There is one of those memes doing the rounds on social media; you know, a picture with words to give a message.
This time it is a chart telling the public where to go for their health needs: “pop off to pharmacy if you are having diarrhoea and can get off the toilet” it begins, concluding with “don’t go to A&E unless you are comatose”.
In spite of my cynicism, it is a useful message; but one which is clouded by a statement that has been accompanying it: “Pass it on; if it prevents one time-waster it’s a bonus”.
Time-waster: what exactly does it mean?
“The implication to me is that they are wasting my time as a nurse”
The person is wasting their own time, sitting for five hours waiting to be seen in A& E when they could be home watching TV or playing on their Xbox?
The implication to me is that they are wasting my time as a nurse – the professional who is being paid to be here.
It speaks of a paternalistic attitude of “I know best”, “I am more important than you” and “you are below me”.
It is judgemental and enshrines the patient in front of us as “wrong”. It may mean the meme creator is suggesting that there are patients who waste my time as there are people more poorly than them who need it more; but that elevates one person as more valuable than another and is accompanied by assumptions about what one is deserving of.
The ‘time waster’ sits alongside the ‘bed-blocker’ character and represents a similar attitude in a different part of the NHS.
“This is outside the ethos of the NHS value-based 6Cs of care and compassion”
This is outside the ethos of the NHS value-based 6Cs of care and compassion. The person - the so-called time-waster in front of you is a real person who needs care.
They may have been sat at home on their own for hours. The pharmacy they are meant to go to is shut. The health-line 111 is busy, or their pay-as-you-go phone is out of credit and they do not know who to call for help. The GP is closed and does not do visits and they cannot get an appointment for three days anyway. The out-of-hours service is in the centre of town, and costs to get there on the bus, and they live fairly close to the hospital where they can walk easily.
They are feeling scared that they are going to die as they have never felt this ill before, or they are a parent who has had a child crying for hours who suddenly goes floppy and they have run out of paracetamol. Is that a heat rash or sign of meningitis?
“With services in the community eroding, people don’t always know who to go to”
With services in the community eroding, people don’t always know who to go to, and when scared and unwell don’t have the time or capacity to find out. The hospital, with its doors always open and bright lights shining in the night give the message that this is where you can get help.
There is no question that things need to change in the way of education to better support people to understand their own health needs.
“Labels such as time waster are unhelpful and inappropriate”
However, labels such as time waster are unhelpful and inappropriate. Instead we have a duty to provide a service that is caring, compassionate and welcoming - no matter the pressures.
You never know, one day you may need the service and would expect people to respect you as a valued member of society and provide optimum care.
Dr Jenny Hall is senior midwifery lecturer, Bournemouth University