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.

londonchick Fri 27-Dec-13 19:52:30

It doesn't give you priority. You are assessed on arrival by Ambulance and if well enough to wait you will wait. The assessment is exactly the same whether you walk in or arrive by Ambulance.

They don't get priority, if they've called an ambulance for something non life threatening they'll be triaged and wait, just the same as everybody else.

OhThePlacesYoullGo Fri 27-Dec-13 19:52:52

It doesn't.

maddy68 Fri 27-Dec-13 19:53:06

That's bit true, ambulance admittance still girls through triage, the paramedics assess en route, if it's not an 'emergency' they will wait their turn just the same

toobreathless Fri 27-Dec-13 19:53:10

Triage is independent of method if arrival.

So they are judged on clinical severity alone.

I have seen many people triaged from an ambulance and asked to take a seat in the waiting room.

(doctor)

maddy68 Fri 27-Dec-13 19:53:23

Not true!

Snowhoho Fri 27-Dec-13 19:53:49

It doesnt, thats what triage is for.

StarlightMcKingsThree Fri 27-Dec-13 19:54:32

Bruised foot last probably attended to by the cleaner, your DP prolly waiting for someone who knows something about shoulders.

RabbitPies Fri 27-Dec-13 19:54:47

It doesn't.

pimmsgalore Fri 27-Dec-13 19:55:25

Trust me having had DS taken in in an ambulance (he cracked his head open in B&Q, they called the ambulance) it gets you a seat in the waiting room with everyone else. The ambulance triages you so you skip that part but we still had to wait 5 hours for 6 stitched hmm

toobreathless Fri 27-Dec-13 19:56:36

maddy do you work in A&E??

Triage doesn't mean you have to go into the triage cubicle it can often be done at the bedside or next to a stretcher by a nurse. Triage nurses are usually very experienced & can often triage at a glance & discussion with the ambulance crew.

RedLondonBus Fri 27-Dec-13 19:57:54

How did he do that pimms?

StephenKatzCrackerHat Fri 27-Dec-13 19:58:03

Yes, ambulance is a way of getting to A&E, but triage is completely seperate and patients are seen in order of need. I'm very surprised your A&E operates like that. Perhaps the lady with the 'bruised foot' had a medical history that you were unaware of that meant she had to be seen quickly? I'm thinking a clotting disorder or something along those lines.

SpikeyChristmasTree Fri 27-Dec-13 19:58:45

As others have said, arrival by ambulance does not get you seen faster. However, A & E often have several different clinics running at the same time. Ours has Nurse Practitioners, GPs etc so sometimes people arriving with seemingly trivial complaints are seen much quicker as they are being dealt with by different people than the more serious cases.

Fairylea Fri 27-Dec-13 19:59:27

It doesn't.

Maybe the woman with the bruised foot had underlying health problems (immune issues, bleeding and clotting issues or something else) that meant it needed attention more quickly.

Sometimes the people who seem the most well are actually the sickest. My gran was brought into a and E by ambulance because she had suffered a nasty fall and the gp was worried about her because she revealed she had been having black poo. When she reached hospital she was feeling much better and was annoyed they'd called her an ambulance. She was sitting up and chatting in the cubicle and flirting (aged 90)with the young male doctor she had.

She had numerous blood tests and other tests. They found she had terminal bowel cancer. She died 6 weeks later.

toobreathless Fri 27-Dec-13 19:59:31

Also you may see people being out into cubicles for various reasons who then are waiting in there rather than in the waiting room. Possibly due to potentially being infectious, distressed or whatever. They don't get seen any quicker. They are just waiting in the same queue in a different area.

Rubbish pimms poor DS, hope the experience wasn't too upsetting.

elfsmamma Fri 27-Dec-13 20:00:28

I think the problem was that people arriving by ambulance had gas and air, they couldn't just take the gas and air away from them and make them sit in the waiting room.

The Dr recommend that if it was to happen in future we call an ambulance as then dp could have effective pain relief right away.

I am glad to hear that it isn't policy to priorities ambulance arrivals, the only time I have arrived at casualty with someone in an ambulance they have been having breathing difficulties or a fit so obviously been seen right away.

I'm not sure why people with minor injuries don't just get a taxi!

NigellasDealer Fri 27-Dec-13 20:01:16

nope not true how quickly you are seen depends on where you are bleeding from....grin
(I'm from bleeding Romford do I get seen first?)

pimmsgalore Fri 27-Dec-13 20:02:20

Red it was a couple of years ago, he managed to get out of a five point harness and tip his pushchair over hitting the concrete floor hard with his forehead. I only had one hand on the pushchair, looking at something on shelf, so felt guilty for months after. We can laugh about it now but at the time it was scary. Fastest I've ever seen the B&Q staff move thoughgrin

elfsmamma Fri 27-Dec-13 20:03:26

Bruised foot lady I think possibly just was lonely and wanted a day out, she told me her entire life story, actually said her foot wasn't that bad but it was a good excuse to get out!

ElaClaw Fri 27-Dec-13 20:04:14

toobreathless - maddy was correcting her own typo from "bit true" to "not true", not commenting on your post smile

toobreathless Fri 27-Dec-13 20:04:32

Severe pain puts you into a higher triage category regardless if the cause.

And, obviously pain is as severe as the person perceives it to be....

Poor DH, dislocated shoulders are hideously painful.

toobreathless Fri 27-Dec-13 20:05:32

maddy very sorry! I am simultaneously eating chilli and feeding the baby.

PeriodFeatures Fri 27-Dec-13 20:07:43

A & E is fucked. That is why you had to wait. Imagine healthcare in a developing country, rooms full of people waiting, sitting on floors, not enough beds, 1 doctor and one nurse running about for literally days trying to stem an ever increasing tide of people. That is Britains NHS A & E. If you don't like it go private.

I hope your DH is feeling better.

Some people are fucking idiots.
I once dressed a superficial wound on a woman's palm where she had accidently cut herself with a knife.
She was telling me about how she had called an ambulance to get her there. I was incredulous and told her so. The paramedics have to attend, it takes the piss.

Some people use it as a taxi service, then you get other stoic buggers who insist on driving themselves while mid MI.

