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To think 4 hours isn't that long a wait in A&E

(77 Posts)
lisad123everybodydancenow Wed 20-Feb-13 19:46:41

Message withdrawn at poster's request.

Sharpkat Wed 20-Feb-13 22:58:26

I had amazing care in a major London a&e on Sunday night and they were so busy. I had a major UTI and had not passed urine for 36 hours (TMI). When they could not get the catheter in they respected my wishes to have a break and calm down (they had made 3 attempts) and my friend was crying as it was obvious I was in agony.

They could not have been kinder and did everything they could to help me and were so understanding that I was in agony.

I would not normally go to a & e for something like that but it happened about 6 weeks ago and so NHS Direct told me to go urgently this time.

I have had some shocking experiences in the past but there was one particular nurse there who made the NHS so much better than the private care I have had elsewhere.

Spoonful Wed 20-Feb-13 23:06:58

I have never had a bad experience with A and E.
They do reassess you in the waiting room if you deteriorate and they do take into account your general 'vulnerability' in my experience.

expatinscotland Wed 20-Feb-13 23:07:00

'4 hour wait from admission through to diagnosis/discharge is not too long, depending on the medical condition presented. Some things takes a long time to investigate, other opinions are often sought after, more tests are needed and other professionals required to decipher the results of said tests. Many things need to be ruled out in order to ensure a safe diagnosis is reached. I am sure you would prefer to wait 4 hours and know you are okay, than to be rushed out and something serious to have been missed.'

This. When DD1 was sent to A&E (at a major children's hospital), a junior did come out and see her in the waiting room and explained that there was discussion as to how best to treat her. I know now that her GP rang ahead with concerns DD1 had a serious blood disorder (boy, did she ever! The granddaddy of blood disorders alright) and haemo were involved already. So we did wait a while, then waited more for blood testing and canula insertion. Then some more for the junior to come back, with a consultant in tow.

Basically, we got there around 1PM and it was around 7.30-8 when we were assigned to a bay in a ward, where we stayed until the consultant haemotologist came up to tell me she had leukaemia.

Believe me, when you're that life-threateningly ill, things move fast!

I'd rather wait, tbh, than be that person who needs to be treated pronto.

I'm in two minds.

I do see that someone with dementia, or anyone whose pre-existing condition is likely to make things much worse for them, should be seen quickly if possible.

But I wouldn't want to see someone whose condition wasn't so much of a medical risk take priority.

Ideally there would be someone to come and calm you down. There were volunteers in one of the hospitals my gran was in who'd come and take someone with memory issues for a cup of tea, and sit with them. They were not trained as far as I know, but were a godsend. But of course once you rely on people like that, you have to train and pay them, so it might not be economical.

I don't know. sad

yaimee Wed 20-Feb-13 23:17:08

ldr the idea of volunteers is a good one, I didn't know that happened, I think that a person there to reassure you if you are alone and vulnerable would go a long way towards making a horrible situation barable.

Sirzy Wed 20-Feb-13 23:19:58

I'd rather wait, tbh, than be that person who needs to be treated pronto.

This, thankfully we have never had anything anywhere near as bad as what you went though expat but in all the times DS has had to go to A and E we have never waited more than 30 minutes to see a doctor because each time he has been in with breathing difficulties.

The first time he went to A and E he was 8 weeks old and we were taking through immediatly because he was so poorly.

It really pisses me off when people complain that others have gone in before them when that is becaus that person has a much greater medical need.

I was wondering myself, as I typed it, how common it was. Of course it was the last thing I wanted to ask them at the time as I was constantly wanting to drop her off at the door and go to park my car, as she couldn't walk far and was very distracted.

I do think volunteers in hospitals can be absolutely amazing, though. Just having someone to come along and tell you it's fine, you're in hospital - that could go a very long way.

lisad123everybodydancenow Wed 20-Feb-13 23:24:37

Message withdrawn at poster's request.

