HP's and Psychos

 

I've always taken a keen interest in ponerology, the study of psychopathy, see background links below, and it is a well-known fact that certain personality types are drawn to certain occupations. According to the psychologist and clinical ponerologist Prof. Kevin Dutton, psychopaths gravitate towards certain career paths and he has compiled a list of the top ten. Number one, no surprise, is finance. However I was surprised to see that number two is medicine. Doctors, especially surgeons, have among them a far high proportion of psychopaths than the average of six percent; or higher, depending on the source. You might think: "But doctors need to care to do their jobs!" No they don't; in fact a doctor who doesn't care has a huge advantage over those who do because they don't experience the emotional trauma that comes from witnessing the everlasting parade of pain, death and dismemberment doctors have to deal with. That kind of character is skilfully reproduced in the fictional film Malice, see: https://www.youtube.com/watch?v=LqeC3BPYTmE. I then wondered if there are any professions that naturally repel psychopaths. My first instinct was to assume that the professions empaths are drawn to repel psychos because of the contradiction, such as community caring jobs and charity work; but this does not necessarily follow. A psycho who is a sexual predator might get involved in a children's charity or nursery school because it would allow them easy access to victims; a perfect example being the Oxfam Haiti scandal, see: https://www.bbc.co.uk/news/uk-43112200. Psychos lack an understanding of many concepts which to non-psychos are obvious; not just the empathy but a sense of time, regret for the past or fear of the future. This is why genuine psychos never apologize to their victims nor do they fear punishment by the law or revenge from their victims' loved ones. One thing psychopaths have an acute awareness of is social status. They crave dominance over others and in a social situation this means eminence within the group. For this reason a psycho will find any job which has low conventional status unbearable... You can probably guess where I'm going with this. Yes, hospital portering is a natural filter to weed out psychopaths. There is literally nothing for them here. I can think of a perfect example, a porter I served with in the early '90's. He was, I believe, a clinical psychopath. He exhibited all the red flags. He was obsessed with leaving portering and joining security. The John Radcliffe has always had its own separate security corps, whereas in smaller hospitals this is very often a portering discipline. Nevertheless JRH porters are often required to assist security in various roles; I did so myself many times. This psycho porter volunteered for every security assist task he could get, sometimes bolting from the lodge the moment the attack alarm went off before anybody else could get to their feet.
 
This psycho porter was never given a job in hospital security; I think they saw through him. His zeal was a bit overplayed, in my view. However, obviously he could not remain in hospital portering. He used to seethe with agonized frustration and suppressed rage at situations where I found a solution through the dignity statement. He eventually managed to get onto a security team at a shopping centre. The last I heard about him he had become a prison warder... makes sense. So, that's another advantage of being a HP; you exist in a naturally psychopath-free bubble. Psychos rarely join HPing and those that do don't last very long. One more reason to love being a HP.
See here for background: https://hpanwo-hpwa.blogspot.com/2015/12/nhs-nurses-destroy-patients-doll.html.
And: http://hpanwo-voice.blogspot.com/2013/12/channel-4s-psychopath-night.html.
And: https://hpanwo-voice.blogspot.com/2019/12/the-empath-test_11.html.

Acute Care Vehicles 2- Second Generation

 

