There is nothing more weird than folk


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I had to go into hospital for the day last week. I was sent a letter with instructions on what I needed to do and what I needed to bring, pyjamas, slippers and a book etc. All simply written out, easy to follow and to understand.

I arrived in plenty of time and was shown up to the ward. The ward was very quiet; there was just one other lady in the bed next to mine. I was shown my bed and asked to get into my pyjamas and told the nurse would be round shortly to take some details.

Then another lady came in. She took herself off to a bed opposite and sat there waiting on the nurse. She greeted the two of us and remarked on the weather, we all passed small talk that you have with complete strangers. Both ladies seemed really nice.

The nurse came in; she went to the lady opposite and drew the curtains.

There was no confidentiality whatsoever, we could hear the whole conversation, the nurse was taking her whole medial history.

When you are sitting there, nothing to do and everywhere is so quiet it is so hard not to hear what is being said.

I know I shouldn’t have but the lady did make me chuckle to myself at the same time feeling sorry for the nurse taking the details as I imagined there was a lot of crossing out on her notes.

Some of the conversation went

Nurse : Where is your bag?

Patient : What bag?

Nurse : A bag with your pyjamas and slippers

Patient : Oh was I supposed to bring something in to change into

Nurse : Yes it was in your information did you receive it?

Patient : Yes I did (and said no more)

The nurse went off to get the patient a gown 

The Nurse returned and continued asking the patient some more questions

Nurse : Do you smoke?

Patient : No

After a pause

Patient : well I do have 3 or 4

Nurse : is that a day or a week?

Patient : errrr well I probably have about 5 or 6 a week.

I imagined the nurse having to cross out what she has already written.

Nurse : Do you drink?

Patient : No

After another pause

Patient : Well………… I might have a couple now and then

Nurse : How much is now and again

Patient : A couple of time a week.

Another pause whilst the nurse crosses out what she has previously written.

Nurse : when did you last eat

Patient : Yesterday at 4.00 pm

Nurse : Did your leaflet not tell you to refrain from eating after 1.00

Patient : Oh I didn’t see that

Nurse : What medication are you taking?

Patient : ohhhh let me think? (this took a bit of time after several changes)

That entry also had a few crossed out too I should imagine!

And so the conversation went on with similar discrepancies to what was originally said.

I must say the nurse was brilliant; she never once got short tempered with the patient, took everything in her stride and was even able to have a laugh with the patient. She really was so professional.

The nurse then came to me.

We whipped through the questions, and when she came to medical history and medication I handed her a typed sheet with all the information on – she smiled and whispered, “if only everyone was as well organised as you.”

© 2011-2017 Reception Training all rights reserved

 

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Help I’m Confused #Bupa #LivingWithDementia #CardGame


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Dementia is something many of us will come across, be it through our work, family, friends or personal circumstances.

For those of us that come across with through work it is important that you understand the needs of the dementia, to be aware or their needs – and just as important the needs of their carers.

I have witnessed this through family members and it takes it toll on the carer who in turn might become ill through the stresses of caring for the patient.

Unless you have ever experienced caring for someone with dementia it is so very hard to explain, every day living can be challenging and utterly exhausting.

I recently came across this excellent insight in what a small part of a patient suffering with dementia can experience, for me taking the test got me frustrated, I played it several times, being beaten every time, but just pause whilst you get frustrated and play it again, stop and think what it would be like to face challenges like this every day

Take the challenge            http://thememorychallenge.co.uk/      Bupa.webloc

How did you get on?

Whilst I cannot take credit for the game I would like to say done to Bupa for sharing this with us all and a small part of what life as a Dementia sufferer can be like.

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Other post that I have done on Dementia:

 

When Love Shines Through #LivingWithDementia http://wp.me/p1zPRQ-vr

Dementia and the Carer #DementiaAwarenessWeek http://wp.me/p1zPRQ-vv

Its Not Always About The Patient #Dementia #Carer http://wp.me/p1zPRQ-xR

Patients Letters for Collection


As a Receptionist/Supervisor how would you deal with the scenario below:

A patient consulted her GP requesting a referral to a gynaecologist for a termination.  She stated in the consultation that she did not want her husband to find out. The GP wrote a referral letter, which was placed in the “for collection” box in reception. For some reason the letter was not collected.

