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.

Patient Access – Appointments


imagesCAUP3U1D“Improving patient access” is all something that we hear about on a daily basis. It constantly being discussed at all levels, Partner meetings, Reception Team Meetings and Multidisciplinary Meetings. There is no one working within the NHS who is not aware of this.

As Managers we all strive to make patient access the best we possibly can. Often systems are changed to try to accommodate patients, yet still we hear people complaining that they are unable to access appointments for days at a time.

Not having appointments can often cause frustration not only from the patients, but from the Receptionist Team too, they often feel that are unable to do their jobs and often having to deal with difficult situations because some patients can become aggressive.

I decided to be proactive and look at the amount of DNA’s we had at the surgeries I managed. We had over 30,000 patients and I was shocked when I realised just how many hours were being wasted on a daily / weekly / monthly basis by patients for whatever reason not attending their appointments.

Patients are often the cause of the lack of appointments. It is not acceptable to just “not turn up”.

But what can we do to improve DNA’s? What does your surgery do to try and keep on top the wasted appointments?

Some surgeries (and hospitals) display in the waiting room the number of DNA’s each month, and this can be pretty horrifying when you see just how many appointments are wasted in this way. But of course the people who did not turn up for their appointment do not see these statistics.

Some hospitals will send out a text message a few days before an appointment, thus giving the opportunity to cancel if the appointment is no longer needed (also a good reminder if the patient has forgotten) This system will only be helpful for those with mobile phones, perhaps not so good for some of the elderly that may not use mobiles.

Some hospitals are now sending out reminder letters a week before the appointment, again helpful when the initial appointment might have been made some months before.

Adding something to a Surgery website is another way to encourage patients to cancel unwanted appointments, you could also display the DNA’s for the previous month.

Practice Newsletters is also another way of encouraging people to cancel rather than just not turning up.

We did a trail at one of our surgeries. When a patient DNA their appointment a letter was sent to them pointing out that they missed their last appointment, and the practice would appreciate if they could not attend a future appointment could they please phoned and cancel the appointment. The letter would go on to explain the amount of DNA’s the surgery was experiencing and that patients were having problems booking appointments.

Another surgery I know of has a system in place, that they feel works extremely well and have been getting positive feedback from patients and the Receptionists. They have over 25,000 patients, and have their fair share of DNA’s. They found the amount of DNA’s they were experiencing each day was getting increasingly frustrating for the staff. The Reception Team Leader started getting the Reception Team on the late shift to phone the patients who had DNA that day to ask the reason why they had not attended their appointment. They make the call as friendly as possible; the call is not made with “all guns blazing” or “pointing a finger” at the patient for not attending. The Receptionist simply asks the patient did they realise they missed an appointment today, and would they require another appointment. They found that most patients were extremely sorry for missing their appointments, and some genuinely did forget, but more important it made the patients aware that the Surgery was monitoring the appointments. Since starting this system they have found that their DNA has fallen.

The most important thing when doing this is when a patient cancels an appointment that IT IS CANCELLED. Often for whatever reason if appointment stays on the screen, despite the patient cancelling the appointment it could result in a letter or a phones call going to the patient.

This unfortunately happened at our surgery, a patient was sent a letter when she had in fact cancelled her appointment, and understandably was quite upset when she received a letter. If this system was to work it is essential that every single Receptionist understand the importance of cancelling appointments on the screen – in not doing so could result in the surgery receiving a complaint.

By highlighting the amount of DNA’s in these ways it lets your patients know that you are monitoring your appointments system – especially for those patients that just have not “bothered” to cancel their appointment.

It could also flag up that patients are perhaps cancelling, but for whatever reason they are not being cancelled on the system – which could indicate a training need.

Are appointments being booked too far in advance (i.e 6 monthly BP checks, diabetics checks etc) if so how can you best deal with this? Could you use the texting system to remind patients a few days before their appointment?

I am always in favour of giving out appointment cards especially to the elderly. Always remember to put the day as well as the date on the card along with the time.

Monitoring DNA’s will flag up those that repeatedly fail to attend.

Always approach patients about DNA’s in a positive way. Explain that the Surgery is trying to look as the amount of DNA’s and at ways of decreasing these and feedback on why they DNA would help with the exercise.

Explain if patients cancel their unwanted appointments then this will free up more for other patients – which could be them.

And when a patient does take the time to call the surgery to cancel an appointment, the Receptionist should always thank them for taking the time to do so.

Patients have to be made aware that by not cancelling their appointments it just adds more pressure to the already busy system.

