Categories
Health

Sinéad O Connor – prurient coverage masquerading as public-interest journalism

Like many others, I’ve watched in dismay as Sinéad O Connor posted a series of anguished Facebook entries that showed she was going through an extremely difficult period in her life. Those posts gave reason to believe she might take her own life, but luckily somebody made contact and now Sinéad is being looked after.

That’s all I need to say about it. You have the entire story in that paragraph.

I don’t need to repeat every word of every post, line by excruciating line and yet that’s exactly what certain journalists are doing, while dressing their stories in a veneer of public interest.

What’s worse than gutter-press red-top journalism of the Rupert Murdoch kind?

Hyena journalism, that’s what. Muck-raking masquerading as responsible reportage.

There is absolutely nothing to be gained by repeating the intimate details of Sinéad O Connor’s Facebook posts which I sincerely hope will be removed soon.  I didn’t need to see them and I certainly won’t be reproducing them because to do so would be to compound the woman’s pain.

These posts were placed on Facebook by a very vulnerable person and any responsible journalist should know that. Too many people have viewed them already and it serves no useful purpose to spread them around even further, apart from a venal desire to attract readers.  Even though they were placed on a public forum, they should only be replicated with the express permission of the person who created them once that person is feeling safer and less vulnerable.

Publishing these posts at a time when the person who wrote them is still so vulnerable amounts to an act of humiliation and exploitation. And any journalist who claims otherwise is simply a hypocrite.

____________________

Elsewhere.

Samaritans’ media guide on reporting suicide. “Avoid reporting the contents of a suicide note”.

 

 

Categories
government Health

Health Service Executive has disrespect and sloppiness at its heart

Today I finally understood the reason why our Health Service Executive is unable to deliver a modern health service.

Today I accompanied an elderly relative to hospital for a simple outpatient procedure, and I saw a highly-trained specialist nurse wasting a full half hour transcribing information from one file to another by long-hand. I saw a highly-trained professional struggling to read notes written by a doctor who, in his infinite arrogance, couldn’t be bothered to write clearly and who therefore endangered a patient.

This is the country Enda Kenny claims is at the leading edge of information technology, and yet our health service doesn’t know what its patients are doing unless a vital highly-paid professional laboriously writes it out time and time again.

Database systems have been in existence for many decades. Most developed societies have properly-designed computerised records of patients available to all health professionals at the touch of a button. This is not some sort of groundbreaking new technology, except in Ireland, so why was I surprised at the 1950s technology still pervading our public health system?

I shouldn’t have been surprised, since the reality is that the 1950s technology is also the 1950s mindset.

The people who run the Health Service Executive are trapped in the past and until the government understands this, nothing will change.

I’ve been talking about the malaise at the heart of the system for many years but at the same time it’s easy to blame systems when in reality it isn’t a system that humiliates or disrespects a patient.

The system doesn’t disrespect patients. People disrespect patients. Bad nurses disrespect patients. Arrogant doctors disrespect patients. Slovenly domestic staff disrespect patients. Sniffy administrative staff disrespect patients. And all of those people should know better but many can’t be bothered.

Ultimately, though it isn’t their responsibility, since a properly-functioning system should do three things:

A working system should educate them to understand that respect is vitally important.

It should warn all health employees that they are the employees, not the masters.

A functioning system should impress on medical consultants that they are simply employees paid by the public and that they are obliged to show respect to their customers.

If none of that works, a properly-functioning system should remove people  from their jobs when they fail to meet the appropriate standard, but ultimately, none of this works if disrespect and sloppiness are at the heart of our society.

Is it as simple as that?

Do we tolerate doctors with a god complex (people whose education we paid for) and administrators who treat us like dirt because that sort of thing is embedded in the nature of who we are?

Do we tolerate condescending receptionists and gruff nurses because that’s how it has always been?

Are we simply a disrespectful society? Are we a bunch of ill-mannered boors and is that why we have a boorish, ill-mannered, incompetent arrogant health service?

Sadly, I suspect we are.

I  suspect that the Health Service Executive is no more than a reflection of the sloppy, arrogant, class-ridden, incompetent, slovenly society we have created for ourselves.

