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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To think the a&e crisis is largely our own doing

175 replies

Diemme · 09/01/2017 22:21

So much on the news at the moment about unacceptable waiting times in a&e departments. And it always makes me think about the few times I've been to a&e in the past few years, and noticed that the waiting room resembled a social club! Full of people eating, drinking, chatting and walking to and from the toilet, vending machine etc. Aibu to think that educating the public to stop inappropriate a&e attendances would come pretty close to sorting the problem?

OP posts:
TheNiffler · 09/01/2017 23:39

Oh and I'll be sitting in Resus for hours until I'm stable enough to be moved. But if you see me through the doors during a good patch I'd look fine. You might not see the O2 tube from a distance, you'll see me chatting with the nurses and doctors because I know them all. But you would probably be sitting there wondering why the fuck I'm there.

nursy1 · 09/01/2017 23:44

Cool names.
So true. Completely under resourced, demoralised, badly managed right from the very top. Many bits of my job now outsourced to private companies because it's cheaper/ better. Soon becomes apparent it very obviously isn't either. My previous practice now closed, partners retired and salaried GPs there all gone to Australia. Patients amalgamated into a Virgin Healthcare Practice. All Doctors there on Locum Contracts.
It seems now that the private healthcare companies are circling the NHS like wolves. Can't bear to see a group of people they can't make a profit out of. Yes we, and our patients are fucked.

MimiTheWonderGoat · 09/01/2017 23:59

It does not help when NHS111 send you an ambulance because one of your symptoms is heartburn. "You mentioned pain in your chest, so I have to send you an ambulance." Well, I mentioned heartburn. Acid reflux? Nope..I was vomiting every hour at 16 weeks pregnant and very dehydrated. I phoned for advice and they sent me an ambuLance because I mentioned heartburn, which the youf hadn't heard of (clearly). As it happened I waited 5 hours in a cubicle in A&E before being rehydrated by drip, but could have easily sat in the waiting area looking perfectly fine (no visible bump) between vomit attacks, and I could have easily gone there by taxi had the flow chart not included heartburn as a medical emergency!

hungryhippo90 · 10/01/2017 00:08

Some of the A&E crisis is our own doing, but not all.
I for one believe that 111 is an absolute waste of space service. Every time I've called, I've been sent to A&E.... I genuinely just needed a bit of advice when the Drs were closed. I've not been the past few times. I don't want to waste resources.

I may sound a little like an off grid hippie type now, but I've genuinely taken up a bit of a slap dash approach in regards to the whole A&E visit thing. I run through a few checks if I think There's a broken bone. I don't just rush to A&E anymore... likewise last month, I believe I broke a bone in my foot... I wrapped it and got on with my life.. it's still sore, but no less than the NHS would do.

Likewise with cuts. I've done first aid (and had plenty of sets of stitches) if it looks bad enough to need stitches, ill do my own butterflies and I've got some medical grade glue in the first aid box... why can't we all take a little bit of responsibility in learning to do these things ourselves?

I had an allergic reaction a few weeks ago... when moving all my stuff out of the house I'd had a box of cleaning products, I'd found a few pens. Doing shopping list so I used one of said pens. I stuck the pen in my mouth... on comes allergic reaction. Obviously had swollen lips and tongue (think it was blimmin soflora!) and the pharmacist tells me she can't sell me the antihistamines because it may stop me from going to A&E and I must go...,
Well, I got my friend to buy it, and swigged it straight away.

Better education would help. Instead of being sign posted straight to A&E all the time.

I was there only a few months ago when DD had a particularly nasty fall where she's smacked her head off the floor. She'd complained about dizziness and a headache so we went to A&E. there were a lot of children who seemed like they'd have done better with a drs appt the next day. But DD who had suspected concussion was waiting almost 6 hours to be seen.

KittenDixon · 10/01/2017 00:13

I've been to A&E on a Saturday night around midnight twice in the last 4 years, both times after called the helpline and being advised to go in.

