To wonder why A&E seems to be designed to be the worst possible place you could possibly be when ill?

[CassandraWebb]

My GP asked me to go to A&E and while I was waiting I was just struck by how it was a pretty unpleasant environment to wait in for the family members of the ill and injured but utterly irrationally poorly designed for people who are ill or injured.

Firstly you were expected to stand and wait to check in, I explained I couldn't and they grumbled but accepted my explanation but a lot of people with obvious leg injuries or desperately ill were being made to stand and wait and then stand to check in and then move and stand in another line to speak to an initial clinician.

Then there were people clearly in huge physical discomfort sat on the world's most painful chairs with no way to get comfortable for a long stretch.

Plus people were explaining why they were ill and giving their symptoms and contact details and the receptionist was literally announcing them back loudly to the whole room, I think there was some sort of microphone so her voice could be heard through the glass. And no microphone going the other way so she was getting irritated with me because I was hard to understand (my condition gives me dysarthria when I am having a flare).

It just seemed mind bizarrely poorly designed for a place where unwell people go.

I realise cost is a real factor, but some simple changes like chairs while you wait and a privacy screen so the whole room doesn't hear your symptoms and address /living situation would seem like a good start.

Maybe it's just our local a&e but I was totally puzzled by it.

I would love to hear if other places have really good tweaks to make it more bearable though.

(And I would add that the clinical staff were absolutely brilliant and very knowledgeable and switched on about my rare condition and also very kind and compassionate despite an obviously busy evening)

It frustrated me just seeing people suffer but it also frustrated me because the process of waiting and dealing with that made me more unwell

I have to admit this wasn’t my experience last time I used A&E.
I went with severe bleeding during a miscarriage and I could not have been treated better.
I didn’t even sit on a waiting room chair before being taken into a cubicle, made a cup of tea (for me and my husband) seen really quickly.

I think those saying that it's like that to put off the unnecessary visits are barking up the wrong tree, it's precisely the sicker people who struggle on the small upright chairs, those who aren't that unwell do just fine.

Same for saying that in the past everyone was very ill and came in on trollies, this is not true, A and E has always treated accidents and many accidents don't require trollies, they are broken or sprained wrists, ankles, kids who fell off beds and need a quick scan, those facilities aren't available at the GPs at all, so there's no option to go elsewhere. In fact, it would be neglectful not to take someone in with a suspected broken bone, even if most times it turns out fine.

A and E does best when it has quick triage, like ours does, so that it can correctly allocate people to what they need, so GP if antibiotics (again not always predictable in advance), cubicles but not trollies if minor break/sprain, and trollies for those who are more severely ill or just older and can't sit for long time periods.

Our city does not have one minor injuries unit which does not help matters, but other than that it's quite good now, apart from the chairs and the harsh lighting (if you have an eye problem, a migraine/potential stroke or a brain problem that harsh lighting is very unpleasant).

That wouldn't work at our local A& E @Bellamari. Parking is limited to 20 mins.

I was seen, treated and out of a French hospital in about 90 minutes once, after a fall. Didn’t cost anywhere near 2000 euros.

Not that this is actually what this thread is about.

Yes completely agree OP. My most recent experience is nowhere near as bad as so many people's experiences on here but I had to sit for 4 hrs on a hard plastic chair with nothing to elevate / support / prop up my leg even though my injury was snapped ACL and torn knee cartilage, and also with no painkillers.

It was only for 4 hrs because I gave up and went home at that point (so no idea how long it otherwise would have been) because the triage nurse was so unpleasant (which I think was v much an exception, almost as the only exception in terms of hospital staff I've otherwise encountered being kind and compassionate but in this instance it seems I had gone to the wrong place - my bad (had had the accident abroad, been seen in hospital in France - also horrific, not given any painkillers just told to get some from pharmacy when opened the next day, fly home and see a doctor at home - it was weekend and had been picked up by parents so didn't think would be able to see their GP so went to A&E thinking that was the 'correct' way to get in the system back home)).

Another good thing our A and E does is to do the screening blood tests and measure BP/temperature while you are in the waiting room, and any further tests are added on the top by the doctor, this means that when the doctor sees you they have a lot more information than in the past when bloods were only ordered once you saw the doctor after, say, eight hours. They do this via a nurse who works alongside the triage person. It's very efficient.

That cost is based on a thread yesterday where a woman posted about her husband being taken to hospital in France by ambulance. That is what he was charged. And the ambulance went via a cashpoint so he could pay.

They also order scans immediately if you go in with something suspected to be broken, so again, by the time the doctor sees you they have more information. It's not a perfect system, and if you turn out sicker than they expect, they can order more things as they go along, but it makes complete sense to get the most information early on for a pre-diagnosis and then refine it, rather than wait a very long time to see the main consultant, who then orders tests.

