Nelson's Column, Bolg, Blog, whatever...

Jerry Nelson is a surgeon in a reputable DGH near you

Things to do with your Infection Control Policy

By Jerry Nelson - 2nd March 2010 10:12 am

Arsington arse, it never bloody stops. Major infection control crisis in the department. Just because a couple of patients got that C. Whiff virus or whatever it is, now there’s all hell to pay. Typical - anything goes wrong, blame the surgeon.

Turns out that on one of the forms that the managers have to fill in and send to the DoH, there’s a box to tick. And that box is labelled: “Didn’t kill all the patients with C. Niff”. And the managers want to tick the box, because that way they get money. Or something.

So, they’ve appointed some bossy over-promoted nurse as the new Infection Control Coordinator, who looks like that old bint with the ridiculous hair from How Clean Is Your House, only several orders of magnitude more stupid and bossy.

Why will they never learn? Making appointments like this is so counterproductive. If they had any sense they’d appoint some fit-looking piece of totty for once, and they’d find that compliance with the new regime would be much higher. Look at my new anaesthetist Gabrielle - I do everything she tells me to immediately, if not sooner.

Anyway, she’s bringing in a whole load of stupid new rules - wash your hands blah blah, don’t pick your nose when scrubbed blah blah, usual rubbish. What they don’t take into account is the negative effect of all these things. They’re a single issue pressure group - they only care about infection rates, and so long as they fall, they couldn’t give a monkeys about whatever else happens.

Whereas doctors like me have to consider all the possible consequences for our patients. It’s like that stupid 20mph speed limit they’ve put on the main road by the hospital, near the school for the blind and the pensioner’s day centre. You know the one, opposite the Cute Kittens That Might Stray on to the Main Road Refuge. I mean, sure it’s going to save a few lives, but hundreds of us are going to be late! 

So, the next thing I know, I get a call from her. She’s called Dawn, and she has a voice like fingernails on a blackboard, only not as pleasant. She has “things to discuss”. And do you know what it was? Smoking.

That’s right, she wants to talk to me about smoking. Since when did infection control have anything to do with arsing smoking, for arse’s sake (apart from the fact that they’re both subject to interfering fascist puritan fuckwits)? She says she’s “not comfortable” with my practice of nipping out for a fag during my operating list. 

Well, as you can imagine, I lamented her lack of comfort, but asked her to consider what would happen if I shoved her infection control policy up her arse sideways, and how comfortable she would be then.

And anyway, if it wasn’t for the anti-smoking fascists, we could smoke on hospital property, and I wouldn’t have to nip out, go all the way to the edge of the hospital grounds, hop over the fence to the Manure Farm and Slurry Processing Plant next door, just so I can get a bit of nicotine, whilst in the midst of a list of life-saving surgical procedures.

Jeez! She’ll be making me de-scrub next.

More bullying required - not less - to make this country great

By Jerry Nelson - 23rd February 2010 10:19 am

In an excellent mood today, being the first day when the lovely Gabrielle does my list instead of Dan The Fat gasman, who has been temporarily suspended after ordering six million quids worth of booze through the NHS for his own party. Still, doubled as a leaving do I guess.

Another reason for joy is that the theatre directorate, which usually excels itself by buying the cheapest, crappiest kit they can possibly lay their hands on, has actually come up with something good. It’s called a Preop Glove. It’s a sticky glove you wear to pick up the hairs after you’ve shaved a patient before surgery. Works really well, too. One should never underestimate the positive effect of neat little tools like this.

Slight problem while I was shaving the first patient, as Gabrielle wafted in and I blew her a kiss, and got a face full of old man’s pubes. Arse!

Anyway the big news this morning is all about what a horrid bully Gordon Brown is. Allegedly he does things to his staff like calling them names and throwing phones at them, and they’ve contacted the anti-bullying hotline.