First time there was literally no-one else there. I had been given an appointment time, which was approx 15 minutes after I phoned and when I arrived there was no-one in the waiting room and we were in and out in under five minutes, including being disposed prescription drugs. I had been really worried about going along at prime drunk time, but it was all unfounded. This was in a large rural town.

Second we were told just to go along. It was a bit busier, quite a few walking wounded in the waiting area, range of ages including children (some obviously the patient, others obviously there as they couldn't be left alone at home whilst parent or sibling being seen).

People coming in needing urgent attention e.g. semi-conscious or bleeeding, were seen very, very quickly. There was only one drunk person in the waiting room- very amiable and well behaved. Some other drunk people came in as more urgent patients from time to time, only one made any disturbance- and he was literally carrying in someone with a broken leg and was just shouting for help. Everything was busy, but it wasn't chaotic or scary.

I was seen by a nurse within 20 minutes, saw a junior doctor within an hour or two. Took another hour to be transferred to a ward, saw a consultant the next morning.

The only thing I saw that scared me was how tired and sleep deprived the junior doctors were. The A&E nurses were very obviously concerned bout the doctors and felt very sorry for them! This was in a major city.

So I do think there is fear monger img going on. And also a lot of "blame the patients" with ill targeted "educational" patronising edicts, or poor systems. Whether it's about going to A&E, missing appointments or requesting anti-biotics, there is a lot of pointless and insulting lecturing going on. Often it is blame shifting for incompetence.

My mum, when she had terminal cancer, would often receive postal notifications of her next appointment on the same day as the appointment. So she would get a letter through the door stating her appointment date/time either an hour before or an hour after the time of the appointment. No wonder she sometimes missed appointments. That will have contributed to all the "missed appointment" statistics, but the fault didn't lie with the patient there.

I do object to being lectured on being responsible when I am already responsible. Target the people who misuse the service for the education. And where there are departments with high levels of missed appointments etc- well maybe that say something about how the department is run.

user1471545174 · 10/01/2017 00:25

Biggest problem is difficulty of obtaining GP appointments. There are clear emergencies obviously requiring A&E and there are other medical symptoms that can wait a couple of weeks. Between those two extremes is a world of worry and no service to deal with them.

user1471545174 · 10/01/2017 00:25

*them = the range of other symptoms comprising world of worry!

TheoriginalLEM · 10/01/2017 00:28

nursy1 thank you for pisting about the repeat prescription brigade. This is me ShockBlush and i can't believe ive done this. I will not do it again. Fuck.

but Op yabu

LuisCarol · 10/01/2017 00:37

Biggest problem is difficulty of obtaining GP appointments.

And that is because there is a nation wide shortage of GP's.

No one wants to do it any more. For good reasons.

MrsMulder · 10/01/2017 00:41

nursy I have said the same about private healthcare waiting in the wings to pounce once the NHS finally collapses. In my hospital this week there was a desk set up in the main area trying to get people to sign up for medical insurance, they are coming to talk to staff next week too. It makes me sick, I told them under no uncertain terms that I do not need medical insurance because we have the NHS, I really hope this continues to be true

Rhayader · 10/01/2017 00:51

I've been in A&E before and there was a lady with a small child looping around the room on his scooter. It was a blisteringly hot day and the doctor left the door ajar. Turns out she had bought him in for a (barely) grazed knee, they didnt even patch him up.

The doctor started to explain that this is not A&E worthy and then obviously glanced down at the notes. It turned out the woman had rung an ambulance for her son and then the doctor started to get quite cross!

"Was he unconscious? Did he stop breathing? No? Then don't call an ambulance, what a waste of time and resources!"

