Lucy Letby case #22

[docmum]

I’d say please keep the Google thing as open minded as you can. I have apps for antibiotic formularies and for certain blood tests/meanings on my phone. I have NICE cks guidelines open on my desktop at work and I absolutely always check the BNF or the NICE guidance for doses of medications in children and pregnant women. Might be for amoxicillin which can be several times a day for the same aged children, but I still check - the same way I always check the calpol bottle when giving any to my own (literally last night did this and couldn’t remember their age for a few seconds even when I did check ). There is so much going on in healthcare, and guidance can change often too. There can be huge changes in doses of meds or sizes of tubes in different aged children - more so in the weights of neonates. This line would have to have been ‘signed off’ previously by a senior doctor if the doctor was expected to be doing it independently - perhaps they were due to talk through it to a junior/student so wanted to use the official teaching website to do so, maybe they had been in general paediatrics and away from neonatal medicine for a few months so wanted to refresh. Maybe there was more negligent behaviour in play and I am defending something genuinely done wrong.
All I’d say is that if you see a doctor looking up or checking something in front of you and discussing it, it probably should give you more confidence that they respect their limitations and acknowledge patient safety rather than assuming their incompetence.xxx

 

[LittleMy]

I’d say please keep the Google thing as open minded as you can. I have apps for antibiotic formularies and for certain blood tests/meanings on my phone. I have NICE cks guidelines open on my desktop at work and I absolutely always check the BNF or the NICE guidance for doses of medications in children and pregnant women. Might be for amoxicillin which can be several times a day for the same aged children, but I still check - the same way I always check the calpol bottle when giving any to my own (literally last night did this and couldn’t remember their age for a few seconds even when I did check ). There is so much going on in healthcare, and guidance can change often too. There can be huge changes in doses of meds or sizes of tubes in different aged children - more so in the weights of neonates. This line would have to have been ‘signed off’ previously by a senior doctor if the doctor was expected to be doing it independently - perhaps they were due to talk through it to a junior/student so wanted to use the official teaching website to do so, maybe they had been in general paediatrics and away from neonatal medicine for a few months so wanted to refresh. Maybe there was more negligent behaviour in play and I am defending something genuinely done wrong.
All I’d say is that if you see a doctor looking up or checking something in front of you and discussing it, it probably should give you more confidence that they respect their limitations and acknowledge patient safety rather than assuming their incompetence.xxx

Was going to say this. It would reassure me that at least they were making sure things were right. Nobody can know everything off the top of their head especially with, as you say, advice and guidelines changing a lot over time.

 

[DellaC]

I’d say please keep the Google thing as open minded as you can. I have apps for antibiotic formularies and for certain blood tests/meanings on my phone. I have NICE cks guidelines open on my desktop at work and I absolutely always check the BNF or the NICE guidance for doses of medications in children and pregnant women. Might be for amoxicillin which can be several times a day for the same aged children, but I still check - the same way I always check the calpol bottle when giving any to my own (literally last night did this and couldn’t remember their age for a few seconds even when I did check ). There is so much going on in healthcare, and guidance can change often too. There can be huge changes in doses of meds or sizes of tubes in different aged children - more so in the weights of neonates. This line would have to have been ‘signed off’ previously by a senior doctor if the doctor was expected to be doing it independently - perhaps they were due to talk through it to a junior/student so wanted to use the official teaching website to do so, maybe they had been in general paediatrics and away from neonatal medicine for a few months so wanted to refresh. Maybe there was more negligent behaviour in play and I am defending something genuinely done wrong.
All I’d say is that if you see a doctor looking up or checking something in front of you and discussing it, it probably should give you more confidence that they respect their limitations and acknowledge patient safety rather than assuming their incompetence.xxx

Of course, It's not something I would question. When you visit a GP they check the BNF etc. You can't expect anyone to keep such a wealth of information in their head all the time. We need all medical staff to research and develop.

For the family it probably lead to the anxiety in an already chaotic situation. It was just another thing to pluck out and question. I bet they've relived the whole scenario repeatedly.

I hope they get some closure and some answers from this trial ‍🩹

 

[CabalofBolorneaise]

Of course, It's not something I would question. When you visit a GP they check the BNF etc. You can't expect anyone to keep such a wealth of information in their head all the time. We need all medical staff to research and develop.

For the family it probably lead to the anxiety in an already chaotic situation. It was just another thing to pluck out and question. I bet they've relived the whole scenario repeatedly.

I hope they get some closure and some answers from this trial ‍🩹

Yeah I get the impression in this case it's another thing added to the issues that they already (rightfully given their experience) had with the ward and if it had just been that alone, probably they wouldn't even have noticed.