So I’m like: and? Call that bullying? I don’t know what kind of wimps they employ at Number 10, but they wouldn’t last five minutes in the NHS. Here, where we’re dealing with life and death, we have to keep our subordinates on their toes. Especially if they’re foreign or a woman, or they’ve got a squint or something. I made my last houseman do ward rounds in a Guantanomo-bay orange jumpsuit with a bag on her head. And we make the staff grade carry all the notes from clinic, and then trip him up, and make him pick them all up again. Hahaha!

Oh, look! Gabby’s brought some cake in! Mmmm victoria sponge, my favourite! ARSE!! forgot to take the glove off again!!

Anyway, these rumours have been circulating for a few weeks now, and I can’t help noticing that Gordon the Moron’s personal ratings have been going UP in that time, thus proving that the British public want to be led by some sort of fat one-eyed version of Flashman, and not some sort of touchy-feely nancy-boy. So if Dave wants to win the election, he’s going to have to start flushing Michael Gove’s head down the toilet pretty soon. I’m sure they did that sort of thing at that crappy secondary modern in Slough that he went to.

Just about to start the last case when Sir Charles Pimbley-Pombley pops his head round the door. Sir Charles is the chairman of our local clinical excellence award committee, so obviously I went straight over and shook him firmly by the hand…oh AAAAAARRRRRRRSE!!

“I love a party with a happy atmosphere”

By Jerry Nelson - 15th February 2010 9:32 am

I am, quite simply, a legend.

All those years trying to eject the great nose-picking arse Dan the Fat Gasman from my lists, and replace him with the luscious, posh totty Gabrielle, all to no avail. Yet in the end it was so easy.

You may remember I was recently alerted to the useful things one can purchase from the NHS supply chain.

Now for some reason,  possibly due to an outbreak of ebola virus in the Anaesthetic Department, they made Dan their clinical director. So all I needed to do was wait for him to drop off over some paperwork at the head end, then make a note of his departmental cost code. Then…

Of course, he was very chuffed. When one of your colleagues throws a big party in your honour, to express their respect and admiration, and to say a big thank-you for all your (cough) hard work, it’s flattering. We even declared the day of the party ‘Dan The Fat Gasman Day’. The whole hospital was invited, doctors, nurses, managers, spouses and partners. And just in case that wasn’t enough to fill the Great Hall, I put out a couple of ads on FaceSpace and MyBook

What. a. night. Of course, everyone responsibly enjoyed alcoholic beverages according to the government’s wise health guidelines, which took about ten minutes, after which we all got completely wankered. A few extras turned up - a couple of thousand teenagers, some skinheads, the local chapter of the Chicken Head Death Motorbike Bastard Squad.

I think the police were involved - I vaguely remember some people with riot shields and a couple of horses wandering around. Unfortunately the hospital got a bit trashed - nothing too serious, just a few broken windows, and the occupational health department got burned down. I woke up in a student nurse’s room wearing waders (never did find out what happened to my toga). 

I must say, give NHS supply chain their due, the booze was endless. And very reasonably priced too, as I’m sure Dan appreciated the next day, when he got the bill.

It all happened rather quickly after that. The Turnaround Team was sent in within days. They said they’d never come across a trust that had rung up a seven million pound deficit by blowing it all on booze. 

Radical cost-cutting measures were taken, including shutting down all non-essential services, like the department of General Medicine. And Dan was sent on gardening leave.

Still, it may turn out for the best. New research has shown that being an anaesthetist can be bad for your health

For public health wishlist, read bunch of arse

By Jerry Nelson - 8th February 2010 10:13 am

One of the best things about this new Information Superhighway thingy is that you learn new things every day with just a few clicks of the mouse. During my idle moments, like in clinic, say, when some patient is droning on about all their tedious problems, I surf away and pick up all sorts of little gems. For example, I have recently learnt all about something called ‘Fisting’.

What you do, is take something that someone else has written that’s a whole load of arse, and challenge it line by line. (Er…shouldn’t that be ‘Fisking’? Ed).

Anyway, I thought I’d give it a go and I had to look no further than the pinko leftist ban-everything site called Hospitably Doctored and its succinct coverage on the latest pronouncements of the Royal Society for Public Health Fascists With Nothing Better To Do.

