Behind a Cancelled Appointment #Dentist


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Its happens to the best of us – most of us as a Receptionist will have at one time or another booked someone in with the wrong healthcare professional. But it’s how you deal with mistake, and the actions we take to ensure that:

  1. a) it doesn’t happen again and
  2. b) the patient is inconvenienced as little as possible, most important to remember it wasn’t their mistake they were booked in with the wrong person.

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A good friend of mine had this happen to her only last week. She was booked in with a wrong dentist at her Dental Practice – and here is the impact both emotionally and financially it had on her life due to a wrongly booked appointment.

Firstly, the patient has a phobia of the dentist, so to book an appointment in itself is a major ordeal for her. She was told at her last appointment that she needed to have a tooth extraction. The appointment was booked some 6 weeks away – 6 weeks of anxiety about the forthcoming appointment.

No one enjoys going to the dentist but to have a phobia is on another level and unless you understand this you have no idea the stress and anxiety it can cause the patient and those around them.

Her appointment was booked for 10 am last Monday morning. At 9.15 she received a call from the Practice tell her that she had been booked into the wrong dentist (she had been originally registered with the dentist she had mistakenly been booked in with – but because she had gone over a certain period of time without an appointment she had to re-register with the same Practice but was registered under another dentist) She was told that the dentist she was NOW registered with was fully booked for that day, and her previous dentist had refused to see her despite having the half hour appointment booked out.

The receptionist did apologise, and commented that she could hear how anxious the patient was at having the appointment cancelled. She was offered another appointment for the Wednesday at 8.30. She had to refuse this because she had children that she had to get to school and the dentist was a good few miles away from where they lived. She was then offered another appointment on the Friday morning at 10.00.

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Now this already had started causing the patient problems. Because of her phobia of the dentist her husband who is self-employed had to arrange to take time off from work to accompany her to the dentist. When he doesn’t work he doesn’t get paid. The patient also works 3 evenings a week, and Mondays were one of her nights to work.  Because she was going to have a tooth extraction it was suggested because of the type of work she does that she didn’t go into work that evening, so she had to arrange a swap with someone at her work. So, the cancelled appointment had already started to cause unnecessary problems as she now had to have another night off as the appointment was booked for the Friday which was another night she was scheduled to work.

She didn’t feel she could ask for another swap and she didn’t want to take this off as sickness as she prides herself on her exemplary sickness record and didn’t want to leave her work colleagues under pressure if she phoned in sick. She spoke to her boss and she had to take the night off as unpaid leave – another loss of earnings. Her husband had to also swap work around meaning that he was again losing more money on the Friday morning.

She arrived at the dentist, with her phobia now causing her concern she looked for reassurance from the dentist – which sadly she didn’t get. She was given the injection and asked to sit in the waiting room – the injection didn’t seem to take, so she was given a second and third injection before being told that it hadn’t taken and therefore the dentist couldn’t do the procedure. She was told she would have to be referred to the hospital to have the extraction done under a general anaesthetic and was told to expect to wait between 3-6 months. She really wanted to have this procedure done and dusted just to get it out-of-the-way and she certainly wasn’t keen on the thought of having a general anaesthetic, but understood why this would have to be done.

So, she was sent home, she had paid for the extraction that she didn’t have. On top of that now having to take a night off work without pay as well as her husband losing another half day’s wages. This tooth extraction that didn’t happen had now cost them both a lot of money.

10 minutes after leaving the dentist her mouth went completely numb and she couldn’t feel a thing, making her question if she could have indeed had the procedure done after all. She did feel that the dentist had certainly rushed through the appointment.

All of this causing annoyance and stress which could have been avoided if she had been put in with the right dentist when the appointment was being booked.

The importance of getting the appointment right is not only for the benefit of the Practice but also the benefit of the patient – you never know what is behind a cancelled appointment.

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Working Together #NHS #111 #A&E #GPSurgeries


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Sadly, as most of you are all aware there is a lot of negative publicity in the press at the moment about our great NHS service and sadly some of it with good reason.

It saddens me to read some of the dreadful reports about patient care and those working for the NHS being abused and often overworked. Working for the NHS and being a patient I can see a lot of this from both sides.

Doctors surgeries are busting at the seams with patients struggling to get appointments. Practices are merging together but are they able to continue to offer the service they did before?

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The Ambulance service is stretched and A&E are struggling to find beds resulting people being treated in corridors, whilst Ambulance crews are held up in the car parks with patients on board waiting to be seen and treated, often resulting in the ambulance crew not being available to go to the next emergency.

