to not understand why arriving at A+E in an ambulance gives you priority regardless to your injury?

(157 Posts)
elfsmamma Fri 27-Dec-13 19:51:08

We had the pleasure of spending this afternoon in A+E, dp had dislocated his shoulder.

Dp was in lots of pain, he couldn't walk, his arm was hanging down and he was crying, shaking and almost loosing consciousness.

We had to wait for ages, first for an x-ray and then for a Dr to give pain relief and eventually attempt to put the shoulder back in.

People kept saying to me "oh you should have called an ambulance, you would have been seen right away" "poor guy go and tell them he needs to be seen now"

When we eventually went in the lady in the next cubicle had bruised her foot, she had come in by ambulance so been taken directly in. She was happy as could be, chatting to us asking dp ( who couldn't speak easily) what was wrong with him.

Aibu to think that all patients should be judged on pain and severity of injury rather than method of arrival to casualty.

Anyoneforacheckup Mon 30-Dec-13 00:18:57

48 hrs average per week over 26 weeks can work more by choice

DippityDoo Mon 30-Dec-13 00:14:02

OP, please be eternally grateful any and every time your loved one is not the priority at a+e.

Having staff recognise your child and remember their name; being told to ignore protocol and just carry them straight into intensive care/high dependency when needed rather than stopping to sign in at reception; being given the 'card' to carry just incase you are out of area and need a+e are all pretty horrendous things to experience.

I would love my child not to be seen as a priority.

beitou Sun 29-Dec-13 23:56:53

As a rule of thumb, it is not those that are shouting and screaming about the pain you have to worry about. They have a lot of energy and focus to spare if they can scream. It is the quite curled up ones who are turning grey that we go to first. The exception to this being the old dears. If an old person is complaning it is usually serious and they usually apologise. If a 25 yo is moaning, whinging and bitching we usually ignore it.

beitou Sun 29-Dec-13 23:43:51

I am lucky I have a shift. That means i have a set of regular hours that I follow. It took me 7 years in post to get this. Before I had a shift I was on reserve. Reserve means that you go where you are sent and work the hours you are told. Staff on reserve can work up to 70 or 80 miles away from home, start at 0630 finish at 1830, if they dont get a late job. A job at 18.25 means they can finish at 20.30 or thereabouts. They may then be on at 0630 the next morning, they can do this for up to seven days in a row vbefore a day off. They can finish a night shift 1900-0700 at 0900 or so on monday then have to be in 24 hours later after one day off and a totally buggered sleep pattern at 0700 tuesday. They then have a 12 hour shft responding to emergencies on blue lights, oh and they have to work 3 out of 4 weekends, usually on nights.
I feel your pain hotdog, what was it Hunt said about the NHS, cruelty is the norm, twat.

HotDogHotDogHotDiggityDog Sun 29-Dec-13 23:33:02

The bloody shift work!

I've never opted out of the WTD, so I shouldn't be working no more than 48hrs per week.

Our working week is Sunday - Saturday.

So many times I've done 12.5 hr shifts (rarely get a break) Thursday, Friday, Saturday, Sunday, Monday & Tuesday.
75 fucking hours. Not including the commute. Yes I get my days off towards the end of the week but I'm half dead by then.

Their reasoning is that its over a two week period.

It's had such an impact on my family life and my own health. I'm only 33 and my back is going and my shoulder is on its way out too.

Some days I'm so tired I want to curl up into a ball and sleep.

Strawberyshortcake Sun 29-Dec-13 23:24:42

Arriving by ambulance does not mean u or your child will be seen immediately. In an ideal World yes they would, but sadly it is not an ideal World. For example, once we were at A&E for hours when my son, who was about 5 at the time, had split his head open and we were waiting hours. I was doing a fair bit of moaning to myself about the wait until I found out a young lass has just died from a severe asthma attack, it put things into perspective for me.

