To think 70% of people shouldn’t be in A&E

[PrettyPleaseXo]

Recently I was admitted in excruciating pain to A&E due to kidney stones. Over the time I was there it got progressively busier as expected and there was corridor care (I was stuck in a corridor without pain relief and crying in pain for two hours) and ambulances backed up out the door.

When I was discharged and went back out through the A&E reception/wait room I couldn’t help but notice
that 80% of the people sat there looked perfectly fine, chatting etc and didn’t appear to be in either an accident or emergency.

AIBU to think that unless you’re seriously unwell, in acute pain or have an injury that needs immediately addressing you should be turned away from A&E and told to go
to the GP instead?

I don’t think it’s fair point. The problem is with the health service , not the patients. Lack of staff and beds. I was in A&E recently with chest pain and had been told to ring for an ambulance. Got there about 5pm and it was heaving. You get the initial triage with a nurse quite quickly (ecg and bloods) and then it’s the long wait to see a Dr. 10 hours in my case. During that time they go round doing BP pulse etc and ask about pain levels. That is another indication of who needs to be seen quicker and who can wait. In addition to all the people waiting they have critical admissions coming in from another entrance by ambulance- really critical people - on the point of death ,road traffic accidents etc - you dont see everything from a waiting area - they quite rightly get prioritised - everyone else is lower priority. It’s not right but they are understaffed and not enough Doctors.

Im also disabled and sitting in one position for 10 hours was very bad for me - but I wasn’t as critical as some because my observations were fairly stable despite a pulse rate of over 100 and chest pain. But the pain wasn’t excruciating.

During my 10 hour wait two people gave up and left. One was in a lot of pain and said it was her pancreas .She had raised this a few times but eventually said she count stand being in pain any longer - I assume she left to go and get some painkillers elsewhere. Even though that might have been dangerous if something later ruptured.

One person collapsed and the crash team had to come out. Two people were vomiting violently for hours. One very distressed.

We are all high priority - there just sent enough Doctors. I couldn’t be seen until a Dr had seen my ecg. And they then wanted to admit me. But as it was 4am by then they said wait for the day Consultant - then decided not to admit me because bloods were ok and the consultant decided it wasn’t bad enough and could be viral and see if it improved but told to come back to urgent daycare centre if it got worse. So I was a borderline admission.

Everyone was wonderful but the wait was horrendous. I can’t see how it can be improved other than more Doctors available.

And it really isn’t good enough. It’s almost a third world system.

I also don’t believe there are people sitting there waiting for ten hours with a broken nail. I think it is propaganda.

So OP you where crying in pain, does that make you more worthy? Other people where chatting, that actually works because it can take your mind off your pain. Last time I was in A&e for myself I was admitted for a week, I wasn't crying in pain I sat there in silence waiting. In your eyes I didn't need to be there. When I've been there for my kids theyve had appendicitis, dislocated bones and allergic reactions. They needed to be in A&e every time but they didn't scream or cry they played with toys or watched a video. But in your eyes they shouldn't have been there. You carnt diagnose with your eyes walking through a waiting room

Plus a huge bouncer to see people off the premises.

And patients should be limited to one accompanying adult. If two need to come to the hospital (eg one to drive and one other) the plus one should wait in the cafe or the car.

I think the reason is, there aren't enough Doctors! Partly. Ideally everyone would be triaged by a Dr straight away and sent on one path or another or discharged. eg sent for x ray or bloods - and that's when the delay kicks in - the investigations get done quickly but then a Dr has to review everything and there aren't enough of them for everyone. I also think it's just the way the system is and "systems" get stuck in mindsets. Nurses are all doing things that Dr's used to do now - taking bloods, doing ecg's etc. In fact it was a healthcare assistant that did my first ecg - not even a nurse. I asked if it looked normal and she said oh I can't read them I;m just a healthcare assistant. So that would be one way of reducing time. If the person doing the ecg was actually qualified to read it and say yes that's fine or no that needs further investigation.

I couldn’t help but notice that 80% of the people sat there looked perfectly fine, chatting etc and didn’t appear to be in either an accident or emergency.

You are being v v unreasonable. You have no idea at all what's wrong with people. My late father, when he was admitted to hospital for the last time, would have fit your criteria above. In fact, he had a soon-to-turn-dangerous fecal impaction due to his secondary terminal lung cancer, which had spread to his bones. He died three weeks later. Yet he walked into A&E that day, sent there moaning and groaning about the fuss, because he had diarrhea which can signal a potentially serious side effect of his immunotherapy, so anyone with that profile needs to be seen asap.

Likewise my mother seemed TOTALLY FINE to the naked eye when she had terminal cancer, except for the last three weeks. But people in that situation have a million things going on in their bodies which can take them down pretty fast.

Another example is AIDS, where the virus hides in "pockets" all over your body and, if you can't get your meds for some reason, or something else is going on, those "pockets" are the reason you can get very sick, very quickly. They all activate at once. But in the early stages of that happening, a casual observer wouldn't know.

ETA: I went to A&E with chest pain, had an initial EKG which was fine, but then I had to wait for a lung scan because they were concerned I had a blood clot in my chest from a long flight. Which I did, but I still looked normal. You wouldn't have known I had chest pain to look at me.

It's actually incredible what serious trouble people can be in and look OK - before getting worse.

Last time I was in A&E it was with DD who had delayed concussion. My mum went with a heart attack which was a slow burner. Some people with broken arms / legs are ok if they don’t put weight on it…

DS had a spate of going down to A&E with asthma, concussion and injuries.
One Saturday night he was ambulanced in and needed to stay in the GP lead zone for a medication review. A couple of hours into the wait the Dr said that he was the only one on duty (for that zone), he had 32 patients waiting for him and that waits were at least 6 hours (an all-nighter). 3 minutes later, half the families in the waiting room had left.

There are a lot of families that end up there for routine illnesses because they're struggling to access GP care either from time of day or avaliability. Sometimes it's lack of confidence in self-care, or other services like pharmacies or accessing Out Of Hours. One one occasion a family said openly that they were there to get anti-biotics for their child's cold 🤦‍♀️ (a few days later I had Covid... if that's where I caught it, anti-biotics would have been no use!)

You can't generally see worthiness to be down there by casual looking though.

DS has often been tired, pale and grey round the eyes, but sometimes that's the recovery from asthma or on another occasion he was in surgery within 8 hours of arrival.

The biggest issue is access to primary care.

I can see what you mean but if you have someone admitted with a life threatening condition, you probably need your most senior and experienced staff, you dont need them to to be assessing cut lips and swollen fingers etc.

On the whole I think that people who say that others “look” like they shouldn’t be in A and E are talking bullshit. You don't know anything about other people or their issues.

There are people who shouldn’t be in A and E and are time wasters, but there are others who need to be seen somewhere and are not being.

I was sent to A& E at a bigger hospital by my local A & E for a quinsy on my tonsils. I had no obvious symptoms to look at but I had a huge boil filled with pus in my throat and was seen very quickly as it was a proper emergency - the board said 8 hour wait but I was seen in 10 minutes by an ENT specialist, who lanced the quinsy. Then i was properly ill as pus inevitably gets into the body, and I had to be admitted.

I love this. Did you let the fart out in the A and E waiting room?