Dr Anant Sachdev highly values the HCAs he works with at a GP practice, however one HCA’s actions and initiative led to a patient receiving care that went above and beyond the call of duty
”We are invisible. The doctors rarely make eye contact with us, and we are rarely acknowledged by those in superior positions. We are not nurses, we are not the ones who are thanked. We know our opinion is not sought, we know we have a job to do quietly that most would find mundane and bothersome. And we are paid the least. I’d just like the doctor to know that I have a name, a personality and, probably surprisingly to them, a degree” (The Guardian, 21st March 2015)
Healthcare assistants are an invaluable group of individuals who not only help manage demand but more importantly “make a difference” to patients, carers and families. It is time that these unrecognised individuals received appreciation for what they are – health professionals in their own right.
I work at a 16,000 patient GP surgery in Bracknell, Berkshire, with the usual six full-time GP partners, three salaried GPs, one practice-based pharmacist, four nurses and two HCAs. Apart from stocking and clearing rooms, the HCAs carry out phlebotomy services, dressings, assist in minor surgery, and carry out health and basic chronic disease management checks. More recently one HCA undertook training in ear syringing and is being put to good use daily now.
But crucially an unrecognised quality that HCAs bring is that of loyalty, commitment and compassion – as demonstrated by the below reflective account of a single episode of care which made the greatest of differences to a family, and which will never be forgotten.
Reflective notes of a HCA:
8th December 2016
Using Driscoll (2007) reflective framework
During a routine five minute blood test appointment, a regular patient of mine explained that his wife had become very unwell and was not expected to survive the weekend (four days away). I could see that the patient, Mr S, was understandably very upset. Tearfully, Mr S went on to explain that he could not hear his wife speak to him from her hospital bed, because his ear canals were now blocked with excess amounts of Cerumen.
He had tried to make an appointment for an ear irrigation procedure (a required length of 20 minutes) however, was informed by the receptionist that there would be a seven day wait.
I felt an overwhelming urge to help Mr S. It seemed paramount that his ear canals were cleared today so that he could hear his dying wife’s wishes before she passed away.
After a discussion with Mr S, it became clear that he had had the irrigation procedure previously and had been preparing his ear canals by oiling them as instructed. I felt that even though I did not have any time allocated for this procedure, I must insist on helping Mr S today. However, I was concerned. Although I have completed the training course and performed four successful ear irrigations, I had not yet been signed off to work without being observed by a colleague. This resulted in having to ask a practice nurse to observe me. What if she did not feel as strongly and understand the importance of avoiding a delay in the procedure?
I explained the situation to my colleague and felt relieved that she agreed to observe me perform the procedure immediately. I irrigated both ear canals and released the excess Cerumen until it flowed free, revealing the left and right tympanic membranes. I felt elated when Mr S confirmed that he could now hear clearly.
After performing another ear irrigation on the same day, I have now been signed off as competent to perform the procedure without being observed. This will allow me to carry out this procedure without having to rely on the agreement of a colleague, time wise.
I am pleased to have been able to assist Mr S and to have relieved his distress so efficiently at this difficult time. I feel reassured that funding the related course myself, encouraging my colleagues to support me and using annual leave for the study day were all incredibly worthwhile. I believe I can continue to provide this service for the patients and that their wait for an appointment will be reduced as the procedures can now be spread amongst an additional clinician: myself.
Hana Whittick, HCA at Ringmead Medical Practice, Bracknell, Berkshire
I am a Palliative Care GP Specialist, and rarely does one get these opportunities to make such a difference. The joy Mr S would have had at hearing his dying wife’s last words, and the potential pleasure of the response from him to her is priceless. This HCA has achieved, in one moment, more in “making a difference” than many.
Anant Sachdev, GP cancer & palliative care specialist