 

[sassmaster3000]

I’d say please keep the Google thing as open minded as you can. I have apps for antibiotic formularies and for certain blood tests/meanings on my phone. I have NICE cks guidelines open on my desktop at work and I absolutely always check the BNF or the NICE guidance for doses of medications in children and pregnant women. Might be for amoxicillin which can be several times a day for the same aged children, but I still check - the same way I always check the calpol bottle when giving any to my own (literally last night did this and couldn’t remember their age for a few seconds even when I did check ). There is so much going on in healthcare, and guidance can change often too. There can be huge changes in doses of meds or sizes of tubes in different aged children - more so in the weights of neonates. This line would have to have been ‘signed off’ previously by a senior doctor if the doctor was expected to be doing it independently - perhaps they were due to talk through it to a junior/student so wanted to use the official teaching website to do so, maybe they had been in general paediatrics and away from neonatal medicine for a few months so wanted to refresh. Maybe there was more negligent behaviour in play and I am defending something genuinely done wrong.
All I’d say is that if you see a doctor looking up or checking something in front of you and discussing it, it probably should give you more confidence that they respect their limitations and acknowledge patient safety rather than assuming their incompetence.xxx

My two most visited websites are BNF and tattle

 

[Tofino]

“probably back in with a bang lol”

 

[MmmB777]

I’d say please keep the Google thing as open minded as you can. I have apps for antibiotic formularies and for certain blood tests/meanings on my phone. I have NICE cks guidelines open on my desktop at work and I absolutely always check the BNF or the NICE guidance for doses of medications in children and pregnant women. Might be for amoxicillin which can be several times a day for the same aged children, but I still check - the same way I always check the calpol bottle when giving any to my own (literally last night did this and couldn’t remember their age for a few seconds even when I did check ). There is so much going on in healthcare, and guidance can change often too. There can be huge changes in doses of meds or sizes of tubes in different aged children - more so in the weights of neonates. This line would have to have been ‘signed off’ previously by a senior doctor if the doctor was expected to be doing it independently - perhaps they were due to talk through it to a junior/student so wanted to use the official teaching website to do so, maybe they had been in general paediatrics and away from neonatal medicine for a few months so wanted to refresh. Maybe there was more negligent behaviour in play and I am defending something genuinely done wrong.
All I’d say is that if you see a doctor looking up or checking something in front of you and discussing it, it probably should give you more confidence that they respect their limitations and acknowledge patient safety rather than assuming their incompetence.xxx

My child was experiencing migraines and our lovely GP was thinking out loud about medi and whether it was worth trying and he tends to get out a big old school book and looks through at the recommendations for the drugs etc and he gave me his best opinion but referred to a consultant to be sure. I cannot imagine how the docs felt in this situation. I imagine people were losing their heads more than usual because of how awful the last few months had been.
Really shocked by her not being sure of the doses of adrenaline as imagine that’s extremely crucial?

 

[docmum]

Perfect (at the time) cover up for Lucy, having a student nurse with her. The opening statement said she was designated nurse these two babies. So if the parents are correct and she wasn’t around much then what was she doing?

Dr Gibbs getting snappy with Lucy makes me wonder if he made an association by that point as he had seen quite a few of these babies collapses.

when there’s a resuscitation process going on there should be a member of staff allocated just to scribe events over that time - there should be a strict timeline of what happened, what’s given, along with the exact times. That person doesn’t do anything else at that time to ensure the events are clearly documented and clear for reference of the person running the resuscitation. To me he’s absolutely right to want to know exactly how much has been given and could be a coincidence that it happened to be LL he asked - or could be interpreted to show her concentration was elsewhere, or that she was trying to negatively influence treatment. It definitely shows the chaotic nature of things though.
ETA - but yes, maybe he’s absolutely exasperated by it always being her around any problem. Todays reporting makes it sound so harrowing for everyone there

 

[DellaC]

Yeah I get the impression in this case it's another thing added to the issues that they already (rightfully given their experience) had with the ward and if it had just been that alone, probably they wouldn't even have noticed.

I loved watching how the Doctors and Nurses looked after my boy, they were just fantastic.

I was put to sleep for delivery and the scalpel caught his little face when they cut me open. That was absolutely nobody's fault. It had been a terrible labour and it was a risky birth but they got him out and he was safe.
If it had ended differently I maybe would've focused on that cut...I may have seen it differently.

This poor family must've been ripped apart by grief and of course they're going to focus on the things that seemed a bit off.

