the consequences. This is totally unacceptable in this day and age in the UK!!

Look back at when things started to get worse. Maggie Thatcher and her privatisation of cleaning hospitals. need we say more?
You will note that most of the people making the rules tend to go private because they know what they have created.
the public not washing their hands seems to get the blame a lot, but no one seems to say anything about hospital staff coming to work in their uniforms after sitting and travelling on filthy public transport.
A message to all Government ministers: Stop knocking smokers, fat people, or anyone else you can blame when your policies on hospitals are killing more people than the other two put together.

You are making a very good point, Voldemort! I recall a friend chiding me for giving cows milk to my one year old - "it's full of all sorts of bacteria" she said. Where was said one year old? In the garden crawling around on hands and knees inspecting (eating?) gravel!

Well, she has made to to almost 14 and she is extremely healthy, as am I - neither of us have had the need to consult a doctor in over 2 years and my daughter has never had an antibiotic in her life.

Has no one noticed that hospital acquired infections started to become a problem just when nurses (but not many doctors) stopped swabbing patients' skin before making injections? Maybe this was not the direct cause, but it signalled a decline in the attention to patient cleanliness that had prevailed until then. Now everyone is concentrating on swabbing floors, sometimes even toilets, but they have stopped swabbing skin - even when putting in long lines and catheters, though that's against the rules!
The excuses given for stopping swabbing before injections include the claim that there is no evidence that it works - if only evidence-based treatments were allowed, there would not be much tratment going on at all.
Other 'reasons' for stopping - saving nurses' time, saving cost of swabs, reducing waste, and, believe it or not, nurses cannot be trusted to remember and management has no time to supervise.
So just let the patients catch everything that's going, that means more NHS jobs, bigger budgets, bigger profits for PFIs. And just let the patients rot.
If YOU are a patient, then don't be intimidated by the 'professionals', insist on being properly washed, report dirty toilets (nag about them again and again if you have to), make sure visitors and nurses use hand gel and, at home, don't trust the claims of antiseptic cleaners, stick to good old soap, water and bleach - not only cheaper but more effective, especially against c. difficile.
Please excuse the rant - I've been banging on like this for years and still 'they' don't seem to recognise that attention to such details as swabbing skin before injection sets the standard for everything else that goes on.

A lot of very valid points and seriously cutting remarks,
Staphyloccus microbial lives on the palms of the human hands, not a pretty thought and this is why we are told from an early age to wash our hands etc,
Despite massive government enforced enactments and awareness campaigns etc, the average human is still remiss in something so simple as attending to personal hygeine,
These germs are mutating all the time, some survive even the most rigorous cleaning schedules,
I am not surprised that "man" seems to be behind in the never ending battle of developing medicines and treatments which would be effective,

I do to a degree concur with *3 Scullion from Canada,
The more sterile we make our world, the less resistant we become to disease, on the other hand our Hospitals must be clean,
I agree with the idea of a Matron, in charge of individual wards, keeping on top of the domestic staff and the nurses under her control.
Love the last paragraph of *35 weeshooie from Edinburgh,
Put simply in this context, we are all human, some of us are in Hospital laying our lives in their hands, we should, I think be entitled to some kind of confidence in the abilities of the people treating us,
With regard to smokers, whether they be a patient or a nurse, standing outside to smoke, in the old days, Hospitals did have an area where people could go to smoke, therefore reducing the risk of airborne germs gaining entry into a sterile area.

Non smokers cannot have it both ways,
When you consider that twenty or thirty years ago Doctors encouraged their patients to smoke, smoking it seems was thought to have a calming affect on those deemed to be of nervous disposition,
Now with the executive itself dictating where one can or cannot smoke, it is in my opinion, the executive who have brought about this catastrophe of superbugs etc being brought into the hospitals, by insisting sick people go outside to smoke and c

#36. It is important to avoid taking antibiotics unless absolutely necessary but how can anyone say...'I have never had an antibiotic in my life with any certainty' especially when livestock are being fed such antibiotics in their feed? Our food is being tampered with and it is dreadful when animals are being fed antibiotics. Some of us may not have directly taken antibiotics but may have (indirectly) through the food chain.

The misuse has to stop and cleanliness in all forms must be adhered to as mentioned by many in the above posts. It is awful how a great profession has been turned into a pen pushing army trying to cover
all risks. Such fear of risks results can only result in reduced care.

#20 Livilion. What an awful situation.

Jaysus weeshooie!

Yer a trew Scoat if ye kin still blayme Maggie!!

I fundamentally disagree but hats off for the wild swing!! It kind of like blaming Ronnie Regan for the monica lewinski affiar ...

Great stuff you brought a smile ... !

*40 Faye,
I would think the food standards agency and most environmental health departments, in councils countrywide would be quite appalled by what you say, not to mention farmers at one end of the market and chefs and cooks at the other.
In Scotland, we produce food which is considered to the best and of the highest quality, and definately NOT tampered with.
This is why the executive actively promotes local produce,
Buy Scottish Madam,
If your food comes from abroad, you have no absolutely no guarentee of what you are eating, despite what it says on the label.
And don't be fooled into buying only organic either,
The only difference in buying organic foods is the price.
Risk assessments are important in every profession,
This is so that the chef/ or whoever can realistically pinpoint the origin of outbreak, whether it be in a hospital or a kitchen.
I disagree with your comment in its entirety.
I find it most disturbing that you/ and or others would think your food is being tampered with or that we as professionals would seek to misuse our profession in this manner.

Totally agree with #4 Guga. There were Matrons about when I was in hospital having my children - scary but extremely efficient women who ran wards that had floors you could eat your meals off. There was no such thing as dirt - blimey even visitors never put a foot wrong or sit on a bed. Bring them back - it's the only way to make us proud of our hospitals again

43, the Cat
Well said and most likely to be the answer.

