I had to register with a GP practice today…
As long as I can remember, I have always had the same GP back home. My family registered with the practice when we moved to Belgium and I had never needed to see anyone else unless it was for a more detailed examination, such as allergy tests. That practice was based in the bottom half of a house. You walked through the front door, a bathroom on the right, a small waiting room through the door on the left. On the walls of the hallway, stock pictures of pebbles or something of that nature – you know the ones you find at Ikea or the pound shop? When you walk into the waiting room, there is a small table in the corner with a pile of magazines, several relatively comfy chairs to choose from. The walls also had generic pictures of flowers, and some posters and leaflets relating to healthcare (vaccinations, promotion of health services, etc.). Opposite the entrance door is the door to the consultation room, a brightly lit and secure environment. a desk towards the front, an examination bed and sphygmomanometer (blood pressure machine), scales, and the like towards the back. The walls had cabinets stocked with medical goodies, with those 3D posters placed strategically around the room.
It’s a tiny GP practice, family run I think. The two consultants, a man and woman, that alternate the days they work – so depending on who you felt more comfortable with, you went on those days. They would have drop in clinics from 7:00 til 12:00 almost every, and appointments the rest of the day. No reception, no nursing staff. It was kept neat, simple, and soothing. You either booked online or called in for an appointment – or woke up at 5:00 to try and make it to the drop in sessions first. Although I don’t remember signing up, I do know that every time you went, whether it was a drop in or scheduled appointment, you would wait in the waiting room, and the consultant would come to the room and call you in. You would sit at the desk, discuss your concerns, complete your appointment, then they would walk you to the front door and shake your hand goodbye when you leave.
My new GP here could not be more polar opposite.I received a call from someone named “Jen”, telling me that they received my online application to the practice and would need to come in just to complete two more questions and prove my identity and address – all pretty standard stuff. She told me when she worked, and to ask for her when I come in, no appointment required. Great, I have time tomorrow so I’ll drop in then before heading off to university. Upon my arrival, I notice that there are A4 sheets of paper with a notice stuck to the front door, stating that drop-in clinics were no longer a thing. Okay, but I was told over the phone to come in whenever. I ignore the notice and walk in.
That first notice should have been a warning for the chaos that greeted me inside. I could not tell you what colour the walls were originally, if they were painted or papered. Well, actually, they were papered – to an inch of their life – with notices, posters, and health promotion campaigns. It was so overwhelming that I forgot I was a student nurse and panicked at the fact that I was at the GP. Suddenly, I wanted to spend as little time there as possible. To the right was a door (also covered in notices, something about your weight and asking the reception for details – like what, does my coat make me look fat?). In front of me was a desk, presumably, with a counter. It was hard to say, there were so many stacks of paper on it. A clear plastic pot, which looked like the leftover packaging of a cookie tin, holding 5 miserable looking pens, had the words “Pl se Re u n Pens, THANK YOU” scrawled on it in ballpoint. The strangest looking machine was positioned in front of the counter, with a chair. I assumed it may have been a ticket dispenser as it had buttons, the time, and a bizarre circular opening with cloth bag inside.
It took me a couple of minutes to get used to my surroundings, by which time the two receptionists at the desk noticed my presence and asked me what I was here for. I told them that I was here for Jen. After asking me my name about 5 times, they finally found my online application and asked me to sit down and complete the outstanding questions. For a second I was confused, as the only chair I had seen up til now had an elderly lady sat in it. The realization, that the onslaught of chaos from the walls had given me tunnel vision, suddenly dawned on me as I heard a cough from the left side of the room. In an almost tv-trope manner, I turned slowly to notice the waiting room, with about ten people sitting, staring at me. I don’t blame them, I was the only part of that room not covered in A4 notices! I grabbed a pen and hurried over to the only available seat, next to a dirty looking children’s play table. I tried to concentrate on the documents in my hand, but I could almost feel the stares on me.
Finally, I managed to answer one of the two questions, “What is your activity level, circle one of the answers below”, check and sign the application form. The second question was my blood pressure. I have no clue what my blood pressure is, so I left it blank, assuming a nurse would come and take it for me. I handed back all my material and sat back down, careful not to make eye contact with anyone else in the room. Every now and then, you hear a voice from inside the practice shout someones name, and the person solemnly gets up and walks through that door on the right.
Suddenly the receptionist called my name, I jumped up thinking I would finally meet someone face to face. No such luck.
“You haven’t taken your blood pressure. Please take your blood pressure. Sit down, take of your coat. Take off your coat, put your arm in as far as possible and press the start button.”
What in the world is she talking about? I must have had a look of utter confusion for her to need to repeat “take of your coat” with such exasperation. But then I realized. The ticket
machine was not a ticket machine, but a sphygmomanometer. I took of my coat, rolled up my sleeve, and hoped that this wasn’t an episode of Indiana Jones, as I stick my arm in the hole and start the machine. The sphyg tightens, and I watch the numbers displayed on the top. Then it’s over, and a ticket does actually come out with my blood pressure written on it. I sheepishly hand it to the receptionist.
“Is that all you need me for?” I hope her answer is yes, I just want to leave. My newfound claustrophobia isn’t helping. She takes the ticket and skims over my papers. “Yeah, that’s it I think.” They hadn’t checked my ID, or my address. I have no idea who Jen was, or who my consultant is (there was a list of people working at the practice on the top of the documents, so at least I know there are medical staff). The single medical task required was done by an automated machine that resembled a hole-in-the-wall trap from adventure movies. The only interaction with a person I had during my visit was with busy receptionists, who let the phone ring continuously for the 15 minutes I was there.
You forget, when you’re a student, that you are also a service user. And when you experience the healthcare system from the other end, it really makes you reflect upon your own behaviour and practice. Until now, I have only been in CYP services due to my placements, so this was my first experience with the GPs in the UK. I had previously been to the dentist here, and the dental nurse gave me a bit of a scowl when she found out I was a foreigner and a student nurse to boot. Yet that was such a small incident compared to the rest of my experience that it barely left an impact. Applying to the GP however, reminded me how lucky children in this country, and therefore, to an extent, how unlucky the adults can be when it comes to services. Whereas children get piles of toys and cartoon posters, in a brightly lit waiting room, the adults get a chair and patronizing health promotional posters on every inch of available wall space. Children get greeted with a big warm smile, and a “how are you?”, whereas adults are called for like misbehaving children at the principles office. It makes me sad to think that 18-year-olds must have this harsh transition from one extreme to the other. Although I’m sure they are glad to be rid of the stickers and pastels of paediatric services, I doubt they appreciate drab waiting room of the adults.
If I have any questions about my health, I think I will be waiting until I visit home.