I consider the second generation of acute care vehicles a golden age of engineering; this was from the late 1990's to the mid 2000's. The hero of this boom was undoubtedly Egerton, a company based in Poland. There were three general bed designs that made up the backbone of the JRH fleet. I can't remember their official names, but we nicknamed them the "blue" and "grey" because of their colours. The blue Egerton was a pleasure to handle. It was by far the most manoeuvrable bed I have ever used. It had a folding handle at the foot for the sit-up mechanism and a separate squeeze handle for the pitch. Level was raised and lowered by a pair of smooth pedals at the side which needed very little pressure to operate. The top level was about five feet which added to the vehicle's portability. The grey Egerton came in three models. There was one with a lift-and-pull headboard that was mostly used to replace the original fleet maternity beds. The second design was more like the blue, but had slightly different controls. The pitch was altered by two black squeeze handles at the foot. It was also slightly heavier. The third variant was basically the grey with electric posture controls. I have always considered electric power an extravagance and a typical example of over-engineering for its own sake. Early electric vehicles had to be plugged in whenever they were in use and had backup manual handles and pedals. They can also actuate by accident when, for example, somebody leans against the control paddle. They grey had no manual backup. It had a battery which very quickly ran flat because staff usually didn't bother to plug it in, sometimes because the ward bed-spaces didn't have enough electric sockets. Another problem was that very few staff used the proper storage hook for the flex and plug. Some developed a bad habit of wrapping it around the rear corner fenders. This not only made it easy for it to fall off, but when the bed was raised it sometimes ripped the flex out of its fitting. (One theatre porter in particular was very irritating because he would do this on purpose when I told him about the wrong method just to wind me up; because that's the kind of person he was.) The second generation was not all a bed of roses though, if you'll excuse the pun. I'm thinking of the Hill Rom. Only a handful of these awful contraptions ever made it into the John Radcliffe fleet, but I used to groan whenever I had to use one. They had a feeble plastic footboard that usually broke and without it, as I said in the background link below, it was like a car without a steering wheel. We often kept a secret store of spare footboards in the lodge and a Hill Rom one was like gold dust. It also had a nasty static sting problem, sometimes producing an audible crack and visible spark... Good job anaesthetics no longer use ether! There was one bed that was a real bummer; it lost one of its footboard mountings meaning it could only be used without a footboard. Whenever I saw it unoccupied I used to wheel it to the "cage", a store in the industrial block for vehicles needing repair. I stuck a note on it explaining that it was not safe to use, but the maintenance team always returned it to service without replacing the mounting. I was tempted to sabotage that bed quietly in secret so they had to take it off the wards. All the second generation beds have a centralized footbrake; the blue Egertons' were the best; they were easy to apply, like the level pedals, and the lever was unobtrusive. The Egerton's were also the first full-size beds to have a function previously reserved for trolleys; optional steering lock. By raising the brake pedal to a third position, usually at the top, the foot wheels would lock into a north-south position rather than the usual free caster. This made the bed very easy to manoeuvre and it could even be pushed with a single porter, but only when empty. We hardly ever used to wheel lock with a patient, but then we were never alone with a bed patient anyway.

The second generation also provided one of the best wheelchairs ever, the Bristol Maid. This was a nifty rear wheel steered chair with an excellent sliding footplate and retractable telescopic arms. Its small size made it ideal for cramped passages in corridors, wards and departments. It had a unique storage compartment at the back for patient notes folders, but I learned quickly not to use it because it was too easy to lose the notes, something that would get you into terrible trouble. If you get one of these chairs I recommend asking the patients if they can hold them, if they are able, or put them behind their back.

The second generation was the first to deliver what I regard as specially designed bariatric beds. Bariatric is a politically correct way of saying "very big and fat". These were sometimes based on standard designs but were bigger and stronger. There were some other models specialized for bariatric cases from the wheels up. Along with bariatric beds we were given equivalent wheelchairs, operating tables and even mortuary slabs. Together with these innovations were far better intensive care beds with inflatable soft mattresses to reduce pressure sores for patients who were stuck in them a long time. The largest and heaviest of these we called "the Beast" and it needed at least three porters to move it. I wondered where technology would take us in the future, to better or worse machines. The answer was both.

See here for background: http://hpanwo-hpwa.blogspot.com/2023/09/acute-care-vehicles-1-original-fleet.html.

Being Human

 

Being Human is a TV series by the BBC and it's one of the few by the Beeb in recent years I would say is any good. It is described as a "supernatural comedy drama"; but, although it has its droll moments, it's not very funny. Actually it's pretty grim. It follows the lives of three young urbanites who superficially appear to be ordinary people, but they are not. They're not even human, they're only trying to be like humans; hence the title. One is called Mitchell and he is a vampire, the second is called George who is a werewolf and the third is Annie, the ghost of a woman who was murdered. All three of them face different challenges. Mitchell is trying to get by eating normal food and giving up his lust for human blood. George is trying to manage his condition by hiding himself away every full moon; and Annie is haunting the man who killed her, her ex-boyfriend. Despite being completely different denizens of the undead, George and Mitchell share a very important common destiny; they are both HP's. My two brother porters, if I can call a werewolf and a vampire my brothers... Of course I can, they're HP's for goodness sake!... Anyway, George and Mitchell serve in the same hospital and appear to be in the same section, but they deal with the challenges of the profession differently. George maintains a light-hearted attitude and he has a part-time job teaching English as a foreign language. However, Mitchell is bitter and exhibits a lot of self-pity. In one scene where his partner is mourning the death of her goldfish, he says to her: "I wade through blood and shit from dawn till dusk for the minimum wage, so don't whinge to me about some bloody goldfish!" As I've explained before, that might be true, but the victimhood mentality is not helpful. It breeds an inner darkness and cynicism that becomes a goal in itself; almost an addiction. HP's can easily fall into that trap and we must avoid it at all costs. George manages to find a girlfriend of his own at one point. Of course this means he has to make up some excuse to explain why he goes away on his own once a lunar month. At one point he tells her: "I have to go off on a training course." She replies: "Training? You're only a hospital porter, George!" I'd dump her on the spot if she said that to me! There are some pretty horrific scenes and storylines in the series, making it more of a horror than a comedy. At one point, the protagonists are kidnapped by a religious cult who do sadistic experiments on them. Despite this, and its sometimes patronizing anti-HP-ism, it is very well done in terms of writing, acting and plot; so it's worth watching. Since the original BBC seasons it has been picked up by an American network that have produced their own version, as Americans tend to. See here for the trailer: https://www.youtube.com/watch?v=YWjZ2QU999o.