Basic hygiene and too many people coming and going is a problem in hospitals today. I was in hospital for 2 weeks about 4 years ago. There does not appear to be any set visiting times anymore and lots of visitors brought takeaway food in for patients.

Medical staff do not seem to wash their hands between patients and they wear their uniforms at home and when travelling to and from work.

Hospitals, nowadays, are havens for all kinds of bacteria. Perhaps if basic standards of cleanliness, limitations on the number and frequency of visitors per patient, no food brought in from outside and commonsense were applied we might go some way to controlling these infections.

#42. Your post indicates you appear to represent or work in the food industry. The rising use of antibiotics in food production should be of great concern to us all. See http://www.soilassociation.org/web/sa/saweb.nsf/GetInvolv...

Please tell us details of a credible source where one can get such assurances that our food is not laced with antibiotics.

LM@42. You might also want to read this.

http://news.scotsman.com/latest.cfm?id=14332007

LM and The Cat -
I agree - but no use hoping for something that is currently impossible - please read my comments (15, 21, 31) from my unfortunate but real life perspective and lengthy knowledge of the nursing NHS and it's management manufactured de-professionalised indifference. There are occassional hotspots of excellence - thank goodness - mainly through the determination of professionals to reason with some of the more marginal but rational members of management, to re-implement traditional principles of clinical excellence. It is ridiculous that none of these effective initiatives are rocket science but are unrecognisable to the ignorant invested with power beyond their intellectual grasp, who always think that they know best for the rest of us? It seems that these exemplar hotspots of medical and nursing competence are in spite of so-called 'modernisation' and prove the case to hand back health care, it's organisation, prioritisation and function to the health professionals?
The CONCEPT of Matron and Sister is still possible through the combined authority of professional clinical minds at the head with non-political small teams of competent managers in support of them - instead of the tyranny of managementerialism playing games with peoples lives by deluding themselves that they know what they are talking about! The facts speak for themselves - a 'no-brainer' as they say today?

You are correct in your assumption Faye, 46
Food production does indeed require the attention and concern of all of us, especially those who spend many years studying its science and practical theories,
I am a cook,
I personally will use nothing brought from abroad unless I know its exact origin, I do realise that I am most fortunate in many ways in as much as I do know exactly where my food comes from, right to point of origin.
The Soil Association is all very well, however, they are like any other business, they promote those who care to join them,
Ie; Vegetarian Society, or Vegan and those who think they are doing their bodies a favour by eating organic foods only.
If you wish to know what is going on the world of food, go to the food standards agency, or better still suscribe to their food alerts,
That way, you will know exactly what the situation is with regard to all of your concerns and you will know this as it happens, not some time later when a website chooses to throw the fear of God, into innocent folks like yourself.

http://www.food.gov.uk/consultations/consultscot/2002/55560
I personally know of no one in the food industry who would deliberately go out of their way to hoodwink anyone, (leaving out the fanatical regime)
Your general wellbeing and good health is, if you will pardon the pun, our bread & butter and always will be, because without you, we have no future.

I was a victim of C. Difficile last year and it laid me low for a considerable time. My wife was afraid I was going to die and I was afraid I wasn't. The scariest thing was that we could not figure out how I got the bug. I had not been on any antibiotic (a common precursor to the infection) and as far as I know had not been anywhere or done anything to get the infection. (I am retired so my travels and activities are somewhat circumscribed.) It is indeed a serious problem and one can only hope that a solution is quickly found.

I'm a native Scot who comes home annually : God forbid I get really sick on one of my future visits.
Joseph Lister must be turning in his grave!

In response to the idiot 7)

"Here we go again. "

Indeed so, please apply thought before typing.

"I was at the ERI just a few days ago and saw 3 patients and numerous nurses and other staff outside smoking. "

Good for them, exercising their freedom to choose.
why don't you choose to mind your own business.

"The wind was blowing dust around"

Wind does that, and most of the dust isn't from tobacco, what do you want, that we should control the wind?

"which I can only imagine"

Exactly, Imagine not know.

"worked it's way into the dressing gowns, robes and nurses uniforms and hair."

Smoke and ash from cigarettes is burnt organic matter, burnt at a high temperature and is sterile.

"When will the madness STOP! "

Which madness, the madness of control freaks and
the politically correct.

"I can't believe patients are allowed out of the hospital to smoke."

Why? They are taxpaying clients of the health service, not prisoners, who incidentally are allowed to smoke in enclosed spaces.

"Their patients for goodness sake, now might be a good time to prohibit their smoking to begin with. "

I hope you and your kind are ready and willing for the backlash that prohibition will cause. I doubt it,
this is supposedly a free country

"They wear robes and slippers outside, the slippers for sure bring dirt and muck back into their wards."

As do staff, visitoors, cleaners, contractors, whats your point?

"Smoking is a bad idea any way but in this case it drives people out into the open air"

Yes, yes, mr. self righteous I know it's a bad idea,
so are a lot of things people enjoy, but it is people with your attitude which have forced others to smoke in the open air, so you can't complain about the results of controlling legislation.

"to pick up

53 Arthur,

Brilliant! that is telling em!
Funny, ironic and totally original and precisely the sentiments of many Scottish folks, including me, I cannot stand Dictatorship.

I do indeed enjoy a cigarette or three.

Arthur -- Great comment. Most excellent.

Stuart F. -- Viruses are unaffected by antibiotics. Thus, docs don't prescribe antibiotics for colds, though I've heard of it, sad to say.

#51. Glock23
I know how you feel.

Some number of years ago I came down with Campylobacteriosis.

