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?

[ElephantsNeverForgive]

Our minor injuries is absolutely useless. One rather nice, but dim nurse absolutely trying to do the work of two with brains.

This the third and final time I take an injured child there instead of A&E 20 miles away.

I accept they only have Xray once a week, except last week when it was broken, but a reasonable guess at wether it's necessary to go to A&E, referral paperwork done when they say it will be, child sized bandages in children etc.

DD1 may have broken her foot over 2 weeks ago, vague tape toes together it should get better. No idea how much she's allowed to use it.

DD2 has a huffy attendance letter after missing a week of school with an totally unusable foot and a similar bouncing about between MI, GP and one day a week X-ray dept.

[ElephantsNeverForgive]

Both problems A&E would have fixed in a few hours, no bother.

DD2 has broken both arms, when she was younger and A&E were brilliant.

But their X-ray dept is massively over loaded I'd much rather not use them as a default for minor stupidity/gymnastic injuries.

[macdoodle]

£1000/shift, much beloved drama of the fecking Daily Wail.
So a 12hr OOH shift (which I personally wouldnt touch with a bargepole) is £83/hour, not excessive for a highly trained professional. An OOH plumber would cost that no?
But take off the absurdly high medical protection fees (which if you are doing a lot of OOH a year, will be in excess of 10K (yes that TEN THOUSAND pounds) a year.
So take off that, plus pension, plus tax/NI, the GP is probably taking home less than half so roughly £40/hour for a 12 hour stressful, busy, likely unsafe/risky, antisocial work shift. He has trained for at least 8 years (at the very least and most likely more).
Do you really think that is unreasonable pay?? Really?? Because if so then no bloody wonder we have a GP recruitment crisis, with very few newly qualified doctors wanting to be GP.

[macdoodle]

I am an experienced OOH triager, but I can only just manage 4hours straight without starting to feel unsafe. That oh so quoted £1000 will be for 12 straight hours, no paid breaks and constantly busy. If its so easy then you do it. I didnt train hard and work hard, and make life and death decsions every 10minutes, to be paid less than other professionals (my divorce solicitor charged me £275/hour, yes I know he didnt get that, but he sure as hell didnt get £40/hour) and I sure as hell couldnt call him at 10pm on a sat night.

[oohdaddypig]

YANBU

I find minor injuries utterly ineffectual.

It makes me laugh when the government ponders the issue of an A and E service that is collapsing. The answer is so bloody obvious as to be laughable.

[HarveySchlumpfenburger]

And that's the problem isn't it, Elephants? You end up getting a 2nd or 3rd rate service because that's the 'service' you are supposed to use despite the fact that you know that if you bypassed it, you would actually get treated. I don't bother with ours and just go straight to the walk in/A&E department at the major hospital an hour a way. It cuts out the middle man because most of the time you'd get sent there anyway.

An MIU that can't properly diagnose or treat isn't fit for purpose and is just a massive waste of the NHS budget.

[nocheeseinhouse]

Go Macdoodle...

[ElephantsNeverForgive]

Exactly A&E, X-ray and the fracture clinic at the hospital are very very busy. It's catchment extends 50 miles into a really rural area. It's fair enough adding to their workload when DD falls 6ft out a tree onto her wrist.

However, I don't want to clog it up with, now, teen DDs who might or might not have broken toes or small bones in their foot miss landing a front flip, falling off the beam or tripping over a bit of wood.

MI have an Xray machine, they need it manned more than once a week and a system to get both results and care advice back to GPs the same day and nurses who can provide strapping and sort term loan of crutches to get kids back to school.

[Bugsylugs]

op suggest whilst you are out to buy an alternative antihistamine you can get them in supermarkets, aldi boots to name a few. try cetirizine or loratidine, elevate the arm as well. As someone suggested draw a marker around the edge of the redness will give the Dr an idea how your body is still reacting.

you do not need tetanus booster for a spider bite it is just an ideal time to give

[Teddybeau1988]

Yanbu. My local miu are quite useless, but luckily I found an out of hours GP surgery that's operates a walk in system at weekends and holiday times and you don't need to be registered with them to be seen. Anything more serious I would just go straight to A&E

[Teddybeau1988]

Also OP my sister gets a prescription for an antihistamine in advance if she's going away or of its summer she stocks up in advance as bitey bugs love her. Could be worth checking if your GP could organise that?