Stop Expecting Better

 

I keep hearing complaints like this from my fellow HP's.
"Why do civilians talk down to me all the time?"
"Why does the head porter never take my side in a dispute?"
"Why do people have a go at me when I've done nothing wrong to them?"
"Why do senior staff lie about me or twist things?"
You might have noticed that I have made similar complaints about my own career, legitimately. The invention of the Dignity Statement is for the purpose of undoing and eliminating this situation, for example: https://hpanwo-radio.blogspot.com/2020/08/the-gas-spanner-programme-2.html. It can't make the head take your side in a dispute, but it will work in all the other examples I gave. The first step to overcoming this bleak state of affairs is actually not learning the Dignity Statements, it is expecting these things to happen. I used to be like that too. Whenever one of the above scenarios unfolded I would storm around the lodge lamenting "That was so unfair!"... "Why did she do that!?"... "I can't believe he just told such a blatant and shameless lie about me!" I was not alone; nearly all my brothers and sisters did the very same, in fact hardly a shift passed without it. I only found a way to integrate these very unpleasant experiences when I realized that I should stop expecting better. We're part of a massive, heartless, mindless, gutless government bureaucracy. The NHS is the world's third biggest employer (after the People's Liberation Army of China and India Railways). It is a purebred mutant baby of the state. 1.27 million servicemen have to be organized into an effective healthcare provision unit with no natural incentives at all for justice, diligence, conscience and duty. More than that, these sentiments are actually discouraged, to say the least, by management. The unspoken truth very quickly sinks in that there are no rewards for honest hardworking service, quite the opposite in fact. Corruption waxes, discipline wanes. Is it any wonder people within it are so spiteful and backbiting? Battery hens peck at each other not the farmer. This realization is actually an incredible liberation. When you stop expecting better from your colleagues, including your brother porters sometimes, you can face the world for what it is rather than what it should be. That is when the Dignity Statements come in. That is the first step to creating a world that is as it should be.

Gaza Hospital Attacked

 

See here for essential background: http://hpanwo-hpwa.blogspot.com/2023/10/gaza-hospital-evacuation.html.
The news is reporting that the Al Ahli Hospital in Gaza City has suffered a gigantic explosion. It is reported that "hundreds" have been killed. The IDF says that this hospital was not one of its targets, but to me it is incredibly unlikely that this was not the result of Israeli offensive action. (EDIT: This is now seriously been called into question.) They have claimed that Hamas terrorists have established makeshift bases in Gaza hospitals. It is not the purpose of the HPWA blog to discuss the rights and wrongs of what's going on politically in Israel and Gaza now; we're going to focus on the HP's and their duties. The background link below has a wider scope. A spokesman for the Palestinian National Authority has stated that the Gaza hospital infrastructure has now totally collapsed. Water and fuel for emergency generators has run out. A surgeon, Professor Ghassan Abu Sittah, said: "Parts of the hospital are on fire. I don't know whether that is the emergency department. But it's certainly the operating suite, part of the roof has fallen. There is broken glass everywhere." Source: https://www.youtube.com/watch?v=oUxZFxwwp-Y. From what I've seen, at this point the situation at the damaged hospital is one for the fire brigade, and indeed I have seen videos of firemen entering the premises. Some casualties have been moved to waiting ambulances, but right now the ambulances are the only places they can be treated. There is nothing more we HP's can do at this point. With the breakdown of the infrastructure and the attack on the campuses, probably personnel discipline will also weaken. The surviving staff have their own families and loved ones who need them. I'm afraid I don't fancy the chances much of any patient still left in the hospital. If they were too sick to be evacuated a few days ago, they are unlikely to survive now. The focus must shift to those who have a fighting chance. An Egyptian spokesman claims that the border at Rafah is not closed, but this makes no sense because the bottlenecks of refugees on one side and aid lorries on the other are not moving in either direction. My heart goes out to all those affected by this, in Gaza and Israel.
See here for more information: http://hpanwo-tv.blogspot.com/2023/10/israel-war-livestream.html.