Constant pain, shivers, sweats, cramps, you name it, terrible.
I wouldn't even wish it on the likes of Union Joke.

Most folk I meet have never even heard of it, at the time neither had I, but it is more common than Salmonella, Clostridium and Listeria put together.
Usually transmitted by food handlers or kitchen porters not washing hands after 'comfort breaks'.

At the time I did not realise that it was dehydration shutting down vital organs that was going to kill me but I could not eat or drink anything without it running straight through me.

I lost 14lb in 7days, mostly through dehydration.

What I also discovered was that it is contageous, my wife was ok but the dog was infected and could have given it back to me.
In my weakened state I doubt I would have survived a second bout.

And you know? to this day I've never gone back to that Indian restaurant up by the Baird Hall end of Sauchiehall Street to tell them!
I know I should have.
I've never eaten anywhere in Sauchiehall Street again, period, neither has any member of my family.

These days I advise hotels and restaurants on hygiene issues and I'm often astonished at the low levels of personal hygiene and maintenance of hygiene critical equipment.

Even supposedly 5star eateries.

So much so that I'd advise anyone who is in any doubt about cleanliness 'front of house' ie tables, menus, cutlery, floors, WCs,
DON'T EAT THERE!

Imagine what the bits they don't show you are like.
Usually scary.

If you want to be sure, pop into the kitchen and just have a look at the 'bactericidal' handsoap at, and the state of, the handwash sink.

Have they being used for hand washing any time recently?

That's usually the difference between what they say and what they do.

thank you Voldermont and Arthur, you made my day. A good chuckle is worth more than any antibiotic. I have to listen to a lot of the same pc stuff here in the USA. I'm going to have a good glass of scotch when I get home tonight to kill all those germs.

#53. Arthur +54. LM +55. Richardo, USA

""...I'll make it simple, Fag ash, and fag smoke are sterile, hospitals are not, Smoking is neither a transmission nor culture agent for bacteria or viruses.
Smoking is not responsible for MRSA or C.diff

Now what else would you like to control today?...""

WRONG,WRONG,WRONG Arthur!

It is not 'fag ash' that is the problem, it is the MRSA bacteria etc of the nose and mouth transferred to hands that make smoking an instant dismissal case in any food handling area.

I would suggest a room full of people with reduced imunity to disease should be every bit as strictly controlled as a kitchen.
http://www.food.gov.uk/multimedia/pdfs/sfbbpersonalhygien...

btw that's why hospitals now have hand washing stations at their entrances.

thank you Voldemort and Arthur, you made my day. A good chuckle is worth more than any antibiotic. I have to listen to a lot of the same pc stuff here in the USA. I'm going to have a good glass of scotch when I get home tonight to kill all those germs.

How many off the wealthy elite and their families who frequent their private hospitals when requiring medical care and attention, succumb to such a *trivial* recent
phenomenon as MRSA?
Or, is it, as it has always been in the past; the THEM and US society?
A few years ago, my late wife was literally snatched from the jaws off death when a patient in one off Blair and Brown's NHS hospitals, after it was handed over to private cleaners.

56, livilion

There are many forms of food poisoning, microbial etc.
Most of them have the same type of unpleasant symptoms,
Most can have a devastating affect on their victims,
Some are fatal.
More is known of them now, the public awareness has risen sharply in recent years and the public have a right to know that their chosen eatery on a night out or whatever has been inspected and certified as being hygenically safe and that those responsible for food preparation and cooking are qualified to do the job,
Your comment and I quote "if you want to be sure, pop into the kitchen, blad de dah........
Is not in my opinion, good practice and certainly not from the view point of cross contamination,
I reckon any Chef worth his salt would have fifty fits if his guests were to be popping in and out of his kitchen, I know I would not be pleased and that is a fact.
It would be a most dangerous practice indeed.
If, I am not mistaken this is why when you do an inspection, you read back to the Chef/ Manager etc all that you have written, it is then signed by both parties and therefore there is a record of all or any issues to be addressed.
It seems strange to me, that you only see the bits they choose to show you, somehow, I do not see that.

Recently, me son had a knee operation and the wound turned septic after he had been discharged. I took him back to the hospital and the nurse was not too happy with what she saw when she removed the dressing, so she called for the doctor to examine him. She, of course, was dressed in her uniform and was wearing latex gloves at all times.

The doctor duly arrived, along with a young woman of about 24, who apparently was under some sort of training and both looked as if they had just walked in off the street. She was dressed in jeans and a pullover and he was a bit more formal with a shirt, tie and slacks. Neither of them were wearing white coats or gloves. The doctor then decided to take a swab of the wound, to have it tested, and probed around inside with a cotton ball on a stick. Still no gloves nor even hands washed!

It's no wonder that patients often end up in a worse condition than when they went in and it's not always the fault of the nursing or cleaning staff

58 Livilion,

You must work with a load of Numpties then?
Your opinion of kitchen staff in general is very low,

With regard to rules, regulations and hygeine laws in this country at least, they are stringent and enforcement is always there to ensure they are followed.

With regard to the transferral of Bacteria, via the nose, mouth and hands, ears etc, this has always been the case,
Then there is the off chance some numpty who smokes in a kitchen will drop ash into food, unwittingly of course,
I would not employ such a numpty and I don't know of any who do,.

It all comes down to personal hygeine,
Practicing hygeine in all areas of our lives, be it in a kitchen or a hospital,

#61. LM
""...Is not in my opinion, good practice and certainly not from the view point of cross contamination, ...""

Any kitchen that cannot provide a clean white coat and disposable hat for 'visitors' has no business selling food to the general public.

""...I reckon any Chef worth his salt would have fifty fits if his guests were to be popping in and out of his kitchen, I know I would not be pleased and that is a fact...""

