A&e frequent flier

[Welshie5]

Was just thinking about this out of the blue tonight after I saw a post on here talking/complaining about frequent flyers in hospital

obviously I’ve heard the term frequent fliers before, but I always thought it was a negative thing, like when people were being timewasters, but I suddenly realised I would probably be considered a frequent flier because unfortunately I have to go to a&e a lot

i have problems with my heart rate and unfortunately have to present to a&e for it when it kicks off. Last time I went there I literally went to reception and said ’hi I’m in SVT and I need 18mg of adenosine to fix it’ because I’m so used to it now so I know what I need! They checked my heart rate, it was 190, and 3 doses of adenosine later and it was back to normal again. Unfortunately there’s no other way to get it fixed than going via a&e.

but I suppose technically I’d be classed as a frequent flier as I’ve had to go multiple times and had multiple admissions. Last time I went to a&e it was less than a week after the previous visit and the resus dr was joking I’d need to start paying rent haha (all in good spirits)

I know it’s not really anyone’s business but I was just curious after reading a post on here complaining about frequent fliers. Do a&e staff get annoyed at situations like this? Where people have to go
regularly, but it’s because of a condition and not time wasting? I was taking my medication and avoiding triggers etc so I did everything I was supposed to do, but I can imagine it maybe gets frustrating seeing the same people again and again?, And will there be some sort of bad black mark against my name that I’m a frequent flier or something along those lines?!

just curious that’s all!

Nope, don’t get annoyed about genuine frequent fliers at all. Lots of people have repeated admissions with COPD or heart failure, that’s a normal, expected trajectory of those diseases.

What we get pissed off about is the people admitted drunk and injured every week, or the person who “doesn’t want to bother their GP” (ie knows their GP will give them short shrift but is hoping the inexperienced F2 will give them some tramadol). Time wasters.

Adenosine for SVT is actually usually very satisfying to treat, fwiw. Always enjoyed those coming in.

Have you been assessed for a radiotherapy ablation? It fixed my SVT for 20 yrs.

sorry, not the point of the thread …

Haha, I remember a nurse telling me once before that adenosine was one of her favourite treatments to give! Because it usually worked so fast and basically switches your heart off and on again or something like that

unfortunately it’s horrendous to get as a patient lol, absolutely awful stuff and I genuinely hate it so much! Hopefully one day they can find a treatment that doesn’t make you feel like you’re dying in the process!

ah ok, that all makes sense. Just hadnt ever really considered myself a frequent flier until I saw a post on here and suddenly I was worried people were thinking I was a timewaster or I had a black mark against my name or something like that, haha

Yes I’ve actually had it ablated recently and it’s been amazing so far! No palpitations or problems ever since, and I’m really hoping it continues that way 👍🏻 was very scared for the procedure but was worth getting it done because my SVT was awful before and basically out of control.

I think this is one of the problems with the NHS where people like you are forced to go A and E without any alternatives, it must be horrible for you to have to go through that all the time, I hope you don’t have to wait long.

Our daughter was admitted to hospital 7 times between February and April this year, I was begging the consultant for open access to the ward, but was refused. The worst part of each visit was A and E.I know I we are going to end up on the ward, the staff know we are going to end up on the ward, why waste everyone’s time and my sanity.

I wouldn't be surprised if many frequent fliers are being let down by the health service and just trying to get some help. I had to go to A&E for an ear infection this week and It's the second time in the past year I've been there for a similar reason. I felt like a proper time waster but I had tried in vain to get support from my GP who refused to call ENT for me (as ENT have told them to do in letters!) Like you, this is a chronic thing and I know what I need and when I need specialist intervention but I was unable to access what I needed - ENT were clearly unimpressed with the GP when they heard this due to my medical history! I went there out of desperation and, on paper, that was a ridiculous reason to go to A&E but I ended up there because (most) GP's won't respect my knowledge of my body and health needs. I just wonder how many frequent fliers would fall into this category? Probably very frustrating for A&E staff I'd imagine but primary care really does let many people down.

I think it happens
I went having fallen down 2 flights of stairs, no idea how I did it and broke my ankle and foot

9 months later I got out of bed and broke my other ankle and foot, no idea how. Same staff member They said they didn't think it was broken... she came back and said "I can't believe you don't know what you did, it's a mess!"

I get a piece of glass stuck in my eye, again no idea how. Same staff member...

