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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Perspective from staff within NHS

314 replies

lowercaseletter · 04/01/2023 04:44

Posted anonymously by an A&E doctor:

Im writing this because I’m angry. Actually more than that, I’m fu*king livid.

I’m an A&E reg with 9+ years experience in A&E both here and overseas. This morning was the first time EVER that I cried in my car after a shift.

I was on nights over this New Years period, but New Year was not the issue, every shift is like this now.

Where 5 years ago we had 50 patients in the department on handover at night, we now have 180. It used to be around 20 patients to see with a 1-2 hour wait for clinician, it’s now 60-70 with a 10 hour wait.

People used to lose their minds if patients were coming up to 4 hour breaches. Last night 60% of the patients in A&E had been there for more than 12 hours, some for more than 40. Many I saw the night before, still in the same place when I came on.

No triage or obs after 2 hours of arrival, no bloods or ECGs or gas for 4 hours. Regularly finding people in the waiting room after 4 hours with initial gases showing hyperkalamia or severe acidosis or hypoglycaemia.

87 year olds coming in after falls sitting on chairs for 18 hours. Other elderly patients lying in their own urine for hours because there’s no staff, or even room to change them into something dry. As the reg in charge of the shift, Ive had (on multiple occasions) to help the sole nurse in the area change patients by holding a sheet around the bed because we have to do it in the middle of a corridor. People lying on the floor because there’s no chairs left, trolleys parked literally wherever we can put them.

Things have been getting even worse for the last 3 months. 5 weeks I came home raging to my wife that people are sitting in their own piss for hours and it’s so inhumane. Now we’ve got to the point where people are actually dying. People who’ve been in A&E for 2-3 days,

The media and public might blame the A&E nurses and doctors for this, but honestly what the fu*k are we meant to do with 180 people in a department built for 50. With 8 nurses rather than the MINIMUM staffing of 12. 1 or 2 nurses per area, giving meds, doing obs, trying to provide basic cares to 25-30 people, an absolute impossibility. And there’s less nurses every week, because honestly why would you put yourself through this day after day?

Resus patients are quickly assessed and stepped down to make room for the next pre-alert, going to the area with those same poor nurses, already overstretched, now inheriting an severely unwell patient.

We need to accept the truth, the NHS isn’t breaking, it’s broken. And the same bastards who broke it are doing reality TV shows and writing books about how they saved the NHS whilst refusing to increase nursing pay. We try and shovel shit with spoons whilst they pour it in with dump trucks

The NHS as we knew it is dead, and it breaks my heart, because it’s a beautiful system. It shouldn’t be like this, and those of us who have been around for longer than 5 years know it wasn’t always like this.

The public have no idea, they don’t really know how dangerous this all is. When they come in they’re horrified, but most of the population don’t know how bad it is. This could be their mum on a trolley for 17 hours, or their wife or son or daughter.

I genuinely feel it’s now our responsibility to speak out. We don’t for fear that it will make our hospital look bad or harm our careers. But it’s not a hospital problem, it’s a national problem, and it’s a problem brought about by the politics of the people in power.

We need to shine a light on what they’ve done, make the public so angry that they demand a change. Massive recruitment of nurses through a proper wage/paid uni/free parking/free Nando’s if that’s what it takes would be a start.

If anyone has any idea how we could coordinate some kind of campaign to show the state of emergency departments in the UK right now please write a response, because I can’t work in this much longer, and more importantly I’m not sure the patients can survive it.

OP posts:
Letshaveablackcelebration22 · 04/01/2023 05:21

I don’t know what the answer is but everyone who cares should vote the tories out at the next election and I hope it’s sooner than 2024

pompomdaisy · 04/01/2023 05:25

This is the worst I've ever seen it and I qualified as a nurse in 1991. Its horrendous. The Tories have completely *** it and have the nerve to blame everybody but themselves. Please look after yourself op. You're not a saint.

GoAgainstNicki · 04/01/2023 05:35

I’ve just returned home from A&E with my 8 month old son and I cannot believe our experience today. We were in A&E for 8 hours just to be told to go home and there’s nothing they can do. We were triaged within 5 minutes of arriving as we came in the ambulance but we were waiting in the reception area for 7 hours. Both the children and adult A&E was overflowing with people and you could see that the ratio of staff to patients isn’t anywhere where it should be.

