The Madwives of New Zealand - another baby dies
When I was studying law, Patrick Atiyah was Professor of Law in Australia. Within legal circles he was best known as a proponent of “no fault” compensation for personal injuries. There is much to be said for it particularly when we consider the fate of a foetus, severly injured during labour. In England, a birth-damaged child’s chance of compensation depends solely on his lawyer’s skills in proving fault on behalf of the doctors and midwives. Did Mr Jordan pull too hard and too often on the forceps when trying to deliver Mrs Whitehouse’s baby?
"The recent decision of the House of Lords in Whitehouse v Jordan brings to an end a sorry tale of protracted litigation surrounding this case of alleged medical negligence….the importance of the Whitehouse case lies not so much in its clarification of the relationship between medical negligence and the concept of “error of judgement”, but rather in its underlying indictment of the present system of compensating victims of medical accidents.” (Whitehouse v Jordan)It is a complex and fascinating area of law. In Britain, and particularly in the USA, the ever present risk of a negligence claim makes it essential for all doctors and midwives to have proper professional insurance. For the US obstetrician this is becoming prohibitively expensive. For the British “independent midwife” (many of them madwives), who insist on working outside the NHS, professional insurance is no longer available. No commercial insurance company is prepared to underwrite their idiosyncratic professional behaviour.
It is different down under in New Zealand. Professor Atiyah’s dream of “no fault” compensation has come true. A reader from New Zealand writes in to say:
In keeping with your previous posts on birthing outside of hospital (in a seemingly bizarre place run by a company known as 'Birthing Units Ltd') & more insight into the international madness of midwives, I can recommend a recently published report by the Health & Disability Commissioner here in New Zealand (basically a government appointed commissioner who investigates complaints against anyone in the health sector) into an appalling catalogue of cock-ups that led to a neonatal death.It is indeed a detailed report. It contains a catalogue of errors, incompetence, indifference, and attempted cover-up, at the end of which there is a dead foetus. What happened to the independent midwife?Midwife, Ms DMidwife, Ms EObstetric Nurse, Ms FA Birthing UnitA Report by theHealth and Disability Commissioner
It's fairly long & detailed but deals with similar themes to those you raised - what happens when private companies or individuals are allowed to run midwifery services. Over here everyone is covered by ACC (Accident & Compensation Claims), essentially a national insurance policy, so the midwives are allowed to roam free without fear of tort. The upside is that no-one can sue for damages which makes for a refreshingly open & honest healthcare system with no-one practising defensive medicine; the downside is as previously described - midwives roam free, unfettered by self-awareness.
The Tribunal found these actions amounted to such a significant departure from the accepted standards that discipline was warranted, it upheld the charge of professional misconduct. Penalties includedIs that enough? In England, this midwife would probably have been prosecuted for manslaughter. This report makes me shiver. Be warned. If the government gives in to the independent midwives and provides them with state (aka taxpayer) underwritten indemnity insurance, there will be no controlling them. Tragedies like this will become common place in the UK.
- supervision/monitoring of the midwife for a period of two years
- a limit of no more than four midwifery cases per month for a year
- a recertification audit by the Midwifery Council
- a New Zealand College of Midwives Midwifery Standards review
- a fine of $2,080.00
- a penalty of censure.
Labels: independent midwives, madwives, no fault compensation, professional insurance
29 Comments:
"For the British “independent midwife” (many of them madwives), who insist on working outside the NHS..."
Dr C - why the use of the word 'insist'? These midwives 'CHOOSE' to work outside the NHS. Presumably most were trained with the NHS then decided to work independently.
So the question is, do these midwives make this decision because they can offer a different and more personal care model with continuity, or do they do so largely because of incompetence?
And why exactly do you even care about this? Other than to use it as an opportunity to malign what is technically a competing profession.
The fact is insurance is simply a numbers game.
For the US obstetrician this is becoming prohibitively expensive Now I wonder why that would be? Of course you hear the same thing from 18 year olds when they try to insure a Subaru WRX.
Obstetric insurance is expensive all around the world. Fortunately they have strength in numbers. Insurance companies like that. It gives them meaningful statistics to calculate premiums. Then the fuck-ups can be offset by those heavily loaded premiums. Just think how much their insurance would cost if there was only a handful of them, like those madwives for example. Jeez, I bet it would be really, really expensive then. In fact they may not be able to get it at all.
