Saturday, March 12, 2011

Daphne the Difficult Customer

The student doctors I work with sometimes want to practise dealing with "a difficult patient". Now then: I maintain that there's really no such thing. The patient they describe as "difficult" wasn't born that way. Something has happened that has made them angry or upset, or both.

Usually when people start being "difficult" in hospital it's because they are worried, or frightened. When my mother broke her shoulder last winter she was very "difficult" indeed in Swansea Hospital because she has a hospital phobia and was in deep shock. The staff all ignored her constant attempts to run for the exit and left me to deal with her and bring her back.

At this point, I too became "difficult" and enquired loudly, in the form of an announcement to the whole waiting room, if it was hospital policy to leave distressed patients entirely to the care of their relatives, and to ignore an elderly lady with a broken shoulder who was in deep shock?

This provoked the staff into action, and they began taking it all more seriously. Presumably, up to that point, they thought that my mother sitting there with a newspaper covering her head (she didn't like the flourescent lights) and from time to time making a break for freedom was some enjoyable game being played out for her own selfish pleasure.

However, I must say, thinking about it, that when healthcare professionals do need to practise their ways of dealing with someone who is distressed or angry and hence who is "difficult" to deal with, I am often called into service to play this role.

There's a reason for this. I don't shout, or punch people. I am always polite. I just know how to be really, really impossible, and how to push all their buttons so they want to punch me. One thing is, I am never, ever at a loss for words (yes, I can hear those who know me sighing at the deep truth of this) and in verbal combat I am extremely fast, with more than a touch of Patronising Cow.

And so we come to Sainsbury's this morning.

I wanted to buy some Lemsip, some Sudafed (decongestant), some paracetamol and some ibuprofen. My illness over the past week and a half has sadly depleted all our stocks and Stephen has a painful arm which only really responds to ibuprofen.

I arrived at the checkout with all these little packets, and the young assistant called the supervisor.

"You can only buy two of those," said the supervisor sternly. "Company policy".

"There was nothing on the shelves to say that," I said sweetly. "I did check."

"Yes, well you can only buy two," she said. "Company policy."

"I am a grown-up," I said politely. "My father was a pharmacist. I know about the dangers of overdosing on paracetamol."

"Yes, but you can only buy two," she said. "Company policy."

"Do you know what happens if you take a paracetamol overdose?" I asked.

"Err - - no - - errr - - " she said.

"You wake up after they've pumped your stomach, and you feel a lot better, and you regret taking the overdose, and you're glad they saved you. And then three or four days later you die a hideous death from liver failure. So it wouldn't be my suicide method of choice."

"Yes, but you can only buy two," she said. "Company - "

"Policy." I added. "Yes, you said. But in these two packets is plenty enough to kill me. So you're happy to sell me enough to kill me, but just not happy to sell me as much as I want, is that right?"


"And oh look! There are lots of cigarettes over there and you'd sell me the lot if I wanted. So clearly Sainsburys are happy to sell me things that will kill me, as long as I do it slowly."


"And you'd sell me a whole big bottle of whisky, wouldn't you? Or a whole big bottle of bleach?"


"And, furthermore, I could just go and put all my shopping in the car and come straight back in and buy two more packets, couldn't I? So the whole policy is totally ridiculous and I would have a large bet that it hasn't prevented one suicide: it's just the company covering its back, isn't it?"

She turned swiftly, and left, because she was about to hit me.

Now then, I never expected to win this argument - I'd just gone straight into roleplay mode: I simply couldn't resist it.

However, if that had been a communication skills training session - and that woman needed some training, believe me! - then I would have suggested in some feedback afterwards that she firstly apologise to the customer - because it's very hard to keep ranting at someone who's just apologised to you - and secondly explain that yes, this policy didn't seem applicable to me but unfortunately it was out of her hands. Thirdly that if I wished to complain this is the address to complain to, and fourthly that she would ensure that the shelves would be correctly labelled from now on. And, fifthly, if there IS any evidence that such a policy has ever prevented suicide, she should both know it and direct me to it: certainly she should have explained WHY it was company policy.

I called in at the local pharmacist on the way home to buy the remaining tablets.

