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?

The times I’ve been to A&E and when we’ve been taken through to cubicles with dh I’ve seen what some people think is staff sitting around doing nothing…at first glance it looks like that but thet Doctor to the far left in front of a screen is actually the Senior doctor in charge, he’s looking at X rays, blood tests results, urine analysis results, etc, he’s advising more junior doctors on patient care, liaising with other consultants. And whole lot more.
That nurse to the right of the desk in front of a screen is the senior nurse, finding beds on wards, sending nurses to cubicles, checking that patient in cubicle 1 has come back from X-ray or the bloods have been done on for the one in cubicle two.
That nurse wandering up and down is observing patients in all cubicles. Or she’s looking for a piece of equipment.

and more staff than pre-pandemic

Have they managed to fill the 40k plus nursing vacancies then ?

I think you misinterpreted the RN's post. (S)he has had a horrendous shift, most likely not had a break in the 12-13 hours worked. She was also physically and sexually assaulted during the course of her work. That's a crime, namely Assaults on Emergency Workers (Offences) Act 2018. How many times have you been sexually and physically assaulted whilst at work? How would you react if you were?

Accusing her of hate towards her job and patients is disengenuous. Here is an exhausted nurse giving readers an insight into her night shift.

@AllInANightsWork Sending you hugs. What we endure and expected to endure is relentless. I hope you reported the assaults to the police and got appropriate support from management (although I highly doubt it)

I totally agree with the posts saying the demographic has changed and this has put very new challenges on the nhs that weren’t there when this “free” healthcare was conceived. Couple that with the advancement in science which now means there are huge costs in modern drugs and life sustaining treatment. All this means there isn’t, and can’t be enough money in the system to support the needs of today’s society.
I do wonder if there was a direct cost to people when they access healthcare then for some, they may make different choices in life - I’m talking about risk taking things, or self care, like contact sports eg. rugby, drinking to excess, poor diets. People don’t deliberately go out to get injured / ill, but if there was a financial consequence to choices we make in life, maybe we’d make better ones - and help relieve pressures on healthcare system to those who have medical needs they have no control over.

You don't know what's going on being the scenes
My son collapsed nearly a year ago he was in Severe Diabetic Ketoacidosis( we had no idea he wss diabetic) we called 999,and the paramedics stabilized him and blue lighted him to A&,E he went straight into resus as its w life threatening condition, there was no messing about waiting for Triage as he needed treatment there and then.

Hope she’s been seen now.

I work in a large city A&E, and the front is the worst place to be. Our A&E is made up of 6 actual departments.
Ambulatory, which is where you will have been and see the paramedics checking in patients, is for patients that dont require immediate assessment, these patients sit in the waiting room, there are 10 cubicles in our ambulatory where patients get seen, if they are seen and a decision to admit is made they stay in the cubicles, making the wait for the patients in the waiting room even longer.
We have and onsite GP for ambulatory patients who need oral antibiotics or similar so some get filtered to there after triage, and we have an ambulatory emergency clinic for patients requiring a treatment that wont require an over night stay. These help with flow, but ambulatory is always the longest wait, because there is always a backlog due to no free cubicles.
Ambulance triage which has its own booking in systems is for patients who cant be left in the waiting room, however, they can be waiting on the ambulance under the care of paramedics for hours outside, as theres no flow from ambulance triage, we can have 14 patients in ambulance triage all awaiting a bed space on majors at any given time.
Resus is for the sickest of patients, traumas, and paediatrics traumas. We have 8 spaces in resus, this isnt enough, often there will be a patient in the middle of resus too. If we get a standby we have to try and make space, so these patients will be moved to a cubicle as a priority, but then require much closer monitoring. Slowing down other areas.
Majors is for when there has been a decision to admit, or, patients that require phsyios, or occupational therapy, care packages, social input etc etc, so are medically fit, but its unsafe to send them home. We have 40 majors beds, and 18 "corridor" spaces as capacity is none existent. The old target was 4 hours on A&E, new targets are 12, we have patients on majors for 60+ hours. This is the issue. Previously, ambulatory patients where a DTA has been made would be moved to majors, now they cant as majors is full. Majors is full as the wards are full, they cant discharge as they hav ethe same issue with PT/OT and social. Previously patients awaiting social, physio etc could be moved to cottage hospitals, these have all but gone. As well and a massive increase in the amount of patients visiting, the time stayed in the dept has made the waits for walk in patients longer. What you see from a waiting room, isnt a realistic image of what is actually happening, the whole hospital impacts that ambulatory wait room

Im sorry you had to wait as you did, I hope your daughter is feeling better. I'm sorry the system is broken, theres no quick fix to this though. At least not one i could suggest.

Wouldn't work.
Very many of the hospital beds are taken up by elderly making poor choices.
Refusing to downsize, adapt houses, accept carers, etc etc. Muddling on in unsuitable circumstances falling repeatedly. As an ex district nurse I've seen it all. The wards are full of them. Lots of it avoidable with a little forward planning and willingness to accept and yes, pay for help.
Would you charge them all?

The failure to hit recruitment targets or provide bursaries to get staff in for the last ten years is the governments fault. It’s chronically understaffed, coupled with more demands on it than ever before.