Isn’t it time we changed not only the Health Service Executive but the way we behave?

Categories
Health

Scandal of old people on hospital trolleys

How many ninety-year-olds now have been left for a full day or more on hospital trolleys in Irish A&E departments?

It doesn’t matter.

What matters is that our health service has been hijacked by employees with no medical training and no managerial expertise, people whose only skill is passing civil service interviews.

This is the class of people who have decided that a person with cancer, even if they happen to be a regular patient,  must go through A&E with the drunks and the junkies if they feel unwell. This is the class of unfeeling pen-pusher who might decide to defer treatment for women with breast cancer in order to make the administration easier for them and their subordinates.

This is the sort of individual, as we saw in the case of Tallaght Hospital, whose first instinct was to investigate how the scandal of an old person on a hospital trolley was leaked to the press before trying to understand why such a thing should have happened in the first place.

Make no mistake about this.. The word “management” is a misnomer in the HSE, just as it is in the Irish public service as a whole. Old people are not lying on hospital trolleys because of bad management.  Women with breast cancer are not being herded together like cattle because of bad management.  These things are happening because it suits the needs of administrators — the same administrators who started their careers in the HSE and local authorities as junior clerks, and who never managed to escape their limitations.

These people joined the local council at an early age and spent the first ten years of their careers issuing dog licences.

People in the care of the HSE are dying because the dog-licence people somehow came to be called managers, and what’s worse, came to think of themselves as managers when in fact many of them are hardly fit to keep track of the photocopier.  TK Maxx has a lot to answer for.

How do we solve the problem of the HSE?

I don’t know. Now that so many administrators have persuaded themselves that they really are managers and not just jumped-up clerks, perhaps the only answer is to buy them off with a handsome pension because in the end it might be cheaper. The only way, in my opinion, to run a proper public health service is to put experts in charge. Nurses, doctors, physiotherapists. People with real-world experience of health care and real managerial skills.

What’s the alternative?

An endless history of terrified, sleep-deprived old people tortured on emergency-department hospital trolleys?

 

 

Categories
Health

Mental illness. The Asylum – an attack on the most vulnerable in our society

the asylum bruff

We live in a time when mental illness is plucking our young people from among us and flinging them into the same river we hold as our defining emblem. We live in this time when men and women of all ages are thrown to the bottom of despair and choose to take their own lives, to the utter devastation of those who love them. We live in a time when the victims of our dreadful economic crash find themselves on their knees, powerless, and often homeless, unlike those who had the financial means to weather the storm and perhaps even gain from the poverty of their brothers and sisters.

But we also live in a time when we have abandoned words like Lunatic, Imbecile, Madman and worst of all Asylum.

For many years in this town, as in similar towns throughout Ireland and Britain, the word Asylum carried with it the most appalling overtones of opprobrium, of judgement, of belittlement, and more often than not such judgement came from the most ignorant among us. The most ignorant, the least informed and perhaps the most insecure.

Lunatic asylum

I once knew two brothers who looked different, dressed in a different way and behaved in a manner so different that I asked one of them — the better dressed — if they really grew up in the same little house in the same little street in Limerick.

Of course we did, he said, unconsciously fingering the silk handkerchief in his blazer pocket. Why do you ask?

Oh, I said. It’s just that you have completely different accents.

False accents. That’s what insecurity will do to you and that’s what put our people in asylums.

But we threw off that ignorance. We stopped incarcerating our most vulnerable people in the prisons we called asylums. We stopped inflicting electro-convulsive therapy on those who wouldn’t conform to our notions of normality.  We stopped locking people up in mental institutions for becoming pregnant, for being atheists or for having a claim to the farm.

We stopped treating mentally-ill people as criminals and began to understand that mental illness is part of all of us, each and every one. We began to understand that everyone can become depressed from time to time and we started to accept that. We began to realise that a person suffering from schizophrenia or bipolar disorder isn’t an axe murderer but simply another one of us who needs support and encouragement to continue as an equal member of society.

Or so you’d think until you come across a cheap gimmick calling itself The Asylum. This is a horror experience set in an old building in Bruff, County Limerick where you can go to be terrified by actors posing as mentally ill people.

How classy is that?