The patient then visited the surgery 3 months later to ask for a letter for the clerk at the Magistrates court, explaining that she could not attend court due to a medical reason. The GP had the letter typed and this was also placed in the box for collection.

The patient’s husband came into the surgery 3 days later to collect the letter to take to the Magistrates court but the wrong letter was given to him. The letter he was given was the one typed 3 months previously for the Gynaecologist.

The husband took the letter to the Magistrates Court. When the Court clerk opened the letter and found it was not for them she handed the open letter back to the husband who then read the letter.

There are several issues here – can you identify what could have happened and what action could have been taken to ensure that it does not happen again.

  • All personal letters should be placed in a sealed envelope.
  • Each envelope should be dated on the back of the envelope and the “collection box” should be checked on a monthly basis.
  • Any letters that are over 4 weeks old should be opened and checked.
  1. Inform their GP that the letter has not been collected so they can follow this up. The GP might need to call the patient and ask if they still need the letter, and according to their reply the necessary action taken.
  2. If your practice asks you to follow the letter up ensure that you record the event. Enter on the patient’s records (or in a separate message log) that you have spoken to the patient about the letter and their response and the action that you have taken. Also remember to date and time the call.
  3. If the letter is not longer required remove the letter from the “collection box” and ensure that you have guidelines on what to do with it. Shred it, or other.
  4. If the letter is required and the patient is going to collect it cross off the first date and add the date you spoke to the patient on the back of the letter to avoid the same process happening again.
  • If you go to the “collection box” and identify two letters there look at the dates on the back of the envelopes, check the patient’s records and see which date corresponds with the envelope. If you are unsure open and check the letter and place it in a new envelope. remembering to add the dates on the back again.
  • In today’s society Patient Confidentiality is vital – we should be asking if we should have actually given such a letter over to her husband. But it was the patients choice to have her husband come in and collect the letter for the Court.
  •  Having it in a sealed envelope is definitely more secure than just handing over the letter without an envelope. So please ensure that all confidential letters are in sealed envelopes.
  • 99% of the time it would be safe to hand over such a letter  – but there is always that 1% that could backfire. But with everyone living such a busy life we always rely on family/friends helping out at such times. If you are in any doubt speak to your Supervisor/Manager or even phone the patient and ask if they are happy for you to give the letter to the person at the desk.
  • The 1% of this backfiring could be that when her husband read the letter which was meant for the Gynaecologist it could have caused a big problem, especially as she had already said she did not want her husband knowing about the termination. This could have led to the surgery being sued for breach of confidentiality.
  • Always think of the 1% and cover yourself as much as you can.

Does your practice have a policy on the collection of letters?

How do you give out repeat prescriptions at your Surgery?


Do you keep your repeat prescriptions in a secure box? Are they kept near to the reception desk for easy access to give to patients when they are collecting them? Do you lock or secure your repeat prescription box  during the lunchtime and at night? If not you should.

There have been occasions  (not many I am pleased to say) where the prescription box was kept in easy reach of the reception desk and they have been snatched – so always ensure that the box is kept a good distance from the desk to avoid this from happening.

Do you give our prescriptions to people other than the patient? Of course you do – prescriptions are collected for patients by family members, neighbours or carers. In today’s society people work or might be housebound and often cannot get into collect their own prescription – so we all accept that people other than the patient will come in to collect a prescription.

We all like to make things easier for our patients – after all that is what we are there for – we get to know our patients and will often go out of our way to help in any way we can. But sometimes you might think you are doing the right thing – but perhaps you are not – you need to stop and thing before you maybe “offer” that extra help.

Here are two true stories that actually happened to me when I was a Receptionist. On both occasions I thought I was doing the right thing. I thought I was being helpful when in fact I wasn’t – it actually could have backfired and cause a problem. Let me share them with you.

True Story  1

Mrs Joan Morgan came into the Surgery one morning to collect her normal repeat prescription. I went to the box to get the prescription and seen that her daughter Miss Catherine Morgan’s prescription was there too waiting to be collected. Mrs Morgan did not ask for her daughter’s prescription, but had in the past collected a prescription for her as did her daughter for her.

