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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

To complain about A&E not changing my dressing?

270 replies

HarderToKidnap · 21/04/2013 15:15

I have an open wound on my abdomen that has a small pack in it. Last Friday my consultant told me I would need to see someone on the Saturday to have the pack removed and changed. I was due to drive 2 hours to stay with my MIL for the weekend, to catch up with the all the inlaws and attend several family events.

On Friday morning after seeing my consultant I called my MILs GP to try and arrange to have the pack changed the following day. GP flatly refused to help or see me the next day but did tell me I could go to a walk-in at the local hospital.

Friday pm I drive 2 hours to MILs. Sat am I get up and head to local hospital. I find the Walk In boarded up and looking deserted. There is no other option to see anyone other than A&E. Receptionist/Triage nurse said they couldn't take the pack out. Just that. They couldn't, and wouldn't do it. It wasn't their dressing to change. Oh, and the walk in had been closed for 3 years!

There followed quite a long Mexican stand off during which she repeatedly told me they wouldn't change the dressing, and where I asked for reassurance that I would not get an infection or the pack would not adhere to the inside of the wound if I didn't get it changed until the Monday. She told me she couldn't assure me of that but that they couldn't do it. She phoned an OOH who wouldn't do it either. In the end I told her I would go to the toilet, remove pack myself and if I experienced a lot of pain/bleeding I would come back and be seen as an Emergency. She then said they would do it "just this once" and let me go through to a deserted waiting room, I was called 2 minutes later and dressing changed by a lovely nurse, back in car 10 minutes later.

Now, I'm a frontline HCP and bolshy with it, so I got seen - but what if you were a vulnerable person who had the temerity to be far from home when you need your dressing changed? Who thought if the receptionist was telling you they wouldn't do it, that you would wait however many days until you were back home, potentially causing problems? There was no "we can't do it, but if you go here/do this they will see you" just a very very flat "no". I'd like to complain to PALS, not about my treatment but about the lack of healthcare options there and the fact I had to throw a hissy fit to get medical treatment I needed. Other people wouldn't have thrown the hissy fit and wouldn't have got seen. WIBU to do so?

OP posts:
5madthings · 22/04/2013 10:12

And if i was told by a gp to go to an ooh centre i would assume they were giving me the right advice and go.

sashh · 22/04/2013 10:30

A&E was my ONLY option unless I wanted the pack to become infected or adhere.

Bet the local private hospital would have seen you.

But a receptionist shouldn't be making medical decisions.

olgaga · 22/04/2013 10:31

The MIL's GP should have placed a call to the district nursing team and asked that they add the OP as a temporary patient to have her wound dressed, asking the OP to bring sufficient supplies and a written care plan.

Yes that's correct. But this kind of one-off care is unlikely to be available on a Saturday, which is probably why the MIL's GP flatly refused to help or see (OP) the next day. Not all GPs do surgeries on a Saturday, and certainly the DN team would not be available for one-off care on a Saturday.

The only fault here is with the GP who incorrectly advised the OP to go to a walk-in centre which had been closed - but who knows, it may have been a locum for all we know.

If the OP wants to make a complaint it should be sent to the GP surgery, but it's unlikely to go anywhere (except straight in the bin).

olgaga · 22/04/2013 10:35

But a receptionist shouldn't be making medical decisions.

It was a Receptionist/Triage nurse. Not a receptionist.

featherbag · 22/04/2013 11:12

Can I just clarify when I said I wouldn't, under any circumstances, have changed this dressing, I wasn't being cruel but would've been protecting myself and my registration, without which I cannot work. The NMC insist registered nurses should never perform tasks which they are not competent in doing, as to do this puts the patient at risk. I have encountered people unhappy at my refusal to do certain things that are well out with the remit of an A&E nurse, but is rather they were unhappy/inconvenienced than me being out of a job and them suffer physical harm at my hands! There is no reason why an A&E nurse would be competent in changing these specialist dressings, and the OP was U to insist.

mrsmindcontrol · 22/04/2013 11:13

I actually meant why didn't OP establish where the nearest OPEN walk in centre was once she'd discovered that the one the GP had recommended was closed before heading off to A&E. I appreciate it's not the same in every area but in my locality there are 4 walk in centres within a 10 mile radius of my home.

5madthings · 22/04/2013 11:19

The ooh center the go sent her to was AT the a&e and the nurse phoned an ooh bit they said they wouldn't change the dressing.

kilmuir · 22/04/2013 11:26

Surely basic nurse training covers dressings??? An A&E nurse could follow a care plan if it was available

flangledoodle · 22/04/2013 12:00

dear God

Fayrazzled · 22/04/2013 12:35

sashh, I don't think the local private hospital would have helped at all. Private hospitals usually need a referral from a GP, and even if the OP could have paid for a private consult with a GP I wouldn't mind betting the private hospital wouldn't have had appropriate staff in to do the job over a weekend.