PigsInTinselToppedWellies Fri 27-Dec-13 20:10:59

My dad got taken to A&E by ambulance for indigestion. He wanted to drive himself but his doctor insisted on the ambulance. My dad then kept trying to get others seen before him because he only had bad indigestion and was embarassed about all the time he was wasting when there were people with much more serious problems. He'd actually had a massive heart attack but was in complete denial. So don't go by what the stranger in the next cubicle says, you don't know the truth of why they're there.

elfsmamma Fri 27-Dec-13 20:14:32

It was a bit of a shock, we don't actually live in the UK, the healthcare system seems less stretched where we live.

At the end we asked where/how we can sort out payment from the country we live in to the NHS, the Dr looked very surprised, went of to find someone to ask, then came back and said she had decided as dp wasn't admitted we didn't need to register and they didn't need to claim money!!

Dp is on the mend, relaxing on the sofa rather than energetic days out.

lougle Fri 27-Dec-13 20:16:57

I'm sorry you had a long wait.

In defence of A&E departments, I had to take DD3 to get her head glued yesterday (I was stupidly playing a physical game with her and accidentally cracked her head on the corner of the window alcove) and we were triaged within 15 minutes of arriving, then called through within 15 minutes of that, and out half an hour later; glued. Very impressive.

giraffesCantSledge Fri 27-Dec-13 20:17:09

It doesn't. I have walked in before and been taken through to A&E bit then in to resus, and same day saw people taken in by ambulance and sent out or left to wait on a trolley.

Ds3 broke his wrist .

We drove him up to a+e and he wss assessed.

Seen immediately due to him being green and sweaty.

Still sent home that night despite an obvious injury and recalled next day for surgery.

Ubik1 Fri 27-Dec-13 20:25:47

I'm glad your husband is feeling better.

I remember speaking to a lovely young foreign student, he had a sore throat which was worsening. I told him he would have to wait for a callback from the nurse.

"How many days?" He said

grin

Our health service is not perfect but is pretty good when the shit hits the fan. An acquaintance was hit with a bill for $1000 in New York for attending A&E with what turned out to be hangover.

NorthernLebkuchen Fri 27-Dec-13 20:26:33

Some info for you here OP just in case you need other services whilst visiting. Yes A&E treatment is free to you - so dp got a x ray, meds and doctor time all for no cost. I know you had to wait but it's not a bad deal really is it? My dh visited a&e in Seoul a year or so ago with cellulitis. The first thing they did was swipe his credit card.

Bearfrills Fri 27-Dec-13 20:29:45

Our A&E triages on arrival and if your complaint is not worthy of A&E you get directed to the minor injuries unit/walk-in GP next door.

We've been by ambulance once. DS split his head open, taxi refused to take us as he was bleeding and there was no one to give us a lift so ambulance it was. We still waited our turn in the waiting room.

wombat31 Fri 27-Dec-13 20:30:36

In my A and E the priority seems to go to those who are children over those in need! I went with a severe allergic reaction....lips/mouth swelling and was told to wait in the waiting room. Got lots of comments that I should be first in from other waiting people but a few children with broken fingers or nasty cuts got seen first! Went another time with another allergic reaction (I am a frequent visitor due to these) and was told I would be seen immediately upon which a gobby mother had a screaming do that she had been waiting longer and god forbid if I should go straight through as I had only just got there. Guess who got seen first?!

ouryve Fri 27-Dec-13 20:35:56

Last time I was in A&E for myself (10 years ago, mind!) I was seen almost immediately. I had gone via NHS direct, though and was told which one to go to, as they would be expecting me. It still took5 hours to be processed and admitted, though. I just had the benefit of an oxygen mask, while i waited.

Both of the boys have been taken, by car, to paediatric A&E at the same hospital, one after breakfast, and home for lunch. The other after tea and home for bedtime.

DizzyZebra Fri 27-Dec-13 20:38:54

OP - They took the gas off me when a bloke belted me with a bockan (big wooden sword) even though i was in horrible pain. (he smashed it over my knee because i told him to stop making fun of my friend who had had cancer).

Your a and e seems weird as ambulance doesn't mean priority here. The only people i know who get priority are those with existing conditions. Like my step mum has angina, theyve told her to ring an ambulance and she will get priority but shed get that either way once she got there and told them what was wrong - the only reason the ambulance comes into it is because its faster and they can warn ahead if it looks life threatening.

ilovemydoggy Fri 27-Dec-13 20:40:09

Things like this always make me feel guilty when i have to attend a&e. Due to previous medical conditions (oncology patient) i am always sent straight through to major's and to some people they must think they are worst then me and normally are. But no one wants to say to me wait just in case . It annoys me that i am sent so often but understand why they do it. So what you see as someone not as in much pain as your husband being first they may have other reasons why.

DizzyZebra Fri 27-Dec-13 20:40:56

Also what previous poster said about denial/not going bybwhat they say.

I was taken in with what i was convinced was a pulled muscle. It was in fact an ectopic pregnancy (didn't know i was pregnant) and it ruptured while i was there. But for the five hours previous i told various people id pulled a muscle riding a horse at work.

CaterpillarCara Fri 27-Dec-13 20:41:05

Wombat31- sorry to hear your story, but again remember you don't know ever the full background.

I got abused by several people when I took my daughter to A&E in July because she looked very well and we were given a side room very quickly and seen almost immediately. It was because she had an infectious illness so needed to be kept away from everyone else - it was all arranged by phone first. She had a serious complication which was not making her unwell at that point, but needed to be checked to ensure that it wasn't going to.

CaterpillarCara Fri 27-Dec-13 20:42:13

Oh yes, and denial is quite something. I was in total denial both times I went into labour... don't know why, am usually quite sane!!

PointyChristmasFairyWand Fri 27-Dec-13 21:02:18

Last and only time I was in A&E I was blue lighted in an ambulance following a car crash with a possible head injury - felt very very rough and was very glad to be seen immediately but when I'd been X-rayed and assessed and it turned out to be nothing much I did feel like a bit of a fraud... Staff were lovely and kept telling me better safe than sorry. Triage can't be an easy job.

lougle Fri 27-Dec-13 21:13:13

I once went to Out of Hours with a migraine and was rushed straight around to A&E after a Cardiac Arrest call blush I bet I made a few people cross that night. It turned out that the medications I'd been prescribed were short-circuiting my brain, but it looked like I was suffering from a subarrachnoid heamorrhage to the doctor when I suddenly lost consciousness.

A hour or two later, after some lovely IV aspirin and various meds, I was saying that I could go home. The A&E nurse was a bit hmm and said 'you have been quite, quite poorly you know...'

