A typical day in May
This is how it goes…..
Home visit to a rest home resident on the way to work. Saw the patient and then spoke to the RN and charted some medication, back to the resident to inform her of what I have changed. Discussed next follow up. Off to work. The 15 minute drive is a great breather.
8:45am: arrive at the practice greet my colleagues, dash to the coffee machine, grab the papers from my in tray, and then briefly look at the day’s line up with the practice nurse, discuss any patients there are concerns about or booked in for follow up. Check the provider inbox, briefly see any results that are through, any urgent results I’m expecting. And we are ready to start the first consult.
A sprained ankle, repeat meds, abdo pain, and then pop through to the practice nurse to see a patient she wants me to review. Bilateral Otitis media with effusions, task to self for referral to ENT as recurrent x 6 presentations in as many months. Back to my room … And drivers licence medical for 75 year old physically and cognitively fit gentleman. Explanation given that I can’t sign the form and he will need to come back after a Locum GP has signed it, in two days. Hmmm, disappointing he had hoped to go to AA while he was in town tomorrow. Ok, how about I get the form to the GP in morning and get it dropped out to practice by lunchtime. (Thanks PA or aka husband)
Right now back to the list… Who’s next, 78 year old with multiple co-morbidities and polypharmacy needing addressing….and 15 mins to do it in. Idle chatter can only take up so much of this precious time. So how can I help, yes a list… Ok let’s start at the top. Four issues addressed and meds list being reviewed and oh by the way I’ve had terrible indigestion just of late…(now I’m running late) and on the morning goes. Every consultation is different.
Lunchtime… Touch base with the nurse re’ the morning patients. Sign a few prescriptions, make a phone call to the pharmacy to clarify a prescription. Arrh, that’s right… Need to eat some food before the pm starts! Gobble down some sustenance, and talk to the manager about documents we need the GP to sign and the appointments for next week. That’s right I’ away on Tuesday in Wellington at a meeting for the day. NP colleague from another practice will cover in my absence.
And… the afternoon begins with a few more results actioned from the inbox, the task box remains “red”, but all the urgent referrals have been sent off. Oh yes, I must reply to the email from ACC regarding the persons off work certificate needing more information, a copy of all notes, and investigations and … a further duplicate of information I’m SURE I have already sent them.
Repeat meds, a child with spots, another drivers licence, sore throat, mental health first time presentation, and needing time ( oops, late again), and the the apologies to each patient thereafter as I am late. Phone call from Dr ABC, to discuss the patient being discharged from hospital to hospice today, yes of course I can admit him tonight after clinic , on way home….
And back to the pm clinic, pop in to see the patient with the nurse. Best we book them in to see me tomorrow, it’s a big too big to deal with now. As I dart back through the waiting room with eyes boring into me, I notice the young chap with a bloody tea towel over his knee. Hmmm, looks like a added extra will need to be seen. Teenager with sore throat, swollen glands, febrile and in pain… Hmmm strep… potential for EBV. Rash with penicillin? Then time to uncover the knee injury. Casual patient, no previous history, last tetanus unknown, cleaned, no deep structural damage. Sutures x 6 and dressings applied. ACC forms done. Call in the last patient, thank them for waiting, and then excuse myself, as I just need to pop in to see a small child for review with a rash, cold, miserable! Ok… Where was I? Right last patient, long history of low mood, terrible sleep, poor diet, high stress work place and no support. 45 minutes later we finish.
…Breathe…
Finish the inbox, send off text messages with results to patients, send off those last referrals that are needed from today. Scan the task box, and see three prescriptions are needed for controlled drugs… today! Handwrite the prescriptions, put away the script pads and any patient letters notes etc into the drug cupboard. The staff have left. Turn off the lights, heater,remember to turn on the alarms and then out the door. 6:20 pm not too bad. Still have the admission to hospice to do tonight.
20 minutes drive to hospice, is quite a nice break. Assessment, notes, medi-map system, patient-family discussion, nurse discussion …(7:30pm) One hour later I leave, feeling pleased that the patient is settled, the family are up to date with the plan and the wonderful staff have all the correct documentation they need to do their job.
Home time!! That completes an enjoyable, busy twelve hour day in general practice!