Make it make sense - hospital rant

TheCatWoman said:

but others can be really abrupt and unfriendly to everyone, as an autistic person I find this really difficult.

Me too. 

Having been there in that situation from both sides I am drawn to consider what it is that makes the staff member be abrupt and unfriendly. 

Maintaining a pleasant demeanor may seem to be a fundamental in a caring or service environment however for people who for, whatever reason, don't "feel" that way is put simply: emotional labour.   This can be as hard or indeed much harder than physical work.

One might reasonably say well, that's what they're paid for...

However in practice they are masking - and as autistic people we, I propose may be well placed to acknowledge how hard and damaging this can be.

I consider it important to give people at least the benefit of the doubt on whether they have a good reason for being unpleasant and try not to take it personally - at least until I know more about their circumstances.

understood TheCatWoman I was making a statement about myself that might also be considered in a general sense.  Naturally any system needs to be able to be flexible enought to enable fair solutions to individual needs and diversity rather than a "one-size-fits-all" policy.  In practice this includes the individual professionals and hospitals too I feel.

I physically couldn't wait 3 hours, I'd be in so much pain I'd hardly be able to move and mentally I don't think I'd cope either. I'd be totally overwhelmed, the noise, the business, not knowing if I an go to the toilet, or to get a drink or something to eat and not knowing how long I'd be waiting for. Some staff can be very helpful and friendly and understand that if you have a long wait, then you might need food and drink, but others can be really abrupt and unfriendly to everyone, as an autistic person I find this really difficult. Also what makes not sense to me is that some clinics do individual appointments and others do group ones and all at the same hospital, which suggests to me that some surgeons/doctors have some amount of say in how thier clinics are organised. 

  hehe - up the workers!!

Now that I can definitely believe!

I agree it would.  In the bigger picture this would reduce waiting times.  However in my experience in many situations the people who are setting the time frames when people are already under significant pressure, stress, or intense scrutiny to perform a task or meet a deadline in work activities. are not those who are actually doing the job...  

Sounds a lot nicer than the dentist in "Little Shop of Horrors"Cinnabar_wing 

:-)

I absolutely get it's more complicated than what I see. But what I don't understand, is that if they run that far behind, they most go well over the time scheduled for patients. So it would surely just be easier to put a bit longer for each appointment as they are going to have to work that long regardless.

Understood Expecto_Patronum I wish to highlight tho' that public focus is currently directed to waiting times and this might be a sideshow when we might best be focusing on quality of outcome as a measure of service.

Given the choice between a 3 hour wait in uncomfortable situation and my problem being resolved and 10 minutes and not getting anywhere, unless there is an acute emergency for myself and others, I would go with the former myself even tho' I completely empathise with your experience.

Ideally this would not be the case.  Yes we might hope or ask for better.

In the current situation and based on available evidence I think we might struggle to expect it.

Maybe we'll all have to wait 10 years for the current government plan for healthcare to achieve this?  However when analysing this please bear in mind that the goals that are being set are also for a real terms reduction in public health care spending.

The only time it was different was the old dentist when I was a kid. He had a mobile van and used to go round all the schools in the area, and often when you went, the person sitting next to you had the same time. But you were never waiting long before you were seen and had to go back to class.

When he retired they found they needed to hire 3 dentists to replace him. He was a legend and the nicest dentist to boot, but the poor guy eneded up with a bit of a humped back from spending his life bent over.  He gave my littlest sibling a thundercats sword once which his grandchild had grown out of.

Sorry, it's a complete tangent, but I was hoping it might cheer you up from a rough day.

Yes I can see that hospitals are under pressure to get patients seen etc. But I can't see how hours worth of wait times is helpful to anyone. Patients or hospital staff. 

I can sympathise, with hospitals, but also with you as I find it distressing to be left waiting that long and anxiety can spike.

It can also lead to people getting annoyed and then if they complain can get accused of being abusive if staff themselves are short tempered. If you have ADHD, I can imagine a wait that long is unbearable.

If someone works, trying to explain why your so late to your boss might not be good for staying employed either. 

Not a good system all round.