Then perhaps the government would bail them out. Like they did in Australia co-incidentally.
Oh well, what goes round comes around.
They insist on working outside the NHS because the boring old NHS will not tolerate their methods.
+++++
Why do I CARE about it? Because I hate children sustaining avoidable birth trauma because of the odd practices of these women.
And it is not primarily a numbers game. It is about actuarial risk assessment.
John
Interesting John. I'm afraid I'm very sceptical about Doctors CARING about anything other than their self-importance. The money is a nice of course, but isn't the driving force, however it sure as hell isn't patient care either.
If doctors cared so much about patients why don't they simply train as paramedics, nurses or (gasp) midwives? Na, it would never satisfy their superiority complex. Ironically the years of training and long hours as an SHO actually fuels their self-importance even further. Such martyrs need our respect – they think.
I suppose lawyers care about justice or my mechanic cares about my car? You can believe it, but I won’t.
Risk assessment is a fine phrase, but it’s simply semantics. Insurance is done purely off statistics and probability, hence a numbers game. There is no other way. I suppose we could say insurance is for pompous bookies.
A holistic therapy provides a complementary alternative healing method to standard medicine. Holistic natural health education and health care includes alternative natural health remedies, like herbal healing, and an abundance of health and wellness products and services. http://natural-health-care-information.blogspot.com
I'm afraid I'm very sceptical about Doctors CARING about anything other than their self-importance.
If you read some of the other blogs, you should be able to feel that there are doctors who care for their patients. I personally know a lot of doctors who really care for their patients. And why we didn't become nurses, because we wanted to learn to help people to the best of our ability, and therefor did a study on the highest level. Cryptic automaton, you are too sceptical. Hope you will meet a caring doctor when you need one.
As long as they continue feasting on swans, I will continue to have doubts about the compassion of the savage Brits.
There was another New Zealand case recently in which a baby died at a homebirth and the midwives were censured after the parents demanded and investigation. The midwives failed to call for back up when they could not hear the fetal heart, and the baby was born with a pulse of 60 bpm 30 minutes later. Resucitation efforts, which, of course, did not include intubation, were unsuccessful. Only then did the midwives call for an ambulance.
According to the report of the investigation, the midwife recounted that:
"At birth it was noted that [the baby] had no tone, no refle[x], made no effort to breathe, was blue and had a heart rate of 60bpm...
[Ms G] was unable to detect a pulse in the cord and so listened with the stethoscope. [The baby] was immediately stimulated and I attempted to inflate his lungs with oxygen bag and mask, but was unable.
[Ms E] then suctioned a significant amount of mucous from [the baby's] mouth and nose and successfully started artificial respiration. At this time the heart [rate] was low and I began chest compressions. [Ms E] and I continued CPR.
I reassessed [the baby's] heart rate and stopped chest compressions because it was 120-140. [Ms E] continued bagging because he had made no effort to breathe on his own."
The report continues:
"At 6am, the ambulance arrived while Ms E and Ms D continued their attempts to resuscitate [the baby]. At 6.10am, the cord was clamped and cut, and there was no pulse in the cord. [The baby's] HR fluctuated between 80-140bpm, and he was toneless. At 6.15am, it was noted that [the baby] was becoming cold, and attempts were made to warm him with hot towels, hot water bottles, and skin-to-skin contact with [the father]. No HR was detected at 6.20am. At 6.23am, the ambulance departed from [the mother] and [the father's]home... Shortly afterwards, at 6.28am,the ambulance arrived at hospital.
On admission to the hospital's Emergency Room, [the baby] was intubated and manually ventilated, and Ms A delivered the placenta with the ward nurses' assistance. He was then transferred to the neonatal unit for review. The paediatric team advised [the mother] and [the father] in the presence of Ms D, Ms E and Ms G that [the baby's]prognosis was poor, and a decision was made to withdraw active treatment. The ventilator was disconnected and, after several intermittent gasps, [the baby] died in [his mother's] arms at 10.40am."
The mother has spoken out about her care and the preventable death of her child:
"Lynne Jamieson, now of Queenstown, said midwives should be better trained in communicating with mothers and should also receive nursing training.
