My experience of A&E

Manxman_in_exile

Cyclizine wrote: »

Manxman_in_exile wrote: »

You're still missing the point - yes, you probably did need admission when you attended the ED however, you left before you were seen by a doctor! You attended another doctor the next day and were admitted. I struggle to see what you're venting about, other than you had a long wait in the ED (and then a longer one overnight before seeing your GP). The way triage works has already been explained to you - patients are seen in order of priority in the ED, not in order of attendance. There is more going on behind the cubicles...

No - I think you are missing the point. If you'd read all my posts you would see that my main point is I don't believe I was appropriately triaged in E&A. (In fact I think they should have sent me to Minor Injuries and Urgent Treatment in the first place). Of course I do not know this, but it is what I think. But I may very well be mistaken.


The wait is a secondary matter. I fully expected a long wait but I reckoned it was going to be at least another hour before I saw anybody. Precisely because of the unpredictability of the flow of patients through A&E I decided to cut my losses and go home (where at least I could watch TV!) as I was confident I could get a GP appointment following day. How long do you wait before drawing the line?


As I said in an earlier post I will give praise and credit where it's due, but this means I also have a tendency to give criticism where I think it's due. Does that help you understand why I'm a bit unhappy with E&A?


I didn't need to have triage explained to me. I knew.


I know E&A patients are dealt with in order of priority and not attendance. I have no problem with that. In fact only an idiot would think otherwise.


One of the most important lessons my first manager taught me was not to rely blindly on systems and procedures to automatically produce the correct results. Always critically review the results you get before finalising them. And always look at ways of improving the systems you have - even if it means getting a third party (eg internal auditor) to review them.


I've witnessed loads of mistakes and errors in the NHS - and I willingly own up to sometimes being the culprit myself - but I always learned from those mistakes and they never happened again.


What I'm finding a little hard to accept is the apparent attitude of some posters that the triage nurse in A&E could not possibly have made a mistake and that I must be wrong. Partly because I didn't die overnight (but read my post #55 again).


As you can see in the first paragraph of this post I am perfectly willing to accept that I may be wrong.


But of course it is also possible that I am right and the triage nurse did get it wrong. People (including me and triage nurses) are not infallible.

Cyclizine

Manxman_in_exile wrote: »

Cyclizine wrote: »

As you can see in the first paragraph of this post I am perfectly willing to accept that I may be wrong.

With respect, if you read your own posts back, you will see that this isn't the impression you're giving.

The triage nurse in the ED would have been an experienced nurse. You were triaged to see a doctor, you did not wait. You then waited overnight and were seen by another doctor and admitted. I take your point that the signposting from reception to triage should be improved, however, from what you have said over many posts, I think you were appropriately triaged.

Loanranger

Cyclizine wrote: »

Manxman_in_exile wrote: »

You're still missing the point - yes, you probably did need admission when you attended the ED however, you left before you were seen by a doctor! You attended another doctor the next day and were admitted. I struggle to see what you're venting about, other than you had a long wait in the ED (and then a longer one overnight before seeing your GP). The way triage works has already been explained to you - patients are seen in order of priority in the ED, not in order of attendance. There is more going on behind the cubicles...

Patronising. Unhelpful.

Maybe time to back off and allow Manxman to know what he experienced and to have his vent.

Manxman_in_exile

humptydumptybits wrote: »

You don't know what decision the nurse made when you were triaged, all you know is that the wait for your particular level of need was longer than you were prepared to wait. [That is true, I don't know. Perhaps the first improvement to the system would be to explain to patients what classification is being used and which one they fall into. Also make it clear that higher priority patients will always go ahead of them].


It doesn't mean she was wrong. [Doesn't follow that he was right either].


There was lots of talk about the Birmingham Pub Bombings on TV last week. That night in 1974 saw 21 people die, loads more injured. I know a nurse who was working in A&E in Birmingham, off duty staff rushed in but they were still struggling to cope. How long do you think people were waiting in A & E that night, how could the hospital have prepared for that night to ensure no one had to wait for 3 or 4 hours? [I suspect much longer than three or four hours.Somewhat exceptional circumstances going back over 40 years and perfectly understandable and reasonable that there would be very long waits. No dispute with that]


A&E is unpredictable, it is pretty obvious if you think about it. [Funnily enough I understand that but it's largely irrelevant to the point I'm trying to get across. Maybe my communication skills are not as good as I thought].