It's funny how the more ill someone is, the less they seem to realise it.

zzzzz Fri 27-Dec-13 21:13:45

Trust me you really don't want to be the one rushed through with no wait. sad

Caitlin17 Fri 27-Dec-13 21:16:38

It doesn't give you priority. I've only been once for an injury to me taken in an ambulance as I was on my own and couldn't drive. It wasn't actually serious and I had to wait until more serious case had been dealt with.

BitOfFunWithSanta Fri 27-Dec-13 21:22:52

This blog from a paramedic is superb insight into the workings of the emergency services- I read the whole thing in one sitting after seeing it linked on here recently.

Sneezecakesmum Fri 27-Dec-13 21:27:14

I used to work in A&E and patients were triaged on arrival and prioritised according to need not whether they came in an ambulance.

Dislocated shoulders were prioritised as a category 2 which is to be seen within 10 minutes. Obviously you can't organise X-rays that quickly but pain relief like gas and air should be given. Shoulder dislocation can cause permanent damage to the nerve supply.

Equally a broken ankle can cause permanent damage and loss of blood supply to the foot. Neither is a minor injury in all cases but must be properly assessed.

elfsmamma Fri 27-Dec-13 21:42:56

They gave him some pain relief but it wasn't really helping.

He was suggesting trying to put it back himself ( he hasdone this before) which is when they decided to see him.

nocheeseinhouse Fri 27-Dec-13 21:47:03

It doesn't give you priority, as others have said. You're triaged on need. And it works surprisingly well. Sorry your DP was left in pain, though, painkillers should be given at triage, too, did you ask for some?

lisad123everybodydancenow Fri 27-Dec-13 21:53:07

Message withdrawn at poster's request.

MrsDeVere Fri 27-Dec-13 21:54:30

I worked on reception in an inner london A&E for six long years.

Every day people would come to the desk and complain that 'I was here before them!' when they saw somebody wheeled in on a trolley.

Yes people would even whinge about poorly kids being seen before them.

Patients are assessed by clinical need.

It is horrible waiting when you are in pain and worried.

Its better than dying because the hospital has a first come first served policy.

When I go to A&E now I am bloody glad we are not a priority. When you are a priority it is fucking horrible.
DD never had to wait. She eventually got to bypass A&E altogether.

Sitting in a waiting room for a few stitches or a check over is bliss compared to that.

frogspoon Fri 27-Dec-13 21:57:55

I've noticed that often minor easily sorted conditions tend to be in and out very quickly in my local A&E. Makes sense because then you don't have people with minor conditions clogging up space.

They may have seen the lady quickly to discharge her as they could see she didn't need as much treatment, whereas your DH was clearly going to need x-rays, pain relief and reduction, which would take more time.

zzzzz Fri 27-Dec-13 22:03:43

When I go to A&E now I am bloody glad we are not a priority. When you are a priority it is fucking horrible...Sitting in a waiting room for a few stitches or a check over is bliss compared to that.

This^^

minmooch Fri 27-Dec-13 22:08:10

On advice of my GP I took my DS up to A&E. She had called ahead and the neuro team were waiting for us. To others I took my vomiting, but walking teenage son, seemingly ok straight through to be examined ahead if any queue. He was diagnosed with a massive brain tumour two hours later.

I am very grateful that my GP and the A&E staff too my instincts and his symptoms seriously and we were rushed through.

sadsqueaker Fri 27-Dec-13 22:09:03

I arrived at A & E in a Sea-King helicopter once and i still had to wait 2 hours to be seen by a doctor, but since I only had a sprained ankle it wasn't a big deal. I didn't even mind being tipped out of the wheelchair used to move me from the helicopter to the hospital building.
And before I get flamed as a time-wasting drain on the emergency services, I called the helicopter to rescue two paraglider pilots who'd had a mid-air collision, I sprained my ankle running down the mountain to help them and ended up as a very embarrassed extra casualty blush

Almostfifty Fri 27-Dec-13 22:09:40

I've been taken to hospital by ambulance and then triaged. I had a head injury and they were bothered about my blood loss, so I was seen immediately.

They were brilliant, absolutely and utterly brilliant.

Sirzy Fri 27-Dec-13 22:18:04

Our local a and e is a peads one. DS has chronic asthma so spends a lot of time there, generally he goes straight in after he is triaged because he needs immediate treatment but he doesn't have an audible wheeze so looks well to anyone we pass. One time when he was settled I left him with my mum to go out and make a phone call and heard a mum on the phone complaining they were still waiting even though her so had come in an ambulance after falling down the bottom 2 steps and hurting his foot, and the some other child came in by car and wAs taken straight though"

I would happily be in a position of having to sit and wait rather than knowing the a and e staff so well I think we will be invited to their next night out!

Our local hospital has a separate children's A&E which is bloody brilliant, to be honest.

I recently skipped the queues for A&E despite not arriving by car - to be fair I had chest pain and was, well, bright yellow. This aggrieved the obnoxious teenager with possible tonsillitis but not the young lady who had taken ketamine - she was content to skip up and down pretending to be a fairy...!

Bearfrills Fri 27-Dec-13 22:42:23

Our local A&E has a separate children's bit too, it has a buzz system for the door too so only people with children can get access. I think it's a great idea as the children are triaged and treated by paediatric staff, there's proper facilities for them (e.g., toys, relevant patient information displays and leaflets, lowered toilets, baby change facilities,, etc) and they're away from certain people in main A&E such as the 2am on a Saturday pissed people or the ketamine lady mentioned above.

lisad123everybodydancenow Fri 27-Dec-13 22:53:42

Message withdrawn at poster's request.

HmmAnOxfordComma Fri 27-Dec-13 22:54:57

Our local A & E is brilliant too and I agree that you shouldn't judge on how ill people seem to be or tell you they are. Dh has compromised immunity due to chemotherapy and we've sometimes had to go through A & E if we couldn't get hold of the ward in the middle of the night and he had a nasty infection. It might have looked like queue jumping to others I guess.

I wish we had a separate children's A & E though. Ds has bad asthma and on a number of occasions we've sat next to drunken or drugged up people swearing all over the place and being aggressive (not quite bad enough to be thrown out but scary enough for kids).

