Patients With Special Needs (Patients Special Needs Board)


How do you keep staff informed about patients that perhaps need special attention?

What do I mean by “special attention”? Well this could come in many forms but for me as a manager I felt that certain patients needed to be at times “highlighted” to the rest of the staff.

Who would these patients be?

I know a lot of people think that Receptionists ask too many questions – that they are “nosy” or perhaps a barrier to seeing the Doctor – but believe me this is not the case – Receptionists ask these questions on behalf of the Doctors and Nurses and try their very best to ensure than anyone that needs to see the Doctor sooner rather than later does – if everyone was give this priority then the system would be in quite a mess. Then where would that leave the people who are possible at risk and do need urgent medical attention.

For me it was important that these people did not slip through the system without being given any necessary follows ups that were needed.  These people at times needed urgent appointments, urgent prescriptions or just access to the doctors without having to go through the many questions that sometimes a Receptionist has to ask.

Most of your staff will be dealing with these patient and will know of such cases – but what about the staff that work part-time – or those that have been on holiday for 2 weeks – it is amazing what kind of changes can go on in a surgery in this short space of time.

How many times I have seen a Receptionist that has been away ask a patient how their husband/wife/mum/dad are only to be told that they had died. It will happen – but there are ways that you can keep staff updated these issues.

What sort of things would these patients or their families phoning or coming into the surgery about?

An urgent prescription might need to be generated for a terminally ill patient. This could be done almost immediately instead of the usual 48 hours.

An urgent Doctors Visit might be needed for a terminally ill patient.  The visit would be logged without question. And then when the Doctor does his visits he could prioritise this patient if needed.

A patient might need an appointment that day due to a bereavement, or a miscarriage. The patient might be too upset to discuss with the Receptionist and might need to be seen immediately.

A relative of a patient that has recently died might need to see a Doctor. They would not want to wait a few days for this – does your surgery have a policy on patients that have recently been bereaved.

Often if the Doctor is aware that a patient has died he or she will often phone the relatives of the patient – this can be very comforting at this very sad time.

All of the above would mean the patient would need to be dealt with quickly, without fuss or questions and with compassion.

To have their call / query dealt with efficiently without question will no doubly help they already stressful situation.

I decided in creating a “message board” a “specials needs board” or  “patient board” it could be called whatever you like but at the end of the day this is how it worked.

In reception we had a wipe clean board. We used a wipe clean board simply because it was easy to use and update quickly. This would have three sections headed with:

  • Terminally Ill
  • Ante Natal
  • R.I.P. (recently deceased)

At the start of any entry the date that the entry was made should be dated.  This is a way of knowing when the message was written.

TERMINALLY ILL

Any patients that were terminally ill either in hospital in a Nursing home or at home their name would be entered onto the board and the place that they were at.

ANTE NATAL

If we had an expectant mum that was having a difficult pregnancy, had recently had a miscarriage or a still-born their name would be entered onto the board.

R.I.P.

Any patient that had died their name and date that they died would be entered onto the board.

Beside each of their names we would have the patients Date of Birth. This is important to identify the correct patient.

The board would be kept in the Reception Area – but most important not in view to anyone other than staff. This is most important – remember patient confidentiality.

This board would be seen on a daily basis by all staff in the surgery. District Nurses used to come in each morning and have a look to see if any of their patients had died over night.  The health visitors would also check the board on a daily basis. The midwife would look before she started her clinic and the doctors would look before their started their morning and afternoon sessions.

By having the board in Reception it is there for all staff to see – and the good thing about this board is you don’t even think you are looking at it – but when you answer the telephone and one of the names on the board is mentioned you immediately are drawn to the board – the board is almost subliminal you see it without realising it.

You will need to ensure that the board is kept up to-date. You could allocate this job to one Receptionist.

The terminally ill will need to be there until they sadly die and then go onto the R.I.P. (This also highlights those terminally ill that have died)

Your surgery will have to agree on how long you keep the Ante Natal information on there – at our surgery we kept it up there for a month after the entry.

R.I.P – again you will need to agree how long you want to keep the information on there – again we kept it up there for one month.

Try this board system – it really does work and those patients that need special care can get it without having to go through lots of questions to get what they want.

Here is an example of how the board might look.

