Just back from doctor's and am fuming and livid

[deckofcards]

Before I write a formal letter of complaint, am I being unreasonable?

Went to doctors' before Christmas for a routine appointment and repeat prescription. Needed a blood test and to have ears syringed (have been going deaf). Dr gave me print out and told me to make an appointment with the nurse. Went to reception and asked for an appointment with the nurse which is what I thought I had been given.

Arrived this morning, having fasted. Called in by a sweet enough girl although she wasn't wearing uniform and didn't properly introduce herself as a nurse or anything else. She took my arm and sweetly put it on a pillow, told me I had very deep veins (which I know but it isn't usually a problem but sometimes a doctor has been called), tried the other arm using elasticated cuffs that were clearly broken because they kept popping open and she later said they were no good. She gave me a glass of water to hydrate me better for the veins (which I would have thought would take more than a mintue to work). Still no joy so she went to get a colleague to help her.

The colleague was the receptionist who leaned over me reeking of tobacco and tried to find a vein. I questioned this and was told she was also a trained phlebotomist. The original one then said they would have to give up as the vein wasn't pronounced enough but she would start on my ears. I asked if she was a qualified nurse and she said, no a health care worker.

I declined her offer to deal with my ears and said that I would prefer an appointment with a fully trained practice nurse.

I went out to make another appointment and have been offered one for today with the proper nurse for my ears and have another on Thursday morning for blood tests. I am extremely grumpy that my time has been wasted.

Am I wrong in thinking that if I am told to make an appointment with the nurse and ask for an appointment with the nurse I should be given an appointment with the nurse or advised either when making the appointment that it is not with a nurse. I certainly should not embark on treatment without being appraised of the full facts.

It was clear that the person I saw this morning was not capable or experienced, it did nothing to inspire confidence that she got the girl off the reception desk to help her (and who reeked of tobacco) and I left feeling cross, upset, disrespected and messed about. I would have thought as a minimum of a health care assistant is expected to take blood or syringe ears (and I think the latter is more of an issue actually) then there should be a fully qualified nurse on the premises to supervise, not the stinky girl from reception.

Is this really what healthcare has come to and surely I'm not being unreasonable to expect the tin to contain what it says on the label.

I am minded to make a formal complain to the surgery but needed to get that off my chest first and to take some feedback - hopefully from those who work in surgeries. Oh, and the receptionist/phlebotomist told me it wasn't just my time that was wasted from their side the healthcare assistant now had 30 minutes with no patient because she wasn't doing my ears. My response to that was that had I been told my appointment wasn't being made with the practice nurse in the first place that wouldn't be the case because I wouldn't have made the appointment.

Sorry - very long but I feel better for a rant - and even more that the entire episode was totally out of order. But am I being Unreasonable to think that.

In fairness our healthcare assistants often get called nurses because people see the uniform, see them dealing with patients etc,

Their job title is neither here nor there if they are trained in what they are doing. Like people have repeatedly said, some HCA's are trained in things nurses aren't.

It perhaps should have been explained to the OP that she doesn't need a nurse, it's a HCA she will be seeing but I've yet to have someone ring up and say 'can I book an appointment with the healthcare assistant please'.

Op I totally agree with you. Imagine my shock to find someone my family have known for sometime , who was a new receptionist in our GP , being peddled as a "nurse" having done 2 days worth of health care worked courses. DH went in to have his ears syringed. No way.

The hairdresser salon anology isn't the best really.

You book in with a salon director because they're more highly trained in hair, and you're paying more for it.

The OP requested an appointment with the nurse, it is up to the practice to identify which member of staff is better to preform the procedure and as such she was give the healthcare assistant. Who may have far more training in ear syringing and taking bloods than the nurse.

Who may have far more training in ear syringing and taking bloods than the nurse.

The operative word there being may.

That's the trouble, the OP didn't know.

And don't nurses mind HCW/P being called nurses when, presumably, they don't have a degree or the experience a nurse has? Similar to TAs and LSAs being called teachers when they're not.
It is a tad misleading.

A person who has not had training in ear syringing and bloods will not be doing it. A lot of nurses were never trained in this.

The OP wouldn't know if a nurse was either, so it's the job title again getting in the way isn't it.

