Archive for April, 2007

Bloomin’ heck…

Posted on April 26, 2007. Filed under: Journal from behind the desk... |

Part of the reason I blog, is because I don’t believe in the old phrase “I’ve seen it all”. The longer I work, the more I realise that the human race is diverse and totally unpredictable.

Max on a diverse & unpredictable day!

For example – I have often commented that in the winter we should allow extra appointment time, just to allow our elderly patients time to take off their clothes and multiple undergarments. 

“All I want to do is listen to you chest – but I can find it”. So you could be thinking – that’s not diverse, all old people wear lots of underwear.

“Brief” history of underwear link

This week (fair enough the weather is warmer as spring has sprung) I needed to examine a lady in her 80′s with a pain in her buttock. I shouldn’t assume or be ageist, but I expected that under her trousers I would find a long vest tucked into thick crinkly suspenders, clipped and belted over a whopping great pair of briefs… but NO there she stood in her back G string. (Look if I say thong - the Australians will think she has a sandal up her butt)

misses cartoons, misses cartoon, misses picture, misses pictures, misses image, misses images, misses illustration, misses illustrations

Surely I am not ageist! I treat everyone as equal, even barking mad people I have respect for.

It’s only a fine line between sane and being insane…That gets me thinking – “oh no not again!”

Some of the words we use are interesting. Insane is a classic.

If you take the word “in” to mean within or inside something- and the word “sane” to mean in a good state of mental health, then to be “in-sane” is to be within a good state of mental health. Yes?

It’s a bit like the Psychiatric/Audiology assessment, which proves everybody is insane or going deaf:

Do you hear voices?”

Yes = you have a schizophrenic tendency

No= you have gone deaf.

Well? What’s your answer?

I know – you must be mad, to have read this.

Until next time when we will discuss the finer use of medical word – like sphygmomanometer – bye!!

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Condom Advocate!

Posted on April 20, 2007. Filed under: Did I say that? |

Sometimes I think I have been here too long… 

Don’t worry – I’m not going anywhere, in fact I had an odd week on my blog.

Before this week – my record amount of readers per day was around the 150 mark.  This week I had 695 views in one day – and I didn’t even leave a post with Change of Shift this time. (By the way it is out again – but finish reading here before you zip off to Erica).  I think someone kept starting to read my pages but getting disturbed – 695 disturbances – sounds like a nurse – probably a male nurse (not multitasking!!- thought I’d say it before the girls got a chance)

Anyroad – As I have mentioned before, sometimes we use a bit of a script in this job.  I am a condom advocate, I don’t like sexual transmittent infections (nothing personal – I HAVE NEVER HAD ONE)  I have had crabs – but only in a sandwich.

So where is this leading???

Well in general practice it is a case of trying to find a balance between:

a: insuring your patients are not spreading their nasty sexual transmitted infections and getting new ones

and:

b: not getting that nasty little parasite in their tummy (AKA pregnancy)

legend condomsGreat condom ad: Protect yourself

Yes I can rant on all day about using condoms, but some people just won’t!  During this ranting to my patients I have a bit of a habit of saying:

“I’m a big condom fan – well, actually I’m not necessarily a fan of big condoms, just a fan of condoms generally” and then rant on as stated. 

So yes I should say “I am a condom advocate”, but it relaxes the patients when I say stoopid things, especially giggly teenagers, who sit there looking at me like I’m some nagging father figure. (Anyway they really shouldn’t be going out dressed like that!)  – my poor daughter, merely two years old and has no idea how much she is going to hate me in years to come. 

Anyhow (I’m easily distracted today)…I used my “Big condom” line again today, and my patient piped up:

“You said that last time I came”

OK so maybe I have been here too long or should just change my script a bit.  Of course I was tempted to retort:

“I’ve never been near you when you came – and if I was I would have used a condom! – now go away and catch something nasty!”

Harsh, sorry. Bit teste today!

This is becoming a bit of a regular feature…In the news today...

Proclamation

Apparently “People who significantly cut back on the amount of salt in their diet reduced their chances of developing cardiovascular disease…”  

HELLO!! My patients must think I spend hours doing unpublished research in my spare time, just for their benefit – I’ve been telling them salt is bad for years. 

OK - so there is new research, and I suppose it is useful as it makes the news, thus making people think they have found out some fascinating new information and so they might just put 1 kilo of salt in the spuds – so they cook quicker.  

