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?

 

© 2011-2018 Reception Training all rights reserved
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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.

A&E – The Morning After Pill


Working in the A&E Department at my local hospital at the weekend for the out of hours was never dull.

I would work part-time one evening a week and part-time Saturday evening and Sunday mornings. For the out of hours service and we were kept fairly busy at a steady pace.

A&E was very different. They never knew how busy they would or would not get until it happened.

I loved the buzz and learned so much in the time I worked there.

Working in a GP Surgery and in an A&E Department was so VERY different in lots of ways.

GP Surgeries, and the out of hours service was mainly for people wanting to see a Doctor for minor ailments, prescriptions and referrals onto the hospital. Along with “well” people visiting to see the Health visitors, Nurses or the doctor to have medicals or forms completed. Of course we had the terminally ill patients that needed the care from the whole team at the Surgery.

Then at the hospital you would get in the more urgent cases – A&E = Accident and Emergency. But it never failed to amazed me just how many people used the A&E Department as an extension of their Doctors Surgery. People would often come in for a prescription, for a simple cough or a sore ear – the A&E Department would be bursting at the seams and people would still come in and want to be seen.

Foreign students cottoned on very quickly that if they went to see a GP they would have to pay – but present themselves at A&E they would not be charged.

One patient that sticks in my mind was a young girl about 19 years of age walked up to the Reception Desk around 7.30 pm one Saturday evening.

The A&E Receptionist took her details and entered them onto the computer – she asked the usually question

“What brings you to A&E this evening”?

The girl replied “I want go get the morning after pill”.   

Now working at the GP Surgery I am fully aware that this is an emergency – a woman has up to 72 hours to take the morning after pill after unprotected sex. The longer she leaves it the more chance she has of being pregnant.

At the Surgery we always would fit someone in with an appointment immediately if they requested this.

What I could not understand was why this girl had come to  A&E Department when she could have phoned her surgery and been put through to us working for the out of hours service (the emergency out of hours for local GP’s) Waiting in A&E she could have been there for hours, seeing us in the out of hours she would have waited about 10 minutes.

The A&E Receptionist realised that although this was an “emergency” it could in fact be dealt with the doctor on call that I was working with. So she asked if the Doctor would see her – I was happy to help.

I went over and took the girls details for our system. She then confirmed that she wanted the morning after pill. I had to ask her when she last had unprotected sex – as this would be important for the Doctor and then this information would be passed onto her own Doctors Surgery when they opened up on Monday morning.

Her reply was “I haven’t had sex yet – I want it for tonight as I am going
out”

She seen the Doctor and after a long chat in how to be more responsible she was sent away with a flea in her ear.

Saturday Nights In A and E


Saturday Nights In A&E

 

Being a single mum to two girls and having no support from my ex it was down to me to support the three of us. I worked Monday to Friday in a Doctors Surgery and Weekends for the GP Out Of Hours Service. This is the emergency cover that your Doctors Surgery gives evenings and weekends when they are closed.

 

I worked a shift on a Saturday and one on a Sunday – often more if there were other receptionists away sick or on holiday.  I worked alongside the duty Doctor on Call. Although we worked for the Out of Hours service we were based in the local A&E Department.

 

I enjoyed this role so much – I worked with some lovely Doctors – who were more laid back doing these shifts than they would be working in their normal surgeries.

 

I also worked with some lovely people who worked extremely hard in the A&E department. I have and always will respect these people for the work that they do. I worked very closely with the Receptionists and was accepted as part of their team. I was honoured to be included in all their social events.

 

In the earlier days the Out Of Hours Doctor was quiet – so I would help the girls out on the A&E reception desk. I would help file, make the tea and help patients if they needed anything.

 

The “emergencies” came through another section of the department so we actually only dealt with the “walking” wounded. I cannot tell you what I seen and learnt during those years I was there. It certainly opened my eyes to how some people live their lives.

I will respect the patients that came into the Department – I will not identify anyone or use any names in the stories that I tell. These stories are true but unidentifiable.

 

I will say that some nights working in A&E were better than having a night out – I have never laughed so much as I did working there. We had some lovely patients through the department – the odd ones that would kick off and obviously there were some very sad stories too. But all in all the time I worked there the funny stories far outweighed the sad stories.

 

I will start with the “most used appliance” for a man seeking pleasure……………………………… a Dyson Hoover. This was confirmed by the Doctor I was working with – apparently men  get a lot of satisfaction from a Dyson – and it’s not the housework they enjoy!! They seemed to be a regular occurrence in A&E.

 

There are so many stories to tell regarding “aids” used by everyday “normal” people. Just a shame they get into difficulty and have to seek help!!

 

Another story. One Saturday night a young couple came in – she was about 20 years old and he was no older – he was the patient – she did the talking as it was apparent he was in far too much pain to talk! He was crying in pain – the receptionist rushed over to help and took the details why the young man tried to sit down – it was the receptionist’s duty to log the problem – this helped prioritize each patient. Apparently he had a problem with thrush and reached for the cream in the dark and by mistake reached out and grabbed deep heat and rubbed that onto his meat and two veg. Poor lad. He really was in a lot of pain.

 

Another Saturday night around 8.00 a gentleman came to the desk – he was clutching his ear and I could see blood through a tissue he was holding. He was also clutching a plastic sandwich bag with something in it. The Receptionist asked what the problem was. He replied that he had been working away from home, back after being away for 4 months and him and his girlfriend was making love. She was nibbling his ear when she had an orgasm and bit his ear – right off! This was what was in the plastic bag. He was in good humour seeing what has just happened. He was seen and referred on to the plastic surgeon team. He seen the funny side of it and went on his way.

I really did meet some lovely people working in A&E – staff, patients and visitors. Working as a receptionist in a Doctors Surgery and a Receptionist in a A&A Department is so very different  – but I loved both of these roles so much.

I will bring you different stories from my days in A&E from time to time. Working in A&E you never knew what lay ahead of your shift.

 

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