And no I don't mind. I don't expect my patients to differentiate when they're going through a bad time or in pain. The thing is they are nursing. They just aren't nurses. And 'hello healthcare assistant' or 'excuse me healthcare assistant' is a bit of a mouthful is it not? As long as I know they're pointing out that they aren't in fact a nurse when needs be, it doesn't matter.

i used to be a gp receptionist. i dont think the OP is being unreasonable at all and im usually the first to come to the defence of a the hapless gp receptionist!

at the practice i worked at, if an appointment was needed with the practice nurse - the patient got the practice nurse.
we did have a HCA, she also doubled as a receptionist - she was more trained than us but did things like take BPs, do spirometry, ECGs and the like - no ears and no bloods. And the gps made it clear to the patients (of which i am still one) who it was they were to see - whether that was the nurse, HCA or GP.

i personally do not think the OP is being unreasonable here - she asked for an appointment with the practice nurse who the gp told her to see - she was not given the information upfront and did not feel comfortable with the efforts of the HCA, who it sounds like she didnt even know she was seeing.

i do think HCA have a place in gp practice. But so do nurses. If i have a smear test, or want stitches removed, i want a practice nurse. I have seen both HCA and practice nurses, as well as nurse practioners - i have no issue with that at all - but i want the see the right man/woman for the job.
i dont think thats remotely unreasonable. The op didnt feel comfortable and asserted that - maybe if more people didnt just accept crap health care then things would get better. I am in hospital next week for surgery - i will have no qualms about asking questions and making informed decisions.

i was once in hospital with my asthmatic son - i watched a doctor go from patient to patient without washing their hands or using sanitising gel. He went from a little lad with pnuemonia to my son with chronic asthma - and i asked him to wash his hands before he touched him.
and i would again.
my son contracted meningitis in hospital - unlucky - and he spent almost 8 weeks in hospital - i would never be shy about asking questions and saying i wasnt comfortable with something. more people should. our NHS is precious - but its falling apart. And we are letting it by putting up and shutting up.
when my DS was in hospital there were not enough nurses, even on the resuss ward where he was - and the nurses there told me to complain because nothing would change otherwise.
it felt wrong - they had done their best and i had got to know them all really well (8 weeks living on a camp bed next to your critically ill baby will do that.....) i felt i could not complain as it was somehow "dissing" them and their efforts which i appreciated more than i could say.

but they were right. i should have complained. sometimes ds meds were hours late - and he was on iv antibiotics. he should have had meds every 4 hours on the dot - but it wasnt the nurses fault - it was an overstretched system with not enough frontline staff.
i know that feeling now all to well as im on the front line in my job which is being cut to shreds....

no one should shut up and put up with something they are not comfortable with.

Sorry need to point out it is the patients calling them nurses, NOT staff.

If I went to the hairdresser and booked an appointment with a salon director or senior stylist I wouldn't expect to get someone who's only been on the floor for a month.

But you will very likely end up with that person doing your hair wash or blow dry, because that's a better use of their time than the senior stylist.

baubles we found our acquaintance was being called "the nurse" by staff.

cleofatra then that's very wrong. But your example isn't the same as the OP's to be honest.

How do you know? It was only when asked that it was revealed the HCA wasnt the nurse the OP was booked i to see.

Vicar I'm in complete agreement - patients should complain, it's the only way we can hope for things to change, but it feels counter intuitive. Believe it or not, I usually love complaints as they are a fabulous opportunity to try to make things better.

But op has not only wasted NHS time but she is "fuming and livid" and wants to complain that she was going to receive substandard care by being booked with an hca. If someone isn't appropriately trained to do syringing then they don't do it.

It's all very well putting in a complaint, but only if there is actually a reason to complain. Frankly I find op's stance to be entitled and wasteful.

deckofcards I wouldn't make a complaint as such but it wouldn't hurt to write a letter of feedback. After all, your GP said to make an appointment with the nurse, so no wonder you were feeling uneasy when it was a HCA. I would also expect health care professionals to wear identifiable uniforms and to introduce themselves to instill confidence and to come across as professional; having treatment can be a nerve-wracking experience for many people so staff should minimise stress as much as possible IMO. I also don't think HCPs/anyone dealing with patients should smell of fags either. I realise it's not illegal (and can't be helped if having done a home visit for a smoker), but it's a pretty revolting smell, especially up close and personal.

