AIBU to ask you not to take your frustrations out at the system failures of the NHS on the clinician?

[IncognitoPanda]

It’s been a long week. I loved my job but honestly it’s got so tiring being moaned at about things I cannot control. I want to help you with your problem, that’s why I am here. But the sad truth is that in an over stretched service under immense pressure the limited time I have to help you is not best used with you complaining.
I know how many months you have waited for this appointment, I have your referral letter. I know you’re unhappy about it. I am too, I would much rather have seen you when it first occurred rather than you suffering and worrying until now.
I know how long you’ve sat in the waiting area, I can see your check in time. If we don’t have enough staff we will be delayed in seeing you. I will always apologise if the delay is excessive but please don’t delay me even further by spending ten minutes complaining about it.
I know you’re scared, I really do and I completely empathise. But if I tell you it’s a three month wait for a given test, it’s not because I want you to wait 3 months, it’s because that’s how long the queue is. Getting angry at me doesn’t help, and doesn’t give me any ability to speed up that time frame. I could be evasive and not give any clue as to how long your wait is but that wouldn’t help and would just put more pressure on my administrative colleagues when you are chasing for an appointment that they cannot provide.
I know you may have seen the last patient leave my room ten minutes before I call you through, that’s because I have had to complete their paperwork and take time to read your referral and relevant history. I look rude if I have my back to you to read my screens, so it’s important I take a few minutes to understand why you are here before I invite you through. The systems are so disjointed I may have to view multiple software platforms (all of which are slow to open due to the poor it infrastructure). Even doing this I won’t know your full history so please understand if I ask questions that you may have had to answer before.
I know you may have seen me disappear from clinic for 10 minutes. I can assure you I won’t have been off to the coffee shop. Instead I am probably addressing a critical issue that would further delay the clinic if not remedied.
I know you would like to see the clinician each visit. I get it, as I like to see the progress of patients. However if we all had individual waiting lists, the system would become even more unfair as the wait times would vary between clinician. We do talk, we do leave good notes for each other and you will be looked after. Sadly I cannot promise I will see you myself next time.

It’s the desire to help people that keeps most of us in the profession, it’s certainly not the salary or working conditions. Please believe me that I am just as fed up of the system as you.
YABU - it’s a British right to moan
YANBU- I get it

This goes both ways op. I received a letter for a long awaited scan today. Unfortunately it's booked for the same time and date as another appointment in a completely different hospital. Slightly annoying but these things happen.
I work in a public facing role so im NEVER rude to staff that i encounter.

I called the number on the letter and polity explained that I wouldn't be able to make the appointment as I was double booked and would have to rearrange. I was abruptly cut short before I could finish my sentence asking for my chi number.

OK no problem, started reading the number and was aggressively told to slow down! At this point I fell silent for a few seconds Trying to understand what was happening. The woman on the phone obviously realised she was being a cunt for absolutely no reason and apologised, then asked me to read it slowly, which I did.

I understand that we all have bad days but I would never speak to someone with such venom, especially as I was nothing but polite. It's not my fault that 2 hospitals in the same city, can't share information with eachother.

I've had such a shit week with my health and I had a little cry after that call.
I hope your next shit is a hedgehog because you ruined my day today and It was completely uncalled for!

This is why I am on the verge of leaving the NHS. I passionately believe in health care free at the point of provision and having lived and worked in healthcare overseas, including the US, I am heartbroken about what is happening. I would have been earning a lot more over the last decade if I had gone to the private system, but wanted to work in the NHS because of my values and beliefs. But there is only so much you can take.

Thanks for what you do, OP.

I reckon 90% patients are lovely and 90% staff are lovely. We can solve this if the lovely clinicians look after the lovely patients.

Would @Haydenn be interested in heading up the Arsehole Patient subcommittee then we can allocate your folk to the Arsehole Professionals group?

It can be frustrating working in the nhs. I have reached a point where I try not to think about the state the system is in and the barriers we face in the day to day of work, it is too frustrating. I chase referrals, try to expedite them by making phone calls / sending e mails etc and where possible I go to depts to speak to someone face to face. I feel that it is harder for some clinicians to say no if you are in front of them rather than just a person on the end of the phone. I keep a smile on my face and try not to take it personally when patients are abrupt/ rude. I think knowing that you have done the best that you can is all you can really do. I work in secondary care.

@Haydenn

You have absolutely no idea what you're talking about. I'm the daughter of nurses. I've seen the injuries they came home from work with, and it was on a weekly basis. One of my father's nurses was murdered by a patient. These are just the actual, visible injuries, not the near misses or the verbal abuse. I'd like to see how the majority of the "real world' would deal with that constant threat and danger every day.

The vast, vast majority of NHS staff work so hard and are so kind.

What I've noticed is people not understanding that not all pains/problems can be diagnosed, or treated. It's just not possible. Where you have something very obviously serious clinicians will try as much as possible and then manage the symptoms, but sometimes, if you're 'walking wounded' as it were, you just have to wait something out or learn to live with it.

