To think this is a fucking joke - A@E wait?

[CanNeverThinkOfAName]

So our local hospital serves 350,000 residents from a large area.

Arrived at A&E at 11pm. Expected it to be packed and to have a long wait. There were around 15 patients waiting. At 3am there were 4 still in the waiting area plus us.

From that time only one person has been called to see a doctor and at least 10 people have gone out after being seen.

Ambulance staff check patients in near where we are sitting and only 3 have checked in since we got here.

Obviously not a busy night.

AIBU to think this is totally piss take and the staff must be on a bloody go slow or something?

Some staff will work well and hard, but so many others ?
I had the misfortune to have many many outpatient appointments for blood tests due to ongoing issues.
Attending many different areas of the hospital, sitting in so many waiting areas, for two different issues a few years apart.

once you’ve sat for 3 or 4 hours, you see the same clipboard carrying staff, wasting time, walking, and walking around the wards.

At another appointment, a nice group chat and meeting with staff popping in to chat with others, for hours at a time, it was an office not a rest room.
Most of us work at work, but not all.

Hope your DD has been seen now? These situations are stressful scary and worrying and you are tired.
Our local hospital is same.
waits always very long as busy but there are a lot of rooms behind the main walking wounded areas where pts and staff also working.
It can look quiet when it is totally not as you do not see all the rooms and behind scenes stuff. This happened to us recently and we thought the department looked nearly empty but were taken through another door and there was loads of lrooms behind main waiting area with pts all over been treated and waiting.
The staff were working really hard. The time spent with our family member was alot when they eventually got seen so it is difficult for nurses/doctors to be in more than one place. They can't cut themselves in half.
Let us all know how your DD is when you get time?
Take care.

Too easy to blame everything on underfunding.

I think that nurse has given a reasonable response to the situation that the OP found themselves in.
Your suggestion @NotQuiteHere is to make an already overstretched NHS even more stretched by telling one of it's trained staff members that if they hate their patients and job so much they should leave.

I didn't get any such impression from the nurse here. I got that she was assaulted, that they were very very busy but that they keep getting up and doing this for the very reason that they do like their job. I'd go so far as to say they love it. I have zero clue who this nurse is but I do know that nurses in general get such personal fulfilment from the job that it really would take a hell of a lot for them to decide to up sticks and leave their careers. All that said and getting back to the situation that the OP found themselves in, they could only see one aspect of the A&E department and a very overstretched nurse was giving her opinion on what else may have been going on in the hospital that the OP was quite likely unaware of.

While the two situations were most likely to have been in very different hospitals, the situation that the nurse described is being played out throughout the NHS.

I do hope @CanNeverThinkOfAName that your relative has been seen by now (I got to this post while catching up on the situation and responded to it before carrying on reading the whole thread).

If you want a better NHS, one where people get seen within 4 hrs of arrival (or sooner) then you'd better be prepared to pay for it. Lobby your MP to pay the Junior Doctors what they are looking for, value your health care workers because without them, you don't have an NHS. You have a private health care system and then you really end up paying for it!

This is true regarding the trauma entrance. My mum arrived this way after falls and shortly before she died. If you’d have been able to take a look at this area, you’d doubtless have seen dozens of people on stretchers, really really ill and still waiting hours to be seen. When my mum was in there, I’d also see lots of others like yourself in the seated area outside, many of whom were clearly feeling very poorly. I doubt the staff were on a go slow, just trying to work in a broken system that’s not fit for purpose.

This is a general observation of what we have seen and been told. The nhs staff aren't keeping people waiting on purpose. They are always pushed by managers and pts to get things done as quickly as possible so they would never have people in the department twiddling their thumbs.
They want the work done and pts well or transferred appropriately just as much as anyone else.
I think sometimes we forget that the staff who work for the nhs are not robots and also have feelings, family members who are unwell and so on.
We have friends who work for this organisation who frequently don't have proper breaks, work many hours over their schedules unpaid and have people having a go at them because they have a cup of tea at the desk while doing documentation. They say to us they have a drink there as they haven't had a chance to leave departments for toilet or meal break due to how busy things are. Things are not always how they seem on the surface.

Those 3 who came in from an ambulance will likely need more time spent with them than someone who has a piece of Lego stuck up their nose and takes 5 minutes to deal with. Stabilising someone's condition, managing multiple issues on one patient doesn't just require a 5 minute assessment. It could require multiple doctors to save their life. Those who can wait, have to wait.

Just need to rant / advice as sometimes I feel like I am going mental. I have a nearly 3 month old baby, she is a dream and I love her so much. But my bf, he is a good dad but just not very present, he works 6 days a week and on Sunday the only day he doesn’t work, he either gets up and goes gym or goes to work (but wouldn’t tell me he is going to work) I’m only asking for one morning a week where we get up as a family and I can actually have a shower without having to bring her in. Am I going mad or is that reasonable? Just he makes out I’m so needy and I need help being a mum and that I’m struggling with motherhood. Does anyone ever feel like they are parenting solo? It’s like if I didn’t ask him to do anything he wouldn’t do it.

