HCP’s What’s it like in hospitals at the moment?

[Speckledhem]

Just ‘normal’ busy / stressful for this time of year or do you feel Covid is still putting increasing pressure on staff and services?

There were reports on the BBC of people being banned access to toilets there and twice it was. Believe what you like but that was the reality today.

And the male doctor was clearly at the end of his teather saying he wished someone would burn the building down. But it was just him on his own for one whole ward as far as I could tell and his emergency buzzer was going off constantly. Think most people would be hacked off working like that.

I think the toilet issue is arising because of the delays so when you enter you would normally be checked in in 5 mins or so then you go to waiting area. Bbc was reporting people waiting 4 hours outside A&E for A&E and being told not allowed to use toilets. It may just be a covid A&E issue. But I was allowed in where you normally register but because of backlog you have to sit there for 45 mins and I was classified as red and in red A&E. The male nurse even when I explained I had chronic diarrehea, its been every 30 minutes 24/7 a lot and it can come on in seconds, said I was not allowed to use a toilet until he had done my bloods and they had approved me to move on and when I said he he said I must do as I am told. I am happy to but my stomach had different ideas and seems wrong to me to block toilet access, I dont have a change of clothes. I had to start walking to find a toilet before he asked another nurse who got me moved. It was same on way out there are bed shortages so as soon as you are allowed to go - it was a nurse that did mine as she said no doctors were available all involved in emergencies so she was doing doctors role then - you have to wait outside and because you are classed as red you cant access any toilets. I had no access to toilets for an hour overall.

The male doctor in the one time he did come round ward was being buzzed for emergencies non stop, it was relentless and I thought I heard him tell nurse to only let him know about people at risk of death in next 24 hours. I hope I misheard that. The nurses were excellent and fortunately most of the patients were 40s or younger, only two very elderly, both of those were quite distressed. People were being realised quite ill. It did not seem overly safe to me though not medical. In the waiting room we were all a meter apart for an hour not knowing who had covid and who didnt.

The doctor was annoyed GPs arent doing more. I can understand this but our GPs the average patient is very elderly and they wont deal with anyone with covid symptoms says on website to call 111 instead. Then 111 first time doctor helpful but said to ring back if got rash and appeared concerned about sepsis. Overnight a bad rash appeared so called 111 back who started arguing I could go into GPs and get them to do bloods, a stool sample etc with covid as I was out of 10 day period. It would take about 6 months to get that at our GPs and no way would I want to put elderly at risk either and I was fed up of being expected to put myself at risk and manage with no help. Thankfully backed down and got hospital and overall it was good but normally our hospital is amazing and this seemed very broken. I am probably not making sense completely as no sleep and no food really since Monday. Will leave you to it as at least now I have realised its a HCP thread.

I was admitted to our local hospital at the end of August and can only say that the care and level of staffing on that particular ward was better than anything we have ever experienced over the years. My GP rang the surgical team and I was able to by-pass A n E and be admitted immediately. Two days later I was home having had a minor operation.

If all these wards and departments are one third clogged up with patients well enough to go home but with no social care plan to allow it then surely this is when the nightingale hospitals are needed? If the patients are generally well but still need basic care then surely they could ask for volunteers and student medical staff to staff it. It annoys me so much that the government don’t seem to look in at the main problems and do anything about them. They’re all obsessed with covid which, from these accounts, don’t seem to be the problem other than the knock on effects of other services refusing to see patients.
I don’t know how it works, but I honestly wish a normal, everyday person with some common sense would form a political party where their only aims were just to short this fucking mess of a country out.

In my experience of hospitals, 90% at least of the patients have been elderly. And most of those, as LostinaCloud observes, needing social care rather than acute medical attention.

When df was in hospital for three months for a hip replacement (bad complications), every single other patient had dementia. When I was in hospital for an extended period I was the youngest patient by several decades. The other people were just lying there. When ds broke his arm the other patients in x-ray were non-compos mentis. When I had a mri scan the other patients were also non-compos mentis.

