Category Archives: Urgent Care

Without Meaning

I’m having trouble saying who I am at present.

It was easy when I worked on the ambulances – I was ‘ambulance worker’, the job defined me completely. The shift work made me sleep at weird hours and be grumpy when I was awake. I walked around other people’s homes as if they belonged to me and I raced along the road on blue lights. I was part of a clique of people who had seen things and done things that most people never even think about, the camaraderie and the in jokes, the swearing, the ‘us vs. them’ attitude. My job defined who I was.

Then I left the ambulance service (just in time, as my crumbling back gave me numb legs and I couldn’t see myself carrying 20st patients any more) and I became a nurse practitioner. There is something about being a nurse practitioner that just doesn’t give me meaning like when I was working on an ambulance. Is it because it is less stressful? Is it because the camaraderie is not as strong? Is it because, instead of saving lives and delivering babies, I’m now telling people how to deal with sore throats and runny noses?

I’m no longer described and defined by my job. ‘Ambulance worker’ was my super hero identity, ‘Nurse practitioner’ is just a job. When I’m not at work I’m not ‘off duty’ any more – I’m just not at work. Working on the ambulances defined me but being a nurse doesn’t seem to fulfil that same role.

I’m not sure that this is a bad thing, but I think it is something that has been worrying away at the back of my mind for a while. I’m wondering if it’s come to the front of my mind because my old blog Random Acts Of Reality has finally been deleted from the internet (due to Blogware shutting down). I have the whole site in a vaguely unusable export format – but something that was such a large part of my life has now gone, and I’ve nothing new to replace it with.

Maybe I need to find something…

Raised Expectations

There is a simple rule on the internet – and that is you do not feed the Trolls. Trolls being the people who write something in order to start an argument. You know, the sort of people who say that Hitler was an alright sort of bloke in a holocaust support forum.

But… but… The article in the Daily Mail yesterday by ‘Liz Jones – professional troll’ was beyond the pale. It was truly epic in the way it combined unreasonably high expectations, a complete misunderstanding of the NHS, a lack of medical knowledge and inflated sense of self worth.

I’m not going to link to the original story because I don’t want to send visitors to the rag that is the Daily Mail.

Here is the thing – I often deal with unreasonable expectations from the patients that I see, often these expectations are because the patient doesn’t understand what an urgent care centre can provide – and yet with all the people I see who have these expectations, none have pissed me off as much as this article from a fashion writer. Largely because once I explain that the Urgent Care Centre can’t order them an MRI scan they seem to understand a lot better than this supposedly highly educated columnist.

I don’t scrape and scrabble at the coal face of the NHS very often. I was born, I suppose.

Congratulations on not having a long term medical condition.

I have a private GP, gynaecol­ogist, two therapists and a dentist, who charges £900 for a root-canal filling. I don’t drink, smoke or overeat. I don’t have children. I exercise every single day. I’ve been a vegetarian since the age of 11.

And the reason for all this private stuff is…? So you don’t have to mix with the proles? So the GP surgery has nice pictures on the walls? No – I’m sure that the reason you are private is so that you do not place a strain on the NHS. And two therapists?

Let us just say that, so far, I have not been a burden. But, on Friday morning, I found I needed the NHS for the first time in about 20 years, and it let me down. Very badly.

You needed the NHS? I hope you are alright – did you fall off your bike breaking your arm? Heart attack? Stroke?

I am catching a flight to the Horn of Africa tomorrow, to cover the famine in Somalia. In order to obtain a visa, I am required to be inoculated against hepatitis A and B, yellow fever, typhoid, diphtheria, tetanus, polio and so on. On Thursday, I called my GP, a private GP, in London’s Sloane Street.

Oh. Immunisations on a short notice.

‘Yes, Miss Jones, come in any time.’ And so I did. But my doctor could only give me the ‘live’ vaccine, yellow fever; the other jabs would have to be done the following day. The next morning, back home in Somerset, I called my local GP or ‘health centre’.

