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.

Also the doctors always say 'with a nurse' where I work. They just group them all together.

Can I just note please that today was not the first time I have had to have blood taken. I have a medical condition that necessitates it. I have had it taken over the years by phlebotomists, midwives and GPs. Some have sometimes had difficulties. However I have never experienced anything like the unprofessionalism I experienced today.

What do those on here not understand. I was told to make an appointment with the nurse, I asked for an appointment with the nurse. At no time was I told it was with an HCP and indeed the HCP I saw did not introduce herself to me as an HCP before starting the treatment. If she had been confident it would have been different. If she had put me at my ease it would have been different. She told me she was getting her colleague and came back with the receptionist. She could have said x on reception is a phlebotomist and is great with difficult veins but she didn't.

I am shocked that many on here think that substandard care is acceptable because that is what I think it was. Why is it unreasonable to expect to see a nurse if one has asked for an appointment with the nurse? It always used to be the practice nurse who did bloods and syringing.

You clearly feel you we're mislead by the practice as you specifically asked for an appointment with a nurse and you got a HCA. So make a complaint. If you feel you were also treated unprofessionally by the staff who attempted to take blood, complain about that too.
But I think you have rather strange standards.

Struggling for a vein happens. You could have a 100 blood tests that are straightforward then one that isn't for many reasons. The experience of the practitioner is irrelevant. The fact that two professionals (and asking for a second opinion is sensible not a measure of experience) couldn't find a suitable vein demonstrates this.

This woman was a qualified professional, as was her colleague, walking out was rude, unnecessary and childish. How on earth your veins not being prime for a test at a particular point of time is a revelation on the professional's ability to syringe ears, I don't know.

Your complaint is ludicrous - and you are exactly the kind of patient overburdening the NHS and causing huge additional stress to staff at the most testing time in the health service's history.

This has really made me People can be so bloody entitled when it comes to the NHS. Sooner or later we may all well have to live without the service. When you're paying to see a specialist then you can complain about how they smell.

I don't quite understand why you are being so harsh towards the HCW for failing to take your blood when in your OP you said '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 in the past, presumably, even fully qualified nurses have failed to take your blood?

I appreciate you would have preferred her to then call for a doctor to try, but a trained phlebotomist is just that: someone trained to take blood, so they were just as qualified as anyone else.

I have to admit, in your circumstance, it would not have occurred to me to not let the HCW attempt to syringe my ears. I would have assumed that, knowing what the appointment was for, the correct HCW was being assigned to do the job. I would be put off by someone smelling of smoke, however, though would not think that enough to write a letter of complaint about.

So, really, I can see their point of view in that, refusing to stay for the syringing, you were wasting the HCW's time. If you were going to make a fuss, I think you would have been better off staying at the surgery and insisting someone more senior took your blood (be that the receptionist, a nurse or a doctor) as I can sympathise with you that you had fasted for this appointment, and spent time going to the surgery and it must be very annoying to now have to do that all over again.

You'll find many doctors group anyone not a doctor in the nurse group. They wouldn't differentiate between a HCA and nurse. So for thy reason I think YABU and massively over reacting.

If you are adamant that you are NBU, why ask AIBU...?

If you didnt feel confident in any aspect of your care I believe you have a right to withdraw from treatment. The person treating you did not put you at ease.

I encountered this with a trainee midwife - I was in bits and she quoted 'the textbook says...' and was told by the MW they were short staffed. Trainee did not know her blood test tubes I had to tell her what colours to use and she was not able to take the blood either.

It hardly fills you with confidence when this happens - some people are more relaxed than others about medical treatment or visits to GP. A skilled practioner is able to be responsive to people who are nervous.

FWIW I wouldnt want someone with stinky tobacco leaning in close to me anywhere.

I have very tricky veins and generally find that nurses and HCAs do better than doctors at getting blood - presumably because they do more of it. Sometimes it just isn't happening though and it wouldn't occur to me that this would mean they shouldn't do my ears.

Why does everyone keep saying I was wasting the HCP's time and the NHS's time. I was told by the GP to make an appointment with the nurse, at no time was I told the appointment was with anyone but the nurse. Surely it's my time that has been wasted. Had an appointment been made with the nurse this morning, I can appreciate she too might have had difficulty taking the blood but I also feel sure there would have been more professionalism, I would not have ended up feeling too scared to let the HCP anywhere near my ears and nobody's time would have been wasted.

I have never wasted NHS time.

I syringe my own ears, I didn't realise it was a job that required training.

Think you massively overeacted. You wasted your own time and hers. You yourself said you have tricky veins.
Iv had doctors and nurses struggle with mine.