I have a constant refrain about why can't cottage hospitals (or even big Nightingales) be recommissioned for those who are long-term patients? I understand staffing would be a problem, but the idea of it being part of medical training seems a good one. In Italy trainee doctors have to complete ambulance work.

Staff are predominantly off sick @Tuba437 with stress because we got shat on from such a great height over covid and got given a single pizza instead of a pay rise!

Not to mention in our trust they begged for staff to come in and promised double rate, back tracked when substanive staff booked them as bank shifts and said "zero hour contract holders only", then didn't even fucking pay or bank staff the double rate anyway. So now a huge amount of our bank staff have fucked of elsewhere to work for Agency rates.

So yes, it is bollocks.

I work as part of a medical team covering two wards (roughly 60 patients). All 4 of our consultants are currently either off sick with covid or having to self isolate due to family contacts. This was bad enough, but now our senior reg is also off as his children tested positive. This leaves a group of SHOs and PAs being lead by two very new Reg’s who only joined the NHS in the last couple of months.

The lead consultant is having to do ward round on new and critically ill patients from home via WhatsApp video call, as there is no one else to do it, and we have no other IT set up.

Luckily, due to awful staff shortages in nursing homes and community care, most of our patients are medically OK, and just stuck in hospital waiting.

There are several problems in the NHS right now.
Staffing: In the NHS,for clinicians, if anyone in your household tests positive, you cannot work for 10 days. You can do everything else but not go to work. This causes endless absences.
Also, because people are becoming less good at masks and hand washing, people are off sick with colds. We are getting them badly as our bodies have not been exposed to germs for 20 months and because staff are tired.
Logistics: Hospital patients are tested every few days for Covid. If they have Covid on admission they go to a Covid ward. If they don't but later test positive(usually asymptomatic) they have to move to a side room or red ward and the other 5 patients in the bay are deemed to be' exposed' so have to be treated as if they might have Covid. This means no one can be admitted to that bay and if those patients need care on discharge our live with a vulnerable partner or need rehabilitation, they then have to remain in hospital for 10 days unnecessarily. So you end up with non Covid wards unable to admit more patients because of the exposed bays.
Community Support: there is a new model being pushed called discharge to assess. It is a good idea born from the historic hospital delays when patients needed support on discharge and CHC and social care would take weeks arguing who was responsible for paying. Now, everyone is supposed to leave hospital with a short term package of care or short term community bed whilst the arguments continue in the community. This has meant that in our area, social workers have left the hospital and community rehab units and complex patients, rather than have a long term plan made in hospital, sir and wait for weeks for short term beds and packages of care because they all get discharged via same bottleneck. We have over 100 patients who do not need to be in hospital but nowhere to move them to.
Care agencies have lost unvaccinated staff and also have staging issues with staff staying at home with Covid positive kids etc.
Our hospital is not overwhelmed with poorly Covid patients. Half of them are asymptomatic, but we are in business continuity as we try and work out logistics and staffing. Flu admissions are also on the up.

My elderly DF was sent by his GP to A&E for an emergency scan to rule out a stroke. DB drove him but wasn’t able to wait with him due to the hospital’s Covid policy.

DF waited 8 hours for the scan (he was at least triaged within 2 hours). He’s ok, but spending that long without support (plus vertigo, nausea, etc) in the waiting room was tough on him.

Thankfully he didn’t have a stroke, but it really brought home how A&E is absolutely up against it, and it’s still only autumn.

Can I ask here what happens if someone admitted has had covid in the last 90 days. Do they get PCR tested or as they wouldnt normally be expected to take a PCR for 90 days do they get a lateral flow test or are they just put in a covid ward anyway?

Not a HCP but know quite a few and hearing the same stories of stressed out people, no beds available and patients waiting hours to be seen in a&e.

If people went back to wearing masks over winter and saw fewer people babies would still be exposed to other infections, just more gradually, becauseno-one is suggesting you stop seeing everyone.

Ward staff wouldn't know that they'd tested positive three months earlier.

We wouldn’t swab them if we had evidence they’d had covid in the past 90 days. So that’s only if it’s on the patients GP record, and they’ve consented to GP connect so we can see it.