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?

You be trippin

We were told by the ward my husband was on that he missed the cut off for admission straight back to it when the office closed at 5pm. He had to wait 10 hours in A&E to be readmitted. Along with numerous elderly people. My husband got back on at 4am. Another elderly lady didn't get admitted until 6am in the morning.

You are right, @Whatsinthebag2 - and of course it is A & E, not just E.

Two of my dses have been to A & E with broken bones. Dh went when he came off his bike and gashed his leg, needing it to be cleaned out and dressed, with gas and air for pain relief because of how bad it was. He’s also been there with a broken finger, and on a different occasion with a gashed finger where he had opened his finger to the bone and had severed the nerve and almost severed the tendon.

None of these were life threatening - but all were 100% appropriate reasons to go to A & E.

Yes - A&E are for accidents. I just think since Covid we have all become less skilled at judging what illnesses are emergencies. And that is exacerbated by the way some people struggle to access GPs etc. (and also the internet giving us suggestions of worse case scenarios so when we have ill children some default to this ‘what if’ stance)

I am so sorry about your mum it is unbelievable and unacceptable but, this is the reality.

We cannot provide safe care anymore and sadly personal care is so far down the list of what is expected of us.
For patients to soil themselves because we are too busy or too late to help really kills me. Sadly, I might have to choose between giving antibiotics to a septic patient or helping an elderly patient get to the toilet. Of course it is not really a choice.

I could go on and on about beds in corridors etc or 2 members of staff for 14 patients but I have done that on countless other threads. I have also highlighted/datixed it as far up the chain as possible. It has now become the norm as medical professionals we do try to highlight it but, the government doesn't give a shit. It is unsafe on a scale I have never seen.
I really care for my patients and that is why I stay. But I don't know how much longer my MH can take it.
It is dreadful how long people are waiting and dying alone is so undignified and sad. I didn't think this could happen in the UK but here we are.
I know nurses are accused of being lazy/gossiping but honestly this rarely happens, you will always get the odd bad nurse.
I often go without breaks or finish late to get work done, so I do have a drink at the desk while completing assessments etc, and the day I am told that is not acceptable is the day I will quit.

We are not robots and this will lead to further loss of staff.

@Whatsinthebag2 - I don't think that the system is perfect. But it is literally tiered on a risk assessment from the moment you call 999. What is the imminent risk to life? They may say "go to A&E", but that is saying you may been seen, not that you are emergency in medical terms. It is a risk that is taken more and more; A&E works literally on the principles of an observed risk. If someone is capable of texting, talking, breathing freely then they are graded downwards in terms of need.

It's not about what you did; it's about what the system will provide. People don't understand that they triaged and graded like this and it applies to their families. When the NHS was better resourced, there were enough clinicians to do more than the bare minimum of checks if someone does not present obviously life threatening symptoms.

Once again, sorry for your loss. It's not what you did; it's the design of the system to manage emergency admissions.

I haven't always been on the right side of this as once I had to wait a long time for an ambulance to deal with serious pain. Why did it take six hours? Because I was 36, didn't fit any risk profile, and others deemed more important. I did get treated eventually, but the failure was my GP who had not prescribed adequate painkillers. That meant an admission to A&E that was avoidable.

Yes I understand there's a triaged system but even the system no longer works.

My friend's husband heart stopped at home. She was doing CPR and ringing 999. She was put on hold and when she got through there were no ambulances. So no matter how serious her situation (very) she couldn't even get help.
A belief that the system will be there if your problem is serious enough is not going to be any help, when you ring 999 and no one comes. Or you go to a&e and no one gets to you.

And if, while you were en route, someone had come in with something life-threatening that required immediate treatment, so that the doctor was no longer available, you'd be absolutely livid that you'd been called back unnecessarily!

Okay, I've not had a situation where with an actual imminent risk of death an ambulance did not come. It did. The call handler stayed online, to tell me what to do and keep the person alive. This has happened three times in the last six months all these people survived.

I have never heard of someone being put on hold for calling at ambulance - where was this!

In the north west. I was also put on hold when I rang 999 for my mum. Like some dystopian nightmare!

Why aren't reception turning the people away when they turn up for things an OOH GP would be more appropriate to see? Also agree that once triaged, you should have the option to wait at home, since it will be at least 4 hours until you are seen.

