Can I call you Jezza, Jez? I just wanted to write to you, really so you can get a feel for what goes on in the NHS. Let me tell you about my day, it began when I got up at 6.15am, I arrived into work at 7.30am, not 8am when I actually start because it is Thursday today. Thursday means that my unit is running three operating lists, this causes chaos as there will not be beds for half of them when they arrive at 8am. I will have to see and consent any day case patients and make sure they are ready for theatre.
On top of that and that I have to see all of our in-patients on the 8am ward round. There is only me about today as my colleagues are on call, on holiday and on study leave respectively. The junior doctors essential to my ward round start at 8am, they arrive on the ward at 8am with a coffee, looking bad tempered.
The junior doctors change weekly being moved around different units and even hospitals within our trust. There is no continuity of care. No wonder they are annoyed and learning nothing, I don’t even know their names half the time.
The nursing staff are looking after 8 patients each, they are doing the drug round when I begin the ward round and so can’t join me when I eventually get started. I have 30 ward patients, 6 boarders, 2 in HDU and 1 in ICU. I have to see them all by 9.30 when I will rush to theatre and begin an operation that will take about 7 hours. I have no time for a coffee or a drink of water prior to starting this case, there is no lunch break, no opportunity to go to the bathroom.
The operation finishes and I am off and out again, I have an ill person to review urgently on the other side of the hospital, I arrange a CT scan for them and then head up to the ward to do the round. The junior has gone home, like me she finishes at 5pm, unlike me she has left.
I do the round alone, I see all my patients most of whom have relatives in with them who all want to talk to me. It takes a long time to get round them all, then I go to the CT scanner to see my sick lady, she needs a drain inserted which I have to arrange.
She has not had her clotting checked though and first I have to find someone to do that, after 20 minutes I give up trying to find an F1 doctor and take the blood myself.
The on call radiologist is at home and isn’t sure if he wants to come in and do the drain, he wants to know how sick she is and if she can wait. I tell him that she can’t and an argument ensues.
I feel bruised by this encounter and stop at the shop to buy some chocolate and a can of coke, my first food or drink since breakfast. This is swiftly followed by the need to urinate, again for the first time since I got up. I ponder the cost of toilet paper, you have pointed out how much money we waste on not getting the best deal on toilet paper. I can assure you Jeremy, I rarely get the time to pee and feel I am a low user of toilet paper.
I’m a fan of multi tasking so I use the opportunity to check my emails. Management are banging on about the 18 week wait breachers, we have a list of anal skin tags and other crap to do tomorrow to prevent them exceeding 18 weeks. I can think of other patients who more urgently need surgery but they aren’t breaching so there is less rush in management’s view.
The on call registrar is running about looking stressed, he has had 36 admissions so far and not enough beds are free. He’s too busy to sort out my lady with the drain, so I wait and get the clotting study back and then phone the radiologist to reiterate that she remains septic and needs a drain. He agrees to come in and do it.
I head to the changing rooms, it is 2145. I know that my best friend from uni, an inner city GP will be available for a chat and I ring her from the car, she is still at work attending to mountains of paperwork that she can’t get to during the day, she’s a part timer too.
Safe care costs less you say? Indeed it does, but it’s only safe because most of us are working hours far beyond what we are paid to do.
I get home and kiss my sleeping children, look out their uniforms and speak to Mr KBW. I am worried about the lady with the drain so phone and check she is well, I eat and try and drink a litre of water before bed as I am so dehydrated. I’ll be back in tomorrow to start it all over again.
Then I see that you Jermey are wanting to make the NHS safer, for less money, which is curious. I see you are also worried about the babies killed every year during childbirth. This wakes me up as crikey, so am I! That’s completely terrifying, some satanic psychopaths perhaps? What could you mean? You can’t mean the babies that die during childbirth? Can you?
Lights out at casa KBW and I dream of clinics that aren’t over booked, operating lists based on need not targets, managers that are free to manage departments not meet targets.
The alarm goes off and it starts again as it does for most of us, you see I am not some disorganised muppet who can’t organise herself, this is the daily grind for us all. We are the NHS, we live it every day and will continue to do so when you are foreign minister or PM or (ideally) in the opposition.
Best wishes and good luck finding those baby murders! I’m in your team for that one.