Jamieson's baby, Erik, died in July 2005 after complications during his home birth saw his heartbeat slow and stop.
A Health and Disability Commission report into the birth censured the two midwives involved lead midwife Lana Kroll, now living in Canada, and back-up midwife Hannah Mae, who has now left the profession.
Commissioner Ron Patterson said Kroll failed to provide Jamieson with reasonable care and skill, failed to document the progress of the labour adequately and did not communicate with Jamieson when complications arose.
Paterson said Kroll's inaction in calling specialist help when she could not detect a heartbeat deprived Erik of a key opportunity to save his life...
"I had three women attending the baby but, because they were so inexperienced in emergency situations, they did not function well and could have got Erik and I to hospital sooner.
"The Midwifery Council need to look at situations like this and take them more seriously," said Jamieson..."
The Midwifery Council denied that there was evidence of improper care:
"Council chairwoman Sally Pairman said Jamieson's case was tragic but stood by the competency of the midwives who attended the birth.
"I think it's difficult to make a jump from one very tragic outcome to saying that she (Kroll) wasn't competent or that she shouldn't be able to look after a woman having a baby at home," Pairman said."
Anom at 7:19
Swans are are protected species in the UK.
Give me names and times.
And obstetricians have never overseen the preventable death of a baby? Miraculous.
Fx
Dr Dr Crippen
Allow me to prepare the first line of your next comment:
'You just don't get it do you?'
Carry on...
Swan eating savages!
Cryptic automaton,
Many of us got asked that question (why not be a nurse etc) when we had medical school interviews.
The answer is because we (well i can only speak for myself) really do want to help, the reason for not being a nurse? Nurses have limited powers and can only intervene to a certain point.
I have had a ouple of jobs before medical school, one that paid a fair bit more and one that (well i think) had a lot more of a wow factor and really did get a lot more respect.
Not everyone (and i dont even think most) go into medicine to stroke the ego.
Oh my goodness-stroke the EGO, are you KIDDING? Clearly you don't know any doctors personally. Since becoming a doc I have been treated so shabbily, with so much disrespect and lack of regard for me as an employee, as a human being, and spoken to so rudely that my self esteem is about that of a small invertebrate. Patients scream at you, often threaten you, and take their frustrations out on you despite anything you do to try to help them. Nurses are aware that you are in a position of vulnerability as a junior and often exploit this mercilessly and verbally abuse you too. Management treat you like a piece of shit, force you to work the hours they tell you to-not for TRAINING, don't make me laugh, but for service provision, even if that is a 50 hour SHIFT with no break for sleep. Everyone hates you, and the pay is astonishingly low for the level of responsibility. I went into medicine not for money, not even primarily for caring, but because I found it fascinating and thought that a career in something as interesting and with so many interesting branches and constant development and research would be a wonderful thing to be part of for the rest of my life. Of course I thought it would be great to use all this knowledge and science to help people and see it put into practice as well. But the working environment and hatred levelled at you-wow. I'm planning to get off the frontlines soon. Maybe there is a place in the world of academia for me.
"If doctors cared so much about patients why don't they simply train as paramedics, nurses or (gasp) midwives? Na, it would never satisfy their superiority complex. Ironically the years of training and long hours as an SHO actually fuels their self-importance even further. Such martyrs need our respect – they think."