The Chefs I know are delighted that customers show an interest in their work.

Sir Terrence Conran has built a number of restaurants which only have glass partitions between the kitchen and dining area to showcase the talent at work in their kitchens.

It is not an uncommon feature in new restaurant builds, as part of the dining theatre and experience.

John Torode worked like this when he was at Mezzo.
Georgio Locatelli is happy to have customers inspect his kitchens.
ditto his pal Gordon Ramsay.

Some others prepare food in front of the customers, for the same reason.

There are restaurants where it is possible to actually dine at a table set in the kitchen itself. I have.

Anton Mossiman's Belfry in Belgravia(the Queen's favourite chef) has always had a very nice dining area in his kitchen.

Only a chef with something to be ashamed of will turn you away from his kitchen, try it at someone else's kitchen, you may be surprised..

The answers are surely simple and obvious:

1) Stop hospital visiting altogether. Use videoconferencing instead: it's 100% bacteria-free. A few millions out of the gazillions spent on the NHS each year would provide the facilities needed in hospitals and wards for visitors to see and talk to their loved ones, and vice versa. If necessary, sack some NHS bureaucrats to offset the cost.

2) Assign personal responsibility for hospital cleanliness to named individuals. Use a carrot and stick approach of targets, incentive payments and penalties for missed targets to motivate the staff concerned. Hygiene employee of the month, anybody?

#64 - Agreed - I working in a restuarant in Edinburgh where the Head Chef was not just pleased, but proud, to show our diners around the kitchen.

#63. LM
""...With regard to rules, regulations and hygeine laws in this country at least, they are stringent and enforcement is always there to ensure they are followed...""

I don't know about you LM, but I've witnessed personal hygiene and food safety practices, even at WACS competitions, that have made the hairs on the back of my neck stand on end.

That was when they were being judged by their peers, and on 'best behaviour'!

Although there is still room for improvement, I have seen that the standard at national level has improved greatly in the last 4-6 years, simply because the public have become, and are becoming more, literate in hygiene issues generally.

The business has had to keep up with these expectations.

One observation; like dole croungers who know how to work the system to screw as much money as possible out of it.
It is normally the poorer kitchens that see their local EHO/FSA inspectors the most, and can quote inspection procedures chapter and verse.

The better kitchens tend not to worry them so much and receive far less attention.

Scullion (3) has got it spot on, also Louisa Perth speaks a lot of sense!

64 Livilion,

Why am not surprised by this comment,
I am sure the Chefs you know are all to be comended for their abilities in managing to fit in time in what must be a very busy schedule in the juggling of two careers,
They manage to look the part for the Camera,
and run very busy kitchens at the same time, which is if I am not mistaken is the very reason we are having this discussion at all??
Either you are in showbiz or you are in an apron.
And of course, all these chefs, they do all have staff, who do the fecthing and carrying, leaving them time to stay immaculately clean at all times, which is not eactly a hands on affect is it?
I imagine there is not a chef in the country who has not at sometime throughout his career felt pride when complimented on his work, but that doesn't mean he will toss a white coat at someone, and say hey you jimmy, c'mon in a see ma kitchen, does it?
It does not mean, that he is ashamed of his kitchen either.
It merely means he is a concientous hard working chef who is no doubt aware of the rules of health & food safety and shows he is adherring to them.

Many chefs these days do work in the public eye, I have on occasion done so myself,
Many kitchens are in buildings which are old, but safe and cannot be re-constructed to allow public viewing, this does not mean they are dirty,
What I am trying to say is, the old ways worked, the new ways sometimes work and sometimes don't work at all.
With regard to our hospitals, the news ways are not working,
Disease is rife, death could be avoidable if more care was taken,
Doctors dressed like Doctors, nurses like nurses and someone in overall charge, of them all.

#56 Livilion

Know what you mean about campylobacteroisis, my then flatmate and I came down with a mild form of it a few years ago which was bad enough, I sympathise with your more serious case.

We developed an early form of the now common management practice of "hot desking" except in our case it was "hot bogging" A graceful balletic exchange of places on the porcelain throne. Not pretty, but efficient.

I was very interested in #3 scullion's point about using plain old soap and water instead of antibacterial soap, it sounds initially counterintuitive, but it does make sense.

It has been implied for years (through the medium of TV) that not using antibacterial products will make us and our children get horrible diseases, another example of the "fear factor" in selling products. "There are more germs on your chopping board than your toilet seat" and so on.

I suppose a little thought would tell us that any bacteria which can survive antibacterial products will be tough little nasties and will reproduce like mad.

Removing dirt and bacteria using soap and mechanical action will maintain the bacterial balance and not selectively favour the development of tougher and tougher bacteria.

This puts all these alcohol hand gels in hospitals and indeed, over the counter medicines (Vick's First Defence Hand Foam anyone?) in a different light I'd say?

67 Livilion,

I am not surprised by this comment either, it seems to be your way, with words I mean.

If you cannot beat them, try and do what you believe you are being paid for, class them as scroungers and what did you say? dole dodgers?
And put the buggers down!

Just as well, I have one of those better Kitchens, then isn't it?
I get the distinct impression that you do not like persons who either know their job inside and do not need to ask your advice or just don't like people on par with your obvious specialised knowledge.

I do look forward to my next visit the environmental boys in our area, even if it once every 18 months or so, and sometimes even longer.

I always believe its better to try to work with them than against, afterall we are all just simple human beings trying to do a good job in our chosen career.

48 Faye,

I do not have to read that,

Like I said, I use nothing unless I know its origin, and what it ate, before I eat it.
Even down to the very seed I plant.

