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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:
Freysimo · 04/01/2023 07:31

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

I don't support the government regarding NHS but Wales NHS is Labour run and just as bad, if not worse.

America12 · 04/01/2023 07:32

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/

Very angry. NHS is very top heavy. Lots of management never been clinical either so happy to have patients lying in corridors for days.

latelydaydreams · 04/01/2023 07:34

There is a problem in all areas of the NHS. Fewer Drs and Nurses because- who would want to work for less money than they did 10 years ago? Alternatively, those who can stick it out might choose to work as Locums/Bank where rates are higher and you can pick and choose when and how much you work.
Inability to discharge patients to social care/the community is rife because there is a lack of social care/care staff, because they aren’t well paid, the job is hard and as a country we voted for Brexit whichever meant- we lost valuable staff AND we are stuck with very very high levels of inflation.

Recruitment of both Doctors and Nurses is stifled and many leave to work overseas after training because they get better pay and conditions.

The Tories in 2019 got rid of the moderate thinking and experienced ( and I am NO Tory voter) members and instead we have a rabble of MPs with little experience and even fewer morals.

As a whole, with population increases, this is utterly unsustainable.

With many of the major unions ( not just healthcare) endorsing strike action, this is likely to continue for some time.

As a nation, we have a government who have effectively stifled public protest, and here we are waiting for 2024. We need PR to ensure that this can NEVER happen again. We should be out on the streets and in many other nations, the public would be.

America12 · 04/01/2023 07:34

Can't see a GP.
No carers ,some nursing homes have cut beds.
NHS treating more people for more things for longer.
Massive money pit, suppliers rip off the NHS.
People calling ambulances for nothing.

List goes on.

BreatheAndAgain · 04/01/2023 07:35

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.

Of course, this is happening it isn't rocket science. People can't get GP appointments as they will only 'see' you over the phone IF you are lucky and many of the minor injury /urgent care units have been shut. This is why A&E is so busy.

Bring back more urgent care and walk in clinics and give GPs a kick up the butt, their 'service' is abysmal, truly shocking. And the system with locus doctors and nurses raking it in is frankly outrageous. The system is broken.

One small rant, why do some families insist bring their whole extended family to A&E, come on people that is the hight of idiocy.

BreatheAndAgain · 04/01/2023 07:36

locum

Menopau · 04/01/2023 07:40

@BreatheAndAgain

a lot of parents chose not to vaccinate their small children against flu this year. A lot of CEV also chose not to get it. 🤷‍♀️

Your GP is not a mini A&E or an urgent treatment centre. They are also expected to provide a whole service to the entire population from childhood vaccinations to end of life care.

KangarooKenny · 04/01/2023 07:43

The was a statement sent out showing that those children who’d had the nasal flu spray were less at risk of strep A. This was from info during the nasal flu pilot, yet take up was down again.

CloseEncountersOfTheTurdKind · 04/01/2023 07:43

I had to take my daughter to a&e a couple of months ago (on advice of 111 after she swallowed a magnet). The nearest a&e wouldn't accept more patients as it was overflowing so we had to go to a different hospital. The waiting room was full of kids with ear infections/chest infections/ other bugs whose parents said they had been trying to get GP appointments but couldn't. I don't know what the answer is, but something needs to be done about the lack of access to GP appointments.

sheepisheep · 04/01/2023 07:44

BreatheAndAgain · 04/01/2023 07:35

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.

Of course, this is happening it isn't rocket science. People can't get GP appointments as they will only 'see' you over the phone IF you are lucky and many of the minor injury /urgent care units have been shut. This is why A&E is so busy.

Bring back more urgent care and walk in clinics and give GPs a kick up the butt, their 'service' is abysmal, truly shocking. And the system with locus doctors and nurses raking it in is frankly outrageous. The system is broken.

One small rant, why do some families insist bring their whole extended family to A&E, come on people that is the hight of idiocy.