So the GP you pay lots of money for could only give you one set of injections – I assume that they explained why. And why is ‘health centre’ in quotes? Is it because you work for a ‘paper’.

‘Hello!’ I said cheerily. ‘I am not registered with you, but I live two miles away. I wonder if you could possibly squeeze me in today to complete my jabs for travelling to Africa, and fill in my malaria prescription, as I need to start taking the tablets on Sunday.’

‘Hello, you don’t know me from Adam – normally one pays for these things, so I was wondering if you could see me without doing any of those oh-so tiresome health checks that you have to do when you register with a GP, and then ignore any appointment system you have so I can jump the queue of people with chronic conditions that can’t pay for a private GP. Because – you know – it’s important to me, and so should be important for you’.

‘You are not registered?!’ the woman said, clearly appalled I had made her pick up the phone. ‘We can’t see you then. And we can’t fill out a prescription that hasn’t been written up by us.’

‘But I will pay for the jabs, it only takes a couple of minutes.’

Appalling – Tell you what – why don’t I phone you up and ask you to discuss this story more fully – I don’t need an appointment do I? I’m sure you can put off someone else in order to talk to me. I’ll give you a fiver.

‘But the nurse is fully booked. She can’t do it. I don’t even know if we have the drugs.’

‘Can you find out?’

‘Well, no. I’d have to ask her. And she can’t fit you in.’

Oh goodness – loads of people who can’t afford to go private need medical care – how dare they, can’t they all just die.

‘But this is an emergency. I have never bothered you before in the three years I have lived here. Not with a snotty-nosed kid, not with depression, nothing. Never!’

Yes. an ’emergency’. It’s an emergency because you need some vaccinations that you doubtless had plenty of time to get.

Here is a hint.

A heart attack is an emergency. A stroke is an emergency. Being stabbed is an emergency. Needing vaccinations is not a bloody emergency.

I also find your linking together of ‘snotty nosed kid’ and ‘depression’ a red flag that you know very little about health at all.

‘But we don’t have your notes.’

‘You don’t need my notes. Lots of people go to walk-in centres. You could telephone my doctor if you’re worried about anything.’

I work in a walk in centre – we don’t give vaccinations because (a) we are not funded to do so, so we don’t have the drugs and, (b) we don’t have your medical notes which are, despite what you think, rather important.

‘I don’t have time to do that. Why don’t you go to A&E if it’s an emergency?’

‘I’m sure they wouldn’t classify a routine jab as an emergency. I mean, it’s a global crisis. Millions of people are dying and you won’t put yourself out to allow me to be seen by a nurse, not even a doctor, for five minutes?’


Hold up – I thought you said it was an emergency? And yes, the famine is a global crisis, which is why you need to fly out and cover it with opinion pieces like this? Something starting out with not getting a business class seat on the way out there I suppose.

Here is a hint – you are a journalist, not an aid worker, not with Médecins Sans Frontières. You aren’t going to be saving lives by getting out there immediately. This. Is. Not. An. Emergency.

Last week, the boss of the care company Castlebeck, whose Winterbourne View care home in Bristol was exposed by Panorama for practising routine abuse, used the defence that the home was understaffed, and that the employees needed more training.

Of course that is part of the problem, but it doesn’t explain all of it. I don’t need to be trained to know that it is wrong to slap someone, or ridicule them, or pin them down, or deny them privacy and respect. That is called being a human being. You should not need to be trained to do that.

I always wonder why people who don’t like people go into the caring professions. The problems in the health service and in privately-run homes are not always to do with money. Attitude is often the issue.

So now you confuse criminal abuse with you not being able to jump a queue with a surgery you have not seen fit to register with for a complete non-emergency.

That’s like saying every journalist is guilty of phone-hacking. So – Grrrr. Liz Jones – I hate you because you hacked the phone of Milly Dowler’s relatives.

Andrew Lansley, the Health Secretary, said last week that NHS managers were abusing the system, forcing patients to wait so they either die or go private. The report, by the Co-operation and Competition Panel, said that one trust was insisting patients wait at least 15 weeks for treatment.