Then I go with numbness from severe back pain, see the same woman again who almost goes grey when I say "I don't know what I did"
one MRI later and I have cauda equina.
After the op she found me and said "next time you say you don't know what you did, find someone else, anyone but me"

My best friend is a paramedic and gets called to some of the same patients a lot - she said they never have a problem with most of them as they are genuine. As someone else said it’s those who are genuinely time wasting because they’re either drunk or choose A&E as some kind of crutch!

my Nan was admitted to A&E many times and I went with her most times (followed the ambulance in my car) as she had dementia and would forget by the time she got there what was wrong. The nurses were always so lovely because it was always a genuine reason - she had many complex health issues that whilst under treatment with her GP would flare at any given moment and require immediate attention. But I’d see a lot of the same people in A&E time and time again who were clearly not genuine and it was wasting so much time. Sadly for some of them it was a way of getting some attention as they were very lonely and that’s a different issue that needs addressing

😢 Hope your daughter is feeling better now x

yeah, I wish I didn’t have to go to a&e. I always feel bad but it’s the only way to get help. Although in fairness I can’t complain because everyone has always been amazing and I’m usually sorted quickly- either adenosine helps in which case I can go home, or it doesn’t and I go up to the cardiac ward, so either way I luckily don’t have to stay in a&e usually, but just feel bad about having to go repeatedly for the same thing!

Nobody gets annoyed about frequent visitors for legitimate and unavoidable reasons. Any annoyance is reserved for the the way the system works meaning that the patient themselves has no choice other than to be inconvenienced by going to A&E.

:) the best kind of frequent flyer! No diagnostic uncertainty and clear treatment plan, what's not to love as a clinician :)

One of the reasons they don’t give ward access is that sometimes there may be no bed available for your daughter and they would then be responsible ( as you had referred ) for trying to sort out an alternative , or perhaps she doesn’t need admitting on that occasion but would be taking up resource they don’t have to provide treatment, which isn’t their role on the ward. If you go via A&E , your daughter will be assessed , treated and sent home if practical or, if she needs admitting they will and either to the ward, or if no bed source an alternative elsewhere. From your personal perspective it feels like it’s unfair / not necessary, but imagine if multiple patients were given the same direct access, the system wouldn’t cope.

The staff in our local peads A and E know my son by name, on the rare occasions he is well enough to be in the waiting room they will stop as they pass to check in. They know he has complex needs so no matter how often if we are there it’s due to needing to be

I worked in A&E years ago. 1 of our frequent flyers was apparently the 3rd highest caller of ambulances in all of London! He would attend 3x in 1 day sometimes! Each time, calling 999, getting an ambulance called out. They'd try to persuade him to stay at home, but the crews said that if the patient insisted and had mental capacity- they had to bring him in!

The real cases like that, tended to be from social issues- not always a physical, medical issue. The call would always be for a medical issue, but the crux of it was generally loneliness. Calling 999 would result in someone coming to the house, having a chat about THEM and asking THEM questions, going to a warm hospital where more people chatted and asked questions. A cup of tea and biscuits might come along and even sandwiches on a good day. You then sit in the discharge lounge chatting to more people, then the transport takes you home. Its an entire day out!

We has similar regulars and it could be extremely frustrating, knowing they were taking the time and space of someone else with a genuine medical needs. Yes, social isolation is a real problem, but I was more angry that social services and support took years to come about for these people. Once they had proper support, sheltered housing or other help- they suddenly never needed an ambulance again!

We had frequent flyers in ICU. No problem. Everyone wanted to work with them. We knew them well and they were there because they needed to be.

My mother got a letter off the health board admonishing her for abusing the resources of A&E, and her GP got a telling off too and he got quite cross with her. She had a collection of genuine health complaints combined with some mental health conditions and it was hard to tell which was in the ascendant when she was angling to go to A&E. Except when she timed her needs appropriately to get into the part time A&E at her favourite hospital, that was a big clue. I just felt horribly embarrassed going in with her and seemingly enabling this behaviour so much that I resisted going in when I had sepsis and again when I was in liver failure.

Frequent flyers are those who are always in A&E with the same drink/Drug issues every week. In my trust they are anyway, not you OP you have a genuine medical problem which you have no control over, unlike the same patients who come in week in week out after overdosing etc.

There are unfortunately people about who like coming to A&E and will fabricate or induce (!) illness in order to get there. Or people who are strongly suspected not to be in any physical pain, but are seeking opiates. They take up a lot of time that could be spent on patient care for people who really need it
(I do appreciate that these people have MH problems and social problems, but A&E is not the place they need to be, but unfortunately there is nowhere else they can go as MH support is cut to the bone)
It's shit

But obviously no one has any problem with people who are genuinely frequently unwell and need A&E!

No-one ever minds how many times you attend if you have a genuine illness. It's the time wasters turning up with stuff that could be treated elsewhere that are irritating.

We are frequent fliers but I am very lucky to have open access for my child so we skip A&E, I do call ahead though to check whether they think he needs to be seen.

Awe, haha! That’s reassuring to hear :)

I had an (ex) friend that had back pain at work so went to a&e. I said could your GP not see you? She said well I was up at work which is near the hospital, didn't want to go back down into town where my doctors is..
It's those people that are the issue. Not you.

I have been a frequent flyer due to MH issues... and from bitter experience, the staff hate it because they think I should just have a bath, cup of tea, and go to bed and hope the next day is better. But I also get that the staff like it when they can "fix" someone during their time there... you simply can't do that with MH stuff.
A lot of the time I was not there out of choice.. it was the police who took me there.