My experience of A&E

System

I fully understand that, but the following day the hospital agreed to admit me to an inpatient bed!immediately!after a ten minute 'phone call from my GP. I don't actually know how seriously ill I was, but I assume that for this to happen it must have been recognised by my GP and hospital admissions to be sufficiently serious to admit me there and then.

A&e is not the only route Into hospital. Your go obviously spoken to the speciality consultant and the bed managers to get you a bed where you needed to be. You would have been admitted the first time you went if you'd hung around to be seen. As others have explained several times there's a process. Yes you needed treatment but didn't need a Dr at your bedside within ten minutes you just needed to wait your turn.

All I can suggest if you want special treatment then get private healthcare. Although they're not always fabulous either.

Manxman_in_exile

tessiesmummy wrote: »

A&e is not the only route Into hospital. Your go obviously spoken to the speciality consultant and the bed managers to get you a bed where you needed to be. You would have been admitted the first time you went if you'd hung around to be seen. As others have explained several times there's a process. Yes you needed treatment but didn't need a Dr at your bedside within ten minutes you just needed to wait your turn.

All I can suggest if you want special treatment then get private healthcare. Although they're not always fabulous either.

My GP did not "obviously" speak to a specialty (not speciality) consultant. She made the call to the admissions unit of the hospital in my presence, and so far as I am aware they were the only people she spoke to.


Why are you so certain I would have been admitted if I'd stayed in Emergency? Are you using Humpty's NHS crystal ball?


I didn't expect to see a doctor in Emergency within ten minutes. Where have I said that? I expected to be in Emergency for a minimum of two hours, but after waiting somewhere between three and four hours and being told it would be about another hour before seeing a doctor I told my wife to take me home - I'd had enough of sitting around and was feeling really ill. How many more hours would I have been waiting as apparently more serious cases came in. I'd had enough.


I'd hardly describe it as a "process".


Where have I said I want special treatment? I simply want appropriate treatment and that is not what I received in A&E as evidenced (I think) by my admission to hospital the following day. Sorry you don't agree with me. And please don't jump to conclusions that I either want or expect special treatment. As I have posted previously I'm actually a great supporter and defender of the NHS and always stick up for it when I hear people complaining about the NHS. Unfortunately, I now understand why many people are unhappy

humptydumptybits

Manxman_in_exile wrote: »

I didn't expect to see a doctor in Emergency within ten minutes. Where have I said that? I expected to be in Emergency for a minimum of two hours, but after waiting somewhere between three and four hours and being told it would be about another hour before seeing a doctor I told my wife to take me home - I'd had enough of sitting around and was feeling really ill. How many more hours would I have been waiting as apparently more serious cases came in. I'd had enough.

But you know they can't predict what is going to come in the door so they can't guarantee you treatment in two hours or even 4 hours. What do you think should have happened if when you had been waiting 2 hrs I arrived with my son who was rapidly deteriorating and needing to have the quinsy lanced and antibiotics? Do you think they should have let him die so that you weren't disappointed?


A&E has limited resources, sometimes a doctor or nurse might be ill so they have even fewer staff than they normally cope with, people get ill and have accidents and they can't operate a first come first served system or people would die.



You went home and 24 hrs later were admitted to hospital so if you and my son were both waiting he was obviously more urgent than you because he wouldn't have lasted 24 hrs. Similarly when my toddler drank a bottle of weed killer we were rushed straight through, it was judged to be life threatening and the people with less life threatening conditions continued to wait, some of them might have been there for hours. When my son broke his leg (thinking about it I've had good value from the NHS) we sat and waited as although it was an accident it wasn't an emergency.


At the end of the day we get what we pay for and at the moment the majority of us have voted for lower taxes and strict controls on spending so the queues are inevitable.


Just wanted to add that the bed situation could have been different after 24 hrs. People might have been discharged, they might have had a quiet night, the first day they might have had to close a ward due to staff sickness (happened to someone I know last month, they were due to be admitted one day and so many nurses were off sick they closed part of a ward, they were admitted the next day as presumably staff were feeling well enough for work, or different staff were on shift or agency staff were in.) Without my crystal ball to ensure all these things are dealt with in advance there are always going to be peaks and troughs.

Manxman_in_exile

Several posters seem to think that this was my fault because I left A&E voluntarily. This seems to be based on two questionable premises.


First, that I was still alive the following day, therefore I must have been correctly triaged in A&E. Well that may or not be correct. It may be that if this were to happen ten times that I would actually die nine times and that I was extremely fortunate that this happened to be the tenth time and I survived until the following day. Who is to say? I don't know and neither does anybody else posting here. All I really know is that two GPs were sufficiently concerned to get me admitted immediately the following day.


Second, that because I wasn't seen more quickly by a doctor in Emergency, that I obviously didn't need to be seen by a doctor more quickly. This assumes that the "process" works (near) perfectly and there simply can't be any mistakes


Both of the above seem to me to be pretty good examples of the logical fallacy "begging the question". That is where you assume the conclusion of your argument at the outset and then argue in such a way as to support the pre-assumed conclusion. (It is not a fancy way of saying "this raises the question" which most people seem to think it means). eg "You were still alive the following day, therefore you were processed correctly in A&E" and "You didn't see a doctor more quickly because you obviously didn't need to".


Additionally, the assumption by one poster that because I'm being critical of my experience in A&E that I expect "special treatment". As a logical fallacy I would say that's a "non sequitur". Nothing could be further from the truth. I'm starting to feel guilty now as I must have jumped the A&E queue and taken somebody's bed away from them.


