A & E Wait Time Overnight With NO Doctors!!

[ShabbyNat]

Last Saturday night I arrived at my local A & E at 7.45pm by ambulance, with lights & sirens going with a suspected stroke.
Went through Triage within about 20 minutes after being kept waiting in the back of the ambulance for 30 minutes, which meant the ambulance could not go back out to help anyone else in that time!!
After Triage, I then sat in A & E until 5am Sunday morning, with obs only being done once & me asking several times "what was I waiting for?"-bloods, "how long is the wait for my bloods to be taken?"-no bloods, your waiting to see the doctor, "how long to see the doctor?"-there are no doctors in A & E!!
Lots of nurses & cleaners though, with the cleaners looking bored stiff as no cleaning really needed doing as no treatments were going ahead & nobody was really moving about much as it was overnight-too tired!!, & nobody really eating as too tired & ill !!
I ended up walking out at 5am & going to my GP on Monday morning, who diagnosed Bells Palsy.
So, my AIBU is, after stewing on it for a week now, AIBU to be getting quite angry about an A & E department who did not have even 1 doctor in the whole department overnight to actually see anyone??

Bell's palsy is for the most part quickly distinguishable from a stroke by the history and how it presents. I'm surprised the ambulance crew and nursing staff didn't feel they could let you know it was likely Bell's. You'll often go through a stroke pathway since the treatment window for stroke is just 4.5hours from onset of symptoms, therefore if its missed/incorrectly diagnosed the reprocussions of the delay can be catastrophic.

If you were on a stroke pathway you'd have been given an early CT scan which you didn't mention. It's possible a Dr did review you and diagnosed Bells/not a stroke, put a management plan in place to monitor you until/low priority, you were just waiting your turn for someone to prescribe your meds/write up your notes.

The A&E will have had Doctors and other ACPs availiable. There will also have been doctors on call/covering wards, cdu/amu/sac. An A&E large enough to be open overnight and have a stroke unit will not be run without a doctor in the department. Seeing as you were managed by your own GP the following day you were likely correctly triaged as a low priority and the Doctors were with other patients.

Whilst the wait times are absolutely going beyond what is acceptable and will take some monumental changes to bring back down to something sensible, its likely not the staff in the department to blame. They're being asked to look after too many people

If there were no doctors in A&E overnight, the department would have closed. Suspect you were not told entirely accurate information. There may not have been any doctors available to see you because they were dealing with other things, but not nobody physically in the department.

That aside, it is shit that you had to wait so long with concerning symptoms, even if it did turn out ok in the end. This is not the fault of the staff you actually did see though, so if you do complain it should be to your MP that the hospital is so badly under-resourced.

Went through Triage within about 20 minutes after being kept waiting in the back of the ambulance for 30 minutes, which meant the ambulance could not go back out to help anyone else in that time

That's pretty good to be honest, compared to some how long many ambulances are kept waiting outside a&e.

Are ybu? Well yes and no...Don't be angry at the wrong people. A&Es are doing the best they can when desperately underfunded.

One of the causes of Bell’s palsy is Lyme disease. If you live rurally, it’s worth asking for bloods to check . I know of 2 people in our area whose cause was this.

The communication was the issue here.
If they had suspected a stroke I'm sure you wouldn't have been waiting that long.
In the midst of the pandemic when we were asked to refrain from dialling 999 except in life threatening circumstances , I was alone and thought I was starting to have a stroke. I phoned 111 and within 20 minutes I had an ambulance at my door and was blue lifted to hospital and immediate admittance.
I'm forever grateful because they undoubtedly saved my life, or at the very least reduced some of the longer term ramifications.
But it's appalling that you were left not knowing what was happening. No way would they have left you if they considered you to be having a stroke.
So sorry though that it sounds like you were left afraid and confused for many hours

Sadly plenty of people wait hours even for suspected stroke

You're not being unreasonable BUT that's honestly a lot better treatment than I've had.

I was placed on a plastic chair right next to medical waste bin, whilst miscarrying my first baby, alone. Whilst 6 drunk people got all the beds.

I asked EVERY single person I saw who worked in the hospital for a pad as I was sitting in a puddle of blood for hours but never got one ... walked out as soon as I could physically stand. They wouldn't even help me to a bathroom (I couldn't walk, got taken in by ambulance and dumped on the chair)

The NHS service was shocking... I would have /should have complained officially but I was too distraught

The having to wait half hour in ambulance - I'd be so mad... because what if someone was dying and needed it? I think that's stupid

I don’t understand people like you who walk out of a&e and then complain they weren’t seen quickly enough. The fact that you were able to leave and go to your GP the next day confirms you weren’t a priority.

The height of the pandemic, many A&E depts were much emptier than usual, I know ours was. Got straight few twice, with only one or two in the waiting area. This would have been the height of lockdown, so when many people were too scared to go to hospital. Scary to think of those severely ill, sitting at home, too scared to go.

Unfortunately now things have picked up again, and A&E depts are at breaking point, there are unfortunately many suspected stroke patients sitting in ambulances for hours before they're taken into the hospital. Given how time sensitive a stroke is, it's very scary.

You have no idea how busy A&E staff are, triaged for a reason, and if you had a long wait, that means there was a lot more critically I'll people in than you.

