And Brian, here you describe the treatment of the “good people” in a (supposed) supporting environment of Hospital. Would you care to take a “peek” inside the clandestine world of the Corrective Services, operating as it does with the same mentality from above, in a world of darkness and horror, buried deeply and darkly, away from all concern for humanity, in a world of total expediency where nothing and no one matter to anyone.

Brian, have you wondered why, only about 10 ex nurses took up the incentive offer, offered by the Rudd government to attract former nurses back into the public hospital sector.

Brian, in essence you are correct in your analysis of cowardice amongst management in hospitals. Nick Greiner started the process that led to the current State Executive Service; under this scheme staff are on limited time contracts and can be terminated for any reason. That arose because Departments had become a law unto themselves with Railways refusing to submit accounts until 2 years after the event and refusing to follow cabinet direction.

What has now transpired is Departments are merely backdrops to the political ambitions of the government of the day. Labor has mastered the art of manipulating perceptions to its agenda, starting with Carr who controlled the media agenda masterfully.

The political process at work within the Labor party is one of power plays, strong arm tactics and factional brawling. Threats, intimidation and rumours are stock in trade. We ridicule other countries for corrupt and autocratic processes yet tolerate such processes within a ruling party!

These processes then flow out to how Labor manages Departments.

Brian’s article points to the consequences – staff do not rock the boat or they lose their jobs. Decisions are shaped by political needs not by good medicine.

In the field of management the construct of efficacy was introduced to the field of management at Lancaster University – the question is does the chosen means work. The system looks to effectiveness (doing the right thing) and efficiency (using resources wisely) but ignores efficacy.

Until Public Health is: at arms length to government; has transparent, clear requirements placed on it; and is open to public scrutiny the problem will not be addressed. The harsher issue to resolve is the expectation that life is prolonged no matter what the cost – perhaps this is the harder thing to raise.

The same author proposed that people over 80 should be left to die without resuscitation.

http://www.onlineopinion.com.au/view.asp?article=10468

Now he laments the premature death of the elderly and ill in hospitals!?

He says the most dangerous situation is "being admitted to a Hospital". Err..don't think so Brian. The most dangerous situation is NOT being admitted to Hospital when you are injured.

Atman - there is a considerable difference in not recusitating an elderly frail sick person to making 'medical mistakes' which lead to death.

I'd just like to point out that the problem is not confined to the Public Hospital sector. Private hospitals are often just as understaffed and generally less well resourced. The main difference is that you pay for the privilege of the Doctor of choice (sometimes) who may not necessarily be available outside of normal rounds time anyway and the privacy and comparative peace of a private room.

Otherwise as a consumer, anticipate similar risks and take steps to reduce them.

For those of you who are interested.

Nurse as a coalmine canary
http://www.impactednurse.com/?p=2341

Its not a nursing shortage, its a nursing crash
http://www.impactednurse.com/?p=708