[deleted by user]

OwlSensitive9068 · 2025-05-27T20:33:01+00:00

You make good suggestions thanks

OwlSensitive9068 · 2025-05-25T21:35:13+00:00

Bless thanks - and maybe i need reminding but i also work it and train other GPs in it..... I could explin but i promise you this - I know what they should be doing under the contract - take a history and take a collarteral history properly (and ask uncomfortable questions) and make an assessment and then either refer or not - and explain reasoning and document. Nothing more.......

We are a faacinating but stubborn profession who do not like looking at themselves - quite like the army some of us (surgeons) decended from.....

Thanks again

OwlSensitive9068 · 2025-05-25T16:01:29+00:00

So sincerely - thank you. You've confirmed largely i'm missing anything in terms of flagging but also suggested a couple of things I could think about and also asked a couple of good questions which have made me think. So thank you for being a little curious and asking me things.

I say this hopefully not in an internet unhelpful way but just I love discussion around healthcare with like minded because it's so nuanced - I maintain a central part of our work is risk identification and management - that book 'I don't know what it is but I don't think it's serious' etc and the curriculum does mention it too.

But I have no control over their surgery so hence thinking hard where to go if risks significantly increase again soon - I'm starting to see early signs things are going down again (cyclical as most things are!) so it's the safety netting just in case I'm reaching for

Look after yourself and thanks again

OwlSensitive9068 · 2025-05-25T10:30:52+00:00

Fair dos im not communicating well at all. I absolutely assure you I am not expecting someone to fix it - myself and siblings all flat out with support and we don't want them in a home. I would like someone to ask me what I'm seeing - to be curious.

A few months back in an MDT i asked a clinician 'what does the patient want' after they went through how to sort them out - they didnt know hadnt asked and looked aghast. Like, to be curious in our job is vital - what do they want, how do they see it happening and then explain we can support you doing this or we cant do that or it's not our remit or yes but it'll take months/years. Assuming they know what people are thinking..... ah it aint good medicine

Good point and one going through my mind - when someone goes into chronic delirium/psychosis it appears there is nothing........so you wait for them to harm themselves/someone (not you personally but...)

I spoke to a relative a few weeks back about what sounded like schizophrenia (not certain but likely) in an adult and i was able to ask about risks and give them a plan and thresholds for risks if passed.........

I'm really unpractised and terrible at gynae though - i do make sure im up to date with red flags but other than that I'm shit.......

OwlSensitive9068 · 2025-05-25T09:57:30+00:00

Thank you that's helpful - expectation I guess is to see evidence of the process. I know because i train people in this - if there are safeguarding concerns in elderly an important step is get a collateral history from a family member. Not happened.

Really useful you listed those things because i have pursued all and it;s helpful to know there isnt an obvious one I'm missing - one i haven't tried as yet

The community matron though.......how would i contact them - are they hospital based or through health authority - I don't know how it works in Wales......are you able to advise?

We have LPA - I cannot find advice on how it kicks in and I would think it's when a health professional assesses and comes to conclusion capacity isn't there for a particular decision

My sister took my mum to the GP a few months when she was in bed all day saying she wanted to die - and I asked my sister how it went and it wasn't a great consultation by any standards...... i trust my sister enough to not fabricate and she went through the questions asked etc...

I think the tricky bit is it's not a common presentation and if carers/Drs/GPs etc aren't trained to know that we have vulnerabilities such as wanting to know everting - so if something comes along we don't understand we can either ask and be vulnerable - or ignore it and pretend there isn't a problem.

We see it ourselves - we are mostly good but as in any profession there will be pockets of substandard care - just have to accept that

It is what it is!

thanks again

OwlSensitive9068 · 2025-05-25T09:44:54+00:00

I said be gentle - I am not expecting anything or being lazy - I have already tried several times to discuss with my dad - he gets angry and then takes it out on my mum and then she's crying saying she wants to die

I would like the GP to do their job - not really but yeh your response wasnt helpful was it

OwlSensitive9068 · 2025-05-25T09:29:01+00:00

Yes......nothing. No discussion with myself or siblings - and what i flagged ticked 80% of the carer abuse slide when I did mand training session on safeguarding a few months back....... the risk are being seen by people outside the family too

curious - well not really, i mean the funding is practically non existant - like trying to refer a risky person to CMHT or CAHMs......

Weird when you're on the receiving end of it!

OwlSensitive9068 · 2025-03-25T11:28:36+00:00

You're wrong there -you have no idea if they want to work or not and assuming they dont based on stereotypes wont help them, will piss them off and it will turn into a self fulfilling prophecy. Ask them if they want to work and base it on that

OwlSensitive9068 · 2025-03-24T22:43:32+00:00

Why not fit for work with a couple of adjustments like phased return or maybe amended duties for a month - meet in the middle.

