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I think of the wards as pretty much the trenches of World War One, but our enemy is a sophisticated modern guerrilla outfit.

We are bogged down in a quagmire of inefficiency, with our Staff Officers safe many miles behind the lines, but sending us up fresh supplies of paperwork to add to our backpacks, so we sink ever deeper into the quagmire, as the Officers blame us for the impending defeat “Fight harder, fight longer, do more fighting, we are bound to win …”

The dementia screening form is the final straw that has broken the back of my enthusiasm – if we ever get the time to work out that the patient has dementia, we still do not get to meet a nurse to share the information and plan the appropriate care! My “Nurse at Bedside” or “Report from Nurse before Bedside” rate remains stubbornly below 50%