Monday, 9 December 2013

It's Not Brain Surgery

I have a friend who suffers from mental illness. I don't know the diagnosis but I do know that she feels that all the world is against her. She also feels that anything that involves other people and goes wrong is actually deliberate and against her. This includes getting the medication wrong that is supposed to be helping her. So if her name is wrong on the prescription or label for the medication then it's a deliberate error. If the pharmacy doesn't have the tablets then it's deliberate too. The doctor might write mane (take them in the morning) and it may become nocte (take them at night) after a visit to pharmacy. So many things have gone wrong that the doctor doesn't want her to visit a pharmacy again and she picks them up from hospital.

Tablets are picked up on Monday mornings after 8.30am. So 10am was a safe bet to pick them up and they weren't ready but would be delivered by 12.30pm. This made matters worse. She couldn't go and I was asked to pick them up. They weren't ready and I was told that she should not have been told 12.30pm as there is no delivery before 1pm. I didn't use the word iatrogenenic (disease caused by medical intervention) but I did tell the receptionist that she was worse and this is why tablets were being picked up at the hospital. I asked if this message could get back to the doctor as I am sure that he would like to know that his intervention was making matters worse. I was also hoping that communication could improve as when I worked in the NHS and a physio was off sick we used to phone the patients to let them know. No such luck here.

I went again at 3pm and was wondering whether to ask if my request to inform the doctor had been acted on. I told a different receptionist why I was there and he told me categorically that no medication was dispensed on Mondays. He went on to tell me in great detail how medication is only dispensed on other days. I know it is not funny but I laughed because he was so wrong and he felt he was so right. I am not ill. I don't have to pick up any tablets but this person tells me that there is always something wrong with her tablets. Pharmacies are so bad that one health professional told her that there was one good one in Morecambe. It is a sad indictment of all the other Morecambe pharmacies when one is mentioned as good (this pharmacy had been tried and wasn't).

If I wasn't sure at 3pm whether I should check on my polite request to inform the doctor then I was sure after the third receptionist of the day had got it so wrong. It's a good job I'm not ill because I may have been after one day of trying to get tablets. After a gentle explanation of what had happened in the day, I received the tablets. I asked the pharmacist if she could ensure that the message would get to the doctor. The primary reason was to let the doctor know that he was inadvertently causing ill health but maybe my primary aim was to improve communication between receptionists. I left with the feeling that the pharmacist didn't really get the problem - and that's the problem.

What does it matter if you don't have exactly the right name on the label for your medication as long as it is the right medication? What does it matter if mane becomes nocte as long as the medication is taken at the right time? What does it matter if it takes three trips instead of one to get tablets that could have taken one trip if a phone call with accurate information had been made? Some may say that the patient still gets the tablets and the patient isn't doing anything special so it's no big deal. It is a big deal and highly trained receptionists and pharmacists have to recognise this.

I am sure that my friend is not on her own. Most patients who see a slight error would dismiss it at once but anyone may feel that the world is against them and getting the name wrong adds to that feeling. Getting the name right is not brain surgery.

Change the world

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