Obviously it's horrible when u have to go to hospital with your child, but unfortunately they have to deal with patients in order of emergency. Sad but true.

beitou Sun 29-Dec-13 23:23:19

I am still very very proud of the NHS. The NHS, the Welfare state and the OU are what make me proud to be British. Every time I put my uniform on and see myself in the mirror I am so proud of what we do, the we is the frontline crews and staff not the managers. When we bring a bad job in and everyone from the porters up to the consultants pulls together and work as a very well drilled team I am sooooooooo proud. Seeing nurses, HCAs,emts paramedics, everyone just responding in a calm professional mmanner, well i finish my shifts amzed at what people do. Then I run into the dicks that like ticking boxes and writing jargon laden crap, and I dry heave.

beitou Sun 29-Dec-13 23:16:23

Yep that's it with us, yes we can try and take a break but what do you do if you get an arrest, an old dear down, a child fitting or anything really. What do we say to someone when we turn up to a very ill person and say sorry for the delay we were having a brew. we try to sneak brews at hospital beofre clearing but our management have now made it a disciplinary offence if we go into the A and E staff room and make a brew

Anyoneforacheckup Sun 29-Dec-13 22:59:28

We work 13 hrs no defined breaks so we don't get the breaks..if we left sick people in resusc and went off for a break it would be craziness, someone could die, but medical staffing told us we " should take breaks to comply with the EWTD " Yes, we know but if they don't pay someone to take over from us to have that break then we can't go! Crazy!

beitou Sun 29-Dec-13 22:53:12

Excuse my crap typing but I have had a few beers.

beitou Sun 29-Dec-13 22:51:24

I don't have any other skills that would let me leave the Ambulance service, if I did I would be out in a shot, luckily I only have a few more years to go before I retire. I despise the professional mangers who have never worked on the road. These are the people radioning me to clear when I am talking to and making a brew for an 89 yo lady who has fallen aand whose husband died two weeks before christmas and who will not see any one else on Chrismas day than us. These are the peole on very senior management contracts whose salaries are not pulished, my is. These are the people who refer to the ambulance service as a business, I didn't come into it to help run a business, I came in it to help people. These are the parasites that have come into post in the last 2 or 3 years and will not disclose their backgrounds. These are the peole that think the European working hours directive does not apply to the emergency serices so I can go for up to 13 hours without a break or anything to eat and if I crash on blue lights then I'm at fault automatically despite my blood sugar levales being lower than people we treat.

Anyoneforacheckup Sun 29-Dec-13 22:25:41

Completely agree. Absolute stupidity. It's just all a money saving exercise and patient welfare is way down the list. The other thing that worries me is the lack of cohesion and communication that will ensue. The govt has eroded the pride we all felt in the nhs and so now it will be destroyed, what no one realises is it will not be replaced. At present, people are well cared for medically, the corridors and desks may be scruffy but that doesn't matter. The public should be aware that doctors work on shift for 13 hrs with no food and drink most ofthe time, while bed managers and mx sit around endlessly discussing beds and getting paid for it.

I have never felt like this before, nd I am old enough to remember when managers first came into hospitals. It shouldn't be the case, but because their values are alien to ours, they are effectively the enemy and it is a constant battle.
I am considering getting out, it's becoming demoralising now .

beitou Sun 29-Dec-13 22:10:37

At the moment the only private ambulances in the North West are second line and usually only do discharges and non emergency hospital to hospital transfers. They use the same grade structure that NHS ambulance staff use, they have the same uniforms that we use. To the untrained eye they look like Ambulance serice amulance crews, even nurses on the wards get us mixed up. That is where the similarity stops, they are basically untrained taxi drivers. Get very, very worried if private ambulances ever respond to 999 calls. They do not have the training, experience or equipment that NHS ambulance staff have and I include St John ambulance in this. The idea of a for profit company responding to 999 jobs makes me want to vomit.

Anyoneforacheckup Sun 29-Dec-13 21:40:47

Private medicine in the traditional sense usually means a clinic appt and a short uncomplicated stay in a private hospital with urgent transfer to an nhs hospital if the patient becomes at all unwell.
With no notes.
Cameron private will now start to mean just tendering stuff out to companies like Virgin and Tesco..... That is ok for a while but once market forces start to kick in you may find that they will not look after people with chronic illnesses which is most people who currently require treatment. They will choose who they look after, just as currently you don't get private health travel insurance if you have a serious illness.

Market forces should not be used to drive the nhs or healthcare because only the very wealthy will get treatment. The smokers, alcoholics, obese patients....what will happen to them I wonder?
I feel really sad about this and Cameron's unwillingness to even tryto fix it.....you will not find doctors who wish to bust their guts for their own patients putting their own health at risk only to find that they will be blamed for system error which is down to understaffing and treating doctors like idiots.

The young ones now mainly go to Australia, the middle aged take early retirement and the rest only want to do General Practice . No one wants to be a hospital doctor anymore and until that changes, they will not get any more AE doctors . They are hoping to fast track Indian Doctors into AE to fill the gap, hopefully that might help but don't be too surprised if the system should collapse at some point.

