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Is care in A&E good enough?

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crazychica On March 13, 2011
A taste of insanity





Aberdeen, United Kingdom
#1New Post! Apr 20, 2009 @ 17:16:32
I was reading on the sky news website about the older patients who had been inproperly medicated and died and one of the related stories was a video on A&E care in NHS hospitals and it made me think.

As some of you know, I had my gallbladder out on the 17th March and was released the same day (Tuesday). By Friday, I had become really sick and was taken back in by Ambulance. The paramedics were amazing, they really took care of me and my mum who must have been out of her mind. They calmed me down, told me that I wasn't too hot but had a dangerously low body temp and just let my head sit where I was getting a draft.

But the in the hospital it was nuts, typical for a weekend in A&E but that's another issue. I was brought in with pain which had actually made me bite chunks out of the sick bowl that I'd been given on Tuesday in case I was sick in the car, just trying to stop myself yelling. I had really horrible pains in my chest, right down the sternum, and in my stomach. They came and went but when they were there...It was pure torture because I couldn't get pain relief until I saw a doctor, and that took about 2 hours. At one point the pain got so bad that instead of just griping the side of the trolley or folding, I was actually writhing a bit and couldn't stop myself giving a moan that sounded a lot like screaming. An old lady across from me in the corridor shouted on a nurse who came and then told me to "Stop screaming. You're scaring the other patients". Never mind how scared I was or that fact that I couldn't stop the noise, it was totally involuntary.

The old lady came in at the same time as me and walked out because she was in pain too and saw the way I'd been treated. Then they actually lost me. The call went out in the waiting room for me when I could finally see a doctor when I was on a trolley in the corridor. If my mum hadn't been there they would have assumed I had left and got the next patient.

To make the whole thing worse, walk-ins were getting at least paracetemol and ibuprofen when they saw a triage nurse and this is what the doctor gave me because he thought I was just constipated. I was just grateful to finally have something to stop it. When my body temp jumped up again, he finally decided it could be an infection and gave me morphine and anti-biotics, saying to my mum, "She must have been in a lot of pain".

This is just one hospital, I don't know if they all have the same policies in A&E but is this really acceptable? Is it really ok to have patients like an old man I saw, who had an oxygen mask, to be left in corridors without pain relief for upwards of two hours? And what level of care are you getting while in pain only surpassed by that time you shattered your wrist and forearm is simply to be told to shut up? What's going on? It's the National Health Service, something we all pay for to be there when we need it, so why is it letting us down?

jonnythan On August 02, 2014
Bringer of rad mirth


Deleted



Here and there,
#2New Post! Apr 20, 2009 @ 17:18:38
@crazychica Said
It's the National Health Service, something we all pay for to be there when we need it, so why is it letting us down?


No competition. Guaranteed, law-enforced revenue stream means low motivation.

In the US, I would have walked out, gone to the other, competing hospital down the street, and lodged a formal complaint with the insurance company.
crazychica On March 13, 2011
A taste of insanity





Aberdeen, United Kingdom
#3New Post! Apr 20, 2009 @ 17:21:29
@jonnythan Said

No competition. Guaranteed, law-enforced revenue stream means low motivation.

In the US, I would have walked out, gone to the other, competing hospital down the street, and lodged a formal complaint with the insurance company.



Not sure where the next hospital with an A&E is. Maybe Dundee. But either way, this should not be happening.
angelcake On January 18, 2016
Say whaaa





Eastleigh, United Kingdom
#4New Post! Apr 20, 2009 @ 17:24:54
It depends. The NHS is usually running pretty damn understaffed.

I have personally found a&e to be very good when I've been in for a 'proper' emergency it's once I get onto the ward that bad things seem to happen. A&E nurses especially seem to be changing speciality because they are dealing with abuse from patients that is unfair and unnecessary especially when alcohol is involved.