I don't understand this reasoning at all I'm afraid. If everyone did that there wouldn't be any doctors at all. Who would we go to when we get sick? I find it a bit strange that you don't think that mechanics or lawyers care about cars or justice. I think you may be confusing emotional caring with healthy interest in one's job and a desire to see it performed well and furthered as a profession. No, your mechanic may not emotionally care and love your car (would be a bit strange-checking the oil would have a whole new meaning!) but I bet he enjoys tinkering around with all the different parts and putting them together and looking around to see what the problem was. I know a mechanic or two, and they (both male of course) think they are in hog heaven messing around with cars and engines all day and getting paid for it. They love their jobs. Law is interesting too-how could you think it wasn't? Every case would present a completely different challenge, to be approached in a different way and learned from. I think quite a few lawyers enjoy their jobs and like doing well at them. You seem to think that if you get paid for a job that you are incapable of being interested in it, enjoying it or wanting to do it well-having pride in your job. Well, everyone gets paid for their jobs. You have to remunerate people for their work. I do think that people who work with people,particularly in healthcare get some extra motivation to do as good a job as possible when they meet the people for whom they will be doing the job. When I worked in oncology we pushed extra hard for every little thing to be done for our patients because we saw what they were going through and wanted to make their already difficult path as smooth as possible for them-we even provided a walk onto the ward service where they could come and see us instead of their GP if they needed something or were worried specifically about a symptom that may or may not pertain to their cancer. This caused serious disruption to our working day and was not convenient, but we did it because-I don't know why-this may illustrate: one consultant told me once, whenever you're tired or you're not sure what should be done-say to yourself-if it were my father or mother in that bed, what would I want done? This has gotten me through some tired moments I can tell you. You want a good service to be there, not just for the patients now, but for yourself, your parents, your children, your friends. All of your patients are someone's friend, parent, child, and someone cares about them as much as you care about your family. If you think about it that way, that makes you do the extra little bits when you're tired and upset. Sadly, people want us to suffer so much for daring to want to be doctors that most of us who do give a shit are leaving. Oz and NZ are getting a pretty good crop of caring docs though-they treat us well and don't hate us!
Why are you so cynical about people liking and wanting to do well at their jobs? Do you hate your own job and not care how you perform at it? I don't understand why you would think that some of the most interesting and responsible jobs people can do are only done for an ego boost and money-that's politics and investment banking I think.
Cryptic,
Just to correct you on a couple of things. Firstly, I didn't get into medicine for the ego or money... I got paid more and got more ego stroking as an IT consultant. I went into medicine because I wanted to make a difference to people's lives. Trite? Perhaps, but true all the same.
Why didn't I go into nursing? Well, primarily because I come originally from a science background. And being a doctor is taking science to the patient. And I love the whole surgery process.
And secondly, your understanding of insurance is very simplistic. Yes there is an argument to be made in strength in numbers, particularly when compensation turns out to be huge.
Sadly, it is not a handful we are talking about here. And if their practices were safe, they would be an excellent insurance risk, especially considering they take on (supposedly) low-risk patients.
But cases like the above illustrate why they are a bad risk. The major problem is that they are isolated, both mentally and physically. They prefer not to involve the expertise of a hospital unless absolutely necessary, and when they do, being at home or at a separate "birth suite" it is too late.
Also, you briefly comment on the Australian situation to back up your argument is totally flawed. Whilst Ob's insurance premiums are quite high, the "bail out" you refer to had more to do with public liability rather than professional liability and were the result of frivilous law suits closing playing fields and people going under because some drunk jumped off their fence.
Legligence laws have not changed since the reforms.
So unless you have something real to argue from. Let's just drop the pretence and say you just don't like doctors.
If you read some of the other blogs... Yes I do like Dr Rant – He gives it to the man! Society is full of caring people, including a few Doctors. What I'm saying is the vast majority of Doctors are not in their profession because they are more compassionate than the next person. For example this blog could be used to bring public awareness to medical incompetence (OK, just pretend it happens). Instead we have an anonymous Doctor who's spends an inordinate amount of time selectively lambasting other health professionals who've made the news. All to the exclusion of his own (superior) discipline mind you. Are we likely to hear about his unhappy clients or don't they exist? Do Doctors ever make fatal misdiagnosis or mistakes? Well as we know they are fortunately kept in the system. We wouldn't want the ambulances broadcasting them over the airwaves so the paparazzi can get a juicy headline. Do any Doctors here fancy blowing the whistle on some of the fuck-ups they've encountered? That is if you really care about alerting patients to bad care. Or can't Freemasons do that?
The thing is incompetence and mistakes exist in every profession. That includes Doctors! However, it seems the negative publicity is not distributed equally.
Then Amy Tuteur M.D roles up, espousing her usual rhetoric. Now you'll notice it's not just Amy or Amy Tuteur, but Amy Tuteur M.D. Not that she's full of self importance or anything. How uncharacteristic. How many of you doctors never use your title outside of your practice I wonder? What's on your driving licence? Exactly! I once lived with a Doctor. She had been out of practice for about ten years and was in reality unemployed. Yet all her post was addressed to her “Dr” title. Always made me laugh.