Let me quote.

The Wailing Ward – An unknown virus has infected the patients and staff of St. Griselda’s Mental Asylum turning them into blood crazed mutants . They love to have visitors but hate to see them leave!!!!!

The Skullery – Clarice and Dexter Draco the deranged maniacs have escaped the ward and await your presence at Dinner in The Skullery.  You’re all invited, but who‘s on the menu,  Could it be you?!

Sanctuary – The occupants have fled the asylum to take refuge in the chapel only to discover that Fr. Archiprete and his congregation have been badly infected with the virus and are constantly on the hunt for their next victim.  Are you next???

Got that?

St Griselda’s mental asylum.

It wouldn’t have been enough to present the experience as a standard horror show that nobody objects to. Instead, the people who dreamed up this concept thought it would be appropriate to stigmatise mental illness, as if it hadn’t been stigmatised enough already by ignorant clowns.

Imagine what the reaction would be if they advertised their horror show a different way.

Spastic Attack – An unknown virus has infected the patients and staff of St. Griselda’s Hospital for People with Physical Disabilities  turning them into blood crazed mutants . They love to have visitors but hate to see them leave!!!!!

That’s really going to work, right? And nobody will be even slightly offended.

How about this?

Direct Provision DreadAn unknown virus has infected black people at St. Griselda’s Direct Provision Centre ,  turning them into blood crazed mutants . They love to have visitors but hate to see them leave!!!!!

No.  That doesn’t work either, somehow.

Now, I know who’s behind this idiocy and so do many other Limerick people. I won’t name them yet, but when the time comes I’ll be very happy to list their names even though they have a reputation for threatening legal action.

They can do that all they like in this instance, since this article contains nothing defamatory about anyone, apart from calling the sponsors of this stupid gimmick utter morons.

Let me address them directly.

Guys, I know you. I know you’re not the worst in the world. I realise that this venture is not born out of malice but out of crass stupidity since you are uneducated fucking imbeciles.

Be men.

Overcome your stupidity and abandon this attack on the most vulnerable in our society.

Oh, and I’ll be happy to take down your silly logo if you ask nicely.

 

 

 

Categories
Health

Irish public nursing home standards are delusional

Since the State oversees standards, one might expect that HSE-managed nursing homes would represent the gold standard, because otherwise the State would have no moral authority when imposing standards on private operators.  But, as anyone with an elderly relative living in a HSE nursing home knows, these standards are beyond delusional.

Here’s one sample extract from the HIQA standards for nursing homes.

____________________________

 

Standard 2: Consultation and Participation

Each resident’s rights to consultation and participation in the organisation of the residential care setting, and his/her life within it, are reflected in all policies and practices.

2.3 The resident contributes ideas to and participates in the day-to-day activities of the residential care setting.

2.4 The person in charge facilitates the establishment of an in-house residents’ representative group for feedback, consultation and improvement on all matters affecting the residents. At least one nominated person acts as an advocate for people with dementia/cognitive impairment. Issues raised by the residents’ representative group are acknowledged, responded to and recorded, including the actions taken in response to issues raised.

2.5 Feedback is actively sought from the resident on an ongoing basis on the services provided. The residential care setting clearly demonstrates how the impact of the resident’s feedback informs reviews and future planning.

_____________________________

Let’s look at these rights, as laid out by HIQA.

The resident contributes ideas to and participates in the day-to-day activities of the residential care setting.

I can tell you from personal experience that there is absolutely no consultation with residents.   If you suggested to the staff of these units that an in-house residents’ representative group is required you would not be laughed at.  You’d be met with a blank stare of incomprehension, because this notion is so far removed from the culture of these institutions that it would be inconceivable to the staff who, in many ways, are just as institutionalised as the residents.

The resident contributes ideas to and participates in the day-to-day activities of the residential care setting. 

The reality is that nobody asks the residents’ opinion about anything.  Where residents are routinely blamed and challenged for minor infractions such as dropping food on the floor of their bedrooms, where some staff raise their voices as if talking to an idiot, there is no possibility of this.

