14 April 2009

The return of the doily

A strange thing happened the other day. Dr Grumble was seeing patients and a nurse offered him a cup of tea. This is not altogether unheard of but Dr Grumble generally declines. Sipping tea in front of patients doesn't come over too well. But, as it happens, Dr Grumble has started seeing the odd private patient and, because they have bigger slots, Dr Grumble often has time for tea. So, because he had time, Dr G accepted the nurse's offer of a cuppa. Now normally if you accept such offers you get a chipped and often somewhat grubby mug. But you are grateful nevertheless. On this occasion it was different. The tea was delivered by a smart waiter. There was a pot, a cup and saucer and a doily. And biscuits. Dr Grumble was amazed and then he thought a bit and wondered if he really should be amazed that somebody gives him a cup of tea - especially since he pays for the private rooms. And then he thought again and remembered that decades ago when he was a house physician in a large London teaching hospital everybody sat down to tea in the middle of the ward round. There was a big china teapot, cups and saucers and, yes, doilies.

Thinking a little more Dr Grumble remembers many times in the past when he used to have such breaks. The doilies disappeared but ward rounds as a junior doctor were often punctuated by coffee breaks. These occasions were immensely valuable because it enabled a different sort of information to flow between the consultant and the others. But now, as you will have guessed, Dr Grumble never has such a break - except on the rare occasion that he is in the private wing. Dr Grumble rarely passes the time of day with his juniors. We are all too busy with clinical information being passed hurriedly from one person to another following which Dr Grumble issues his orders staccato fashion. It's not good but there is little time for anything else.

So it made Dr Grumble laugh when the oldest Grumble child, a medical student at St Elsewhere's, came home for Easter and related what he had overheard a manager saying in the corridor. It went like this:

"What? The consultants don't have a break? Not even 10 minutes?

"That's dangerous!"

Yound Edward Grumble thought this was very funny. It's both funny and sad at the same time. Unfortunately NHS managers have no idea how things are at the coalface and they reveal their ignorance even to medical students. This one overheard remark will colour the young Grumble's view of NHS managers for some time to come. And worse, he's told everybody else.


angus said...

out of the mouths of babes and sucklings (From the Bible, King James Version:

Psalms 8:2: Out of the mouth of babes and sucklings hast thou ordained strength because of thine enemies, that thou mightest still the enemy and the avenger.)

No One said...

Obviously I'm not a doc but random thoughts you have provoked...

But I have worked in offices and factories with old fashioned "tea ladies" who come round with a trolley and dispense tea to the worker bees at their desks or stations

Which compares and contrasts with the more common coffee bar arrangement nowadays where the office workers have to queue for ages to get a poncy coffee from some fancy branded cart in the middle of one of the open spaces

On reflection I think the old fashioned tea ladies approach was much more efficient, folk didnt waste so much time waiting for their drink

While the coffee machine or water cooler unplanned meetings often produce the best ideas which reap rewards for companies, there is something in the chaotic way this happens that really ought to be studied

In the same way I think the old fashioned station master with a modest salary at most small rail stations was probably cheaper overall than all the money spent on cameras and fixing vandalism nowadays, the proud station master really did care about his station and in some remote places locals often still "adopt" a station and make it a lot nicer than the rail companies could ever do centrally

Anonymous said...

There are plenty of students at the place that I work at that would like to become doctors. I just shake my head and point them in the direction of your site,and wish them good luck.
all the best
John Gibson

Dr Grumble said...

Oh dear, John. So you are not just wallowing in the Grumble gloom yourself but encouraging others to do so. What a responsibility for Dr Grumble.

No One, how right you are about the unplanned meeting. When he was active in research Dr G used to share a coffee room with other researchers working in what seemed like quite different areas. We bounced ideas around and generated collaborative research projects which otherwise would never have happened. This happens when people have a little time and an uncluttered mind. When Dr G joined an extremely large medical school the managers realised the importance of such meetings so tried to organise them with formal cognate group meetings. They never worked and wasted a lot of time. There is something about humans relaxing that generates ideas. Watson and Crick dined six days a week in the pub where they announced their discovery of the structure of DNA.

The consultants' dining room was said to be a place where lots of valuable work and what managers would call networking took place. Now we don't know our colleagues so we don't know who does what. Human beings do not work well with each other unless they have informal human contact. It is the complexity of interacting with individuals that leads to patients wanting to see the same doctor - and vice versa.

No One said...

hey dr g we agree on something!

small shoots and all that eh


Kenali dan Kunjungi Objek Wisata di Pandeglang said...

Kenali dan Kunjungi Objek Wisata di Pandeglang
Keyword Kenali Pandeglang
Mohon dukungannya yach....?!
Pandeglang telah hilang Kenali Si Dunia Aneh
Mari bersama Pak Firman yang bekerja di SDIT Nurul Ilmi Medan dalam kontes Kenali dan Kunjungi Objek Wisata di Pandeglang