Phlebotomists are probably more experienced at taking blood than a nurse or doctor. They are usually health care assistant grade. And receptionists are often trained phlebotomists. I am a 5th yr medical student and will be a junior dr next year and I have taken loads of blood lately but still struggle to find blood sometimes.

If 2 people tried and failed then you probably do just have tricky veins.

Smelling of tobacco is neither here nor there. It is not illegal to smoke.

You are well within your rights to ask for someone else but they are not wasting YOUR time.

Furious and livid? I don't really think there's any need for that, do you?
Nothing bad happened. You refused treatment from someone qualified to administer it, so tough luck.

Lots of doctor's receptionists are also qualified as clinical support workers and have lots of training to do so. I think YABU although I wouldn't be especially happy about the Smokey smell either.

They prob booked you in with hcp because you only needed bloods and ears syringed, savings the nurses time

Substandard care! Well if you'd said that in the first place then yanbu

So op, how is it that you were able to tell with such certainty that the care you would have received would have been "substandard"?

Yes, it may have always been a practice nurse who did bloods and syringing, but here's a reality check for you. The NHS is cash strapped. GP's are now doing ever more complex tasks, such as rigid sigmoidoscopies (where you have a rigid baton shoved up your arse to check for abnormalities). Now, in my surgery it is the practice nurse who assists with this as a "just in case" precaution. Or vaccinations - you know, when they are actually putting something into you which can't really be taken out again.

So, are you saying that you'd rather have the most senior (don't confuse this with most qualified) person in the practice to sort your ears out when they could be undertaking more complex tasks? Really? What makes your ability to hear more important than checking someone for cancer, or ensuring that the right dose of a vaccination is given?

Entitled much?

You do sound unreasonable and a time waster OP.
I had my bloods done this morning , it took two tries in two different veins.
I have them done every 3 weeks by the district nurse or my Macmillan nurse and even they can't always get it right first time.
Depends on the veins.
Go private next time.

Does it not occur to you Deckofcards, that by 'nurse' the doctor was talking in shorthand for any health care worker at the surgery who is not a doctor, and when the receptionist saw the slip of paper and knew what the appointment was for, she booked you in with the person assigned to take blood and syringe ears, ie the person you saw?

It wouldn't surprise me if that was the case. All these different levels of qualified heath care professionals these days can be confusing to the uninitiated, and the term 'nurse' might have been used loosely.

The alternative is that the receptionist deliberately booked you in with someone totally unqualified to do the task in hand. Likely? I don't think so.

You refused to have your ears stringed and insisted on another appointment to see a nurse. That is wasting NHS time money effort and, quite frankly, sympathy

'Deep veins'?

I would be thankful if my GP surgery had the presence of mind to get their receptionists trained as phlebotomists. It would save me trekking to the nearest outpatients centre every time I need a routine blood test!

If, at the point of making your appointment, the receptionist had informed you that a healthcare assistant would be seeing to you, would you have kicked up a fuss? If so, why?

Because you have:
a) taken two slots today, that of the HCP and one for the nurse, and will take a further slot later in the week; and
b) taken a slot with the nurse who should be using their time carry out procedures that only she or he is qualified to do, which require a qualified nurse - not carrying out a relatively simple procedure like ear syringing.

This is exactly the problem. People don't consider that every appointment has a cost. It is a free service only at the end point. Then there is the time/availability factor. You then get people who can't see a doctor or nurse when they need to quickly and end up clogging A&E.

As for your time being wasted, why is that more precious than the HCP's or nurse's time or that of another patient.

I'd be concerned about the fetching of the receptionist who is a "trained phlebotomist." Yeah she might well be, but at that point she was being EMPLOYED as a receptionist.

I assume you need to keep up-to-date to be allowed to practice. How was OP to know whether the receptionist had a current certificate and is employed partly as a receptionist but also as a troubleshooter for difficult bleeders (so to speak) or whether she trained 5 years ago, has not practised for 3 years, is employed by the Doctors purely in a clerical role, but is a bit of a know-all and has made the young HCA think she's got all the answers, and has overstepped the mark by offering to help in this instance.

eg I have a DC with severe allergies, who carries epipens. I know better than most people how to use an epipen. However, in my place of work, I have not had the epipen training, and therefore I am not on the list of people to run to if you need to give an epipen. Obviously, needing an epipen is an emergency, so I would give one if I needed to, and risk getting the sack. But I am not allowed to do so, as I am not on the list, and if anyone said "Let's not run and get xx or yy to do it, Balloon can do it, she knows all about it because of her DC" that would be unprofessional.