Ellie you made a long retort so it's worthy of at least an acknowledgement. You admit you didn't become a doctor for the sake of “caring”, which is exactly my point. If all the really compassionate Doctors became nurses we would still have an abundance of them because only a small proportion of them are exclusively in the role for the sake of the patient. Even those that might have started out with that ideal, are now simply lost in the daily grind. They may even be passionate about it, but that doesn't mean they are not trying to enforce their agenda over the patient's.
So you want to help people. How many doctors here, if they were in another profession, would be giving up their free time to help the Samaritans, AA, or St Johns. All for no money or status. Not many I bet.
Anonymous, did you seriously get an ego boost from being an IT consultant. You have got to be joking. How does the classic consultancy saying go “If you're not part of the solution, there's good money to be made in prolonging the problem”. Looks like you've taken it to your new profession. You should have found some other way to make a difference. To be honest I don't dislike Doctors at all, yeah they generally lack humility, but there's far worse occupations (IT consultancy for example). This doesn't seem the place to discuss them though.
Finally this blog entry is about a baby dying in NZ. Dr Crippen cares no more about that baby than anyone else who might have read the story. However, what he does CARE about is ostracising a profession that he believes should be under the complete control of physicians. All you midwives bow down to the master. None of you are worthy. That is what this post is really all about.
Instead we have an anonymous Doctor who's spends an inordinate amount of time selectively lambasting other health professionals who've made the news. All to the exclusion of his own (superior) discipline mind you
Guess you haven't read the posts on Andrew Wakefield (a Doctor in case you didn't notice) then...
I think you have missed cryptic automatons point, anonymous (at 8:20).
Wakefield may a maverick, but Dr Crippen has never implied he reflects badly on the medical profession AS A WHOLE, i.e. one rogue doctor, is just that, a clever bastard, perhaps, tormented by his own genius, who has lost his way ?
No, Dr Crippens fundamental polemic is that ALL non-doctors (who practice autonomously) are:
[1] dumbing down health.
[2] incapable of lateral/creative thought.
[3] have no insight into what they do not know.
A lexicon has emerged to prop up these assertions, "madwives", "monkeys", "noctors" etc are all familiar terms to regular visitors.
The health scene IS changing - largely because of:
*cost (present NHS expenditure exceeds £100bil).
*technology - more drugs/toys, etc.
*demographics (growing/ageing population) - look at the latest Kings Fund report which estimates that by 2026 more than a million will suffer with dementia and the cost of care will increase by 135% (from £14.8 to £34.8 billion).
The UK has a low doctor-patient ratio when compared to France, Germany & Switzerland, or indeed Italy, or the Netherlands - we could do with a few more doctors, that goes without saying.
http://www.civitas.org.uk/nhs/downloads/NHS_staff.pdf
But doctors, nurses, midwives squabbling amongst themselves is an unedifying situation, and one that will do little to address the needs of our patients.
Of course, it is perfectly fair to highlight dangerous practice but the crass generalisations that tend to get tagged onto the back of these incidents invariably precipitate a fresh bout of mudslinging - fun, admittedly, but hurtful, too ?
Ummmm...despite the fact that no doc friend of mine puts "doctor" on all their correspondence etc, why the hell shouldn't they? They worked hard for a hard qualification and they ARE doctors. You seem to think that being who they are and being honest and proud of their achievements is arrogance. That's truly a strange attitude. Your housemate-obviously NOT your friend-was a doctor. So why is her post being addressed to her as "doctor" offensive? Holy hell, only in the UK....And what on earth is a doctor's "agenda"? I don't have an "agenda" that I know of. I want to do my job, treat patients, learn and become well trained. OOH-what an evil person I am.
"So you want to help people. How many doctors here, if they were in another profession, would be giving up their free time to help the Samaritans, AA, or St Johns. All for no money or status. Not many I bet."