You can only get a gp appointment "if you're lucky" because demand is up the wall. It's nothing to do with the service being offered, there are more gp appointments being provided than ever before. Do you say the service at a&e is abysmal because you had to wait? No, because the demand is clear to you. Stop gp bashing.

cptartapp · 04/01/2023 07:45

I work in general practice. Our clinics are rammed with f2f appointments for weeks ahead. Our numbers are well up on last year.
We have another two nurses leaving next month. Retiring early. Had enough. No replacements.

DolphinWars · 04/01/2023 07:46

A dr posted a long Twitter thread as couple of days ago (which I can’t find now!) explaining how a big problem is elderly people not being able to move to care homes as council’s funding has been cut.
Plus the perfect storm of floods of patients with flu.

This has been building up - where have the government been? What have they been doing to help?

I know for a fact there are drs trying desperately to make changes, talk to people within the government, but no one is listening.

Nurses need to be paid more, the BMA needs to stop restricting the numbers of drs in training, the government (useless fucking wankers that they are) need to pull their finger out and start doing something to help hospitals at this time, because it’s getting difficult to see what use they are at all.

Apart from trying not to get ill and not voting Tory, is there anything the public can do that could make a difference?

FangedFrisbee · 04/01/2023 07:47

KangarooKenny · 04/01/2023 07:43

The was a statement sent out showing that those children who’d had the nasal flu spray were less at risk of strep A. This was from info during the nasal flu pilot, yet take up was down again.

Well you saw it on here didn't you? So many threads from parents saying that they weren't able or capable of holding their child still for a nasal spray and they weren't 'putting them through that again' and now they're paying the price

hettie · 04/01/2023 07:55

@America12
Actually the NHS isn't too heavy in fact it probably has too few managers. At least this is what the data suggests rather than a one off job that can be used to England the old too many managers trope that gets trotted out.
see here;www.kingsfund.org.uk/publications/future-leadership-and-management-nhs/managers-and-the-nhs-2010

Beautifulsunflowers · 04/01/2023 07:57

The whole system needs a major overhaul - GP Surgery’s should work 7 days a week - we live in a society that’s open 24/7 and our gp surgery’s are operating on a 30 year old model.
our social care system is broken too - no more places in care homes and no carers to accommodate those who need at home care. People are waiting in hospital medically fit waiting for something to come up.
Op you are right - the general public have no idea - and it’s being kept out of the media too. only the good things are reported on.

For those of us sitting in our cars not wanting to go in to work today (me) have a hand hold. I’m with you and I hear you.

MissyB1 · 04/01/2023 07:59

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.

Nonsense. There’s a massive recruitment and retention issue with staffing in the NHS. Higher wages will make the jobs more attractive and hopefully help to keep staff.

Menora · 04/01/2023 07:59

FangedFrisbee · 04/01/2023 07:47

Well you saw it on here didn't you? So many threads from parents saying that they weren't able or capable of holding their child still for a nasal spray and they weren't 'putting them through that again' and now they're paying the price

I might out myself but during the strep A outbreak we invited over 300 parents to take up a flu for 2-3yo and 4 turned up

KangarooKenny · 04/01/2023 08:00

MissyB1 · 04/01/2023 07:59

Nonsense. There’s a massive recruitment and retention issue with staffing in the NHS. Higher wages will make the jobs more attractive and hopefully help to keep staff.

But that won’t fix the problem, it’s one piece of a very big pie.

bottledgrapes · 04/01/2023 08:02

We are more populated than we were years ago but still expecting the same resources or less to go around more people and resources are stretched, schools are bursting at the scenes, medical treatment is practically unavailable to most, the roads are chockablock, dentist waiting lists are years long and services in general are stretched and not available to most, add the money being cut and staff wages being low and you have the situation we're in.
We need more services to match the population of today.

bloodyplanes · 04/01/2023 08:03

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.

