Today wasn’t so much about fire fighting.  It was like wrestling a fire-breathing 40ft dragon to the ground while juggling four broken printers in the air.

Another Monday in general practice.

I drive in, I try to dig out the optimism that is at the bottom of my my new calf-length brown Boden boots.  I edge through towards the car park and briefly close my eyes before I count how many GP cars are in the car park.  My heart sinks as I see four rather than five.  The Audi is missing.   It’s Monday.  We’re one GP down.  I spot the queue of patients seeping through the doors.  For a second I think of reversing, the whole ten miles back to my flat.

Before I get chance, Mrs Gertrude spots me and begins fiercely waving, waving her fists.  She won’t move from the queue for fear of losing her place thankfully.  I pretend not to see her.  Park up.  Sneak in through the back door.

It’s suddenly apparent that today’s problems aren’t going to just revolve around the GP that is off sick with yet more issues with his toes.  The nurse is walking around bravely with pink eyes and skin the colour of a ripe beetroot.  I try to gently convince her that it’s probably just a cold and she should be ok.  Then the sweat drops from her forehead on to her keyboard and she looks more ill than any patient in the waiting room. I know I have to send her home.

I peek out at the growing angry patients and cowardly dial the receptionist number to ask them to tell the waiting patients all their appointments have been cancelled.  I gently drop the catch on the door and turn radio 2 on to drown out the shouting.

After twenty minutes or so it seems safe to come out and I creep to the kitchen for my green tea fix.  I only just manage get the kettle on and she comes in, she’s fiddling a lot and I ask about her weekend.  I like her and we chat a bit.  She hardly makes eye contact and then drops in conversation that she’s 4 months pregnant.  I’m pleased for her but I also want to scream NOOOOO!!! You’re my best nurse.  You can’t be pregnant.  Please don’t make me have to recruit again.  Please don’t make me. Please.  What I actually say is ‘congratulations, how lovely’.

I walk depressingly down the corridor and then see him, he’s wearing odd socks again, he’s in a better mood today though as he doesn’t swear that much when I ask how he is this morning.  He mumbles something about his wife and his credit card as he calls his first patient in.

I enter the admin room with the usual trepidation.  At first things seem calm.  It’s 8.34am and the Quality Streets are already being shared out.  I cheerfully say hello and as usual ask how their weekend has been.  As usual I get barely more than a nod or a look.  I think I’ve got away with it but then she swings around on her chair and points at the calendar and grunts.  I’m not entirely sure what the grunt means but it seems to be making her angry.  After much more grunting it seems that I’ve made a mistake on the rota.  She doesn’t work until 4.30pm on a Friday, she works until 4pm.  I apologise profusely for this gross error.

How I make mistakes while I’m trying to juggle managing 10,000 patients, QOF, clinical governance, personnel, complaints, health board visits and a dodgy clinical system I just don’t know.  I keep this to myself of course.  I smile again and encourage her to eat some more Quality Streets and offer to make her usual coffee with 6 sweeteners in the hope this calms her down.

The health care assistant catches me on my way to the kitchen, she’s very agitated.  Her son has been in trouble at school, he has thrown a custard cream at his teacher and she needs to go home right now.

Three staff down, it’s only 8.45am.

I take my coat off and gently push the dragon into the cupboard for the time being as I make a call which will get me nowhere, yet I make it anyway.  Hi, are you available to locum today?

I move the receiver away as the laughing is so loud it hurts my ear.

I say thank you.  Put the phone down.  Open the drawer to the haribos and munch on a gummy bear.

9hrs 42 minutes to go.

Good morning general practice!

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