Privacy Curtains – the Protocol


 

I speak a lot in my blogs of Team Work. As a manager you can only be as successful as your team will allow you to be.

It is vital to have support from your team. Communication is a two-way thing. Your team not only learn from you but you can learn from them too. After all they are the ones facing the many obstacles that come up on a day-to-day basis. Learn to listen to your team and let them know that you are on their side.  Often staff can see Management as the “enemy” it does not have to be like that. Make your team feel that they are part of YOUR team.

A thank you at the end of the day can mean so much. When asking a team member to do a task always ask in a polite way – and always thank them and tell them that you appreciate their help.

The best way to share good ideas is at staff meetings – always use staff meetings to your advantage – include the staff in these meetings – make them a two-way thing – staff will feel that they are part of it that way and will be more inclined to attend.

Let me share with you an example of how a new protocol/procedure was written for the Surgery from one of these meeting.

It was the normal monthly Receptionists Meeting – the agenda had gone out and as always everyone had the opportunity of adding an item to the agenda.

One of the Receptionists had added “Privacy Curtains” to the agenda.

The meeting started and came to the part of the agenda that she had added.

She suggested that the girls at the Reception desk have access to privacy curtains as she had recently had an experience whereby her own father had collapsed  and died in his own Doctors waiting room with a heart attack and was left lying on the floor until the Doctor came out to him and took the necessary action. During this time patients were all watching what was going on – and the receptionists at the Surgery found this quite stressful.  Our Receptionist felt that her dad was on “show” and found this quite upsetting.

So, from a personal experience we wrote a Surgery policy on what would happen in the event of someone collapsing in Reception.

Some of the points that were taken into consideration were:

  • Who to notify in the event of a patient collapsing – first the Doctor – but as you know there is not always a Doctor on the premises. So your receptionists need to know what to do in that event – I would suggest calling the nurse, or if she is not on the premises call an ambulance.
  • A Receptionist would they get the privacy curtains and put these around the patient giving them a bit of privacy.
  • If in the rare event that a patient has died you might need to evacuate the waiting room as the patient might be there some time until the appropriate people have been notified. Maybe direct the patients into another area or another room.
  • It is important that your Receptionists will need to know what to do in the event of an evacuation.

It is rare that this happens – but it is how you or your team deal with it that can make all the difference.

Has your Surgery got such a protocol in place?

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When The Doctor/Nurse is running late.


When a patient books in at the reception desk and you identify that the Doctor/Nurse or other healthcare professional is running more than half an hour behind schedule PLEASE inform the patient before they sit down.

No one likes to be kept waiting, but everyone would rather be told and given the option to wait or re book another appointment.

Lack of communication can often lead to a complaint or even worse someone getting aggressive.

When a patient comes to the desk you could say:

“I apologise but Dr Smith is running about 35 minutes late this morning – he had an emergency / visit to do. Would you like to wait or would you like to re-book another appointment?”

By doing this you are giving the patient a choice. If they choose to wait then they can not come back to the reception desk after 25 minutes and complain – which they more than likely would have done if they had not been informed.

  1. It also gives the patient a chance to go to the paper shop/car to get something to keep them occupied while waiting.
  2. They might want to make a phone call to tell someone who they are running late.
  3. They simply might need to go to the toilet.

They would be reluctant to do any of the 3 above if they did not know they were in for a wait – they would sit there waiting to be called in at any minute.

If the patient cannot wait for various reasons, it gives them the opportunity to re-book at a time suitable to them. By patients booking another appointment it will lessen the already late and give the Doctor / Nurse a change to catch up.

Always try to defuse any potential complaint. It is always better to try and solved a situation sooner rather than later.

Always look ahead.

The Importance of Giving Your Change of Address


I have written about policies and procedures and the importance of them – let me share an experience I had while working as a Manager – and the importance of ensuring that every job is carried out no matter how each and every one of them carried out responsible jobs, dealt with difficult people at times as well as at times grumpy doctors.

Some people see a Doctors Receptionist role as a “cushy little number” after all they just sit behind the desk booking people in and making appointments. If only!!!

Each and every Receptionist is constantly running around like headless chickens. Often not stopping for a cuppa and working through lunch breaks to get their jobs done. On top of being at the Reception Desk booking patients in and answering the telephone they also have individual tasks to deal with. Prescriptions to be sorted and printed ready for the Doctors to sign.  Preparing Medical Reports for the Doctors to sign, ensuring that all relevant claims forms are sent into the local Health Authority, ensuring that all clinics are set up correcting onto the computer system (and usually when they have done this a Doctor or Nurse will decided that they want holidays and it all has to be changed again) Inputting data to ensure that patients are monitored and recalled to the Surgery for checks such as Blood Pressure, Diabetics, Heart, and many more clinics – scanning and the never ending job of filing – the jobs are just endless.