58) I don't think there is any difference in viewpoint here, I was pointing out that smoking per se cannot be held responsible for all the ills of the world and definately not MRSA C.diff.and PVL. Your point about
hand, nose , mouth interactions happen with everyone in any case, whether they smoke or not and do contribute to the spread of bacteria, and your further point on hand cleansing stations was unknown to me since I have not visited hospital for some time, my wife however pointed out that they should be at the entrance to every ward, not at the hospital entrance, I would not argue with her because she is a nurse.
I also find it odd that as my wife nurses in a 27 bed
nursing home, the incidence of these organisms is zero, on the odd occassion when it occurs it has always been because a patient has brought it in with them on return from hospitalisation. when it happens it is quickly eradicated and so far no one in her charge has died from any of these conditions.
I may be being smug here on her behalf, but she was trained to be a nurse at the old E.R.I. under the old system, where nurses were trained to be nurses
and care for people, not manage wards, or ilness, or
conditions, or budgets etc. In short she is RGN not BSc.

We have similars problems here. Perhaps doctors should perform routine surgeries on patients kitchen tables as apparently they are cleaner than hospitals.

73 Arthur,

Good honest to God common sense comment.

Scotland was once a nation held in high regard for its educational standard, right across the board.
Children did not leave school one day and start work as a nurse the next day, nor do they become successful chefs overnight, now at one time, we did actually train them before giving them their respective qualifications and churning them out ten a penny to join an equally inexperienced workforce.

Standards have been allowed to slip and fall.
The old system worked.

its a symptom of capitalism, or greed as my grandmother calls it.

Am strained wi awe this talk ´o strains en hospituls Crivvens, dae ye awe no ken yuv got tae dee ´o sumthin?

Bacteria is mightier than the blade, accept it........

P.s Happy New Year

#76. Your grandmother was right. Sh*t pay, poor working practices. It can only result in death in the vulnerable people. People who require the attention from the health service need clean wards.

Bring back that dreaded fearful matron.

Let's not blur responsibility. Matron has always had the responsibility to keep everything clean organised and well run.

These days it all seems the 'palsy walsy' attitude, a fear to challenge others.

Contract cleaning is not the way comments such as "that's not in the contract" endangers patient safety. If its dirty, it needs clean regardless or whether its in the contract!

78 Faye,
I second that.

In Canada we have really witnessed the power of this thing, one Hospital in Quebec was very badly hit with over 100 deaths per year as a result of this new multi drug resistant strain.

If it is the same strain as in Quebec and now Ontario expect things to get a lot worse before they start to improve.

At the heart of it is very poor handwashing complicance and slack attitudes in terms of the importance of good cleaning of critical surfaces.

People that have had to be on anti-biotics over a long period seem to face the greatest risk and correct management of patients Meds and close observation are very important steps.

In Canada years of Government cutbacks to the Healthcare Industry led to housekeeping departments trying to clean high traffic heavy soil environments with minimal labour and material resources.

Double cleaning touch points and surfaces that patients come into direct contact with seems to help slow this thing down.

To beat C Diff you have to be willing to invest time and resources and given the much higher mortality rate in impacted patients this should be a real focus for the Hospitals.

Funny thing clean does count..

RE 14.

All hospital employees whether photographers or unionstewards must be trained in the basics of hygiene. I've been there done it.. Without the photographer the UNION will deny the poor conditions ever existed!!.. I've had unionworkers who cleaned only the lower 2 ' of walls..IT'S NOT GOOD ON A CLEANERS BACK TO GO HIGHER!! Who should clean higher? 'Somebody else' is the answer you get! Things were MUCH SAFER when the nurses scrubbed the floors and cleaned, the Ward Sister was equal in rank to God Almighty and Matron was the SUPREME being.

# 20
livilion

Most doctors here in the US are also incompetent diagnosticians - some are just incompetent; some are negligent; some are too busy being condescending to patients to do a proper intake interview, listen carefully to the patient's responses, and make accurate notes; and some actually lie about diagnoses to justify doing their pet surgeries, about which they then publish, gaining prestige for themselves and their home universities.

When it comes to hygiene, what studies here have shown is: the worst offenders are - you guessed it - the doctors. One tv 'news magazine' closed its story with the encouragement for patients and their visitors to speak up and insist, if necessary, that the doctor wash his hands before touching the patient. (Of course, they didn't warn the patient that the doctor was likely to give him a hard time if he dared to address a physician as [gasp!] an equal.)

Further, your description of hospital administrators' attitudes are relevant here, too. (If anyone ever talks tripe about the great medical care in America, refer him to this.)

Hope your mother's doing better.

As for me, I have made a self-diagnosis after dealing with idiots posing as healers for years - and I am going online to get the drug I have prescribed for myself. I'll bet it does me a lot more good than all those 'healers' combined. (Mind, I am not advocating others doing this. I spent a lot of time in medical libraries before I came to this decision.)

- - -

QU: How is the American medical establishment like a duck pond?

ANS: It's full of quacks!

Had to add that #12 has said it all, our mistake is in using the {would be soaps}.
We need major scrutiny in all institutions.
Shirley {Canada}

Just stick to good common sense stuff - Faye I think you matron post was cracking! Well said! We have proved the armies of administrative staff and bean counters don't work - why not get matron back on the case ...?

82 - Alec in Chicago

Books may tell you about standard, typical and average circumstances (most written at least three years prior to publicatiion and therefore not necessarily up to date) - but NO book has been written about your very own individual and unique set of signs and symptoms linked to your very own individual pathological context of onset, duration, severity and affect. Investigative, diagnostic and therapeutic medical wisdom comes from years of experience on which individual cases may be reflected upon. Unqualified, uneducated, inexperienced self-prescribing of drugs may be foolhardy and I would be surprised to find anyone medical and non-medical who would support such behaviour. How will you deal with titrating therapeutic blood levels, responding to initial subtle signs of side-effects before they become iatrogenically damaging, catastrophic adverse reactions or assessing your physical and mental status to rule out compromising potential contra indications? Your time might be much better spent finding a doctor (there are thousands and thousands) who will listen to you, investigate you if necessary and treat you if you actually have a disorder. Isn't this sort of ad hoc, uninformed behaviour you are indulging in yourself, exactly how quacks function?

