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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:
nenevomito · 21/04/2013 18:33

I had to check I wasn't in the food topic reading this thread due to some of the thick as mince responses.

No OP, you weren't being unreasonable. Its also not unreasonable not to put your whole life on hold while you wait for your wound to heal as life isn't like that.

nenevomito · 21/04/2013 18:34

Out of interest, our local dressings clinic is in our A&E dept...

olgaga · 21/04/2013 18:38

Olgaga, surely if GPs did this it would be swings and roundabouts? less work if your patient went elsewhere and to compensate you treat someone elses?

No it doesn't work like that.

Nerfmother · 21/04/2013 18:39

Some one earlier posted that people like the pp mean real emergencies have to wait. Get a grip! As if the staff would say okay, we'll just get the (insert emergency) to wait while we take your Elastoplast off.
Op, not unreasonable at all , best in unfortunate circs

IneedAsockamnesty · 21/04/2013 18:42

Some areas do hold dressing clinics in the same area as a&e but its not a drop in service and they don't tend to use a&e staff.

EduCated · 21/04/2013 18:45

I feel I need to apologise again for misreading, although it seems like I wasn't the only one by far and it certainly wasn't intentional Hmm

AIBU can move so fast that by the time I had read and replied to the thread I had x-posted with a lot of the posts highlighting the bit I had misread (where I missed that you had spoken to a GP local to the A&E, rather than local to you)

crashdoll · 21/04/2013 18:49

Even if a GP gets charged if a patient attends A&E, that is not a cost, it is funds being moved from one part of the NHS to another.

I know it's not relevant to the OP but I don't think it works like that. The money doesn't move patient care and that's where we want it really. GPs have to manage budgets.

ginmakesitallok · 21/04/2013 18:55

ffs - Id just written a big long response and it got deleted.

In short - OP YWNBU at all! I hope you have complained to MILs GP who is giving out incorrect information

fanjoforthemammaries7850 · 21/04/2013 18:59

YANBU.

Some people just love a chance to act holier than thou in AIBU.

IneedAsockamnesty · 21/04/2013 18:59

Ohh its so frustrating when the forum eats a long post.

featherbag · 21/04/2013 19:01

But someone else would have to wait longer - once she's booked in they have to get her out within 4 hours or get fined. So if thanks to a hissy fit someone has to do the dressing, there's a time limit on actually getting it done. The breach can't be explained away by saying 'well, she didn't really need to be here but refused to leave, we agreed to do the dressing but had to see all the people who attended appropriately first, so didn't get her out until 5 hours had passed'. It doesn't work like that. Do you have any idea how under pressure these services are? Or how much of an impact there'd be on real emergencies if people like the OP weren't turned away?

mrsmindcontrol · 21/04/2013 19:03

Why could you not have investigated where the nearest walk in centre was before going to A&E?

OhYouBadBadKitten · 21/04/2013 19:09

She did!!!!
This thread is driving me bonkers!

Salmotrutta · 21/04/2013 19:10

Err, the OP was sent to the non-existent walk-in by her MILs GP. mrsmindcontrol.

Who should have known it didn't exist anymore.

That, apparently, was the nearest walk-in. Only it wasn't. Because it had closed a couple of years earlier.

Salmotrutta · 21/04/2013 19:11

Hahahahaha!

X-post with OhyouBad!

ChestyNut · 21/04/2013 19:19

Perhaps drop a letter to GP about the difficulties his incorrect info caused.

YWNBU to want to go away with a chronic wound and believe GPs info

But

A+E WNBU in that its not an A+E role and will have been unaware of your treatment plan/dressings/ history.

Chronic wounds can be complex to treat.

sneezecakesmum · 21/04/2013 19:34

There had to be SOME facility for dressings if they were urgent. A&E is NOT appropriate.

Next time call your MILs GP number and ask for the district nurse service. To the best of my knowledge they are the official people to do out of hours dressings.

(ex A&E nurse, ex out of hours call centre nurse!) So I know what I'm talking about Grin

dollywobbles · 21/04/2013 19:42

DH had to have dressings changed every day for about 7-8 months. The District Nurses used to come out at first, then, when he could walk a bit more, he'd go to surgery to see them. At weekends/bank holidays, they'd come to the house.
Honestly, never occurred to us that we might try and arrange for the dressing to be changed somewhere else.
I don't think it's the A&E you need to complain about, it's the GP who gave duff advice.

