to expect to see the doctor, not the nurse?

[User912]

For worsening pelvic pain over the past week and half?

I called & asked for an afternoon appointment with doctor. Pain is getting bad enough to make me shout out in pain. As always, asked what the problem was - I explained and was offered an appt. with the nurse. I said "I'd prefer to see the doctor please, I have had an issue with this in the past" - at which point she told me they had no afternoon appointments left - the odd thing is, you need to call at 11am onwards for an afternoon appt, (so I'm told by them) and it was before 11am. I have been lied to before by this surgery regarding available appointments.

AIBU? Without wanting to go into my full health history, which I can't do on the phone either, I have PCOS but yet have never had symptoms this bad before. I appreciate pelvic pain can be sexual health related, but it can also be anything from ectopic pregnancies to appendicitis which I would think a nurse isn't equipped to deal with? - I am however, fully prepared to be told I'm wrong.

FWIW, I very, very rarely bother my doctors as it's so ridiculously hard to get an appointment (as it is across the UK I think!) and don't want to put added strain on them for minor ailments when they are clearly struggling.

Thank you

Hi OP, see the nurse (nurse practitioner or nurse?) and if she can't help she'll call a doctor through.

I would have taken the nurse appointment if that was all they had. In our surgery the nurse will get you in with a doctor if she feels it is needed. If you are in that much pain you need to be seen.

This happened to me when i wanted a dr appt. I took the nurses appt and as soon as she saw me she asked me to wait while she got the dr. Bit of a backward way in but worked for me.

Thanks both. I did take the nurse appointment, as I had no other choice. But I was thinking of raising it when I go in.

Our practice nurse will call for a doctor if she thinks you need it.

I'd take whatever they offer.

Can’t you say “I’d like a doctors appointment” and when they ask why say “it’s for a private medical reason that I wish to discuss with my doctor”

I cannot believe the receptionist is triaging patients like this.

No point in 'raising it' really. They didn't have any Dr appointments they could offer you. They gave you a nurse appointment instead. A nurse will involve the doctor if what you present with is beyond their capabilities. So you've been offered an adequate same day appointment.

Yes you should raise it. Ask to speak to the practice manager. If they ask why, say it is to make a formal complaint and it’s between you and the practice manager. Fucking hell this kind of thing makes me really annoyed.

The problem is: they can’t give you what they don’t have. There are not enough doctors and thereby not enough doctors appointments.

It’s a nurse or nothing. Better to get your foot in the door and see a nurse who can then get one of her on-site GP colleagues to assist if needs be. It might mean a slight wait as they will be doing their own clinics but it’s better than waiting a month for a routine appointment. Also the nurse will be able to do you’re history, obs, urine dip etc all of which are helpful.

At our surgery there are no urgent GP appointments. It’s staffed by nurse practitioners only. There aren’t any GPs to do it so there’s no other way really. To be fair our practitioners prescribe, can admit people to hospital, order and interpret their own bloods and X-rays so you do end up with a pretty decent service.

Frustrating though it is at least you have an appointment with the nurse. Sometimes I think half the battle is getting into the system at all, once you are in then it is easier. If the nurse is concerned you will get to see a doctor.

I would go to your local sexual health services rather than a GP Surgery. If you were to see a nurse there then they are clinical specialists in this area and are often just as helpful as the Drs- this is speaking as a clinical nurse specialist in this very area. Practice nurses may not be able to deal with the issue due to having a large scope of practice but all I do everyday is deal with women with pelvic pain so would be capable of dealing with ectopic/appendicitis/PID/ anything else that could cause it. Also Drs often have not been working in the field as long as very experienced nurses and often it's the nurses that tell the younger Drs what to do.
I hope you get it sorted soon! X

I cannot believe the receptionist is triaging patients like this.

Were told in our surgery thats exactly the receptionist's job

I don't think there is anything to raise, the nurse can do all of the checks of other things causing it (UTI/STD for example) and also ask for a doctor to see you as well. I wish my surgery had a nurse clinic, sometimes I don't need a doctor, they can see people who do!

For those saying that's all they have - the reason I want to raise this is because I have reason to doubt it. I have called before for an issue, and rather than straight away telling me they had no appointments available, they asked what it was for. I told them and was very bluntly told to phone the next day. After the call I thought on this and decided to call back and ask about it. I had the same receptionist on the other end. I asked why I had been asked to call back tomorrow - that she didn't explain why, were there no available appointments today? I explained I was really suffering and needed it seeing to. Ta-da, I got an appointment with the GP on the spot...

I was a bit taken aback tbh but I guess should have complained there and then really.

Coming from a primary care environment, the reason the receptionists triage is to weed out people who don't need to see a GP or sign post people to more suitable appointments - nurses, physio etc. The amount of people who request GP appointments for minor ailments is staggering. (I'm not inferring you are a time waster or have a minor ailment - just explaining why receptionists triage). If no GP appointments are available they will book you in with another medical professional. Whilst I appreciate it is frustrating, a complaint will do nothing to improve the situation and will ultimately take up even more precious NHS time. Some practices do not have the time or resources for a GP or nurse to do the triaging.

User you might doubt it but it doesn’t make the receptionist a liar. Our afternoon appointments aren’t meant to be bookable until 12 noon but often they get used early and there’s nothing left.

When someone kicks off on the phone, more appointments don’t magically become available. All that happens is the receptionist books an extra appointment with one of the doctors. Most of the time they then get bollocked for doing so but when they get ranted and shouted and (and a lot of the time threatened) they don’t really have much option. I wouldn’t do their job for a million quid.

