Blood Donors

[PanBiker]

Text from NHSBT to say my last donation after processing was passed to Leighton Hospital in Crewe.

[Stanley]

Thanks Ian.....

[PanBiker]

Having had to cancel my appointment today due to a minor injury. I have looked to book another appointment but it's looking like it's going to be in the New Year.

[PanBiker]

Had an appeal email for my blood group A Positive which is the second most common group so always in demand. I have booked at West Bradford, (Grindleton Road) for the 5th February.

[Stanley]

But what a good job you have a car.......

[PanBiker]

Indeed, I would be restricted to two sites, Colne and Skipton on bus routes if not. The service is suffering from Shadow Factory syndrome. Barlick is so far in the backwater that its too far away from the two donor teams that serve our part of our the North, based in Leeds and Manchester.

Having said that, its the lack of staff for the donor service really. Lack of coverage in Barlick was always a given, first under Leeds and then passed to the Lancashire team. St Josephs when I started donating and then Rolls Leisure Ballroom. It all went belly up with the break for Covid. Both venues are still available and still meet the requirements if they ever come back. The sessions used to cover about 20,000 people. Many of the 4% in Barlick and Earby can't donate now.

[Stanley]

Indeed Ian.
One more example of what happens when you starve a social service of funding in the name of financial probity! It's a disgrace. we build high speed rail lines that failed, financed nuclear defence systems we can't use and built aircraft carriers that can't be manned or equipped. Bloody brilliant!

[PanBiker]

I received a hydration reminder text this morning for my donation appointment this afternoon. I have not received my appointment letter and medical screening questionnaire for this session. I went down to the sorting office this morning to check if they were holding on to it. We had mail but none from NHSBT. I will have to rock up at bit earlier at West Bradford Village Hall as I will have to do all the paperwork before my donation. Time for a glass of water.

[Stanley]

So a failing postal service allies with funding cuts to make it as awkward as possible to give blood. Shocking.....
If it wasn't for persistent buggers like you Ian they would be in trouble.

[PanBiker]

I learnt something from Leslie, the nurse that sorted me yesterday. Apparently before the year 2000, only doctors were allowed to cannulate donors. Consequently there was a higher incidence of failed donations or brusing incidents. Doctors of course normally delegate such tasks to the nurses in general practice so they are not particularly skilled in that regard. From 2000 onwards nursing staff were specifically trained for the job and they of course with NHSBT do dozens of procedures everyday so are pretty good at getting it right.
That woulld explain my first donation at St Josephs a long time ago. It failed as the doc managed to go straight through the vein, my session was terminated before it started and I ended up with a bruise from hell, halfway from wrist to crook and the same distance in the upper arm!

When plastering me up at the end of the donation she also did something that no other has done. She turned a corner down a bit on the first square plaster and then also created tabs on the two cross plasters that hold the compression pad down. Made removal of both dressings a lot easier.

[Stanley]

That's prime source evidence Ian. Very valuable in my book!

[PanBiker]

When I think back 26 years or so to when I first started donating, the advancement of the tech and operating practices at sessions has changed enormously.

Flat trolley beds were the order of the day then. After donation, (if the doc got the cannulation right) you were first sat up from the horizontal and then you swung your legs over the side of the trolley and applied compression to the crook of your donation arm after the cannula was removed. Plasters administered and you were sent for your tea and biscuits when the nurse thought you were OK. I never had a problem but there was a much higher incidence of light headedness or feeling faint in which case those donors were despatched to a different area to recover. Hot drinks were made for you and you had the choice of a multitude of different biscuits and snacks.

I cant remember if the hydration regime or the rotating chairs came first. I think it was pre donation hydration. On entry and registration at the desk you are given the safety and donation procedure stuff to read and encouraged to drink a about a litre of water while you wait to be called to triage. This simple change reduced the incidence of fainting or light headedness by about 60%. I think the pre donation haemoglobin level check and banter changed slightly as well. The nurse would ask if you had eaten and drunk during the day before you attended and if you felt well before you signed off your agreement on the questionnaire. Attendant nurses were in charge of cannulation by that stage so an improvement again in the efficiency of the procedure. Depending on staff levels you usually kept the same nurse throughout the procedure. Another change at that time was the ability to book your next appointment which you could do at the tea and biscuits recovery station. Laptops were in use for booking in to the sessions and new appointments.