I don't think the OP was unreasonable at all; if her wound had become infected or the pack had adhered because she couldn't get it changed then it would end up costing the NHS a damn sight more. Now budgets have been so devolved in the NHS, all the different areas have become silos- no-one wants care to come from their part of the budget, patient care is suffering and ultimately it's costing the NHS more when things go wrong. What has happened to the NHS in recent years is despicable.

Fayrazzled · 22/04/2013 12:38

mrsmindcontrol- you're forunate. Where I live there is one NHS walk-in centre in about a 20 mile radius, possibly more. And actually, it's not even a walk-in centre it's a minor injuries unit so limited in its remit. NHS provision varies dramatically by area.

thistlelicker · 22/04/2013 12:44

Just out of curiosity who normally dresses the dressings? And why didn't or couldn't they do it this time???

olgaga · 22/04/2013 13:14

Just out of curiosity who normally dresses the dressings? And why didn't or couldn't they do it this time???

Because the OP was due to drive 2 hours to stay with my MIL for the weekend, to catch up with the all the inlaws and attend several family events.

thistlelicker · 22/04/2013 14:14

The reason I asked was perhaps the person originally doing the dressing change could have passed details on to the nurses or p in the area for dressing to be accommodated if enough notice was given? District nurse request are almost instant I think

saintmerryweather · 22/04/2013 17:23

The op has said that it doesmt require daily dressings normally. she went to see her consultant on friday, not expecting to have it done, her MIL took the ops DS with her back to her house 2 hours away where the OP was going afterwards and the OP was told she needed the dressings. i presume as her son was with her MIL she would need to get him anyway so she rang her MILs gp who said, i cant do it for you but the walk in centre can. op goes to MIL house having also checked on the out of date nhs website that the walk in centre is open. it apparently is. she goes there to find its been shut for 2 years.

So op asks at a and e and receives no help. op makes a fuss and dressing is changed in 10 minutes, op is happy, nobody died because the op was seen and some of MN still think.op is somehow to blame for the.whole sorry saga.

just in case anyone else cant be bothered to read the thread.

saintlyjimjams · 22/04/2013 17:28

Just asked my mum (a district nurse) she said your treatment has been terrible & you should complain.

FordTractor · 22/04/2013 17:31

well done saintmerryweather, this thread is shocking :(

TumbleWeeds · 22/04/2013 17:36

Well I have to say if a GP who knows his are tells me there is an OOH centre then I would believe him. Why shouldn't I?

I think if there is a complain, it should be done to the GP first and foremost. Why on earth did he say there was an OOH centre when there isn't one? Confused

I would also have expected A&E to tell me where I could go to have the dressing changed. Again they should know the area and be able to send people to the right place anyway. Unless of course, there is no OOH in that area and A&E is unfortunatly taking over all of the OOH work....

TumbleWeeds · 22/04/2013 17:38

I have to say, it does make me wonder what on earth you are supposed to do if you are ill/need a dressing and you aren't in your 'normal' area ie you can see your own GP.
Can't see the local GP for a new dressing, no OOH. Where are you supposed to go then?

crashdoll · 22/04/2013 17:48

What's with the "CAN YOU READ?". It's really bloody rude!

thistlelicker · 22/04/2013 17:48

My point is.... If the op knew she was going away and the consultant told her she needed it dressing. Why didnt consultant arrange for a gp? Or a nurse to sort the dressings? Was the consultant aware op plans were in place? Care plan would have been accommodated accordingly

featherbag · 22/04/2013 17:48

Basic nurse training covers basic dressings and basic dressing techniques. A packed wound requires a specialist dressing, which requires the person changing it to have had specialist training.

thistlelicker · 22/04/2013 17:54

A wound of this sort,..... Is it not possibly down o tissue viability long term as op has suggested seeing wound is 6 months old.. Or am I getting mixed up ?

AmberLeaf · 22/04/2013 17:58

I imagine the OP would have had a supply of the packing dressing. I always did.

Sorry, but it is really not that difficult to do and I'm amazed that a trained nurse would struggle with it, it was done by the A&E nurse in the end so she obviously managed it.

thistle, maybe the consultant thought she'd have no problem accessing a walk in centre?

thistlelicker · 22/04/2013 18:15

Dressings are complex dependant on the wound! It's not as simple as Elastoplast!!! Perhaps wound needing cleaning or its now infected hence its went from infrequent changes to daily!

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