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.

Sorry but yabvu. Appointments are a precious commodity and a full half hour was wasted. I understand why you're upset but you could have had your ears done - they wouldn't book you in to see someone if they weren't capable of doing stringing.

Just as an aside, I didn't start smoking until I started in the NHS full-time. You would not believe how utterly fucking stressful it is dealing with patients.

YABU. It is normal for jobs like ear syringing to be carried out by Health Care Assistants and for blood to be taken by either them or phlebotomists who are usually trained receptionists. The "stinky" receptionist was probably not on the rota to do phlebotomy this morning but came through to help out as the other was struggling. This is also normal. Everyone, however experienced will have patients that they struggle to get blood out of from time to time - on another occasion she might manage fine. It sounds like she did everything she could to sort it out in what was probably a very limited appointment time (we usually allow 5mins for routine blood tests). The rubber tourniquets will be the new disposable ones which we are supposed to use that are more hygienic but not nearly as good as the ones we used previously. I'm amazed (and impressed) that they managed to give you an appointment today with the practice nurse for ear syringing. I think you've had a reasonably good service from what you describe and complaining will only divert doctor and management time away from seeing patients in order to foramally respond and leave a bad taste in everyone's mouth.

OP you do realise that the NHS is on it knees don't you?

No doubt when the NHS eventually collapses due to the continued unreasonable demands of patients to not use cheaper, qualified staff you will be happy to pay the premium required? Don't be deluded it wil happen if we don't accept change?

Yanbu. If you made an appointment with a nurse, a nurse is what you should get. If you aren't comfortable with the person giving your treatment, you are allowed to decline it and request someone else (in this case the person you were actually supposed to have!) so I don't know why people are jumping on you for wasting the health care worker's time. The smelling of smoke thing is annoying too but nothing you can do about that.

I'm impressed that your doctor's surgery has people there to take bloods. Ours don't and when it needs doing involves a huge round trip to somewhere miles away.

Im a nurse but not trained to take blood.

Lots of HCAs on my ward are trained.

Well said Mrs Morton.

OP are you over 60?
As I get older everyone else just seems so young.
I was convinced that my new dentist was a student as he didn't look old enough to be qualified. He was the best dentist I have ever been to even though he looked like a 'lad'.

Crikey. I'm a doctor and have fifteen yeas experience but still sometimes fail at taking blood. It can be technically difficult.

The hca would not have been able to syringe your ears if she had not been trained. The receptionist would also have been trained in phlebotomy. One of our receptionists is trained in phlebotomy (it frees the more highly trained staff up for other problems) but she does wear uniform when performing these duties.

Unfortunately demand in practice nurses and GPs is so high that simple jobs are being passed to other staff. Training for these is rigorous though.

Complain if you think you were treated badly by all means, but there is no guarantee anyone else would have been able to take your blood this morning any more easily.

As for the tobacco: its unprofessional but I'm not sure what you are hoping will happen if you complain. Last time I checked smoking was still legal. Unfortunately.

Stayaway has hit the nail on the head tbh

I dont think the OP is being unreasonable at all. She made an appointment with the nurse, and at no point did anyone advise her that she wouldnt actually be seeing one.

Its not about what the HCA is or isnt qualified to do, its about the OP feeling lied too - and suddenly being expected to let this person stick things in her!

Maybe OP would be better going private?

You are overreacting massively. The HCW or Clinical Support Worker would have been a Band 3, so completely qualified to do what you needed her to do. I have worked with doctors who have attempted to take blood from a patient with 'deep veins' up to 14, times so a degree does not help when treating the clinically obese.

GPs surgeries often advertise jobs which are part receptionist/part HCA so they have full cpver at busy times.

Well if you do write a letter, you might want to be a lot less patronising.

Cut out the 'sweet little girl' shit and what she smelled of, because that has nothing to do with anything.

YABU - a job title gives no indication of experience for a specific task. For example consultants hardly ever do blood tests or canulate patients however in the unit I attend the HCW do blood tests day in day out & are extremely experienced. I would rather a HCW than a Consultant any day.

stayawayfromdeliriumdrive
"The HCW will be trained in ear syringing and you refused to let her do it. It's time wasting like this that costs the NHS millions of pounds each year."