Cancer Care At Its Best


 

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I have a friend that has recently be diagnosed with cancer and she is facing many weeks of chemo. Her hair is falling out, and she has got those dreaded mouth ulcers amongst other things. But through this she is staying positive and I must say she is pretty amazing.

What keeps her so positive?

It’s the support she has from her family and friends. But that’s not all, she has shared with me the support she has received from everyone involved in her treatment and the care she has received has just been incredible, she has found every single person caring for her in the NHS just amazing.

From the Receptionists at her doctor’s surgery, to the doctors and nurses, hospital transport and volunteers at the hospital she has found every single one of them helpful and informative.

It’s not just the treatment that plays a big part in someone getting better and staying positive, it’s a lot to do with they support that they received from every single healthcare professional that is involved in their care.

Being a Medical Receptionist is more than customer service, its patient care at its best.

You could make someone’s treatment just that little bit more bearable in the way that you deal with them when they visit your surgery.

Always treat someone they way you would want to be treated.

The Lost Faxes


When a patient is suspected of having cancer it is vital that the correct procedures are met to ensure that they are seen by the correct consultant / healthcare professional.

Every possible action will be taken to ensure that the referral letter will get to the consultant / healthcare professional at the hospital concerned as soon as it possibly can. Surgeries will have their own protocol of dealing with this situations.

Let me share a story on a referral letter that was never received at the hospital.

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True Story

It was 6.00 on a Friday evening – the doctor had a patient in with him who he suspected had a mass – possible cancer. It was too late to phone through to the consultant’s secretary for an appointment and too late for a letter go out in the post that same evening – so the procedure was the doctor had to fax the letter through – something that was done on several occasions.

All of the receptionists knew the procedure.

The fax went – and the letter format went on the Monday in the normal post. Tuesday there was a call from the hospital asking why they letter had not been in fact faxed through on the Friday – the Doctor said it was – but the hospital said they had no record of receiving it.

I was asked to investigate what had actually happened.

I went and spoke to the receptionist that sent the fax. She was obviously concerned and upset that I had to speak to her about the incident – to her it looked like I was accusing her of not sending the fax – I soon put her fears at ease and explained that I had to find out what had actually happened.

This was one of those moments where I was pleased that we kept a printed receipt of every fax sent and this was attached to the fax and filed. We found the letter and the receipt was attached that confirmed that the fax as indeed sent – and no errors had occurred whilst it was sent.

I telephoned the hospital – they were adamant that they had never received it. We had the “proof” that the fax was indeed sent from our office. But the still said they had not received it.

I am pleased to say the patient was not put at any extra risk and was seen within the allocated timescale.

Some weeks later I received a similar call from the hospital – they were waiting on a fax coming through and they had not received it. I checked again with Reception that they had sent it and they had all the confirmation that the fax had been sent. This happened for a 3rd time and I started getting concerned. Something was not right.

The faxes had been sent by 3 different receptionists – all very competent receptionists I might add and ones that took pride in their work. All of the receptionists were long serving receptionists and had been at the surgery for some years. Each and every one of them was concerned about the incidents that had taken place.

I went along to see the supervisor at the outpatients department where the faxes were going. She I was as concerned as I was about what was happening. This is where I found it very useful to have a good working relationship with the hospital because I felt that I could go along and chat to the supervisor about the incident – at the end of the day we wanted to get this matter sorted out and make sure that it didn’t happen again. After all we both wanted the best possible outcome for the patient.

(see my blog on Communication between the Surgery and the Hospital. http://wp.me/p1zPRQ-mT )

I asked her if we were the only surgery that this was happening with – she told me it was – they made me feel that for whatever reason the error was happening at our end – but I could not for the life of me work out WHY. Each fax had been sent and the receipt of that fax kept and attached to the fax sent – we got a print out from the fax machine to back that up and it confirmed that the faxes had in fact been sent.

So, I went back to the surgery. One by one I asked each of the receptionists to send a text fax through to the supervisor at the outpatients department – who was waiting at the other end for them.

After the third fax had been sent I phoned the supervisor – she said that they had not come through – she confirmed that they had received many others from other surgeries in the time I was with the girls sending ours. I was baffled. I had actually witnessed the faxes being sent through.

I called another receptionist in – I asked her to send the same test fax – she did and I straight away got a phone call from the supervisor to confirm she had received the test fax.

Then it dawned on me – I knew what was happening……………………….

We had recently had a new fax machine installed in the surgery. The old fax machine used to send faxes face down – this new fax machine sent faxes face up! Such a simple error to make but such a bit impact when it did.

They were actually sending blank pages through to the hospital as they were sending them upside down.

