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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:
Kolakalia · 04/01/2023 09:54

Lauraa7 · 04/01/2023 09:51

I left the UK 15 years ago and the service was poor then. I now live in Melbourne and last week I went to my GP, I got a referral for a scan and gynaecologist appointment. I had my scan today and gyne appointment is on Friday.
I paid $20 for doctor, $100 for scan and I’ll pay about $250 for gyne. Surely this has to be a better system.

Not really. Millions of people cannot afford to pay for their healthcare. That's an incredible amount of money for some. There were times where I couldn't afford an £8 prescription, let alone hundreds/thousands on healthcare..

cptartapp · 04/01/2023 09:55

XingMing · 04/01/2023 09:50

@cptartapp I'd take a charge from everyone. And refund it on attendance if the patient actually required Rx treatment, was unwaged or on pension credit. Frankly, I think everyone else should chip in a nominal amount. It would deter the lonely frequent flyers and the timewasters who should have used Livi or 111 or the pharmacist.

I completely agree but can imagine the furore that would cause. I had an eighty something straight off a Caribbean cruise last week who was aghast that we wouldn't then and there, prescribe her a 'tonic'.

Bepis · 04/01/2023 09:57

@Lauraa7 I wouldn't be able to afford those prices so I would end up not getting checked which could ultimately lead to serious results.

ArabellaScott · 04/01/2023 09:57

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.

Bloody hell, that's awful. I hope you're okay, and able to continue with your nursing. Most people value the NHS enormously, I think it's just impossibly hard for staff and patients at the moment.

Melminiani · 04/01/2023 09:57

I strongly believe that this government- and previous governments- have been purposefully trying to kill the NHS from the inside out, and that this has been happening for about the last 15 years.

The lure of the sickening amounts of money to be made by going the route of the US healthcare system has meant that multiple governments have been looking to waste money by bad spending decisions (umm hello PPE), too many middle management, using expensive but outdated IT systems all in an effort to waste money and bring the NHS to the point that it’s at now.

So that when the system finally breaks down enough that people are finally motivated to do something about it, the government can say look, the NHS is clearly no longer fit for purpose and instead we will re-design our healthcare model. And then we will all be f**ked because suddenly, we will be at the mercy of big pharma who are driven by nothing more than money, profit and greed.

Losing the NHS will be one of the most terrible things to happen to this country, and we need - as an absolute mass - to get very angry very quickly, and to demand that the mis-management of it stops. To demand that nurses are paid more. To demand that staff are treated with respect by the people running this country, running the NHS and by any end users.

It clearly needs extra funding to help stop it from sinking. Someone once suggested a rounding up scheme for the NHS and it could possibly work. Your petrol is £35.89? Round it up to £36 with the 11p going to the NHS. Your shopping is £58.34, round it up to £59. Obviously small amounts in and of themselves, but if as many people as possible can do it (and I understand that not everyone can at this point in time) but for those that can afford to, it could really mount up.

I’ve been waiting for people to get angry and vocal for a long time. We should ALL be marching, we should ALL be demanding that the government does better, and we should be demanding that they do better by keeping the NHS going, not by stripping it and selling off the parts.

To quote a recent quote that I’ve seen that seems fairly fitting (apologies, I don’t know the original source): Resist! Or die horribly in a vat of ravenous pigs.

XingMing · 04/01/2023 09:59

@Kolakalia You can't pay for healthcare, because there's 70 years of history to say that it's free at the point of use.

If it were routine to pay for healthcare, it would work through into pay demands, and employers would demand a mutualised insurance package, not a private BUPA system to make fund it, instead of expecting UC to make up the deficit between hours and wages. The costs need shifting back to shareholders.

There is a reason that Australians earn higher average wages than in the UK.

Swissmountains · 04/01/2023 10:00

Social care needs to paid for by wealthy pensioners. Those that are in poverty obviously need some support.

Why on earth are we paying huge social care bills for people that are sitting in houses that are worth a fortune?

PaterPower · 04/01/2023 10:01

All of that is poor procurement practices. If the public sector are stupid enough and incompetent enough to hand out contracts that aren't value for money, don't understand contract wording, and don't control the contracts, then obviously the firms providing the services aren't going to complain, are they?