OhYouBadBadKitten · 21/04/2013 19:52

But the a&e could have had some compassion as there really was no where else to do it. Sometimes it's just not appropriate to have 'rulez is rulez'

lougle · 21/04/2013 19:53

Ex outpatients nurse here, if we're talking about why we know what we know...

I once had a lady who needed frequent dressings through clinic, just before a national holiday. She was booked to spend the time with family, but needed daily dressings. She was crestfallen, but as is typical of her generation, accepted that she shouldn't go away because of her dressings. I took her relative's address, contacted the GP and arranged for the DN services while she was away, as a temporary patient. She was incredibly grateful.

The OP couldn't do this. How exactly was she to contact the GP on a Saturday? Once she had followed the advice of the GP and that advice was wrong, she had no choice but to access the medical service which was open.

I'd argue that at the point she found that her recommended health care provider was unavailable, yet had clear instructions from her Consultant for daily dressing, it became an emergency and she was entitled to access A&E.

OP, YANBU.

NorthernLurker · 21/04/2013 20:08

To use the example of dialysis again though - patients need it to stay alive but they are expected to make arrangements before travelling and any dialysis unit which had a patient who just went away on spec and turned up at a unit expecting to be treated would find themselves on the end of a shirty phone call from the unit thus lumbered. Not just because of capacity but because we need to know a patient is negative for various infections before dialysing them and we need to know what sort of dialysis they need.
The harsh reality of being on haemodialysis is that if we can't arrange dialysis for you in advance you can't go away. In the case of the OP I think she should have stayed at home.

AmberLeaf · 21/04/2013 20:15

That is ridiculous Northern.

You can't compare dialysis to dressing changes, of course in the case of dialysis it would be silly to just turn up, dialysis is very different to dressing change in the level of skill required to do it and equipment.

Some people need daily dressing changes for extended periods of time, are you really suggesting someone in that position never leaves home?

Lougles post is very sensible.

NorthernLurker · 21/04/2013 20:23

I think you're under estimating the skill involved in getting difficult wounds to heal. The OP didn't have any old surgical wound. It's open and packed. Continuity of care is very important. The time involved is less than dialysis but the skill and need for the patient's history is to some degree comparable.

firesideskirt · 21/04/2013 20:26

YANBU - as if we still had a decent GP out of hours service you could have gone to that. We don't, so you couldn't.

evansthebread · 21/04/2013 20:31

As ex NHS hospital employee, I'm pretty sure they could have slotted OP in somewhere for a simple dressing change - or she's gonna end up there somewhere along the line being treated for septicaemia or something equally unpleasant, costing a lot more.

I turned up at 9am at my A&E with a broken leg. It was just after shift change, fresh staff (I'd waited for this as I refuse to attend A&E on a Friday night with all the drunks - now there's time and money wasting!). Several staff hanging round station having coffee and a nice little gossip, I eventually got seen by a nurse who didn't lay a hand on me or ask me to stand and try to bear weight. Was sent home with an exercise sheet and told to use it or risk damage by not exercising. A fortnight later, still in agony after trying the sheet several times, I returned to see different staff and being given an x-ray - broken leg - could've knocked me down with a feather! No apology, just a telling off for leaving it so long and "risking the break getting worse with pressure and ultimately costing the NHS a lot more" - I kid you not!

Going back to me being ex-nursing staff, Most of my age group noticed the younger staff developing a mini God complex towards their importance at about the time nursing pay started to increase. All of a sudden, nursing became just a job to most and no care was being shown by an awful lot of new-joining staff.

The most disturbing aspect noticed by myself and the older staff was the "punishments" being meted out by some staff if any patients dared to complain (or sound like they might). It may not sound like much, but some would actively ignore patients, especially the bed-bound, and then be sickeningly sweet when those patients had visitors. Some poor patients were, I would say, emotionally tortured. The lucky ones were the ones I felt sorry for when they were being ignored!

It was an awful situation for the genuinely caring staff to have to put up with as they were being bullied themselves by the younger, nastier staff. If whistle-blowing had been around then (and changes made) I would probably would have stayed nursing.

The last straw for me, however, was one male staff "dosing" a "difficult" mental patient before he was discharged. He was left completely out of it outside the main doors, having lost control of his bladder (side effect of the drug he was dosed with). The police eventually removed him and charged him with being drunk & disorderly.