Gaza Hospital Evacuation

 

There is an ongoing evacuation operation underway in hospitals all over the Gaza Strip. This Palestinian enclave has a population of over half a million in an area of 141 square miles, about the size of the Isle of Wight. The enclave is therefore highly urbanized. The hospitals there are already overcapacity because of retaliatory strikes against Hamas by Israel (as are Israeli hospitals because of initial Hamas attacks). As a former hospital porter I can understand exactly how dire a situation these hospitals are in. Yesterday, the Israeli government warned Gaza hospitals that they had two hours to evacuate all their patients because the buildings risked being targeted by strike missiles and aerial bombardment. The reason is that Israel suspects Hamas has set up headquarters in some hospitals. At my hospital, the John Radcliffe in Oxford, we often did evacuation drills, but this was moving patients quickly from one part of the hospital to the other in case one area was struck by fire, flood or explosion etc. At no time did we think of a contingency involving the evacuation of the entire hospital. The noble welfare group Médecins Sans Frontières, French for "doctors without borders", protested saying that two hours is not nearly long enough to evacuate all the patients. Israel relented and increased the grace period to eight hours. Source: https://www.timesofisrael.com/liveblog_entry/israel-warns-hospital-in-northern-gaza-to-evacuate-by-6-a-m-rights-group/. However, is this long enough? The difficulty in evacuating a patient is primarily dependent on how serious their condition is. The walking wounded can move themselves; somebody with a minor fracture, burns or lacerations can be transported by trolley or wheelchair, but what about somebody in intensive care? How about somebody undergoing major surgery? What's more, where do they go afterwards? When evacuating seriously ill patients there is really nowhere you can evacuate them to except another hospital. If all the hospitals in Gaza have to be emptied, where do the staff take the patients? It is obvious Israel is preparing for a full-scale invasion of Gaza which will probably happen in the next couple of days. The only way out is through the border with Egypt which is currently tightly controlled. There are large hospitals on the far side of the border that will be able to help, such as the Rafah Central Hospital. Obviously Egypt does not want Hamas terrorists in its midst anymore than anybody else does, but if they don't help then there will be carnage in Gaza and 99% of the people killed will be innocent. I salute my Extremely Proud and Dignified Brother and Sister Porters in both Gaza and Israel; as well as the brave civilian healthcare providers. May this crisis end soon and without further atrocity.

Platelet Hand Agitation

 

What is it about HP's that when we do our job we might have to do it well, but not too well? I have been challenged several times in the course of my career, not because I wasn't being a good enough porter, but because I was too good a porter. One of these examples involves platelets. Platelets are blood cells whose function is to cause coagulation when a blood vessel is breached. They clump together at the rupture site and form a gelatinous blockage which eventually hardens into a scab. This is essential for stopping bleeding; without it we could not live. Platelets are extracted when blood components are separated in the transfusion laboratory before being given to patients. They look like opaque yellow fluid and are stored in a plastic bag, illustrated above. Unlike red corpuscles and plasma which have to be chilled, platelets have to be stored at a warm room temperature, twenty to twenty-four degrees. They also have to be continuously "agitated", this means kept in constant motion otherwise coagulation initiates and they set into a solid lump of jelly; making them useless. In the storage cabinet they are put on a machine that constantly lurches and rotates. Now, when I was being trained in the late '80's the porters who trained me told me that when I'm carrying the platelet units to where they are needed I have to do something called "hand agitation". This means simply imitating the action of the storage machine with our hands. I did this for my entire career when delivering platelets. Newer porters didn't do this because that part of our training was discontinued, like so much else in our traditional skill-set. Welcome to a result of the casualization that I have described elsewhere, for example: https://hpanwo-hpwa.blogspot.com/2011/09/why-do-we-need-hpwa.html.
 
One day I was delivering platelets and was accompanied by a "boy wonder", a young and well-connected individual with "one foot in the lodge", as we used to say. Basically they all had ambitions to be trust directors and were doing their standard six months in portering for three words on their CV. I can't recall why this boy wonder was with me, but we were standing in a lift together while I did the hand agitation and he frowned and said "Why are you doing that?" I explained why and he immediately replied: "Don't do it please." I asked: "Why?" He said: "It looks unprofessional." I asked him to explain and he made a chopping motion with his hands and said: "I'm not going to have this conversation with you here and now; I am a senior member of staff and I am just asking you not to do that with the platelets." I refused and continued, calmly and politely, to demand some clarity and he said: "Very well, Ben; if you're refusing to obey my order I will have to report you to the office." He looked almost as agitated as the platelets I was holding. I shrugged and said: "Go ahead." He never did. Actually I was never really worried that he would. Despite this, I was dismayed and baffled at his actions, and his insistence that I do not do the hand agitation. What difference does it make? Where's the harm? It is almost as if he had been given instructions to pull the porters up if they did their jobs too well. Are the original skills of hospital portering not merely being accidentally forgotten, they are being deliberately outlawed? Is the enforcement of mediocrity a policy? Is porters' Pride and Dignity a threat? Is expertise and commitment in the Hospital Portering Service a detriment to today's NHS? If so, why is that? I can think of other examples and I will describe them in future articles. Something to think about, isn't it?