I think a whole load of changes arrived at the same time as technology improved. Invitation letters now had bar codes so portable hand held terminals came into use for all the staff. You documentation was scanned into the system and all the hand held terminals were updated automatically with your appointment time and the fact that you had arrived and were available to donate. Big game changer was the upgrade from flat trolley beds to 3 position rotating chairs. Armrests can be changed from left to right on the chairs. As you are supported better in the chairs the reading matter given once in the chair while the nurse prepared your donation pack now included suggested exercises you could do to help circulation during the process. Another minor thing, timers introduced for arm cleaning, (1 minute + drying time). The agitator collection stations now had indicator chimes to signal flow interruption and completion of donation. Chairs are rotated to not quite horizontal for the donation. At completion you are rotated halfway back to the normal upright and the timer deployed again after the cannula is removed for 2 minutes as you have 3 finger compression on the crook of your arm. Two plasters now used, one square one and then a short round compression pad is taped on top. Chair rotated back to vertical and after checking by the nurse you are discharged to the biscuits. No hot drinks now, various juices and more water are available but still the full compliment of snacks.

I think the change from tea production to cold liquids came just before the pandemic. You could no longer book your next appointment, you have to do that yourself now either online, via the NHSBT Donor App available for mobiles or by telephone. This change released a member of staff for other duties as the person on reception keeps their eye on the donors during recovery. Donor sessions did resume during the pandemic and all cleaning precautions were taken, hand wash gel, mandatory masks for everyone and no water station for pre session or the recovery station you had to take your own hydration of choice in your own receptacle. Cold water and the juice selection has bee reintroduced post pandemic. The incidence of fainting has reduced enormously and most sessions have a single chair available behind the reception table again attended to by whoever is on duty at reception for anyone who needs a bit more time.

I have no doubt that underfunding of the service and staffing issues will have encouraged the introduction of a multitasking model. Session staff rotate jobs all the time. One constant that has always been present is the dark blue nurse who is in overall charge of the session. Invoked during triage if you have to tick a yes box on the medical questionnaire. This leads to a deeper conversation which determines whether you can donate or not. They are rensposible for overall care and safety of all the donors and staff during the session.

[PanBiker]

My latest donation has gone to Royal Lancaster Infirmary. It's journey is shown here on the notification I received this morning:

Blood Donation Journey



Just booked my next session at Victoria Hall Keighley, 20th May 2.30pm. Will send some Yorkshire way with this one.

[Stanley]

[PanBiker]

Just received an email from NHSBT regarding changes to the appointment system. Donors normally get an appointment reminder letter about a week before the booked date, this also includes the medical screening questionnaire. To save money, they have done a trial and have decided to stop sending the appointment letters in favour of reminders via text or email, probably both. That should save a bob or two and the only difference for the donor will be that you will have to fill the form in when you arrive at your session. When you are scooped up to your medical review session prior to your donation there is a requirement on the form for you to sign, twice, once that your answers are truthful and once you are past the haemoglobin test stage to agree to the donation procedure.

This will save thousands of sheets of A4 sent out every day. You don't need the appointment letter as once confirmed when you book you are already tagged electronically as a donor for that particular session and are booked in at the reception desk when you arrive.

[Stanley]

The only problem I can see with that improvement Ian is that when communications are text based they tend to increase in number. The Post Office parcels delivery system is a good example. The delivery of a parcel the other day involved five text messages and now I will get text requests to ask me to rate their performance.
It's almost as though they equate activity with action.

[PanBiker]

I'll find out around the first week in May and report back.

Actually, come to think of it, I have been receiving text reminders of appointments from NHSBT for quite a while now. My last donation a case in point. Booked late, in answer to an urgent appeal for my blood group. Too late to get a letter. No great shakes, the medical questionnaire is a tick box job and five minutes at most if you do it right.

[Stanley]