Ah, I'm sorry. blush

Excuse me.

yaimee Wed 20-Feb-13 23:29:19

Glad to hear she wasn't by herself.
I posted further up the thread about a lady who I'd seen in a&e and I was quite upset about the situation she was in (8hr wait, on her own, in a wheel chair, covered in sick). I was more thinking of her when asking about the volunteers.

Redbindy Wed 20-Feb-13 23:38:08

Nothing was said about other patients. If this woman showed up to an empty A&E and was ignored, that is indeed terrible. If there was a load of other patients who were in more need of treatment, then this is another non story.

sashh Thu 21-Feb-13 00:52:55

I work in a pharmacy on a Sunday and there is a never ending stream of A&E scripts for eye drops, paracetamol and anti-biotics - with the best will in the world if you can walk around a pharmacy looking at hair colours and chatting to your mates on the phone, then you could have probably waited until your GP was open on the Monday

Not always. I get iritis. When it happens I have to go to A and E. The pressure has to be checked and my GP does not have the equipment. The blast of air at the optician's isn't accurate enough either.

Fortunately for me, when they closed the eye hospital, they moved the eye a and e but kept it separate so I don't have to wait as long and I don't take up the time of a Dr / nurse dealing with major traumas.

AvoidTheTrees Thu 21-Feb-13 07:28:49

Sashh - I am not saying that all are undeserving, but in my opinion, the opinion of the A&E staff I know and if you read the PCT / CCG board papers then a high percentage of them could have waited for a GP appointment, gone to an out of hours GP or bought some ibuprofen.

It depends doesn't it - the 4 hour target does mean that someone will be seen because they're at 3 hours 55 minutes while someone with greater (but not life threatening) clinical need waits. Or, as someone mentioned they'll get shipped off to the pretend ward next door, which isn't really a ward, but isn't A&E so decreases the number of 'breaches' (of 4 hours). As you are assessed more on meeting 4 hours than your clinical care (so managers care more about 4 hours than clinical care even if medical staff don't).

Extra staff needed far more than targets IMO.

Having said that whenever I have taken ds1 (severely autistic) to A&E we have never waited at all. Last time I went they called him through before I'd even given his name (it was a return visit a few days after the initial one) and they said 'we saw you on the camera'. He jumped the x ray queue as well.

MercedesKing Thu 21-Feb-13 07:44:08

Ditto.
YABU.

DomesticCEO Thu 21-Feb-13 07:49:44

Saintly I agree. My brother is a senior staff nurse in an exceptionally busy A&E and the cases he has to deal with sometimes are unbelievable. But then often on MN posters are advised to rush to A&E for the most minor of complaints.

He also gets sick of the amount of time spent looking after drunks wasting his time and getting abusive.

If so many people didn't abuse the system then those in real need wouldn't wait so long.

varicoseveined Thu 21-Feb-13 08:31:59

My elderly mum had a fall and was seen by the triage nurse for her sore wrist. She took one look and said to go straight to A&E. Within an hour she was seen, x-rayed and had a plaster cast put on. Thank God for the NHS I say.

lisad123everybodydancenow Thu 21-Feb-13 08:55:17

Message withdrawn at poster's request.

HellesBelles396 Thu 21-Feb-13 09:07:40

when my dad had a stroke, he was seen straight away; when he had hypothermia after passing out on a walk (alone, in the evening at the beach and was there all night), he was seen straight away; when I was having acute chest pains while the whole family was being tested for a blood-clotting disorder, I was seen straight away; when my son was screaming because of abdominal pain, he was seen straight away; when my mum couldn't breath, she was seen straight away.

if you're not seen quickly then, chances are, you're in the wrong place.

the choose well campaign needs ramping up imo. if you're injured - go to miu (you're seen faster and the triage nurse at a&e will send you there anyway).
if in doubt call oohgp or nhs direct - they'll tell you where best to go. thankfully, it's rare to be so ill that minutes make a difference so it's better to work up the nhs chain than down.