I can guarantee there were drs in the department otherwise it would have been closed. You can distinguish between a Bell's palsy and a stroke. I'm sorry you had such bad communication though. Perhaps the drs were all doing other things like cpr in resus etc. they also take a while to hand over at 9 in our trust.

I went to a&e after an appointment with my dr where my hr was 168 and stayed that high the entire appointment. No ambulance available, got a taxi and told the receptionist I thought I had SVT and got an ecg within 10 mins of arriving at reception. Then after my ecg I went into resus because it was steadily between 150-180, they treated me for sepsis and then found I was in a thyroid storm and would have died that night.

The department was rammed but I felt safe.

I think a&e is just incredibly busy.

My horse threw me off badly whilst jumping and I had to lie on the ground for 3 hours without moving due to a suspected neck injury. The ambulance took me to the hospital where we had to wait another 3 hours to get inside. The paramedics were annoyed and unhappy as obviously a potential neck injury is urgent, and the drs and nurses in the hospital were extremely apologetic, but unfortunately there were just too many people who were sicker than me so I had to wait. Between the accident and getting scanned there was around an 8 hour wait. Not ideal but nobody’s fault. I didn’t complain once as it’s just life and the poor staff were overworked and exhausted.

I suspect something similar in your case- you should have been seen sooner (in an ideal world) however there is a limited number of DRs and staff available and unfortunately other cases were more urgent. I know that doesn’t reassure you when you’re unwell and need help, but I suspect this is what happened in your case. There will have been DRs but they presumably were sent to the most urgent cases at the time

hope you’re on the mend soon.

A&E nurse here, you would've likely been triaged and then prioritised based on that assessment. Observations would've been done to then give you a NEWS score, if you were scoring low, it was likely you were deemed low priority. Again as previous posters have stated, if there were no doctors in A&E, it would've been shut. Clearly there was a communication issue here.

Why are we accepting this. We should be marching on the streets demanding our politicians sort the NHS out ASAP. I doubt if Boris called an ambulance this is the service he’d get!

@Summerfun54321 what do you want? She was triaged and treated appropriately. Would you not want the sickest people to be prioritised?

Of course there were doctors on shift.

This is what A&E need - those walking wounded, or able to see GP need to go home. As you did.

@QuidditchThroughtheAges so a 9 hour wait at A&E is acceptable then? We’ve got so used to such awful service in the U.K. Can anyone name a single other 1st world country where you’d be taken to hospital and have to just walk away fed up after 9 hours? Clearly there were drs there, but that doesn’t make a 9 hour wait with only triage OK.

@Summerfun54321 I mean it's the same in Australia and the us at the moment. But yeah okay you just get pissy at Health care professionals as though it's our fault. Really gonna fix things that is

@QuidditchThroughtheAges I’m not pissy at health care professionals, I’m pissy at the politicians for not providing more money to fund the NHS that was promised. The service isn’t good enough, not because of the staff, because of lack of adequate funding. My post clearly took issue with politicians.

@Summerfun54321 you come to & early with whatever you present with. You're seen in triage by a qualified and experienced nurse who triages and puts you into the system. With the use of observations and their clinical experience they decide where you need to be.

If you need immediate treatment you will see a dr immediately. If you can wait a bit for a dr you will go back out into the waiting room.

We only have a finite number of drs in the department at any one time. Drs are busy taking blood, seeing patients, lumbar punctures, putting shoulders back in, cpr in resus, referring to surgery and medics, dealing with sepsis etc etc, not including the car accident traumas or the child run into a&e barely breathing. You won't see any of this.

The problem is we don't have anywhere to put the people who need to be admitted.

If you're waiting for 9 hours and then are discharged that probably could have been seen by a gp. Be thankful you aren't being seen quicker.

It's always been busy in a&e it's worse at the moment.

Bring a book

The Republic of Ireland is worse. You could wait twice that and then be charged 100 euro for the pleasure

@QuidditchThroughtheAges I can’t get my head around why you’ve taken issue with me saying the NHS needs more funding. Are the people dying waiting for ambulances meant to just read a book as well?

@Summerfun54321 in my defence I didn't read your post properly. I'm just sick to death of people complaining when we barely get a break and it's so hard to go in everyday and be screamed at by members of the public who think their sore finger needs to be seen before a child not breathing.

Sorry

My son cut his lip and chin open aged 5. Lots of blood couldn't eat or drink. We waited 6 hours in childrens a&e because there was no doctor. (Literally it was a day time lunch had about 12 kids waiting and none of us were seen for about 5 hours before 1 doctor arrived . (We had all been triaged by a nurse) We were seen 3rd out of 12 (others were more serious) The doctor wasn't a paeds doctor, he couldn't do stitches and knew nothing about teeth. He sent us to another hospital after taking advice over phone , by the time son was seen they said it was too late to stitch it would heal but scaring would be more significant. He has about four scars on his chin. It's not the doctors fault but it's appalling to watch people suffer due to a failing system.

I've just got home after a bloody horrendous 12.5 hour shift.
I've left a department that resembled a war zone.
The average wait for a patient in the back of an Ambulance was 5hrs.

Waiting time for triage was 9hrs when I left, there were 63 patients waiting for triage and 1RN and 1HCA ploughing through them all.

Dr waiting time was 18 hours when I left.

Its a shit show. I've worked there for 25 years.
I estimated that 80% of the patients didn't need to be there. They could have been seen by their GP/pharmacy/dentist/mental health teams.