Such a time frame is within the 18-week target, but many hospitals can deal with patients more quickly than that. Everyone has become very ‘jobsworth’, doing only the minimum that is required.

I’d say that there is no actual proof of this as yet – and yet you ignore the way that the Co-operation and Competition Panel are rather close to lobby groups for privatised healthcare.

But when you challenge them on their attitude, as I did when I called the ‘health centre’ and spoke to the receptionist, or manager, or whatever she calls herself, they are shocked at your temerity.

Again the ‘journalist’ puts Health Centre in quotes.

How would you like it if you were queuing and someone jumped in front of the line? There you go – that’s why you have receptionists – to stop bossy, over-entitled ‘journalists’ thinking that they are so much more important than anyone else.

They are too used to being bossy. They call the shots, not you, the patient – or at least potential patient. What would it have cost this woman on Friday morning to have said: ‘Sod the protocol – everyone needs to know about this famine, Miss Jones, so I am going to speak to the GP and see what we can do.’

What would it have cost to send a ‘journalist’ to the famine? It would have cost the appointment slot of someone coming in to have their asthma monitored, a chronic leg ulcer dressing being changed, a diabetes check or a renewal of a contraceptive implant.

And the world knows about the famine, because people like the BBC have journalists there. Not ‘journalists’ like you.

Have a serious think and ask yourself – what are you going to add to the reporting? All you are going to add to is the burden of people having to support you while you are out there – unless you are going to carry all the food and water you expect to eat while you are there in your Gucci hand luggage.

But no. People no longer talk in such a way. They follow the rules. They never put themselves out. They never look at the bigger picture.

Madame – you are a douche of the highest order.

And a Troll.

(Article reproduced fully for criticism)


It has been quite a while since I last wrote, and while I would like to say that the reason behind this is because I have been busy, that would be a lie. Unless you count playing ‘Rift’ and lounging around on the sofa watching TV while eating chocolate ‘busy’.

As Sirens is due to air from next week (Sirens being the new name for ‘Naked Apes’, a name change that I believe came from Channel 4) I’ve been doing a fair bit of publicity for it, mostly in print, and one of the questions that I am normally asked is ‘Why did you start a blog?’

The answer is largely in two parts – the first and most superficial part is that I was reading blogs and thought that people were having a whale of a time as a result of them being bloggers and that I wanted to have that sort of lifestyle. The second reason was due to passion.

When I was working on the ambulance service I was passionate about a lot of things. About the way the service was being run, about the patients who would use and misuse the service and about the supporting services and the rest of the NHS. I would be angry about the care that the elderly were getting in nursing homes. I would be frustrated at the lack of working kit on the ambulance. I would struggle to understand how someone with a verruca could consider that an ambulance was an appropriate response. I was joyful about the fun jobs that I would go to.

While a lot of that passion was negative (especially towards the end of my time in the ambulance service), it still provided me with the energy to come home after a twelve hour shift and write about something.

Since changing my job I am a lot more content in life. I don’t have to fret about shift work, I have less pressures from above to do the impossible, I get regular hot meals.  Most importantly I am treated as an adult who doesn’t have to ask for permission to go to the toilet.

What this means is that I am a lot less passionate about my job, and this is a good thing – certainly it is good for my health, but it’s not particularly brilliant for shifting my backside from the sofa to start pounding on the keyboard.

The other reason is that essentially I am starting from the bottom again. I like to think that my insights into ambulance work were reasonable because I was quite good at it and had been doing it for a while before I started writing about it. I am yet to feel ‘expert’ about nurse practitioning, although I am starting to see the patterns of patients that we get.

As confidentiality is a big issue, I can only write about these patterns and generalities so as to not have any possiblity of identifying patients.

I also wanted to spend the first few months at my new job keeping a low profile, sounding out the background and social structure of the place and generally trying to avoid trouble.

However, I’m now starting to get the itch to start blogging again because I’m starting to see the ways in which Urgent Care is used (and abused) and the way in which we fit into the community.

While Twitter has largely replaced my blogging, there are some things that deserve more than 140 characters.