And who do you think the Governments (of the day - both NL and Tory used them) employed to advise on the contract T&Cs?

That wouldn’t have been the big private consultancy firms (Deloitte, PWC etc) who all pride themselves on being the experts in this type of thing would it?

The very same consultancies who were brought in by the Tories (and expanded massively by Blair and Brown) to hamstring and bypass the Civil Service?

The same consultancies who did (and still do) cream off the best of the civil service (or at least those who manage to push their way up the ladder into leadership roles… not always the same thing) and recirculate them back into Government procurement but at vastly inflated rates?

The same consultancies who provide SPADs and other resources for Downing Street and who therefore get to ‘nudge’ decisions on contracts and wider policies?

The same consultancies who give the ‘right’ politicians, of both major parties, a nice soft landing when they’re kicked out of Parliament?

There are poor(er than would otherwise be) procurement practices in government because the conditions that lead to them were deliberately engineered.

XingMing · 04/01/2023 10:03

@Swissmountains I completely agree, and I am a pensioner. Still working and paying tax, and in good health. I should be making a routine contribution every single time I have an appointment for my health or teeth or eyes. I've paid for my dentist since 1985, because NHS dentistry has been threadbare ever since.

pleaseletmesleeptonight · 04/01/2023 10:06

This is the GP fault 100% they have all basically quit doing their jobs and everyone need to go to a&e.

Lauraa7 · 04/01/2023 10:06

Bepis · 04/01/2023 09:57

@Lauraa7 I wouldn't be able to afford those prices so I would end up not getting checked which could ultimately lead to serious results.

People on a lower income receive a concession card, so they don’t pay. My understanding is that people who can afford it pay, and those who are unable to get it for free.
the fact I can be seen by my doctor , scanned and see a specialist all in 10 days, I’m more than happy to pay.

AndNowForSomethingCompletelyDifferent · 04/01/2023 10:07

A&E is awful at the minute. We had over 2 hour waits for children to be triaged recently, patients in the department over 12 hours and paediatric patients queuing for beds. We cannot cope with this! It’s relentless. Imagine coming in every shift knowing what you’re walking into. Dreading coming in, not knowing if you’ve even got staff. Then the abuse from families because they’re having to wait, which isn’t our fault but we can’t cope with the numbers coming through the doors.

Even if we do have staff they’re taken off us to staff other areas that are short. The wards are overspilling with patients. You can’t relax if you walk in and see you’ve got the right amount of nurses as you’re just waiting for someone to be moved elsewhere. Often to an area they’re unfamiliar with.

We often go 12 hours without a break, maybe a wee if we’re lucky. It’s no wonder staff have had enough and are trying to leave. But knowing where to leave to, is difficult.

WiseUpJanetWeiss · 04/01/2023 10:08

pleaseletmesleeptonight · 04/01/2023 10:06

This is the GP fault 100% they have all basically quit doing their jobs and everyone need to go to a&e.

Anyone is perfectly entitled to quit their job if they can do better elsewhere. Are you proposing slavery?

XingMing · 04/01/2023 10:08

A poster said recently on another thread that consultancy firms put their worst people on government projects because they will be a nightmare and never reach a conclusion. The projects are badly framed and badly managed by a toxic combination of civil servants and career politicians.

Swissmountains · 04/01/2023 10:08

Melminiani · 04/01/2023 09:57

I strongly believe that this government- and previous governments- have been purposefully trying to kill the NHS from the inside out, and that this has been happening for about the last 15 years.

The lure of the sickening amounts of money to be made by going the route of the US healthcare system has meant that multiple governments have been looking to waste money by bad spending decisions (umm hello PPE), too many middle management, using expensive but outdated IT systems all in an effort to waste money and bring the NHS to the point that it’s at now.

So that when the system finally breaks down enough that people are finally motivated to do something about it, the government can say look, the NHS is clearly no longer fit for purpose and instead we will re-design our healthcare model. And then we will all be f**ked because suddenly, we will be at the mercy of big pharma who are driven by nothing more than money, profit and greed.