Alpha

There are NO MATRONS today - they do not and cannot exist in today's NHS world. Read 15, 21 31. Please remember that they worked alongside a strong and well established cohort of very senior Sisters, Medical Superintendants and experienced medical Consultants who ALL TOGETHER made the hospitals work well - it was NEVER just the action of a single Matron.
Do you seriously believe that ONE person can sort out an entire hospital that is under so much politically enforced management and administrative complexity that yesterday's Matron would be totally disempowered by? From whom would these modern Matrons have learned their function for todays purpose? Sadly the tradition of learning and passing on the torch as Deputy /Assistant Matron has long gone. I agree that we need to re-establish clinical thoroughness and pride back into the nursing profession which will probably rely on bringing back the health professionals to the senior positions with good and smaller management in support and not in the political and administrative lead?

Are you aware that a high incidence of MRSA is now considered "COMMUNITY ACQUIRED"? Watch your "health club". After working out,shower and put on clean clothes,not those you used for your workout.Some hospitals here in Massachusetts are doing blood tests on pre-op patients scheduled for elective surgery.If positive for MRSA,they can be treated before surgery. I also do not use antibacterial soaps as they can contribute to making the "bugs"stronger

Seein's how it's mostly old people ( I'm 50 ) can't be a bad thing. We have to have some kind of population control and this is out of our hands guys an'gals. It's up to the Big Man.

The trouble with these bugs is that they are usually there on our bodies anyway.

You cannot practically sanitise your nose, mouth, or 'nether regions' but we have to be conditioned not to touch them, when under stress.

We all know that people with lowered imune defences are the most likely to develop symptoms; the very young, very old, expectant mothers, chemotherapy patients etc.
sick hospital patients.

If this is the 'Big Man's way' why do we bother with medical care at all?

Still, thoughtless or ignorant, people visiting 'clean' hospital wards can contaminate door handles, bed ends, tv remote, anything they touch after you have, could be innocent enough looking but potentialy fatal to patients if the MRSA from your nose has gotten onto your hands.

You'll never know what you've done to the poor soul you infected, say, after your 'quick puff' outside, but readily blame the 'sloppy' cleaners if you do.

Spending time in hospital sterile services departments sharpened my attention to these risks, or rather the SSD managers did.

eg I'd wash my hands BEFORE using the toilet and never put my hands anywhere near my face when I'd been working in there. Stops you biting your nails.

Mechanical action, chemical sanitation, dilution, time to make sure bugs are killed/removed are ALL important factors to be remembered.

The other element I find not often considered is that our own immunity to infections we may be carrying, built up eg. by eating clabber as a child, may not be shared by those mentioned above we may contact.

btw I find in kitchens that swabs from sink taps, fridge doors, and handles in general are often lousy with bacteria waiting to recontaminate just-washed hands.

71. LM
""...I get the distinct impression that you do not like persons who either know their job inside and do not need to ask your advice or just don't like people on par with your obvious specialised knowledge...""

Quite the reverse actually.

What gets me is people who should know better, and ought to be setting the examples, letting us all down.

I suppose once you've suffered a bad case of food poisoning you feel more sensitised to the subject.

It's not just about a night stuck on the toilet.

In some cases the consequences can be terrible.
eg
John Barr in Wishaw, incurable E Coli O251; 21 killed, hundreds injured, many for life.
Victims having to be carried to hospital in black bin bags full of their own diarrhoea, they were so bad, as their nervous systems and intestines broke down.
http://news.scotsman.com/topics.cfm?tid=678&id=169471...

Latours in EastKilbride; salmonella triggered reactive arthritis, £1m+ payout for newly wed's wrecked life.
http://news.scotsman.com/topics.cfm?tid=178&id=221942...
http://www.scotcourts.gov.uk/opinions/2005CSOH146.html

When we know how to prevent these hundreds of deaths, and ruined lives, surely there should be no excuse for not preventing them.

Voldemort- who are you ? I must know. You so get it !

The sterilising of equipment in present day hospitals could most likely lead to early deaths of the nurses involved. Well it used to, maybe things have changed. My local doctor was an ex chest surgeon, he reckoned that I was good enough for another ten or twelve years provided I never had to go into hospital. Personally I reckoned with my smoking and drinking, plus the odd episodes of mayhem, I could maybe reach seventy. I would like to be proved wrong, but I reckon there is no way I am going into hospital. I want to die of my own diseases, not some other buggers.

# 85
Louisa

I just said that doctors don't pay attention to patients when they talk.

No doctor I've had paid attention to any reported side-effects: they weren't listed by the drug manufacturers, so they didn't exist (at least, as far as the doctors were concerned).

I have seen a number of doctors. They all stick to the old line: what the drig manufaturers state - and you ought to know that that is just the tip of the iceberg, (but doctors act as though the inserts were the entire story). I reported a side effect to a doctor, (one that I had learned had been exerienced by others), and you know what she said? She'd never heard that one before. Several weeks later, she said that she had talked to the rep from the drug company, who had assured her that she'd never heard of it, either. (Truly. A sales rep! They've been caught lying no end of times, but there was my doctor, using her as some final authority.) By the way, my doctor was an associate professor of medicine.

As you should be able to see, I live in the US. I don't currently have insurance, but even with it, there are only a limited number of different doctors whose consultations they will pay for. Would you like to finance my search that that one in [how many?] doctors who knows what he's doing?