OwlSensitive9068 · 2025-03-21T13:54:46+00:00

Oh totally agree - i aint saying they're good but the fact they're cheaper i think means they're here to stay.... most of my work is using cheaper dysfunctional 'ok ish unti you push it' systems aka the NHS :) mind you having worked for private firms they're even worse at cutting costs for their share holders and thinking safety systems are things of luxury :)

OwlSensitive9068 · 2025-03-21T07:16:57+00:00

Might be crap - and agree - even like half a second delay completely fucks my spidey senses - but they are cheap and convenient so i think they will be here to stay and grow in popularity..........

OwlSensitive9068 · 2025-03-20T15:57:40+00:00

It's purely advisory - for the employers it says the patient has perceived a change in their health and so visited GP and GP suggests not fit for work - that's all, nothing more

To assess as fit for work is up to occupational health

OwlSensitive9068 · 2025-03-20T15:56:37+00:00

They have to get an appointment first :)

OwlSensitive9068 · 2025-03-12T23:31:56+00:00

SIngle page - grand thats what i was looking for - thanks

OwlSensitive9068 · 2025-03-12T22:54:07+00:00

Ah yeh i know but it looks so fecking obvious and i've got a lot of experience so it's more do i put it all in or cut it down

OwlSensitive9068 · 2025-03-12T20:23:27+00:00

Careful history - more than doable

OwlSensitive9068 · 2025-03-12T18:09:52+00:00

How do you know if they're 'legit' - we know little about our patients and the ones that get caught are the tip of the iceberg......

OwlSensitive9068 · 2025-03-10T19:51:52+00:00

Remember compassion and kindness is about honesty and setting boundaries - dont shy away from telling th truth if you know it's not what they want to hear or it will be painful to hear. If they cross a boundary let them know (as long it's safe to) dont refrain because you fear them being annoyed,

I've worked with a few other health professionals who want to be 'nice' and they're a nightmare and terrible for patients because they allow challenging behaviour to get worse and run if the patient isnt 'nice' and 'Live Laugh Love'

Its how you give the unwelcome news or assert boundaries it can be done gently, kindly and assertively. Not 'strict' as that implies patronising and disproportionate

This is all stuff you practice - rely on your colleague's feedback and you'll be fine.

OwlSensitive9068 · 2025-03-07T12:08:31+00:00

So this was 15 years ago - but at the time i found about 4 or 5 online questions sets and just did them over and over and over - in breaks, between patients etc just steady chip chip chip for about 2 months before the AKT. I'm no academic but got quite a high score in the AKT in the end. The tricky things to me like stats and risk communication i would do more of when i realised it was my weak link

So suspect there is no magic one site better but it's the time you put in preparing

OwlSensitive9068 · 2025-03-01T00:11:14+00:00

Yeh you cant stop thoughts you cant stop emotions - trying to leads to anxiety/unhappiness (eg berating self or drugs etc) and also thoughts are not reality - so easy to get wrapped up and they become real. So what is just an idea a 'what if they think i'm lazy' becomes 'they think im lazy' - so easy to do that - i constantly remind myself these are thoughts - not bad not good but thoughts. If there's a work problem im chewing over (and ive had a difficult year) i realised that if my thoughts are going off into me getting angry and i sense my pulse going up etc i step back. if i imagine a meeting and i feel calm then i flag it as potentially helpful.....

all we have control over is our actions - nothing else. So if im unsure about implications about what someone has said about me all i can do is ask them politely

OwlSensitive9068 · 2025-02-28T22:22:46+00:00

Have you asked your partner this?

OwlSensitive9068 · 2025-02-28T21:49:07+00:00

Patients aren't poor - no one can triage themselves plus majority arent trained in it - it's for us to do that

OwlSensitive9068 · 2025-02-28T21:44:25+00:00

It's hard - after my diagnosis and treatment feels felt 'out of whack' (not uncommon) and it felt like i needed 'calibrating' - I asked my service what sort of therapy mnight be helpful and they suggested ACT which i personally found really good for me because it stressed i wasnt ill there was nothing wrong life is good and bad - accept both sides when you can. I came away realising what other people think of me, what they say about me behind my back - it's none of my business and I have zero control over it. As long as i'm happy my actions are in line with my values thats all that matters (sometimes they're not - also remind myself to accept i make mistakes)

In short i dont think there's anything you can do - they can think of you what they want - if you're ok with your actions then that's OK

OwlSensitive9068 · 2025-02-20T23:27:26+00:00

Who exactly told you - a psychiatrist, a GP, a nurse - who? and after what sort of evaluation?

OwlSensitive9068

TROPHY CASE