HmmAnOxfordComma Fri 27-Dec-13 22:57:36

Oh and twice I was told by the on-call oncologist to bring Dh in by car as it would be a quicker journey than ambulance (10 miles one way as opposed to a 20 mile round trip for the ambulance) but he was still classed as a higher priority than many who came in by ambulance.

Chasdingle Fri 27-Dec-13 23:06:24

we also have a seperate childrens A&E at our hospital. The door is only a few metres away from the adult door and I think its the same staff on both but the waiting area and consultation areas are seperate and the childrens waiting room is full of toys. I suppose it also helps with people in the main waiting room not getted pissed off with kids being seen first as they just don't see.

There is also a notice on the wall that waits for medically unwell patients and minor injuries may be different. I think that is because medically unwell i would guess have to be seen by a doctor but if just a few stitches are needed then that can be done by a nurse without having to wait for a doc.

ReallyTired Fri 27-Dec-13 23:10:45

I once walked to an urgent care unit and I was seen pretty much straight away. I had smashed my thumb. It did not require anyone with a medical degree or an x-ray to see that I had broken my thumb. It was a matter of a medically trained person deciding how best to fix it.

it is impossible to judge the servity of other cases

a) you do not have access to confidental informaiton
b) There may well be an injury that is not obvious to you.

Prehaps the lady with the bruised foot had more than a bruised foot and was happily chatting to you because she had been given a shot of morphine. Prehaps she had a thrombosis and didn't realise it due to being as high as kite on painkillers.

If someone doesn't need A and E then the ambulance won't take them to hospital.

SoonToBeSix Fri 27-Dec-13 23:29:40

Wombat unless it's life threatening of course children should be prioritised. Have you considered their emotional well being as well as how they are physically?

LeafyGreen13 Fri 27-Dec-13 23:29:54

I think it depends on the country.

A friend of mine in Japan drove her son to hospital when he broke his arm. They had to sit and wait his turn with all the kids with colds and tummy upsets.

In Japan if it looks even a little bit serious you should call an ambulance and they will assess you and find a hospital with a department which will suit your needs. But that's the system there. They prefer you to call an ambulance. Totally different from the UK.

DeckTheHallsWithBonesAndSkully Fri 27-Dec-13 23:32:58

i've only ever had 3 rides in an ambulance, all to do with my bad bout of renal colic last year.

i have only jumped the queue once though, and that was when the OOH dr had me rushed through from his room, round to the A&E so they could pain manage as i was in absolute AGONY with said Renal Colic and i was seen immediately!

I think the only time i've been miffed about someone getting in quicker than someone else was when i took DH into A&E with a chunk of apple stuck in his throat. He was struggling to breath, having to spit his saliva into a plastic bowl because he couldn't swallow and was still made to sit there for 2 hours before anyone saw to him.

ReallyTired Fri 27-Dec-13 23:42:15

"Wombat unless it's life threatening of course children should be prioritised. Have you considered their emotional well being as well as how they are physically?"

You seriously think that children should ALWAYS take priority unless its life threatening?

Some people take their kids down to A and E for stupid things. Why should some poor old lady have to suffer in agony with a broken hip becuase little jonny with the over anxious mother has scraped his knee?

Most A and Es triage children quickly because children can go down hill quickly. Children who TRUELY ill need medical attention are given attention quickly. Our local hospital has a seperate waiting room with toys so that annoying kids don't upset other patients. There is no reasons why a child with a minor injury should not wait four hours if there is an adult in substantial pain. The children's room has plenty of toys and books. Usually the parents are more unhappy about the wait than the child.

PosyNarker Fri 27-Dec-13 23:44:22

Try not to make assumptions. With my background I get taken in earlier than most. You don't really want my background.

OTOH I have complained when things weren't taken seriously (I'd had a high fever but it had dissipated and I was actually very cold, so the triage nurse thought nothing wrong when I was actually going into shock?).

So yeah, don't make assumptions about the order but if you truly think you're ill, don't be fobbed off either is my view on A&E.

Anyoneforacheckup Fri 27-Dec-13 23:49:20

There is no private A and E!!!!

Tell, petition , beg , the govt to stop making cuts and increase the funding to doctors and treat us and the health service with some respect.

On top of all the cuts, because of the way we have been treated and maligned, the UK is facing a brain drain and if you think waiting in AE with minor injury is bad, then imagine having a serious or life threatening problem and not enough doctors to treat you. Either because they have left to go to Australia, or because Cameron has reduced the no of Drs on shift for financial reasons.

That is the reality of what David Cameron is doing, and no one has noticed because the BBC is just Cameron's propaganda tool.
Remember the missing weapons of destruction ....? well for this PM it will be the undermining and destruction of the NHS.

Private medicine is fine if you are ambulant, young and visiting clinic, but they can't cope with sick patients . Those inconvenient customers are immediately transferred to the NHS facility.

Take notice people, before its too late

fuckwittery Fri 27-Dec-13 23:55:40

My mum waited an hour on a stretcher before she saw a dr in A and E, she died 45 minutes later. Not sure if any of the walk ins were prioritised or
It was just v busy. I didnt realise she was dying but it was certainly rcognised as soon as they hooked her up to take her oxygen levels reading I think (clip on finger?).

Anyoneforacheckup Sat 28-Dec-13 00:10:51

If she was brought in by ambulance they would have done O2 level and other obs then. Your m um either deteriorated while waiting and was in the trolley area not the emergency / resusc area so it wasn't immediately noted or she came in via the GP route so no paramedics.
sad

Mouthfulofquiz Sat 28-Dec-13 01:25:44

There is usually a target associated with ambulance turnaround - releasing ambulances back into the roads ASAP. This means the emergency dept might need to take over the care of the patient quickly. This is a good thing I think, as it gets available crews back on the road to answer blue light calls faster rather than being stuck in the queue.

IneedAsockamnesty Sat 28-Dec-13 01:33:19

Anyone who complains about waiting unless medical negligence is occurring is a bit of a wanker really,

Be careful what you wish for because you really do not want to be that person who has not had to wait.

IneedAsockamnesty Sat 28-Dec-13 01:38:03

fuckwittery

My above post was in no way at all connected to yours, bad timing that makes it look incredibly insensitive but not intended to be.

My mum got blue lighted in and then spent an hour and a half on a trolley in the corridor, before another 30 mins in a triage cubicle, four hours in a&e waiting to be seen, then shipped to a general ward, then seven hours after that moved to coronary care.

She had been on a trolley in the corridor in agonising pain because she was having her THIRD heart attack in five months.