 

[Tofino]

when there’s a resuscitation process going on there should be a member of staff allocated just to scribe events over that time - there should be a strict timeline of what happened, what’s given, along with the exact times. That person doesn’t do anything else at that time to ensure the events are clearly documented and clear for reference of the person running the resuscitation. To me he’s absolutely right to want to know exactly how much has been given and could be a coincidence that it happened to be LL he asked - or could be interpreted to show her concentration was elsewhere, or that she was trying to negatively influence treatment. It definitely shows the chaotic nature of things though.

oh yes absolutely right he was annoyed with her. Given she looks down on a lot of the staff you would expect she would be able to do a better job of knowing how many shots of adrenaline the baby had. I did wonder about her trying to sabotage treatment.
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Wanting room 1 again. And the boys that died were in room 2 where she was designated.

 

[MmmB777]

oh yes absolutely right he was annoyed with her. Given she looks down on a lot of the staff you would expect she would be able to do a better job of knowing how many shots of adrenaline the baby had. I did wonder about her trying to sabotage treatment.

Mum says Letby was there the whole time. She has the note, she’s scribed it so why wouldn’t she know and why did he have to badger her to get an answer. Crazy imo.

 

[stardust1]

oh yes absolutely right he was annoyed with her. Given she looks down on a lot of the staff you would expect she would be able to do a better job of knowing how many shots of adrenaline the baby had. I did wonder about her trying to sabotage treatment.
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Wanting room 1 again. And the boys that died were in room 2 where she was designated.

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Does anyone know what the job was?

 

[Tofino]

No time to do anything except continually WhatsApp.

Baby Q was already in room 1 at this point too.

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Does anyone know what the job was?

It doesn’t say. This is the only other thing reported.

She did get a new job, a job in admin not sure that was the job she was after though…

 

[MmmB777]

No time to do anything except continually WhatsApp.

Baby Q was already in room 1 at this point too.

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Omg just about to share the same. Get off WhatsApp you absolute bellend and you’ll have more time. wick.

 

[Ray_of_Sunshine]

A really awful one, poor little baby.
Lots of experts on this one and a very familiar story unfortunately.
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So “result of impact type trauma and not the result of cpr” and “inflicted traumatic injury to the liver” …she hit the baby???

 

[Tofino]

She’s so rude about anyone she deems less experienced than her. Going to be hard for BM to claim the babies were left with a student when Lucy herself is moaning the student was with her the entire time.

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So “result of impact type trauma and not the result of cpr” and “inflicted traumatic injury to the liver” …she hit the baby???

I’ve wondered this. I don’t think they have reported (or said in court) what can cause an inflicted trauma injury on the liver. You’d think there may be external signs but maybe the baby deteriorated too quickly for that to happen.

 

[IGiveUp22]

Surely it can’t be normal the messages she sending that dr? I feel like he was fishing a bit when he asked her which room she worked in & if she gets a choice…

 

[docmum]

She’s so rude about anyone she deems less experienced than her. Going to be hard for BM to claim the babies were left with a student when Lucy herself is moaning the student was with her the entire time.
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I’ve wondered this. I don’t think they have reported (or said in court) what can cause an inflicted trauma injury on the liver. You’d think there may be external signs but maybe the baby deteriorated too quickly for that to happen.

good point re being unable to blame the student. I wonder if the student is giving evidence, if they saw anything. I wonder if they’ve managed to psychologically be able to continue with a career after this. Awful.
Did cross my mind as to whether she was given a student towards the last few babies as a way of the senior nursing staff members feeling LL was in some way being supervised (not in a senior way, in a more busy environment ‘do no harm’ way) or accountable for decisions she was making throughout the shift. Genuinely I hope it’s not the case though!

 

[gimmethattea]

I'm derailing a bit, but I'm really behind and skim reading bits today, but I just want to add re the googling.

My son was in Neonatal with Group B Strep Sepsis for a week and then the Children's Ward with Group B Strep again for nearly 2 weeks a week after.

Some doctors had never even heard for Group B Strep, especially when referring to it as Streptococcus agalactiae. on the second admission to the children's ward, most don't have a clue why he had caught it twice, I got given lots of contradictory information that changed daily, all about how long his antibiotics should be, if there was any tests they should do and they were consistently in contact with another hospital who had more experience to help make decisions about what they should do next.

As much as I found it very frustrating at the time, I kind of got the idea that they didn't really have much experience with Group B Strep, so I was happy they were seeking extra advice and making sure they were doing the right things. Especially as it can be a dangerous and fatal infection if not treated early.


Wouldn't they also have to make lots of different decisions based on baby? In the Neonatal, there is such a variety of babies and their needs. Lots of different sizes of baby and born at different gestation too. Would the size and weight of the baby make a difference into their treatment too?

As much as we'd like people to know everything, it really is impossible to successfully remember all that information and I'd rather they check before they had to do something if they were unsure, but that's me personally.

 

[Tofino]

I think the potential issue was the mother believed a junior doctor was googling how to do a procedure, before doing a procedure. (Although grandmother said nurse). This would understandably be alarming esp on a premature baby but I think it’s more likely one of the scenarios others have given.