Picked up a leaflet in my GP surgery this morning, advertising their new Minor Illness Clinic. It's run by Flossie and Ada (names changed to protect the presumably innocent) who 'can help you with any of the following'.
I emphasise some of the more worrying items. Well, they would worry me were I suffering from them.
Sore throat
Earache
Colds and Flu
Sinusitis
Cough
Fever
Hay fever
Nosebleeds
Headache
Head injuries
Dizziness
Neck Pain
Back Pain
Sore eyes
Styes
Rashes
Acute itchy rashes
Eczema
Nappy Rash
Fungal Infections
Cold Sores
Genital Herpes
Shingles
Pityriasis Rosea
Warts and verrucas
Boils
Infected wounds
Ingrowing toenail
Head Lice
Moles
Insect bites and stings
Sunburn
Mouth problems
Dental infections
Abdominal pain
Indigestion
Diarrhea (sic) and vomiting
Constipation
Cystitis
Threadworms
Vaginal discharge
Menorrhagia (heavy periods)
Missed pills
Emergency oral contraception
Mastitis (in breast feeding women)
Depression
Insomnia
Anxiety / panic / phobias
Hyperventilation
Bloody hell. That is some impressive list! These girls are trained to treat all that?
Depression? Sod the psychiatric consultant. I'll go and see Flossie.
Abdominal pain? Could be a burst appendix, you say? Possible quick painful death from peritonitis? Nah. Ada will sort it out.
D&V? Cholera, perchance? Tsk. Stop making a fuss. Just go and see sweet F&A.
No need for the GPs at all, really, not even for head injuries! But, erm, what are the doctors actually doing if sweet F & A are handling all this stuff? Or am I not supposed to enquire?
What a pity that our fab new all-purpose clinic is only open for less than hour a day, though. Mid-morning. Convenient for someone, I expect, but not for me. For the nurses, maybe?
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11 comments:
I had a prescription today from a patient who had seen a Nurse Practitioner.
The patient was suffering from active genital herpes and has a fairly regular prescription for 200mg Aciclovir tablets. Today that prescription was for that well-known antiviral, er, clotrimazole. I did check with the patinet in case she had something fungally too. Nope, just the herpes...hmm
Spoke to the NP. Very arsey and said "no, no, of course I didn't mean cream I meant the pessaries".
At this point I gave up and sent her back to see a proper doctor.
I'm not sure how long the NP course is, but it isn' long enough.
I'm going to look really stupid if Clotimazole is the latest treatent for herpes and I missed the flyer :)
BTW, shouldn't anything dental be booted to a dentist and not a medic?
Interesting that they are dealing with moles, warts, and verrucas, along with rashes and acute itchy rashes. I presume they know which ones are skin cancers and which are keratoses, among other things. And that they are able to biopsy anything they aren't sure about.
I don't know why I wasted 10 years getting a medical degree and going through residency. Whatever was I thinking?
This is frightening. I'm a mother and I have to make decisions about whether to seek medical advice for my children from time to time.
Does this mean I ought to make an appointment to see a doctor every time one of my kids is a bit under the weather. I've always tried to avoid troubling the doctor unless I thought it was necessary.
I can see it would be best to get a GP's advice but what if he's not up to it. Can I rely on him to refer the problem to a consultant?
It's all so confusing.
No, no, Ethel. Of course you're better seeing a nurse. Clearly the worry that your GP might be unreliable far outweighs the risk of seeing someone who has not had 6yrs of med school and a minimum of 6 years on the job experience as a doctor (and more likely 20yrs plus)
For the love of little apples...
Madre de dios, this is scary! I'd be ok with a nurse looking at a nappy rash, yeah, but a head injury? No way. I want someone who went to medical school taking care of that, not someone who went to school to learn how to follow the orders of the person who went to medical school (and that's speaking as someone who WENT to nursing school herself).
It denigrates physicians in general, I think. If I were a physician I'd be pretty angry about it.
I work in a GP surgery and it's the GP's themselves appointing the NP's (we have 2) so they can't really be that worried or upset.
