My experience of A&E

Manxman_in_exile

tacpot12 wrote: »

The triage nurse did appreciate this the day before and told you wait in A&E. Had you waited you would have seen a Doctor and should have been admitted to Hospital immediately. I'm not a doctor or a nurse, and I don't know about running an A&E department but I expect that the nurse is not allowed to admit you.

You took the risk of leaving A&E when you were clearly very ill. No one else is at fault here - apart from some other NHS manager that doesn't care about signage. I'm glad you feel better now that you have shared your experience with others, but the fault is your own.

I understand your points. However, my wife and I are not stupid people and after a long discussion between us we decided I was probably at more risk remaining in the "Emergency Department" rather than going home and seeing my GP the following day. At the time we made that decision it looked as if I would be waiting for at least up to another hour, and longer if "more urgent" cases came in or if there was a 'bus crash involving nuns and kittens!


As other posters have suggested, our main fault was in going to A&E (as advised) in the first place, rather than seeing my GP. Also, on reflection, my problem was a medical one, not an accident although it was an emergency.


We weren't expecting the triage nurse to admit me - we were expecting him to get me to a doctor more urgently. I certainly couldn't have waited 24 hours in A&E.


I think my main complaint is about the inadequate signage and the asinine process for getting into A&E in the first place. How can one nurse book people in AND carry out triage assessments? No wonder a backlog built up. I was an NHS manager for 25 years, and as I posted above, you couldn't devise a more stupid process if you deliberately tried to do so.


Anyway, thanks for your input.

Manxman_in_exile

Hermia wrote: »

A lot of the out-of-hours clinics I have been to have been held in the local hospital. The NHS really need to be promoting these better as I am sure it will reduce the number of people going to A&E.

Pharmacists are great and people don't use them enough. The local pharmacist now does the medication review appointments at my GP surgery. I really like this as he seems a bit less out-of-touch than the GP and a lot more approachable.

You are absolutely correct.

iammumtoone

I think your vent about the booking in procedure is valid. However the rest I am sorry I disagree.


You chose to leave against the advise given. Its quite possible the nurse suspected you would be admitted that night but it wasn't her decision you had to wait to see a doctor to make that decision. You weren't an urgent case as your were already at the hospital, if your condition deteriorated while you waited you would have been bumped up the list and seen sooner, as it turned out you were 'well' enough to wait as you managed in that state until the next afternoon.


You were admitted straight to the hospital missing the emergency department as a senior doctor had diagnosed that is what needed to happen, it you had waited then the same would have happened at the emergency department once you had seen a doctor, the nurse was not qualified to make that call.

Manxman_in_exile

Funnily enough, my wife said in the first place I should have seen my GP rather than go to A&E. But I'm a fairly compliant and "by the rules" sort of person, so having been advised to go to A&E that's what we did.


On the way home, wife: "Told you to see your GP!. We should never have come here!"

greenbee

The problem is a massive shortage of staff in A&E. Very few people want to work there, and with the overall staffing shortages in the NHS most medical staff have the option of going elsewhere.

I’ve heard from a number of medical friends in various disciplines that even when they have enough doctors for their clinics they are often short of rooms, nurses or even admin staff to keep clinics running to time.

Manxman_in_exile

iammumtoone wrote: »

I think your vent about the booking in procedure is valid. However the rest I am sorry I disagree.


You chose to leave against the advise given. Its quite possible the nurse suspected you would be admitted that night but it wasn't her decision you had to wait to see a doctor to make that decision. You weren't an urgent case as your were already at the hospital, if your condition deteriorated while you waited you would have been bumped up the list and seen sooner, as it turned out you were 'well' enough to wait as you managed in that state until the next afternoon.


You were admitted straight to the hospital missing the emergency department as a senior doctor had diagnosed that is what needed to happen, it you had waited then the same would have happened at the emergency department once you had seen a doctor, the nurse was not qualified to make that call.

Again I understand your points, but who is to say how long I would have been waiting to see a doctor? 24 hours like an earlier poster? My wife and I basically carried out a risk assessment and decided it was more risky to stay there than to go home and see my GP next day.