The regulations also require that people should, as far as possible, be able to lead a normal domestic routine, as close to their home-life as possible, independent of staff rotas, but the reality is that often, elderly residents are woken at 6 am to be washed, because that’s what suits the management, even at the expense of personal dignity.

The regulations require that residents should be able to meet visitors in a private space.  In reality, there is no private space because such a thing would be anathema to those who believe the residents require supervision rather than care.

The regulations require that residents should have a lockable, secure space to store their personal belongings.  The reality is that any staff member, from nurses to cleaners, can, at any time, go through residents’ personal effects.

The regulations require a presumption that residents are fully compos mentis unless evidence to the contrary emerges.   The reality is that all residents are treated as subordinate to the management.

Feedback is actively sought from the resident on an ongoing basis on the services provided.

Nobody asks the residents anything.  The reality is that elderly residents are afraid even to report snappy comments or sarcasm for fear they might be further victimised.

The reality is that some (though not all) staff think of themselves as being in authority over the residents, instead of being responsible for their wellbeing, and that is a culture permeating the entire HSE nursing-home structure.  Until that culture is rooted out, there’s no point issuing well-meaning but hollow regulations reflecting a non-existent elder-care Utopia.

 

Categories
Favourites Health

Residents of Public Nursing Homes Are Deprived of Human DIgnity

I’ve been visiting a public nursing home very frequently, and I’ve been shaken by some of the things I’ve noticed and some of the things I’ve been told.

The clue is in the name.

Nursing home.  That’s Home.

I can see nothing homely about the public nursing home I’ve come to know so well.  What I’ve seen is an institution, a place where everybody — staff and residents — are institutionalised.  But what’s tragic is that it wouldn’t have to be like that if only attitudes were different.

Ireland has a strong authoritarian streak, limited only by our membership of the EU that forced us to comply with certain basic norms, whether we liked it or not.  One of those norms is this: people are entitled to their essential human dignity.  This is not something in the gift of any other human being.  It is not to to be offered or withheld at the whim of a ward manager, a cleaner, a nurse, a doctor, a kitchen assistant or a clerk.

And yet, from what I can determine, human dignity is withheld all the time in nursing homes under the control of the HSE, though in a more subtle way than the days when a staff member felt comfortable threatening a resident: take your pills or I’ll bust your jaw.  Legislation and the fear of the HR department have changed that, but neither law nor HR administrators can change mindsets.

That”s why there’s no more overt bullying, or at least not when anyone is watching.  Instead, it’s covert and insidious.

Let me give you a few examples.  Would you, as a grown adult tolerate anyone addressing you as Good girl or Good boy?

Would you, if your mobility became reduced due to an injury,  tolerate anyone berating you for dropping food on the floor?

How would you react if somebody constantly spoke to you in an exaggeratedly loud voice?

If you had diarrhoea and vomiting, how would you like being told you’ll have to wait?

How would you feel about a uniformed authority figure assuming you have  some cognitive disability even though you know you are far better read than they are?

How would you, as a grown adult, like it if you had no defensible space, no privacy and no say in the decisions made about your living conditions?

How would you like it if you had nowhere to keep your personal possessions or the little luxuries that a grandchild might bring?

How would you feel if those little treats mysteriously disappeared in the middle of the night?

How would you feel if you had no entitlement to a key for a locker?

How would you like it if your clothes went to a common laundry  and if they returned stretched, shrunk or not at all?

I know that a nursing home is not a hotel.   I realise that all residents have health problems of one sort or another,  but a nursing home is not a hospital.  It’s a home.  It’s the only home the residents have or will ever have, and yet, the regime in public nursing homes is all about authority, at the expense of the residents’ dignity.

Let me ask a few questions.

Why does a nursing home physically need to look like a hospital?  Why is it painted in the soulless hospital cream?

Why can’t there be semi-private spaces that people can retreat to when they feel the need?

Why do staff need to wear uniforms?

Why can’t staff address residents in a normal conversational tone of voice as equals, unless they happen to know the resident is deaf?

Why can’t staff assume that a resident is compos mentis unless they have evidence to the contrary?

What would be wrong with basic courtesy towards another human being?

Why are staff given to understand that they have authority over residents when in fact they do not?

Why do some staff think they have a right to discipline residents verbally, as they might do to a child?