Terminally Ill

  • Mrs Jessie Jones    DOB 30.03.29   (ca breast)
  • Mr John Smith       DOB 25.06.57  (heart disease)

 Ante Natal

  • Annie White           DOB 26.09.80   (miscarriage)
  • Joan Brown            DOB 25.08.86   (stillborn)

 R.I.P. (recently deceased)

  • Mr Alex Swords       DOB  06.04.75   (died at home)
  • Mrs Susan Bird        DOB 12.12.45    (died in St Marys Nursing home)

You can of course make the board up in any way you think will fit in with your Surgery. But I must stress how important it is that this information is not seen by anyone other than staff.

Patients With Special Needs (Patients Special Needs Board)


How do you keep staff informed about patients that perhaps need special attention?

What do I mean by “special attention”? Well this could come in many forms but for me as a manager I felt that certain patients needed to be at times “highlighted” to the rest of the staff.

Who would these patients be?

I know a lot of people think that Receptionists ask too many questions – that they are “nosy” or perhaps a barrier to seeing the Doctor – but believe me this is not the case – Receptionists ask these questions on behalf of the Doctors and Nurses and try their very best to ensure than anyone that needs to see the Doctor sooner rather than later does – if everyone was give this priority then the system would be in quite a mess. Then where would that leave the people who are possible at risk and do need urgent medical attention.

For me it was important that these people did not slip through the system without being given any necessary follows ups that were needed.  These people at times needed urgent appointments, urgent prescriptions or just access to the doctors without having to go through the many questions that sometimes a Receptionist has to ask.

Most of your staff will be dealing with these patient and will know of such cases – but what about the staff that work part-time – or those that have been on holiday for 2 weeks – it is amazing what kind of changes can go on in a surgery in this short space of time.

How many times I have seen a Receptionist that has been away ask a patient how their husband/wife/mum/dad are only to be told that they had died. It will happen – but there are ways that you can keep staff updated these issues.

What sort of things would these patients or their families phoning or coming into the surgery about?

An urgent prescription might need to be generated for a terminally ill patient. This could be done almost immediately instead of the usual 48 hours.

An urgent Doctors Visit might be needed for a terminally ill patient.  The visit would be logged without question. And then when the Doctor does his visits he could prioritise this patient if needed.

A patient might need an appointment that day due to a bereavement, or a miscarriage. The patient might be too upset to discuss with the Receptionist and might need to be seen immediately.

A relative of a patient that has recently died might need to see a Doctor. They would not want to wait a few days for this – does your surgery have a policy on patients that have recently been bereaved.

Often if the Doctor is aware that a patient has died he or she will often phone the relatives of the patient – this can be very comforting at this very sad time.

All of the above would mean the patient would need to be dealt with quickly, without fuss or questions and with compassion.

To have their call / query dealt with efficiently without question will no doubly help they already stressful situation.

I decided in creating a “message board” a “specials needs board” or  “patient board” it could be called whatever you like but at the end of the day this is how it worked.

In reception we had a wipe clean board. We used a wipe clean board simply because it was easy to use and update quickly. This would have three sections headed with:

  • Terminally Ill
  • Ante Natal
  • R.I.P. (recently deceased)

At the start of any entry the date that the entry was made should be dated.  This is a way of knowing when the message was written.

TERMINALLY ILL

Any patients that were terminally ill either in hospital in a Nursing home or at home their name would be entered onto the board and the place that they were at.

ANTE NATAL

If we had an expectant mum that was having a difficult pregnancy, had recently had a miscarriage or a still-born their name would be entered onto the board.

R.I.P.

Any patient that had died their name and date that they died would be entered onto the board.

Beside each of their names we would have the patients Date of Birth. This is important to identify the correct patient.

The board would be kept in the Reception Area – but most important not in view to anyone other than staff. This is most important – remember patient confidentiality.

This board would be seen on a daily basis by all staff in the surgery. District Nurses used to come in each morning and have a look to see if any of their patients had died over night.  The health visitors would also check the board on a daily basis. The midwife would look before she started her clinic and the doctors would look before their started their morning and afternoon sessions.

By having the board in Reception it is there for all staff to see – and the good thing about this board is you don’t even think you are looking at it – but when you answer the telephone and one of the names on the board is mentioned you immediately are drawn to the board – the board is almost subliminal you see it without realising it.

You will need to ensure that the board is kept up to-date. You could allocate this job to one Receptionist.

The terminally ill will need to be there until they sadly die and then go onto the R.I.P. (This also highlights those terminally ill that have died)

Your surgery will have to agree on how long you keep the Ante Natal information on there – at our surgery we kept it up there for a month after the entry.

R.I.P – again you will need to agree how long you want to keep the information on there – again we kept it up there for one month.

Try this board system – it really does work and those patients that need special care can get it without having to go through lots of questions to get what they want.