I've seen people turn to A&E for a bloody sprained ankle. Literally something that you can address yourself. That's the issue

An empty A and E sounds off to me, referring to the OPs original story. A friend of mine lay for 2 days in A and E recently, with little care, before age was given a bed. She was smart enough to see that they are just too busy, whatever bollocks people are putting online.

We were 17 hours on Thursday waiting when I went in with my DH. It was awful and 5 days since we'd last attended. On the first visit I dropped a quaver under a chair and went to pick it up but there was various pieces of cotton wool with blood on so couldn't bring myself to do it. It was still there on the second visit 5 days later!

I think we’re all aware of the issues of funding, lack of staff etc.

The NHS is in crisis; this is a full-on, on-going emergency. So why is the machinery of the NHS not actually operating as if it’s an emergency? I mean, an actual emergency.

In an actual emergency, people move fast; they dispense with many of the ideal processes that characterise regular best practice.

Instead, we still have the ambling, ideal-world protocols in operation. At our local minor injuries unit (so not A&E) you’re booked in, usually at a glacial pace, then you see one person, who asks you a series of questions and seems very cross with you for having a suspected broken foot. Then you go and sit down again. Then you see someone else who may or may not put you in for an x-ray (but good luck with that as x-ray closes at 5.00). It’s a massive pantomime of bullshit.

There’s this misconception about ‘safety’ as if it’s a binary, with things being either safe or ‘unsafe’ (silly word). Being seriously ill or injured is always dangerous; the issue is just how dangerous. If you’re busy ensuring that the treatment you give to someone with a broken finger is ‘safe’ and jumping through loads of bullshit hoops, things suddenly become a lot less safe for the person dying on a trolley.

Yes, in an ideal world, everything is done in a certain way (preferably not at a glacial pace…). But in an emergency (which is what this is), stick someone vaguely qualified on the door to turn away the time-wasters (or the people who genuinely don’t know if their child’s illness warrants a visit to A&E and just want the very brief reassurance of someone capable saying ‘no, she’s ok; just do x’) Have one room that’s literally just for bandaging up wounds. Have a fast-track x-ray queue overseen by someone capable of making a reasonable call as to whether it might be broken.

I know what I’ve described sounds more like the medical care you might expect in a war zone… But, if the cap fits…

But sometimes it's hard to distinguish a sprain from a break

And some more serious sprains ( tendon tears ) actually need support

When I lived in Southend, our A&E had an out of hours service next door, so patients could be sent there, if they didn’t need to be seen in A&E.

I don’t know if it is still the same - but every A&E should have an attached OOH service - but that would need staffing and funding, and as I said earlier, the NHS has been cut to the bone and beyond.

No- I pay into a pension same as most. I don’t get a salary when I retire. My service being rewarded- really?
And we don’t get asked to work over- we have no choice. We can’t just leave patients in need. That is part of our Code as RN’s.

@midgetastic - in such circs does that really need A&E? That person can easily be treated as a lesser priority. They still need treatment but they should be guided out immediately somewhere else. You can strap an ankle, go to urgent care (this is my local system) and wait there. Works very well.

Not always if you have an underlying health condition. You have open access to a ward. This means your not clogging up A&E waiting around unesseiraly for hours.

She will have been triaged, but if you think they were wrong in their assesment, or that her condition has deteriorated, go and tell them.

MNer's who respond by saying "well you're well enough to be typing on MN so it obviously can't be that bad" never cease to amaze me...

I don't know why it's so hard for people to understand that different people have different levels of pain tolerance and that one person's 10 is another person's 4 for the exact same medical issue with the exact same level of extremeness/emergency.
Good grief.

Hope your DC is okay OP!

You obviously don't understand triage.....the ones who are quiet withdrawn and uncomplaining are the ones to watch .... I take it you've been triaged and are in the appropriate place in the queue

I got turned away from children's ward one night. Because the doctor on duty didn't recognise DD. She insisted she had to go through A&E. We got there and there was a poor young Dr tearing his hair out people everywhere absolute mayhe asked paramedics what she was doing here. He did apologise but if they come by ambulance they go straight to a ward and bypass checking in at reception. We have an ambulance triage bay as well. So we wouldn't know how many there's already waiting already who came by ambulance when we checked in.

Hopes she’s okay, OP