Here goes:

“The Royal Society of Public Health and UK Faculty of Public Health want the political parties to adopt a 12-step wish list to boost the nation’s health.”

Whether the ‘nation’ wants it or not. Note: political PARTIES plural, in case in our childish ignorance we try to vote against any of this arse gravy.

“Jointly representing about 9,000 public health professionals.” 

Is it me or does that mean there are far too many of them?

“…their manifesto calls for: 1. A minimum price of 50p per unit of alcohol sold. Alcohol consumption in the UK has doubled over the last 40 years.”

Doubled!! Oh, no that sounds terrible, that means it’s as high as - save us, o wise Public Health Professionals - the level it was in 1900! You know, when the town centres were awash with vomiting Victorian Chavs beating up policemen, and everyone died of liver failure?

“Alcohol is now 69% more affordable than in 1980.”

What a load of arse. Check the Office of National Statistics. “Between 1980 and 2008, the price of alcohol increased by 283.3%. After considering inflation (at 21.3%), alcohol prices increased by 19.3% over the period”. Can you think of anything else that’s gone up by 20% in real terms, apart from the number of portentous authoritarian announcements from public health professionals? 

“Tackling price and availability are the most effective alcohol policies.”

So, if we ‘tackle availability’ all the way to zero, the problem would disappear, as in prohibition-era America, when nobody drank. And there was no crime!

“No junk food advertising in pre-watershed television. The Ofcom measures, in 2006, to ban junk food advertising between programmes where 20% of the audience were younger than 16 have been ineffectual. A complete ban is needed to effectively reduce consumption of salt, saturated fats and sugars by children and adolescents, reducing the risk of cardiovascular disease later in life.”

So if a partial ban had no effect, why would you assume a complete ban would do anything, other than make you feel butch and important?

“25% increase in the number of cycle lanes and cycle storage facilities.”

Don’t get me started. Looks like they didn’t read this. Oh, and this is a cycle storage facility and they’re everywhere.

“Introduce presumed consent for organ donation.” Your kidneys now belong to the state. So they will take them out and give them to someone so cack-handed and useless they could only get a job in transplant surgery.

“Free school meals for all children under 16. Evidence shows that cardiovascular diseases can originate in childhood, and it is important to start good dietary habits early.”

‘Good dietary habits’? BWAHAHAHAHA. Yeah, that’s why we all still eat school meals as adults! School meals is a byword for ghastly inedible 14p-per-head state-delivered swill. Also dangerous in combination with previous item. 

God helps us all. I shall leave the last word to Professor Henry Brubaker of the Institute of Studies: ”Once again [doctors are] talking about ‘public’ health as if that’s an actual thing. There is ‘my’ health, which is ‘mine’, and ‘your’ health which is ‘yours’, but there is no ‘our’ health. D’you see?”

Quite.

It’s enough to drive you to drink (cheap NHS cider)…

By Jerry Nelson - 1st February 2010 7:24 pm

Oh, for arse’s sake what NEXT??!?!??

They’re not content with banning smoking. They’re not content with banning butter. Now that weasely little sixth former Andy Burnham reckons he’s going to set MINIMUM PRICES for alcoholic beverages?! WTF??!!

All the usual bollocks, complete with made-up statistics about how this measure will save fifty thousand lives a day, and save the NHS twenty million billion pounds. And of course when it’s shown to do no such thing, it’ll be because the minimum price is too low, so they’ll keep cranking it up and up until a screw top bottle of Happy Shopper British Wine, ‘Red Flavoured’ costs the same a Chateau Lafite.

And why? Just because of ‘binge drinking’. Well who is doing the binge drinking, you morons? Yes, the WORKING CLASSES. All that trouble you see in town centres on a friday night, it’s all lowlife - chavs, oiks, slappers, anaesthetists. It is completely unreasonable to punish us all for the antics of a few.

Targeting the price increases - on people who didn’t go to private school, say, or anyone who uses the word ‘toilet’ - THAT would make much more sense. But no, we’ve all got to suffer.

