To love A&E despite the wait?

[HotTiredDog]

Over 9 hours in a very busy city A&E today with DM, following a fall at home.
They have established that her heart is fine, lots of good blood stuff, X-rays of queries and carried out dressing of wounds.
This was free at the point of need & was carried out by amazing professionals, with the utmost care & thoughtfulness.
Seriously, 9 hours was nothing for all this attention, not really.
The tragedy was on the MH side, with some seriously unwell folk who couldn’t be given the care they so desperately need - I dearly wanted to help but had no way of doing so.
I am so proud of & grateful for the people of A&E. We must keep it safe.

It’s awful.

had to take my middle DD there a few months ago. She’s had a chest infection for 3 weeks which after multiple antibiotics was finally going away. She still had a horrendous cough tho.

one night she coughed, then squealed, clutching the side of her ribs saying she felt like something popped, then fainted. When she came round she could barely breathe, saying she couldn’t take breaths and was crying (she is NOT a cryer, so I knew something was really wrong). Phoned NHS24 because it was after 7pm and they advised to take her straight to A&E

waiting time said 8 hours. She was taken in, triaged and sent to xray within about 45 mins. They brought her back to the waiting room in a wheelchair around 9pm. We were then left sitting there until after 3am waiting. Still struggling to breathe, struggling to sit and in serious pain. No one came near her for 6 hours. I went up a couple of times to ask for painkillers and the receptionist said she would find out. No painkillers came.

while we were there an elderly woman who had fallen, and had blood pouring from her head, fell again. No one came to pick her up, my DDs boyfriend and a man who was there with someone else ended up picking her up from the floor

at 3am they came and took DD into a side room. Told her they couldn’t see anything on the xray, sent her home and told her to take ibuprofen.

wasn’t happy with that but dying to get out of there by this point so we went home and waited for the doctor to open. Got a doctors appointment in the morning and when the doctor went to check the xray from the night before, it wasn’t there. He had to request it. Phoned DD hours later to tell her he had managed to track it down and had someone look at it. He couldn’t see anything but wasn’t happy due to the pain she was in and the fact she still couldn’t take deep breaths. He prescribed stronger pain killers and made referrals

she eventually got an mri and had torn her inter-costal muscle.

all of this should have been done at A&E but wasnt.

something really needs done about the care people are receiving there

Your satisfaction level is likely being swayed by your mums positive outcome. People are far less likely to complain about health services when they end up cured/given a clean bill of health than when the outcome is poor, regardless of any difference in service recieved.
I agree with you that we have some excellent highly skilled practitioners, access to impressive tests and facilities and that the advancement of skills and knowledge mean remarkable things can be done. This is something to be celebrated and appreciated.
However 9 hours in A&E is very poor and so the administration and operations still leave a lot to be desired.

I've been the one in pain many a time, and I agree with OP.

Good point.
There were two people that we spoke to who clearly were in pain & their struggles were awful; credit to the two
nurses who got them meds in the end but a couple of hours earlier would have been better.

Our a and e is filthy, uncomfortable dirty chairs where you are stuck for hours no fresh air ! No windows, it's awful. .

No, YABU and your standards are too low.

Nine hours is far too long to wait. Only 15 years ago it was very rare to wait more than four hours.

The people who staff A&E do not think nine hours is acceptable, because it isn't.

Agreed

I have a friend who works in A&E.
The number of people who take the p* is unreal.
A lot of injuries/problems are self inflicted. A lifestyle choice.
A lot of people treat it as a family day out.
Lots of people are repeat offenders who use it as some kind of social meeting place.
Lots of people are there because their doctor has failed to deal with the problem like they should have.
Weekends/Bank holidays are different to mid week.
It does vary greatly depending on which doctor is on call.
Lots of people don’t have the basic intelligence to realise it is not a first come first served service. It is based on medical need. The less urgent your case, the longer you will wait.
All patients are directed to the notice board which clearly states the approximate waiting time, yet it is beyond a lot of them to comprehend. They will constantly ask her how much longer they will be waiting. Read the sign! It’s not rocket science.
I could not stand to do her job. Dealing with these types of people day in day out.

So it’s the fault of the patients then? Okay.