The doctors and nurses *do* care but are being failed by the system also.
karljkampovsky On May 13, 2009

Deleted



undisclosed location,
#5New Post! Apr 20, 2009 @ 17:25:08
Even in the greedy USA patients who are indigent or not insured,are treated in the exact same way,I think its criminal!Doctors take an oath to not do harm,allowing sick patients to languish for whatever reason, is harming them!
40isnotsobad On December 07, 2010




Houston, Texas
#6New Post! Apr 20, 2009 @ 17:25:09
This is exactly why I do not want any kind of National Health Care in the US!
angelcake On January 18, 2016
Say whaaa





Eastleigh, United Kingdom
#7New Post! Apr 20, 2009 @ 17:27:28
@karljkampovsky Said

Even in the greedy USA patients who are indigent or not insured,are treated in the exact same way,I think its criminal!Doctors take an oath to not do harm,allowing sick patients to languish for whatever reason, is harming them!



There are only so many doctors on at one time, if 3 people come in with critical injuries and there are three doctors the non critical people have to wait. Yes they made be in pain but they aren't going to die from it.

They aren't breaking their oath by prioritising people.
crazychica On March 13, 2011
A taste of insanity





Aberdeen, United Kingdom
#8New Post! Apr 20, 2009 @ 17:31:05
@angelcake Said

It depends. The NHS is usually running pretty damn understaffed.

I have personally found a&e to be very good when I've been in for a 'proper' emergency it's once I get onto the ward that bad things seem to happen. A&E nurses especially seem to be changing speciality because they are dealing with abuse from patients that is unfair and unnecessary especially when alcohol is involved.

The doctors and nurses *do* care but are being failed by the system also.



I've usually found it to be the other way around, except for one time when the ward was majorly understaffed but I still think I should have been given something. I wasn't abusive but even before the screaming I had been begging the nurses to stop the pain, literally begging.
angelcake On January 18, 2016
Say whaaa





Eastleigh, United Kingdom
#9New Post! Apr 20, 2009 @ 17:34:21
@crazychica Said

I've usually found it to be the other way around, except for one time when the ward was majorly understaffed but I still think I should have been given something. I wasn't abusive but even before the screaming I had been begging the nurses to stop the pain, literally begging.


I didn't mean you were being abusive but in a busy a&e on a weekend I can almost guarantee someone would have been.

The thing is you can beg nurses to give you pain relief until they are blue in the face but unless they have undertaken specific training they cannot administer drugs without a prescription/order from a doctor. Some nurses can and some can't it's not a requirement to work in hospitals or anywhere else.
karljkampovsky On May 13, 2009

Deleted



undisclosed location,
#10New Post! Apr 20, 2009 @ 17:35:10
I understand triage,but in the USA people have died in waiting rooms,because superficial assesment of thier problems was done! Just because a person does not have insurance is no reason to let them die! I cannot say anything about National Health in UK,I don't have direct knowledge!
crazychica On March 13, 2011
A taste of insanity





Aberdeen, United Kingdom
#11New Post! Apr 20, 2009 @ 17:36:52
@angelcake Said

I didn't mean you were being abusive but in a busy a&e on a weekend I can almost guarantee someone would have been.

The thing is you can beg nurses to give you pain relief until they are blue in the face but unless they have undertaken specific training they cannot administer drugs without a prescription/order from a doctor. Some nurses can and some can't it's not a requirement to work in hospitals or anywhere else.



I know but it's still all just so ridiculous. To be fair, when my body temp finally normalised I was shivering and they did give me warmed blankets when I asked but I would even had swallowed paracetemol if they could have given me thaat, just to take the edge of it.
angelcake On January 18, 2016
Say whaaa





Eastleigh, United Kingdom
#12New Post! Apr 20, 2009 @ 17:37:19
@karljkampovsky Said

I understand triage,but in the USA people have died in waiting rooms,because superficial assesment of thier problems was done! Just because a person does not have insurance is no reason to let them die! I cannot say anything about National Health in UK,I don't have direct knowledge!



As far as I was aware the hospitals in the US had to treat critical patients whether they had insurance or not.

Wrong diagnosis do happen quite frequently with some conditions, gall stones or gallbladder problems is one. It's unfortunate but not the doctors breaking their oath.
angelcake On January 18, 2016
Say whaaa





Eastleigh, United Kingdom
#13New Post! Apr 20, 2009 @ 17:42:05
@crazychica Said

I know but it's still all just so ridiculous. To be fair, when my body temp finally normalised I was shivering and they did give me warmed blankets when I asked but I would even had swallowed paracetemol if they could have given me thaat, just to take the edge of it.



