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?

[macdoodle]

** diagnosing over the internet (not phone)

[macdoodle]

Horsefly bites can get infected because they take a long time to heal, and can have a significant local reaction. Infection usually develops after 48hrs.
Again if you are worried or unwell, you need to see a dr, be it 45mins or over an hour to get there.
Sadly this is the NHS, and you chose to assumably live somewhere remote.

[arethereanyleftatall]

Oh phew, I was hoping you would see this macdoodle!! Nice to have a real doctor add weight to my 'don't worry' mantra!

[TheBogQueen]

I think talk of drips and septicaemia is quite unhelpful too. Ooh gets lots of calls about these sort of insect bites, best to phone and get medical assessment.

[Theincidental]

Well, 111 say that a ooh doctor will call me back inside 12 hours, so I guess I'm sitting tight for now.

Thanks for other info up thread.

FYI for the query re: why I live so remotely; I didn't have a choice to speak of. It's a wonderful place to live, but our nhs services are really difficult to access.

[Theincidental]

And also, it's not me and 12 sheep living here; there's a very sizeable population year round and ATM (due to summer hols) the population has more than trebled, which is a heck of a lot who may need care.

Probably a separate thread entirely but a significant chunk of our emergency services are provided by charities an don't receive any government funding which is also a sorry state of affairs

[TheBogQueen]

Really? Are they giving 12 hour timeframes?

[Viviennemary]

I can see exactly why you are annoyed. The point is they couldn't help you so what really is the point of them. I think it's fair enough to tell you to go to a chemist if you can get what you need there but if you need a prescription somebody should be there authorised to write them otherwise they might as well close the whole show down. IMHO.

[Theincidental]

Yep. 12 hours and no other breakdown... They are very busy.

[Thenapoleonofcrime]

I find threads like this very annoying with everyone wading in saying you should have done this/been there/not been there- I don't know how lay people are supposed to know where to go! I think going to a minor injuries for a bite is perfectly reasonable

It is not because we are overwhelmed with trivial things that the NHS is in a mess, it's in a mess because there is a complete lack of both resources and signposting for out of hours treatment, and this causes lots of time wasted, resources wasted and so on. It is well known that the OOP contract was a complete stuff up, a massive mistake for which we are all now paying.

I won't go on- several people have said you need to go to A and E, I would go there, all the tough nuts shouting 'that's just a scratch'- scratches used to kill people before antibiotics and they still can. The first person to try antibiotics/penicillin had a scratch from a rose bush, sadly although it worked miraculously they only had a few days supply, they then died.

It is not trivial and stupid to seek advice for a scratch like that especially if you have a history of allergies/bad reactions.

Good luck OP.

[macdoodle]

Sadly NHS services in remotes areas will be the first to fail and as you have discovered is already happening. There is no extra funding to try and improve them or recruit people. Remote scotland and wales are already in trouble.
OP, ice is helpful as well, to decrease inflammation and help itch.

[TheBogQueen]

there is a complete lack of both resources and signposting for out of hours treatment

We do! It's a 24 hour phone service called 111!

[mousmous]

a service that cals back in up to 12 hours.
where the drive to see a dr is an hour or more (as described by th op).
where the minor injuries clinic is not equipped to deal with a (at that time) minor injury.

sounds more like a hird world country than a ver densely populated island.

[Theincidental]

Mac doodle- I have a cold compress, but was specifically told no ice. I'm not sure why? Would it burn?

I've also stripped an aloe leaf which helps the most and popped another piriton.

Arm is all cramped and sore, but no fever so I'm just going to wait out my 12 hours.

I really feel for our nhs. Privatisation is such a joke.

[macdoodle]

As I mentioned, removing OOH from GP's was a very bad move by the government, but one GP's happily jumped at. We were providing a pretty good service for dire funding, mostly running on the goodwill and hard work of the doctors.
We were well aware it would be impossible to maintain the service with the funding they were giving, but it showed how little the government valued GP services.
Tendering it out to private providers (and the utterly dire 111) has resulted in the mess we now have. My OOH provider is always desperately trying to fill shifts, but working OOH has become increasingly busy/risky/unsafe. The medical protection societies (which we have to pay for ourselves) put an increasing excess amount on working OOH, which means a lot of doctors just wont do it.
They are currently in the process of doing the same to daytime services, and it will only get worse, we will not be working 12hr days to keep it going, when Serco/Virgin/Care UK are paying peanuts for 4hr shifts.

[Selks]

Yes, ice - bag of peas over a wet flannel on the inflamed area will help soothe.

[Selks]

oh sorry - you were told no ice. I'll shut up now.

[macdoodle]

AFAIK ice is fine, not directly but wrapped in a flannel or towel should be fine. Paracetamol or ibuprofen if you can take them will help the irritation. OOH will be very very busy on a sat night.
111 is a joke.

[bayrans]

Not sure if it's been said already but some nurse practitioners can and should be able to prescribe steroids. If it's a severe reaction then yes steroids would be needed.

I'm sure a MIU should have at least one NP, that's the whole reason that they are there.

[Theincidental]

We'll the ooh gp called and was lovely. I have to go to ooh tomorrow and pick up anti Bs and steroids - given my history. Also surprised no one could provide more at miu - apparently on week days there is a doctor there to do just that.

[Pollywallywinkles]

Pleased you have got sorted; or at least will be in the morning.

[TheBogQueen]

So not 12 hours, then.

I think 111 in Scotland works very well. But it's nhs run, there are nurse practitioners firmly in control. It takes around 5000 calls over a weekend.

But yes services are stretched, people rightly or wrongly demanding more from the service and want it now, now, now.

And I've read that doctors are earning £1000 a shift. It's nuts!