To think I've just wasted 5 hours in A&E

[Littlelanecountrygirl]

DD hurt her finger at school yesterday. This morning it was swollen and v painful.

Dutifully head to minor injuries where they X-ray it expecting they'll just strap it up. Radiographer and nurse both say it can't be strapped and needs a cast. It's the fifth metacarpal in her hand not her finger. Hand swollen and can't bend little finger anymore.

Turn up at A&E which is like a war zone. No seats, no floor space standing room only. See the nurse after 30 mins she agrees it needs a cast, wait for doctor.

4 hrs and 10 minutes later the doctor calls us in. Abruptly accuses DD of punching something and that she has a boxers fracture. DD repeated that she didn't punch anything, injury was at school when she collided with a friend in PE. Doctor says well ok then (eye rolls at her) manipulates her finger round (DD has tears now) and then says

Oh we can just strap that .

Two bits of tape around her finger, not even a splint. DD crying in pain still and a £6 parking ticket later we finally leave.

Surely we could have just had it strapped in minor injuries 4 hours earlier?!

Away - was she properly consented and able to understand that there are no 100% guarantees with any surgery? Have the negative results been laid at the door of poor practice?
Your mother is perfectly entitled to be upset and frustrated that she has poor health. What she and anybody else is not entitled to do is blame hcps for things which aren't their fault.

Yes Dr was not great. But agree you were essentially referred for a second opinion. May not feel worth it, but it was worth waiting to make sure you get the right treatment. It was 5 hours wait because it was not a serious issue.

No seats because everyone seems to bring their mum their dad and Joan from next door. 😂

When I took DD for her x ray someone else in the room had brought all of their family with them too, and both next door neighbours by the looks of it

And with DD I wanted to go private but they insisted we didn't. It's frustrating beyond belief.

Refreshingly the school are welcoming of criticism and concerns, they too offer their service free of charge.

The fracture clinic is the key to the management of the fracture - if it has slipped by then they will implement plan B.

It's important that the most senior person available assesses injuries in which there is a not insignificant chance treatment may fail.

You didn't waste time in a&e. You waited to be seen by someone who you needed to see to make an assessment on what needed doing.

I went to a&e with a broken big toe once. Broken big toes depending where the fracture is can sometimes need surgery. Mine didn't. So I had an X-ray and trotted off, can't even remember if it was strapped. I don't feel I wasted either my time or theirs. I needed to know if any treatment was required and also to rule out a fracture higher up in my foot as my foot was bruised and painful.

Actually lol-ed at the Amazon prime comment OP. Quite

It does seem like this could have bypassed A&E. Immediate strapping at MIU and asap referral to fracture clinic within few days to see the specialist, for example. The A&E doc isn't a specialist, that's the point. I've had a fracture wrongly cast in A&E and the ortho doc I saw the next day said it was very common.

It's not so much the patient's time being wasted - although that is immensely irritating - but the visit to A&E has taken up admin, nurse and doctor time, and apparently contributed nothing to the care of the patient. The MIU is supposed to ease the A&E workload, not add to it.

If we all adopted the 'must not complain about free treatment' approach then things would go downhill
Nobody would complain and bad practice could then be allowed to continue
Negative feedback is often what prompts change
Unfortunately too on rare occasions health professionals need to be questioned as sometimes things are missed

There's being grateful for the NHS and then there's being naive

Northernlurker no bugger ever says that about schools do they?

How dare anyone complain about the free at the point of use education service?

Actually lots of countries have free at the point of use health care which is at least as good as the NHS.

Just because something is free at the point of use doesn't make it sacred nor should it make expressing frustration or dissatisfaction about that service a heavily enforced social taboo.

Loads and loads of people have studied at university for 4 or 5 or 6 years, it doesn't make them gods or beyond question or criticism. Doctors are just people and get things wrong, like any other professional, yet they are the only ones that we get told we are never allowed to question or "bitch" about for absolutely no sane reason.

My nearest hospital has been on and off 'black alert' for two years now. I know an HCA who works there - she and her colleagues frequently have to cook patients' meals because the private catering company the hospital pissed money away on, frequently leave early, don't clean up and leave the fridges unstocked. Sorry but that's shit service, free or otherwise and otherwise a shit way to treat their lowest paid members of staff (who in my opinion, work their bloody arses off and yet are completely under-valued). Also maybe teach the selfie/selfish generation that they don't need fucking A&E for a sore throat. The OP's daughter had a genuine fracture - she's asking why she was sent to A&E when it could have been sorted at minor injuries. Not sure why she's getting the vitriol, tbh.