But the thing is quite often they can't just give you drugs they need to have it cleared with someone like the doctor especially if you don't have a diagnosis. If they gave you a drug which caused a reaction and you had a fit and subsequently died, I can assure you people would be more pissed than you are for being in pain for a couple of hours.

If they don't know what's wrong it's not a very good idea to go around dishing out drugs and without a doctor present, whether the nurse could give drugs or not, it may well complicate your existing problem.

Yes it's a pain in the arse and yes it's not nice to be in pain but it's safeguarding you not just themselves. Like before you had your gallbladder surgery I'd guess you were 'nil by mouth' at least over night if you had to go in for emergency surgery and you'd had something then it can complicate surgery too.
crazychica On March 13, 2011
A taste of insanity





Aberdeen, United Kingdom
#14New Post! Apr 20, 2009 @ 17:49:58
@angelcake Said

But the thing is quite often they can't just give you drugs they need to have it cleared with someone like the doctor especially if you don't have a diagnosis. If they gave you a drug which caused a reaction and you had a fit and subsequently died, I can assure you people would be more pissed than you are for being in pain for a couple of hours.

If they don't know what's wrong it's not a very good idea to go around dishing out drugs and without a doctor present, whether the nurse could give drugs or not, it may well complicate your existing problem.

Yes it's a pain in the arse and yes it's not nice to be in pain but it's safeguarding you not just themselves. Like before you had your gallbladder surgery I'd guess you were 'nil by mouth' at least over night if you had to go in for emergency surgery and you'd had something then it can complicate surgery too.



Yeah but every time I've been in an A&E as a walk in,except when I broke my wrist because that was pretty much straight to a doctor, for whatever reason, the triage nurse has always given me some paracetemol, ibuprofen or both to help with the pain. Then, after I've seen a doctor, I've been put as 'nil by mouth'. This is only the second time in my memory that I've ever not been given something to help with the pain, including the time my ankle looked broken (not that I needed the pain relief because I could only feel my leg if someone touched the giant lump). This was less than the broken arm but more than anything else I'd ever felt and all anyone could say was, "Stop screaming, you're scaring the other patients". Not to mention that they actually lost me!

My gran says that you should never complain about the wait because there's always someone worse but that's not much comfort when you're trying to sleep so that you won't have the nurse yell at you again and are trying to supress the thought "I just wanna die. It doesn't hurt if you're dead".
angelcake On January 18, 2016
Say whaaa





Eastleigh, United Kingdom
#15New Post! Apr 20, 2009 @ 17:57:08
@crazychica Said

Yeah but every time I've been in an A&E as a walk in,except when I broke my wrist because that was pretty much straight to a doctor, for whatever reason, the triage nurse has always given me some paracetemol, ibuprofen or both to help with the pain. Then, after I've seen a doctor, I've been put as 'nil by mouth'. This is only the second time in my memory that I've ever not been given something to help with the pain, including the time my ankle looked broken (not that I needed the pain relief because I could only feel my leg if someone touched the giant lump). This was less than the broken arm but more than anything else I'd ever felt and all anyone could say was, "Stop screaming, you're scaring the other patients". Not to mention that they actually lost me!

My gran says that you should never complain about the wait because there's always someone worse but that's not much comfort when you're trying to sleep so that you won't have the nurse yell at you again and are trying to supress the thought "I just wanna die. It doesn't hurt if you're dead".


If you were taken in as an ambulance it's a much different thing than walking in by yourself.

Given your history (recent abdominal surgery) if they had to go back in eating or drinking anything would screw up anaesthetic calculations. A broken arm/leg isn't as likely to need instant surgery and after assessing the injury they took into account your risk.

I'm not saying the nurse who told you to shut up was right, but at the same time you don't know what she was doing and how rushed she was. You may well have been the straw that broke the camels back.

It's an incredibly stressful job, where they are understaffed and s*** on from a great height constantly. In the vast majority of cases any lack of care or poor care isn't because the staff didn't want to do it properly but they just don't have the man power to do it.

Apart from telling you off for screaming it doesn't sound like they did anything out of the ordinary or that would class as mal-practise.
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