Headache? In my Emergency Department in Australia, all patients presenting with headache MUST be reviewed by a senior doctor (registrar or consultant) - even the junior medical officers aren't allowed to clear someone because it can be potentially LIFE THREATENING.. and you would trust a nurse with a little sheet with check boxes??
For those of you who would rather see a GP, a cautionary tale from my shift as a paramedic today...
I was asked to take a patient to the Assessment Unit at our local hospital. Their GP had been to visit this gent earlier today and had booked him in to the EAU. The GP had kindly left a note of their findings. I duly arrived with my colleague to find the patient literally gasping for breath. For the medically inclined his respiratory rate was 44, heart rate 150, oxygen saturation 79%, breath sounds reduced on both sides with creps, temperature of 35.6 deg. Bear with me, the numbers are important.
It was apparent to me (without the benefit of 10 years of medical training) that this was a 'big sick' patient likely suffering from sepsis as a result of pneumonia - a life threatening condition especially for the elderly (he was 78). He needed medical care far beyond that available in the community and he needed it now.
I didn't take the patient to the EAU. I disregarded the Doctor's instructions and took them to the Emergency Department. Into resus. (familiar to all those avid viewers of casualty). I handed over to the doctors in the ED and went on my way.
Why were the numbers important I hear you ask? Because they were exactly the same as the ones that the GP (with the 10 years of medical training) wrote on his note. Before he asked for an ambulance 'within 4 hours'. As luck would have it, we arrived a mere 90 minutes after his request. Otherwise I might have been following one of my other 'protocols' - recognising life extinct.
For those who think this is GP bashing, it isn't. I have met some really outstanding GPs. And a disturbing number up (or rather down) to the standard of today's example. Like all professions there are good, bad and indifferent docs. We're all skilled in different areas and the days of the doctors monopoly in all aspects of healthcare are fading. This is not necesarily a bad thing. I think the A&E consultant I handed my patient over to today would probably agree.
I agree with you, as it happens, AP. And - brown-nosing like mad - I rate paramedics over nurses - from experience. In trauma situations, I rate PMs MUCH higher than the average GP. Sit down and make yourself comfy and I will tell you a story.
Once upon a time, I had a major post-operative haemorrhage ('complications') late on a Sunday evening and called what was then the GP call service operated by four local practices as a team. I explained what was happening to the doctor (yes) who answered the phone who did not know me personally and asked him whether I needed to worry or would it stop. He was round in ten minutes. He got me prone and put up two drips - one in each arm, and got on the bedside phone to admit me directly to the operating theatre at Addenbookes. No 'casualty' nonsense. Operating theatre.
Interestingly, he said I was lucky to get him as he was the only GP in the town who knew how to insert a drip without which I would have died before I got to hospital.
In the ambulance (two and blue... would have been exciting if I had not been both terrified and euphoric from blood loss) the paramedics behaved like, dare I say, casualty doctors. I received drugs and a full clinical assessment. (I know enough about such things to recognise the level of expertise for what it was.)
Inside the hospital, they ran me on a gurney at full tilt through the corridors to the theatre prep room where three doctors took over while two nurses made a signal contribution by, er cutting my clothes off (around the drip lines) and, er, that was it.
Two days later I came round and the ward nurses were superb. At nursing which, these days, nurses have so little time for what with their heavily-loaded desks and all, so thank God for HCAs.
Two more things.
I come from a long line of 'old fashioned nurses' for whom I have nothing but the highest admiration. They knew more, and did more, than the average modern nurse.
Lastly, I have nothing but praise for the GPs in my local practice who have cared for me with expertise and great kindness over the years. (I don't get flu. I just have major surgery once in a while.) I always receive a proper hearing, good information and wise advice. One turned out in his own time to check me over after a tricky bout of (back) surgery. Another stayed to make me a hot drink late one night and sat with me while I drank it because I was in pain and fed up about delay to another back op because I had caught a bad cold. Heroes, the lot of 'em.
And those are the people I want to consult if I have a fever, a bad (I mean bad} headache or a head injury.
As for the practice nurses, they're jolly nice and I go to them for stuff like holiday jabs, BP check, etc. You know... nurse stuff.
Posting this a a standalone post, too.
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