It was not a particularly busy shift. The patients were not any more sick than other evenings I have worked. I may have been a little more tired than normal, but I don't think I was anymore distracted.
However, as I walked out of the consulting room, I realised I hadn't #hellomynameis.
I'm pretty thorough by nature. I have always felt my communication skills were at least ok and I certainly think I've gone out of my way to introduce myself to patients since being a junior doctor.
I actually felt everyone else did as well. But it wasn't until Dr Kate Granger's #hellomynameis campaign really took off earlier this year that I realised that this simple everyday practice might not actually be common practice.
It's interesting what is perceived as common practice or 'assumed' to be normal. You would think that most health systems or people working in the caring professions would deliver, at the very minimum, a style of care that at least doesn't harm people. But we know from some tragic events that this is not always the case.
We also know, from the variation between healthcare outcomes (the Atlas of Variation in care in children being one example), that there must be pretty huge differences in the way things are done from one healthcare institution to another.
It always upset me - and the term upset is correct - when I was a trainee representative for the Royal College of Paediatrics in Child Health and the Association of Medical Royal Colleges and a senior medical leader or educator made a pronouncement on what trainees must be able to do. "It's ridiculous trainees can't get their Work Based Assessment signed off by consultants. At my hospital there is always a consultant available".
Yes - at your hospital perhaps. Your world and training environment is very different from others.
And so I raised a wry smile when I saw a tweet related to the forthcoming NHS Change Day, which read:
"Appreciate NHS pledge day work but some of them are bemusing...raises the qs why it needs a pledge to do something you ought to do anyway ;)"
I've never met the author but from a glance at his impressive background he sounds like a pretty awesome bloke, who clearly has a great vision and passion for health care.
It's worth following the chain this tweet produced.
I make no secret of my support for NHS Change Day, and I'm happy to accept and defend criticism about it. "What's the point?" was one response. "You had 3,500 people pledge to smile last year. Don't they do that anyway?" was another.
For the answer to the latter, we healthcare professionals should reflect on when was the last time we spent an entire shift in public view and at no point looked like we weren't upset, annoyed, bored or frustrated. How do we think our patients felt when they saw us looking like that?
Yes, someone has pledged for Change Day that they want to keep patients safe. And yes, this is a fundamental part of a healthcare professional's role. But, unfortunately, sometimes the healthcare service doesn't always keep patients safe.
By the same token, it's fairly obvious that you should always introduce yourself properly at the beginning of every consultation. But, unfortunately, even someone like me, who has been supporting #hellomynameis passionately, can fall short.
In some ways it is a shame it is 'change' and it is 'day' - because it's not always about 'change' and hopefully it's not about one 'day'.
But if you can find a better mechanism for bringing the NHS together to say "look, lets just think about this" then please let me know.
Because until I find one I will continue to support Change Day and people pledging what they feel is important to them - however obvious that might seem to you.Suggest a correction