Monday, 30 April 2012

Seven Hours In A&E

This is in no way meant as a critique of the NHS which, as everyone knows, is a National Treasure - rather a description of what I saw during my Saturday at A&E.


Yesterday morning when I got to work at 10:00 there was an ambulance parked outside. One of our residents, Barry, who has had a stroke was in some difficulty and was being taken to hospital. My colleague Jackie told me that she thought a second resident, Chester, may also have to go to the General. To cut a long story short, I accompanied Chester to the hospital in the ambulance and it just so happened that he (and I) ended up in a bay next door to Barry. But only after 20 minutes in the gangway getting in everybody's way.

I had no money with me for a start, meaning I had to rely on the free water and juice provided, plus one cup of tea I managed to beg from an orderly. That was fine because I didn't expect to be fed and watered and it kept me sharper for my earwigging and general nosiness. Chester is 86 and Barry is 82 and during the whole time we were there Chester wasn't offered a drink - when I asked the orderly for one for him she told me that 'the nurse' said he wasn't allowed one. Barry was given a cup of tea though - sadly, due to his stroke he only has use of one arm and hand and couldn't get the cup from where it'd been left 3 feet away. From about 12:45 meals started to be brought to the department. I think the distribution must've been quite arbitrary because Chester was allocated food by the senior nurse (despite him being in obvious stomach pain from a twisted bowel) whilst Barry was given nothing. I was able to get permission to give Chester's meal to Barry - roast chicken with stuffing; roast spuds and some carrots that could have done double duty as small orange discuses - but I had to feed him since there was no way he could've balanced it on his stomach and eaten it with one hand, and there was no table available either. All I kept thinking was 'what would either of these guys have done if I hadn't been there?' Additionally, neither Chester nor Barry can speak coherently - Chester has dementia and Barry has had the stroke - so it would have been impossible to get any details from them had I not stuck around. There were plenty of staff members around; nurses, senior nurses, auxiliary types, even one or two doctors but nobody to just check folks were drinking or were able to eat the food that was being given out. Having said that, the nursing staff was constantly on the go - there was none of this standing around gassing about their personal life like you see in 'Casualty'. But then there was none of the chatting to patients and solving their problems like you see either...

Throughout the hours I spent darting between Barry and Chester there was a constant stream of people being brought in on stretchers, most of them elderly though some were middle-aged. The majority walked out again under their own steam, within a couple of hours - one even had the strength/energy/whatever to argue over whether his friend, who had followed him in in her car, should have to pay for the 3 hours of parking she'd bought. From what I could glean most people were, or had been, suffering from 'chest pains'...I'm guessing Saturday morning is a prime time for this. Or they had fainted. Nobody came in and had a crash team working on them or had masses of blood on them. There was no sense that anything emergency-like had happened. And everyone had friends, or family including small children, with them. I couldn't get over it because there is a perfectly good and really very efficient 'Walk-In Center' in the city. It's a sort of buffer between a doctor's surgery and the A&E Department - I've been twice recently with Red and would recommend it 100%.

So what are these people doing, clogging up the Health Service, and how much could be saved if they made their own way to the Walk-In Centre? They clearly have people who can drive them around, and they clearly are not really ill (as in not suffering from something critical necessitating emergency treatment)....is that called 'the worried well'? It got me wondering how different it would be if the people at A&E yesterday had been required to pay at source for their treatment, rather than pay through their National Insurance. I'm not advocating the kind of situation we read about in the US where uninsured patients are dumped on the street after receiving emergency treatment but there has to be some kind of check put on the use of our scarce resources. I really don't see that we can continue to spend the kind of money we are spending on health but the problem is that our NHS is such a sacred cow that to try to change it in any way is seen as completely awful and beyond the pale. I don't know what the solution is but before too many years go by I see the inhabitants of the UK having to be insured. Our NHS is good but it's not great, and I don't think we should expect it to be...we just don't pay enough for it. What do you all think?

Barry was admitted with a very nasty chest infection after four hours in A&E; Chester was admitted after six and a half hours in Bay 5, with the possibility of an operation on his bowel; and outside, on my way to get my lift home I passed a chunky girl and her boyfriend, both smoking furiously and arguing about walking home (her choice) versus getting a cab (his choice). She had been brought into A&E on a stretcher two hours earlier......



10 comments:

  1. The socially and morally inept people clogging up the triage at A+E of a weekend, can be found clogging up the GP surgery, job centre, social services, courts, citizens advice and solicitors offices through the week.
    There are far too many needy people in our society. Failed by their families, the education system, and every other system designed to socially cleanse our supposed 'demicracy'.
    My home town is choc-a-bloc with obese middle aged people who have never worked, heroin addicts, young parents, and people with mild learning difficulties and mental health issues who are discarded after leaving education.
    The NHS should NOT be cleaning up people's tears after a boozy weekend, should NOT be dealing with headaches and dehydration, and should not be seeing the elderly as a burden or nuisance.