@ToffeePennie maybe they won't refer you because they know if won't help, you'll wait ages, and just clog the system. I had a chronic ear infection that lasted 6 months. I was referred to the ENT after my GP couldn't shift it, but though they tried they couldn't clear it. They just kept having me come back every 2/3 weeks to check it wasn't getting worse. Even if you get that referral, if they don't know, they don't know.

I've tried PALS - no help, not their problem, passed it on, no one replies.

Outpatients when I spend over an hour on hold to them are rude to me - no understanding of the frustration.

My consultant only works for the NHS 1 day a week, the rest is private. Easy name to google and find out where he is working. I have seen him once, no notes in my file due to disorganised systems - he was 90 mins late, then opened a file to a blank piece of paper. Every appointment I get told my scans are too old, so I get sent for more scans, appointment within 10 weeks so not bad, follow up appointment - 9 months after my scans - guess what I am expecting to be told in March!

@Haydenn To be honest I think most of them love playing the martyr but would struggle in the real world. They waft around, doing bugger all

What a totally bitchy and unnecessary post. You are a vile human being.

This NHS staff bashing thread (I know it wasn't meant to be) just makes it harder for us to go work, knowing what the public think and makes me wonder why I try so hard any more.

I've worked in the NHS for 20 years and have been a patient for some serious stuff during that time and very recently.

I've seen excellent, gold standard care some of the time and most of the time it's pretty good. I've rarely seen the terrible. Despite that always being talked about in the media, there is HELL of a lot of normal, good healthcare going on that no one is talking about because most of the public don't see it.

To say 'the NHS is shit' is just really ignorant to what is going on in healthcare settings up and down the country.

This year I have seen it from both sides! Qualified as a nurse 16 years ago and have been a nurse practitioner for the past 6 years.

The wait and multiple injuries my husband has sustained due to sudden onset of seizures to actually see a neurologist...and have investigations has been diabolical!
I actually took him to the doctors to ask....how damaged does he have to be before anyone takes this seriously!!
Apparently multiple shoulder dislocations....the last one needing x 2 surgeries on his shoulder due to fracture and dislocation (needing another consultants input, actually costing the NHS more money)

This is even going through consultant secretaries, PALS, GPs and another consultants.

The wait for a 10 minute appointment to put the shit you've had for 6-9 months into words.... epilepsy nurses won't ring you back for a week...

We are lovely to consultants/doctors and nurses, physios and health care assistants! But... I can understand the frustrations of people! It has had me poorly myself.... needing CBT and still having regular flashbacks.
It's a shit show to be honest...
And I'm so glad that I work for the service I work for providing a high standard of care to patients... it's unplanned/urgent care in the community. I don't think I could if I was providing a terrible service.... such as the ones we have received recently.

I have never held clinicians personally responsible for the state of the NHS.

The healthcare system in this country is dreadful and buckling under the pressure

I feel for you Op! If it's any concellation I had an amazing service recently in A&E and I think the reality of receiving help from lovely people like yourselves is so different to the perception certain types of people have. I know someone who moans about the NHS & the police constantly but would never do either job, please remember when people are rude to you they're already irrelevant as they don't have the experience, knowledge or insight to actually critique anything. Until they do your job they can keep quiet! Thank-you for everything you do

People always complain about ENT I notice. I think they don't understand how grossly and dangerously stretched ENT services are.

A friend who is a GP told me a few years ago that patients she was referring because she believed/suspected they have oral or facial cancers were waiting many weeks, much longer than 2ww pathway to be seen by ENT to be seen - this is on literally the most urgent pathway available to patients. This was a few years ago and is probably even worse now (albeit she probably works in a particularly underserved area). My friend really cares about her patients and she was very upset and genuinely didn't know what to do. She had resorted to telling patients to go private if they could afford it. ENT cancers are time critical because they're literally destroying your face and/or highly functional structures and they're often minimally or non specifically symptomatic until advanced with a high risk of mortality or disability / disfigurement. If ENT can't see people in a decent timeframe to prevent their face/tongue/throat etc from being gobbled up by cancer, because they don't have enough clinicians, then it's not as surprising that something like chronic/recurrent tonsillitis (even though it can be very disabling, distressing and indeed dangerous) has to wait much longer still.

I had to tell the parent of a child recently that the wait for their child to be seen by ENT was 56 weeks, for suspected obstructive sleep apnoea. In the meantime I am fully aware of the awful impacts the possible OSA is having on the child's sleep, behaviour, development, education, whole family etc. This was a referral accepted as "urgent". Clinicians can do literally nothing about this (other than share what few relatively ineffective tips there are for optimally navigating the system). It's not that the ENT service is badly run or they are useless. There are just literally not enough ENT surgeons to run an adequate service and the government in its oversight of bodies like HEE etc have done nothing to address this over decades other than a move toward using PAs which in my opinion is a slippery slope of de-qualification fraught with danger for patients and professionals.

