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Dinah's Diary

Dinah can't stand the throwaway culture but her autoclave is proving a challenge

Dinah can't stand the throwaway culture but her autoclave is proving a challenge

Monday
Meeting with nurse and practice manager on surgical instrument audit. How many do we use, should we buy disposable or use CSSD? Nurse asks if PCT is going to reimburse us for the autoclave that we'll no longer use. Snort with laughter. No, we have to bin it or find another use, probably making steam puddings.

I can't stand waste and hate the throwaway culture. Especially as we haven't had a single wound infection in all our years of minor surgery – seems like huge expense for little gain. Grumble extensively (then notice nurse and manager have both quietly left to discuss it next door). Buzz for coffee and turn to patients instead.

First patient panicking – he woke in the night and realised his wife wasn't snoring. Concerned, he woke her to see if she was okay. After being angrily assured that she snores just as loudly as ever, the truth hit home – he's gone deaf. Suck out lovely lump of wax and recommend ear plugs; at great expense, however – that nice little suction tip has to go now. (Can you get CJD from ear wax? How would anyone know?)

Tuesday
PBC meeting. Infection control comes up – apparently we were hoping for group deal on bulk usage but CSSD don't do discounts.

Privately reflect it sounds like a business opportunity but we'd probably be more successful selling second-hand autoclaves on eBay. They have all sorts of uses and not just cookery: what about veterinary practices? Wake up in middle of a heated discussion about prescribing budgets so decide not to mention business idea just yet.

Friday
Surgery. Patient hobbles in who often comes with his various chronic diseases. I thought he was having a foot operation – what happened? Turns out he was admitted, pre-medded, gowned up, lay in bed all day, then at 5 o'clock the staff said: 'Sorry, you'll have to go home.'

When they were getting theatre ready they dropped the instruments on the floor and they didn't have any more clean ones. So that was it. Crazy – why couldn't they get any more from CSSD, or even the next hospital down the road? The poor fellow hobbles back out again, not knowing when he will be called for another day's rest at the local hospital. Flash of inspiration – phone hospital, do they want my old steriliser? No. Okay.Used autoclave, anyone? One careful owner, offers invited.
Dr Dinah Roy is a GP in Spennymoor and chair of Sedgefield PBC group

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