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

I had a similar thing with my son when he was a toddler. I was told that there were no GP appointments but he could see the nurse. The nurse took one look at him and brought the doctor in.

I just assumed that if it was beyond the nurse's remit she would find a doctor or send us to the hospital.

When I phone the surgery I always ask for an emergency appointment if necessary otherwise I take what comes and am prepared to wait for a particular doctor if I have to.

Receptionists have had to start asking about ailments because so few people are able to grasp that though a GP will be the most highly qualified professional in a practice, they may well not be the most appropriately qualified for a particular issue.

There's a doctor shortage up and down the country. It's a symptom of the fact that our government treats our health care professionals so poorly. Nurses are often now trained up to fill gaps and practice nurses are usually fantastic when given a chance.

As someone also in the field I personally wouldn't see a nurse practitioner for any new problem. I don't deny they tend to know small areas well but I have seen too many times they miss things or go down the wrong path because they just don't have the same breadth of experience.

I find the nurses very good on the whole. They are often experienced and are able to give good advice.

The appointment thing is because there are not enough appointments, they try to save them for urgent/serious problems. If the receptionist feels your problem is bad enough to warrant a doctor they will book you in. But a lot of the time people think they need a doctor but actually a nurse is able to deal with their problem. So by using a nurse they can reserve the doctors appointments for people who need them. It's not some kind of conspiracy to avoid doing any work. If a nurse calls a doctor through there and then, it probably means everyone else on the doctor's list will have to wait a bit longer, but because the nurse has done most of the triaging already, it will be much quicker for the doctor than if they had to start from scratch.

I also find the nurse very good, as are the pharmacist.

Three times now the pharmacist has recommended the doctors and I've taken the kids in when the nurse was free. Each time she was able to subscribe the medicine they needed. One time she couldn't sign the prescription so took it through to a doctor to sign.

I don't see your problem.

My GP Surgery states that emergency appointments will be with the nurse practitioner, not one of the GPs. Some times you do get a GP. I've had appointments with the nurse practitioner has then gone to consult with the GP. Once the GP confirmed what the nurse suspected needed to be done next and once the GP came in. The times a consult was needed was when further treatment/assessment at hospital was needed.

If I was told there are no GP appointments but I could see the nurse then I’d be ok with that. And I wouldn’t mind discussing a problem on the phone with a nurse either. Or a pharmacist. Or someone with medical training.

I would strongly object to discussing my medical history and current symptoms with someone at a reception desk.

Luckily for me, at our practice you can always get an appointment with the GP either same day or next day. The two times I really needed to see a doctor the same day I asked to have an emergency appointment - they have an emergency clinic every day for the final hour. No problem.

While I understand the need to allocate slots in terms of need, the receptionists tend not to have the proper tools or training to make those judgements. If you call 111 they have a flow chart of questions they go through to determine severity so why can they not use this system for GP surgeries?

When I was young, the family next door had a policy of children eating everything on their plate. If they didn't it would be reheated the next day and the next until it was gone. As a result the kids were always getting D&V and heading off to the doctors. On one of these occasions the receptionist saw who was calling and noted the abdominal pain and claimed there was no appointment for a week (when they hoped the gastro would be over on its own). The girl passed out a few days later when her appendix ruptured and she was in intensive care for 3 weeks.

actually twice the GP came in. One of those we got sent off in an ambulance but I'd blanked that out!

I prefer to see the nurse practitioners as I find them very knowledgable and able to give you time to discuss it.

I have been with my health centre for 12 years and only once seen an actual GP.

If it means getting an appointment that day then I will take whoever is on offer.

I'm a pharmacist and I'm university based now but have previously worked in a large busy GP surgery. My role was a combination of conducting medication reviews for those with complex and long term conditions but also, as a pharmacist prescriber, in seeing a range of 'urgrn care' patients - a role a shared with 3 nurse practitioners and an ACP (advanced clinical practitioner) who was a former paramedic. In my exerinace of that role, there is normally a duty GP available to see any patient being seen by the nurses, nurse practitioners, the non GP doctors who may be working in the practice (such as Junior doctors on a rotation) etc who feel GP input is necessary. Taking an appointment with a clinician who is not a GP doesn't mean you won't see a GP if it's actually needed when you arrive. The reality is there only so many appointments available. Take the nurses appointment.

How does the nurse involve a GP if needed? If it is actually needed, then they'll interrupt the GP between patients, and then both of their lists will run late/more late. But because for many things they don't need the GP, it still adds up to more patients seen and sorted in the same time.

Most GPs would prefer to have enough GPs to do everything. But there is a national shortage of doctors in general, and GP is one of the particular shortage areas. And it's going to get worse because quite a lot are getting close to retirement. And when they go the rest will probably burn out.

Years of underfunding are really catching up now. The NHS has visibly deteriorated over the last few years.

I probably see a nurse in an extended role more often than I see a GP. Most of the time it is fine. On the occasion it isn't they ask for help. If it's a good practice, they will have been actively involved in training the nurse, ensuring they know their limitations, and setting up how they get help. If it isn't a good practice, then you probably don't want to see the doctors either...

I'm often quite happy to see a NP e.g. for a Tetanus jab. Unfortunately, our automated appointment system only allows you to book an appointment with a GP!

Let us know how the apt went, OP, I hope they can offer you something helpful.

nocoolnamesleft - at the surgery I worked there was a duty GP each day who's role was to support the non GP clinicians and that GP wasn't running their own list that day. The GPs woukd act as duty GP on a rota basis. Admittedly this was a big practice with a large staff, so probably not all practices can do this.