The problems are twofold: recruitment and retention. Eg: more people would train in ENT if they could (it's a competitive specialty) and many of them would become consultants, only the training jobs required have not been funded. This is true across many specialties. Many more people would train in medicine in general (medicine remains a competitive course with many applicants turned away) only the government has not adequately expanded the number of university places available. So recruitment is artificially stifled by a lack of funding for training at all levels, and retention is scuppered by worsening conditions and pay for the staff that are in the systems, and issues with pension taxation that function as a perverse disincentive for the most experienced consultants to continue working.

The reality for patients is there is nothing they can do to complain effectively about eg the wait time to see ENT urgently. The outcome of their complaint will not be the recruitment of additional clinicians. The government has to address this but they don't care. The failure of serial governments to prepare the NHS (or indeed, any alternative to the NHS!) for rise in demand (twofold 1) aging population and 2) more advanced treatments available which are firstly directly more expensive but secondly keep people alive, which is obviously fantastic and literally the purpose of a healthcare system but is inevitably more expensive than letting them die) is truly shocking. An absolute national scandal and very, very concerning.

I have to say maybe I'm lucky, maybe it's an acute paediatric thing (babies and children do tend to look awful or be obviously sick and in need of help, the management is usually simple and then they get better very quickly - so I probably get more credit for that than is deserved, relative to eg a GP for whom the fruits of their labour are less obvious / direct) but I get along with patients/parents/relatives pretty well and overall find they are pleasant toward me and their concerns and complaints are generally fair enough. There are some exceptions but having a sick child (or indeed a well child) you are worried or distraught about is an extremely mitigating factor and I sort of consider it in my job description to deal with that at times. I'm also aware it's a lot worse for the nurses I work with who get waaay more abuse in general.

@MoserRothOrangeandAlmond I hear you, it can be exhausting constantly advocating for the patient. I used to say it was like a full time job taking my husband to appointments, rearranging them, missing them due to the letters not being sent, getting there and not having the notes, having prescriptions written wrong and so on. On several occasions, I caught a mistake such as the wrong dosage given of a neurological medicine which would have resulted in many more nasty seizures. I hope your husband is getting seen and treated now.

What gets me about the whole thing is it's so arbitrary which bits of the NHS work and which don't. I've recently been in a speciality which is very well organized and reasonably well resourced and it's been excellent. I've also been in PALS offices as things just don't get done or get done wrongly, due to chaos and overwork of everyone. It just seems so random whether you get good care and that's what makes it so stressful.

Well I have to say I not only don't recognise this picture but find it offensive and ignorant.

And no I don't work in the NHS.

I went to a&e last week. I had what was a type of seizure and lost consciousness. Dh called an ambulance but it was going to take too long so he took me himself as I could walk. The paramedic who trusted the call thought I’d may have had a stroke so made dh do the tests. I hadn’t.

We got to A&e about 9pm and I wasn’t seen by a doctor until gone 9am. It was horrific waiting on an uncomfortable plastic chair all night. When I eventually saw the very young doctor she was nice but totally focussed on the black out and not the unusual symptoms beforehand, I had to ask for a further test as wasn’t happy with just bloods/ecg. I knew it wasn’t my heart, it was obvious it was a neurological issue so after a 12 hour wait I wasn’t going to be fobbed off.

Im following it up with my GP after Googling the symptoms which are very specific to a type of epilepsy, but this wasn’t even mentioned in a&e - pretty lame tbh.

And will probably have to go private as well to avoid all you posted about above - a long wait to see a neurologist for an eeg.

Oh and I’m almost sure the GP will try to fob me off when I see her but I’ve screenshotted my symptoms from an epilepsy website to make it easier for me and her.
I

@Goatymum what I do is look at the NICE guidelines for that particular set of symptoms or disorder and go and wave those, you can't argue against those...I would also go private, find the neurologist you would be referred to and they will do one day a week most likely at the local private hospital, often they can then put you back through the NHS system for tests. Or wait, get referred by GP and then ring the consultant's secretary and say you'll do a cancellation on any day.

I am used to working the system, which is very unfair on those who can't but I won't accept poor treatment and suffering for my family, we've had enough of that as it is.

Probably sick of dealing with PITA patients like you.

Thank you OP for all you do.

If you have mono then neither antibiotics nor an ENT referral will help.
Kindness goes both ways.

@Blinkityblonk - thanks. I did look at NICE guidelines and it said 2 weeks for a neurologist appt after a first seizure. I thought - yeah, right!!
At least I can say ‘this is exactly what happened to me & then I blacked out’.

making yourself feel virtuous because that’s all you’ve got left after being under paid and treated like shit by your employer.

Not everyone feels ‘treated like shit’ by the nhs as an employer, what an odd thing to say.

@ToffeePennie health care assistants don't prescribe anything........

I am aware, they do, however, leave the room, come back with a signed script and tell you to go get it filled at the nearest pharmacy.