I don't have that kind of time, anyway. Besides, my diagnosis was clear enough for several laymen to make - but my blood test (I won't be specific, for obvious reasons) was borderline normal. There are articles that I have found by a specific physician who has prescribed this drug for people with exactly my result - and said result has been quite steady over a period of years. I could afford to go to the doctor, which would entail several trips by plane, or I can afford the drug - but not both.

Lucky for me, I know a fair deal about the drug I plan to take, and I know how to look out for the most likely side effects. That's about all I ever got from doc

Correcton for 93 -
I ought to have typed that the physician was prescribing for people with test results like mine.

By the way, did you think you were going to scare or blind me with medicalese? I may have trouble generating the correct terminology, but my comprehension rate is pretty darned good for a layman.

You know, I once had a surgeon tell me that he didn't want me watching my own minor surgery because of the vaso-vagal reaction. I was much younger then, so I had to go to someone to enquire. I watched the surgery. What difference would a vaso-vagal reaction have made, when I was going to be lying down anyway? Medicalese doesn't frighten me - and if you couldn't (wouldn't?) put it in plain English, doesn't that say a lot about you?

# 22 Voldemort

I wish I could recall the title - or at least where I found it - but I recall reading an article that said the a study in Germany showed that country children suffered fewer chronic ailments (like allergies or asthma) than city kids. The researchers thought it was because the city kids were not exposed to as varied/natural an environment as the country kids, and therefore built up fewer immunities.

Is this part of your argument?

I have two distinct point to post. (1) My first job was in chemical analysis. Without going into detail it required that I gather tiny invisible residues for subsequent weighing. I had to BELIEVE the existence of the residues or my results were wrong.
I get the impression that medical practitioners vary (as do chemists) in their ability to believe in the invisible and take appropriate action. I wonder what steps are taken in their training to develop this skill.
(2) I have scanned all the postings on this site and see no reference to the application of bacteriophage.
This is no surprise. Medicine, like so many other fields of human enterprise, tends to work in "cells" (no pun) and communication is limited. Those who really want to know how to tackle stubborn bacterial infection should visit Grace Filby's website "Relax Well". The bacteriophage approach is over 100 years old and well established in parts of Europe.
Matrons and cleanliness can prevent, but only a bacteriophage can cure.

Alec in Chicago

I am always concerned that freedom of choice and informed consent is restricted to the knowledge you can understand but maybe limited by the knowledge barred to you through lack of experience and wisdom. This can also be altered by the illness itself and the degree of stress (physical and emotional) it causes to the patient? There are plenty of things that none of us know or because of our intellectual or cultural status we cannot know? I am aware of the different financial circumstances of the US health care systems but that does not negate my concerns for those about to embark, for whatever reasons or pressures, on a self-inflicted course of pharmokinetically active treatment. "Ad hoc" refers to the singular action on which you are focused and by what means can you establish the level of competence you have achieved to initiate, implement and assess self medication? At least professional codes of practice and the law give patients reasonable protection but there is very little for those who take it upon themselves to self therapy - no matter how much alleged knowledge they have? I have no intention of frightening you - only my own morality provokes me to point out a few pertinent issues with which I am familiar. Take care.

90, Livilion,
71. LM
""...I get the distinct impression that you do not like persons who either know their job inside and do not need to ask your advice or just don't like people on par with your obvious specialised knowledge...""

Quite the reverse actually.

I am surprised.

What gets me is people who should know better, and ought to be setting the examples, letting us all down.

Me too.

I suppose once you've suffered a bad case of food poisoning you feel more sensitised to the subject.

AS it happens yes, I thought I too was knockin on heavens door.

It's not just about a night stuck on the toilet.

I am aware of that Sir,

In some cases the consequences can be terrible.
eg
John Barr in Wishaw, incurable E Coli O251; 21 killed, hundreds injured, many for life.
Victims having to be carried to hospital in black bin bags full of their own diarrhoea, they were so bad, as their nervous systems and intestines broke down.
http://news.scotsman.com/topics.cfm?tid=678&id=169471...

I remember it well, church outing/fete or similar.

Latours in EastKilbride; salmonella triggered reactive arthritis, £1m+ payout for newly wed's wrecked life.
http://news.scotsman.com/topics.cfm?tid=178&id=221942...
http://www.scotcourts.gov.uk/opinions/2005CSOH146.html

Aye,

When we know how to prevent these hundreds of deaths, and ruined lives, surely there should be no excuse for not preventing them

I suppose like man, bugs will continue to evolve, and I think we are a long way off, complete eradication.

A distressing situation and a lot of pertinent comments.

Alec in Chicago: doctors in the standard profession are trained to listen to patients only to evaluate the objective symptoms. They are not interested in what you say otherwise. The use of subjective symptoms in medecine exists only in certain "complementary" medicines such as modern homoeopathy. A classic book which might help visualise this is Herbert A. Roberts' "Sensations as if..." http://www.homeoint.org/books1/robertsasif/index.htm . I have the same feeling as you, having been to homoeopaths who note the content of what I say, then having to go to the standard type of doctor and emerging with the feeling of not having been heard.

My observations of doctors leads me to conclude that the problem is them. They immerse themselves in so-called scientific professional journals, which they obtain for free of course, because they are paid for by advertisers. These doctors then prescribe and overprescribe the products being pushed.

The producers of new drugs, which may or may not be better than the products which go out of patent and therefore become uninteresting to sell (because any mexican, indian or anywhere generic producer can compete), have limited time to make money to pay back research costs for their new products. They must sell as much as possible -- quantity, quantity, quantity! This is in opposition to the public interest which is to use powerful antibiotics only in emergencies.