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Sadly, there are still the time wasters and abusers of the service. Those that call that emergency ambulance when all they needed was a GP appointment, the hoax callers that can tie up the emergency services for hours before they finally find that there was no “emergency” to those that present at A&E for minor ailments. Working in the past in A&E it never ceased to amaze me just what people would present with at A&E with. (I have written other blog stories when I worked in A&E)

As a Manager working in the NHS it’s a hard job. Struggling on a daily basis, trying to hit targets, wanting to give best patient care is almost impossible, dealing with staff that are forever under pressure on the front line and answering to stressful those who need to be obeyed.

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As a Receptionist, you will never please everyone, and many will be sure to be vocal and let you know how unhappy they are and often blame you for the “awful service”.  Telephones ringing constantly, people demanding urgent appointments that you just haven’t got, GP’s and Managers constantly asking the impossible from you, and all while you are working for barely more than the minimum wage.

Hearing from friends, updates on social media and press reports everyone is struggling to be seen resulting in people misusing the NHS because they had no alternative.

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A friend recently phoned 111 (for my overseas readers this is an out of hours service which covers GP surgeries when they are closed – an excellent service which gives patients 24/7 cover). My friend felt very unwell, sore throat, temperature and generally feeling very unwell. She spoke to somewhere at the 111 Service, for whatever reason the 111-service suggested she took paracetamol and phone her GP surgery the following morning. She had a bad night and phoned her GP Surgery first thing the following morning. Her surgery was unable to offer her an appointment and she explained how ill she felt, she was than advised if she continued to feel unwell to take herself off to A&E – as ill as she felt she would have never done this but many might have acted on this advice. She left it another 24 hours and phoned the surgery again where she was given an appointment for that day where she was given Antibiotic and Steroids for a chest infection.

My husband was recently poorly at a weekend, as thought he had a nasty chest infection. I phoned to see if we could get an appointment at a local Treatment Centre (the out of hours service where you can see a GP). After giving the operator all his symptoms (he was breathless due to the cold/chest infection) the operator said they she recommended that they send an ambulance out to him. The protocol said that if the patient was breathless or had breathing problems that an ambulance should be sent. There was no way that he needed an ambulance, he could have actually driven himself to the Treatment Centre, he was ill but not that ill, and even if he was I could have driven him there.

I believe that both of the above where 2 incidents where the emergency services (A&E and an ambulance) were not needed. I know that people have protocols to follow but in these two instances the patients could just have been seen and treated by a GP.

Do we need to look at the bigger picture, to look as how we can signpost people in the right direction, to ensure that people who need A&E are seen, and those that can see a GP do so? We have a great NHS, we can see a GP free, we have GP cover 24/7 and at a last resort we have a great emergency service in the ambulance service and A&E. It’s important that everyone needs to see those that are appropriate to them. Is there anything that we can do together to ensure that this happens most of the time?

I would be very interested to hear from my many overseas followers on how their GP Practice work. How does your routine appointment system work and when patients request emergency appointments what is your practice policy and does you’re A&E Departments get clogged up with people who don’t need to be there?

Dealing with the Bereaved #caring


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It’s been a tough couple of months. 2 very close friends have lost loved ones and 2 family members have died. 2 of them young woman in their 50’s losing their life to that horrendously awful disease CANCER. Every single one of them leaving behind broken-hearted family and friends.

I have shared their journeys through the caring for their loved ones and it saddens me to hear that they had many battles along the way. Getting much-needed appointments, lack of communication between different organisations and sadly just not enough resources in the NHS to assist them in their caring. But also, the many different positive stories they shared about the many different GP, hospital staff and voluntary organisations that often helped make the day that bit better for their professionalism and caring natures.

Often when someone is ill, especially terminally life is very hard on the people caring for them. They often have very little support or no support at all. One of the carers had to give up their job to care for their wife so he could accompany her to the many appointments for chemotherapy and radiotherapy and to the many visits to A&E and the GP. They had to be the “strong ones” Every single bit of help for them (the carer) goes a very long way in their fight to give their loved one the best possible care that they can………………but they need support from so many other organisations to be able to do this.

The carers often get worn down, quickly feeling low or even getting depressed and often face financial difficulties. Who cares for the patient if the cater gets ill?

Attitude, communication, empathy, time, and listening skills don’t cost a lot but can be invaluable to the carer – and the patient.