I’m a medical doctor. I often see medical patients in A&E. At night they may only have 2-3 doctors on. Majors cubicles could be packed, patients in corridors. Resus could be full.

Someone could have had a cardiac arrest in resus taking up over an hour of the doctors time. They may be sedating someone so they can pull a broken wrist.

Likely there are no beds in the hospital so they’re trying to manage patients who are sick and can’t go to the ward.

Having worked in A&E often it’s so busy you spend half an hour trying to find a free cubicle, pushing your patient into it, taking their bloods yourself because the nurses are busy. Then you have to wheel them back out the cubicle because the nurse in charge needs it for someone sicker and find them a spot on the corridor again.

Maybe the A&E registrar is speaking to a shocked and bereaved family in the relatives room.

As an A&E doctor and more recently as a medical doctor on call I’ve worked in 6 A&Es. I’ve never seen the A&E doctors slack, they’re run ragged.

Maybe they had a busy night before you got there and were catching up.

This threads are amazing; people moaning about staff, using A&E as a secondary out of hours service, and then making assumptions about how they haven't been seen is because of staff laziness.

I've using A&E for several emergencies recently and it worked. Where was a real, imminent risk of death. They were brilliant. The prioritisation worked.

What needs to be managed better are people with long term conditions. A&E is the last place you can go to get treatment, and it's overwhelmed. People really need to realise that. It's now literally for life or death. That's why the wait times are so bad. It was never designed for what its doing, which is picking up long term conditions which GPs used to manage.

Totally agree with @bombastix . I think increasing testing centres would help. The number of times I read on here about people going to A&E (often being sent by GPs) to access blood tests must flood the system unnecessarily.

Did your DD get seen by now, @CanNeverThinkOfAName ? I hope you're both ok & recovering.

I doubt that an A&E that serves 350k people had no emergency admissions between 11pm last night & 5am this morning. But I don't know why OP didn't see them, either.

@CustardySergeant I’m a “junior doctor” and will be until my late 30s. Sorry that we striked because we didn’t think paying newly qualified doctors £14/hour would result in a well staffed and sustainable medical work force!

I’ve often been paid less than physician associates and nurse practitioners who I’m expected to supervise, who have less training and come to me for advice and document my name in the notes to push responsibility onto me.

We have huge amounts of student debt and pay a lot of money for our own compulsory postgraduate exams, online portfolio and indemnity, literally thousands and thousands of pounds. We can get sent two hours away from our home at short notice as we have to “rotate” to different areas as it’s the only way to staff undesirable areas of the country. We bear the financial cost of that.

The ignorance is astounding.

I think OP is in no place to comment as she has not seen who came in during the day and she’s not watching the ambulance bay! She’s seeing the most well patients aka ones who can sit in the waiting room. They’re not prioritised as someone in resus is probably trying to die of their sepsis/accident etc and the staff are trying to prevent that.

As a doctor I’m completely and utterly appalled by some of the attitudes on this thread towards me and my colleagues. A&E nurses are some of the toughest and hardest working and they often see true tragedy on a daily basis. Cut them some slack, we’re doing a job most of the population aren’t cut out for. And many of us are leaving.

Okay I did observe a lot a triaged, unhappy patients waiting when I went to A&E the last two times. These are people able to sit in a chair, play with their phone, complain at lack of service, eat, drink, and other function once stabilised. There are lots of them. But they are not a priority. They could use urgent care. They could use an out of hours GP. They default to A&E where they are just not that important.

There are also people who are emergencies being rushed through, according to medical need. That is the principle of the NHS, according to need.

Totally agree

Personally I think the rhetoric of 'if you are a time waster then obviously you're not getting treated in a&e/ a&e works for real emergencies' is in fact not true.

My mum was on a trolley all night in a&e after a six hour ambulance wait, she had to soil herself because no one was free to help her mobilise to the toilet. She was texting me at that point. But then she died. On a trolley in the corridor. That's not care ! I'm not criticising the staff, I understand they're working hard. But a belief that the NHS will be there for you if you're ill enough- it's no longer always true.

@CanNeverThinkOfAName while you've clearly been in a traumatic situation - and I hope you've been seen and all is well - I have to say you are actually fortunate to have a full-time A&E. I live in a small city whose hospital only provides cover 9-6 each day, and you have to ring first.

@Medstudent12 and I note that you were very kind to me on another thread. However, my last experience of A&E was dire. I arrived after being kept waiting 2.5 hours fir an ambulance in the rain after a very bad fall. My wrist was very badly broken and I had a broken vertebra.

The ambulance crew gave me morphine thankfully. We arrived at an A&E dept with no facility for surgery, no consultant oversight and no orthopaedic expertise.

We heard nursing staff yell at the ambulance crew because they hadn't told them they were waiting. They were standing in front of the nurse fir 10/15 minutes who was chatting. We also saw and heard reception staff lay into a patient who politely inquired about waits. I was fitted with a sling by a nurse who could not speak adequate English and then wheeled to sit facing all the other patients ts under a TV on full blast. I asked to be moved and was told no, I asked for the TV to be turned down and they said they couldn't find the remote. Funnily when reception went home five hours later a patient went behind the desk to find the remote and put the TV back on. I waited for 5.5 hours with the sprained ankles and cut fingers.