There are nowhere near enough staff, we have an ageing population and people attend A&E for things that can be dealt in a walk in centre. My local A&E has an urgent care filter system to deal with people who turn up expecting a minor, non urgent injury or condition to be managed on the spot. It works well, but it pisses people off who have high expectations; you can tell those people because they are shouting, demanding attention and complaining and certainly not in a state where their physical or mental health is urgent. They just think it is.

I agree with this. 111 also could use some revamping. Every single time I’ve phoned for some advice re what I’m almost certain is a minor ailment they advise A&E. Before DD turned 2 they sent an ambulance, she’s given ibuprofen or another medicine based on weight and not back of the box guidelines then lo and behold she’s running round happy and I feel like a total twat because in the same room there are poorly children, stressed and worried parents and overworked knackered nurses

I was in a&e in Nov and waited 12 hours to see a doctor (who was clueless tbh). I was exhausted and scared, dh had to go by then as he had work. We were told at 8am by the doctor that no-one would be seen for an hour (I was next) so we went to get something to eat and when I got back at 8.45 they said I’d been called twice - then had two people be seen before me. 🤷‍♀️ By the morning I felt ok but had had a v scary ‘turn’ hence DH calling ambulance (triage said bring me in if possible as wait was so long). Now waiting for my outpatient appt in a couple of months.
The system is broken.

Will Labour give the strikers the pay they want?
Will that help the backlogs and recruitment problems?
Will Labour up the numbers allowed to be trained and put resources into that process so we can be self-sufficient in doctors and other medical staff?

This is my MIL to a tee, just waiting for her to have a big accident at home (4 bed house). She just about agreed to a rail in stair wall as well as the bannister and I think dh and BIL are going to organise an alarm thing, but she really should not be there. She did have a fall a few years ago (not at home), but she’s deteriorated a lot since then.

How many patients are there already in the cubicles receiving treatment and being ‘ housed’ whilst they wait for a bed? How many vacant cubicles are actually left for the staff to see and assess new patients in? How many critically ill patients already in resus when you got there, what is the severity of their illness and how many staff members have been taken up with those patients? Perceptions from the waiting area honestly mean very little and do not reflect what is actually going on. Completely agree that wait times in A and E are long, it’s frustrating for everyone but demand is high. Hopefully your daughter will be seen by now.

If they did, it's the work of years to do it and will take a lot of money and resource. The kind that people haven't voted for in a decade, and there are no quick fixes.

It's not free though is, we pay for it already.

A private service would t survive if it has 4 hr waiting targets that it never achieved. Customers would go somewhere else.

We accept it because we considered its free, but it isn't. You don't get an NI reduction because you choose and can afford private healthier either.

The purpose of the NHS is to provide equitable healthcare for every citizen, which it is failing at regularly.

Honestly I'd be surprised if euthanasia for the elderly poor isn't a thing in twenty years.

Id just like to add as well, that as a nurse on A&E i now have to document every interaction with patients i have. I could be going to do obs, patient asks for a drink, on the way to get a drink another patient calls me over asks for a commode, or to be walked to a toilet, the patients in the next cubicle is due their parkinsons meds at a set time, one opposite wants pain relief, and a new patients i need to do fill admission for is arriving who also needs an infusion getting for the clinical room at the other side of the department which needs measuring out and checking and i need to find an infusion pump cos theres none in majors at all, one is waiting for me to glue their head lac, and the end of life patients needs personal care. But the fact the first patient wants a drink i still have to do, as there is no one else, its just me for these 8 patients and its 4 hours till the tea trolley is due. So i make the drink, i then have to document that i made the drink for a patient. But i save all the documentations for when i have time, so you may see me sat at a desk, you may even see me sat at a desk talking with a colleague about a holiday, or anything for 15 minutes of normality, but thats whilst im also racking my brain to remember every interaction i have had with every patient and roughly what time so i can record it, whilst making sure its done in time for them being moved to a ward, or their next medication or infusion is due.

Private healthcare won't do A&E as its uninsurable. If you have major complications during private care that creates an uninsurable issue you will be discharged into NHS care. They will treat you irrespective of risk. Private medicine will at a certain point not.

so you left A and E and expected to keep your place in the queue? Your lucky it was only two people seen before you!

Obviously the OP has disappeared. I hope your DD is ok DD but your posts are very ill judged.

Having been to A&E recently, when we went through all the beds were full. They couldn't see more patients as the wards wouldn't take any patients not safe for discharge. My DH had a serious heart issue, he did get seen quickly but never occupied an A&E bed. They saw him in nurse triage room then moved him straight to an emergency cardiac assessment unit - which already had 5 people waiting in it as there were no doctors available to cover nightshift! Some had been there several hours. Thankfully when a doctor turned up for dayshift people did get seen quite quickly.

The only way to fix the NHS is to vote the Tories out

It's not about the NHS in as much as the complete crushing of social care and mental health the Tories have spent decades performing. Kidstart to educate parents, oh no, we'll let the NHS pick up the cost when they've had a life time of unhealthy eating and no social clubs to do so they'll get addictions and hang out in rough areas with knife crime. Mental health care, pffft, who wants to spend on people that don't notice if you don't and no one will believe them for years when there's no help - let's leave that for the police and NHS to pick up the tab for and cut some corners there, sell off the old land the hospitals and help centres used to be in to our developer chums to sit on until the price skyrockets. Then they'll give us some money in our back pockets and we've shunted it 10 years into the future for the next govt... Rinse and repeat.