One of the jobs that are allocated to a Receptionist is “change of address”. This is when a patient moves house. They will come in and advise us that they have moved. They will be asked to complete a form and this would then be given to the appropriate Receptionist to change on the computer and the patients notes.

This was seen as one of the less important jobs – and the Receptionist doing this job worked 3 days a week – so often a change of address could often be in her tray for a few days – and longer if she was on holiday.

That was until…………………………..

A patient came into the surgery to see the Doctor – she was 35 years of age a wife and mother of 2 children. She was complaining of stomach pains. The doctor examined her and felt it would be best to refer her to the local hospital for more tests.

The doctor dictated the letter while the patient was sitting in front of her.

The patient came out of the surgery and went to the front desk to book another appointment and then informed the Receptionist that she had in fact moved – the Receptionist asked her to complete the appropriate form and put the form into the Receptionists tray that dealt with the changes of addresses.

Later on that afternoon the secretary typed out the letter to the hospital that the Doctor had dictated. Can you see what happened next?????

The letter went to the hospital with the patients old address on as it had not been changed on the computer or the patients notes.

The patient came back to the Doctor about 6 weeks later saying that she was feeling worse and still had not heard from the Hospital.

The Doctor telephoned the hospital and after a while it was discovered that the hospital had written to her old address with an appointment and she failed to attend they never follow-up on failed appointments.

The doctor at this point was extremely worried and asked for the patient to been seen asap. She was and it was discovered that she had stomach cancer.

The paitent underwent surgery and treatment but sadly died some months later.

Her husband came in to see me some weeks after her death to ask what had happened and why they letter had gone to their old address.

I was mortified – I just felt so awful for this poor man – left without his wife and now had two children to care for that had lost their mum.

He said that he was not there to put blame on anyone – he just wanted to make sure that it didn’t happen to another family – he said that the hospital had indicated that she had the cancer for some time – but as he said – what might have been if she had been seen earlier. And I must admit I could fully understand what he was saying.

I assured him that I would look into our procedures and I promised him that nothing like this would ever happen again. He  left the surgery a devastated man – I went up to my office and cried – it was just awful.

So, from that day on our policy on “Change of Address” changed. Every single Receptionist as soon as she was given a change of address it was to be entered onto the computer system and the patients notes immediately.

It goes to show that this “little” job was so so important and could not be left a moment longer than necessary no matter how small you might think it is at the time.

The Receptionists at the Surgery always worked extremely hard – long hours and for nothing more than just above the minimum wage – I always said that these girls were worth their weight in gold – more than a Receptionist and should have been recognised for this.

So for any Doctors Receptionist/Manger reading this please adopt this policy and ensure that whenever you have a patient change of address its done immediate.

And

If you are a patient reading this and you move house PLEASE inform your Doctors Surgery immediately.

I also discovered over the years that many patients moved house and never ever let their surgery know – patients either forget or don’t think its important. So regular notices in your Surgery to remind patients to let you know if they change address or telephone numbers is also a good start to ensuring that you have their up to date information.

Weekends in A&E – The Baby


As I  mentioned in previous blogs I loved the buzz that A&E brought. I worked with the “On Call” duty Doctor. This was a scheme whereby if you called your surgery out of hours you would be put through to a Doctor for advice or asked to come along to see him at the Local Treatment Centre – which was held in the local A&E Department.

Working with the Doctor we really only seen minor illnesses – some we did refer on to
the hospital if someone needed admitting or seeing a specialist but mainly they were just routine coughs and colds. But working in the A&E reception area I witnessed some of the more critical cases that came in. One that comes to mind and I still find very upsetting when I think about  it………….

 It was a Saturday night around 10 pm  – I sat in front of a window in the A&E Reception office,  my window  faced the emergency doors that the ambulances arrived with the patients.  The critical cases were brought straight into the resuscitation area and bypassed the A&E waiting room.

The ambulance pulled up I knew straight away that it was urgent as they had their blue lights on and came in at quite a speed.

Before the ambulance came to a stop the back doors opened and a young man got out
screaming and shouting running around like a person possessed. I wondered what on earth was happening – I wondered if the man was possibly drunk – how wrong was I.

Just behind this man one of the paramedics jumped out of the ambulance and in his
arms was a baby – he dashed in through the doors. I later found out she was 10 months old. She was wearing purple and pink pyjamas. I can still see her little lifeless body in the arms of the paramedic. He rushed her into the resuscitation area.

