Merope Mills’s article (‘We had such trust, we feel such fools’: how shocking hospital mistakes led to our daughter’s death, 3 September) should be mandatory reading for all medical and nursing students. All of us who are senior doctors or nurses will recognise only too well the dangerous conditions that Merope describes: the senior doctors with overinflated egos; the internecine warfare between departments; the nursing staff and junior doctors who are rendered impotent by repeated attempts to galvanise action from off-site but know-it-all seniors; the lack of integrated thinking that results when there is no consistent lead clinician; and, most dangerous, not listening to the patient or their relatives, and not directly examining the patient.
Candour and co-production are terms much used in healthcare, but for some staff these aspects of care are a million miles away from the ego-driven practice in which they engage. This is why Merope’s advice is so important. Do not have blind faith in your clinician. Do not leave all the thinking to them. Do equip yourself with knowledge and, most of all, do demand to be treated as an equal partner in the care of your body or your loved one.
I cannot imagine the pain that Merope went through. All I can do as a medical reader is thank her for her extraordinarily illuminative writing and her powerful message.
Virginia Davies
Consultant child psychiatrist
• The meticulous, measured and heart-stopping account of the harrowing last weeks of Martha Mills’s life should be read and reflected on by every one of us doctors. I have published research on medical errors by junior doctors (tiredness and inexperience were the most commonly self-reported explanations). Our later research also found that doctors tend to carry on working despite their own health impairments, for fear of looking “acopic” (unable to cope or function).
Clinical medicine is complex. It involves immersion into a sometimes bewildering mixture of slow-moving and fast-moving life-threatening events, where a doctor’s admission to feeling deskilled can be the first step to a safe outcome. Learning from error should be embedded in medical practice; learning from patients and their relatives, as partners in healthcare, is equally important.
Dr Robert Wrate
Edinburgh
• Working in the NHS as a consultant in anaesthetics and intensive care, I am always saddened to hear these stories of poor care. There are many of us trying to deliver good standards of care. But the story of Merope Mills’s daughter is not isolated.
I have forwarded the article to my colleagues, to remind us all of the standards we should be aspiring to, and the outcomes when we don’t. The practice of medicine requires all of us to listen to patients, have empathy and, when we make mistakes, own up to them.
David Turnbull
Sheffield
• Merope Mills’s words, “We had such trust, we feel such fools…” regarding the actions of the medical staff who failed in her daughter’s care really struck me. As a former children’s nurse, I know that having the trust of a family is paramount.
The culture of the NHS should be challenged, and changed to one that respects and responds to parents and junior staff, where nurses are not frightened to contact doctors, and junior doctors insist that more experienced colleagues do respond to intuition and/or red flags. Until then, more patients will become victims, and the notions of candour, learning and accountability will be just that: simply notions.
Sue Dunlop
Mathry, Pembrokeshire
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