The HCW was presumably trained also in taking blood but proved to me she couldn't do that, therefore, I was not going to let her practice on my ears. Also if I had been told the appointment was with an inexperienced HCW I would have declined it. In that case her time and NHS time wouldn't have been wasted and neither would mine have been wasted. That matters too I think.

pobblewobblehasnotoes
"So you think because she was a health care assistant and not a qualified nurse she was not able to do the job in question?"

She couldn't do the job in question - had she been able to she would have been able to take the blood. She couldn't do that and neither did she seek help from someone more qualified than her, she sought it from the receptionist who happened to be a phlebotomist as well. I would have been more reassured if she had called in the nurse or one of the doctors rather than the girl I have only ever seen on reception doing reception duties. I would also have been reassured had that girl not absolutely have reeked of tobacco. I do not want my healthcare delivered in that way - it is not professional.

I would have no issue with a non-qualified person doing those things, provided they had adequate training, demonstrated by being capable. I would however take massive issue with people muddling through, which is what the OP desribed here. Having your ears syringed, i would imagine has to be done properly or it would cause damage to the ear drum. Most phlebotomists are not nurses and HCAs have taken blood from my mum pretty much every time she goes to the hospital. Its not about qualifications, its about competence and it would appear that between the two people who "treated" the OP, it was pretty scant on the ground.

I expect when they booked your appointment they booked it with the most appropriate person for the job, i.e the hca as taking bloods and ear syringing is obviously part of her role. Leaving the practice nurse to see patients with other issues.

I'd much rather a phlebotomist take my bloods than a doctor or midwife (and I have to have regular bloods).

I think you're undermining the roles of HCAs. They're a valued part of the team I work in.

OP- how do know she was inexperienced? did she say?

I think you're overreacting too, sorry. And if a member of staff smokes, as they are perfectly entitled to do, then they will smell of smoke, just as some people smell of other things, like strong perfume or B.O. I can't see why you have grounds to complain about that. My SIL is a HCA and she takes blood and syringes ears fine.

So the person struggling to take blood should have carried on struggling & not asked for help??

She asked a phlebotomist and they couldn't do it, so not sure a nurse would have had more luck either!

I think I might suggest to them that patients are told when it will be a HCP rather than a nurse, but that's it.

I am a nurse.

I have huge concerns about the variation in extended roles for health care assistants and GP receptionists.

I work with HCAs and some are very well trained for specific tasks, but they do not have the back ground training and qualifications that a qualified nurse has, and often it is this training and experience that is very important, even when carrying out what seem to be basic, simple tasks.

Some GPs use their reception staff for checking blood pressures. I personally don't think this is appropriate.

The problem is that it is impossible to know what training/accreditation the HCA has been given.

I think that if a patient is offered an appointment with the practice nurse, that should be what is given. Ear syringing is a risky procedure - many surgeries don't do it now.

A trained phlebotomist is often the best person person to take bloods though. My blood taking skills are pretty rusty now, as I hardly ever do it. I used to be really good at it though.

So - all things considered, you are NBU.

I do a specialist job and have to have extended training and regular re-accreditation, for which i receive a certificate. I have to display my certificate at work.

Maybe HCAs who have specialist training could do the same. After all, the mechanic who fixes my car has his certificates on the wall in his premises, as does my dentist.

I've made appointments with a duty go before only to be put onto the practice nurse's list to be "triaged" so that only more serious cases got to a doctor. What's the problem? The NHS is free at the point of delivery, we're actually fucking lucky to have it, and sometimes, just sometimes, because resources are so stretched patients have to see who is available. As long as they are appropriately trained what's the problem?

YANBU. If you didn't feel comfortable, it's best to stop and request someone more qualified. Why sit and be polite when it's your health at stake?

Their reaction was extremely unprofessional. I have no problem letting students, assistants, etc. perform procedures, how else would they learn? Whenever I have agreed to this (I was always asked first), they have been appropriately supervised.

TBH, I am repeatedly amazed at what people will put up with from their health care in this country.

She couldn't do the job in question - had she been able to she would have been able to take the blood.

Just as a point, DS spends a lot of time in hospital and frequently needs to have blood taken from his hands/arms by a Doctor. The Doctors who do this are generally Registrars. They are clearly trained to do this. They clearly know how to successfully take blood from a child . They do it all the time.

Sometimes they struggle to get blood from DS. It depends on the day. It doesn't mean they can't do their job.