Losing the NHS will be one of the most terrible things to happen to this country, and we need - as an absolute mass - to get very angry very quickly, and to demand that the mis-management of it stops. To demand that nurses are paid more. To demand that staff are treated with respect by the people running this country, running the NHS and by any end users.

It clearly needs extra funding to help stop it from sinking. Someone once suggested a rounding up scheme for the NHS and it could possibly work. Your petrol is £35.89? Round it up to £36 with the 11p going to the NHS. Your shopping is £58.34, round it up to £59. Obviously small amounts in and of themselves, but if as many people as possible can do it (and I understand that not everyone can at this point in time) but for those that can afford to, it could really mount up.

I’ve been waiting for people to get angry and vocal for a long time. We should ALL be marching, we should ALL be demanding that the government does better, and we should be demanding that they do better by keeping the NHS going, not by stripping it and selling off the parts.

To quote a recent quote that I’ve seen that seems fairly fitting (apologies, I don’t know the original source): Resist! Or die horribly in a vat of ravenous pigs.

This is a simplistic view that does not take into account the maths. It’s simply not feasible to serve 70 million plus as we are, and indeed pouring more money into a broken system won’t help. The government have paid billions of our hard earned taxes in the last few months to avoid this well flagged winter calamity and yet it’s done nothing at all to avoid the current crisis.

What we need is a huge overhaul. Not to dismantle the NHS but to revitalise it to serve a much smaller band of health needs, funded in a different way with a better deal for health professionals so that they are also cared for.

This is not about ‘getting angry’ we need to start being realistic. We can’t carry on as we are. No one disagrees with that now.

The way forward is a cross party consensus - a realistic solution and one that takes us into the future and has longevity.

ThighMistress · 04/01/2023 10:09

I have been to a&e twice this year. Perhaps I was very lucky, but both times I was triaged straightaway and seen within half an hour. One time I was told that I was the only “genuine” person they’d seen that morning (I had been bitten by a strange dog and was pouring blood).

They said that masses of people came in with head colds and one with diarrhoea, and when asked how many bouts, they said one. Who the hell goes to a&e with diarrhoea?! Surely you can’t leave the house?!?

I think there is a culture of using a&e as a pharmacist, particularly when hospitals are in accessible locations.

i also think we need a major review and new thinking about how to work with a)the elderly and b) the mentally ill as these groups are the most likely to make repeated a&e visits.

lovescats3 · 04/01/2023 10:10

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pleaseletmesleeptonight · 04/01/2023 10:10

@WiseUpJanetWeiss yes of course that's what I was suggesting. Biscuit

Swissmountains · 04/01/2023 10:11

Lauraa7 · 04/01/2023 10:06

People on a lower income receive a concession card, so they don’t pay. My understanding is that people who can afford it pay, and those who are unable to get it for free.
the fact I can be seen by my doctor , scanned and see a specialist all in 10 days, I’m more than happy to pay.

I agree we need a different system and the Australian one seems to work very well.

Wotrewelookinat · 04/01/2023 10:11

I have a yr 13 DD who wants to go into an Allied Healthcare Profession that she has been passionate about for several years and worked really hard on her uni applications. She is now so worried about entering the NHS that she’s not sure she will continue with her applications.

lovescats3 · 04/01/2023 10:14

We are paying social care bills for people in houses worth a fortune because the Story party don't want to upset their voters

lovescats3 · 04/01/2023 10:15

Please email your local MP and the health Minister

Melminiani · 04/01/2023 10:16

@Swissmountains you are absolutely right that it’s having to serve a very different population than the one it was created to serve, but my fear is that the government won’t revitalise it but will choose to dismantle it instead, as it will be an easy and profitable solution for them.

Nameneeded · 04/01/2023 10:16

Might be time to try something radical and remove the gatekeepers to health (GP’s) Many people turn to A&E in desperation as they cannot see a GP. There must be a more streamlined way than our current outdated system,

Winniethepig · 04/01/2023 10:18

Front line is incredibly fucked right now. But OP you're right. NHS is broken. There is too much money being wasted at the top on management consultants and woke training, on redundant systems like test and trace (37 bn spent on this).

The system needs complete and total reform.

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