Here’s a revolutionary idea: what would be wrong with asking residents how they’d like their homes to be organised?  How about consulting the people who live in public nursing homes, listening to them with respect, and doing what they request, as far as practicable?

It’s all about respect in the end.

It’s all about dignity, and most of it would cost the HSE nothing, since basic courtesy is free.  In all likelihood, the staff would never think of treating their own family or friends the way they treat their vulnerable, powerless residents, unless they wanted a strong reaction.  A very strong reaction indeed from those of us who aren’t impaired in one way or another.

There is nothing worse than being rendered powerless, but sadly, as with all Irish institutions, the only way this will change is through fear, and in that regard, we can only welcome the appointment of the Confidential Recipient, Leigh Gath.

I might just get in contact with this admirable woman.  And I might just install a hidden  video camera that operates even when I’m not there.

What do you think?

Failing that, I might get legal on their ass.

 

 

 

 

Categories
Health Our lives

Injury Heaped Upon Injury

I hurt both knees.

No surprise there, you might say, considering the maniac things you did in the course of your life, and that’s perfectly true.  I have no right whatever to any working joint.

I broke my wrist.  I broke my elbow.  I broke my ankle.  I fractured my skull. I fused two vertebrae in a fall from a window while acting the maggot.

In truth, I have no business being here, and yet, here I am.

The knee-injuries  were a little more prosaic than the stories behind the severe skeletal damage I mentioned just there, though I do promise in the end to tell you what caused all those destructions.

The knee-injuries were caused by silliness.  My right knee is in shit because I was foolish enough to do lots of road running without bothering to prepare for it and because I spent years playing squash, five or six days a week, pounding away at the joints.  My left knee is currently in shit because I tripped over something on the bedroom floor and slammed it hard against the ground, as one does.  Idiot.

The physio is a patient, non-judgemental lad.  He doesn’t care how I did the damage.  He just wants to fix it, and so he spends a full hour poking away at my leg muscles.

Jaysus, that right leg is very bad.

Is it?

Yeah.  Jaysus, you must have that problem a long time.

I have.

Fuck, I thought so.  The muscle is fucked.

What?

You’ve been putting the weight on the other leg.

Maybe I have.

Until you fucked up the other leg?

Jaysus.

Yeah.  We’ll have to work on this.

And so it comes to pass that my ever-patient physio advises me to stretch the muscles by pulling my foot up behind my back and holding the pose for 15 seconds, just like the Olympic sprinters do, except that I’m not an Olympic sprinter, and I have many other injuries, all of them self-inflicted.

But still, I’m an obedient patient and so I try to stretch the offending muscles.  I try on both sides, and one side works out fine.  But the other side isn’t such a huge success.

The next day, I’m having coffee in one of my favourite haunts and I bump into my favourite hipster.

What do you think happened when I tried to stretch my left thigh muscle? I ask him, as he caresses his lovely hipster bicycle.

You put your fucking back out, he laughed.

How did you know that?

Because everyone puts their fucking back out doing that, but don’t worry.  You’ll straighten up after a day or two.

He was right, but now I have to face the physio.

 

Categories
Health

Solving the Vaccination Dilemma

By now, only a very small group of lunatics, crystal-healing fools and complete idiots could possibly claim that vaccination is a bad thing, but you know what? There should be a place in this world for lunatics, crystal-healing fools and complete idiots.

On the one hand, it’s true that unvaccinated children pose a fatal risk to the children of sane people, and it’s true that they also pose a fatal risk to old people, sick people and those with compromised immune systems.

But on the other hand, we have to respect the rights of complete idiots and therefore we need some sort of compromise, so here’s the situation.

Let’s not have a society where lunatics, crystal-healing fools and complete idiots are excluded.

Instead, let’s offer the anti-vax maniacs who threaten our children’s lives a simple choice.  If you choose to have your children vaccinated, welcome to our society.  If not, you’ll have to live within a guarded compound created especially for anti-vaccination fools, where you can’t endanger the rest of us.

It seems fair enough to me.  You’re free to make your own decisions, however irrational, but don’t inflict the consequences of your stupid decisions on our children.  If you want to leave the compound and mix with the rest of us, all you have to do is get a vaccination.