That was not good at all.

Not sure where they prioritised her, but I think they got it wrong.

elfsmamma Sat 28-Dec-13 02:03:17

I don't think expecting to be seen swiftly makes you a wanker.

This time last year we were taken directly through with a blue baby with breathing difficulties, I absolutely agree that life threatening situations should take priority over pain but to have to wait hours in terrible pain with no effective pain relief is in my opinion unacceptable.

PenguinBear Sat 28-Dec-13 03:39:42

What country are you in op? Maybe ambulance arrivals are given priority there!

sashh Sat 28-Dec-13 04:09:06

That is Britains NHS A & E. If you don't like it go private.

You can't. There is no private A and E.

Sirzy Sat 28-Dec-13 04:48:08

Elfs did you ask someone for pain relief?

They have no choice but to treat in order of priority and that means sometimes a long wait for less urgent things. Just be pleased your not that more urgent case.

I am sure people were getting annoyed about waiting when 3 doctors spent an hour trying to (and thankfully succeeding) save the life of DS when he was 8 weeks. We had arrived by car too but he very quickly deteriorated.

Unfortunatly a and e departments never know what is going walk in next and they just have to cope as best as they can with the resources available and prioritise the most needy

Spermysextowel Sat 28-Dec-13 05:02:37

We did go to something a few times; can't remember what it was called; Casualty Plus maybe- in Brentford I think?

DS1 split his head open while we were at Dm's. Went to her local A&E & were told to come back in 6 hours. Drove home & 4hrs later he was home in bed with a glued head (done by our local hosp). He did it again when we were at home & when I asked sister to sit with DS2 while I went to a&e she offered to drive us to the private a&e, look after DS2 while we waited & pay for it.
We were in, out & head glued in about 25mins.
DS2 then also cut his head open when we were at DM's (believe me, these accidents have had a major influence when planning my new kitchen) & we just put a clean towel in his head, drove to the private casualty place 45mins away & were home 45mins after that.

It did cost £35 ish each time so not an option for many, but I don't know why they're no longer around. It was like a private a&e but presumably would've taken some pressure from the NHS. Or maybe there just weren't enough children as accident-prone as mine to keep them afloat?

differentnameforthis Sat 28-Dec-13 05:08:13

I'm not sure why people with minor injuries don't just get a taxi!

Don't be silly, OP...they would have to pay the taxi!! Here (Australia) you only really call an ambulance if you need it & have insurance, otherwise you will end up with a bill of $600+, so we don't have many cases of ambo abuse here, thankfully!

YoungGirlGrowingOld Sat 28-Dec-13 05:38:43

There are private A&E facilities in the UK! I have used the one at my local BMI hospital many times - it also has an intensive care department which I have (happily) not used.

I have lots of sympathy with the OP. Our expectations of healthcare in the UK are pretty low because most of us don't know any different. I have lived overseas for the last 2 years and the difference is incredible - I have never had to wait for more than 10 minutes. By contrast I went to A&E in the UK in screaming agony with pleurisy and was accused of "drug seeking" and then when I told a nurse I was allergic to the pain relief he was about to give me he hurled it across the room and stormed out hmm. Envy of the world - not!

Lweji Sat 28-Dec-13 06:01:52

The problem is that they won't give you pain relief until a doctor says to. You could give some paracetamol yourself, though.

If the person does get worse while you wait, to the point of almost fainting, then do tell the triage nurse.

I've had two occasions. Once with a colleague I had gone to A&E with and another with my son, who had bronchiolitis.
They seemed fine on arrival.
He got worse as we waited for over 2 hours (!). They didn't think there was anything wrong with his breathing on arrival, but was seen within a couple of minutes when I went to tell them he was not alert enough. Then I had the pleasure of the doctor telling me that sometimes they don't recover - I could have punched him. But I digress...
She had lost a lot of blood and almost fainted. Still she was taken inside to be put in a bed and warmed, but still waited a long time for the actual doctor.

fiverabbits Sat 28-Dec-13 06:37:53

My DS who is 33 years old was ill with D & V. He is type 1 diabetic and his sugar level was going up. I called the OOH service at 10.30 pm, a nurse called back 1 hour later. She said he is on the dr's list, she will ring within one hour. The nurse rang again after one hour, dr rang at 2.30 said my DS needs a paramedic straight away. ONE hour later OOH nurse told me to ring 999. I did and stayed on the line to controller until 5.45 when the ambulance arrived. Was told at hospital he should have been there last night as he was now hyper, i.e. sugar level really high and dehydrated. He was seen straight away by doctor. Next time I will call ambulance. No taxi would take him as he was too ill to walk. My DH and I are both disabled and walk with crutches so no chance of being any assistance. If I told you where I live in this country and what hospital he attended you would be amazed.

Loveitall Sat 28-Dec-13 07:03:42

I fell on a kerb and the nearby shop called an ambulance as I had a suspected broken ankle and couldn't move. Had lovely gas and air in ambulance ... When got to a and e there was no room in cubicles so they took me off trolley, into a wheelchair with my leg up on a frame thingie, and parked me in the crowded waiting room, with no pain relief and people bumping into the wheelchair frame. Was not a happy bunny! Luckily my ankle wasn't broken but was a very nasty sprain. I was just annoyed that one minute I had pain relief, and the next as there was no room I had no pain relief.

digerd Sat 28-Dec-13 07:19:14

Twice I have been admitted to A&E by ambulance for a life threatening allergic reaction and was taken immediately through to a bed and Dr quickly gave me an IV of steroids. Was also given an IV of antihistamines in the ambulance.
I was not in any pain but my tongue had swollen and was in danger of choking /suffocating me to death.

Misspixietrix Sat 28-Dec-13 08:38:37

DizzyZebra sorry to hear about your ruptured ectopic. One of DMs ICU Nurses had suffered from one and she was extremely ill with it. sad hope you are recovered now. I'm a veteran with the whole 'my child should be seen before yours because I've been waiting here 20millions hours' whilst Dd is struggling to breathe and being rushed through by two paremedics despite being on oxygen. angry. I agree with the others maybe the lady had an underlying health issue? Hope your DPs shoulder is better soon.