And what about the poor retailers, like the chap at my local corner Supa Cheapo Mart? What’s he going to do when he’s no longer allowed to sell 26 cans of premium super strength ‘Battery Acid’ lager to people who look more or less eighteen for £1.99? He’ll go out of business!

Anyway, I was messing around in the office, sending anonymous hate e-mail to various cabinet ministers, when who should drop by but my old mate Keith.

Keith’s a nice chap, good for a chinwag, and he puts a brave face on what has been - if we’re honest - a fairly sad life. You see, everything was looking rosy for Keith, he’d graduated medical school and had the world at his feet, when tragically - and without warning - he became an eye surgeon. Now the poor man has to spend all day looking down microscopes and poking at things with tweezers. It’s sobering for those of us lucky enough to have a proper job.

Anyway, he pops up looking all chirpy, and starts going on about the NHS supply chain and how it has some really useful things on it you can buy. I must say I rather drifted off at that moment, expecting him to start extolling the virtue of some whizzy new phakoemulsification machine or something. But then he showed me THIS.  

nhs-supply-chain-1st-pag81

BWAHAHAHAHAHAHAHAHAHHHAAHAHA!!!

So, Mr Burnham, the first health secretary who has to be picked up after Cabinet meetings by his mum, is being all butch and telling everyone he’s going to ‘ban cut-price supermarket deals on alcohol’. Yet, where a litre of cider at Sainsbury’s will cost you £1.47, he’s knocking it out for £1.32, or £1.27 if you buy in bulk!

Hmmm, I wonder if Dan the Fat Gasman has a departmental cost code? I feel a party coming on with the nurses on Mandela ward.

Toga! Toggaa! Togggaaa!

“I can’t believe it’s not another health fascist”

By Jerry Nelson - 26th January 2010 9:13 am

Arsington bloody arse, with an extra pint of arse for the weekend.

There was I, having awoken in a positive mood, enjoying my favourite breakfast of toast, butter, marmalade, butter, coffee, butter and a cigarette with extra butter, when up pops the health-fascist-of-the-week.

Some ‘leading heart surgeon’ has announced that butter should be banned, an issue that’s so pressing he has abandoned his search for an even vaguely convincing toupée.

Apparently only “radical action” can save growing numbers of young adults from heart attacks and clogged arteries.

Oh gosh, mate, are you sure banning butter is radical enough? Why not tackle the genetic causes of heart disease with eugenic extermination camps? What are you going to do when people start smuggling butter in from France? Jail them? Kill them? Will we need a War on Butter?

Maybe we need a pack of butter sniffer dogs? A heavily-armed Metropolitan Police butter squad? Butter rehabilitation programmes? And when banning butter is shown to have had precisely fuck all effect on the nation’s health will you do the decent thing and shoot yourself in the face with a service revolver, or will you decide that cheese, milk, red meat, and Curlywurlies will have to go too? What would it take for fascists like you to actually arsing well stop?

You know what the real problem is here? Heart surgery! It was always an accident waiting to happen.

You see, not everyone can get into medical school. And not everyone who gets into medical school can be a surgeon. And not every surgeon can make it in a tough discipline like DGH hepatobiliary surgery with an interest in blogging.

So some - generally those who lack the delicate touch to do orthopaedics or the personality to be urologists - end up in the sump of the surgeon’s art: cardiac. And the big problem with cardiac surgery is that it only really involves one and a half different operations, with the difficult bits like vein harvesting done by nurses.

So cardiac surgeons are all, quite simply, bored. And, as Shakespeare said, the devil makes work for bored hands.

Some try to take on different surgical operations which are actually difficult, with disastrous consequences.

Others go in search of other diversions. After a bit of digging I found this article. See what I lengths I go to in order to bring you the truth? I read articles in The Guardian by people called Felicity. I actually feel dirty now.

It would appear from the right royal kicking he’s getting in the Bolgosphere that not only is Mr Leading Heart Surgeon an authoritarian git who thinks he has a god-given right to tell me what I can and can’t eat for my own good, it turns out he knows less about the subject than I do.