Do you do charity work in your free time, cryptic? I think you are one of those people that think that doctors should dedicate all their lives, both working hours and non working hours to helping people because they are answering some type of holy calling....that's just bizarre. Yes, it's nice and professionally satisfying to help people as part of your job, and to feel you are doing a good job for people. But why do you think we are supposed to me martyred angels, caring being our only job or function on this earth. Caring about patients is an important part of our job, but much smaller a part of it than you actually know. We are also committed to delivering scientifically sound evidence based healthcare, improving standards, continuing education of health professionals and public alike, and continuing research and development into new therapies and treatments. Yes, these things should be delivered in a polite, professional and sensitive manner. But saying that "caring" is all it takes-well what about pathologists? What about radiologists? Histologists? Microbiologists? Surgeons even? All aspects of medicine do not require warm fuzzy cuddly individuals. You need brains, tenacity, hard workers, commitment to high standards and academic excellence. First off. Training on how to deal compassionately with patients is important, but providing them with a high standard of appropriate treatment comes first. That is what I am committed to. I care that people suffer and die in a dysfunctional system, but on a few more levels than you think. There is no reason one should go into an academically demanding, uphill struggle like medicine for the sake of "caring" and only caring. I am not saying it is not important-but it is not as central a part of the job as you think. You should care about the individual patients-but also care about the state of the system they are in, the efficacy and safety of the treatments they are getting, your ongoing ability to assess the above, the reliability of the diagnostic tests you use for them, the research and possibilities for the future for them, and teaching these things to others who will have to step into your role and maintain and improve current standards. Caring about the patient-in short-is NOT enough to be a good doctor-though it is a start. You need to care about all of the above, and have the brains, courage and willpower to take it on. If you don't like that, or see it as arrogance, then that is a shame-but that is the reality. People who care about patients alone will bring down the standard of patient care for everyone. Medicine is a multifaceted job, and it is not that simple.
Ummmm...despite the fact that no doc friend of mine puts "doctor" on all their correspondence etc, why the hell shouldn't they? They worked hard for a hard qualification and they ARE doctors. You seem to think that being who they are and being honest and proud of their achievements is arrogance. That's truly a strange attitude. Your housemate-obviously NOT your friend-was a doctor. So why is her post being addressed to her as "doctor" offensive? Holy hell, only in the UK....And what on earth is a doctor's "agenda"? I don't have an "agenda" that I know of. I want to do my job, treat patients, learn and become well trained. OOH-what an evil person I am.
"So you want to help people. How many doctors here, if they were in another profession, would be giving up their free time to help the Samaritans, AA, or St Johns. All for no money or status. Not many I bet."
Do you do charity work in your free time, cryptic? I think you are one of those people that think that doctors should dedicate all their lives, both working hours and non working hours to helping people because they are answering some type of holy calling....that's just bizarre. Yes, it's nice and professionally satisfying to help people as part of your job, and to feel you are doing a good job for people. But why do you think we are supposed to me martyred angels, caring being our only job or function on this earth. Caring about patients is an important part of our job, but much smaller a part of it than you actually know. We are also committed to delivering scientifically sound evidence based healthcare, improving standards, continuing education of health professionals and public alike, and continuing research and development into new therapies and treatments. Yes, these things should be delivered in a polite, professional and sensitive manner. But saying that "caring" is all it takes-well what about pathologists? What about radiologists? Histologists? Microbiologists? Surgeons even? All aspects of medicine do not require warm fuzzy cuddly individuals. You need brains, tenacity, hard workers, commitment to high standards and academic excellence. First off. Training on how to deal compassionately with patients is important, but providing them with a high standard of appropriate treatment comes first. That is what I am committed to. I care that people suffer and die in a dysfunctional system, but on a few more levels than you think. There is no reason one should go into an academically demanding, uphill struggle like medicine for the sake of "caring" and only caring. I am not saying it is not important-but it is not as central a part of the job as you think. You should care about the individual patients-but also care about the state of the system they are in, the efficacy and safety of the treatments they are getting, your ongoing ability to assess the above, the reliability of the diagnostic tests you use for them, the research and possibilities for the future for them, and teaching these things to others who will have to step into your role and maintain and improve current standards. Caring about the patient-in short-is NOT enough to be a good doctor-though it is a start. You need to care about all of the above, and have the brains, courage and willpower to take it on. If you don't like that, or see it as arrogance, then that is a shame-but that is the reality. People who care about patients alone will bring down the standard of patient care for everyone. Medicine is a multifaceted job, and it is not that simple.
A&E CN.
As a very junior one of the most hurtful aspects is that the "leveling" of the playing field seems to mean to nurses "give the doctors as much shit as possible".