Charging time wasters something like the prescription charge seems like a good idea although it might put off people in need who aren't sure. What Jeremy Hunt seems to be doing is changing the way its measured so that only people who should be there are included in the statistics, which is fair enough to be honest...

giraffesCantReachTheirToes · 10/01/2017 01:10

niffler same. When I go into resus I'm torn between gasping for breath and waving to the staff I know. Frequently get told to just sshh and do thumbs up or thumbs down and they will speak to me when stable. I tend to think i am less ill than i am! My hospital... <a class="break-all" href="https://www.google.co.uk/url?sa=t&source=web&rct=j&url=m.youtube.com/watch%3Fv%3DSQsFMG1Wyxg&ved=0ahUKEwiIn8LGsbbRAhVDC8AKHZ_xDG4QwqsBCJ4BMBc&usg=AFQjCNET9r7cWKdskFXINDHL8BJt0Ol-Dg" rel="nofollow" target="_blank">www.google.co.uk/url?sa=t&source=web&rct=j&url=m.youtube.com/watch%3Fv%3DSQsFMG1Wyxg&ved=0ahUKEwiIn8LGsbbRAhVDC8AKHZ_xDG4QwqsBCJ4BMBc&usg=AFQjCNET9r7cWKdskFXINDHL8BJt0Ol-Dg

I am lucky with my GP surgery they are fab. Not sure if being in Scotland is different? But friends on fb in England seem to be in a worse situation.

Hillfarmer · 10/01/2017 01:11

Walking to and from the toilets - out-fucking-rageous!. If you can make it to the lav without crawling on hands and knees then you can't be ill. Spongers and skivers the lot of them.

giraffesCantReachTheirToes · 10/01/2017 01:17

"Hill" you are very wrong. Surely you can only go if you have stumps that have just been severed?

I think the whole charge for an ambulance idea will just put off the most vulnerable from calling. Even if you are only charged if it's deemed a non emergency.

melj1213 · 10/01/2017 01:54

I've been to a&e in the past few years, and noticed that the waiting room resembled a social club! Full of people eating, drinking, chatting and walking to and from the toilet, vending machine etc.

None of those things mean that the people doing them don't genuinely need to be there. People sit in A&E waiting rooms for hour after hour, are they supposed to also sit there hungry, thirsty, in silence and desperate for a wee, just in case someone thinks they're there for fun?!

I was in A&E on Friday night because I thought I had sprained my ankle in a fall in the afternoon, did the PRICE thing at home but by 8:30 my ankle had not only generally swelled, but there was also a huge golfball sized swelling on my ankle joint itself and was hugely painful. I called 111 who advised me to go go to our OOH clinic, which is located in the local A&E dept, since the painkillers I had taken wasn't touching the pain and because of the rapid localised swelling.

I walked into the department and went to the OOH reception, who just re-directed me to the A&E reception, despite the fact I said I had been sent to OOH, they directed me to the general reception as there were no OOH doctors on-site. So, I signed in with the receptionist (who warned me about the long wait) and went to wait ... by 9;30 I had been triaged and they suspected that my ankle was actually fractured, not just sprained so I was sent for X-rays. This was at 10 pm, and I was then sent back to the waiting room for a doctor to have a look at the X ray ... it was 4am before a doctor had chance to look at them, say "Yeah, there's a hairline fracture, but as it's 4am, here's a Beckham boot, some crutches and an appt for the fracture clinic on Monday".

In those hours between 10pm and 4am, I sat in the waiting room with a book (because I figured there would probably be a wait), then after a while I got thirsty ... as I got up to go to the vending machine, a lovely lady sitting opposite who was accompanying her husband saw my clear pain at trying to walk and offered to get my drink from the machine. When she came back, I thanked her and we got chatting to pass the time, and a few other people who had also been waiting for hours joined the general discussion. After another couple of hours, I needed the loo - having sat there for a few hours, it was hardly surprising - by about 2am I was starving - having not eaten since having dinner at 6pm, so again I got a snack from the machine.