I soon found out that the man – her daddy – was looking after his daughter while his
wife was at work – she only worked a Saturday evening. He went upstairs to check on her and found her dead in her cot. The ambulance crew arrived and worked on her and rushed her into the hospital.

The team of dedicated doctors and nurses worked on the little one for over 30 minutes, sadly they couldn’t save her.

But the thought that stays with me was looking into the ambulance some 10 minutes later
to see the paramedic holding a blanket sobbing his heart out. That did reduce me to tears too and seeing the effect that it had on this paramedics and not only him but the whole department. Everyone was just devastated. That night made me realise how much these daily occurrences affect the people who work in the department.

I arrived for work the following morning – the department was still very subdued from
the events the night before. We were told at reception that the parents of the baby would be coming in that morning to see their baby – we were told to notify one of the senior Managers on their arrival.

The parents arrived around 11.00 – you could see the pain on their faces – it was just awful. They were met by the Manager and took away – we never seen them again.

Then one of the nurses came out into reception. In a file she had a hand print and
footprint of the baby – the parents would be told that it was available for them if they wanted it – if they declined it would be kept for years – in the event that they changed their minds at a later date and wanted the precious prints of their beautiful little angel.

One thing I did learn very quickly working at A&E you never knew what was ahead
when you went in through the doors – you didn’t know what the day ahead was
going to bring.

The Prescription


Following on from yesterdays blog I mentioned that many GP’s
have their own specialities in different areas. This can be very beneficial to patients at the practice and can often avoid having to be referred to a consultant at the local hospital.

One of the GP’s that I worked with Dr Paul was a right character. I have written about him
in previous blogs:

The Urine Sample http://wp.me/p1zPRQ-2v  and

The Million Pound Cheque http://wp.me/p1zPRQ-5p

Both are very funny and well worth a read.

I always enjoyed working with Dr Paul, he was fun, always time for a joke or two, and he
would always find time to answer any questions that we Receptionists might have
had. He was also extremely professional.  I learned a lot from him over the years that I
worked with him. If I ever a question about a certain drug, an illness that a
patient might have or just routine medical questions he would always explain it
in such a way that was easy to understand and he always made it interesting. I
have a lot to thank Dr Paul for – he was such a great mentor and very dedicated
to his job. He was the newest partner into the practice and also the youngest –
a breath of fresh air.

Dr Paul was always very popular with the patients – they liked his young outlook –they
liked the way he took time to explain everything to them and always gave them
the time they needed. But on the downside of that he surgery ALWAYS run late – and I don’t mean just 10 minutes late – often his surgery would run late by an hour or more. But what he did say was the most important patient at that moment was the patient that
was sitting in front of him – and that he would always give them the time that
they needed. And the patients all knew this – and those that thought the sun
shone out of him accepted that and would quite happily wait the hour or so to
see him. Of course there were the odd few that would not be happy – but if we
could we would always pre warn people just how late he was running. This went
against all the local Primary Health Care Trust guidelines that said that each
patient should be given a 10 minute appointment.

It could at times be frustrating for us the Receptionists – because if he was on a late
surgery (the evening surgery) we could quite often be there until way after our
finishing time – sometimes an hour late – as we had to ensure that everyone was
booked in and seen before we could shut up the Reception area and go home.

Dr Paul worked as a pediatrician (a Doctor that works with children) before joining the practice – and often would work shifts in the local children’s hospital. He was just great with the children – they used to love going into see them and he was just fantastic with
them – not many of them come out of his surgery without a sticker, or something
else that he might have had in there for them. He had so much time for the tiny
ones of the Practice.

And of course the parents loved him too, they loved him because he was great with the
children and they loved him because he talked TO the children and not over them
– he was just great with them.

One thing that did make me smile – when a child around 8 or 9 would go in with their mum or dad obviously unwell they might have a virus, flu or an infection. He would
give mum the prescription if the child needed one but he would also give the
child a prescription too – but what he would write on it would be something
along the lines of :

“This allows Billy Jones a week off tidying his bedroom due to him having a throat infection”

Or

“This allows Elly Howard a week off doing the washing up due to her having a virus”

 The children would come out of his surgery clutching their “prescriptions” and mum or dad would come out with a smile on their face. What more could you want after
seeing the doctor? Medicine in itself!

The Million Pound Cheque


Following on from a recent blog re “The Urine Sample Pot” I have another story to share you will regarding the friendly GP – Dr Paul


I was in reception before morning surgery began opening the daily post.   In walks Dr Paul. He took his post out of his tray and started his daily signing of prescriptions, letters and other requests. The Practice Manager came along and asked him for a cheque that he was due to give to her. He got out his cheque book and wrote the check as requested.