Cameron and management have the main aim of getting pts out of their hospital bed and home.... They seem to have not grasped that the pt might be in hospital as they are unwell and need to be made better first. It is the opposite to a good business plan and one only clinicians really get.... It costs money to make people better and provide good care for all.

beitou Sun 29-Dec-13 21:29:12

One of the reason why we often blue light children in and why they get priority on arrival is because they can go off very quickly with very little warning. A child's body will compensate for an injury or illness and they will appear well looking, however they do not have the energy reserves of an adult and they can go from well to very seriously ill in a matter of minutes, it takes a lot of training and experience to pick up on this and we always listen to what mum says, if she says her child is not right we take notice and get them in and seen asap.

Sirzy Sun 29-Dec-13 20:56:41

DS rarely looks ill when he is ill, a bit paler than normal but thats about it. I have a photo of him stood in a cot about 18 months old on oxygen, he had been walking laps of the cot getting knotted in the oygen pipes. Take the oxygen off and his sats plummeted to mid 80s.

With children especially how they look doesn't actually indicate how they are.

snowed Sun 29-Dec-13 20:56:26

> If you don't like it go private.

I think you've missed out "if you can afford it" PeriodFeatures!

HotDogHotDogHotDiggityDog Sun 29-Dec-13 20:53:59

Typo's everywhere tonight! blush

HotDogHotDogHotDiggityDog Sun 29-Dec-13 20:53:20

Exactly Lweji

I know work in geriatric medicine. I feel like screaming sometimes when we are accused of neglecting a patient who screams out constantly but is safe and not in immediate danger (most of the time it is part of the illness to shout out) over someone who is seriously medically unwell we are seeing to.

If we could we would have one to one nursing so we could sit with that patient with dementia. It's a fucking horrible illness but it's a medical ward. The medical needs trump the mental health needs.

No it shouldn't be that way, but it's the reality with so few staff.

HotDogHotDogHotDiggityDog Sun 29-Dec-13 20:46:28

Forgot to add, it takes a serious incident to happen before the management to notice.

We raise concerns all the time about unsafe staffing levels, not enough beds/people on trollies. We are told to fill in incident forms. I've filled out so many I know the print of that form like the back of my hand.

When that incident happens, the one we've warned about, guess what happens?

We are given extra tasks/paperwork to do. It's not a myth when you here nurses moaning about paperwork. HCA'S too. It's endless.

Still don't get the extra staff though.

Lweji Sun 29-Dec-13 20:45:42

you couldn't possibly judge the staff for seeing to someone who 'looks well'

One time DS walked into the triage nurse's room pushing his buggy, while in the middle of a bronchiolitis crisis. He ended up spending the night.

HotDogHotDogHotDiggityDog Sun 29-Dec-13 20:37:07

It's hard to explain to anyone from the 'outside' about what the realities are working for the NHS. Of course most HCP will defend it because we see what happens every day and we know the system.
That's not to say we agree with the way it works though.

What might not be a priority to us is a priority to the patient waiting to be triaged or for a bed. Unless you know the history of every single person waiting to be seen in that department, you couldn't possibly judge the staff for seeing to someone who 'looks well' but is in less pain than you.

Increasing demand and minimum staffing/beds will cause many people to suffer.

Every department runs on minimum staffing levels. There is no such thing as excess staff these days. When one person goes off sick, those shifts are rarely covered now.

So if there happens to be a big car accident for example, those same staff who are working a normal shift will have to cope as best they can.

Of course concerns are raised with the people holding the purse strings. It remains the same.

Then as soon as a formal complaint is made, guess who gets the blame?
We are blamed by the patient as well as the management.

I think that's why so many HCP's get defensive.

I'm looking into a career change anyway, I fucking hate the politics in the NHS.

Sparklymommy Sun 29-Dec-13 20:12:58

elfsmamma I think I know you! Haha! Completely off topic but never recognised anyone on here before!

With regards to the nhs and ambulances etc, my dh has been to hospital a few times this year with AF (racing heart). To look at him you'd think (as he himself did) that he was fine. In reality his heart was beating at 240 bpm. He was laughing and joking with the nurses who were desperately trying to reduce his heart rate. He was taken to hospital in an ambulance and then left in a cubicle for an hour because he 'seemed' fine!

needaholidaynow Sun 29-Dec-13 20:06:23

Well I want exactly talking about whiplash! I obviously meant something more serious. But yes you're right.

Lweji Sun 29-Dec-13 20:01:55

It depends on the injuries from the car accident. smile

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