20th Century Medical Innovation

Extract From: Maya Bring Tears Of Happiness

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“THE WORLD WILL NOT BE DESTROYED BY THOSE WHO DO EVIL BUT BY THOSE WHO WATCH THEM WITHOUT DOING ANYTHING” - Albert Einstein

I have been observing how one bacteria MRSA (Methicillin Resistant Staphylococcus aureus) I encountered in 1989 has successfully created an army of eighteen bacteria that threaten our very existence. People in power have been very obstructive and stifled innovations, institution have been defensive because they believe scientist using advances in technology will soon bring in miracle cure to help us fight infections.

Maya is the only tool that can help provided you use our Apps or Website to log in the symptoms to help our server identify emerging infection early. Preventing infected individual travel, visiting health centre, clinic, surgery or hospital is mandatory to protect fellow human, doctors, nurses and staff.

We sincerely hope nurses, doctors, and you will download our apps and help us create a network of doctors and users. We have integrated innovation to initially identify infected individual early by monitoring the symptoms and isolate them. Please support us, offer suggestions, or recommend better alternatives if there are any, so that we can share our knowledge and experiences, joining hands to make sure our family, friends and children are protected.

HISTORY OF MEDICINE

Early medical traditions stem from ancient Egypt and Babylon, from where healthcare originated. The Greeks introduced the concepts of medical diagnosis, prognosis, and medical ethics. The Hippocratic Oath, first written in


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Greece in the fifth century BC, was significantly changed by doctors in the nineteenth century but is still accepted today.

In the medieval ages, surgical practices inherited from the ancient masters were improved and then systematized in The Practice of Surgery. Italian universities formally established a system to train physicians around the year 1220.

During the Renaissance period, the understanding of human anatomy improved, and the microscope was invented. The germ theory of disease was accepted in the nineteenth century. Military doctors advanced the methods of trauma treatment and surgery. Public health measures were developed, especially in the nineteenth century, as the rapid growth of cities required systematic sanitary measures.

Advanced research centres opened in the early twentieth century and were often connected with major hospitals. The mid-twentieth century was characterized by new biological treatments, such as antibiotics. These advancements, along with developments in chemistry, genetics, and lab technology such as the X-ray, led to modern medicine.

Medicine was heavily professionalized in the twentieth century. New careers opened up to women as nurses (starting in the 1870s) and as physicians (especially after 1970). The twenty-first century is characterized by highly advanced research involving numerous fields of science.


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COMMERCIALISATION OF HEALTHCARE

In the nineteenth century, the British ruled various countries and used their power to kindle emotions and promote modern medicine. Using media, they successfully made people believe that doctors trained in western medical schools, save lives and healthcare profession was created to help alleviate pain, suffering, and cure illnesses.

The popular story of Winston Churchill’s father paying for Fleming’s education after Fleming’s father saved young Winston from death is though false, but it was used to promote healthcare.

According to the biography Penicillin Man: Alexander Fleming and the Antibiotic Revolution by Kevin Brown, Alexander Fleming, in a letter to his friend and colleague Andre Gratia, described this as “a wondrous fable”. Also, he did not save Winston Churchill himself during World War II.

It was Lord Moran who used sulphonamides to save Churchill at Carthage, Tunisia, in 1943. The Daily Telegraph and the Morning Post wrote on 21 December 1943 that Churchill had been saved by penicillin. He was saved instead by the new sulphonamides drug sulphpyridine, developed by May & Baker Ltd, a subsidiary of a French group. Churchill referred to the new drug as “this admirable M&B”.

The original sulphonamides antibiotic, Prontosil, had been discovered by the German laboratory Bayer’s. Britain was at war with Germany at the time, and it was thought better to raise British morale by associating Churchill’s cure with a “British” discovery, penicillin.


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FLORENCE NIGHTINGALE

Florence Nightingale is considered one of the great icons of the Victorian age, despite some hostile comments by in particular from F B Smith, the popular image of her remains that of the angel of Scutari. She is known as the genius behind medical reform and the development of nursing in the UK. The fame and influence Nightingale gained would never have happened without the help of the press (BMJ, 2008; 337:a 2889).

Nightingale was born into a wealthy, well-connected family. At the time of the Crimean War, influence was often determined by social standing. Lord Palmerstone, the prime minister during much of the war, was a close friend and neighbour of Nightingale’s family in Hampshire. Such contacts were easily extended, and in her twenties, Nightingale formed a close friendship with Sidney Herbert, who later became secretary at war and her most important political patron. She did not marry and have one special man but had many special men in her life.

She was considered to be a snob, displaying considerable resentment towards poor people, and towards Crimean doctors from poor families in particular, who she thought had dared to rise above their stations.

No previous war had been so extensively covered by the press or in such a way, with sensationalist and scandalous stories fanning the flames of mass hysteria in Britain. Indeed, such was the acclaim with which Cook’s biography of her was greeted that Nightingale’s reputation was largely unimpeachable for the next few decades.


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In the medical department, Nightingale seemed to have no hesitation in participating in the attacks on army doctors working in the Crimea and the army medical department in general. The full extent of her vilification of those to whom she took a dislike, or the extent to which she promoted the cause of her favourites, can never be known because she destroyed many of her papers and letters relating to this period.

One reason this situation remained unchallenged is that historians generally have not undertaken the breadth of primary research necessary to objectively re-evaluate Nightingale’s work, her achievements, and her role in the movement for medical reform in the nineteenth century.