Don't know how to quote but:

"I would go to your local sexual health services rather than a GP Surgery. If you were to see a nurse there then they are clinical specialists in this area and are often just as helpful as the Drs- this is speaking as a clinical nurse specialist in this very area. Practice nurses may not be able to deal with the issue due to having a large scope of practice but all I do everyday is deal with women with pelvic pain so would be capable of dealing with ectopic/appendicitis/PID/ anything else that could cause it. Also Drs often have not been working in the field as long as very experienced nurses and often it's the nurses that tell the younger Drs what to do.
I hope you get it sorted soon! X"

Thank you for your input from experience. Would you be able to also see my history with PCOS and rule that out/book me in for a scan at the local hospital if that's what was needed? I have needed that before and only ever had GP's do it.

I am confused as to posters saying they would get a GP to see me if needed - I don't see how if the appointments are full? I'm not talking a case of needed to be rushed off to hospital - far from it. I also don't know if a nurse can look at my PCOS history and refer me for scans as has had happened at my previous doctors.

I am absolutely taking what you're all saying on board - hence me asking questions. The receptionist was blunt, never explained that a nurse would be able to get a GP to see me if needed, so I have no idea, really. It would have been useful if she had explained this to me.

Thanks everstrong. I've never kicked off, or been rude to receptionists - I wouldn't have the nerve and no desire to. I do get frustrated, you're right. I find the ones at my surgery to be so blunt and say the bare minimum (probably because it's so horrendously busy!) - but still, it leaves people not knowing how it works and wondering why appointments suddenly become available if you query it.

Nurses (and other professionals in the surgery) will have full access to your record. That way we can look at previous scans, referrals, blood results and what treatment plan has been tried previously.

From experience, if I have a patient I need extra help with and I need a GP then I ask one to assist. That GP will be doing their own (full) clinic, there aren’t any extra slots but they will come through as soon as they’ve finished with their current patient to come and assess my patient. It can mean both clinics then run late but at times it’s a necessary evil.

I’m lucky in a sense that I’ve dealt with acute appendicitis, ectopic pregnancies, heart attacks and a multitude of other emergencies on my own. It’s been 10 years of training to get to that level. I don’t need to call on GP back up particularly often but it’s useful sometimes just to have fresh eyes on a situation.

Take a urine sample along with you today if possible, if you’re particularly worried from a PCOS point of view (ruptured cyst etc) then you can always ask them to call the oncall gynae doctor to discuss with them, often they’ll whip you in for an ultrasound to assess.

And I totally get where you are coming from with receptionists being blunt. Ours literally have a script to read from as “training advice” but it sounds so bloody rude. I keep repeating that asking a patient “what their problem is” could be kindly rephrased as “can I ask what’s concerning you so I can direct you to the right person”.

It’s like a brick wall!

Can’t you say “I’d like a doctors appointment” and when they ask why say “it’s for a private medical reason that I wish to discuss with my doctor” - I cannot believe the receptionist is triaging patients like this.

Yes good idea. then no one will ever be able to see a dr because everyone will be seeing the dr for the slightest sniffle and cough. Of course the receptionists need an idea of what the problem is, otherwise how can they seperate the urgent cases from the snowflakes? Not saying that OP is a snowflake, but this attitude really burns me up.

Nurse practitioners are able to do a hell of a lot of the same things doctors can. They may even be older and have more experience than some of the GPs you see. The only times you shouldn't be seeing a nurse practitioner is if you are pregnant, or possibly if you are a young child. This is due to medications not being licensed for use on pregnant women and sometimes children, so it has to be a doctors decision.
If they say you can book appointments for the afternoon at 11 then wait til 11, don't try before. They have these rules so that people who couldn't contact the GP in the AM could still get a chance. If patients really kick up a fuss then sometime receptionists force book appointments. Which is great for you as a patient but then it inevitably makes the clinic run late. If you're really in desperate need and can't get an appointment then you should go to urgent care, though you may still be seen by a nurse practitioner.
Also they can quickly grab a doctor to come see you during a consultation if concerned but even this way doesn't take up as much of the doctors time as a proper consultation would as the nurse would have taken your history etc. It's to save time and pressure and the amount of people complaining about wait times.

Thank you everstrong. It's helped me understand it from the perspective of someone in the field.

It's incredibly frustrating the healthcare service has got to this point but, there we go! I'll not raise it and see how the appt goes. I appreciate they probably have so much pressure - & I understand the comments about all the 'snowflakes'. For me it's frustrating when you meet those snowflakes in the surgery who happily tell you they're there about a cold/tummybug/etc - things that can be remedied at home, and you struggle to get an appt for more serious problems.

the odd thing is, you need to call at 11am onwards for an afternoon appt, (so I'm told by them) and it was before 11am. I have been lied to before by this surgery regarding available appointments.

At my surgery the appointments don’t open up o the computer system until the stated time. So if you called back at 11am precisely I would guess she would have been able to offer you an afternoon appointment with a GP. That’s how ours work anyway.

The nurse will consult with a doctor and get you seen/referred as nec. Best wishes.

I'm not talking a case of needed to be rushed off to hospital

Tbh you don't know that though. If say you had developed PID from untreated chlymidia you might need hospital attention. My first stop would be the GUM clinic for a full screen just to rule out infection, then go from there. They can do more than you think.