Slh122 Sat 28-Dec-13 08:49:11

They don't get seen any quicker. I was blue lighted to hospital in March with suspected meningitis and obviously was put straight into a cubicle and had bloods taken as they thought I had meningitis which is fatal if not treated in time. However once the blood cultures came back after an hour and there was no meningitis I was left waiting around for hours before they came to see me to find out what else it could be.
However there was other people in there at the same time who I heard having to wait a long time before a doctor even saw them despite going in by ambulance. My mum actually asked the paramedic if going in by ambulance gives you priority and they said no, people are treated by priority of illness regardless of how they got to A&E.

Misspixietrix Sat 28-Dec-13 08:49:13

Sirzy me too! sad we was there only last week. I was hoping it was going to be a case of giving her another neb and sending us on our way. a & E doctor warned us she might be in over Christmas sad thankfully she wasn't ghostly ut would much rather be in the 'waiting' category.

TeaOneSugar Sat 28-Dec-13 08:50:16

It's so the ambulance crew can handover the patient and get back on the road to respond to more calls.

Misspixietrix Sat 28-Dec-13 08:52:44

But not ut sorry and don't know where the ghostly came from. blush

Allergictoironing Sat 28-Dec-13 09:10:28

"The problem is that they won't give you pain relief until a doctor says to. You could give some paracetamol yourself, though. "

Ah, there speaks someone who's never been in severe pain - paracetamol is a mild pain relief and doesn't touch things like broken bones, torn or ruptured ligaments, even severe sprains or bruising. I need to take prescription painkillers occasionally for a condition I have, and those wouldn't be a patch on anything the doctors or paramedics can give.

Also, I've always been told to avoid self-medication if likely to need professional treatment as you don't know whether what you've taken yourself may prevent the doctors from giving you something.

Sirzy Sat 28-Dec-13 09:17:20

The triage nurse can, and do, get pain relief prescribed for you while you are waiting. If the pain gets worse then you need to tell the staff because unless you are telling them they can only go off the initial triage.

NewtRipley Sat 28-Dec-13 09:19:38

Elf

Unless you are a medic yourself you have no idea what is life threatening or not, so your point is moot and this thread is a bit pointless. iMO

PinkSnowAndStars Sat 28-Dec-13 09:30:19

Having literally just come off an A&E night shift I can promise you that calling an ambulance does not get you seen any quicker!! It annoys me how people come in by ambulance and expect to be seen straight away.. Oh and also get a free lift home.

Unfortunately it doesn't work like that...!

Bearfrills Sat 28-Dec-13 09:30:32

I'm not sure why people with minor injuries don't just get a taxi!

Don't be silly, OP...they would have to pay the taxi!!

I don't know how it is where you live but round here the taxi companies won't take you if you're bleeding. I tried ringing one when DS, 2yo at the time, split his head open. As soon as I said "hospital" they asked was it A&E, when I said yes they asked "is anyone bleeding? We won't accept passengers who are bleeding". And that was three companies. No car, midday and midweek so everyone else at work (was a SAHM then), only other option was an ambulance. I did apologise to them and even they told me the best option was to ring them.

Not every ambulance patient who can still walk is a time waster.

lljkk Sat 28-Dec-13 09:48:39

Sympathies to OP. DH repeatedly dislocates his shoulder & describes it as agonising; he broke his leg very badly once and still says shoulder was worse. He has learnt to put it back himself, too, better than waiting for them to diagnose the bleeding obvious.

Gas & Air would only last until arrival, I think no one was suggesting anything longer lasting would be available?

HotDogHotDogHotDiggityDog Sat 28-Dec-13 11:02:41

Your A&E wait can very much depend on what is going on throughout the hospital.

A&E departments are often full of people waiting bed allocation on a specific ward.
If a patient is admitted with respiratory problems and needs a bed on a respiratory ward when there are none available, that patient will have to remain in A&E to be treated by the staff there. They cannot just leave that person to attend someone with a broken bone.

If someone arrives at A&E with an infectious disease, they are prioritised over the people already waiting for a bed on a ward.

Beds are like gold dust at the moment, due to social funding cuts and ward closures.

There is a much bigger picture to why A&E wait times are so long. It does irk me when the news stories focus on A&E and not what is going on in the hospital as a whole.

Community care and social care also play a huge part in what is going on.

Unfortunately, it seems to be getting worse. This government are hellbent on destroying all aspects of public funded care. Not just the NHS.

beitou Sat 28-Dec-13 12:04:17

The first point of triage when someone calls an ambulance is the call taker. They ask a series of questions that catogerises the job as either needing a 999 response or an urgent job. Urgents can be taken in within a 4 hour window which may be extended if the service is busy. The ambulance that goes to an urgent job is often not a front line 999 ambulance. It is rare that people are told an ambulance will not be sent but it does happen.

Once we arrive at a job we again asses the patient and decide do they need to go to an A and E department or are there other options. The other options include taking the patient to an urgent care department, not too many of those about. Refering the patient to the local out of hours GP and requesting either a home visit or the patient goes to them. Refering to pats own GP if in hours. Finally we have what is called a self care pathway, this basically means the patient does not need to go to hospital. This is a very risk averse process and can only be used for certain things such as falls, diabetic problems, fitting, usually existing conditions. There is no self care for minor injuires so they get taken in.

The big advantage of a paramedic ambulance crew is the level of pain relief they can give without seeing a doctor, we have Paracetamol, Ibuprofen, Entenox, Codeine and Morphine. If we go to someone in pain we always try to give pain relief before getting them to hospital. Morphine is a very effective analgesic so someone may not appear to be in as much pain or as injured as they really are when they get to hospital.

If the job is serious we pre alert the A and E that we are bringing them in. There are two levels of pre alert, red and amber. Red is for Cardiac arrest, major trauma, reduced GCS, sever breathing problems, status epilepticus etc. A red pre alert gets all the relevant senior and specialised doctors waiting and the patient goes straigh into see them in the resus room. You don't ever want to be a red pre alert patient. The red therefore has a major effect on the rest of the department as the doctors stop what they are doing to work on the new patient. On a busy night this can cause long delays. An amber aler gets a nurse waiting in resus which has very little effect on the department. Amber alerts are often used for protocol driven alerts, chest pain, CVA etc.

When we take a non pre alert patient in we handover to a nuse. There will often be a number of waiting ambulances and there can be significant delays here. We give the nurse an account of the persons illness or injury, the person's past medical history, any treatment we have given and the nurse decides if they go in a cubicle or go to the waiting room. Some minor problems we can do rapid handover and leave the patient in the waiting room.

