Copperfield ponders the similarities between community nurses and East German secret policemen
There’s an old joke that ran something along the lines of, ‘Why do East German secret policemen always go around in threes?’
‘One who can read, one who can write and one to keep an eye on the two intellectuals.’
And what reminded me of that? Another form to fill in courtesy of the district nursing team – entitled ‘Authority to Administer’.
Time for a little role play. You (playing the part of ‘Community Nurse’) visit patient (playing the part of ‘Helpless Victim’). Scene – the patient’s sitting room. Evening.
‘Can I have my tablets please?’
‘No.’ (I know that every fibre in your being is urging you to say, ‘Yes, of course’ but remember who you’re role playing….)
‘Oh. Well, can I at least have the painkillers?’
‘No.’ (I’ll bet you’re finding this difficult….)
‘Because I do not have a signed “Authority to Administer” from your GP.’
‘But I had a prescription, issued by my consultant at St Elsewhere’s by the TV Mast in London. I took it to my GP and he issued a prescription for the medicines my consultant said I had to take. I took it to the pharmacist, who gave me the tablets I need and stuck this helpful label on the outside of the box… “Take one every twelve hours. Do not take at the same time as indigestion remedies. It is dangerous to exceed the recommended dose.” What else do you need? Give me my tablets.’
‘I need your GP to fax a signed “Authority to Administer” to my team leader’s office in the morning. Then I can give you your painkiller tomorrow evening.’
‘So why can’t you just give me the box of tablets so I can take one for myself tonight and another tomorrow morning, like it says on the label?’
‘Because you aren’t considered able to manage your own medication. That’s why I’m here, to manage it for you. It’s part of my extended nursing role.’ ( Are you getting that feeling of power that depriving a patient of his medication brings?)
‘But you can’t manage it anyway.’
‘Yes I can, but not until I get a signed “Authority to Administer” from your GP.’ (Keep it up, you’re playing the part beautifully…)
‘But my prescription was written by my consultant, double-checked by my GP and then triple-checked by the pharmacist. What makes you think there might be anything wrong with it?’
‘I don’t know about that. All I know is that I need a signed “Authority to Administer” from your GP.’ (Go on, don’t waver… stick to your guns. It’s only a painkiller…)
To be honest, I’ve not been able to think of a punchline to that scene.
The usual fiver to anyone who can explain to me why a fully trained nurse appears to be unable to remove a tablet from a box bearing a perfectly straightforward dosage label and hand it over – although not with any water, obviously, she might spill that on the carpet resulting in a health and safety crisis….
‘Sick Notes’ by Dr Tony Copperfield is out now, available from Monday Books.
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