We have recently had a consultation exercise with the patients in our practice. Their main concerns are that they don't like children jumping up and down on the waiting-room chairs, and they are frightened of the practice nurse as she grinds her teeth when she is taking blood samples. What should we do?

'Michael', Bangor Of course your patients don't like the little tykes jumping up and down. Who would? You must provide other activities to take their minds off waiting (this will stand them in good stead for the future). Try leaving suitable reading matter around the waiting room (no, silly, not the NHS plan. It's a bit rich for their young palates). There are some wonderful little booklets available to keep the kiddies quiet. My favourite is Harry Potter and the Crock of Shite (IHM, 1999), or maybe American Psycho if you want to let them into the realities of mental health in a delicate fashion.

As to your nurse grinding her teeth. . . this is a new one on me.

Are her teeth particularly sharp or prominent? Perhaps she spent some time as a dental nurse in the past (you know - all white smocks, Listerine and old copies of Hello! ). Now, on the assumption that she was a DN, make it clear all your doctors are happily married and there is absolutely no chance of finding a husband. She'll soon be off.

One of our doctors recently tried to use the new direct booking system for clinic appointments. He seems to have got on to the wrong system and ended up booking a return flight to Venezuela.

The tickets arrived in today's post. Nobody has the heart to tell him. Advice, please.

'Jackson', Littlehampton

Well it's better than another doctor I know who tried to get the British National Formulary online and was sent some special anatomical studies in the mail. What's wrong with Venezuela? Give him the tickets and tell him he won the recent 'Tell Us Your Opinion and Win A Prize' promotion which was one of that nice Mr Milburn's better ideas (or perhaps I should say 'even better'). The best way round this is to give the patient a letter and tell them to go to the hospital to make an appointment themselves. This is much more personal and patient-centred.

Why not let Mel help solve your problem?

E-mail her, in the strickest confidence, at: Mdestrange@ healthcare.emap.co.uk