Should she have got priority treatment over other non-urgent patients?

[Rabbitradar]

DD is an SHO (dr) in A&E in city X. She was off duty yesterday and so came home and stayed here last night in city Y which is 30 miles from city X. She was due on shift at 10am this morning. Unfortunately one of her contact lenses tore in her eye and despite several attempts a piece of contact lens remained in her eye causing blurred vision and mild pain.
She could not drive due to blurred vision so I drove her to eye casualty in city Y.
Waiting room packed (9am) and average wait time 4 hours.
DD didn’t ask for priority treatment - and wouldn’t dream of expecting to be seen before anybody requiring urgent treatment. She did ask what the waiting time was and explained she was due on shift in A&E at hospital X.

However, to me it seems nuts that she is spending the morning sat in a waiting room with lots of other non-urgent casualties (and doubtless some urgent ones too) whilst 30 miles down the road at hospital X the waiting room in A&E will be backing up further as they are 1 Dr down.

AIBU to think that in some circumstances -like these - it would be sensible for NHS staff to get priority treatment?

Please note I am not suggesting that any other patient’s treatment is compromised just that other non-urgent patients have to wait a bit longer ....

Interesting that you refer to your daughter as an SHO? A term that has not been in use since 2005 in the UK. Junior doctors are either FY1 or 2 or StRs.

No she absolutely should not be given priority for a non urgent eye injury. Some apparent eye conditions which occur spontaneously can be indicative of a much more serious problem like a detached retina which can lead to permanent sight loss. As others have said, a contact lens fragment was a job for an optician not A and E.

The point is that nearly all those patients you listed will be seen much quicker in A&E if the team is not missing a dr. The longer the dr is missing the longer all those others will wait.

And yes, triage is critical. Hence my suggestion is that prioritising frontline staff over all those patients in the lowest category - non-urgent - would be more efficient for everyone.

But I do agree it is U to expect to have this implemented ad hoc.

I would like to see a system trialled where all NHS staff, whose absence from work leads to further delays to patient care whilst also putting more pressure on their colleagues, are prioritised over other non-urgent patients. I suggest this would speed up the process for most patients and do wonders for staff morale but a trial would confirm this either way. And identify the inevitable unintended consequences which may or may not be mitigated against.

Frenchw1fe

@mrscosta
You risk your eyes if you want to , I wouldn’t.
My mum badly damaged her eye because she took your attitude and was lucky not to get permanent scarring.

Exactly - My mother DID get permanent scarring

What’s stopping me from saying I’m a firefighter due on shift to avoid a longer wait? I might not have brought my work ID because I was in a rush, what with it being an emergency and all....

It’s just bloody bonkers to think the NHS has the time and resources to prioritise and triage front line workers. It’s unworkable. Why would a random hospital in X location prioritise a police officer due on shift 30 miles away? Where’s the logic in that?

It's really not who is important- it's as simple as this person not being at work directly affects the workload of this A&E department... because they are not at work, more people are waiting (at both hospitals) - get them back to work, reduce the queues, get everyone else treated or back to their responsibilities...

Stop looking at the daughter as a person but as a resource...

If you have a load of tools to fix with a soldering iron, you have 2 people with the ability to use a soldering iron and one of the things on the repair list is a soldering iron - surely you fix the soldering iron first and hand it to person 2 who proceeds to fix half the tools on this list. Bit of a crap analogy, but the easiest way to depersonalise things

You sound as though you’re just annoyed that your daughter was unable to ‘pull rank’. Having worked in A and E myself, the speed at which people are seen wouldn’t be significantly impacted by the lack of one foundation doctor on a shift. Serious injuries such as multiple trauma from an RTA will be way above her level of experience and the lumps and bumps and walking wounded won’t suffer adversely if they have to wait a bit longer.

You keep talking about ‘non urgent’ - how do you know how urgent someone else’s problem is? Did the triage nurse come into the waiting room and inform everybody how she had prioritised people? As ‘frontline’ staff myself for many years I would never have dreamed of trying to queue jump and, again as others have asked, did your daughter got to work or did she take the day off? I rather suspect if her vision continued to be affected that is more likely than not.

