She's dying isn't she?

3 days on a chair in A&E for an elderly lady who is in pain and poorly. What is wrong with our country!!

I have no words, I am so so sorry your mum felt like she had no way than to discharge herself to go home. Can you ring up a private/ online GP? Would be worth the money

Please get her back to hospital.

This happened to my Nan - she had a hiatus hernia and her stomach twisted after she got a tickly cough. They wouldn't operate and she died over 3 weeks in the hospital. It was awful and she was in so much pain.

It's the UTI. Makes people absolutely delirious. Get that fixed and you can deal with the rest.

If the bed situation is so dire then MAU will likely accept a patient but they'll ask them to wait to be seen in ED hence she's really in the same position. It's horrific but if there's no beds there's no beds. No getting around it. GPs cannot create a bed that isn't there.

Speak to 111 or take her back.

“Sat in a sodding chair for 36 hours at A&E”

This is the state of our NHS, this is now what happens to you. Is she waiting for a consultant and possibly a bed OP? It’s scary and frightening and very uncomfortable but she must stay put if she can or she won’t he seen. She will have to start the process again. When DM was there people were slumped in chairs, elderly, frail people, younger ones (still 50’s) writhing and screaming in pain, one on the floor. It’s a horror. Your poor DM she will be ok if she can just stay there and be treated.
They should be giving her an antibiotic IV if she’s got an infection, I’d ask. Some things they’ll do before you see a consultant /get a bed.

Can the GP refer her to the medical assessment unit? It’s calmer than A&E but there’ll still be a long wait.

UTIs in older people can cause changes in behaviour and hallucinations amongst other things, especially if she's also dehydrated. She should probably be on IV ABs and saline to rehydrate. She needs to go back to A&E.

Advocate for her and be insistent. If toileting is an issue at the moment because of her back pain, get her some incontinence pants, at the very least, she'll have a bit more dignity and confidence. If the back issues are causing the incontinence, meaning she's lost control of her bladder, that's a whole other medical issue and an emergency - so again - A&E is the best place.

Sepsis! A UTI if not correctly treated can cause sepsis and without prompt treatment sepsis can kill!

I don’t think the problem here is the wait time in A&E, more the time of getting a bed on a ward. Sounds like OP’s mum was seen by medics who started treatment & wanted her to stay in to wait for a bed, the issue is the bed capacity of the hospital to move her to a ward. So unless there’s another hospital close by that doesn’t have the same bed pressures (which I doubt) then she would have the same issue going back to A&E.

However OP, it does sound like she needs to be in hospital. With her back pain & UTI, it very much sounds like it’s travelled to her kidneys & she might need IV antibiotics to treat it. Unfortunately, the state of the NHS isn’t going to change anytime soon.

Take her to a different a&e
I really hope things improve 🙏

You need to take her back to A and E and wait OP as awful as it is. I don't know what people are on about telling you to 'demand' things. It sounds like the hospital staff were concerned and organising tests, treatments and admission but mum chose to leave against their advice. You don't need to demand anything she just needs to wait her turn.

There will be very little that a GP can do to bridge this gap. They are not an acute response service. They cannot administer IV antibiotics/fluid/oxygen, they cannot organise tests as quickly and they cannot monitor her continuously.

It doesn't sound like she's dying as such but it sounds like she is very ill due to likely reversible causes and she may well become gravely ill or die if she doesn't follow medical advice. Flip this on its head and ask yourself if the hospital are so overwhelmed that they can't find a really sick person a bed for over a day do you really think they'd keep her in if it wasn't 100% necessary? do you think if there was anything a GP could do right now that they wouldn't send her home themselves and ask the GP to do it?

Your mum likely has many years ahead of her. If you really care about her then take her back to A and E where they can treat her illness before it's too late rather than taking her home where she isn't safe and isn't receiving treatment then bleating that she's dying in such a defeatest way when she's chosen to refuse treatment. It's horrible I know but the staff will be doing their best and A and E is where she needs to be like it or not.