    Was that a bit much for a Monday morning?

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  2. In South Africa, if you want good (no, make that excellent) health care you pay for insurance. If you go State care, prepare to rot in hospital at worst, or receive the most basic care at best. That's what will happen here if adequate steps aren't taken to prevent it.

    My Mum (in South Africa) has just faced the dilemma of going off her health insurance because of the high cost. She thoroughly investigated State care and came to the conclusion that she would have to cut her costs in other places because State Health is too appalling to risk. (Her GP even advised her not to go State.)

    So for me, no matter how inadequate the NHS is in some areas, and how it can fail some people, I still think it's the bees knees and Britain is super duper lucky to have it. It should be cherished for the huge privilege it is.

    Shame on all those scroungers who abuse the great benefits this country offers. When it's gone, crushed and demolished by the sheer weight of abuse of the system, they will all complain bitterly and point fingers wildly, but will only really have themselves to blame.

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  3. I agree totally with your thoughts on this. I also think that the elderly are 'pushed aside' in the treatment stakes. I also agree with Wendz that we are lucky to have an NHS and Lucewomen about the drunks and substance abusers.
    However, our local hospital (Stafford) the one that's been in the news over the last couple of years has closed it's A & E department between the hours of 10pm & 8am since last December. It looks like it won't re-open until at least June. I find the problem with this is that a lot of genuine cases happen (especially the elderly) during these hours, and they're being re-directed to Wolverhampton approx 8 miles or Stoke on Trent approx 12 miles, and wonder just how many folk will loose their lives whilst precious minutes are wasted travelling to the alternatives. Maybe, one day someone with a little sense will come along and sort this out - but seriously I doubt it...
    Hope Barry & Chester get sorted, and shown the respect they deserve whilst in the NHS's hands.

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  4. Dear Keeshling,
    I understand if you wish to delete this comment and would not be offended, but there is a petition and action group called 38 degrees fighting for the NHS (and other important matters), you can take a look here https://secure.38degrees.org.uk/page/s/what-next-on-the-nhs-#petition
    Thank you
    Rose H

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  5. Sorry, slipped up and didn't check spelling of your name Keshling :o( apologies.

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  6. Good post highlighting the absolute lack of thought and concern given to our elderly in hospital. Well done Keshling!
    Liz @ Shortbread & Ginger

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  7. Last week in a casualty unit I "caught" a woman who fainted having a panic attack - she landed on me on the way to the floor. When I shouted for "help" a nurse came quickly, but no-one helped ME, despite me saying that I was not with this woman, I just happened to be beside her as she started to fall and I tried to break her fall! I agree with the comments above, because the overworked underpressure staff are so scared of litigation that they don't tell folk to go elsewhere to seek help if it is not an ACCIDENT or and EMERGENCY; then there's not enough staff to help when someone collapses at the reception desk!
    (rant over)

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  8. I should add that I was at the desk discharging myself having been brought in via ambulance after a faint in a public place: I knew I was fine, but was advised to stay there for a couple of hours.
    I never knock the NHS - I'm knocking the abusers of the service. FM xx

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  9. It's not that different from the state of our Emerg Rooms here in Canada.

    You are considered NPO until seen by a resident. Then they decide if you can eat or drink. Meal service is only for those who are "holding" until a bed is available.

    If you are a genuine emergency, it's fast and brilliant. BUT we get those who have no family doctor wanting prescriptions renewed, trips on the uneven pavement who are convinced they have broken every bone and want to document it so they can start a lawsuit.

    Our ambulance service isn't free, it's around $365 for a trip to hospital, so the vast bulk of people will get driven in by family. The ones who don't hesitate to call an ambulance are either on Welfare or are treat status Indians who have all healthcare costs picked up by our Federal government. If you have extra health coverage from your employer you can get about 80% of the ambulance ride refunded.

    The elderly are over represented in our ERs as well. I've seen seniors dumped by their families because they just can't do it any more. Seniors who demand service because they "built this country" for their constipation. Families go nuts because their senior has to wait because they aren't as sick as someone younger.

    My son had post op complications and when I took him back he was treated in the ER and up in a ward bed in four hours. But a senior complained because he was treated first. Uhm, coffee grounds type emesis and a nasal bleed from a septoplasty trumps your "I ran out of anti-inflammatories and my doctor is out of town".

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  10. I think it not only depends on where you live but what time you visit A & E. My OH had a prolonged and messed about visit with chest pains, last July. However last month, very early on a Saturday morning, our A & E was empty and he was looked at and discharge within 2 hours 15 minutes.

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