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

It was Calais

and the staff were speaking to me in fluent English

If someone had been tasked with coming up with the most unpleasant environment possible, that is guaranteed to make sick and injured people feel as worse as they possibly could, deprive them of any possible comfort and prevent any healing, then they’d come up with something remarkably similar to an NHS A&E waiting area.

DD9 very ill with pneumonia recently, when told we would need to take her to A&E: ‘noooo, I’ll be so much iller once they make me wait on the uncomfortable chairs for 5 hours!’. This from someone so unwell she’s been sleeping on the sofa all afternoon and had cried from fatigue and pain when she’d had to walk more than a few paces. At 9, she’s already sussed that this is a shit set up that doesn’t take into account the needs of the patient.

Perfect!

I’m storing up this idea for next time one of us needs A&E and it’s unavoidable, God forbid.

YANBU

I had to go in for a mental health crisis, I was in obvious distress but had to announce my reason for being there in front of a waiting room full of people. I live in a very small town and whilst there shouldn't be a stigma when it comes to mental health issues there very much still is, I can only imagine I was the talk of the town the following day thanks to local gossipy twats. Great for my mental health that is!

A couple of months ago, bad fall in the garden, on concrete, cut knee open, (looked like an open mouth!) extreme pain, lots of blood. Waited 6 hours in A&E, blood dripping on their clean floor. Nowhere to elevate it without spoiling their lovely new upholstered chairs, under the sign that said "Do not put feet on the Chairs".

Yes this is the thing, and the doctor was as frustrated as I am. My condition can get dangerous very rapidly and I needed to be seen, but equally it was very very hard to make this decision when I knew the environment would be so unpleasant

(Plus DH felt he had to stay with me so it has cost him a day of work today - and he works for a different but very important part of the public sector)

@saltinesandcoffeecups Level 1 trauma is like our A and Es with the range of services offered. I know those centres in the US have a high number of patients who can not pay their medical bills. Many are left financially destitute as a result.

I always thought they were designed to make you not want to go in, thus avoiding being a burden on the DNHS

Write it on a piece of paper and slide it across the desk.

It's really crap going to the chemist for lots of reasons. Mine at least is usually empty.

Yes, the stories in the Facebook group for my condition are devastating. Even those with good insurance are incredibly stressed financially. Many end up working when very unwell to pay medical bills even though working will make them more unwell. One came straight out of being ICU on a ventilator and tried to go to work the next day 😞

Absolutely this. It's not a bloody family outing.

I have some knowledge oh hospital design and a lot of it is to do with infection control but we now have no personal check in, lines of people at iPads and a lot of people can't use them
So it just takes lingering and the screens must be a germ fest.

This is what I was going to say. When I’ve taken one of my kids to A&E I’ve encountered entire family groups - like 3 or 4 adults accompanying one elderly person - taking over multiple seats and having loud phone conversations.

I had to take my DD to the fracture clinic to have her temporary cast replaced and it was super busy. I sat on the floor with DD in my lap but there were multiple able bodied people sitting in chairs while people on crutches with broken legs had nowhere to sit. A staff member had to come and tell them to move! I just cannot fathom it.

If the chairs were comfy or there was somewhere you could lie down it would probably be even worse.

That could be dealt with by a one companion per patient rule though rather than by miserable design.

@thebillcollector 😂🤣 you actually have a good point there. It probably would be quicker!

I have a care plan that is logged as a document on my NHS app by my GP. I can show this document by opening the app but the care plan is also logged on my NHS record should they wish to check.

I have had varying experiences of A&E. The worst was in 2020 when Covid was about. I was rushed to hospital with serious burns. The waiting area was disgusting - cramped, crowded, dirty and no cleaning was done and it was clear it hadn’t been for a while given what was on varying surfaces. In a way I was glad my burns were so severe I saw someone quickly.

Regarding multiple people attending with the patient, I agree for most cases but there are the exceptions where this is perhaps needed. My DD had psychosis and if she couldn't physically see someone, she thought they had died which then caused her extreme distress (as well as already leaving the house and being at a hospital). We had to all go with her (2 adults, 1 teenager) so she didn't think we had died.

Someone, govt,needs to sort out gp services and provide enough capacity for people so they don't have to go to A and E because it's like one of Dantes circles of hell. Truly awful. We are one of the richest countries in the world and it's shameful.

I’m 56. I’ve had a chronic and occasional life threatening condition since I was 18. Hospitals have not changed in their poor, often contemptuous service one iota under all the governments we’ve had since then.

Totally agree on the standing to queue being completely ridiculous.

I don’t understand why more people don’t die in the waiting area as you are just stuck there for the day, with no staff in sight, and the other sick patients are not going to notice if someone is passed out or worse.

After waiting for a few hours you start worrying that your name has been forgotten or you missed it when you went to the loo or misheard, no way of finding out unless you join the 45 min queue again.

I often wonder what you should do if you literally cannot breathe (danger of imminent death) and cannot get sight of any staff member. Perhaps lie down across the main entrance blocking anyone getting in or out? I have read about someone having to call 999 from an A&E waiting room which is so scary.

Unless you die waiting. You could br loaded in the UK but die waiting for 999 to pick up, for the ambulance, to treat your current heart attack.

I was having a heart attack I'd sell my furniture TV and bed to go private.

I'm lucky I live near a great hospital. In my home town you go into the massive major trama centre hospital and die of mrsa. You miscarry full term waiting in the maternity ward waiting room. You die while your dd is on hold to 999. You die sitting outside A&E for 10 hours in the ambulance. I wish I was kidding you. Loosing £2300 would seem appealing when your literally dieing with zero dignity right there in front of the nhs.

It's postcode lottery.

Most of those bills are written off and/or covered by Medicaid.

I saw a really good triage person last time
Was pacing and vaping outside---- as it was the only way I was comfortable
She came out and scanned the room and told me to go with her as I looked grey. She asked what was going on, I said I think I have cauda equina
It was maybe 5 mins later they got me morphine
MRI that evening, neurosurgeon called in, 5hr op the next morning

Should add the waiting time for being seen by specialists isn't helping

Saw gynae in April after a 6 month wait, was bumped up the list after going to a&e. MRI 7 weeks ago. Not seeing him again until November. Then they've got to have an MDT meeting etc etc
There's no other pain relief options and the only thing they can say if it gets really bad, go to a&e

When it's really bad I can't move off the floor! Last thing I want to do is be stuck on all fours in a&e