If you are aware of such a carer needing a doctor’s appointment please communicate, have empathy and use your listening skills. Try and accommodate an appointment that will allow them to fit in around the caring that they are doing.  They might find a telephone consultation easier. Some carers are worn down by the sheer volume of the day-to-day caring and fighting for their loved one. When it comes to them seeking attention for themselves they just don’t have the fight in them anymore. You need to be their “fight” When someone is watching their loved one suffering in pain, they don’t need any extra pressure.

When I was a Receptionist I was often faced with terminally ill patients. People that were caring for loved ones with terminal illnesses and often them needed to be treated as a patient due to the stress of being a carer.

I still remember the first time I dealt with a family member who had just lost their loved one to cancer. They came into the surgery to collect the death certificate. This was the first time that I had ever come face to face with someone who had just had a death in their family. I was lost for words. I didn’t know what to say, so I said nothing and I felt bad for this afterwards. I just didn’t know what to say. I didn’t want to upset the person.

I also was “surprised” at how some people behaved when then had just lost a loved one. Some would appear to be “happy” even cracking jokes, some would come in and were obviously very upset, some would come in and wanting to blame someone for the death of their loved one, others would just act as if nothing had happened.

I had the opportunity to go on a bereavement training session and this explained so much to me. It taught me why people react to death in many different ways.

The training explained the different emotions that people might be going through immediately after the death.

Shock: It may take you a long time to grasp what has happened. The shock can make you numb, and some people at first carry on as if nothing has happened. It is hard to believe that someone important is not coming back. Many people feel disoriented – as if they have lost their place and purpose in life or are living in a different world.

Pain: Feelings of pain and distress following bereavement can be overwhelming and very frightening.

Anger: Sometimes bereaved people can feel angry. This anger is a completely natural emotion, typical of the grieving process. Death can seem cruel and unfair, especially when you feel someone has died before their time or when you had plans for the future together. We may also feel angry towards the person who has died, or angry at ourselves for things we did or didn’t do or say to the person before their death.

Guilt: Guilt is another common reaction. People who have been bereaved of someone close often say they feel directly or indirectly to blame for the person’s death. You may also feel guilt if you had a difficult or confusing relationship with the person who has died, or if you feel you didn’t do enough to help them when they were alive.

Depression: Many bereaved people experience feelings of depression following the death of someone close. Life can feel like it no longer holds any meaning and some people say they too want to die.

Longing: Thinking you are hearing or seeing someone who has died is a common experience and can happen when you least expect it. You may find that you can’t stop thinking about the events leading up to the death. “Seeing” the person who has died and hearing their voice can happen because the brain is trying to process the death and acknowledge the finality of it.

Other people’s reactions: One of the hardest things to face when we are bereaved is the way other people react to us. They often do not know what to say or how to respond to our loss. Because they don’t know what to say or are worried about saying the wrong thing, people can avoid those who have lost someone. This is hard for us because we may well want to talk about the person who has died. It can become especially hard as time goes on and other people’s memories of the person who has died fade.

The training was excellent and I would really recommend if such a training course becomes available. I understood and was able to deal with bereavement a lot better. I was also able to communicate better, had empathy and my listening skills often came into good use.  I felt I made a difference. I was more confident to talk to people and ask how they were coping and make sure that I did everything in my power to make their visit to the Surgery went as smoothly as possible.

People often appreciated this, and would often say that I would be the first person that day that had acknowledge their loss.

Being recently bereaved can often be a very lonely place.

When I was a manager I instigated a Special Needs Board – this was extremely helpful to Reception staff when it came to identify patients that had just died or were terminally ill.

See blog post:      Special Needs Board http://t.co/wnWKmxHV

As a Receptionist, its important how you react to someone who has just had a bereavement. Knowing that this person might have needs (especially if they are a patient) and how you can make such a great impact on them.

How you treat them can give a lasting impression. Make it a good impression and not a bad one.

When You Feel Let Down. #GPSurgery #Rejected #System #AppointmentsSystem


I am very passionate about the NHS and will defend (within reason) any criticism that I hear about anyone working in this wonderful organisation.

My experience comes with working in the Reception areas of both large and small GP Surgeries, Hospitals and for the out of hours’ service. I have seen lots of different policies and procedures, and have worked with many different set up within this different organisation – especially the GP Surgeries.

I hear a lot of people bad mouthing Doctors, Receptionists and other health care professionals, and most of the time it’s because they (the complainer) do not really appreciate or understand the system they are complaining about. There are always two sides of the story.

Sadly, I feel like “one of those people” that I dread hearing from. I have felt very let down by my own GP Surgery and I feel their “system” hasn’t helped.

Let me explain what happened.