I'm sure that those who say "it's all your own fault because A&E don't get things wrong" won't be persuaded otherwise, so let's just agree to differ.

Manxman_in_exile

Humpty - as I tried to explain earlier it wasn't the wait I was most concerned about - it's that I don't think the seriousness of my illness was appreciated. But that must not be true because I wasn't seen by a doctor more quickly! (See my previous post about "begging the question").


I have no problem whatsoever in more needy and more seriously ill patients (particularly children and the elderly) being seen before me, and indeed being slotted in in front of me. If I've been triaged correctly as a category 3 (to use Glaswejens classification) I'm quite happy for people in categories 1 and 2 who arrive after me to be put ahead of me. I actually have quite a sophisticated sense of "fairness". I just don't think I was category 3. (But of course I must have been because I didn't die overnight!)


Of course this does mean your waiting time in A&E is indeterminable if category 1 and 2 patients keep coming in or, as you suggested earlier, there's a major pileup on the ring road. This means your time in A&E is potentially open ended. How long do you wait if more seriously ill patients keep coming in? Six hours or 12 or 24 or 36 or 48? I suspect many people would agree that there comes a time when you have to decide whether to cut your losses and walk out. I did that after about four hours. Maybe I have a low boredom threshold.

System

Several posters seem to think that this was my fault because I left A&E voluntarily

No I just think you're a tad dramatic tbh. You went home and lasted the night. You wasn't subsequently rushed back in via ambulance at deaths door. You're now fine and moaning on the internet. The seriousness of your illness is subjective to yourself. (Although I have no clue about you personally so you could well have been seriously ill). The triage nurse is to assess clinical need and priority. You lasted to the next day so she prioritised you correctly. You didn't wait to see a doctor to even get a diagnosis so I don't see how they didn't recognise the seriousness of the situation.

Manxman_in_exile

humptydumptybits wrote: »

A&E has limited resources, sometimes a doctor or nurse might be ill so they have even fewer staff than they normally cope with [True - but in my experience as a NHS workforce planner there ought to be contingencies for this - especially in A&E] people get ill and have accidents and they can't operate a first come first served system or people would die. [ I don't want first come, first served]


At the end of the day we get what we pay for and at the moment the majority of us have voted for lower taxes and strict controls on spending so the queues are inevitable. [I wholeheartedly agree with this!]


Just wanted to add that the bed situation could have been different after 24 hrs. Without my crystal ball to ensure all these things are dealt with in advance there are always going to be peaks and troughs. [I understand this but statistical modelling can help with peaks and troughs in some areas.]

Points taken

slashlover

First thing is our hospital doesn't have anything known as "A&E". We eventually decide it must be the "Emergency Department". (Sorry - this may seem petty but I'm very pedantic. Why don't they call it A&E?)

Just read the thread and this is very pedantic. I would assume that working for the NHS for 25 years then you would be aware that A&E means Accident and Emergency Department so the Emergency Department would be the correct place? Did they not teach you or your wife that with your 3 law degrees? If they had told you to go to your GP would you have wandered past the building marked "Doctor's Surgery" in a confused state?

Manxman_in_exile

tessiesmummy wrote: »

The seriousness of your illness is subjective to yourself.[Of course the seriousness of my illness is not subjective to me. It's objective to healthcare professionals. Two Gps objectively concluded that I was more seriously ill then the A&E triage nurse thought. Or at least that's my admittedly subjective interpretation of what happened]


(Although I have no clue about you personally so you could well have been seriously ill). [I think the two GPs thought I "could well have been seriously ill"!!!]


The triage nurse is to assess clinical need and priority. You lasted to the next day so she prioritised you correctly. [ "So"? Begging the question]


You didn't wait to see a doctor to even get a diagnosis so I don't see how they didn't recognise the seriousness of the situation. [Isn't that what you say the triage nurse is for?][/QUOTE]


Seriously, please read my post #55 again and not just the first paragraph.


I'm the only poster on this thread who has first hand experience of what happened that Monday and Tuesday - none of the other posters here were there. I repeat, in contrast to the A&E triage nurse's assessment, two GPs considered me to be sufficiently seriously ill to be admitted to hospital immediately. Can nobody entertain the idea that A&E might have made a mistake?


EDIT: And regards your earlier comments about "special treatment" and "private healthcare", they're laughable. I worked in the NHS for 25 years and am opposed to private healthcare. I do not knock the NHS without good reason. You'll see from an earlier post that the inpatient care I received was outstanding. The day after discharge I was surveyed by the hospital and I emphasised the exemplary care I received from nurses and HCAs on the ward. I also sent the staff a personal thank you letter. I give credit where credit is due. If I think criticism is due, I will give that too. I am also more than happy to give good feedback re my wife's experiences in the Minor Injuries and Urgent Treatment Unit and Eye Casualty.

Loanranger

All this discussion of what is wrong with the NHS and the elephant in the room is this: how can we admit 260,000 people from overseas every year and not expect that the infrastructure will break down?
In recent years the net immigration has been double that number. This is net, so the number of people leaving are deducted to arrive at the figure of 260k. This is a city the size of Wolverhampton every year.
We cannot build enough hospitals and train enough staff to keep pace with demand.

I am not passing judgement on whether this increase in the population from abroad is a good or a bad thing, it is simply presenting the fact of it and suggesting that it is a factor in the stress upon the NHS.