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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To ask advice as my parents have been waiting for three hours for an ambulance

247 replies

haveyourselfamerry · 07/01/2017 19:35

They are 500 miles away in Bournemouth. Dad is 80 and frail with poor visual processing and probable autism.
A little over three hours ago dad fell in the sitting room. Mum got him into a propped up position. It hurts behind his left hip.
The history is that he fell last February and broke his hip. He was stuck in hospital waiting for a fictitious rehab place for 10 weeks, as a result of which his gait has permanently altered.
They are hoping this is not another break as it feels less bad than last time.
Obviously though they are getting increasingly uncomfortable and distressed.
He will fall asleep soon. Mum is wondering if she can get him lying down. She is too fail to stop him dropping off/sliding over.
Thanks in advance :(
Old age s not for sissies.

OP posts:
haveyourselfamerry · 09/01/2017 21:31

Thank you all for your support.

Their situation is stable (until next time.....)

OP posts:
PossumInAPearTree · 09/01/2017 21:41

*^I had a similar last June.

Mum had shingles and overdosed on pain killers. She was in a bed way. I phoned 111 who did an assessment and said an ambulance was on its way... Two hours later no ambulance. so in desperation I took her to A&E by car. I was worried about the journey..

When we arrived there were three ambulances in the car park and all the crews were eating ice cream having a lovely day in the sun...^*

Any chance the the patients they'd brought in were waiting in a&e still on the ambulance trolleys? Because I see that a lot. There aren't enough beds in a&e, the patients have to lie on the ambulance trolley until there is a free bed. The ambulance can't leave until they get their trolley back but the paramedics aren't actually needed to care for the patient as the a&e staff will do this. So they twiddle their thumbs until they can leave.

TheNiffler · 09/01/2017 21:48

Agree, I can usually see at least three sets of crew waiting with patients, they can't leave them until they've been handed over, and they can't hand them over until there's space for them to be treated. And there's no space for that until someone else has been discharged or moved out.

And there's no beds...

Sometimes they are there for hours, stuck, unable to move onto the next job. I think they're entitled to have an ice cream or a coffee under the circumstances. Amazing people, every one of them.

OhTheRoses · 09/01/2017 22:03

Perhaps the NHS needs to buy some more trollies. They could be funded from the multiple reports affirming common sense commissioned by so many trusts.

PossumInAPearTree · 10/01/2017 06:29

But 90% of the time they don't need them and they would be obstructing corridors all the time.

Ciutadella · 10/01/2017 06:51

"May be a stupid question but someone above said private healthcare won't get you an ambulance."
Also probably a stupid question but what happens if you hire a private ambulance. Are they even available for 999 calls (rather than planned transfers from home to hospital)? Presumably it could take you to the hospital car park, like any other form of transport, but would not be treated as an NHS ambulance for admissions?

haveyourselfamerry · 10/01/2017 09:12

I have no doubt at all that dad would still be bed blocking had I not intervened.

It's a difficult one. I think that there are lots of hierarchies - and this is necessary to keep patients safe. but it does mean that sensible people are not "empowered to say yes". They are only "empowered to say no".

So several nurses said to me "I can't authorised that....". But clearly they agreed that he needed to get out both for his sake and that of the next patient needing a bed, hence they magicked an OT out of another ward for me.

Thinking about it, the nurses have to exercise leadership and common sense without seeming to do so IYSWIM....

I can just imagine if dad was still there the consultant wafting in and saying "why is this man still here?"

OP posts:
haveyourselfamerry · 10/01/2017 09:14

v interesting about "more trolleys but where do you put them".

Folding trolleys a possibility?

are hospitals like schools in terms of space? In our school every object occupying storage is a balancing act between positive (its usefulness) and negative (it is taking up space that could be used for teaching/something else).

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haveyourselfamerry · 10/01/2017 09:15

could "walking wounded" folk who have taken themselves to A&E be allowed to access the ambulance crews whilst they are stuck waiting? The paramedics could reassure and triage them?