When I registered at the practice I was told that you could only see the doctor you were registered with. When I needed to make an appointment I would have to speak to his secretary and she would offer me the next available appointment with him and him only.

In the event of an “urgent” appointment needed if he wasn’t available then and only then would you be offered another doctor.

I have an ongoing issue that has needed following up. I had to wait two and a half weeks to get an appointment with my doctor. I didn’t feel it warranted an “urgent” appointment as I very conscious about the misuse at times of these appointments and know how difficult they are to get sometimes.

So, I waited the two and half weeks. In the meantime, I started to get a bad ear, again, I felt it could wait as my appointment was due in a couple of days’ time.

On arrival at the surgery I used the check in system and it said that I was due to see the locum doctor and not my named doctor.

I was called in by the locum doctor, she said that she was there covering for my regular doctor. I explained about my ear and she confirmed it was indeed infected and issued a script for antibiotics. I then started to explain about the main reason of the appointment and she cut me dead – she said that she had already dealt with one issue and wasn’t prepared to discuss anything else in this consultation. I had only been in the room a matter of minutes. I fully understand that had it been a “urgent” appointment that I had booked that I couldn’t really discuss ongoing issues, but this was a routine appointment that I had booked some time ago.

I tried to explain that I had waited over two and half weeks to discuss the issue, to which she said I would have to make another appointment to come back and see my dedicated doctor.

I couldn’t believe it, what a complete waste of my time, I had waited two and half weeks for this only to be told I had to see my own doctor.

I left her room, quite upset by the whole thing, and more of her attitude in dealing with me, she wasn’t even prepared to listen to what I had to say.

I went to the front desk to ask about an appointment for my own doctor and was told it would be another 3 weeks ahead. So in all it will take five and half weeks to see my own doctor and thus taking a much-needed appointment that could be used by someone else when my issue could have been dealt with in the appointment I had just had.

This sadly would be one of those occasions where I don’t think I would have been able to defend the situation that I found myself in.

 

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© 2011-2017 Reception Training all rights reserved

When Communication Works Well #PooleHospital


 

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I went along to Poole Hospital at the beginning of the week with my husband for an outpatient’s appointment.

On arrival in the Blue Clinic we were met by a lovely friendly volunteer who was eager to show us how to use the self-service booking system. She talked us through it chatting away whilst she was booking him in. Her lovely friendly nature was a breath of fresh air and it was obvious that she enjoyed being there. She then took us to the area we needed to be ready for our appointment.

The TV screen in the department gave out useful information as well as informing us that the clinic was running a bit late – this was extremely useful as it allowed my husband to pop off to the toilet without worrying that he might miss being called in for his appointment.

After a short while a healthcare assistant came out to apologise for the delay and she told us how many people were in front of us (we only had one other person before us) She went around everyone else in the department informing them of the same.

When his appointment came we were had a lovely welcome from the consultant together with a handshake, smile and great eye contact. The consultation wasn’t rushed, we had plenty of opportunities to ask questions and everything we needed to know was covered. Everything was explained in full details and in a way that we could understand.

We were in the department no more than about 45 minutes from arriving to leaving. It was a brilliant service and the most impressive thing was the communication, it was excellent and this must be so useful for people who perhaps are unsure, or somewhat confused at a being in such a large department.

We were both very impressed with our overall visit. Well done Poole Hospital, your staff, volunteers and communication was excellent.

 

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© 2011-2017 Reception Training all rights reserved

The Intensive Care Bed #Hospital


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Here in the UK last night the BBC aired a programmed called “Hospital”. It was a very moving programme showing how stretched the NHS is. It certainly opened my eyes to the daily nightmares that consultants, managers and nursing staff find themselves in on a daily basis. The shortage of Intensive Care beds the result in operations having to be cancelled and patients being turned away for life saving operations. The look of frustration and helplessness etched on the faces of many.

How I felt for the patient that had his operation cancelled for the second time, being sent home after waiting in the ward anxiously waiting to hear that an Intensive Care bed was available – it didn’t happen the bed was needed for another patient.

It brought be back to when my mum was “that patient”. Extremely poorly with bowel cancel, awaiting a life saving operation. She was prepared for the op by having nil by mouth for 24 hours the day before the scheduled operation. By 4.00 that afternoon she was still waiting, we her family were waiting with her trying to keep her spirits up. Finally, I went along to the nurse’s station to find out what was happening to be told that her operation was cancelled due to there being no Intensive Care bed that she needed after her operation. Her operation was delayed to the following week.