 I knew that Mrs Morgan and her daughter had a good relationship and lived together and they were often in the surgery at the same time. So I had no hesitation is asking her did she want to take Catherine’s prescription at the same time. She said she would.

I gave her the two prescriptions – she looked at the prescription and with a gasp she looked at me and said “I didn’t know Catherine was taking the birth pill”. I realised then that Catherine had not asked her mum to collect her prescription for a reason – the reason being she did not want her mum knowing she was on the birth pill. I realised I had actually broken patient confidentiality. I spoke to my Reception Supervisor and she advised me to telephone Catherine to explain what I had done. Thankfully Catherine was extremely good about it and said that she would speak to her mother when she got home.

It is times like this when you have a good relationship with the patients that you are able to telephone them, explain what has happened and they will understand that you were only trying your best.  I found that by having a good relationship patients they are far more understanding. They know that you are trying to help. You will also find there will be fewer complaints.

True Story 2

Mr Joe Allan came in again one morning asking for his repeat prescription. I went to the box and seen that his son Ben Allan’s repeat prescription was there too.  Aware of what had happened before I checked Ben’s prescription – it was for his asthma inhaler – and again his dad had often picked up this prescription for him. So I thought this time I would be safe – there was nothing confidential on there so I asked Joe if he wanted to take Ben’s prescription as well. He said he would.

Then at 12.55 (five minutes before we closed for lunch) Ben came flying into reception. He asked for his repeat prescription for his inhaler – he had run out and was feeling a bit poorly and needed it. My heart sank – there was no Doctor on the premises as they were away doing their home visits. Ben explained that he was come up to the surgery in his lunch hour and would not have time to go home to get his prescription from his dad.

Luckily enough we had a very good understanding with the chemist across the road from the Surgery and I telephoned them and they said that they would issue Ben with an inhaler as he was a regular customer there and had his records, but on the understanding that he or his dad dropped his original prescription in to them the following day.

Ben dashed over to collect his inhaler

So there are two different examples where I thought I was helping a patient but in fact it led to them having problems because of it.

So from then on in – unless someone  specifically asked for someone’s prescription it stayed well and truly in the box until it was requested.

How do you give out repeat prescriptions at your Surgery?


Do you keep them in a secure box? Are they kept near to the reception desk for easy access to give to patients when they are collecting them? Do you lock your repeat prescription box  during the lunchtime and at night? If not you should.

There have been occasions  (not many I am pleased to say) where the prescription box was kept in easy reach of the reception desk and they have been snatched – so always ensure that the box is kept a good distance from the desk to avoid this from happening.

Do you give our prescriptions to people other than the patient? Of course you do – prescriptions are collected for patients by family members, neighbours or carers. In today’s society people work or might be housebound and often cannot get into collect their own prescription – so we all accept that people other than the patient will come in to collect a prescription.

We all like to make things easier for our patients – after all that is what we are there for – we get to know our patients and will often go out of our way to help in any way we can. But sometimes you might think you are doing the right thing – but perhaps you are not – you need to stop and thing before you maybe “offer” that extra help.

Here are two true stories that actually happened to me when I was a Receptionist. On both occasions I thought I was doing the right thing. I thought I was being helpful when in fact I wasn’t – it actually could have backfired and cause a problem. Let me share them with you.

True Story  1

Mrs Joan Morgan came into the Surgery one morning to collect her normal repeat prescription. I went to the box to get the prescription and seen that her daughter Miss Catherine Morgan’s prescription was there too waiting to be collected. Mrs Morgan did not ask for her daughter’s prescription, but had in the past collected a prescription for her as did her daughter for her.

 I knew that Mrs Morgan and her daughter had a good relationship and lived together and they were often in the surgery at the same time. So I had no hesitation is asking her did she want to take Catherine’s prescription at the same time. She said she would.

I gave her the two prescriptions – she looked at the prescription and with a gasp she looked at me and said “I didn’t know Catherine was taking the birth pill”. I realised then that Catherine had not asked her mum to collect her prescription for a reason – the reason being she did not want her mum knowing she was on the birth pill. I realised I had actually broken patient confidentiality. I spoke to my Reception Supervisor and she advised me to telephone Catherine to explain what I had done. Thankfully Catherine was extremely good about it and said that she would speak to her mother when she got home.