Calling an ambulance should not be a doorway to quick treatment as there is a multiple filter process before the patient gets to hospital. However there are patients who know what to say to get seen quicker, the exagerrate and often lie, they tell us they have chest pain, we pre alert and get them in then it becomes something far less serious once at A and E.

Lweji Sat 28-Dec-13 12:37:13

Ah, there speaks someone who's never been in severe pain

Not sure what I said has to do with having been in pain before or not.
In fact, I've been to A&E with a cracked bone that hurt like hell, for about 4 hours, between arriving and being put a plaster.

FraidyCat Sat 28-Dec-13 12:52:27

Anyone who complains about waiting unless medical negligence is occurring is a bit of a wanker really,

I don't think waits of several hours serve any useful purpose, therefore it is always reasonable to be annoyed by them. I don't buy into this attitude that we should be grateful for what we're given, and its not our place to have expectations about the quality of service.

Sirzy Sat 28-Dec-13 12:54:54

they may not serve a useful purpose but often they are unavoidable especially if staff are dealing with an emergency

VivaLeBeaver Sat 28-Dec-13 13:06:53

The only thing which annoys me a bit about a&e is the receptionists at our local one try and triage you before the nurse. Last time I went they advised me to go to OOH dr the other side of town. I ignored their advice and was admitted for a week severely ill!

Misspixietrix Sat 28-Dec-13 13:15:36

viva she shouldn't have been advising you where to go if she wasn't medically qualified imo. Hope you are better now.

Misspixietrix Sat 28-Dec-13 13:16:23

viva she shouldn't have been advising you where to go if she wasn't medically qualified imo. Hope you are better now.

Allergictoironing Sat 28-Dec-13 13:48:00

Lweji it was your reference to giving paracetamol that seemed a little flippant; I'm sure that wouldn't have helped much with your elbow either!

VivaLeBeaver Sat 28-Dec-13 13:48:07

I'm good now thanks.

She was very snotty with me when I politely declined her advise. grin

VivaLeBeaver Sat 28-Dec-13 13:48:20

Advice.

Misspixietrix Sat 28-Dec-13 13:55:01

Oh they do. Ds once had a bad rash and the walk in centre sent us to A & E,got the whole neurotic parent vibe off both receptionist and Nurse until she lifted his top up and saw the rash for herself. I've never seen her scoop him up so swiftly and rush him through to the bed bays. Thankfully it was a false alarm but goes to show. Glad you are better now.

FraidyCat Sat 28-Dec-13 14:27:18

they may not serve a useful purpose but often they are unavoidable especially if staff are dealing with an emergency

A&E exists to deal with emergencies, so I don't think "emergency" is usually a valid reason not to cope with level of demand. If there are four-hour waits every night of the week (or even only on weekends) that looks more like a planned shortfall in capacity, that could be solved by spending 2/5/10/[pick a number] times as much money. Most people may not be willing to spend more, but that doesn't meaning those who are willing are wankers for having different preferences. (See the original post I was responding to.)

ChestyNutRoastingOnAnOpenFire Sat 28-Dec-13 14:34:08

Paracetamol for a dislocation?

I dislocated my shoulder and have never felt pain like it, too the point of vomiting and passing out.

12 hours before it was put back but morphine defiantly helped me stop wanting to shoot myself.

Hope DP is ok OP thanks

Lweji Sat 28-Dec-13 14:39:55

I didn't actually say that paracetamol would help with whatever disease. My comment was about pain relief that would only be given by doctors, not nurses.
And I only mentioned paracetamol to refer the type of pain relief that we could give ourselves without waiting for a doctor to give it.

The comment about me never having experienced really bad pain was the flippant one.

MrsDeVere Sat 28-Dec-13 14:48:26

When I worked on reception (this was a long time ago, pre triage) we were expected to act as a sort of triage system shock

I was recruited as a group of new receptionist. I make no claim to being totally sane and sensible but out of 6 of us, four were unstable to say the least.

One of them would harangue anyone she thought deserved to be in A&E because it was their fault.
One of them insisted on righting HIGH RISK next to the name of any patient she considered might have AIDs.
They all considered themselves perfectly qualified to give out medical advice.

We were expected to turn away dental patients and direct them to an emergency dentist and direct any woman 20+ pregnant to the labour ward.
I was only in my early twenties. It wasn't much fun dealing with all that with no protection and only two disinterested security guards.

I used to run down to the nurses and ask them to see anyone in obvious distress. It didn't make me popular.

Someone came in with a gun, we were threatened daily and took the flack for the horrendous waiting times.

elfsmamma Sat 28-Dec-13 19:33:23

Dp is recovering although he is unable to lift his arm above his head. I think we will wait until we get home todeal with it.

The country dp lives in has a 20--30 pound charge for A+E treatment, it means that you are seen much quicker because A+E isn't full of people who have bumped their foot or drunk too much.

I think the charge is great as it is a real deterrent to those people clogging up the system with ailments that could be delt with otherwise.

Dp was never taken further than triage, so his shoulder was put back in place whilst he was laid on a bed in the middle of a room with no curtain, no privacy, no respect. People were commenting as if it was an interesting spectacle, if you are well enough to speculate and comment on other patients conditions then you shouldn't have been put before them in my opinion.

ddubsgirl Sat 28-Dec-13 19:56:02

I was taken by ambulance after being hit on the head by a brick in the summer and spent from 6.30pm till 5am before I was treated and was only given paracetamol for the pain result was I lost part of my ear as the flesh had died due to no blood supply was told I should have been taken to the local a&e as thats the major trauma center and has the plastic surgical team instead I was taken to worthing a&e

RudolphtheRedknowsraindear Sat 28-Dec-13 20:01:34

I had a fall on a grassy slope & broke my ankle, sounds like nothing doesn't it. My foot was facing upside down & pointing backwards & my shin had slipped down to where my foot should have been. It soon swelled to the size of a rugby ball.
The ambulance, then the helicopter arrived: I had no idea how bad it was. I was flown into major trauma A&E & taken straight into xray, feeling very guilty because xray was so busy that people were queuing & standing. After xray I was taken into a cubicle where the orthopaedic registrar was waiting for me, Along with a couple of beefy looking male nurses.
At this point, the nurse suggested that my DH take my DC outside & that the waiting room wouldn't be far enough. It was when they decided on the local shopping centre as being far enough to get me some overnight things that I thought, "ooh, not good!"
Anyway, they gave me 3 puffs of gas & air, held me down & pulled the dislocation out, (I did scream), plastered me up, put my leg up on a contraption to keep it elevated to get the swelling down so that they could operate. I was in hospital for 10 days.
I had smashed & dislocated my ankle, broken the end off my shin & the end off my heel. I need a fusion operation & will never walk properly or run ever again.
I had not realised just how bad it was. Since then I've had breast cancer & a mastectomy.
I am so thankful for our wonderful NHS staff: Drs, nurses, orderlies & porters. You are all wonderful & work extremely hard.
I think that a lot of concerns stem from mistrust that is sparked & fanned by the media. NHS staff have saved my foot & my life & I would now go with decisions they make, they do know what they're doing.