We need to accept the truth, the NHS isn’t breaking, it’s broken. And the same bastards who broke it are doing reality TV shows and writing books about how they saved the NHS whilst refusing to increase nursing pay. We try and shovel shit with spoons whilst they pour it in with dump trucks

It’s funny you say this because when I was in the ambulance, one of the paramedics and I was speaking on the NHS and what needs to be done to fix the system. We said the system is like a conveyor belt. If one section isn’t working effectively, the whole system doesn’t work. We spoke about A&E waiting times and I said how it isn’t fair that patients frustrations get taken out on the staff when it isn’t there fault at all. The people whose fault this really is are completely unaffected. Alex could be effing and blinding to a nurse because he’s in pain and he’s been waiting in A&E for 10 hours. Yet an MP is somewhere on their 80K salary with their private healthcare.

It’s absolutely disgusting but I don’t see it changing anytime soon. The people who vote in Tories aren’t the same people that are concerned about the NHS. I’m sorry your hospital has been so hectic OP. Sending virtual love and motivation❤️

flapjackfairy · 04/01/2023 05:48

it is shocking. it really is. And as a parent of 2 children with v complex needs it is terrifying.
Our local hosp is having a critical incident and if we need an ambulance or to go in heaven help.us because on NYE half the counties ambulances were stuck outside trying to offload patients. HALF! just stuck there!
The staff are wonderful on he whole but hiw can they carry on like this ? Who knows what the answer is but the public need to rise up and say enough is enough. And where is our illustrious leader ? AWOL by the looks of things ! No gov response to speak of !

FangedFrisbee · 04/01/2023 05:48

I think the thing that's happening now with morale is a culmination of things, staffing is shocking, long term sickness is awful because of stress. However patients attitudes are appalling at the moment

I can't do anything to make the wait any less long or stressful, but in a normal 12 hour shift I'll be abused numerous times by patients. I get it. It's horrible to be waiting when you feel shit but taking it out on nurses and drs just makes more people think 'oh fuck it'

We had to have estates screw down the chairs in a&e last month because of how many patients picked them up to throw at us.

In the last week I've been spat at, bitten, screamed at, had a cup of (thankfully cold) tea thrown at me, sworn at and hit. It's enough to make me think maybe I'll just get a job in Aldi and I'm a nurse who's been around the block a bit. Thankfully next week I start in theatres and I hope that will be nicer.

But you see it on here all the time with the vitriol of posters about how shit we as nurses are. It's demoralising and it's not actually our fault it's shit.

torquewench · 04/01/2023 06:03

Whats happened locally to this doctor over the last 5 years that's caused such a massive increase in people coming in to A&E?

FangedFrisbee · 04/01/2023 06:10

@torquewench it's not locally. It's nationally. People either don't know what needs to go to a&e or can't get to the gp so they're attending for really ridiculous reasons/ primary care conditions that we can't treat in a&e and then you have the standard strokes and heart attacks

Whoneedsleep · 04/01/2023 06:18

I was forced to go to a&e the other week because of a kidney infection. I wouldn’t have got to that point if I could get a GP appointment but they wouldn’t see me despite being pregnant. I tried all home methods of treating it but it progressed to the point of agony and still I couldn’t get seen so 111 sent me there. My Gp surgery is always the same, impossible to contact or get an appointment for.

I sat in A&E for 9 hours for some antibiotics (which I was bloody grateful to get!) but maybe if people were able to get actual appointments to be seen for minor things they wouldn’t end up there in the first place. Also not being able to access basic medical care every weekend or bank holiday is probably also contributing.

I actually considered training as a nurse at one point but there’s no way I’m sitting through uni for 3 years unpaid to be spat on.

The whole system is fucked, no idea what the answer is!

Iizzyb · 04/01/2023 06:18

I'm so sorry OP. The system really is broken.

Twice last week I tried to get help for a close friend with shingles who was visiting us (away from their home, too far away to see their GP - think 100's of miles away from home).

