Reviews PERSONAL VIEW

Hot buttons and quality

BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7488.427 (Published 17 February 2005) Cite this as: BMJ 2005;330:427

I am a retired general surgeon. I was rung by my daughter one Saturday evening and faced with a problem. “My neighbour's wife is in hospital in this city, and he is very concerned about her management,” she said. “She had an operation recently on her bladder—one to enlarge her bladder using bowel—and this was successful. And then she had a stroke and had to be transferred to a stroke unit (unfortunately on a bank holiday). Her husband was told that she would need regular bladder washouts and that these would be done on the new unit.”

She continued: “While she was making a good recovery from her stroke, he was concerned that she appeared to be lying in a wet bed and asked the nurses about this. He was told that either the catheter was blocked and urine was leaking round it or she was getting incontinent. He asked why the bladder washouts were not being done. And at this point confusion set in. One nurse averred that she couldn't have bladder …

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