For heaven sake – can’t researchers find something better to do, like find a cure for giggly teenagers! (I’m just bitter because most teenagers are half my age! – and what makes me bitter – too much bloody salt!)

That’s enough. Don’t forget to pop and see Erica

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P=Q-D/C/BM

Posted on April 13, 2007. Filed under: Journal from behind the desk... |

I haven’t got any particularly long and winding tale to tell this week, but it’s just been a bit odd.

Very busy (that’s not odd – it’s fairly normal). 

Unlike my days in the emergency department, my definition of busy is fairly moulded. I have set appointments, which more or less means I have a set number of patients I see. (OK so the receptionist squeeze odd ones in here and there, even the midwife got me to see one of her patients today).

The big differential between busy and the “q” word is: the quality of the patients.

I’ve developed an equation:

P=Q – D/C/BM

The number of patients with appointments (P),  is equal to the level of Q minus the proportion of difficult/complex/barking mad patients (d/c/bm)

Yesterday my d/c/bm factor was high, but today I have had (so far) a high q factor. 

Are you listening at the back?!!?

I often wonder why it is that my days seem to either have a High Q factor or a high D/C/BM factor, and very rarely a balanced combination. 

Basically everybody comes in for something simple (and I spend lots of time reading the blogs) or everybody is barking mad, complicated or difficult (and I spend lots of time trying to catch up because I’m running soooooo late).  All I want to know is WHY??

Question for the Nurse Practitioner for this week:

Was from a young lad – one of my regulars – who came to see me for the umpteenth time, with something benign and in no need of treatment.  His mum is a worrier - I don’t mind that at all, if you leave with nothing but a bit of reassurance and peace of mind, that can be just a healing as a prescription.

Before he left, the lad turned to me and said:

How come you know everything?

I had to confess that actually I don’t.  But sweet none-the-less and not bad for the ego.  I think of myself sometimes as someone who knows a little bit about a lot of things, but not much about anything.  I am no expert – keeping to equations:

x is an unknown quantity and a Spurt is a drip under pressure! (xspurt – you follow??)

In the news today: It appears that obesity has a genetic factor.  “Scientists” found people with two copies of a “fat” version of a gene had a 70% higher risk of obesity than those with none, and weighed 3kg (6.5lb) more.

Does this mean that in the future people with the “fat” gene could have it removed/altered to stop them being so fat? 

Well I have often wondered why fat people don’t get rid of those jeans anyway, that bulge is so unattractive, if they got the next size up and stopped kidding themselves they’d look much better.

Hang on! Am I getting confused again?

I’ll be less cryptic next time I promise.

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Easter Egg…

Posted on April 4, 2007. Filed under: Journal from behind the desk... |

There are good and bad things about this job at this time of the year. 

Good: Two four day weeks – thanks to Easter Bank Holidays.  I’ve been working in Primary care for nearly 2 years and the novelty of bank holidays has not yet worn off.

Bad: I work in a area of tourism, and Easter tends to indicate the beginning of tourism.  So I have been expecting the worst. Usually a minibus of pensioners who have all forgotten to bring their tablets. 

“It’s the little white ones I need dear”, a universally recognised problem!

But essentially I’ve had a relatively benign week thus far, someone else presented with body shop syndrome, but also reported a little jaundice – not quite to the standard demonstrated by young Bart.

 Bart 2……so I gave them a blood test form.

Now hopefully those blood will come back fine, maybe Gilberts Syndrome, as oppose to Dilbert Syndrome. (I can’t believe my luck – there are actually web pages on Dilbert Syndrome!!)

In the News today, It appears that the price of using a bedside phone in an NHS hospital has increased dramatically.

We hear that: “Calls to patients from outside the hospital cost 39p per minute off-peak and 49p a minute at peak times”. 

Well that gets me thinking, IT’S A BARGAIN.  If you wanted to speak to someone on the phone who is not wearing much, in the past you always had to get the telephone number from a magazines on the top shelf – and (I am advised) they cost £1 a minute! 

solve this problem.  I’m sure that when you ring these adult lines, it’s only some old granny with a rude imagination anyway, at least “” is stopping the old lady with the severe incontinence from getting bored while the Doctors are doing their grand rounds.

“Ohhhh, yes love, I’m wet alright!!” – Sorry.

The nifty, thrift and nearly 50 Kim has been busy again with:

changeofshift

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