To expect the nurse to do blood tests during my appointment?

[hopefulmumofone]

My GP practice has recently amalgamated with several others in the area to create one huge super-surgery. All three practices are still at original sites with satellite surgeries all over the city.

I managed to make an appointment this morning with a Nurse Practioner for a consultation during which she said I needed blood tests and to make an appointment for these at reception. The only appointment in the next few days is later today at another site so I have taken it.

Would it really have been unreasonable for me to expect the NP to do the blood tests there and then? Is this the norm these days? Incidentally there wasn't anyone waiting after me - was totally deserted.

I am unable to drive today but have arranged a lift, if I hadn't had someone to take me these two separate appointments would have required 8 separate buses costing £13.40 and nearly 2 1/2 hours travelling!

I have the same problem, and I dont think its unreasonable.

A lot of nurses, especially practice nurses haven't done the relevant phlebotomy training, it's very common.

Urk, pressed enter!
...I dont think its unreasonable. Having to make 2 trips is daft for something so simple.

Perhaps they have a phlebotomist who does the blood tests? I know my surgery does, the practise nurse does not do them.

where I live, they send you to the bloody hospital, pardon pun, which is a 1 hour round trip.

In a gp surgery it is usually the treatment room nurse that would do the bloods. Everyone will have their set roles and jobs to do I imagine. I think if every patient thought like you then it would end up delaying her. Also just because there was no one that you could see in the waiting room doesn't mean she had nothing to do after you left. She probably had a list of patients to triage and call back on the computer too. My mum and friend are both nurse practitioners. They don't do bloods, ecgs, dressings etc that's all done in the treatment room to free them and the gps up to see and triage patients. It's a pain having to go to seperate sites though.

Nurse here weighing in... Just because you didn't see anyone doesn't mean that the nurse didn't have things to do after your appointment. She could have home visits, telephone consults, reports to write, blood results to review... The list goes on. Face to face consultations aren't the only thing we do as clinicians. We're heavily audited on our timings... She might not have had the right bottles, equipment etc in her room to do them either.

Additionally, she might not have even completed the training to take bloods within your trust. Some labs will simply not accept bloods from someone who hasn't done the official training and got their little certificate. Believe it or not, many nurses just aren't trained to take bloods, it's not a skill everyone has as a nurse.

I do appreciate its a total PITA though... Quite often they'll give you the form for you to take to the phlebotomy department at your local hospital if you don't have the time to go back for another appointment... It's an option at least

Aha, Cross post with many others

You said it far better than me, Orangesox

It's very frustrating as a patient

But for the practice it is more cost effective to have the most highly trained members of staff doing more specialised tasks, and employ someone on a cheaper salary to do more routine tasks

Although you might not have seen anyone waiting she may have had phone calls, results to check, meetings, home visits, or her next patient may have been late. Also she probably still needed to type up her consultation notes after you left the room

There may not have been a driver scheduled to collect samples and take them to the hospital from her site that day, so it may have been impossible for her to take your blood

Taking blood takes longer if you aren't set up to do it regularly - you haven't got all the equipment set out, you aren't that good at doing it, you have to carry the samples to reception to put them in the collection box, whereas the phlebotomist will have everything ready, be a whizz at it, and pop the samples all in the bag next to them throughout their clinic.

I agree it's annoying for patients though. And whilst it saves money for the GP practice, it can cost patients more through time and travel fares. But GP practices are really really short of money and skilled staff eg GPs now.

The practice nurse does consultations, the phlebotomist takes blood, this is how it is where I am. However, they should keep back some phlebotomy slots on each site for patients seen that day who need bloods imo, it only takes two minutes.

What would they have done if you couldn't get to the other site?

It sounds very inefficient. If the practice nurse is unable to take blood, then you should be able to see a phlebotomist shortly after the appointment at the same site. Making you go to a different site at a later date and potentially have to take more time off work than necessary is not impressive.

It's about time as much as anything. Drawing blood can take only a couple of minutes if it's a calm patient with good veins but it can be ten or fifteen if the patient is nervous, a vein can't be found etc. Then you have the paperwork to fill in on the computer and print out and put in the bag with the labels you've also filled in and printed out... so it could potentially more than halve the number of people the nurse can see.

I'm not a nurse, but I've had infinite numbers of blood tests. I actually asked a hospital phlebotomist the same question a few years ago when the NHS wasn't in as much trouble as it is now!

Ha welcome to the new nhs where everything is fragmented and tendered out. Yes those of us at the coalface know this is neither the most effective or efficient way of doing things but try telling that to our dear leader.

So I take it it's not that unusual then! If I hadn't been able to get to the other site they offered me an appointment with the same nurse I saw today for next week so it isn't that she can't do them.

The practice has to pay the phlebotomist, so they're not going to pay for someone to sit in a room onsite all day just on the offchance someone needs tests. It's inefficient no doubt, but it would take a huge change in funding and recruitment for something like that to be implemented. It would only save time and money in the long run and the NHS can't 'spend money to save money' nowadays.

Not at all unusual. In fact, when I had my pre-op appointment at the hospital last year I had to go and wait for 2 hours in the blood clinic two minutes walk from the pre-op one. It would have been far easier for one of the nurses I saw during the appt to do it from my point of view, but they had other calls on their time.

This annoys me too. My GP actually normally just takes bloods himself, to save you coming back. But everyone else in the practice sends you to the phlebotomist.

The only thing I can suggest for the future is when you book an appointment with a nurse ask if it's possible to see a nurse trained to take blood. I know it's a pain though having separate appointments, I'm difficult to bleed so have to go the hospital for any blood tests.

I expect my GP to do it, and they always do. With the GP you can be confident of their training and skills.

It sounds very inefficient. If the practice nurse is unable to take blood, then you should be able to see a phlebotomist shortly after the appointment at the same site.

Inefficient for the patients, but it is efficient for the practice.
Employing a phlebotomist at each site with enough appointments free to mop up any on the day blood tests would cost more, and there would be empty appointments if the Nurse Practitioner didn't request many blood tests one day, so paying for a phlebotomist to do nothing.

Having the nurse practitioner or GPs doing the blood tests themselves would reduce the number of appointments they can offer for seeing unwell patients and other more specialised activities.

GP practices are needing to save money, so sadly will have to prioritise their own efficiency over efficiency for the patient.

One financial advantage of merging is that GP practices can centralise/ rotate some services, meaning that patients won't be able to access everything at their local GP every day. But GPs are really struggling to stay afloat at present.

Little things like this are so frustrating. My relative has terminal cancer. She has her blood pressure monitored weekly and bloods taken fortnightly to monitor her treatment. Every other week we go into the main bit and wait to see the practise nurse, who takes her BP, then we wheel back out to the lift, upstairs and wait to see the treatment room nurse to have bloods taken. More often than not we have to wait ages for the bloods because no matter how we space the appointments she always misses her slot.

The practise nurse is currently on ML so one of the treatment room nurses is covering things. They still can't/won't do the two things in one appointment even though it would save someone with terminal cancer sitting in two waiting rooms full of sick people.

our surgery has recently got rid of their phlebotomist and we now have to travel to a clinic at the local hospital for a blood test (as have all the local surgeries in our town). No appointments needed, you take a number then wait your turn. Takes about 1.5 hours to get seen on a good day so a 30 second blood test now requires me to take a morning off work! Plus I have to pay the minimum charge in the hospital car park of £3 whereas parking at the surgery is free!

This is the first time my job has made me feel like an inconvenience

We can't get blood tests done at our local GPs any more. Have to travel the best part of 10 miles to our local general hospital and queue up at the walk-in blood-taking centre, no appointments possible.