When I finally went through to another room, after I flagged down a nurse, her first words in an accusatory tone were "what have you done with your wristband, you're not supposed to take them off" I hadn't been given one. We were then shown through to a much quieter waiting area and all the Dr's and nurses were at a desk chatting about their holidays and cake. The nurse told my husband to sit at the front, he said he would stay next to me. Rinse and repeat until he raised his voice at which point the nurse knelt down to my level and rolled her eyes at me.

I was sent through to see a Dr. An F2 who was unspeakably rude and conducted a frailty assessment as though I did not have capacity. Starting it with "you're over 60, I'll assume you are retired." She refused to take my concerns about my back seriously arguing that I couldn't have an XRay because I had to be mindful of the risks of radiation and telling me I had to trust her because she'd been to medical school. Only when I said "fine, but please record in my notes that I requested a back XRay did she relent and allow it. I have severe osteoporosis and had broken the L1 previously. The pain was exactly the same. She then tipped herself by telling me there was only sign of an old break. Six weeks later an MRI confirmed the T12 had broken that day.

Eventually I was taken to resuss to have my wrist manipulated. The junior Dr there was irritated that my rings were still on. They had to be cut off and should have been cut off when I arrived. I was told my wrist would be manipulated using gas & air. They were adamant I could have nothing else. Gas & Air makes me feel sick and does nothing for pain for me. Eventually they agreed to do it with conscious sedation. I discovered later that nice guidelines say that dorsally displaced wrist fractures should not be manipulated with G&A alone.

We left the hospital twelve hours later during which time I wasn't offered so much as a cup of tea.

Whilst I accept people are busy the attitude we encountered was disgusting, uncaring and I would venture, not competent. A full apology was received from the hospital.

So please forgive me but my experience of A&E departments is not good and it's regrettable that I have witnessed hospital staff being far ruder to patients than patients are to them.

The system is broken but it has more to do with attitude than with resources. I am not grateful for sub-optimal care because it's supposedly free. It isn't, it's free at the point of delivery. I for one am not prepared to pay more tax until the NHS delivers services with dignity and behaves towards patients as equal stakeholders.

My wrist was pinned and plated three days later and the care at another hospital was beyond reproach. Possibly because when we got home my husband phoned our MP and let rip. The following day, the Monday, I got calls fromPALs, The CEO's office and the orthopaedic consultant durgeon who did the op. Not everyone's dh went to uni with their MP. I wonder whether the service received when I was admitted for the op would have been to such a high standard and been as swift if there hadn't been an intervention.

Just one experience but whilst I can appreciate the wait, I cannot condone the poor communication, the awful manner of HCPs and the total disorganisation we witnessed. Perfectly happy to wait, but not perfectly happy to be afforded discourtesy and on that occasion incompetence.

I don't want to get into specifics; because this sounds upsetting that there was a death. And I'm sorry for your loss.

But an emergency is something that cannot wait for six hours. That's what I mean by need. It is something that unless you do something immediately, that person will die.

Lots of people are now coming to A&E with long term conditions that are poorly managed. That heightens a risk of death. A&E may well be the last place they come, but it's a stabilisation and patch up service. There are lots of other problems with NHS services that drive old and ill people there, but A&E cannot do it all. The narrative is somehow they can or should.

Similar thing happened with DH colleague a couple of years ago, they fell and cracked their head open badly and were bleeding heavily.
DH called an ambulance and they advised getting an Addison Lee cab because no ambulances were available.

I don't know what the subsequent wait/treatment was though.

I said this on another thread and another poster was insisting said this was exactly the type of "wasting ambulances" that was causing the problem and that they absolutely didn't need one! (Despite the fact that NHS own website lists heavy bleeding as a reason to call an ambulance!)

I think I'm traumatised from my experience with my husband. From no ambulances, he crawled to the car and then to A&E through to saying he had a urine infection. He'd had major surgery and was leaking urine into his body. Even when you get through the door into a bay its still hours to see anyone. When you hear your loved ones screaming with pain and no-one doing anything about it - its horrendous. 10 hours to get pain relief even with suspected sepsis. We would not do that to animals. And then you hear someone criticising the waiting patients and laughing and joking like the world's normal place. Its hell on earth.

The NHS is one of the largest organisations in the world. Its bargaining power with suppliers is massive. It has the power to negotiate more cost-effective deals and bulk-buy more generic versions of medicines. Many private interest groups would like to see it disbanded.

Starving the NHS of funding and using that money to give tax cuts to the well-off is not an accident, it is a strategy. It is in the interests of Tory doners that the NHS collapses and is disbanded. A privatised health system would enable private interest groups to move into the area and make more profit.

Healthcare will become a very profitable industry in a privatised system. Those who can afford private healthcare will be paying multiples of what the NHS received per capita in funding. Those who cannot afford it will be left with a skeleton.

Situations that are suitable for a&e can't only constitute 'will die right now' situations. Otherwise how do you get admitted to hospital? I'm unsure what else we could have done in the situation I mentioned above?