I read it was €260

is that incorrect? €2000 for an ambulance ride?

That’s true. Mine did bloods and an ECG as part of the triage. Doc when I eventually saw him just added a chest X-ray and a referral to Covid medicines clinic. No complaints about the care, just how uncomfortable the waiting room was.

My local ER/A&E is actually pretty good (US). Free valet parking so you don’t have to worry about parking. Clean, comfortable quiet waiting room, and for fun I just checked 48 min wait time. I think that’s pretty average except for the overnight when it can go up to a couple of hours.

It’s the level 1 so all bad injuries are taken there.

Last time I brought my DH in for a suspected kidney stone he was in an exam room before I had a chance to hand the keys off to the valet and get through security.

@MikeRafone you may be right. Sorry.

And don't forget the brightest strip lights in the world!!

Not even sure you can get that much cash out from a cash point
mist have a limit around €500

Both my son and husband have been through our local a and e in the last couple of months . Both had a wait of 24 hours plus as we have this ward where they shove you if they don’t have room in wards . However it’s the same upright uncomfortable chairs !! Son ended up in hospital for 3 weeks so was rather poorly . My husband had an infected gall bladder that led to sepsis while waiting when it ruptured . He then spent about 2 weeks as an impairment while they sorted out the sepsis . That was in July we don’t have an appointment to see a surgeon to take it out until September. So he regularly has to go back to a and e when it gets worse agin !!!!! How does that make sense ??? Oh and 2 days after discharge our gp discovered he had dvt . You cannot make up how shit it is

As a wheelchair user with bladder problems and a history of hemmorages and recurring DVTs I agree.

My chair won't go in an ambulance. I was taken in once when I lost a lot of blood. I couldn't use the toilet for 8 hours as I was dumped on an immovable metal chair with no staff around to help. I was told to pee myself if I didn't like it. It was fine because there was no water to drink anyway.

When I did take my chair I realised it was overnight and there was nowhere to charge it while I waited 14hrs. I always charge it at night at home. The next day I couldn't get home as it was flat. I'd had to keep moving around the fixed metal seating area as they hadn't left any space at all for a wheelchair user and a senior nurse kept coming out and shouting at me wherever I went as the edges of the room had to be kept clear. Where was I meant to go? One time she shouted me away from a door to a broom cupboard then came out of her office with an A4 sheet saying no wheelchairs in front of this door and stuck it above my head.

Another time, I collapsed from breathlessness from a proximal DVT and was taken by ambulance. They gave me one of the porter's chairs to sit in. The leg risers were all broken so I couldn't raise the leg with the clots in the thigh, as per their own advice.

The bins are all foot operated so I can't use any of them. I hate going and despise my body for making me need to go there so many times in my lifetime. I understand why people develop a phobia because the thought of needing to go to a&e again puts me on edge. It feels almost hostile.

If you can afford the top hospitals in the US, the care is very good.
Many insurance policies say you have to go to urgent care first, more like our minor injuries unit.

Just to say as a nurse, we have zero input with these things. I've also found it demoralising and embarrassing to explain in front of a room full of people as to why I'm in A&E. Chairs (If you can get one) are terribly uncomfortable. My trust have introduced portable drug trolleys, with computerised medication charts. they are absolutely not user friendly. We were never consulted about them, just thrown at us as 'progress'

In my local A&E you enter at one end of a long thin room/waiting area. All the seats face the way you come in, so everyone already waiting is watching you as you queue to give your details to the reception team. The drs/triage nurse calls you from the other end (which you are facing away from) so you are constantly turning around if you hear a noise to see if it's your name being called.
It's completely ridiculous as just changing the direction of the chairs would increase privacy for those arriving and be more accessible for those waiting.
Other issue is x-ray is long walk across the hospital. I went in to rule out a possible ankle fracture and had to hobble across the hospital site to get my x-ray, then back to a&e to wait again.
Agree it's probably to make the experience less appealing for those who don't really need to be there...

Appalling treatment.

So you are supposed to be an urgent case to visit A&E, but not so urgent that you can't sit or stand.

It beggars belief.

I was treated in French A&E and it was fast, excellent and €80 euros but as I had my ehic it was € 20 not worth claiming on insurance

bright lights, plastic chairs

but not busy and in and out in 90minutes

Oh @CatMum10 big hugs. 🤗

@MikeRafone that is what it was like in the UK before the conservatives destroyed the NHS.

It sounds like it would be quicker people in the south of England to get on the Eurostar, be treated in a French A&E and home in time for supper and a good nights sleep!

It’s the only level 1 trauma center in the county, You go there with insurance or not.

My insurance policy doesn’t say I have to go to urgent care first.