Anyoneforacheckup Sat 28-Dec-13 20:25:06

It's all about the media...about time they were held accountable for scaring everyone silly and misreporting things and scaremongering

VivaLeBeaver Sat 28-Dec-13 20:30:54

Paracetamol for a dislocated shoulder doesn't seem enough.

I used to work in a mud hut hospital in Africa and was taught to put shoulders back in. I used to stab people with ketamine to knock them out before doing it. However I have no real medical training so maybe that's not best practice? I can pop a shoulder back into place really well though. grin

ToffeeOwnsTheSausage Sat 28-Dec-13 20:36:13

It doesn't mean you get seen quicker. DD has been taken to hospital twice by ambulance, once an emergency, once not really necessary and both times she had to wait to be seen. I was just grateful she was actually in the right hospital since the first crew took us to a hospital that couldn't treat her hmm.

lookatmybutt Sat 28-Dec-13 21:01:16

I'm actually terrified of going to my local a&e now. Last time I was in there, there was a guy with a dislocated shoulder. The doctor came to boot him out saying he was fine, he said: "Does this look fine?" whipped off his blanket to show an obviously disclocated shoulder. He'd already been there many hours and I presume they had given him morphine. He was told to come back the next day because they were too busy - I didn't even see them try to pop it back in for him.

Another guy was screaming in pain for well over an hour - puking and howling. The nurse kept telling him to shut up and that he was making a fuss over nothing. It turned out to be peritonitis. I felt so bad for him, at least when the doc turned up she gave him morphine or something and was NOT impressed by the awful nurse's attitude.

'Lucky' for me, I was admitted with my problem which turned out to be minor in comparison. I'd nearly snuffed it about a month before, so it was related to that, but I was not about to snuff it when I went to a&e (as far as I know, they don't always tell you).

Rachelicious Sat 28-Dec-13 21:26:35

I've gone in before for collapsing from a migraine. Got driven there by a friend and had to wait 2 hours before being seen. I probably looked perfectly fine but was in agony. You can't judge someone's situation just by looking at them there could have been someone worse off than your dh that needed to be seen

ChestyNutRoastingOnAnOpenFire Sat 28-Dec-13 22:50:11

viva the thought of putting a shoulder back in makes me feel queasy.
I went to theatre to have mine put back in.

Did the ketamine render them unconscious?

look that sounds horrendous sad

elfsmamma Sat 28-Dec-13 22:57:31

I just don't understand why people in the UK can't pay just a tiny bit more tax and get a decent emergency service.

I am very tempted to learn how to put a shoulder back into place, dp has dislocated his shoulder before and managed to put it back by himself, I really think my armature attempt in the middle of nowhere would have caused dp less pain than the wait he had.

VivaLeBeaver Sat 28-Dec-13 23:08:11

Yes, knocked out with the ketamine.

Then spend a couple of hours wailing like the undead as they slowly come back round.

SpikeyChristmasTree Sat 28-Dec-13 23:18:08

I had ketamine when I dislocated my knee. Had to wait a while to have it popped back in but I couldn't have cared less after the ketamine. It was lovely.

YoungGirlGrowingOld Sun 29-Dec-13 09:19:53

It's all about the media...about time they were held accountable for scaring everyone silly and misreporting things and scaremongering

Anyoneforacheckup - really? The media should be held accountable for criticising the NHS?? Terrifying attitude from someone I assume is a health professional.

I have been through NHS cancer treatment in the "good old days" under Labour when they were hosing money at the NHS. Care and treatment was diabolical, and so were a minority of the staff. Nothing reported in the media about NHS failures surprises me in the slightest. The only surprising thing is that the Labour gov managed to keep the lid on the criticism for so long, despite routine failures in care. I am so scared of ending up on the NHS that I would rather sell a kidney and keep my BUPA coverage and I assure you it has nothing to do with the media.

One person having a positive experience does not mean it is rosey for everyone.

Anyoneforacheckup Sun 29-Dec-13 16:55:08

Yes, because the nhs has been run down intentionally by this govt with drastically reduced funding and administrative over spending while clinical concerns have been conveniently ignored.
They want to rubbish the nhs so it can be dismantled with no fuss involved, like the Post Office.
The administrators are now in charge and no one cares what the doctors think anymore so they are creating a mess but blaming the doctors and nurses.
The press and media are the gifts propaganda tool or are too ignorant of the true frontline facts to know what's really going on.

There needs to be increased funding in the nhs and cooperation with the clinicians who are the ones who really care about the patients rather than the fatcat management who just sit waffling in a room all day drinking coffee.
It disgusts me.

Ubik1 Sun 29-Dec-13 17:37:47

I often think about how amazing it is to have medical care that us free at point of need, 24/7.

It's a scandal the way shiny Dave and his pals are running it due and hiving it off - but it's no surprise because the NHS us a massive market, where in the future people will be willing to pay a fortune to ensure their children get chemotherapy or their husband gets cardiac surgery.

zzzzz Sun 29-Dec-13 19:14:53

Care I've had in A&E has always been brilliant. Care for my children with sn less so.

Did you know that in Devon children's services are now provided by Virgin?

needaholidaynow Sun 29-Dec-13 19:39:50

I'm pretty sure someone in a car accident is a bigger priority than someone with a hurting foot. "Regardless to your injury" in your thread title is a little bit silly OP.

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

It depends on the injuries from the car accident. smile

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.

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!

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.

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 20:46:28

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.

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 20:53:59

Typo's everywhere tonight! blush

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!

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.

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.

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 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 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 22:51:24

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.

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

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

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 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

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.

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.

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.

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.

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.

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.

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

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

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