To have discharged myself from A&E?

[AandEnightmare]

As the username suggests…

I attended A&E with numbness is my hand, pins and needles in both arms and legs, blurred vision and extreme stuff neck pain.

Stroke nurse was happy it wasn’t a stroke but wanted an MRI as did A&E consultant.

Both concerned about MS and tragically I then urinated myself in the A&E waiting room where I was left on a wooden chair for 8 hours.

i asked for a change of clothes, just a hospital gown and was told until I was seen by a neurologist who agreed to book me in; this wasn’t possible.

I have long covid and extreme fatigue and pain at the best of times and I was in tears in the waiting room crippled in pain and exhaustion and was just told repeatedly that only a neurologist could determine if an MRI was needed as an emergency or as an outpatient and on the time of leaving, after 7 hours, I was number 13 on the list so expected to be seen by this evening.

I will ring my GP as soon as open but I’ve never had such a terrible experience in a hospital in my life!

i feel shocked

@CaroleSinger Does it really take a Dr 13 hours to see one group if patients in A&E? Surely they can get through patients quicker than that? It makes you wonder what they are actually doing while everyone is sat there for hours. It creates more an image of taking all the time 8n the world rather than being run off feet. How did we get here? It wasn't that long ago you just walked in and got seen. There were no 4 or 6 hour waits

Gee Carole, you’ve clued on and solved some mysteries there. Yep, no reason why the Dr’s can’t whizz through - a quick glance is surely enough. In fact they aren’t even doing that. The secret is they are all out the back in a room watching Grey’s Anatomy together complete with nachos and beers. That’s why it takes so long. Ffs.

I bet you are also one of these people who complain bitterly when they hear some conversation and laughter coming from the station. The fact is most people can’t take proper breaks, and to try and keep things moving, after working 15hrs straight and ducking to the loo twice during, taking 1 x 10mins to sneak some crisps and down a can of soft drink and God forbid chat and laugh while doing it, gives people like you the heebies. I know you.

And Carole, as for ‘what’s changed’ - apart from A&E Dr’s now being a bunch of lazy people who seemingly don’t bother with any throughput - could it be that the guts have fundamentally been ripped out of the health system, so things that were adequately addressed in community health previously are no longer, pushing those people through A&E instead? I wonder!

Finally, the reality is, someone sitting in their wee is not great. It is however not life-threatening whereas many other things being dealt with are. Yes, this can be an indicator of something more serious requiring more urgent prioritisation, among all the other urgent priorities, but the beef there seems to lie with communication. It’s not at all clear whether admin passed that on or not and what transpired so that’s where any feedback would lie. It’s also not clear why they couldn’t have fetched a blanket. The chairs are uncomfortable, yes, but it’s not a hotel and if you think of what goes through a wait area, they need to be designed for quick, easy and thorough cleaning/sanitising as necessary (plus space under), which is rarely compatible with comfort.

Lol really . Seems you know me !?
Ive worked in all the busy wards in many hospitals . A&e . CCU, Respiratory. I think that covers two pints you made .

1. Breathing problem. 2. Telling me what to train as . Not once ever did I leave anyone in urinated clothes. There is good and bad in the nhs and I know which one I am .

Peole can train all they like not every nurse has compassion (clearly)

I could and I would, but having worked in a nursing union for years, I don't want to work with the sort of tossers who are already there and bombproof, yet to be removed for conduct/capability. The amount of stuff, including severe bullying and gross incompetence, the NHS trusts and NMC let slide and do nothing about is abhorrent. Private sector HCAs and Nurses in the UK actually have worse pay and conditions than the NHS, including pension etc, but their hospitals have higher expectations of behaviour and take the nurses who actually want to do the job.

So so sorry that you were treated so inhumanely, it is an absolute disgrace. Even if you cannot be seen immediately and have a long wait, a kind word and an update now and then works wonders for sick and scared patients. That doesn't cost anything.

I often feel that under the Foreign Aid contribution, we are giving billions in taxpayer money to countries that have "Third World" conditions especially in healthcare, but it looks to me that our own health system needs that money far more now, and indeed healthcare in some of these "Third World" areas is far more superior to our own now.