It was this examination of primary sources that shows how much of her reputation is based on the myths created by the popular press at the time of the Crimean War and subsequently at her death. It can therefore hardly be regarded as unbiased, written as it was in the aftermath of World War II, at a time when Britain was in desperate need of heroic gurus. (Keith Williams; Wellcome History, Issue 37)

20th Century British Innovation THE NURSE PRESCRIBERS AND CONSULTANTS

The topic of non-medical persons (nurses and chemists) prescribing drugs has taken many years of planning, review, and discussion. It has been a long-fought, hard battle between doctors and nurses, and it was won by nurses in 2006.


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Since the 1980s, nurses have been exploring the right to clinical assessment, to make diagnoses independently, and to prescribe drugs. In 1978 the Royal College of Nursing (RCN) presented a report proposing that nurses should have authority to prescribe dressings and topical treatments. In 1986 the Conservative government appointed a team of health experts (mainly nurses, and economists), asking them to review the provision of community nursing and make recommendations for the future of that provision.

The RCN used the opportunity to highlight the arguments for amending legislation to allow nurses to prescribe medications. Following the publication of the report, which was positively received by the government, support was gained from the British Medical Association (BMA) and the Royal Pharmaceutical Society of Great Britain (RPSGB).

However, in order to create a legal framework for nurse prescribing, the 1968 Medicines Act had to be amended. The amendments were finally made in 1992. Over the following eight years, the Labour government embarked upon a programme of prescribing policy growth. Prescribing policies formed part of a wider range of policy developments from the Labour government that were aimed at increasing the efficiency and cost- effectiveness of the National Health Service (NHS) through modernization.

Nurse independent prescribers are specially trained nurses allowed to prescribe any licensed and unlicensed drugs within their clinical competence. In 2006, nurse prescribers were given full access to the British National Formulary (BNF), and this has put nurses on par with


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doctors in relation to prescribing capabilities. As of April 2012, independent nurse prescribers will be able to prescribe controlled drugs within their competence level and regularize the practice of mixing medicines, which include controlled drugs.

Community practitioner nurse prescribers are a distinct group under independent prescribers. District nurses, health visitors, and school nurses are allowed to independently prescribe from a limited formulary called the Nursing Formulary for Community Practitioners.

Nurse supplementary prescribing is based on a voluntary prescribing partnership between a doctor (independent prescriber) and a nurse (supplementary prescriber), where the supplementary nurse prescriber has the ability to prescribe any drug listed in a patient-specific clinical management plan once the patient has been diagnosed by a doctor. There are no legal restrictions on the clinical conditions that the supplementary prescriber cannot prescribe.

To qualify as a nurse prescriber, nurses must undertake a recognized Nursing and Midwifery Council (NMC)–accredited prescribing course through a UK university. Upon successful completion, the qualification must be registered with the NMC.

Since 2004, all nurses who complete the NMC qualification can prescribe independently, as well as in a supplementary capacity. UK nursing regulators will only accept practitioners who are qualified through UK universities that are following the NMC’s curriculum. Some other countries have their own forms of nurse prescribing, with differing curricula completed at differing levels of education, and with differences in the


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formularies open to these staff, there is very little opportunity for staff to transfer their qualifications across international borders, as they are able to do with their main nursing registrations.

The NCM refuses to accept responsibility for the number of deaths, hospital admissions, compensation pay-outs, and medical errors that have increased since 2006. The studies published by nurses only highlight “patient satisfaction” and do not talk about the standard of care offered by nurses. We made numerous attempts to organize a study in a pilot PMS nurse-led practice in 2003 long before nurses were prescribing drugs in the NHS (UK). Unfortunately, our effort was stiffened by a group of nurses supported by people in power.

The NCM in the UK is busy promoting and implementing their newfound freedom, which allows nurses they’ve trained to collect personal, sensitive information; clinically examine; diagnose; advise; and prescribe drugs in countries all over the world. Doctors who protested were humiliated, harassed, and often outraged by unsubstantiated claims and complaints.

Doctors who felt very uncomfortable created MAYA to fulfil their obligation and duty to help protect their fellow humans. Patients are unaware about the primary role of doctors and nurses but were made to believe they save lives.

Doctors know they are expected to strive hard and to encourage patients to consult early, hoping to prevent complication and long-term problems. Doctors know various treatments and drugs they prescribe seldom cure illness, and it is unethical to allow non-medically-trained professions, not governed by the code of conduct of


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doctors, to use their skills, diagnose, and prescribe drugs.

Because doctors and nurses abuse antibiotics, we have now lost the most precious drug that helped saved millions of lives. We are now struggling to fight the threat of resistant bacterial infections that threaten the medical profession, humanity, and our lives.

Nurses prescribing drugs in hospitals and clinics aren’t worldwide at present. The nursing council in the UK claim a growing number of countries are looking to develop it; they have tried their best to conceal the truth, and they are publishing books and marketing this as an alternative to doctors. They are hoping to commercialize courses, sell books all over the world, promote universities that offer training to nurses who can prescribe drugs, and replicate the success of creating the modern nursing profession after World War II.

We strongly support Colin Powell’s comment in the editorial of Arch Dis Child (2013), which made it clear that other countries wanting to emulate the UK experience should proceed with caution (Jones P, Schimanski K. Emerg Med Australas 2010;22:391–8).

This was based on evidence that points out the continuing increase in the very short- term admission of children with common infections, which suggests a systematic failure, both in primary care (by general practice, out-of-hours care, and NHS Direct) and in hospitals (by emergency departments and paediatricians), in the assessment of children with acute illnesses that could be managed in the community (Arch Dis Child 2013; 98: 328–334).

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20th Century Medical Innovation