Twice I was told to use 111 or go to A&E (once by my own GP's surgery who wouldn't see him as a visitor and second time by a lovely local pharmacist who we know usually knows his stuff as he's really helped my DM with a change of meds).

I didn't even consider taking my friend to A&E.

2 nights ago a senior dr from our local A&E was on a video on Facebook saying please don't come to A&E unless it's a real emergency etc.

Stickortwister · 04/01/2023 06:20

I agree with you.

Ive become very burnt out this winter.

I think people are getting what the voted for.... however this probably all started under labour ( blair and pfi anyone) so not sure the alternative is any better.

Jaybird43 · 04/01/2023 06:28

My dad went in last week late at night with a suspected TIA. 7 hours later (after him being paralysed from the waist down, nothing to eat or drink and no communication at all) we were taken in to see a doc who dropped a bombshell that dad had a brain tumour. We were told to wait back in the waiting room. We were then left for a further 3 hours (dad was being given sips of water by me as he couldn’t move and was worried about going to the loo). I finally managed to get him a bed in a side room. We saw a different doc as the first went home. We never saw that second doc again. They then “lost” my dad for a couple of hours as they forgot they put him in a room.

I have worked in the NhS for 20 years and am
appalled / disgusted by this experience. There was no communication at all and the only saving grace was the A&E receptionist who went out of her way to get my dad a coffee and a sandwich - he is type 2 and had nothing to eat at all as I couldn’t leave him as his vision had gone and he was slumped in a chair.

Something has to change. I would hate anyone else to go through what we went / are going through. It is inhumane.

KangarooKenny · 04/01/2023 06:31

Paying staff more won’t fix the NHS, there are too many people trying to use too few resources.

Blondewithredlips · 04/01/2023 06:37

KangarooKenny · 04/01/2023 06:31

Paying staff more won’t fix the NHS, there are too many people trying to use too few resources.

Rubbish. Tory voter? Remember private healthcare will not cover emergencies...

Nurses, doctors, HCAs and social care staff need to be paid a living wage to retain them.
All of those NHS staff have taken a real terms pay cut. Only way to retain staff. Staff are resources. Not enough NHS staff per person.

KangarooKenny · 04/01/2023 06:38

Blondewithredlips · 04/01/2023 06:37

Rubbish. Tory voter? Remember private healthcare will not cover emergencies...

Nurses, doctors, HCAs and social care staff need to be paid a living wage to retain them.
All of those NHS staff have taken a real terms pay cut. Only way to retain staff. Staff are resources. Not enough NHS staff per person.

I’m not saying I don’t want more money to do my job, but as I said, it won’t fix the car crash of the NHS.

Seymour5 · 04/01/2023 06:41

How do experienced clinical staff, working at the sharp end, feel when they see jobs like this advertised? www.lbc.co.uk/news/nhs-looking-for-an-115k-director-for-lived-experience/

Blondewithredlips · 04/01/2023 06:46

Seymour5 · 04/01/2023 06:41

How do experienced clinical staff, working at the sharp end, feel when they see jobs like this advertised? www.lbc.co.uk/news/nhs-looking-for-an-115k-director-for-lived-experience/

It is a complete joke. Those jobs are useless and need to get rid of them.

The NHS is sinking and they advertise stuff like that? Ridiculous.

Evergreen82738 · 04/01/2023 06:49

This is what happens when people can't get to see their GP. A&E gets clogged up with people who aren't emergencies but still need treatment. This has got progressively worse since 2020 lockdown. People need to be able to access and see a GP!

Bigcrane · 04/01/2023 06:52

I am so with you. I'm broken. It's broken. I just don't think the public realise - if you ring 999 today it might take 5 mins for someone to even answer.

torquewench · 04/01/2023 06:53

FangedFrisbee · 04/01/2023 06:10

@torquewench it's not locally. It's nationally. People either don't know what needs to go to a&e or can't get to the gp so they're attending for really ridiculous reasons/ primary care conditions that we can't treat in a&e and then you have the standard strokes and heart attacks

I'm talking specifically about the OP.