The pendulum needs to swing back a bit I think.

I think widowtwanky was blunt, but accurate. When you discharge from A&E that’s the end of that.

Did you only tell the receptionist though? Then she put it on the system- lord knows when someone will see that. This is the state of our NHS.

There’s a usually a toilet in A&E but not gowns. It wouldn’t have taken a minute to get a gown, but the receptionist may not be able to leave her station. They should have gowns to hand perhaps for emergencies.

I hope your condition amounts to nothing serious OP and you get seen soon. I am sorry this happened to you.

We have a HCA stationed at the doors of A&E 24/7. They are there to help people to and from cars, people in chairs that need moving to triage or when called, patients that need assistance to the toilets, to direct people to the correct place when they have come to A&E by mistake, to advise on waiting times, to find a patient if a relative is looking for them, to make sure there is always fresh water and cordials available and a hot drink and sandwich if people have been waiting a long time.

Its a very easy change to make in large departments, 1 HCA based in the waiting room to assist patients needs. The OP would not have had any issues getting support and clothing if departments all followed suit. There are ways to manage problems that are currently unfixable in the short term.

I hope, if you really do work for the NHS that you show a bit more care, empathy and compassion for the people that you interact with than you have shown here.

Let me tell you, private hospitals are struggling more for staff than the NHS and will take anyone with a PIN and a pulse.

There's a reason Ramsey HC is in the top 10 organisations for 'Never Events', despite dealing with much fewer procedures than any of the trusts.

So many utterly arrogant people who don't have a clue what it's like to work for the NHS right now. Let me give you a not unrealistic scenario of a junior doctor/nurse working in ED

1. A drunken trouble maker is pointing his finger threateningly at the timid new student nurse at the desk and is swearing at her

2. you've just been told that that patient who you triaged earlier with a headache has become unresponsive

3. you're trying to refer a patient with abdominal pain to the wards. Medics and surgeons are both refusing to accept the patient as they feel it's the other team's problem. The shift leader is putting you under pressure to get the patient out of ED as it's so busy

4. The teenager who came in earlier after self harming is still actively suicidal is getting fed up of waiting and saying they're going to self-discharge. They are known to social services due to previous reports of domestic violence

5. elderly patient's relatives come to inform you that their mum has just soiled herself badly

6. another elderly patient's family come to the desk furious that their relative patient has been waiting for a hospital trolley for hours and want to escalate a complaint right now

7. You've just been told that there's 2 patients about to come into rescuss via ambulance after a serious RTA

It's not unheard of for all the above or similar to be happening at the same time. To the oracles on here pray do tell how are you going to manage all of the above? Which is priority? Is there anything you as an individual can do to manage this safely and humanely or is the real issue perhaps that no earthborn person is capable of doing so? Do we perhaps need more staff and funding? Or shall we just keep blaming the only people who are willing to turn themselves inside out to keep the NHS running rather than addressing the real issue?

So your answer is not to bother? Again, the op wasn't expecting a nurse to help, that's not what she said. The receptionists are in charge of that waiting room and be aware of what to do when a patient is in distress. I'm sure the OP would have preferred to hear "We can get you something from lost property / scrubs but it will take an hour" than the "tough luck" approach taken by the receptionist, and it may be that she would have stayed to be seen.

I have two local NHS hospitals - one is excellent and one is dreadful. The difference appears to be that the good one has high expectations on staff to keep patients comfortable while they wait, and they appeal in the local press for volunteers to join as escorts, visitors and general "gopher" help (unfortunately they wouldn't take me while I'm still working full time, they're oversubscribed). The dreadful one is the biggest and best funded in the area; no volunteer scheme, lots of money spent on artwork anf paint jobs, while patients are treated as pests at best. Last time I went there on my own, unable to stand or advocate for myself, and the receptionists allowed a drunk man to continually sexually harass me in the waiting room, right in front of them. It was terrifying.

How on earth was her answer 'not to bother'? Do you always have the comprehension of a 5 year old?

Absolutely this!!

On a train with patchy WiFi but I hope someone has said this.