I agree! The whole system is absolutely fucked! Its a combination of things that add up to the perfect storm! The government are beyond useless but they could throw as much money at it as they want to but it still won't work! The whole thing needs tearing apart and rebuilding! From staff, higher wages, better working conditions, less bullying culture, less pen pushing managers. To patients, need to learn to look after themselves better and take more responsibility for themselves. Stop turning up to A&E for pathetic/trivial reasons ( and this is absolutely not because they now can't get GP appointments because its been happening for years) stop calling ambulances for unnecessary reasons its not a bloody taxi to hospital! I worked for the NHS for many years and i most certainly wouldn't do it under the current conditions! It has slowly been failing under successive governments for many years and covid just hastened that demise to this point! It was not designed to be used by so many for so many minor issues! They need to introduce nominal charges for things like GP appointments and ambulance call outs to make people think twice before they actually use it. As for the statement in the op original post that they have been a consultant in A&E for years and that is the first time they have sat in their car and cried after a shift, I simply don't believe it! Having worked in high pressure roles for the nhs i know that that sort of job is an absolute emotional rollercoaster! When its good it's amazing and when its not it's awful, so I definitely don't believe thats the first time that's happened!

BigGreen · 04/01/2023 08:03

I'm so pissed off with the government and their refusal to even engage with this crisis. It's terrifying.

MissyB1 · 04/01/2023 08:04

is there anything the public can do that will make a difference?

I think we all have a responsibility to make as much noise as possible about this crisis. Lobbying MPs ( although mine is a spineless Tory twat), twitter and other social media platforms, sign any petitions. Support striking NHS workers. I don’t know, if there were demonstrations I would join them. We can’t just roll over and keep taking this.

sheepisheep · 04/01/2023 08:04

DolphinWars · 04/01/2023 07:46

A dr posted a long Twitter thread as couple of days ago (which I can’t find now!) explaining how a big problem is elderly people not being able to move to care homes as council’s funding has been cut.
Plus the perfect storm of floods of patients with flu.

This has been building up - where have the government been? What have they been doing to help?

I know for a fact there are drs trying desperately to make changes, talk to people within the government, but no one is listening.

Nurses need to be paid more, the BMA needs to stop restricting the numbers of drs in training, the government (useless fucking wankers that they are) need to pull their finger out and start doing something to help hospitals at this time, because it’s getting difficult to see what use they are at all.

Apart from trying not to get ill and not voting Tory, is there anything the public can do that could make a difference?

Ok let's say there's no restrictions on how many medical school places universities can offer. Then what? Do you realise its not possible to practice medicine independently in the UK with just a medical degree? You need at least a year of supervised practice. And that needs to be cover general medicine and general surgery. Where are we going to fit them in? How do you propose we fund them? Who is going to supervise the extra newly qualified doctors? How much are you going to pay for the supervision and where is that money coming from?

So tired of people making sweeping statements without understanding anything about medical training or workforce planning.

creamcoffee · 04/01/2023 08:05

more training of GPs and nurses surely is needed
more GP funding
so you can visit your GP and leave A & E to Accident and Emergenies.
clue is in the name

cptartapp · 04/01/2023 08:06

Beautifulsunflowers · 04/01/2023 07:57

The whole system needs a major overhaul - GP Surgery’s should work 7 days a week - we live in a society that’s open 24/7 and our gp surgery’s are operating on a 30 year old model.
our social care system is broken too - no more places in care homes and no carers to accommodate those who need at home care. People are waiting in hospital medically fit waiting for something to come up.
Op you are right - the general public have no idea - and it’s being kept out of the media too. only the good things are reported on.

For those of us sitting in our cars not wanting to go in to work today (me) have a hand hold. I’m with you and I hear you.

Where are you getting the staff for this seven day a week GP service?
I can work all the Sunday mornings you want, but then won't be there on a Friday afternoon for example.
You would also lose a lot of staff working in general practice for the unsocial hours due to caring responsibilities (that was me).
We have an OOH GP service at a sister clinic manned by GP's on a voluntary rota. It's rarely full. Patients seem rather to want to wait and ring their own surgery on a Monday morning.
In theory a great idea. As it stands, not feasible.