Dr Jane Barton

Tricky subject isn't it OC, this morning at 2am the missus agreed to allow the District Nurse to commence what they term 'End of Life Medication' for her mum. We both know she has, in effect, signed her mum's death warrant. It is something most people prefer not to talk about though.

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Originally Posted by oldcolner

Footy
Because every dose has to be billed and paid for, by the patient or their insurers. So there are no stocks of medicines in Ward cupboards for staff to give to anyone. Doses are individually labelled for each patient even tablets.
In addition administration by a syringe driver would be much more expensive than by tablet, injections are 10 times more expensive than tablets and using narcotics would be more expensive because of the legislation requirements for record keeping. Relatives would want to know why their relative who could take tablets was being injected.

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i'd imagine in the current environment of routine over-prescribing of painkillers in the US, it'd be fairly straightforward for a DR death to start offing folk.

perhaps they already are...link

https://edition.cnn.com/2018/03/19/h...ner/index.html

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Originally Posted by footy_le_bordel

i'd imagine in the current environment of routine over-prescribing of painkillers in the US, it'd be fairly straightforward for a DR death to start offing folk.

perhaps they already are...link

https://edition.cnn.com/2018/03/19/h...ner/index.html

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But this story is about the lack of opioids and other painkillers and it’s impact on care and surgery and maybe an odd mistake caused by having to make do with other products..

In the US the doctor has to prescribe medicines and how much is to be given when and how, the pharmacy supplies it (or if in short supply a suggested alternative) with the patients name on the label and adds it to their bill and a nurse gives it to that patient.

In Gosport a nurse held stocks of these dangerous drugs for anyone to get them, without pharmacy knowledge and nurses appeared to have given it to whoever Dr B wanted made comfortable but may possibly not have written a prescription to say how much or by what route.

It looks like a similar situation may have occurred in Chester perhaps without any doctor knowing.
Beverley Allitt killed babies in Grantham some by using Ward stocks of insulin or injecting air in 1991.
https://en.m.wikipedia.org/wiki/Beverley_Allitt

Dr Shipman used his own stocks or patients unused supplies.

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Originally Posted by sinkov

Tricky subject isn't it OC, this morning at 2am the missus agreed to allow the District Nurse to commence what they term 'End of Life Medication' for her mum. We both know she has, in effect, signed her mum's death warrant. It is something most people prefer not to talk about though.

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Sorry to hear that but it’s a different issue Sinkov.
If your wife knew her mums wishes and she was in severe pain, that’s one thing. I would want that myself if the time was right. I would like the law to be changed to allow my wishes to be implemented.
In Gosport people who were often recovering and not terminally ill were disposed of with no family knowledge just because they were sent on those wards.

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Originally Posted by oldcolner

But this story is about the lack of opioids and other painkillers and it’s impact on care and surgery and maybe an odd mistake caused by having to make do with other products..

In the US the doctor has to prescribe medicines and how much is to be given when and how, the pharmacy supplies it (or if in short supply a suggested alternative) with the patients name on the label and adds it to their bill and a nurse gives it to that patient.

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still don't see how this is a safeguard againt a killer doc. as i say over prescription has been routine in the us hence shortage now. given that's the case, it seems to me less likely to raise a red flag if a doc was dishing out ODs a la dr barton.

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Originally Posted by sinkov

Tricky subject isn't it OC, this morning at 2am the missus agreed to allow the District Nurse to commence what they term 'End of Life Medication' for her mum. We both know she has, in effect, signed her mum's death warrant. It is something most people prefer not to talk about though.

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Sorry to hear that news sinkov, I honestly had no idea District Nurse's still existed or indeed they have the authority to administer life ending drugs. Pretty scary really. Best not fall out with a District Nurse eh? :?

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Originally Posted by footy_le_bordel

still don't see how this is a safeguard againt a killer doc. as i say over prescription has been routine in the us hence shortage now. given that's the case, it seems to me less likely to raise a red flag if a doc was dishing out ODs a la dr barton.

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Sorry I don’t understand you flb and I don’t think you understand me or this issue which has nothing at all to do with overprescribing causing shortages or shortages. It’s basically about having independent checks on what is prescribed before it’s dispensed and again. Fore it’s administered. That comes from having at least two and possibly four different people checking the prescribed medicine is correctly and legally prescribed and that the right medicine is given to the right patient at the right time by the right route.
In Gosport and in the NHS generally wards hold stock medicines which can be given immediately and one nurse holds the key. If that nurse also gives the medicine you have no independent check. It sounds like nurses were giving stock medicines on a verbal prescription which if true is illegal for controlled drugs like diamorphine. It can also allow nurses to access insulin which isn’t controlled but equally lethal in over dose.
In the US the pharmacy checks the doctor. The nurse checks the pharmacists work and that the medicine is given to the right patient. The patient checks the bill which lists every dose given.