The following week arrives, my mum another week on, getting weaker by the day but we were all optimistic she was having her op that day. It got to lunchtime and we got the dreaded news her operation was cancelled again for the 2nd time. The Intensive Care bed was needed for a man who was involved in a road traffic accident. I remember feeling anger at this person who I didn’t know – because of him my mum was not able to have her operation again – and then the instant guilt of feeling like that. This faceless unknown person fighting for their life as my mum was doing got the bed first – WHY!! I often wonder how their family felt – they probably just took it for granted that the Intensive Bed was there – as I thought before this nightmare began. Her operation was delayed for yet another week.

The 3rd week arrived – just a few days before Christmas. We were told previously that mum would be first on the operating list. I sat with her – her fight all gone. All 4 and half stone of my beautiful mum wasting away in the bed before my eyes. They came around to get her prepped for the operation. Excitement building like this was something that we didn’t believe was ever going to happen. Somthing that before this we had just taken from granted. Patients starting going down to the theatre – the consultant came up and asked if he could have a word with the family. His dreaded words “I’m sorry but we are going to have to cancel mum’s operation again” Our grief at that moment was unbearable. My heat was torn in two – how on earth could she survive another week. Amongst all of the shouting and swearing the panic and the disbelieve I still remember the look of despair on the consultants face. He just didn’t know what to say. He apologised and said that he would have felt exactly the same if it had been his family. It was the same story – they didn’t have an Intensive Care bed for mum after the operation.

I would never in my wildest thoughts that it would have been a bed that would have prevented my mum from having a life saving operation. It just didn’t make sense. I actually believed at this stage that this was just a lie – that they didn’t feel that mum at the age of 70 years was worthy of this operation. I felt they were just waiting on her dying.

The consultant went and spoke to mum. She had lost the will and just nodded – perhaps like me she thought that she was never going to have this op.

I remember mum saying she was hungry – I sent my Dad to get her a sandwich from the canteen. This has been her 3rd week of starving for 24 hours before being told she wasn’t having the op. She then asked the nurse for the commode. The nurse went off to get one. The nurse took longer than mum could wait and she attempted to get out of bed to get to the toilet – as ill as she was she still had her pride. As she stood upright the tumour burst – all over the floor. Within 10 minutes she was being rushed to the operating theatre where she had the operation.

She finally had the Intensive Care bed that she was promised 3 weeks ago, albeit only for 2 nights instead of the 5-7 she was told she would be in there for. She was  then transferred to the high dependency unit. I often wonder if someone had to be moved out of intensive Care to make way for mum, or if someone who was waiting for it had been cancelled like my mum had.

Watching the programme last night brought it all back. It made me see the nightmares that the staff have on a daily basis trying to access Intensive Care beds for patients. As the programme showed last night we in the UK have the most wonderful consultants with the most amazing powers to carry out life changing operations, the dedicated staff who work around the clock to look after the patients before and after their operations and the most marvellous well equipped hospitals that we should be so proud of. But how shocking it is to think that it sometimes comes down to the “luck of the draw” when it comes to needing that much-needed Intensive Care bed.

 

© 2011-2017 Reception Training all rights reserved

Please Quote Me Right – #NotWhatISaid


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I was approached by another national newspaper last week The Daily Mirror  to do a piece on the bad publicity that GP Receptionists are getting recently in the press lately.

As anyone that reads my blog will know that I am not only passionate about good patient care, but also I am very protective of the Receptionists who do a very difficult and at times very stressful jobs.

The reporter more or less took me through what she wanted to write and for most of this she wrote what I had said correctly all apart from point no 2. DON’T PHONE JUST TURN UP.

I didn’t quote this and I never would. I even had a lengthy conversation with her stating that this was not an ideal solution as someone coming and presenting themselves at the surgery would not get them an appointment over someone who telephoned. If the Receptionists have appointments they will offer them – if they haven’t got any appointments free then someone standing there in front of them will not magic one up out of thin air! This would then annoy the patient and this is where they can often get the bad publicity from.

Every surgery have their own system in place for appointments, but I am confident that there will be very few if any that would suggest that patients turn up for emergency appointments rather than telephone.

The two articles I recently did for two national newspapers I did was purely to stand up for all GP Receptionists.

I never receive any payment for these articles I did it purely to stand up for all GP Receptionists and the great jobs they do, often going over and above their job description to help patients.

Here is the article – which again is a great support for all GP Receptionists across the country but again I would like to point out that I did not quote No 2.

http://www.mirror.co.uk/lifestyle/health/9-ways-you-can-make-8685940

Sadly because of this I will feel very reluctant in the future to do any more articles.

 

© 2011-2017 Reception Training all rights reserved