Can someone in the know please explain how an A&E dept works.

[MegaLegs]

I seem to have spent a fair few hours sitting in A&E with one or other of my four DSs over the years.

At 6.30 last night DS2's bed time pre bath bed bounce ended in disaster as he smacked the back of his head on the radiator cue, screams, blood and a 10 min drive to A&E.

We waited for over 3 hours before he was cleaned up and glued in less than 5 mins.

The dept didn't seem to be that busy, there were loads of docs and nuses milling about - why does it always take so long?

I'm not asking this in a ranty way, I'm just curious as to why there is always such a long wait.

could of been due to a shift change
and also they do have some pretty ill patients in the bays
could of been short staffed

I will be watching this with interest. I too have never understood how it works at A&E. I always get the same impression as you, that there are staff around but no real order to the proceedings as it were.

Im not going to say anymore just yet in case I offend a hard working A&E nurse who is about to come along and explain it all

how old is he? Children under 7 and OAPs are generally given priority after 6pm

There were a couple of patients in the bays but they were on monitors and had no staff with them. There were a lot of limping sportsmen and a few cut hands.

At 10.00 I asked a passing nurse if it was possible we had been forgotten, she checked and said there were two in front of us but didn't know how long they would be.

Another nurse could see ds was nearly asleep, offered me a cup of tea and ds a squash. She then said that if I was happy that ds wasn't concussed she'd clean his head and glue it. DS was fine so I agreed. She was brilliant and I did that sad thing of crying because someone had been nice to us.

He's 5 mp and the triage nurse said that he'd be a priority - that's why I wondered if they'd forgotten us.

They can't treat people if the beds are full, and it can take forever to move people from the A&E beds to a ward. When DH went into A&E with pneumonia he was waiting for ages (6 hours!) before they could find him a bed. In the mean time he was making an A&E patient wait because he was blocking the bed. Doctors weren't doing anything with him once he was on an IV, it was all waiting for him to move. Most of the other people there seemed to be doing the same - waiting to be transferred, waiting to go for tests etc, but at the same time it looked like there was nothing going on!

In our local A&E kids are sent into a separate area and are seen and assessed very promptly (you may have to hang around for a doc, or to be sent to a ward).....niavely thought they all worked like this,..

we always have to wait hours, even in the middle of the night, in the meantime emrgencies come in the "other" entrance and need seeing to. you see a triage nurse to assess you first. then as someone mentioned, it's the space and obviosly emergenices taking up people's time. If you have a minor injuries department near you sometimes that is a better bet.

usually people who are going to be admitted are moved into mau, then moved to wards, it can be a nightmare as if the beds are not avaliable on the wards, then patients cant be moved from mau, which means people waiting for beds can be stuck in casualty waiting to go to mau and so on and so forth, so although it may not appear very busy, it could purely be down to there not being an avaliable cubicle etc, also its possible that a lot of staff could have been tied up in majors(heart attacks, rtas etc) which you might not have been able to see from where you were waiting.

I also presume after each patient is seen a report is done. Most of the Docs were sitting at computers.

BandofGold - there is minor injuries unit near here but my lot only seem to have accidents out of hours. The unit is open mon-fri from 9 - 5.

computers, perhaps there were on docs.net

That did cross my mind BoG

they were probably on ebay

seriously, they were most likely looking up test results etc.

A&E uses triage to prioritise and assess clinical need. Triage assessment will determine your waiting time

in busy departments yes it can be hours to get a steristrip and cleaned up

then u are either seen and clerked in and receive treatment in A&E or Medical Ax unit for observation

the staff milling about may be treating pts elsewhere in bays, so not necessarilly dossing about

when i worked A&E i do remember being RUSHED off my Feet

however communication should be better and u should be given a realistic expectation of waiting time