And the reason his idiotic ideas have gained such a wide audience is because they were spread (har!) by the PR agency that works for big-assed multinational Unilever. And do you know what Unilever makes? I’ll give you a clue: it’s not butter.

Gosh what a great game! Take a groundless assertion, give it to a corporation who could profit from it and expect everyone to do as they’re told because you’re a self-styled ‘leading surgeon’.

Can I play? “Top Middle Bit of England surgeon says smoking is good for you and should be compulsory”. Has a nice ring to it. I’ll give Philip Morris a ring.

Learning about tax loopholes from the master

By Jerry Nelson - 18th January 2010 9:25 am

Well, thank goodness the weather has improved. Been completely snowed in at home, unable to make it in to work without undertaking a treacherous half-mile journey down a flat road which, although it had been ploughed, salted and gritted, still looked a bit too dangerous for me to risk the new Range Rover on.

Needless to say, Dweeb Urologist Johnson sweated it in 20 miles in a Toyota Prius from the arse end of nowhere, and stopping every hundred yards to dig himself out of snowdrifts and losing three toes to frostbite in the process. All that tells you is how very, very badly he wanted to look up old men’s knobs with a telescope. Luckily, despite the relative confinement, my time was not completely wasted since the routes to the private hospital and the pub looked just that little bit less tricky. 

And of course the Test Match was on. Phew!

Still, back to the treadmill today, only to be presented with this joyous piece of news. What a bunch of arse. As if they don’t get their claws on enough of our money! Luckily I have nothing to worry about, since my financial affairs are in the hands of the top accountants Spudge & Co. I must say, they were a real find. It’s amazing what a difference it makes when you hire someone who really understands the rules in detail. Over the years they have saved me thousands. It’s equally amazing how many people are unaware of some of these loopholes.

For example, did you know that you don’t have to declare income from private patients who’ve died? That saved me a ton of money on its own. 

Or from patients who have a ‘Q’ in their names? Or from anyone who had surgery on a Tuesday? Or that the government throws away all your records after six months, so you can’t be done for anything that happened before then? Or that it is quite Ok to tax-deduct school fees, child maintenance payments, groceries, holidays and golf equipment? Neither did I! See what quality advice can do?

All the same, given the climate, I think I will give Spudge a ring check it’s all Ok. 

UPDATE

Funny. Keep getting ‘number unobtainable’.

 

Please rescue me first Patsy (and wear the spikey boots)

By Jerry Nelson - 8th January 2010 6:33 pm

Oh, rapture! Oh, joy! Be still my beating heart! It’s Patsy to the rescue!

Just as I though I’d never see that beautiful face or hear that slightly whiny schoolmarmish voice again, my beloved pops up to save us all from the Evil Clunking Fist Brown. She’s going to cajole and persuade and twist arms and call in favours and rally support and FINALLY persuade the Labour Party to grow some testicles and get rid of the useless arse.

It’s going to be the best back-bench revolt ever!!

Serves him right for being so horrible to her when he took over as PM, after she very kindly offered to help out with the government by being Chancellor of the Exchequer or something, and he turned her down flat, the ungrateful Scottish knob.

She did a jolly good job as health secretary, for very little thanks, and that was after a stint at trade and industry, where she did a stout job of safeguarding the British car industry, and before that she had a pivotal role in masterminding Neil Kinnock’s fantastic 1992 election campaign.

And yet there are people - it makes me angry to even think about this - that reckon she’s a talentless bint whose entire career has been one prolonged car crash of fuck-ups and incompetence. Even Johnson the dweeb urologist can’t see what a jewel she has been in the crown of our nation’ s governance.

He turned up in my office the other day and tried to allege that she was the worst health secretary who’d ever drawn breath, but I managed to persuade him, with cogent argument and by shutting his hand in the drawer a few times, that she was probably the best…apart from seven or eight others.

