Hospital Pharmacy (1)

The hospital pharmacy is interesting. For the past two years, one of the chairs in the waiting area has had a notice tied to it with a bit of string. The notice says 'Do not sit on this chair'. None of us do. I only think about this later, and resolve, on my next visit, to push the bounds of Englishness and disobey the notice. Now there's something to look forward to...

You arrive at the counter, avoiding the gaze of the waiting people, some of whom have been waiting for so long that they have begun to turn the same colour as the jaundiced walls owing to the lack of natural light. Most of the others are folk that you wouldn't want to sit next to if they were beside the only vacant seat on the last rocket off the terminally burning Earth. And there is always an angry middle class woman, usually in a royal blue suit who is on her mobile loudly complaining that she is STILL waiting after 4 minutes*.

Seasoned NHS patients like me are easy to spot, as we always have a book with us, sometimes a flask and sandwiches. Most of us are used to waiting, and don't mind, because we know that we are about to get hundreds of pounds worth of medication for either a fraction of the true price, or, if you're an official cripple like me, nothing at all.

Not blue suit woman, who is now building up a real head of steam about 'going private' 'never again' 'bloody farce' 'late for meeting' and finishing off with 'well, I don't mind telling you Colin, it's like the third bloody world. We're going private. We'll sell one of the children's ponies'.

By the shouting, agitiated pacing and arm waving, I make a laymans diagnosis that there probably isn't much wrong with her. She is what Dr Crippen calls 'the worried well' (15th October Post)

NHS Blog Doctor: The Crippen Diaries 2007 (Week 42)

But when her demanding nature, internal stress, arguments with Colin and two bottles of chardonnay a night habit cause her chest pains at 2am, I hope she rings her private hospital. They will tell her to ring the (NHS) emergency ambulance. The (NHS) paramedics will then convey her to an (NHS) hospital in an (NHS) ambulance where (NHS) staff will tend to her and give her the medication she needs, all without a flourish of the gold card in her wallet. Her private hospital will tell her to ring the NHS, because they don't have a defibrillator or a resident heart specialist or experience in dealing with emergencies. Nope, they chopper all serious cases to the (NHS) hospital up the road.

I know I do moan about the NHS, but I genuinely believe that this large, unwieldy public organisation does a damn good job, despite the constraints put in place by clueless, faceless 'managers'.


*As far as the '4 minutes', it's worth remembering that this is the only pharmamcy in a hospital that seves a city of just under 1 million people. It dispenses all the prescripitions required by over thirty in-patient wards and also serves over a thousand out-patients per day. There are eight staff - not all on shift at the same time.

High Noon

Good news. After an emergency appointment with my lovely specialist yesterday, I have new drugs.
I explained the whole work thing, how I am constantly tired and so on. I got a little bit emotional but managed to wheel out the stiff upper lip.

Me: I never wanted to go round the world on a skateboard before I had Crohn's, and I still don't, but I do expect to be able to go to work and not have to go to bed at 8pm.
Him: Not unreasonable
M:To give you an idea of how crap things are, I did two loads of washing yesterday and washed up - then had to have a lie down
H: So you would describe your life as?
M: In all honesty, crap. If this is to be my life, I'm not sure I want it.

Dr looks through huge file on me, being careful to keep a firm hold on it lest it slip off the desk and render the 2ft tall nurse unconscious.

H: Hmmm. Yup, your recent bloods suggest that you are indeed feeling like crap, physically. And I'm not surprised you are at the end of your tether with work.

I know he believes me, as under todays date in the file he writes ' X is feeling crap, employers being ridiculous.'

Here somes the sticking point. We both know that a steriod called Prednisolone will fix me up straight off. But we also both know that I will have to be off work to take the initial big doses and that eventually, steroids will make my arms and legs fall off.

There is an audible bing - followed by more leafing through the file - and a lightbulb goes on...

H: I've never given you Budesonide, have I?
M: No, but I have read about it
H: So you'll know it's a steroid, but with far fewer side effects than Pred?
M: Yes
H: How have I never given you this before? Humph

Dr tuts at hinself for a bit.

A shaft of sunlight enters the room accompanied by a choir of angels.

H: Right, lets do that then. You should feel better in about a week.

And just before I fall to my knees to give thanks that there is hope,and that there will be no hospital admission, he also says:

H: And if your enployers give you any more problems, refer them to me. You've been through a hell of a time in the last few years. I'll either speak to them or write to them, the idiots. Pfft.

And off I trot the hospital pharmacy to pick up my new drugs.

Sucker punch

After yesterdays little moan, I thought I'd re-read the maternity policy when I got into work. Beware, here comes a really big moan.

Ususal policy for all and sundry is that time taken for medical appointments must be made up or taken as holiday. I take holiday, because I've got no chance of making up the 60-70 hours a year I spend on appointments. So I use around nine days a year on appointments.

However, if I was optionally in need of appointments, i.e. ante/post natal, guess what? I would not be required to make up any time at all or to use holiday, and it would be fine for me to have these during standard working hours. I'd also get a £200 bung from the government for pro-creating successfully. Along with free dental and optical care for a year.

Trying to finish early to get to an appointment that HAS to fall in work time as hospitals are a 9-5 thing? Better have worked over or make the time up. Finishing at lunchtime to go to a room where somebody will teach you how to breathe correctly (somthing you really should have cracked by now to reach the age you are) - off you go.

And then we get the colleague who is on her third preganancy in four years.

That's 52 weeks at five days per week x 4 = 208 weeks
Say, nine months per prenancy on maternity leave = 36 weeks x 3 = 96 weeks
Lets posit an average of 10 days per pregnancy for appointments, morning sickeness, being knackered because you're carrying another human being around 24hrs a day = 6 weeks
Plus the minimum holiday leave each year of 22 days x 4 = 17 weeks (ish)

96+ 6 + 17 = 119 weeks over four years.
Thats 89 weeks AT work, and 119 weeks NOT at work over four years.

Believe me, my absence levels couldn't touch that. And remember, all the above is based on someone who doesn't take her full maternity leave allowance of 51 weeks per pregnancy, and doesn't take much time off compared to others I have worked with. At any given time we have at least 200 emplyees off on maternity leave.

And it's based on CHOICE. Which I don't have about my condition.

Now, I don't want you to think I believe my employer should just let me do as I please, I am aware that they are trying to run a business. I do agree that things like dental appointments and so on should be made out of working hours if possible or that time should be made up where necessary. I'm not a total idiot. However, my employer was aware of my condition and the cycle of hospital attendence when they employed me. Seven years ago. When I had six months off five years ago pre-and post op, I did volunteer for redundancy through ill health, but they declined.

So muttering threats at me now seems foolish at the very least.

It would be like buying a car with no brake pads and complaining that you keep hitting the garage door when trying to park up.

Working nine to five

Bugger.

I had a meeting at work to inform me I may be put onto the disciplinary process as a result of my absence.
I have been off quite a lot this year, I admit. I have always followed the appropriate procedure and obtained medical certification where required.

Here's the thing. My employer knew about my condition when they employed me. I was off for six months following surgery several years ago, and volunteered for redundancy through ill health. They declined.
I have seen company doctors and specialists, granted access to medical records, and complied with every request made of me. I have been sedated, intubated, injected and invaded.

What have I not done?

I have not made a choice to absent myself from my job voluntarily for 51 weeks, expected to be paid for at least half this time, and then demanded the right for flexible working on my return. Unlike any female employee who should choose to have a child.