Not knowing you are unrinating combined with your other symptoms is a huge red flag for Cauda equina

You need an urgent mri referral - like today - make sure you highlight this to the GP or A&E if you go back.

My GP suspected it because I was having similar symptoms and was very very firm that if I weed without realising it - it was a medical emergency

What a pathetic response - try some critical thinking and problem-solving yourself.

I have done, but many years ago.

@AandEnightmare I've read through and it's everyone ranting about the state of the NHS (fair enough)

Your systems are classic cauda equina and you need urgent GP/walk in or back to A&E or ambulance now to rule that out.

As I said my GP suspected it (it wasn't because I wasn't wetting myself) and he said if I did even once it's straight into hospital and urgent MRI.

Btw OP I'm a doctor and totally agree with the above pp. You need to go back to ED and wait, be examined by a specialist to exclude cauda equina/other serious problems. I've worked for the spinal team before and if you've genuinely lost control of your bladder and not even felt it then you'd be getting an MRI before you left the building without doubt

In a nutshell the attitude of A&E staff. Couldn't give a fuck.

In some ways it's probably a good job they can switch off their empathy the strain they're under if you look at it from another angle

I woke up with chest pains once and as I sat there feeling a bit scared. I realised I'd rather die than go to A&E and that was before the plague.

Really hope you get answers soon OP. I'm sorry man

In a nutshell the attitude of A&E staff. Couldn't give a fuck.

damned A and E staff. I mean why can't they just clone themselves or grow an extra pair of arms?! ... they're paid enough of our tax money!

1. Student nurse's problem, not yours - there are security guards in our hospital they can call for backup and the students need to learn to manage these on the job.

2. obviously the priority as they're crashing

3. Report this situation later as high as it will go - this kind of territorial pissing is a good reason the NHS is up shit creek.

4. Not much you can do there if psych won't come down to see them, the receptionist could call psych team and give the patient an update about how long it will take, given they're already known to the hospital.

5. & 6) - receptionist uses the phone to request some scrubs, receptionist finds out how long the wait should be and updates the relatives. Receptionist escalates to overall dept manager if complaint required.

6. Better communication with ambulance service is needed, if you don't have the resources to handle the resus they should be checking if any other local hospitals do.

There are so many "support services" employed by a hospital that expect to just sit behind a desk 9-5 while others are left to manage. Other organisations dealing with the public have realised that staff need to be up and out there helping customers at the times their services are busiest (including shifts in anti-social hours), and in some cases have removed their desks/offices to facilitate that, implementing a shift service instead. There needs to be some creative thinking going on around what the non-clinical staff are responsible for, as in my experience these are often the ones sat chatting with their faces in the chocolate tins.

From my thankfully limited experience it seems that departments don't bother speaking to each other.

Last year I went to the local walk in centre with an infected bartholins cyst (I didn't know what it was at the time and couldn't get a GP appointment). A nurse asked me all sorts of questions in the reception area where everyone can hear everyone's business and got the arse when I showed her the notes I'd made on my phone as I didn't want to discuss personal medical information in front of the entire waiting room. She told me I needed to go to A&E which I did and when I got there I was asked why I'd gone there as I should be at the walk in centre or GP! When I explained I'd been sent there the nurse sighed and said they are always fobbing off their patients to A&E.

This year I broke my foot. I went to the walk in centre and got sent for an x-ray which I had to walk to as there were no porters. That was because they were standing outside talking. The nurse reviewed the x-rays and said there was a possible small fracture and I would be referred to the 'virtual fracture clinic'. I got a call to say I'd broken a metatarsal, followed by an email saying I'd broken 3 metatarsals and a letter saying I'd broken 'a bone' in my foot but not mentioning which one. After a private MRI and ultrasound it turned out I'd broken 3 bones and had ligament damage. I went back to the orthopaedic clinic and saw someone face to face and it turned out the first x-ray was of my ankle only and not my foot so the breaks were missed! Now I've actually seen someone face to face the care has been pretty good but prior to that it was shit.

The fact we are having to point it out, to an NHS worker, is crap, isn't it. It's a dehumanising system to everyone in it.

This I’m sorry but someone not being kind isn’t the fault of funding is it.