[chocolatemademefat]

Maybe if you ever have a serious condition you'll understand why all the doctors are busy in hospitals - not waiting around in OOH facilities for bites and scraped knees.
If you had thought it was bad you should have got advice from a pharmacy and would have known if you needed more intensive treatment. If you can't be bothered making a 45 minute drive it can't be that bad.
45 minutes is nothing these days - maybe next time you should consider demanding a house call - that way you won't have to move at all.

[macdoodle]

He was a partner in a good firm with equivalent training and experience to me I assure you he. Was on significantly more than £40/he. But that's fine if you feel that is a reasonable pay for an ooh Dr then you will very soon discover the kind of service that buys you.

[FeministStar]

Our local one has no x-ray facilities. That is fine except GPs tell people with suspected broken bones to go there. It's 12 miles to the west of us and the A&E department is 10 miles east so you drive 12 miles with a child in pain due to a broken arm and then have to drive 22 miles back to A&E.

Angry? Yes!

[macdoodle]

Umm I know because we discussed the fact that we were the same age, with the same type/length of professional training and the same length of experience, and we discussed how big the pay differential was.
This came about when he emailed me to say he had become a partner (half way through my lengthy, acrimonious, difficult divorce), and his new rates (he was an associate when I started). When we next met I congratulated him and commented how I had been a partner for a few years, and this led onto a conversation about pay. He was most definitely not taking home £40/hr and that was in hours.
I dont want to get into a fight about pay, my comment was in response to the "greedy docs earn £1000/hr", I was trying to put that in perspective.
It is clear that the government nor the public do not value doctors as highly trained professionals, but then they are very quickly going to discover just what kind of service they are going to get for low rates of pay. Thats fine, most of us are tired of propping up the system and being blamed for its failure.
A system can be good, cheap or quick, unfortunately it cannot be all 3.

[Ilovenewts]

Yanbu. What exactly is the point of a minor injuries then ? It sounds like nothing you couldn't do at home or buy from the chemist ?

[differentnameforthis]

To be fair op, if you are allergic to something & you are that far away from medical help, would it not be wise to keep the medication you need at home?

I am allergic to latex & carry stuff where ever I go, because I don't know when I will come into contact with it (balloons, etc).

And I am not usually more than 20mins from an A&E!

[gymboywalton]

if that was cellulitis-that red etc you would have other symptoms.

my husband ended up in hospital for 10 days on iv antiobiotics with it and at the start he was running a 40 degree fever, shaking uncontrollably, and really ill.

i react to insect bites like that and the dr showed me how to tell if it's infected or a reaction... run your fingernail across the swelling. if that is very painful , then it's probably infected and needs a dr. if it is ok..reaction and you need antihistamines.
something loratadine usually works best.

[TheBogQueen]

I'm
Not saying doctors are greedy. I'm questioning the sense of GP contracts. It always surprised me how the ooh service swung into action after 6pm, at weekends and on bank holidays - any local public holiday - and everyone is on enhanced pay. I know because I did it. I knew German gps who commuted to work for nhs because it pays so much more than the German system.


here
Also if 111 is so dreadful - and really it's just a referral system - what would you do to replace it?

[Hulababy]

Chunderella - I know several solicitors on at least £40 an hour - and not in big city firms either. Especially those who are partners

[macdoodle]

Triage should always be done by the most experienced person, thats how the army and top trauma units do it. Thats how the best OOH systems work.
NOT by someone with NO medical training, with 6 weeks training, working from absurd protocols. The amount of 999 calls and ridiculous OOH visits via 111 is crazy.
The funding for 111 and NHSD should be streamed into the OOH system and first contact (ie after an initial call handler taking name/phone etc ONLY) should be by an experienced doctor.
Funding for 111 and NHSD should be streamed into GP OOH, and all triage done by doctors. Good OOH systems work this way and 60% of calls will be dealt with by phone advice.
The government doesnt like that plan, because they believe the false economy that anything and everything is better and cheaper than a doctor. So be it.

[macdoodle]

Junior doctors/doctors in speciality or GP training will be on less than £40/hour for OOH work. It takes time to work up to being an experienced GP on good income. Most of us will take 10years ish with significant debts.