Expecting there to always be short waits in A&E is as logical as the NHS asking you to get sick at a quiet time. [I don't expect that and nowhere have I suggested that].

Of course it is annoying to wait, horrible when you are feeling rotten but you were successfully treated so maybe focus on that. [I have no issues with my inpatient treatment at all. Since I was discharged I have reflected many times on the excellent care I received. Does that mean I'm not allowed to reflect on poor experiences because it was all right in the end?].[/QUOTE]


I think some posters have not read all my posts because some seem to think I've posted things I haven't. Too many assumptions?


Anyway I'm logging off now as I need to re-watch Deutschland '83 before I get into ten episodes of Deutschland '86.

Manxman_in_exile

Cyclizine wrote: »

Manxman_in_exile wrote: »

With respect, if you read your own posts back, you will see that this isn't the impression you're giving.

The triage nurse in the ED would have been an experienced nurse. You were triaged to see a doctor, you did not wait. You then waited overnight and were seen by another doctor and admitted. I take your point that the signposting from reception to triage should be improved, however, from what you have said over many posts, I think you were appropriately triaged.

Well let's agree to differ. I'm actually open to being persuaded that I am wrong. But it will need a very convincing argument - one I haven't read yet. Are you absolutely certain that you are correct and that that conviction is unshakeable?


'Bye. Deutschland '83 beckons!

humptydumptybits

Oh I didn't know Deutschland 86 was starting. Is it on Netflix, I'll have to go as well.

Nicki

How do you know Manxman (a) how many patients were seen in the 4 hours you waited in A&E and (b) what their clinical needs was?

It’s completely possible that only a small number of patients were treated in this time but all so seriously unwell that it took a long time to stabilise then and have them appropriately admitted.

You can only know what your own condition was - ie that you were ill enough to see a doctor and be admitted but not so unwell that you died or lost consciousness in the 24 hour period before you saw your GP. Whilst a 4-5 hour wait is extremely unpleasant when you feel ill, you still haven’t posted anything which proves the order in which patients were seen that day was incorrect.

It’s like waiting for any form of serious medical treatment. If you are in renal failure, it’s extreme unpleasant and you are very unwell. However you will have to wait on dialysis until you reach the top place on the waiting list for a transplant. Yes, as you would have been, you may be accelerated towards the top if your condition deteriorated, but failing that you have to wait for unbearably long periods feeling horrid.

Cyclizine

Loanranger wrote: »

Cyclizine wrote: »

Patronising. Unhelpful.

Maybe time to back off and allow Manxman to know what he experienced and to have his vent.

Er, how about no. Manxman has repeatedly stated what he did. He is entirely allowed to vent what he feels are his frustrations, just as we are allowed to disagree with him.

Cyclizine

Manxman_in_exile wrote: »

Cyclizine wrote: »

Well let's agree to differ. I'm actually open to being persuaded that I am wrong. But it will need a very convincing argument - one I haven't read yet. Are you absolutely certain that you are correct and that that conviction is unshakeable?


'Bye. Deutschland '83 beckons!

Fair enough, although equally, you have done nothing in your argument to convince me that your triage was anything but appropriate. You are an adult with capacity, you can make whatever decisions you wish in respect to your autonomy, even if medically they may not be sensible.

Manxman_in_exile

Cyclizine wrote: »

Manxman_in_exile wrote: »

With respect, if you read your own posts back, you will see that this isn't the impression you're giving.

The triage nurse in the ED would have been an experienced nurse. You were triaged to see a doctor, you did not wait. You then waited overnight and were seen by another doctor and admitted. I take your point that the signposting from reception to triage should be improved, however, from what you have said over many posts, I think you were appropriately triaged.

I'd be very grateful if you would explain what impression you feel that I'm giving? That might give me some insight as to why some posters believe that I'm in the wrong and A&E triage nurses never make mistakes - or at least that seems to be the implicit assumption of some posters..