MRSA etc are antibiotic-overprescribing problems.

By the way, as far as I'm aware, the best general antibiotic is still an apple (organic by preference).

Oh dear - in trying to inform i broke the rules and was disappeared.
If you want to know how to cure bacterial infection put "Bacteriophage" into your browser. Nuff sed.

# 97
Louisa

You have no idea. Professional codes of practice? The law?

You've never dealt with physicians in the US. Lucky you. Our laws are absurd - and, while they exist, they are not practical for most people who suffer malpractice. Did you know that a lawyer won't take a case that will not return a huge sum, because of the cost of prosecuting a case? figures vary, but, if memory serves, $340,000 was about the midpoint.

We have the AMA [American Medical Association], too, based right here in Chicago. Their interests are the interests of physicians. They only stray into providing for the wefare of the patient when it doesn't conflict with their members' convenience.

If by ad hoc, you mean my taking action as limited to just this case, I cannot guarantee that. If you are referring to the medical approach, as I was, my route is the slightest variation on the standard that is supposed to be followed in medicine - if you can find that elusive physician who isn't too busy patronizing or condescending to the patient, who doesn't make up his mind before he's finished his initial intake interview, who doesn't wait 10-20 years - until the FDA moves, if it ever does... At any rate, I did not make this up: there is that doctor who does it.

Also, I know someone who takes this med, and he knows two people who take it; so I have already gotten patient feedback, which I find more valuable than the usual doctor's warnings.

Further, I know people who are in related fields, and I can call upon them for help. (They did not advise my doing this - although they did not exactly advise against it - but they can answer any questions that may arise.

At any rate, this is way off topic...

As you see, I really have done a lot of searching.

C. difficile is deadly, there is no doubt about that, but there are other things to do besides antibiotics. Probiotics and good (plain) yogurt helps tremendously - read the label on the yogurt to make sure that it has 'live' bacteria. (Probiotics are purchased online, as well as at health food stores),with many million 'good bacteria' to offset what the antibiotics wipe out. The probiotics should be taken at least two hours AFTER the antibiotic.

Pesistance in GOOD hand washing (at least 1 minute with each exposure to patient or patient's things). The probiotics do make a BIG difference. It took one year of gradually reducing antibiotics AND PROBIOTICS for my mother to finally be free of any GI symptoms of her C. difficile. Doctors will not offer probiotics - it is up to the family (or friends) to purchase and administer. These probiotics should be taken even after the patient is off antibiotics, especially if they are elderly as our elders frequently have digestive problems and need a boost.

Talk to someone at health food store who is knowledgable about probiotics - the more good bacteria the better. If antibiotics are given 3 x day, then probiotics should be given 3 x day, but at least 2 hours AFTER the antibiotic. It works!!! Good luck.

We (Grace Filby, Bill Riedel & myself) have been trying to persuade our Glorious Leaders in the UK and Canada to accept the validity of phage therapy as a successfully tried and tested method of combating bacterial infections.

If anyone out there can show proof that phage therapy, as practised in Georgia, Poland or Russia for the last 80 + years, has caused even 1 millionth the amount of damage that supposedly-safe drugs such as Thalidomide, HRT or Vioxx etc have caused, then please tell us.

Phages are 'living' organisms (as far as a virus can be classed as living) which Nature has given us to form a natural balance against bacteria; as bacteria evolve to change their cell wall receptors, which phages dock onto prior to injecting their DNA, phages have also evolved to recognise new receptors. And so the fight goes on. When we frolic in the sea we swallow millions of phages, over which the regulatory bodies have no control. That must make them so mad!

The only reason why the big chemical companies have not run with phages is purely because they are natural and could not be patented. Meanwhile, maybe millions of people have died or had limbs amputated, because bacteria have learned how to deal with an antibiotic, a chemical compound which does not change as bacteria change.

If research continues towards the chemical companies' Holy Grail of phage synthesis and genetic manipulation, to produce their version of 'phages', will these new phages be able to evolve as their bacterial prey changes, or will we yet again be faced with the familiar antibiotics Doomsday scenario where relatively 'unintelligent' bacteria manage to side-step a chemical compound, costing billions to develop?

As someone previously succinctly mentioned, doctors should either Goole "phage therapy" or stop burying their heads in chemical company sales literature and get back to intelligent doctoring i.e. first find out what the specific bacteria is, then

I'd also suggest googling 'Ozone Sanitising'.

http://www.lifetechozone.com/en/whatozone.htm

http://www.ciprocess.co.uk/pdfs/CIProcess%20Presentation%...

Swimming pools and laundries commonly have these systems installed to-date, it is another area of technology which is rapidly coming into it's own for infection control and sanitising.

It works on spores and has an incredibly more effective bug kill than eg chlorine.

Is it not about time to return to nature....therapeutic essential oils are much more effective against things like superbugs than anything else [with no side effects].
The folowing oils will help to combat MRSA:
Tea Tree
Cinnamon
Clove
Oregano
Mountain Savory
Thyme
The following oils will help to protect against MRSA:
Eucalyptus Ratiata
Clove
Lemon
Patchouli
Melaleuca Arternifolia [Tea Tree]
Geranium
Myrrh
Oregano
Thyme
Orange
Grapefruit
Spearmint
Mountain Savory
Anyone interested in preventing or curing MRSA or a similar bug, then check out ww.tounglivingeurope.com [890577number needed if wishing to order any]
Their oils are very pure therapeutic and have been proven at several university studies of preventing superbugs.
They have got a special blend called Thieves, which is very highly anti-bacterial/viral and should be used in EVERY hospital and school to prevent the spread of infection from any kind of viral or bacterial bug.
Anyone ,who cares about their health at all, should become a member of this company now.