to think you shouldn't have to describe your symptoms to 6 different people in A&E?

[Katisha]

OK I don't know how this works and would be grateful for explanation from anyone in the know.

My mum had to go to hospital last night in very bad pain. She was hardly able to talk. So first she had to describe it all to the paramedic at home who wrote it all down. Fine. Then again to the subsequent paramedics who took her in.

Then again on arrival at Emergency Care Unit, while in agony. All gets laboriously typed into a computer while patient is retching away. Then again to Dr in that Unit. Then again to the Dr in A&E where she eventually got sent. Then again to the nurse in A&E doing paperwork.

Do all these notes not get passed on? Or are they just for the internal paperwork of each section?

Did they sort her out?

When I went to A & E, we saw triage, the doctor and then another doctor who stitched dd up.
I don't recall them all taking notes but they did treat us in a polite and timely fashion (and all asked what had happened) before sending us on our way :).

Hope your Mum is ok.

At a guess, I'd say they do get passed on amd meet up somewhere eventually, but it is quicker for the staff (and the patient) if the patient just tells them what's wrong instead of them having to hunt down notes that may not even cover all the things a Doctor wants to know.

I would expect the paramedic and the triage nurse and the doctor to be focussing on different things. Like the nurse is trying to work out how urgent it is, and the doctor is trying to come up with a diagnosis, so they might want to know different things, and may want to be sure that nothing has been incorrectly recorded or omitted from the previous persons notes.

I have no experience and no idea if any of this is true or makes sense btw, it's just my guess.

I go in often with a jaw problem. I write it all down and give the sheet to each person in turn so I don't have to speak.

I don't know the answer but I've had the same experience.

When literally the seventh doctor asked me what was wrong, I totally lost it and snapped, 'Don't you people know how to read?'

I know I shouldn't have, they were just doing their job, but I was in a lot of pain and had been passed around a lot. And, after that, everyone did read my notes so mission accomplished, I guess.

Well she got discharged in the middle of the night as the tests came up with nothing but we have had no help with knowing where to go from here with this flare up. Back to the GP I guess.

i think its better to get it from the patient, rather than risk crossed wires or someones idea of whats happened.
If paramedic put "pain in stomach", the question is how bad, which area, only if you move? stabbing, always there? have you had bleeding, scale of 1-10 pain scales.
If you ask the patient you get upto date truthful inforamtion which is what you need, not someones written word.

we had this when my mum was in hospital - constantly having to explain case history to every new medical person.

The problem is that after you have said it a few times you end up missing bits out - and it may be that this is the one person who would have made the important connection if they had had the whole story.

Not sure how you get round this problem though.

Well we did all that with the first paramedic. Who decided it was 10/10. BUt it took another 5 hours to get any pain relief.

same thing happened to my DD when she had really severe stomach flu 2 years ago :(

What's worse is when you have an ongoing thing which is in your main hospital file but then turn up at A&E after 5 pm or at a weekend, then they can't access the file as the records office is shut. Then you waste time with junior doctors who get bogged down with the underlying thing and ignore the issue you've turned up with. And then each junior doctor refers upwards and you need to go through everything again...

I'm now at the point with dd2 that unless there is gushing blood or obvious bits of bone sticking out we can't go near A&E, after the last time when she fainted (ongoing thing) and fell down the stairs, but they ignored the potential concussion/spinal damage in order to painstakingly work through the "does she have epilepsy?" checklist, when we already know what the fainting isn't, and all the test results are in the sodding file. And don't get me started on the fact that the A&E paediatric doctors don't know her actual paediatrician even though he's in the same hospital. But as he's been useless so far, that's the least of my worries.

Apologies for hijacking and ranting

YANBU .... but, it is always possible that mistakes have been made in the notes, so it is sensible for whoever is doing an examination to double check with the patient.

Agree about mistakes in the notes. Disagree about the number of people one has to tell and hope they tried to make her comfortable whilst asking and expressed some concern. I understand that used to be called nursing.

The reason you have to tell different people is because they have different roles and, as you mother noticed, they were only imported into the hospital system (and at that point it wouldn't have been a full medical record anyhow).

I'm not sure why she had to speak twice to paramedics - but they will have been assessing what interventions she might need en route and what to radio ahead to the hospital. They are not doctors and will not be diagnosing in the usual sense.

The triage nurse in ECU/A&E will be taking personal details (and getting up your hospital record if you have one, on an adequate functioning system). He will be making a medical assessment of urgency. You would complain enormously if this step were omitted, as it the filter which ensures that people are seen according to their medical need (rather then the noisy drunk with the gushing but minor cut getting seen before the quiet but seriously ill person who doesn't like to make a fuss).

Doctor there: obvious.

Doctor at any onwards departments: also obvious. They may have read any notes, but will be treating the patient, not their record and really do need to ask for themselves what's wrong. I'd hate to be treated by someone who breezed in, looked at my notes and started treatment without checking anything with me (assuming I'm conscious, of course). also, alertness and ability to answer questions/speak at all may be relevant.

Nurse on exit: usually to check if you need onwards appointments and to out you in the system for them. It can also be a check that you understand what has happened, and what if anything you need to do next to optimise your recovery.

Of course different people need to check. What if your mothers symptoms had changed during the evening and all the treatment was done based purely on what had been told to the first paramedic? All sorts of things could be missed.