My son had the same type of fracture whilst skiiing - he "punched " the floor when he fell. Would recommend in this type of case, where not an emergency but needs looking at, travelling to an a and e which might be further afield but less busy. Some are better than others

We all need to pay more tax if we want faster a and e. It's frustrating but at least it's there when you need it, and we are very lucky to have it imho

NorthernLurker yes. Doesn't mean she can't bitch/moan about it when she's still got to have constant surgeries for it.

She had a routine endoscopy as she'd become.jaundiced. The surgeon doing the op was rushing because it had turned into an emergency. The endoscopic camera went straight through her oesophagus and caused a hole. They kept feeding her through a nasal tube and was prepared to 'let it heal by itself'. She was transferred to another hospital later that day where a thoracic surgeon with their team spent 8hours throughout the night cleaning out her chest cavity of an infection called mediostinitis (google it) caused by the hole and the food and meds getting in. It's listed as a risk in the consent form and states that the chances of it happening are something like 1 in 60,000. I remember an ITU nurse telling us that people have more chance of winning the lottery than suffering that specific complication. (No she didn't sue just in case you're curious - he came up to the ward before she was transferred and apologised to her - she said the NHS was struggling enough - plus their lawyers are pretty good anyway).

Point being. You can't just assume that the hcps don't make mistakes.

One was going to send me home last year mid asthma attack - I'd never had one before and just assumed it was the chest infection making me feel shit. If it wasn't for the nurse that spotted me struggling for breathe, put her head above the parapet and insisted on someone else seeing me. I'd have died that night.

Just because the service is free doesn't mean people can't get understandably jaded when things go tits up or when a doctor isn't very professional with a child.

It's more usual to have a hand fracture in a cast and not just strapped. If so it's out of minor injuries control in your area. Probably just nurse practitioner led?

The X-ray will be reviewed by senior radiologist so you may get called back for a cast. Fun ☹️

The MIU people don't have the authority to decide how to treat it. NHS is very protocol driven. The protocol said they didn't have the authority to decide what to do. Nor did the nurse. Medicine evolves fast & NHS is very rules driven but humans can't so easily keep up. Sometimes only the more senior people know the latest rules how to treat each problem.

GPs make about 15% of "inappropriate" referrals to A&E. It isn't all people with silly complaints wasting A&E time.

I totally understand OP's frustration, I'd be cheesed off too. I just don't know what the solution is. I hope your DD's hand recovers fast & well.

Also wanted to add that I agree with moreminutes - and that the consultant wasn't a bloody VOLUNTEER, for FFS. He's absolutely NOT providing a service for free. In fact, it's the greed for increased wages, when Healrh Care Assistants have to accept Jack, which is costing bloody money.

I don't understand why people are criticising MIU for failing to prevent an attendance at the ED. The HCP(s) there advised this as they weren't 100% happy.

Again, what is there to criticise about that?

And OP you do realise that as the doctor was examining your DD's finger/hand he was assessing for any functional damage to the nerves and blood vessels? (The colour/sensation/warmth/movement/parasthesia routine).

The fact that she felt pain was a good thing, whilst not pleasant for her obviously.
He would have been assessing for any indications warranting surgical manipulation and fixation, a plastercast or a splint.

HTH.

GPs make about 15% of "inappropriate" referrals to A&E. It isn't all people with silly complaints wasting A&E time.

Yeah right.

In fact, it's the greed for increased wages, when Healrh Care Assistants have to accept Jack, which is costing bloody money

You do realise Consultants haven't complained about their pay?

Away so was it not worth hanging around a bit longer to get properly sorted?

Efficiency in healthcare does not mean snap decisions and treatment plans - that's dangerous. It involves observing evolving situations and adapting accordingly.

She's nearly 12

MedSchoolRat I always try and go through my GP with the DCs first. DD has an ongoing ear infection to which shed under the ENT consultants for. She recently had them syringed at the beginning of January I think it was and we got told they'd call us back in about six weeks. We're still waiting. Her ear infection came back / got worse so I rang ent - no appointments - got told to ring the GPs.

Rang the GPs and was told and I quote "it's the consultants responsibility - that's what we referred DD there for in the first place'.

All we needed was some of the same eardrops the consultants had prescribed - didn't need an emergency appointment at the hospital or the GPs for it yet neither was prepared to do it. It was bizarre! Finally got some prescribed in the end though.

EffieIsATrinket sorry, this thread is moving fast. Worth hanging around where to get what properly sorted?