Here is an example of how the board might look.

Terminally Ill

  • Mrs Jessie Jones    DOB 30.03.29   (ca breast)
  • Mr John Smith       DOB 25.06.57  (heart disease)

 Ante Natal

  • Annie White           DOB 26.09.80   (miscarriage)
  • Joan Brown            DOB 25.08.86   (stillborn)

 R.I.P. (recently deceased)

  • Mr Alex Swords       DOB  06.04.75   (died at home)
  • Mrs Susan Bird        DOB 12.12.45    (died in St Marys Nursing home)

You can of course make the board up in any way you think will fit in with your Surgery. But I must stress how important it is that this information is not seen by anyone other than staff.

 

A Tragic Tail


 

I spoke to my daughter this morning and she was pretty upset. She had heard some very sad news about a friend – let me explain what happened

My daughter walks her dog at a regular time each morning and has formed friendship with other people who walk their dogs at the same time.

One particular girl she has got to know quite well over the past year was due her baby last Monday – she was having a girl and they had even named her. My daughter looked forward to the daily meetings and the updates on her pregnancy.

Last Sunday her friend was not at the park – my daughter wondered if she perhaps had the baby. How exciting if she had she thought.

Then on Tuesday my daughter met up with another regular on the park walk. The woman asked my daughter if she had heard the news – my daughter expecting her to say that her friend had in fact had the baby.

She had, but what she heard next just was the most awful news.

Apparently the girl was walking her dog on the Sunday (the day before the baby was due) and she met up with another “doggy” friend who had not been in the park for some time – this woman’s dog is a large bred and his owner had suffered with a bad back and was unable to take him to the park. The stood chatting and the big dog suddenly ran past them both and knocked the pregnant girl right off her feet – it was a pretty nasty fall and they had to call an ambulance.

She arrived at the hospital and they discovered that in fact the placenta had actually come away – resulting in the hospital having to give her an emergency caesarean. Her baby girl sadly dies 6 hours later. How awful. Such a freak accident and such a terrible tragedy.

We discussed how awful it must be for everyone – including thewoman’s whose dog it was. My daughter said that she was  due home a couple of days after the birth – and that apparently her mum had gone in and taken all the baby items away –  because she probably
would not want to face it when she came home. This took me back to a mum that was a patient at the surgery……………………..

When I worked as a receptionist one of my duties was to “manage”
the anti natal clinic one a week. I was responsible for helping the midwife
during her clinic – I would help book mums in, get their records ready and
weigh them before they went in to see the midwife. I loved this as I got to
know the mums all the way through their pregnancy and they would always bring
their babies in to see me when they were born. I always had a special bond with
these mums and their babies too.

But, there were the odd one or two that didn’t get to show their babies off – it might have been due to a miscarriage or a stillbirth – every one of them so very sad.

One particular mum had a baby that had died a few hours after giving birth. We were always notified from the hospital when such a thing happened. Every effort would be made to ensure that the patient would have easy access to the Doctor, Nurse or Health visitor if they needed. (I did in fact set up a procedure to ensure that people who were terminally ill or recently bereaved had easy access and I will tell you more in a future blog).

She came into the surgery about 2 weeks after she lost her baby. She came to the desk – I told her how sorry I was and asked if she was ok. She started crying – I took her into a private room – she went through the events of losing the baby – I felt she needed to talk about it I sat and listened. But what she did say and has stayed with me all these years – and make me think of it again this morning.

When she came back from the hospital after losing her baby she found that everything had been taking out of the house that was there for the baby.

Everything had gone the pram the cot, the mobiles, the furniture everything that they had bought together with all the clothes and baby toys. Someone had thought it would be the best thing to do.

But she said that walking into the house and everything gone was like the baby was never real. It was like stepping back 9 months – she felt that everyone had just wanted to get rid of the memory of being pregnant or even the baby. She knew that this wasn’t true but that is how it felt at the time.

She said that what she had wanted to do was go home and grieve – she couldn’t do that in the hospital. She wanted to go home and go into the baby’s room and say goodbye there – surrounded in the love that had been put into everything in the room – it was the one last time she felt she could be close to the baby and that was taken away from her.

She explained that she hadn’t told anyone how she felt as she didn’t want to put guilt on anyone’s shoulders. After all her husband and family has been though a lot too. She realised that they were trying to spare her any more hurt and pain.

So although we think we might be doing the right thing at the time – are we? I hope this never happens to anyone close to me – but if it did – I think I would ask the mum what she wanted to do.