Know your place Doc

by Nicola Hayward

Well, the end of yet another month has approached and am I any further forward with any of the paperwork I’m supposed to be dealing with…….err…..that’s a big fat NO!!  Just at the point when I want to actually be a little bit pro-active and maybe look at a template that needs tweaking, or read through some of the 83 page Guidance And Audit Requirement documents that come through from NHS England (and yes, they are 83 pages long….!!) something happens that takes me away from my desk, or it’s something that needs my ‘urgent’ attention, like changing a light bulb (!!)……………and so my list of Jobs To Do, becomes my list of ‘Jobs That I Really Ought To Do But at This Rate, They’ll Be Null And Void Because I’ve Missed The Deadlines’ list……………………….

This last week has seen me try to repair the ‘damage’ that one of my really kind doctors did to a bunch of clinical templates   – the thing about templates and why they’re so crucial to our work (and this is not to be a nerdy computer geek) is that they act as an aide memoire and you don’t need to remember what to ask, the computer screen tells you.  Additionally, I get consistency of data entry and thus my searches can be as accurate as the data collected (……actually, that DOES sound a bit nerdy computer geek now!!)

I digress,….. back to my errant GP…….To be fair, and in his defence,  he WAS only trying to help.    Mmm….well, the conversation (or rather his admission of guilt) went a bit like this………..

Doc:    We need to alter the templates for the DESs and LESs so we’re claiming everything we need to, but not doing stuff we don’t get paid for

Me:    Totally agree, but there are still some bits that we need to do, because actually that’s part of the patient care……..yes??…….

Doc:   Well, sure but I’m not having us wasting time doing things for the sake of it

Me:     Absolutely…………so when shall we meet to have a look through the guidance and sort out the read codes?* 

            (*Read codes are entered into the medical record to state what’s been done, given,

etc…….and the computer system searches these read codes, I fill out an excel

spreadsheet and claim the money……simples!)

Doc:    Actually, I’ve already had a look and changed some of them about.  Aren’t I clever??!!!!

Me:   Err…..yes,  if you’ve done it correctly, hahahahahaha (which was, I must admit, a slightly hysterical laugh as I worriedly went through all the possible problems)………….

Cue a moment of terror as I look through the relevant templates and find that not only has he ‘tweaked’ but he’s deleted, amended, removed, added and generally messed it all up!!

Now, it would have been simpler to sit through them together and have a mutually beneficial chat whereby he would say what was clinically needed and I would check the guidance/read codes etc., and make sure each essential item was included in the template …..……..but no………that’s far too easy……let’s do it the HARD WAY!!!

So, on one of the templates, instead of having all sorts of measurements and blood results,  foot pulse measurements, pinprick responses, diabetic medication regime etc (all crucial stuff in the care of a diabetic patient) – my diabetic template had four lines of text on it – all yes/no answers – no good to man nor beast.    I suppose the doc was only trying to be helpful, but I don’t go into his office and offer 5 days of Penicillin to a patient with a sore throat now do I?……..(obviously if the patient is allergic to penicillin, they’d have Erythromycin…but you knew that didn’t you??!!)

And so, dear reader, the moral of this tale is to ensure that your smarty pants doctors don’t try to overstep their remit and get delusions of grandeur……….I’m in charge……surely they know that??!!!!!