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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

To think the fracture clinic should be staffed all the time

52 replies

Queeltie · 31/08/2015 20:01

I have spent the afternoon in A&E with my sister. She has had a temporary plaster put on her broken leg. But she has to go back tomorrow to see an orthopaedic consultant as the fracture clinic was closed.
There were lots of people in A&E being sent to the fracture clinic. It seems a waste of money and time to have nurses giving temporary treatment, and then the next day the consultant having to see them and give them treatment.

OP posts:

JuJuMun69 · 31/08/2015 20:03

They put a temporary plaster on, which will be a half cast to enable swelling to settle. So you wouldn't be dealt with in the way you think on the spot.

YeOldeTrout · 31/08/2015 20:04

Would you want it staffed from 10pm to 6am as well?

Mouthfulofquiz · 31/08/2015 20:05

Temporary plastering is there for a reason - to allow swelling to go down, and then you go back for the fracture to be reassessed.

Northernlurker · 31/08/2015 20:07

Umm when is the orthopaedic consultant allowed to sleep?
Any clinic needs to shut some of the time. Your sister has been treated and will be treated appropriately tomorrow too. They can't always do everything they need to immediately after an injury anyway. I'm sorry you've had a difficult afternoon but this really is NOT unreasonable.

Btw I assume every minute of her treatment was for free under the NHS btw.......it's not bad really is it?

MrSlant · 31/08/2015 20:08

I wrote a long post but you guys have got this. What They said ^^.

Original poster

Queeltie · 31/08/2015 20:10

No it is only temporary because it has to be seen by the consultant. It is a small fracture that the nurse said would probably have been treated differently if the consultant was there.

OP posts:

Smutlins · 31/08/2015 20:11

I used to work in Fracture Clinic. It is/was staffed from 8am to 8pm, Monday to Friday, for clinic sessions (where people have advance appointment to see the medical staff) and we had an on-call clinic running alongside for urgent appointments. On-call appointments are usually booked by A&E the day before/overnight for people they've seen who need a fracture clinic follow-up. We were also open 8am to 1pm on Saturday, Sunday, and Bank Holidays for on-call clinic only.

The procedure for someone presenting at A&E with a break/suspected break is to patch them up, give pain relief, and make then an appointment for the next on call clinic. A proper cast can't be fitted until initial swelling has gone down, in some cases you can't even see the true extent of the damage until it's gone down a bit.

Having same day referral to the fracture clinic would actually waste money because you'd be seen by a consultant only to be told to come back the next day.

HippyChickMama · 31/08/2015 20:11

As pp have said, even when fracture clinic is open a temporary cast (called a backslab) would still be necessary so as not to restrict the limb if it swells. Also, the reason for seeing the Ortho consultant is to check on the healing and arrange any follow up, they wouldn't do anything there and then. The treatment in A&E is not 'temporary' it is the immediate treatment required.

YeOldeTrout · 31/08/2015 20:11

I've been in fracture clinics a lot in recent yrs. There's not just the consultants, there's a whole team of other people around them that makes the clinic run efficiently, people with appropriate expertise to do different parts of the whole service.

I think there's also often a medical case often for letting a fracture 'settle', to see if the bones move before they hit a point of no-return healing etc.

Original poster

Queeltie · 31/08/2015 20:14

The fracture had happened the day before though. So would she still have been told to come back tomorrow?

OP posts:

IHavemyownLighthouseyouknow · 31/08/2015 20:14

YABU. You're lucky you only have to wait til tomorrow - my DM was told that the fracture clinic at our local hospital couldn't see her for her fractured arm for 3 weeks due to the waiting list so she had to have a temp cast on for all that time. (then they had to book her in for an operation & reset it as they hadn't done it right at A&E but that's a whole other thread!)

exLtEveDallas · 31/08/2015 20:16

I must admit I was rather perturbed a couple of weeks ago when I had to take DD to A&E with an elbow injury to be told (after a 3 hour wait) that I could give her painkillers and come back in the morning, or make my own way to a different hospital (only about 15 miles away) for an x Ray as the x Ray dept & fracture clinic at my local hosp closed at 5.