Now i know many more good nurses than bad as i do doctors but i never thought i would be treated as badly as i have by nurses and other ward based staff.
I never expected the nurses to be blindly obedient or however they were in the past but i did expect them to be polite or even just friendly.
I am a bit taken aback by the attitude of many when all i want to do is get on with those i work with...seems to be a common theme amongst the new doctors. It seems to me that nurses have an attitude of "lets pay them back". You have been around a while as you say...was it really so bad that the more senior nurses are that bitter towards doctors to take it out on the juniors?
Thanks, funny pseudonym - I believe it's who you are that really counts (in the long run) irrespective of job title.
Take our host - his posts (over time) have generated incredible interest: he is now, without doubt, the big daddy of the (medical) blogsphere.
This is no accident, he has attained emminence (IMHO) on the basis of the Dr Crippen persona, a sort of "every-GP" with strong, yet essentially humane opinions concerning the issues that interest us so much.
It is very difficult for a nurse to comment on your situation (because I have not walked in your shoes) but my instinct is that life for newly qualified doctors has long been nigh on impossible, and might have been even worse pre-EWTD (leaving aside the MTAS debacle).
You lot are routinely expected to:
*adapt to a series of new/different clinical settings.
*carry out most the 'donkey work' for senior docs.
*put up with meagre pay.
*endure long/anti-social hours, etc, etc.
I can ceratinly see why a shitty attitude (from nurses) only compounds these frustrations.
How to avoid 'us & them' is a very interesting question since it seems to be a universal problem that permeates the health system (be it, hospital vs community, surgeons vs medics, docs vs nurses, etc, etc).
I don't pretend to have an answer of course, but tuning into forums like this at least gives us an opportunity to develop a dialogue ;o)
http://www.gmc-uk.org/concerns/hearings_and_decisions/ftp/20080421_ftp_panel_visnjevac.asp
therefore all doctors are rubbish.
(Only joking! Of course not all doctors are rubbish, but the logic goes the same way...and there are plenty more GMC judgments to look at if you want to....)
Why not post a breakdown of 2007 perinatal mortality statistics - there must be an Obstetrician vs Madwyfe League Table available somewhere?
Ye Gods.
Anon @ 7:46
I strongly suspect that stats for 07 won’t be available for a while and even when they are the numbers will be too small. Why don’t YOU do some research.
Dr Crippen, Thanks for the insightful, and disturbign comments on the madwives. Here is NZ it is almost impossible to have a GP as your 'primary lead car-giver pompously titled person'. The madwives rule, due to some misguided feminist policy, which is of course cost-cutting dressed up as choice.
A good friend recently miscarried at 11 weeks. 8 weeks earlier it was suspected her pregnancy was ectopic, and so she was scanned and this was excluded. However the radiologist reccomended a follow up scan in 4 weeks, as she had concerns. The midwife told my friend this was completely unnecessary (having the superior knowledge of all aspects of medicine, that only 3 years of polytech can provide). Now my friend has been told she was carrying a dead fetus for a month, something the scan could have indicated. But oh, that's not hard to deal with, for a women in her mid-thirites to have grown attached to a much hoped for pregnancy. Much easier than dealing with those silly doctors, who want to medicalise a pregnancy.
N.B. Is the use of medicalise in this manner a trigger for rage in others, as it is for me? One can only hope post-graduate education would have at least prevented this language mangling!
Good article.Especially the language.We end up with a justice system again, where many innocent people are locked up again on the basis of an anonymous witness who may have a grudge financial interest etc in cooperating with the Police or whoever wants the defendant put away.
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Im not a doctor or a midwife and accidently found this page during a search regarding maternity care. I did however want to write as I am amazed that so many professional people can be so scathing toward each other especially considering they all claim to want the same outcome. Also I thought it was unfair that isolated cases kept being bought up and treated as absolute fact, especially by such obviously intelligent people. Im sure we can all agree that occasionaly mistakes and accidents happen, but is this reason enough to site these cases and trash each other professions? As I said Im not a doctor or a midwife but even so I would still not like my profession to be judged by the few unfortunate cases where things go wrong or associates make mistakes or by sweeping judgemental statements regarding our work. Is there not a way that you can each work together and be collegues? If so surely this would benefit the families you all care for
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