I turned to him and asked while he was writing out cheques could he do one for me!! “No probs” was his reply – and duly wrote a cheque out to me – he wrote my full name on the cheque, dated and signed it and gave it to me.

The cheque was made out for one million pounds. We had a good laugh and I said that I probably would never have a cheque like this again and that I was going to frame it!!

A couple of weeks later I was working for the out of hours service and was working with a GP who happened to be a good friend of Dr Pauls, and was just as mad as he was.

I told him about the cheque and with a big grin and a twinkle in his eye said………right let’s get him!!

The out of ours GP took the cheque – and phoned me a couple of days later. He had arranged for his secretary to phone Dr Paul the following week – on the 1st April – April Fools Day.

Picture the moment – the secretary phones me and we had a chat – she was well and truly up for the joke as I put “the call” through to Dr Paul. I phoned him in his room – told him that I had his bank on the phone – he had a rep in his room with him at the time but was happy to take the call. Even better as the rep in there would be able to tell us his reaction.

I put the call through……………………….. About 4 minutes later all I hear is you bas***ds coming along the corridor – luckily there were not patients in the waiting room!!

Speaking to the rep later he said that we had well and truly had ‘got him’. His face was just a picture. The rep said that he had NEVER seen Dr Paul  lost for words. He certainly was on this occasion. All he kept saying to the caller on the end of the phone “this is a big mistake”.

Speaking to Dr Paul afterwards he said couldn’t believe that he had been well and truly caught. He said the call came through and the secretary made out that a cheque for a million pounds had been presented to the bank – and asked when he was going to put the funds into his account to cover this. He tried to explain that it was a joke and it shouldn’t have been banked. To which she replied “well Sir the cheque is dated and signed by you – is it not” to which he had to say yes!! The conversation went on and obviously the secretary was making life very difficult for him – she kept asking him difficult questions – until he heard the other Doctor in the background laughing!!! Game over.

He took it very well – relieved I think that this wasn’t really happening.

He came out into reception and gave me a friendly thump! The secretary on the other hand got a box of chocolates from him for the laugh!

I never got the cheque back – shame – as I said before – it probably will be the one and only time that I will ever get a cheque for one million pounds.

Weekends in A&E – the Referee


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 couple of shifts over the weekend and usually one evening in the week  – and on occasions 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 A&E 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 service was quiet – so I would often 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 bring you different stories from my days in A&E from time to time – some funny and some sad, but I will respect the patients that came in – I will not identify anyone or use any names. These stories are true but unidentifiable.

 

Working with the Doctor we really only seen minor illnesses – some we did refer on to the hospital but mainly they were just routine coughs and colds. But working in the reception area I witnessed some of the more critical cases that came in. One that comes to mind…………………

 

It was a Sunday morning. The waiting room was full of the usual sporting injuries. Footballers, rugby, even golfers!!!

 

The ambulance brought in by blue light a referee from a local Sunday League football match. He was taken straight into Resuscitation – but sadly he didn’t make it.

 

It was awful – your thoughts go out to his family – who are yet to find out and also his colleagues that were with him when it happened. But what was really sad was that no one at the match knew anything about CPR – or if they did no one tried it on him.  Had they have done – perhaps…………………. well we would never know.

 

The referee came in with just his kit on with his coat over the top of him – he had a member of the football team with him but was not a relative. The nursing staff had the awful job of phoning his wife. The staff member took his phone out of his jacket and went into a private room to phone. A job that everyone admits is the worse part of their job.

 

About 30 minutes later a distraught woman comes in – she comes to the desk and says that she is the wife of the referee that had been brought in. Everyone’s heart went out to her.  Little did she know this morning what this day was going to bring.

 

The Nursing staff came out and brought her through. Minutes later another member of the Nursing Staff came out – she wasn’t the wife of the dead man. This poor woman had gone in to see “her husband” only to find it was a complete stranger.  She must have been filled with horror and relief at the same time. I can’t begin to think what she must have gone through.

 

We finally got to find out what had happened………………..the referee had collapsed on the pitch and while they were waiting on the ambulance to arrive someone from the sideline had taken his coat off and placed it over the referee to keep in warm. In the panic to get him to hospital quickly the jacket was taken with him in the ambulance.

 

What an awful error – this poor man was lying there – and no identity – but it only took minutes for them to find out his true identity and the Nursing Staff then had to make a second call – this time to the right person.  It was a lesson to us all – never take anything for granted.

 

And please remember just how important CPR can be. A life saver!