None of those things meant I and the others waiting didn't have a genuine need to be there, they were the by-product of a group of people all sitting in the same room for hours on end because the doctors were busy dealing with the ambulances that were bringing patients directly into the cubicles.

Sallystyle · 10/01/2017 06:20

Yes, YABU

It's not our own doing at all.

3penguins · 10/01/2017 06:43

Biggest problem is difficulty of obtaining GP appointments. There are clear emergencies obviously requiring A&E and there are other medical symptoms that can wait a couple of weeks. Between those two extremes is a world of worry and no service to deal with them.

^This. We now have no walk-in surgery or minor injuries clinic in our area (this was closed down about 2 years ago) so if you can't get a GP appointment, A&E is your only option. Plus IME 111 often err on the side of caution and advise attending A&E when in reality the issue could be dealt with by a GP if an appointment was available.

trinity0097 · 10/01/2017 07:00

I ended up in A and E again yesterday, because the surgical helpline you are meant to ring post discharge and you get worse advised me to. I was basically seen by the same people as I would have been in the SAU - yet in the SAU I could have freed up a space on a bed in majors for the ones that got brought in by ambulance and were waiting with their ambulance crews in the corridor.

They sent me home with morphine and I'm back to the SAU as soon as hubby is ready to leave for work for a MRI. I just want someone to take my gallbladder out!!! I'm now on day 16 of constant pain.

Believeitornot · 10/01/2017 07:02

Jeremy hunt himself used a&e because he couldn't wait for a GP appointment for his children.

It's an indicator that GPS are struggling. How is this the fault of the public?

Yabu

Believeitornot · 10/01/2017 07:02

GPs

Qwertie · 10/01/2017 07:09

YABU. Quite often at evening and weekends the only options are nothing or A&E. The only time I've been in the year I'd phone 111 to ask advice about my daughter & when they got to the end of the questions they decided to send an ambulance! I was telling them I really didn't think it was necessary, I just wanted some advice.

Ciutadella · 10/01/2017 07:10

"We are obliged to regularly review patients on repeat medication, and print reminders to book reviews on the prescription. So many just ignore this however then urgently need seeing. The appointment they take up may prevent us seeing the patient with an acute sore throat/ chest infection who then presents to A and E."

See I would say human nature makes it inevitable that a proportion of patients will forget to organise this in advance - some of them may have failing memories anyway. So I wonder whether anyone's explored a system of text reminders to patients, say a week in advance? Wouldn't work for everyone as not everyone has a mobile even these days, but it could cut down on the number of emergency appts needed for that purpose? I read somewhere that text reminders are very effective at reducing no shows, so could work the same way?

corythatwas · 10/01/2017 07:16

Round our way you can go to all the walk-in clinics you like: you'll still get sent on to A & E for anything that might require an x-ray as they haven't got the facilities at the smaller hospitals/clinics. Hardly the fault of the patient if that is where you're told by the doctor to go. And of course it is perfectly possible to be in need of an x-ray and still be able to drink a cup of coffee.

ivykaty44 · 10/01/2017 07:22

25 years ago if you got sick outside of GP surgery hours, you called your practice and the doctor would come to visit you at home, or ask you to come to the surgery. Assessed your illness and provided you with a prescription.

You got to see your own doctors.

Now if you get sick out of hours you call your doctor's and they tell you to phone 111 or in an emergency 999

So people phone 111 and get told to go to a&e

The government has created this situation.

I think the answer is to have an out of hours GP service run next to every a&e department, then those that need an doctor can go there and have no waiting limit, those that need a&e can be seen. A triage system at both departments would also help confusions as to where people should be.

Musicaltheatremum · 10/01/2017 07:32

Ivy, sounds great I agree with you, and I think in the past when we managed our OOH in coops of GP practices it was great but it was a lot more expensive. but there are not enough GPs for this.
I'm just off to work now and will be there for about 11 hours today. We do not stop all day so the daytime GPs who are far busier than they were 25 years ago cannot work evenings and nights too.