Little things make all the difference to how well we perceive service. For example, I had to have a chest x-ray and the Radiographer told me to go into a cubicle and change into a gown. She then disappeared before I had a chance to ask her what she wanted me to do next. So I waited by the cubicle and eventually she came to get me, wondering where I'd got to. It appeared I was expected to go into the x-ray room up the corridor when I was ready but how was I to know as she hadn't told me! Plus not once did she smile (even though I'm a naturally smiley person), and when I asked her what the risks of having an x-ray were she pretty much told me if I was unhappy I didn't have to have it done. I only asked if there were any risks involved, I wasn't complaining or saying I wasn't comfortable getting it done! I let it go but I wish I'd written a short letter of feedback as I felt her bedside manner needed a tweak.

I love the NHS. I know this sounds really wanky but it's one of the reasons I am so grateful to have been born in Britain. I realise it isn't perfect and occasionally people have the right to be angry with the treatment they've received but honestly OP, this isn't one of those times. You've overreacted to something that's been easily sorted to accommodate you.

Love to know what the OP's response will be if the NURSE turns round and says
"I've never syringed ears before,you should have made an appointment with the HCA as she's the one qualified to do the procedure"

@ fanjo.

All this thread is about is role snobbery!! Who cares if it was a HCA, if she has been trained to provide the care then let her get on with it.

YANBU You asked for an appointment with a nurse, that's what you should have been given. It is irrelevant if the person could or could not perform the procedure. The receptionist should have offered you the health care person as an alternative and let you decide.

You are not over reacting and should make a complaint.

Sounds to me like that particular healthcare assistant was perhaps new and a little nervous rather than there's much difference between HCA/Nurse care for the procedures you mentioned?

The last blood test I had was with a doctor and it was awful, I could tell before she syringed that she hadn't pulled the arm strap thing tight enough.

You do have the right to refuse though if you didn't receive what you had been told to expect, and didn't feel confident. Hope you feel better about it now but totally up to you regarding complaining.

Sorry msmorton I was out last night & have just checked back.

As it was a review of my epilepsy, as I understood it a hca can't prescribe any medication, and I felt that since I have had quite alot of absenses recently I wanted someone who could explain exactly why they happen and what I can do to stop them. I thought that my GP would be better as he could refer me for further scans, consultant, ect. Where as the HCA couldn't do anything other than suggest I book in with my GP, which I'm 100% sure off as the receptionist told me when I rang up.

I'm not usually a snob when it comes to HCA/doctor I'm usually willing to be a guinea pig, but if it isn't being done correctly I'm not adverse to asking for someone else.

I haven't read all of the replies as it ouldn't take far too long but as a nurse I wanted to give my opinion.

Health care workers are often very well trained and you will often find that they have more practical experience than a nurse (eg hcw who's worked for years v newly qualified nurse). A qualified phlebotomist will also often have more experience taking blood than a nurse.

The reason that that non qualified nurses do such procedures is that essentially anyone can train to do a task and it frees up the nurses time to see patients with more complex nursing needs.

In your case the things I would be upset about is the not introducing themselves and the smelling of smoke. Not the fact that they are not qualified nurses. By all means write a letter expressing your feedback but I wouldn't see it as a cause for formal complaint.

I think it's very unfair of half of u on here to judge the hca assuming she is nervous, new, young girl or whatever!

At the end of the day she is employed by the practise to do a job and she should well be allowed to do it without being patronised !!!

She took my arm and sweetly put it on a pillow

How do you take an arm 'sweetly'? Do you mean she was gentle. If that's the case then she was doing the right thing.

told me I had very deep veins (which I know but it isn't usually a problem but sometimes a doctor has been called)

So she made her initial observation and confirmed with you that you had deep veins - again the right thing.

tried the other arm using elasticated cuffs that were clearly broken because they kept popping open and she later said they were no good

She was right again wasn't she, they were no good.

She gave me a glass of water to hydrate me better for the veins

Sensible woman, she did the right thing again.

(which I would have thought would take more than a mintue to work)

Perhaps you could have had the sense to drink some water earlier then?

Still no joy so she went to get a colleague to help her

Yet again, the right thing to do.

OP if you think it's ok to call a kind female adult 'a sweet girl', I presume you will be happy for her to refer to you as 'a crabby ancient crone' or some such derogatory comment?

cockwomble couldn't agree more.

Surely to heavens, if the HCW was the most suited to do the procedures then the doctor should have said 'I want you to book an appointment with Ms Smith as she is the member of staff who takes bloods etc now'

No confusion. If the doctor calls everyone who isn't a doctor, a nurse, then the original fault lies with him.