Now, for me (and DD) it wasn't too much of a problem - I have money, transport etc and DD was able to cope with the pain. But I was really disturbed when another mother and child came in - the child had a really obvious broken arm and they were given the same advice. In the end they had to wait for hospital transport as mum had no way of getting to the alternate hosp.

It just seemed wrong somehow.

HippyChickMama · 31/08/2015 20:17

Yes op, she'd still have been told to come back. It depends on the type of fracture but the usual recall time to fracture clinic is 2-7 days. Some fractures (a scaphoid fracture for example) can't even be seen on an xray until several days after it happens.

Smutlins · 31/08/2015 20:19

When the consultant isn't in the clinic it's either because they are:

at home (they are allowed a hone life)
up on the ward seeing their inpatients
in theatre
teaching
on call, which means they have to attend any emergencies

Original poster

Queeltie · 31/08/2015 20:20

IABU then. I didn't realise that is how broken bones are dealt with, and the impression I was given was that the treatment was simply because the fracture clinic was closed.

OP posts:

Witchend · 31/08/2015 20:21

You would be told to come back tomorrow (or later) even though it had been done yesterday.

Ds broke his wrist this summer. We didn't find out for a week and he had a temporary cast put on for three days. They thought when they initially plastered him up he was going to need a proper cast, but when he came back they decided he only needed a Velcro splint support thing, which is much better. Glad they didn't try sorting it straight away.

overthemill · 31/08/2015 20:22

My DS broke his leg in 2 places late on a Sunday night. Very bad. Took 4 hours for an ambulance to come (paramedics came with pain relief on the spot and stayed) and then 5 hours in A&E. Then op that afternoon ( about 4pm) and a temp cast put on. Stayed in hospital 2 days later another temporary cast and sent home. Then permanent cast put on 10 days later. All in week days (once on ward) and still temporary casts because that's what he needed.

As someone who is always in hospital with very sick daughter, I'm happy to see on call consultant when in hospital at all hours of day and night but I do prefer to see the actual consultant ( although the in call one is often more senior) when they come in for their shift as they know her case. They work long hours. The NHS is 24/7 and sometimes I wish more bits opened over weekends eg dietician everyone needs sleep!

Smutlins · 31/08/2015 20:22

In our hospital we trialed keeping the fracture clinic open until 10pm and it was a total faff. No one wanted the late appointments, most would rather wait an extra day for a day time appointment, and the people we did book in for them often didn't turn up. It was a waste of time and money.

JuJuMun69 · 31/08/2015 20:25

Don't worry OP. I think we all want things fixed "now". We are frightened and upset.

I stabbed myself in the hand a while back peeling a potato would you believe! Apparently its quite common stoning an advocado though :) The knife went right through from one end to the other between my thumb and index finger. I was bandaged up and told to go back in a few days for a consultation then an operation. I wanted them to do it "NOW".. Please fix me "NOW" so do get what you mean.

Original poster

Queeltie · 31/08/2015 20:29

Smutlins, that surprises me.Maybe it is just me, but I find it way easier to arrange lifts and childcare in the evening, when everyone is home from work.

OP posts:

AnyFucker · 31/08/2015 20:31

fracture clinic is not run along the lines of A+E

it's a clinic see, the clue is in the name

hope it heals well

JuJuMun69 · 31/08/2015 20:31

But OP dont you think people that work would rather do that during the day? and have the evenings off? You may find it easier but dont you think thats a tad selfish?

JuJuMun69 · 31/08/2015 20:35

And there was me trying to be understanding

AnyFucker · 31/08/2015 20:42

when everyone is home from work

I don't think you get it, do you ?

Original poster

Queeltie · 31/08/2015 20:46

I am talking about my sisters situation. Both myself and her partner would be home from work and able to take her in the evening.
Yes I understand some people like my DP work anti social hours. Some jobs, it is an integral part of the job. And my OP offers appointments on the evenings for people who work during the day.

OP posts:

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