My surgery's system is to book in advance for non urgent. But all other on the day appointments you have to phone at 8am to get a morning appointment and 1.30 to get an afternoon appointment. The reception will ask what you want to speak to the doctor about and tell you that the doctor will call you baby within 2 hours. Then the GP will triage and either prescribe over the phone. But usually they give you an appointment for the same day. This appears to weed out those who can self treat at receptionist stage and sort out those who actually need an appointment. I have previously felt I needed a little advice and a prescription but didn't need to be seen and said this to the GP.
I think it's a good system. Perhaps ask when you are next at surgery for all the usual options or if they have a website it may be listed there.

I'm a sexual health clinic HCP and unless we have a consultant in to diagnose ,you would probably still be sent to your GP to deal with these sort of issues.

I can easily distinguish between PID/Ectopic etc but I don't have the resources here to do deal with them - nor do our consultants that's why you we advise you visit your GP for specific issues like ectopic so they can refer you to where you need to go rather than be told to go to A&E.
Some sexual health clinics may be able to help more than we can .

No issue with seeing a nurse, they will be able to get you a GP if needed. All HCP have different skill sets, your nurse may have more knowledge about certain things and vice versa. I know that our nurses are constantly picking up where GP's have made mistakes, quite often taking patients off of pills that could kill them.

Receptionists should not be triaging patients. There are many conditions which appear simple on the surface but can in fact be life-threatening.

111 are little better at this - I rang about my OH's sudden atrial fibrillation and got a load of nonsense about "arterial fibrillation" (!!) - what a load of bollocks!

Speaking as someone in the field (I work in A&E) I have colleagues who are GP's and colleagues who are practice nurses or nurse practitioners and I would a nurse practitioner every time. They have had years of training and often have far better hands on experience than a GP. If they think you need it they'll organise travel for you to come see us at A&E. Either way, keep your appointment and get seen by a medical professional. All the best x

For what it's worth 111 are not medically trained and they read off a check list. They'll get an ambulance to you if the list tells them to. They cannot give you personal advice as they must stick to the script and could lose their job if the divert.

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.

Neither is your GP. These are surgical issues. A GP will refer you to ED, where you will be seen by a nurse who will organise your referral to surgery. A Practice nurse will refer you to ED where you will be seen by a nurse who will organise your referral to surgery.

While a doctor might be having the referral conversation, it will be a nurse conducting the triage, supplying the information and pushing them to do so.

But you know. If you want to complain about a same day appointment with a medical professional, then that is your choice.

@Asdf12345 I've found with primary care it is really down to luck who actually diagnoses you with a condition. HCPs in primary care are generalists so it is impossible for them to know everything.

I've been diagnosed by a medical student and a nurse practitioner, when the GPs I had seen before including an experienced GP partner with the same signs and symptoms have dismissed me.

Thanks all. Appt took a fair bit longer than expected. Checked the minor things, asked the usual questions. It genuinely puzzled her. After 2 phone calls to other nurses whilst I was in the room, and talking to a GP, I was referred to Gyno for a scan for my PCOS as it was decided this was the most likely cause and was more urgent. I will (and did) have other tests too just to rule things out in the mean time, but yes it was agreed I needed a referral.

However, she did tell me before this that it was probably 'just a cyst' given my history, and I had to point out that cysts don't always rectify themselves and that of over ten years from suffering PCOS I've not had symptoms quite like this, and have very rarely bothered the doctors for the pain as it's always been quite similar and manageable as I know what to expect - even when it's severe and physically brought me to my knees.The fact that it was different, and was getting worse day by day ,and more constant was causing me concern hence why I was there. That seemed to do the trick.

As for the poster saying I'm moaning about getting an appointment on the day, do actually fuck right off. This isn't a tummy upset - it's a lifelong, painful and debilitating condition which I have largely suffered through myself so as not to bother our NHS. There's no magic over the counter pill that will cure it like a minor ailment. No prescription a nurse can give like they can for kids minor ailments as has been mentioned either. I'll not be sorry for being concerned about my health, and asking questions about the process that the receptionist was too busy to answer to ensure I feel I'm getting the adequate care I need. I had some very useful answers from both sides of the coin.

I do appreciate the NHS is so over stretched, as I keep pointing out - we are all very much in the same boat, and it's a sad state of affairs. Personal experiences on this thread though, have shown it's useful to get some input on when you need to be stronger about things, and when you don't. FWIW I had a b12 & folate deficiency go undiagnosed for a ridiculous amount of time because I couldn't get to physically see a doctor! As soon as I did, I had my blood test and was diagnosed - she knew on the spot even before the test from my physical symptoms alone. It also took me 8 years of strife to even get diagnosed for PCOS . So whilst I love our NHS, I recognise it's over stretched and sometimes we need to push for what's needed - and sometimes we don't.

Thanks to those who have kindly understood & provided reassurance, and different perspectives. I am in pain, but otherwise feeling a lot better just that's it getting dealt with..

As for the poster saying I'm moaning about getting an appointment on the day, do actually fuck right off.
Was that was aimed at me? You saw the nurse and were referred appropriately. That is great. Hopefully the gynae specialists will be able to help and I do hope you are feeling more comfortable soon.

For what it's worth, I assess and refer patients direct to gynae emergency admissions and talk specialist registrars and surgeons into seeing them on an almost daily basis. I am not a doctor (wouldn't want to be).

That isn't my role, it's just a tiny part of it. I sometimes wish I could take people to work with me. The misinterpretation of my role and discredit that the general public give my knowledge, training, experience is a perpetual frustration. Also you know, the getting told to fuck off on a regular basis.

Anyway, that is my problem. I'm glad you got your appointment and are being referred on.