Yes - I could have stayed there and perhaps collapsed and become a higher priority, but that says to me the triage nurse could not have been doing their job properly. The following day when I was being examined by the admitting doctor she asked me to get off the examination table and I actually collapsed to my knees. Fortunately she was close enough to catch me before I hit the floor and she and my wife managed to manhandle me back onto the table.


I wasn't expecting the triage nurse to admit me to hospital - I was expecting him to get me to a doctor.


As a very contented and happy NHS manager for 25 years I'm a great protector of, and advocate for, the NHS. Perhaps I've been lucky but this is the only time I've been unhappy with an interaction with the NHS. I can assure you I would not be complaining without good reason - I understand the problems the NHS faces.


The care I received as an inpatient could not have been improved on. And I have sent the staff who looked after me a letter of thanks. Also, when I've attended other Outpatient clinics I've had no complaints whatsoever.


I appreciate that A&E has particular problems, but this dept is not fit for purpose (in my opinion - maybe I was just unlucky and it was a bad day). I don't understand why it's so poor compared to the rest of the hospital.


But thanks anyway.

Manxman_in_exile

greenbee wrote: »

The problem is a massive shortage of staff in A&E. Very few people want to work there, and with the overall staffing shortages in the NHS most medical staff have the option of going elsewhere.

I’ve heard from a number of medical friends in various disciplines that even when they have enough doctors for their clinics they are often short of rooms, nurses or even admin staff to keep clinics running to time.

I think this is correct. As I posted earlier I frequently have to attend the Eye Casualty Clinic with iritis/uveitis (which is treated as a medical emergency requiring urgent treatment). It is amazingly well staffed with doctors and specialist practitioner nurses who really know their job. But the Lead Consultant in the clinic is by all accounts one of the best in the country at this specialty so maybe that's why it's run so well. During our lengthy wait in A&E I saw only one nurse and no one wearing a stethoscope.


Ironically, my last role in the NHS was as a Workforce Planning & Information manager!

peachyprice

Manxman_in_exile wrote: »

That's interesting - thanks. I've been telling people to avoid A&E except as an absolutely last resort. I've told them that, if they can wait, to try to get a GP appointment. Fortunately for me, our surgery is just 2 minutes walk away and they can almost always give you an appointment on the day. They also don't try to get you out as soon as possible. On the day I was admitted my GP consultation took over 45 minutes.

Well, yes, this is what people should do, unfortunately 'A&E' is full of people who have neither an accident nor an emergency and are simply trying to jump the GP queue. Look around at the vast majority of people waiting have ailments that could have been treated by a GP or pharmacy. Until A&E start turning people away who don't need to be there, which they're too scared to do in case they get sued, nothing will change. People will continue to abuse A&E while genuine emergencies suffer.

unforeseen

During our lengthy wait in A&E I saw only one nurse and no one wearing a stethoscope.

Maybe they were all busy in Majors or Resus? Whose to say? You will never have enough staff to cover everything. That is where triage and prioritisation come into play.

Congratulations on such a short stay in A&E. My last trip there under blue light had me spend 7 hours there for suspected heart problems. It was only 7 hours because I refused to wait a further 2 hours for a further test.

Manxman_in_exile

peachyprice wrote: »

Well, yes, this is what people should do, unfortunately 'A&E' is full of people who have neither an accident nor an emergency and are simply trying to jump the GP queue. Look around at the vast majority of people waiting have ailments that could have been treated by a GP or pharmacy. Until A&E start turning people away who don't need to be there, which they're too scared to do in case they get sued, nothing will change. People will continue to abuse A&E while genuine emergencies suffer.

I think this is generally true. But in my case I didn't need to jump the GP queue as it was easier to see my GP rather than see a doctor in A&E! (Perhaps we are fortunate. According to BBC Look East there is a critical shortage of GPs in this region, but we never have a problem getting a GP appointment at our surgery even though two of the senior partners left last year. It's an excellent practice. I'm always surprised - and disappointed - when friends complain about the difficulty in seeing a GP).


Apart from that, I'm sure A&E is misused by many people. I'm not sure about turning people away, but maybe that is the way to go. I think it unlikely that the hospital would be sued unless there was clear clinical negligence which can be difficult to prove. But as I posted in another thread on the Public Transport and Cycling board earlier today, I'd have no hesitation suing the NHS if I had agood cause of action.