Yes, indeed.
Also easier to love A and E when your mum is found to be fine.

OP, I expect your relief about your mum is playing into your positive feelings about
A and E.

I think we are culturally conditioned to accept the NHS and generally as a society to accept shit standards. The NHS as a whole is a shambles and A&E is the worst of all. I always felt lucky being in Scotland as A&E is probably comparably quick in comparison to England but it’s going the same way now. My dad was in in January for a suspected stroke. Wasn’t seen for about 2 hours by which time it was too late to give him the best drugs. Luckily they established it wasn’t a stroke but he was then in A&E for 6 days. Never saw a proper ward. They wanted to check him for heart conditions. He was 4 days waiting for a scan and then a further 2 waiting for a ten minute procedure to fit a monitor. He was moved to an A&E overflow where a dozen patients were sharing one bathroom and the rooms themselves were clinic rooms. It was absolute chaos and completely unsafe. The major challenge around here, and I imagine a lot of the country, is the elderly. They are filling up A&E and all associated wards. There has got to be a better system than this.

Yes you are being unreasonable. Firstly to say you “love” A&E? How bizarre. I presume what you are saying is you think the level of service you get “for free” (it isnt) justifies the long wait? Well that complete rubbish. There is no justification for the shockingly long waits in A&E or the general poor state of the NHS in general. It is adequately funded but the shear inefficiency and bad management and bureaucracy result in the shit show we have today.

This

I’m not a psyop!
I know we pay tax, I said “free at the point of need”.
There were far too many old people on their own - not the fault of A&E staff, more likely of social care (that is a thousand whole other threads). We did our bit trying to help some of those to navigate their situation & to chat with them.
Sandwiches and drinks were provided by remarkably cheery staff (unquestionably underpaid, as are others).
Obviously nine hours isn’t my benchmark for acceptable service; set against other examples above, it’s woeful. But against other patients on the day, we were fortunate.

The processes were broken down too finely, waits for certain activities weren’t allowed to happen in parallel (yes obviously I accept some reasons for but nonetheless some could be altered). IT systems that should be connected weren’t, and are unlikely to ever be so due to the massive cost & complexity involved.

There were multiple patients under close police & prison officer supervision. Additional officers were there to support NHS security.
The MH crises that were going on around us were heartbreaking & there simply weren’t the facilities to care for those patients.

But just for once, & despite all the above, my DM came out of there in better shape than she went in, and I remain eternally grateful to the people who made that possible.

Both times I was sent home i bet the staff thought that but the reality is both times they completely missed serious life threatening conditions. The reality is by the time its discovered its different staff so the original staff have no idea about their errors and still walk around thinking the patient is a time waster

Just to add - as @Amiacoolorwarmcolour said, the abuse of the system was ridiculous.
Due to where we were sitting at one point, I could hear people as they arrived (another failure in design, their privacy was non-existent)
There were those who said they had been feeling symptoms for days & even weeks. There were those who brought two or even three family members with them. NHS 111 sent people who didn’t know why they were there.
And so it went - people who clearly should haven’t been there for all sorts of reasons, who effectively delayed the treatment of others who needed it.

i’m glad you have had a good experience, OP. A GP sent me to A&E in January. I came out of there feeling much worse than when I went in because the Advanced Nurse Practitioner I saw treated me like a neurotic time-waster. She shouted at me and every time I tried to ask her a question, she talked over me and wouldn’t let me get to the end of the sentence. She told me that my symptoms were caused by diabetes. I tried to
tell her that I had had numerous blood tests for diabetes, including very recently, and they were all well within the normal range but she wouldn’t listen and continued to give me advice as if I had diabetes. Luckily, I had the sense to ignore her advice because once my problem was further investigated, I was actually given the opposite advice. If I had followed the nurse’s advice, I would have got worse. The nurse could have found out that I didn’t have diabetes by looking at my records but she didn’t bother and just assumed. No idea why any medical professional would just assume that when it is easily checked with a blood test.

I wrote a complaint to PALS. A few days later the consultant in charge of A&E phoned me and apologised profusely.