What’s wrong with that idea?

Categories
Health

Honest Politician Shock! Leo Varadkar Tells the Truth About Abortion Law in Ireland.

They’re falling over each other to put clear air between themselves and Leo Varadkar over his recent statement on abortion law in Ireland.

Enda Kenny put on his most disapproving frown and huffed in his best teacher-turned-politician pomposity that Leo was talking in a personal capacity, as if somehow it’s a bad thing to have personal views.  As if, even in such a raw, painful subject, there might be a difference in a civilised society between what a right-thinking person believes and what a government considers to be right.

What exactly was wrong with the views expressed by Dr Varadkar?

In what sense was he factually incorrect?

He pointed out that Irish law takes account only of a pregnant woman’s life, not her health.   If it comes down to a straight choice between mother and baby, the baby will be delivered without taking account of the consequences for the mother, even if those consequences are stroke, heart attack or epileptic seizure.

That’s the law.  Irish physicians may only legally contemplate abortion if a woman might actually die.  If the mother is simply at risk of becoming permanently disabled or brain-damaged, Irish law regards such an eventuality as a trivial matter.

Likewise, Varadkar pointed out that parents who discover that their child is for example, anencephalic, are forced to go through the appalling experience of explaining to anyone who asks that the baby has no brain and that it cannot possibly survive outside the womb.  The baby is, by all clinical standards, already dead, and yet Irish law forces women to go through the hell of nourishing that child’s body within themselves as if they were nothing more than mechanical life-support machines, when in fact there is no life.

That’s the attitude of Irish law towards expectant mothers in distress, if they can’t afford to travel to a mature country.

And that’s all Leo Varadkar pointed out.  How despicable of Enda Kenny to distance himself from such a self-evidently decent position.

Categories
Health Rugby

Joe Schmidt Defies Appendicitis to Watch Ireland vs Australia

After a magnificent, blood-and-guts autumn international battle between Ireland and Australia at Lansdowne Road, news began to emerge that Joe Schmidt, the Ireland manager, had endured an entire day of torture in order to see the match.  Suffering from acute appendicitis, Schmidt gritted his teeth and got on with things, explaining his absence from the team-talk with the cover story that he had some sort of infectious bug he didn’t want to pass on.

The first reaction of the whole country, including me, was What a man.

Much respect.

But later, as I thought about this, it dawned on me that what Joe Schmidt did was utterly irresponsible, not only risking his own life but, even worse, tapping into the same old macho mindset that for years returned concussed players to the game when they should have been under medical observation for head injuries.

Instead of saying What a man, maybe we should have been saying with some annoyance, Typical man.

If Joe Schmidt’s appendix had burst while he was watching the game, he could easily have died.

Presumably, the IRFU and the management of Lansdowne Road knew about the medical situation, so what did they do about it?  Did they defer to Schmidt’s dogged refusal to leave his seat until the final whistle?  If so, they are guilty of culpable weakness, having colluded in a highly irresponsible and potentially fatal act involving one of their employees.

I don’t agree with everything the Health and Safety Authority does.  Sometimes they can be too officious, too overbearing and rather robotic, but I hope they investigate this incident because its ramifications go far beyond the consequences for one man.

In the last decade, rugby has gained popularity in an unprecedented way due to the success of the provinces in European competition and the increasingly effective international squad who now expect to go out and win the Grand Slam and who come home slightly disappointed if all they win is the Six Nations.

This is a good thing.  It has produced marvellous role models for the kids in the dignified, respectful, self-effacing superstars we produced, people like Paul O’Connell and Brian O’Driscoll.  Who didn’t admire Peter Stringer at the height of his Jack-Russell-like cheekiness?  Everyone in Ireland admires wonderful tacticians like Joe Schmidt.

But if kids look up to the heroes, there’s a corresponding responsibility not to send out bad messages, and what worse message could be sent out than the manager of a world-class team stoically ignoring the warnings his body is giving him, disregarding his health for the sake of a football game?

At a time when men are being encouraged to look after their health, these aren’t the attitudes we need to be fostering.

Admirable guy that Joe Schmidt is, I think he got this one badly wrong.