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TheNiffler · 10/01/2017 14:44

I can't see how that would work, some incoming patients can't be left alone - somehow there's always a bed in Resus for me - I know they phone ahead to give them an ETA, but I've still always been v lucky to not have to wait, but if there wasn't I'd be needing 1-2-1 care from them.

haveyourselfamerry · 10/01/2017 15:07

I hear what you say Niffler, but if a paramedic does get "ice cream time" as it were, it would be nice if one of the crew of two could somehow be connected to those in A&E waiting room that the receptionist is worried about (ie they look proper ill but aren't being fasttracked).

Easy to suggest things when you aren't there isn't it? :)

OP posts:
haveyourselfamerry · 10/01/2017 15:08

could the trolleys be hung on the wall on hooks?
sorry this is bothering me now....

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Putthatonyourneedles · 10/01/2017 15:42

It's not about the physical trolleys. It is about the number of staff trying to looking after the patients on the trolleys, ie waiting for a bed on the ward, waiting to be reviewed by Dr etc. The paramedics have to hand the patients care over to the A&E nurse who can only accept them if they have some place to put them and someone to review them.

I used to be a care of the elderly/orthopedic ward nurse and I'm now work in A&E so I've seen both ends of the admission process. I've seen the patients who have sat on the ward for weeks because there's no social worker to assess them or no care home spaces avaliable. I've seen the battle to get funding and equipment to get patients back to their own home safely. I've also seen patients readmitted time and time again because they have refused to pay for the care the they want but don't necessarily pass the screen for.
I've fought with care homes to take back their residents despite their stupid rules ie one care home won't accept residents back on Monday or Friday or over weekend or anytime after 3pm. Another care home won't accept resident back unless they have 4 weeks of incontience supplies (patient didnt bring any in with them)despite the home having their own supplies of them for that patient and regularly delivered.

lougle · 10/01/2017 16:45

I do 2 shifts a week. I have 3 children under 12 and SN care requirements, so can't do full time. Full-timers do 3 shifts per week. It's exhausting, whichever way you see it. We're often flipping between days and nights, as well, so it's not uncommon to have a pattern such as:

Fri Sat Sun Mon Tues Weds Thurs Fri
Night Night Night Off (sleep) Day, Day Night Off (sleep)

so technically 3 shifts per week, because Sunday is the last day of the week, but only one clear day between phase changes from night to day shifts. So nurses are perpetually in day/night swing and completely exhausted.

PossumInAPearTree · 10/01/2017 17:04

The doctors in my local a&e were actually treating people in the back of ambulances this weekend as there wasn't even space to bring the trolleys inside. Literally standing room only in the waiting room.

haveyourselfamerry · 10/01/2017 17:42

Flowers lougle

OP posts:
haveyourselfamerry · 10/01/2017 17:44

what would you want people to do lougle that would make your life more doable?

I know it's tiny but during dad's last stay I could see that someone making tea on demand would be a big help....

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BoffinMum · 10/01/2017 18:44

Love learning Grin

lougle · 10/01/2017 19:17

Well to be honest, in ITU it's more about what we can do to make the patients' and relatives' lives easier - they are experiencing one of the highest times of crisis in their lives.

What we need is more the other end of the journey. When our patients are ready to leave ITU, we need beds for them on wards. But we can't get them. Because they are in the same queue for beds as the patients in A&E etc., so we continue to look after patients who are much too well for ITU, which means that we don't have space for sick patients.

BoffinMum · 10/01/2017 19:23

I don't doubt there are very serious resourcing problems at the moment, but in my past experience I have sensed a deep-rooted belief amongst some who work in hospitals (and that won't include those posting here) that patients don't deserve to have a view about how they are being treated or how long they have to wait, and if they do express a view this is 'demanding'.