I telephoned and spoke to the Supervisor – I explained what had happened – she went into the fax office (the fax machine was in an office on its own and secretaries and administrators would pop in every so often to take the faxes off the machine) The supervisor confirmed there was in fact 3 blank sheets amongst all the other faxes waiting to be sorted. She agreed that the secretaries or administrators would have just thought they were blank pages that had just come through with other faxes.

So a simple thing like a new fax machine caused so many problems. The receptionists were mortified that they had made the mistakes – but said they were so used to using the old fax machine at times when they were so busy they just put them through as they would have normally.

So, I put a big notice over the fax machine that said

~Pease send fax facing UP!

A reminder email was sent out to everyone in the surgery including Doctors/Nurses/District Nurses/Health Visitors and other healthcare professionals who all at times used the fax machine.

That seemed to do the trick thank goodness. No more episodes of blank faxes.

So never take it for granted that a new member of staff can send a fax – always make sure that you run through the procedure with them – just in case!

I must admit I have never been a fan of fax machines!

 

Who Is Responsible For Following Up Test Results


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How does your surgery deal with any abnormal results that might come in for a patient? These might come in via the hospital via the computer/paper and at times via a telephone call from the hospital itself if immediate action is needed.

How do you communicate with your patients that they need to be seen regarding the tests or perhaps notifying them that they have a prescription to collect?

In my experience the Doctor/Nurse or often the receptionist will phone the patient and advise them to either make an appointment or come in and collect a prescription.

Does your surgery keep a record of all test taken and check that all results are back and dealt with in the appropriate way?

There had been at times when I was a Receptionist that some results for what ever reason  never come back from the hospital to the surgery.

There is always a chance on human error – and although we all know how hard we work and how good we are at our jobs that it can still happen. Sometimes A doctor might intend to ring a patient and that gets overlooked, a receptionist has a message to call a patient and that for whatever reason that does not get done, or someone could presume that someone else has done it, there could be a number of reasons why a patient might not be contacted. The hospital may have mislaid the test – sometimes the test is not labelled correctly and therefore needs to be repeated – and for whatever reason the patient does not get told about this.

These occasions are I am pleased to say very far and few between. But they could happen.

An incident similar to one of those above did happen years ago when paper copies of tests came through daily to the surgery – a patient abnormal test results were overlooked and filed away. It did cause a lot of unnecessary worry for the patient when they came back in to the surgery with the ongoing illness and of course this was not good for the surgery.

Just recently a friend of mine her young baby had a bad eye infection; the test was taken and sent off to the hospital. She didn’t hear anything from the surgery on my advise phoned the surgery to see if the results were  back – she was told twice they still were not back. No one at her surgery suggested they would follow them up. My friend was under the impression as there was no news that the tests would have been ok.

She went to see the nurse about another issue and asked about the results – which had been done some days ago by this point. This highlighted to the nurse that they didn’t have the result back so she phoned the hospital to find that the results were there and that there was an infection and antibiotics were needed. The hospital had not contacted the surgery and the results for whatever reason had not been sent out by this point (which now is done via computer link). My friend was of the opinion that if she hadn’t asked it could have gone on over the weekend before she had heard from the surgery – if at all.

In my experience as a Receptionist I would always suggest to the patient that if they had not heard with a certain timescale (depending on the test takes) to phone the surgery to check if the results were back.

Your surgery might want to try to avoid patients phoning for test results, tlephones are busy at the best of times, and I know there are quite a few tests done on a daily/weekly basis – but I think it is worth taking that extra phone call to ensure that the tests have actually come back.  Then if the patient decides not to phone – which many don’t then you as a surgery cannot be held responsible if in the event that a result is overlooked.

So, whose responsibility is it in your surgery to ensure that the patient receives the results of any abnormal results? Everyone would automatically say it’s the responsibility of the surgery. But patients sometimes need to take responsibility too.

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.

Me – the patient


If you have been following my blog you will know that I am passionate about

  • Customer care
  •  communication and
  • Team work

It is vital in any job that you are doing when working with the general public.

When I am out I love to ‘people watch’. It might be in a restaurant, a shop, on a bus or train or in an  Airport – I love to watch how people react and how good people are at giving a good service.

So, it was no different when I had to go into hospital recently for a day procedure – a colonoscopy.

Let me take you through my day and the build up to it and see if you feel that I had “good customer / patient care”.