She absolutely shouldn’t be seen as any more of a priority than any other patient. People should be seen in order of severity of their reason for visit.

it's as simple as this person not being at work directly affects the workload of this A&E department...

Given the number of people failing to understand the basic point the OP was making it might not be so simple

@Lincolnfield
No, it's not 'interesting' - the term SHO is still used - quite universally by the profession actually. FY1/FY2/STR are educationalist imposed (fairly daft) terms that go in applications and on paperwork but SHO is generally understood to be inclusive of a certain grade in daily conversation.

To the OP - YANBU. But only at the ED your daughter works at. If it's separate eye casualty, she'll just have to wait, like everyone else, according to priority.

I've just spent a year explaining to my mother why no, I can't bump her up the cataract list because I know a few of the ophthalmic surgeons.

rafals

@randomsabreuse that’s a useful analogy.

Your assuming though that all nhs staff seen will be fit to return to work. More than likely if seeking the assistance of service like you describe won't be! Even your daughter case untill they removed the lense how could they be sure her vision wouldn't need rest or she would need strong pain killers that would make her unfit to work?

Even with a a strong triage system it's impossible to know the outcome of any treatment at the start so it's impossible to know if someone will be able to go back to work. If you can't be sure they would return to work (well enough to be there) then the whole point of prioritising them is pointless.

All services are over stretched all are working the best they can prioritising based on the clinical conditions of the patients is the only safe way to run a department.

I'm an Anaesthetist who is currently unable to work whilst I am awaiting surgery in my own Trust. Don't worry though, I am waiting with everyone else. No preferential treatment here. And it is proving quite a long wait. I am told it is so long because of "the impact of sickness within the Anaesthetic Dept."
So, lots of people having operations delayed whilst I sit at home on full pay but thankfully, my Trust is very fair to all patients and gives no priority to staff.

I understand what you are saying op but was your daughter ok to work that day after eye sorted out anyway? Would she be fit to work? I don’t think anyone can be prioritised on occupation. People ring in sick in the NHS all the time and it has to be dealt with. Not ideal but real life. Things happen. Hope her eye is ok now?

At least you get an explanation @MAFIL
Us mere mortals get nada.

@randomsabreuse

I’m happy to admit if I’m being thick but OP’s daughter was at a completely different A&E.

Also, I’m not saying it shouldn't happen but how without putting a different pressure on the NHS triage system? OP just seems to think her daughter should be priority and hey, no matter how old our kids are, we still think our kids are the most important people ever.

@MAFIL oh the irony!

Classic NHS thinking there MAFAIL. Forward thinking is not really our strong point is it?

I think the clerk in the admin office gave me the same information as she would anyone else @Alrighteo
If she had known who I was I doubt she would have been daft enough to effectively tell me that operations were being delayed because I am off sick.

What, you mean you can’t be your own anaesthetist, MAFAIL? That’s a poor effort, you need to try harder!

@Sb74 thanks for asking ... yes she was able to work the rest of her shift.

@Schuyler please try - and @randomsabreuse’s post should help - to de-personalise this. It’s not about DD being my daughter it’s about a dr being a resource

Op, your idea of a trial on nhs staff being prioritised is just not feasible. For a start that would use funding that would be better spent elsewhere!! The real problem is the NHS needs more staff and needs more beds. It shouldn’t be so vulnerable that one staff member being absent should cause such long delays. There is a massive shortage of staff and resource. This is for a number of reasons but the answer is not to prioritise nhs staff, it’s to sort the whole damn resourcing issues out. That’s what will motivate people. The NHS is on its knees.

@Rabbitradar

You’re not listening yet you asked if you are BU!
I’m asking how A&E triage the first responders and medics, yet nobody has considered the impact this has on the service. I’m seeing it as a bloody resource ! It’s a burden on triage. I triage in my job, it’s a huge stress and careful balancing act. Adding to it is not as simple as some people think.

Contact lense in eye
Can't breathe properly
Chest pains
Broken bone compromising blood supply
Umm.
Which one do I think I ought to see first. Might choose Dr. So she can get to work and save her patients. Bollocks to mine.

Nobody’s suggesting prioritising over urgent cases, lion. Especially not the OP.