Take her to another hospital.

You’ll have to take her back to hospital. Is there another hospital slightly further away with shorter waiting times? We have two about an hour away in different directions.

She may have something else going on, and she needs a full work-up in A&E. If she will not go back to that one, if she were my mum, I would get her in the car after a night's sleep (hopefully) and drive her to another hospital, even if it means a couple of hours' drive.

Then stay there. Chair or not, if she is in so much pain, she needs to get assessed by a hospital doctor. Are you certain she has a hiatus hernia, and what is this based on?

I ask because the frequent vomiting and pain level sound more extreme than with this hernia type, but I know that a minority can be really bad. She needs the UTI monitoring and also her temperature. She must not discharge herself again and you need to ensure she doesn't, because these things will not get better on their own.

The way I think of it also is that it isn't the doctors' and nurses' fault their A&E is in crisis, but they will do their best when they finally get to treat her.

Remember too, you can go to see any GP! Every person has a right to go into a different practice if they are outside their own area, so drive her an hour away and ask to be seen as an emergency in a practice with good reviews. They will usually see the patient the same day as a one-off.

Fixing a hiatus hernia in a routine op. She just needs a good sleep and she'll eat when she's hungry.

My hiatus hernia caused a flipped stomach (gastric voluvus). At ER triage, I was told it was probably flu and sat in the waiting area for hours in extreme pain. It wasn't. I ended up in critical condition. Spent three weeks in hospital, two of them in a medically induced coma.

You need to take her back asap. A hiatus hernia can be fatal; if strangulation of the hernia happens/if it twist the stomach & can lead to cardiac compression.
As my mother found out a few years ago & was rushed in Xmas day for an operation that saved her life.

Please take your mum back to A&E in the morning. I suspect she was on the cusp of getting her bed and being admitted. This is where she needs to be.

To those suggesting 111 and an out of hours GP appointment etc, she was already on the other side of those when she self-discharged. She was in the right place and the hospital had assessed that she needed a to be admitted to a bed. She was in a safe place. It's shit she didn't have a bed but she needed to stay where she was so she got the next one. She just needs to go back. There is no fast track.

Also there is no admitting straight to a ward anymore. A GP can have the longest chat with a specialty doctor, both of them agreeing she needs to be seen, before sending a patient to hospital, but that will always be to a place where she can be assessed in person by that specialty first, which is A&E.

I'm so sorry this is all so shit. UTIs are a real behaviour changer - but she can get better from this. Please take your mum back to A&E in the morning - early doors!

Calling an ambulance will be slower and won’t make a difference once she is there.

OP, can she keep down the antibotics?

Call 111 there might be an out of hours GP appointment she could get.

I thnk that calling 111 is a sensible step. In our area, 111 would be able to get a GP to call your mum back, and/or arrange an urgent GP appointment for Saturday morning. Sometimes, intervention by an on call GP can be very helpful in moving things forward.

The plan suggested by a PP of going back to A and E at 6am is another possibility. if for any reason you don't get very far with 111. But it does depend a bit on what your mum feels able to agree to, right now.

OP, I'm so sorry that your mum is so ill and that you're this worried. Maybe call 111?

She needs to go back to hospital.

I don’t know why people are saying ‘demand’ or ‘push for’ this or that (also no idea what the ‘test for sepsis’ might be……..) when she’s discharged herself.

Take her back. It’s true a UTI alone could make her delirious -gram negative bacteraemia (that can result one of the most common UTI bugs, e Coli) also makes people feel absolutely miserable and as though they are dying but is readily treatable.

She may well die if you do nothing,

Different hernia, hiatuses go up through the diaphragm not down. The OP's mum has enough going on without leaping to thoughts of sepsis.

Calling 111. They should, if they are on point, be able to fast track a call to emergency services. They might send an in call doctor out as an advance