In such cases, under-resourcing is invoked as an excuse for patient neglect and contempt, whereas in actual fact it is more likely to be poor management or indeed an inappropriate attitude towards patient care, lacking compassion. I am saying this because I've gradually seen it creep across to the private sector as well, so I don't actually think it has a great deal to do with money at the end of the day, and more with a shift in the nature of professionalism.

Why do I think this? It's because of what happens to you if you have the experience of turning up to an empty department, i.e. when there is no good reason for a wait, when departments are clearly not on a war footing.

  1. We turned up to an NHS A and E once on a Monday morning about five years ago after DH had fractured his arm in multiple places, and it was actually empty apart from the receptionists. They had completely cleared it. I checked all the bays. Nothing, nobody. Peeked around all the various areas, empty (I work in the hospital sometimes, so I know the A and E behind scenes layout quite well). I asked where everyone was, as I was starting to feel a bit weird at the thought of an empty A and E, as though we were about to find ourselves starring in an episode of Black Mirror or 28 Days Later or something. The receptionists confirmed it was completely empty, they had cleared it. We still had to wait an hour to be seen. Was everyone off on a collective tea-break after a busy time of it? Probably. Would this be acceptable in my industry? Actually, I think if students were left waiting an hour in a reception area with absolutely no explanation for a delay and no proper idea what was going on, with no contact from any professionals at all, during office hours, they might have grounds for complaint. And they wouldn't be in pain with broken arms.
  1. Another time DC3 fell over and bashed his head and we had to wait over an hour to be seen then as well. This time we were in an empty children's A and E and I was actually in early labour. I finally approached a cluster of nurses having a cup of tea in a room with a sign that instructed me not to knock as they were dealing with patients. They were absolutely not dealing with patients and they had been in there en masse for the whole hour we had been there. I informed them we would be leaving as nobody had seen us, it was over the magic hour, and I needed to get back home as I was in labour. Like a miracle they suddenly stirred and found a doctor to see us. They had basically forgotten we were out there, and not been checking the waiting room at regular intervals. I might give them the benefit of the doubt and assume they were completing lots of patient paperwork but in actual fact I suspect from their furtive reaction that they were just skiving off.
  1. Then there was the private hospital which, despite the fact that it was half empty one night, decided it was too much trouble to feed everyone who had been having late afternoon and early evening surgery. Instead, the main nurse in charge went around people who had been starved all day for jaw surgery and told them the kitchen was closed and they wouldn't be able to have anything to eat unless they could manage a sandwich (which we had all been told by the consultant not to eat, for blindingly obvious reasons). I had to send DH to the local Tesco to get me something; later I found out special soft food had been left for us but the nurse simply hadn't bothered to go into the kitchen to collect it. This was on top of the recovery nurse neglecting to give me the post-operative pain relief drugs I had been written up for because she just felt disinclined to do so, and when I explained I was in a lot of pain and I thought I should have had something, who told me I should expect to be in a lot of pain as I had just had an operation. As I say, lacking compassion. Disliking patients. Finding them a nuisance.

So why is this? Lots of reasons, but the more patients as seen as cost-centres and commodities by the organisations who treat them, the worse it is surely going to get (and I include large private healthcare organisations and insurers in my criticism). It is not the NHS, it is a sign of the times and one I am not very happy about.

lougle · 10/01/2017 19:44

That's very sad, BoffinMum. I'm lucky to be sheltered from that sort of thing in ITU - there, if you've 'earned' your spot on the unit, we deal with you as soon as you get there. But we are lucky to have the resources we do.

BoffinMum · 10/01/2017 20:12

To be fair we have been plenty of times in A and E and been treated well/fairly/professionally. And one would hope that ITU was state of the art in terms of care Wink. My point is that you need better management and a more compassionate framework for care to ensure we don't end up like the US, with mortality rates rising while people suffer sleepless nights wondering how they are going to pay for healthcare.

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