Aibu to think a minor injuries unit at a hospital should be staffed with people can prescribe medication?

[Theincidental]

I have a nasty insect bite with bad swelling and this morning I went to my local minor injuries unit 15 min drive away to check it wasn't infected (which I think it is) and to see what I may be able to take to ease the swelling. My whole upper arm is a balloon and blistering.

The place is only staffed with non prescribing nurses who offered me only off the counter strength piriton which renders me insensible.

There was no examination of the bite, and no other treatment available because the staff were not qualified to prescribe anything at all. I was effectively told there's nothing to be done and don't worry about it, despite giving a history of allergic reaction to bites.

My ooo gp is 45 min drive away and a & e is about 1 hour 20 mins.

Aibu to think that in an area so far away from emergency services (we have helicopters for dire emergencies) the hospital unit for cases just such as mine should have properly qualified staff to help people?

[TheBogQueen]

Ambulance service pay is a disgrace

[ElephantsNeverForgive]

The trouble is we did used to bave a drop in doctor at weekends, but when MI replaced the cottage hospital, it went to nurse only.

I've no idea where or nearest, non A&E walk in Drs. are. Fortunately I've never need to ring the number in the answerphone and find out.

[Aheadofyourtime]

Yes.
Junior drs and nurses wages are much the same btw.

[macdoodle]

cheap or good but not cheap and good (tanstaafl)
The goverment have chosen which and cleverly sucked the great British public into it.

[Aheadofyourtime]

It will be even more fun when the paramedics fall apart as so many are leaving due to being underfunded.

Expertise, who needs it anymore?

[Aheadofyourtime]

Welcome to the new NHS where everything is now done by nurses in AE units that have niw closed and become minor traetment centres. It's like having doctors, but without the specialist knowledge and training on how to examine, diagnose and treat and prescribe.
It can work extremely well, or not that well. But Drs are now too expensive and not needed. Nurses also form most of middle and senior management .

Soon there will be no need to train Drs at all. And all will be well until there's a medical emergency or major surgery and it all falls apart and everyone dies. Happy ever after with David hasn't a clue Cameron.

[MissDuke]

Just catching up on the thread, glad you are ok now op. From the start, I was thinking ywnbu! I went to minor injuries for exactly the same last year - they were able to give me antibiotics for one day with the instruction to get a prescription for the rest of the course from my gp the next day.

[windchime]

I think I would have just had a chat with my local pharmacist. It sounds like he would be a lot more qualified to advise me than a Minor Injuries Unit. YABU.

[ChelsyHandy]

YANBU. I could understand having to travel at least an hour for medical treatment such as antibiotics etc in the African bush, but in the overcrowded UK theres no reason for it other than a poor service. What do the MI Unit actually do, if they cannot treat minor injuries?

Perhaps the staff were particularly reluctant to actually do anything, and weren't a typical reflection on the service?

[Theincidental]

Hear views!

[Theincidental]

Very interesting debate following this as well. Good to eat views of people who are involved in ooh care - I hadn't appreciated how complicated it all is!

[Theincidental]

I have steroid cream and anti Bs. Bad blistering and very angry looking skin. Swelling has gone though.

GP was great and very puzzled as to the miu's response. Said piriton is only good as an immediate treatment to reduce histamine levels and not a good idea to take after 24 hours.

I remain utterly confused: 1 nurse and 2 doctors all with differing views.

It feels like a complete waste of resources if I think about how many people were involved in diagnosis and care, as there's a call handler and two receptionists in there too!

[MorphineDreams]

YANBU

I had a head injury once and was sent to Minor Injuries. I had to wait 5 hours before I had a neuro exam because the doctor had 'wandered off'. At this point I was throwing up, seeing flashing lights and was just generally unwell.

They need more staff, who are more qualified.

[macdoodle]

OP how is the bite now? Did you get seen?