The sad thing is, prior to that, I went to the same A&E around summer 2023. I had a very similar experience and again I complained and the consultant in charge apologized. Apologizing is nice but it is not much good if nothing changes. I am actually now fairly scared to go to that A&E. I have no confidence that they would look after me.

To be honest, that’s terrible!

Im in Australia and I’ve never waited more than forty minutes for me or a sick child to be triaged. Then the actual care for the broken bone etc. might take another hour for the xray, cast etc.

We have an urgent care system in NSW which I think really helps. It’s where you go when you are too sick or hurt for a doctor but not quite A&E. Open 24/7. They can do stitches, help with croup, xray and make casts for broken bones, put dehydrated kids on drips for stomach bugs. It keeps A&E free for serious emergencies.

I’m glad it worked for you.

Some of the nurses were okay but there was a communication issue and I was distressed the entire time (ND). Some were loudly chatting about holidays etc in the middle of the night while I was trying to sleep.

The next time the dr wants to call the paramedics to take me there as a matter of urgency, I’m not going. Not risking an overnight stay. Happy to take the consequences but if there is any chance I will have to go through the same experience then I’m out.

We have urgent care here too and it works quite well ime

I will never understand why British eulogise the National Health Service and actually celebrate a 9 hour wait. I mean I know there is the Dunkirk spirit and all that but why do you put up with these kind of developing world conditions? My son, a doctor, nearly fell over laughing when I suggested he might try working in the UK. Just think about who is prepared to work in these conditions.

My son collapsed at home 3 years ago i rang 999 and the Ambulance was there within minutes they quickly established he was in DKA ( we had no idea he was diabetic ), he was blue ligted to A&E and straight through to resus and was in critical care within an hour
I couldnt fault thrm
But it was a life threatenig emergency

Its all relative. Here in Aus my DD had kidney stones. She was seen, operated on, a stent fitted and sent to the ward in not much more than 9 hours.

I had a massive herniated disc, I was seen in less than 20 mins, sent for CT within an hour and on a ward in three hours with major spinal surgery booked two days later.

Also 'free' (paid for with taxes) at point of care.

My mother on the other hand was left on a trolley in a corridor after a 14hr wait in an ambulance. She crashed and ended up nearly dieing in HDU in an NHS hospital in Wales for a simple urinary tract infection. Had she had access to primary care, this could have been 100% avoidable.

My nephew sat on the floor in A&E with suspected appendicitis for 16hrs.

So no I don't get excited by substandard NHS care, even if the staff are undoubtedly doing their best.

I agree that having a universal healthcare system is something we need to protect. However, I don’t think that means we should accept lower standards and long waiting times. My experience of A&E was that firstly the waiting area was shockingly dirty and messy and felt more like a police custody facility than a hospital waiting room. The paint was peeling off the walls which had random notices stuck up everywhere. There was a discarded gown with blood on left on the receptionist desk and not one member of staff moved it for 5 hours despite it being in front of them. The receptionists spent hours talking about their holidays, kids etc and barked at anyone who dared come to the desk and ask for help. There were police accompanying prisoners waiting for hours alongside parents with young children and old people just left sitting on hard chairs for hours. The whole place just seemed badly run. I appreciate you cannot see what is happening behind the scenes but there was a lot of walking around, chatting and no action or any kind of empathy towards people who were clearly in pain. So no it’s not good enough and it’s not ‘free’, we all pay into the system and should demand that it is a lot better.

We have had positive experiences of prompt triage and treatment, and on two occasions emergency admission and surgery, but I fully appreciate that many people simply do not have this experience at all.

As we all know, investment is needed in primary care services so that many people simply do not need to go to A&E at all. A new centre has opened near us for just this purpose to take the pressure off the local hospital, and it has a number of diagnostic facilities so that people do not need to be referred onto the main hospital - we need many more places like this.

The public also need to understand that patients are seen based on clinical need, not order of arrival. There will also be patients with diagnosed conditions that mean you jump the queue immediately I.e my cousin has Haemophilia and in our home country he jumps the queue instantly when he arrives with a bleed requiring immediate pain relief. Well, he has lost count of the number of times other people have massively kicked off about it. People need to understand that some who come to A&E do have a greater, or more immediate, need than them.