But now she’ll show them! Now she’ll rescue the whole country!! She’ll be kingmaker!!! Perhaps in gratitude the Labour Party will see sense and vote her in as leader, then I can gaze at her gorgeous yellowing skin and slightly weird hair at PMQ’s as she talks patronisingly to the leader of the opposition.

You just wait! Maybe she’ll remember me and I’ll become her ’special’ advisor again. Oh baby. She’s unleashed a groundswell, an unstoppable force, a tsunami! It’ll be her finest hour! She’ll….

Oh Wait. It’s failed. Arse!

Jerry survives vaccination only to find the world a colder place

By Jerry Nelson - 7th December 2009 10:19 am

Sorry for my - what’s the term? - ‘light blogging’ lately. Been off work for a bit. Had a flu jab a couple of weeks ago, and felt a bit feverish and achey for a while and then the next thing I know I’m sectioned under the Mental Health Act and detained in a secure unit for the irretrievably autistic. Bloody vaccinations.

Anyway, I’m a bit blown away by all this Climategate stuff. It looks like a bit of a blow for those fascists who want to stop us travelling by plane and enjoying 24-hour flloodlit, patiowarmer golf.

For those of you who don’t know what I’m talking about because you get your news from the BBC, a massive file full of emails and other data from climate scientists (who work at the ‘University of East Anglia’ - bwahahahaha polypolypolypoly) was hacked/leaked/left lying around, and has now appeared on the interweb.

The upshot of it all appears to be that scientists fudge data when it doesn’t fit the theory, collude and gang up on anyone who doesn’t agree, and all they care about is chasing kudos and research funding.

I’m like: and?

What do you expect? They’re scientists. It’s what they do - they’re a bunch of shysters.

There is this foolish image of scientists being sweet-natured boffins who only care about the truth. Well, it’s a load of arse! The typical research department is a pit of vipers full of the sort of characters who make Scarface’s Tony Montana look like Bungle off Rainbow

Take our own world-renowned research institute, presided over by the Headmaster, The Middle Bit of England Centre for Anorectal Diseases. I happen to know that when they couldn’t get some paper into the journal Arse, they had two of the editors killed. And the HM actually sold his own grandmother on e-bay to get a letter in the BMJ. And one of their seminal papers on the precise clock positions of haemorrhoids was based on a single patient, which was the Headmaster examining himself.

The thing is, once they get in too deep, and they’re all being invited to join the UN Intergovernmental Panel on Haemorrhoids and fly off to exotic conferences, and they get all the praise and fame and money and chicks (well, probably not the chicks) it’s too late. They have to keep the lie going at all costs.

No-one’s going to be interested in a paper showing that - sorry to bother you - but the classic haemorrhoid positions of 3, 7 and 11 o’clock were right all along. Are they?

Jerry says ‘aksya ng oras’ to nurses having a degree

By Jerry Nelson - 13th November 2009 3:31 pm

My God, I think that’s the first time I’ve managed to make Rice Krispies actually come out of my nose.

Headline in the paper: “All nurses to have degrees by 2013.” BWAHAHAHAHAHAHAHAHAHAHAHAHAHAHA!

What a hoot?! And in a related announcement the Health Minister has said that all nurses are to have a massive chip on their shoulder by…oh wait - they already have.

So they’re going make nursing a ‘degree course’, to be studied a ‘university’, giving it equal status with existing intellectual bastions such as Star Trek Studies, Dressmaking and Form Filling In. I can’t wait.

Told Dweeb Urologist Johnson the hilarious news and he came over all serious. Actually that happened the day he was born, but anyway. He said: “Actually, Jeremy this country has been successfully producing graduate nurses for many years now.”

I was flabbergasted! This country produces nurses? I though we stopped doing that around the time of the Festival of Britain. Don’t we get them all from the Philippines now? (And long may it continue if my dalliance with the hottie on Mandela ward was anything to go by).

By the way, in the native dialect tagalog the word for ‘degree’ is ‘titulo’. But, more importantly, the tagalog for ‘waste of time’ is ‘aksya ng oras’.