"Are you on any other medication?" asked the young assistant.

"No," I lied, firmly and clearly, because otherwise she'd have gone off for a twenty-minute discussion with the pharmacist as to whether I could buy them or not.

I am a-weary of the Nanny State. I wish that we could be expected to take more responsibility for ourselves, and to take the consequences if we don't.


Anonymous Anonymous said...

Hear, hear, Daphne!

4:17 pm  
Blogger Jennytc said...

You have my deep sympathy, Daphne. I knew what was coming next as soon as I read the list of things you wanted to buy. As for apologising, have you noticed that no-one in the so-called 'service'industry ever, ever apologises for anything these days? Grrrr!

6:02 pm  
Blogger Ailbhe said...

That's really irritating. And it can't be company policy, because I've always been allowed once I've explained that there are four - or five - of us sick at home, and I won't be taking it all myself. Unless that's not company policy either. Your Sainsburys or mine is not upholding policy!

11:17 pm  
Blogger mutikonka said...

In Australia they are very strict about sales of Sudafed because it is often 'diverted' to make amphetamine. There are organised gangs who used to visit every pharmacy in one area and buy five packs from each, enough to convert in a backyard lab into a few thousand dollars worth of speed. That's why they brought in a one pack per customer rule and shrank the pack size to five tablets. As you have shown, the problem with 'blanket' policies is that they are left to be implemented by casual staff on minimal wages and with minimal commonsense.

3:44 am  
Blogger Unknown said...

As far as I have been able to find out, it is the law, rather than company policy. Anyone exempt from payment, or with a prepayment certificate, could find it worth asking for a prescription for them.

10:56 am  
Anonymous Helen said...

I was about to say what Dfo has said - I think it is the law. In fact, when I've queried it in the past (with much the same exasperation as you!!) it turned out the supermarket checkout system won't even allow the person to scan those items.

And, much as I agree with you about the dreaded nanny state in general, I've discovered that the statistics in this case are that it has saved many lives. Suicide is usually impulsive and overdoses tend to involve whatever is lying around the house - this law ensures it is always small quantities. The act of going to several shops to purchase paracetamol, interacting with the outside world, can give a suicidal person a moment's thought and prevent them going through. For various reasons this is something close to my heart and these days I'm quite prepared to put up with the inconvenience.

Perhaps you should offer simulated shopper training to supermarkets so they can deal with this better though!!! For one - explaining that it is the law rather than policy would probably have drawn the argument to a more equitable conclusion!

2:07 pm  
Anonymous Jay at The Depp Effect said...

Oh, tell me about it! It is a favourite (and well-justified) rant of OH's, this 'youcanonlybuytwoofthose' hypocrisy.

I've been in the same situation. You go to buy a couple of things for yourself and a couple for your other half and you get stonewalled. In fact the last time it happened I was shopping with OH, so I just handed him two of the packets and told him to go and queue at the next checkout, and there was not. a. single. thing they could do about it.

And if that doesn't show the whole damn shooting-match up for the farce that it is, I don't know what does.

2:56 pm  
Anonymous jay said...

Oh yeah, and I get the 'drug factory' thing, I really do.

But we have so far failed to make a single worthwhile dent in the drug industry by all this criminalising legislation (at the same time treating addicts like the victims that they are), so why are we all still being punished for the sins of the few?

2:58 pm  
Anonymous mumof4 said...

oing back to UK we always used to stock up on Lemsip capsules and got bolocked often for buying too many at once. A quick shour from girl on til to pharmasist and the pharmasist would look up, see if you looked 'dodgy' and then say OK. Used to make us think it was a ridiculous system.

Over here in USA i have to have my drivers' license swiped every time I buy cough medicine. Probably in case I am going to do anything illegal with it....

8:52 pm  
Blogger Jan Blawat said...

Thank you for the sample script. I am more like your mother, but I will study to be a more effective difficult patient. Usually the nurses and pharmacists are fine, it's the arrogant doctors I grate on.

9:06 pm  
Blogger Kim said...

I know this is a bit late.
Just wanted to let you know that I apologised to a woman several times and she still carried on shouting at me.
Made me cry :(

2:44 pm  

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