Orangesandlemons77 · 04/01/2023 07:01

It also must be very expensive as if things are left they can get a lot worse and require much more treatment / surgery, as well as being much more stressful and painful for the patient.

crazycadetmum · 04/01/2023 07:18

I am a nurse who needed to get GP for my daughter over boxing day who had pleurisy. I contacted 111 and waited 12hs for a call back..its absolutely outrageous the GP surgery's were allowed to shut for 4 days..this drives the flow of people who have already struggled to get GP appointments even when they are open to go to A/e snd overwhelm them. Working out on the community i think they need to address GP cover and need to get patients seen and sorted by them. My mum said to take my daughter to A\E...I refused she hadn't had an accident nor was her illness life threatening. People abuse the service because they can't get seen locally.

sheepisheep · 04/01/2023 07:27

crazycadetmum · 04/01/2023 07:18

I am a nurse who needed to get GP for my daughter over boxing day who had pleurisy. I contacted 111 and waited 12hs for a call back..its absolutely outrageous the GP surgery's were allowed to shut for 4 days..this drives the flow of people who have already struggled to get GP appointments even when they are open to go to A/e snd overwhelm them. Working out on the community i think they need to address GP cover and need to get patients seen and sorted by them. My mum said to take my daughter to A\E...I refused she hadn't had an accident nor was her illness life threatening. People abuse the service because they can't get seen locally.

Because GPs aren't commissioned to be open on bank holidays. The same way routine outpatients and theatres aren't. In a functional nhs this is completely reasonable- gp's do provide emergency out of hours cover, as you used through 111. In a functional health system this is completely reasonable. Let's stop throwing the blame for this at gp's, eh? It's really not our fault. We're giving more appointments than ever, the same as the rest of the health service.

malificent7 · 04/01/2023 07:27

I work in A and E and it's my favourite place in the hospital to work but it is buckling under the pressure. The other night I was taking patients who were on ambulances, treating them and putting them back on the ambulance as there is no room in beds, corridors or waiting rooms.

This year is very bad as people are mingling and catching nasty respiratory infections.
I don't intend to work anywhere else but it is sad to see people waiting for hours. I intend to stay working there for now though.

malificent7 · 04/01/2023 07:29

Sorry..repeated myself.

Menora · 04/01/2023 07:31

crazycadetmum · 04/01/2023 07:18

I am a nurse who needed to get GP for my daughter over boxing day who had pleurisy. I contacted 111 and waited 12hs for a call back..its absolutely outrageous the GP surgery's were allowed to shut for 4 days..this drives the flow of people who have already struggled to get GP appointments even when they are open to go to A/e snd overwhelm them. Working out on the community i think they need to address GP cover and need to get patients seen and sorted by them. My mum said to take my daughter to A\E...I refused she hadn't had an accident nor was her illness life threatening. People abuse the service because they can't get seen locally.

This is the contract. They aren’t ‘allowed’ in the sense of ‘asking permission’, 111 providers are paid and contracted to cover out of hours and has been for many years. 111 doesn’t have enough staff and aren’t able to fulfil their contract. They are GP’s working OOH. There aren't enough GP’s. Primary care doesn’t have enough staff and is struggling to stay afloat. They don’t have enough appointments or capacity. It’s bizarre for people to think that primary care wouldn’t be in the same state as A&E, it’s just not in the news. All the GP surgeries are also declaring OPEL status critical where any locality is bothering to ask them (but often they don’t). The nasty bug that is going around has also affected doctors and nurses leading to extreme staffing shortages this winter. A lot of HCP have covid and aren’t allowed to work for at least 5 days.

People who are in A&E waiting for a bed would still be there if they saw a GP, these are not primary care conditions.

This is a pressure cooker effect, people forget what primary care is there for. It’s not just an emergency illness service. It’s also got to screen the population for long term health conditions and cancer screening. We can’t convert all our nurse appointments to minor illness as they need to do all the asthma, HRT, diabetes and contraception reviews and cervical screening that people need/want.

We can’t convert all the routine medication reviews to urgent appointments as who will review the medication? who will review your X-ray, your bloods, issue all the medication you need?