It started 3 weeks ago when I had to phone the consultants secretary to see if she had received my referral as I had not heard anything –  I phoned 2 times and left 2 messages before she phoned back and confirmed that she had in fact received the letter from my GP and went on to give me a date for my procedure.  I did not find her very helpful and found myself apologising for phoning and bothering her! Why did I feel I needed to do that?

She said that they would phone me the day before to let me know what time I have to book in for my procedure.

It got to 2.30 the Friday before my procedure and I had to phone to see what time they wanted me in – the secretary still did not know – but did phone me back at 4.30 and confirmed that I have to be in for 10.30 the following Monday. Still appeared to be cold and uncaring.

The day before my procedure I had to starve from 08.00 – that was pretty hard going I must say as everywhere I looked there was food being advertised. On the telly, in magazines and every social network that I looked on everyone was talking about the wonderful roast dinners they were about to have. It was a tough day.

I woke up the next morning feeling pretty awful – I had one almighty headache and was sick – perhaps a combination of not eating and taking medication the day before.

I arrived at the hospital at 10.15. I reported at the front desk giving my name and the name of the consultant that I was seeing that day. The receptionist said that I needed to have an ultrasound and would I please go to the 2nd floor.

I went up to the 2nd floor – I went to the nurses’ station. The nurses were obviously busy and flying backwards and forwards – one stopped and asked if she could help me – I said that I had been sent up for an ultrasound – she asked my name and  pointed me towards the waiting area asking me to take a seat. There were 3 other people waiting there too. One by one they went in –  a nurse came along and asked my name – again. I gave it to her and she said that they would be long before someone would call me. The third person went in – and then two more people came into the waiting room. Another nurse came along and asked my name again, the two people who came in after me went in. An hour after I have arrived I was still sitting – feeling quite unwell.

Then a nurse came along and asked my name – for the 4th time! She asked me to go back down to the reception desk. No explanation given.

So, I went back down to the main desk – there was a woman (I now know was a secretary) who promptly said “oh there you are – I had to come down to see if you have arrived”.  No introduction to who she was – no name badge that I could see for myself who she was – but was just ordered to “follow me”.

We then went back up to the 2nd floor – and into a different area – I was asked to take a seat and then was called in for my ultrasound. Up to this point I had no idea where I was going or why. I explained to the secretary that I had in fact been in the hospital for over an hour at this point – but no apologies to the fact that I had been sent to the wrong department in the first place. No conversation – just left sat in silence.

Then, after the ultrasound was done I was asked to go BACK down to the main reception desk and report in there. So, off I went.

Got to the ground floor, the receptionist ticked me off ‘her list’ and I was asked to go to the patients waiting room on the lower level. So off I trotted again. At this point I was getting to know the hospital very well.

I waited 5 minutes and was called  – I booked in and was asked to report to the nursing station on the 2nd floor.

So off I went to the 2nd floor again – getting to know this area pretty well at this point – and reported to the nurses’ station – for the second time that morning.

A nurse took me along to the ward and asked me to get ready and pop myself into bed – she then came along and took my blood pressure and gave me an ECG – how on earth they were not both through the roof at this point still amazes me. I certainly felt pretty stressful.

I waited, and I waited – many had already gone down to have their procedure or had already had it done back up and eating tea and toast – and I waited and I waited – nothing – no one came to tell me anything.

Eventually I was taken down – it was about 4.00. I actually have visions at this point of being told they had run out of time and I would have to come back. I wonder if they have ever had a “sit in” from a patient before – because I certainly was going through this again in a hurry. I vowed I would have stayed there until they had done it come hell or high water.

I came back up from my procedure – I should have been left to rest for an hour – but after half an hour the tea and toast was there in front of me. Not that I was complaining at this point – and boy it tastes as good as those roast dinners people were talking about the previous day. If not better.

I looked around – I was the last one in the ward – the nurse then came up and asked who was picking me up – I told her my husband – she asked me to call him which I did.

The cleaners then started coming in the ward clearing up around me – I really felt like I was in the way.

5.30 came and my husband arrived to pick me up.

I was never so pleased to see him and be going home.

I was more than happy with the procedure and the consultant, but I did feel that communication, and patient care could have been a lot better and perhaps prevented me from feeling so very drained and stressed from it all.

Did I really need to go to all of the different places to book in? Had I gone to the lower ground floor first and booked in then on to the 2nd floor that is where the ultra sound and day ward was – why send patients up and down all over the place.

As a manager I certainly would be looking for a more stress free way of admitting patients into the hospital.

There certainly was a lack of communication, and in areas lack of team work – no one knew what the other teams/departments was doing – something that really needs addressing.

And to top it all this was a private hospital – somehow you would expect a slightly better service that what I got.