It is times like this when you have a good relationship with the patients that you are able to telephone them, explain what has happened and they will understand that you were only trying your best.  I found that by having a good relationship patients they are far more understanding. They know that you are trying to help. You will also find there will be fewer complaints.

True Story 2

Mr Joe Allan came in again one morning asking for his repeat prescription. I went to the box and seen that his son Ben Allan’s repeat prescription was there too.  Aware of what had happened before I checked Ben’s prescription – it was for his asthma inhaler – and again his dad had often picked up this prescription for him. So I thought this time I would be safe – there was nothing confidential on there so I asked Joe if he wanted to take Ben’s prescription as well. He said he would.

Then at 12.55 (five minutes before we closed for lunch) Ben came flying into reception. He asked for his repeat prescription for his inhaler – he had run out and was feeling a bit poorly and needed it. My heart sank – there was no Doctor on the premises as they were away doing their home visits. Ben explained that he was come up to the surgery in his lunch hour and would not have time to go home to get his prescription from his dad.

Luckily enough we had a very good understanding with the chemist across the road from the Surgery and I telephoned them and they said that they would issue Ben with an inhaler as he was a regular customer there and had his records, but on the understanding that he or his dad dropped his original prescription in to them the following day.

Ben dashed over to collect his inhaler

So there are two different examples where I thought I was helping a patient but in fact it led to them having problems because of it.

So from then on in – unless someone  specifically asked for someone’s prescription it stayed well and truly in the box until it was requested.

Patients Letters for Collection


As a Receptionist/Supervisor how would you deal with the scenario below:

 

A patient consulted her GP requesting a referral to a gynaecologist for a termination.  She stated in the consultation that she did not want her husband to find out. The GP wrote a referral letter, which was placed in the “for collection” box in reception. For some reason the letter was not collected.

The patient then visited the surgery 3 months later to ask for a letter for the clerk at the Magistrates court, explaining that she could not attend court due to a medical reason. The GP had the letter typed and this was also placed in the box for collection.

The patient’s husband came into the surgery 3 days later to collect the letter to take to the Magistrates court but the wrong letter was given to him. The letter he was given was the one typed 3 months previously for the Gynaecologist.

The husband took the letter to the Magistrates Court. When the Court clerk opened the letter and found it was not for them she handed the open letter back to the husband who then read the letter.

There are several issues here – can you identify what could have happened and what action could have been taken to ensure that it does not happen again.

  • All personal letters should be placed in a sealed envelope.
  • Each envelope should be dated on the back of the envelope and the “collection box” should be checked on a monthly basis. Any letters that are over 4 weeks old should be opened and checked. If necessary a phone call to the patient to ask if they still need the letter, and according to their reply the necessary action taken
  1. Inform their GP that the letter has not been collected so they can follow this up.
  2. Enter on the patient’s records (or in a separate message log) that you have spoken to the patient about the letter and their response and the action that you have taken. Also remember to date and time the call.
  3. If the letter is not longer required remove the letter from the “collection box” and ensure that you have guidelines on what to do with it. Shred it, or other.
  4. If the letter is required and the patient is going to collect it cross off the first date and add the date you spoke to the patient on the back of the letter to avoid the same process happening again.
  • If you go to the “collection box” and identify two letters there look at the dates on the back of the envelopes, check the patient’s records and see which date corresponds with the envelope. If you are unsure open and check the letter and place it in a new envelope. remembering to add the dates on the back again.
  • In today’s society Patient Confidentiality is vital – we should be asking if we should have actually given such a letter over to her husband.  Having it in a sealed envelope is definitely more secure than just handing over the letter without an envelope. So please ensure that all confidential letters are in sealed envelopes.
  • 99% of the time it would be safe to hand over such a letter  – but there is always that 1% that could backfire. But with everyone living such a busy life we always rely on family/friends helping out at such times. If you are in any doubt speak to your Supervisor/Manager or even phone the patient and ask if they are happy for you to give the letter to the person at the desk.
  • The 1% of this backfiring could be that when her husband read the letter which was meant for the Gynaecologist it could have caused a big problem, especially as she had already said she did not want her husband knowing about the termination. This could have led to the surgery being sued for breach of confidentiality.
  • Always think of the 1% and cover yourself as much as you can.

Does your practice have a policy on the collection of letters?

 

 

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.