rant over.

perplexedpirate Thu 21-Feb-13 09:12:58

Neither my brother, my mother or myself would be alive today if it weren't for the NHS.
Free at the point of use medical care is the best thing we have in Britain IMO. If I have to wait 4 hours to use it, so be it.
YANBU.

slhilly Thu 21-Feb-13 09:52:37

Some really thoughtful comments here, vv interesting. For what it's worth, in my view moralising or complaining about people turning up at A&E for non-urgent issues is a waste of effort. Social marketing might be able to shift some behaviour (particularly if it looks to the dreaded supermarkets who are really quite good at shifting the public's behaviour patterns); berating people certainly won't, especially as they may have very valid reasons for going to A&E, such as finding it difficult to get an appointment with their GP.

But as important as social marketing may be, we also have to design systems to deal with how patients use the service. And lots of people have urgent need for help with minor issues (somewhere between a half and three quarters of all people turning up at A&E), and it should be feasible to treat them in dedicated facilities at a high rate of knots in such a way as to avoid tying up lots of very experienced A&E consultants and very expensive kit. That's the logic behind the notion of an urgent care centre.

In London in particular, we need more urgent care centres and fewer, but bigger and better, A&Es. The urgent care centres should be able to have people in and out the door in an hour. The A&Es can then focus on the serious injuries and illness, and can be seeing enough patients to staff properly (eg 24/7 consultant cover). This is precisely what is behind the plans for North West London that were signed off this week, which a poster referred to (there are also big plans to improve primary and community care). The longer travel times are a worthwhile price to pay for being able to provide a better service at A&E.

Chattymummyhere Thu 21-Feb-13 10:28:33

In do hate the long waiting times however one time when my youngest was just toddling somehow managed to get past daddy and the first I knew she was at the bottom of the stairs we where straight though although she was happy and fine in her self. We drove to the hospital, checked in got seen by the nurse who then took us straight to a cubicle and then took us into resus as they have better equipment. Little one was happy and fine but because it was a possible top to bottom fall they acted so fast we was in and out within the free 30min parking time!

I think once you have seen the resus room you realise just what goes on back there, when we went in you could see 4 curtains closed filled with doctors and nurses our doctor while checking got buzzed for an incoming and you realise just how scary it must be for those people's family members waiting out in reception knowing their family member is in resus. I nearly popped my pants when they said that is where we was going even though our little one looked fine and happy!

Vagndidit Thu 21-Feb-13 11:35:13

Saying that a 4 hour wait is ok in any scenario is exactly why problems will persist within the NHS. We deserve better than this.

Why continue to defend a system that obviously needs a massive overhaul? Embrace the change.

SueDoku Thu 21-Feb-13 11:44:18

Vagndidit - hope that you've started saving now to embrace that change? You'll need a lot of money if the NHS goes...

mollymole Thu 21-Feb-13 11:55:39

IME when you are really very ill you are seen very quickly - if it is more minor,
simple broken bones etc then it will take longer. If you are ill/damaged but it is not life threatening you should not take priority over those that are. Just be grateful that you are able to wait !

There should be more 24 medical centres (not A & E) - this would free up A & E for real emergencies. Where I live it is dire trying to get a doctors appointment, I have seen the doctor at my local surgery who tells me that I need to come back in 7 days time - he gives me a slip to take to reception saying this and the reception tell me I can't be seen for another 2 or 3 weeks,
they say that the doctor 'does not know what the appointment situation is'.
I have also been discharged from hospital care with a note to take to my doctor saying that I need an appointment within 48 hours - take note to GP
receptionist, she says that thetre are no appointments for another 10 days, show her again hospital consultant wants me checked again in 48 hours - her answer 'well go back to the hospital then'.

We need more GPs in local practices that do not open only 9-5 Monday to Friday but 24 hour cover.

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