Agreed, I think that things could and maybe should be a lot better.

I've been told to sit back down by nurses, so moving about isn't an option.

I do understand about not charging people for missed appointments, I would be against it too, most of our doctors and hospital send a text the day before asking you to reply yes or no as to whether you still want the appointment. But things can still happen, the bus dosent' turn up, or the car won't start, or you get stuck behind an accident.

The thing that's bugged me in the past is appointment letters turning up a day or so before the appointment is booked for and if you don't get the letter you go to the back of the queue, which is a bit harsh when you may not have been at home to get the letter. The other thing is the delay there seems to be between letter being written and printed and their arrival date, often as much as ten days or a fortnight

It makes zero sense to me that it could possibly be a more effective system than actually giving patients their own times. As I was seen an hour and a half late, it obviously isn't a system that is working.

I went thro' a phase of resenting patients - quickly... it's like blaming a wall for falling on you when it has been pushed over by someone the other side of it.  Those who can't see that are lacking in imagination or can't see the bigger picture.

Many services rely on no-shows as they provide time to do the admin or simply de-compress from the relentless nature of the work.

As regards why people do not attend, as you say, there are genuine reasons.  To prevent them might be intruding on people's civil liberties.  And if a charge were introduced with intention to reduce them how could that be fairly done without potentially setting up a service where the rich get better service than the poor...

If I'm uncomfortable where I'm sitting I try to remember that I can get up and move around.

Best wishes

I get that if there's an emergency then there will be a delay or cancellation, but it annoys the hell out of me when you're left sat waiting for ages. Is my time not important too? 

Another thing is that I find sitting for any length of time really really uncomfortable and often my back will go into spasm and my legs start trembling, it dosent' help that the chairs are so uncomfortable and theres so little room to move around. Often you're a trip hazzard as you're sat in a corridor and people are rushing about.

It often feels like as far as many of the staff are concerned the patients are in the way of the smooth running of the hospital.

I guess it dosent' help when people don't turn up either and there are others waiting for appointments, it's so inconsiderate and a waste of everybodies time, I know that sometimes there will be genuine reasons for no shows, but often it just feels like laziness and lack of curtesy

Expecto_Patronum said:

How does giving numerous people the same appointment time help in any way shape or form?

Because there are more patients than slots as Ferrosol has pointed out.  (and maybe because waiting list are the priority and what is being measured...)

I've run clinics myself and regularly over-ran on appointments because I found short cutting them meant I personally wasn't able to do them in the time available - still not sure if this was autism having a delaying cause, being thorough to save time and grief later or  just I was not very good at it!

Personally were I responsible for arranging them I would suggest this:

Because appointments with patients cannot be predictably timed for how long they will take.  Different patients different needs.  By placing 4 patients in one slot of 4X the average time for one patient this difference may be accomodated whilst optimising the maximum use of the limited resources.

Also have a thought for the poor souls having to meet professional and ethical standards and meet increasingly challenging demands.

Whatever, telling you this first might have made things easier to tolerate, granted.

Best Wishes

My understanding was that 4 of us had been booked for half past 1 and then more people booked for 2. They obviously couldn't get through us fast enough as I was waiting an hour and a half. It wasn't an appointment with a doctor but with a nurse who consults with the doctor when needed. It is just the one nurse that sees the patients for that clinic so I can't see any logic to booking us all in at the same time. 

Source: I work in Hospital Admin, so your hospital may be different.

Basically the way a clinic is usually set up is that it lasts half a day and is broken up into 20 minute slots. Now each of the slots is usually taken up by one patient. However if there is an emergency rather than bumping a patient from one of those slots (given that they may have had to wait months to get a routine appointment.) they'll book additional patients in and count on either working faster through their regular patients or getting help from a resident doctor who will usually be a trainee to see some of the extras. 

Also if the clinic has to be cut short for any reason (say the clinician is required to do emergency surgery at short notice.) They may ask patients to come in early and see them on a first-come first-served basis. Or on sadly common occasions if they want to get home early on a Friday they will sometimes ask the admin team to ring patients to get them to come in earlier so they can finish early for the weekend.