[TheBogQueen]

But sometimes patients have good reason fur not taking pain relief. Which is why call handlers never suggest anything like that - we leave it up to the clinicians.

[MammaTJ]

We have recently had to fight to keep our 24 hour MIU as we are in a similar situation to you. We are at the ends of the earth and an hour away from all other help.

Fortunately for us, the nurses there are able to prescribe. Great when I had a strangulated hernia and the OOH Dr told me I needed help quicker than he or the over stretched ambulance service could get to me, so to go there. I got pethadine and entinox! Then an ambulance an hour later.

[JellybeansInTheSky]

thewavesofthesea, My comment was in the context of another poster saying that £1000 for a 12 hour shift was not that much money and that lots of other professionals earn the same or more.

I just wanted point out that as that as that equates to around 170k a year (taking account of holidays, insurance etc) that most other professionals really do not earn that much.

However I have no idea whether this figure of £1000 is accurate or not. Probably not. Which is good news for it being possible to provide an affordable out of hours service.

I also have lots of sympathy for doctors feeling like they are unfairly represented in the media.

[HarveySchlumpfenburger]

Yes I would often hear nurses say: " have you taken anything for the pain?...no...have you thought of doing that... "



I might be guilty of doing that. For some reason it very rarely occurs to me unless I'm in a lot of pain. I did feel like a bit of a tit explaining to the GP that yes, my hip was so painful I couldn't bear weight on my left leg for 4 days but no I hadn't actually taken anything for it.

[edamsavestheday]

I'm in danger of saying it were better in my day when it were all fields round here, BUT the old OOHrs system where GPs were responsible for their patients but could, if they wished, delegate the work to an out of hours GP co-op (or AN other provider) worked much better.

Hiving off OOHrs to PCTs was a grave mistake IMO. The GP you are registered with should be responsible for your care, whether or not he or she provides it themselves. If your GP has clinical and legal responsibility for OOHRs, they have a massive incentive to ensure it is done well.

None of this importing cheap locums from Germany who don't know how to prescribe morphine, like Dr Ubani, the cosmetic surgeon who killed a man on his very first shift in the UK.

[TheBogQueen]

Yes I would often hear nurses say: " have you taken anything for the pain?...no...have you thought of doing that... "

[thewavesofthesea]

GP trainee here; I DO NOT earn anywhere close to £168,000 a year!!!

People will not realise what we have with GP services until they are gone. It's already happening. They are disappearing due to unrealistic demands from public and government; and we are expected to meet it all with a smaller and smaller pot of money. It is just not sustainable.

[TheBogQueen]

Sorry x - post

I worked fir 111 in Scotland which us run by some really scary nurses the NHS and yes calls go in a queuing system and are picked up by drs and nurses.

Call handlers do a small number if routine referrals - v straightforward stuff, but anything amiss and iwe speak to nurse.

I'm shocked that they are allowing call handlers to triage anything but the most routine of referrals that's not fair on call handler or patient.

[macdoodle]

And I'm not in England either thank goodness.

[macdoodle]

Good question? I suspect the former sadly, a full triage pool will be the majority < 40years old with minor self limiting problems. The elderly with multiple complex problems are mostly absent, and if they do call it is their younger relatives panicking. The end result of a nanny state sadly. Honestly the amount of advice I give on managing a temperature is crazy.
The solution? Well not one this government wants.

[TheBogQueen]

I agree with you mac doodle ( I don't work in England)

"Somehow the demand for instant/early/cant be too careful etc care needs to be stemmed, people need to be re-educated to self care,"

Yy to this - but there are sections of society who honestly do not know how to self care -themselves or their children. But what do you do?

I don't want to give you a false impression though, In most cases call handlers do not refer patients, the nurse practitioners refer patients.

Anyway I am out of it now but as a layperson it was an interesting insight. We sometimes wondered whether ooh is a monster that has been created or whether it was a necessary and life saving part of the nhs. I still don't know.