Thursday, 8 January 2015

A and E.


                                  

Let's get one thing straight; hospital A & E departments are specifically for ACCIDENTS and EMERGENCIES.

They are not dormitories for drunks, or for space cadets seeing pink monkeys, or even for hard pressed nurses to patch-up amateur alcoholic pugilists.

There is a real crisis in our A and E departments, but those who require an aspirin for a headache, or a bandage for a scuffed knee, should be re-directed to the nearest pharmacy or local doctor's surgery; NOT admitted to a hospital department that is specifically designed to cope with serious emergencies.

Only when the time wasters are sorted out will our A and E departments be able to practice the role for which they were intended.

May I suggest a simple triage area at the front door (a couple of hefty bouncers). Admit those who are really in need, and tell all the others to bogger off!


36 comments:

  1. Ok just letting you know how it is down under in a suburban hospital. As you enter the ER you first are seen to by a triage nurse who you tell what is wrong with you. They will prioritise and assess your needs, take your temp and BP and then you pass you to an admin person to take down details. This usually happens within 15 minutes of entering. Then its off to a waiting room. This waiting can take several hours depending on number of drs on duty so you only go if you do indeed have an emergency. There is a small clinic in the ER and any small cuts and bruises, small prescriptions of low dose headache tablets etc are administered here by registered nurses. There is security in attendance and any inappropriate behavior is dealt with. We have a very good service called Nurses On Call. It is a free service that runs 24 hrs a day and if you are unsure if it is an emergency you can call them first from home and they will advise you if you need to attend the hospital. I used this service many times when i was at home with my first baby and thought everything was an emergency.

    We do indeed, live in a lucky country.

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    1. It is being reported daily, back in the UK, that their A & E service is in crisis. I heard a radio interview just recently by someone who had visited several different hospitals to see what was REALLY going on. He reported much of what I describe above; drunks, time wasters, children with pencils up their noses, etc. I'm sure not all hospitals are like this, but if just some of them were sorted out, it would make a huge difference.

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  2. The headlines in our local paper this morning were that A. & E. had record numbers on January 2nd with 150 people admitted.

    One does start by seeing a triage nurse though and there is also White Cross Medical Centre available but they had record numbers on that day as well.

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  3. I thougt at first, becouse of the picture, that it have to do something with what happened yesterday.

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    1. I couldn't bring myself to write about it.

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  4. I blame Jimmy Choo for 50% of A&E admissions on a Saturday night.

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  5. I agree absolutely - it is stupid to see some of the idiots who turn up with the most trivial injuries.

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  6. We live in rural Scotland. My husband fell off a ladder a few weeks ago and somehow managed to land on the sharp edge of the end of the ladder, and it went through his hand. I don't drive so we walked the short distance to our local A & E. Two nurses were on duty but not qualified to deal with A & E! They phoned A & E 15 miles north of us but there was no one on duty there. They phoned the doctor on duty only to be told that he was about to go off duty so wouldn't be able to come out. They then sent us to A & E 12 miles south of us (a neighbour drove my husband) only to be told that the nurse on duty wasn't qualified and there was no doctor. This was early Saturday afternoon. My neighbour drove my husband back home as he was due to go out that evening. Somehow, my husband managed to drive the car 27 miles into the city to A & E. They were horrified that after 3 hours with such a bad injury, my husband still hadn't been attended to. They saw to him pretty quickly. To get to your point, A & E was packed full of people with mild sprains, coughs, colds, people who had run out of repeat prescriptions etc. The doctor actually told my husband that it made a change to have a genuine case to deal with. I have since made a formal complaint to NHS about our understaffed A & E departments in our area. It has been thoroughly investigated and they are now advertising for staff who can deal with emergencies in our area. As I said to them, if there are no qualified staff on duty, they may as well rip down all the 24 hour A & E signs outside the hospitals. In retrospect, I suppose I should have called for an ambulance, but I felt that was extreme for an injury. I always thought that ambulances should be used for heart attacks, major traumas etc.

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    1. That's a terrible story. As for Ambulances, I believe people order them as if they're Taxis.

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    2. They also do this with Police cars in Norwich, dial 999 for a lift home. No word of a lie..

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    3. Well, I used to use Bethel Street nick as a hotel...

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    4. I watch kicking out time on the way past in the mornings...

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  7. Sadly, in the blame culture we have today, medical staff are unwilling to accept responsibility for turning anyone away. The media will just as happily run a headline, 'Man turned away dies in ditch' and demand the resignation of the Health Trust Manager as 'A&E collapsing'.

    My recent experience of A&E was as pleasant as one could expect under the circumstances. I had to sit and wait to see a Dr./Senior Nurse (?) but I expected nothing less, there were probably far more urgent cases than i, but once I showed her the wound, a Consultant was called. I was placed on a trolley in a curtained enclosure and stayed there, being monitored and with a drip in for most of the day before finally being admitted to a ward late at night. At all times I was treated with the utmost courtesy and consideration. I spent three days nil by mouth waiting for a slot in the operating theatre but, as I say, there were many far more urgent cases so being an ex amateur alcoholic pugilist, I was quite content to wait my turn..

    I did spend a night in a London A&E on one of their busy nights many years ago, it was the only chance I had to see an old pal of mine who was the consultant on duty there. Your description fits most of his clientele that evening. He sacked it all and is now a flying doctor in Australia.

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    1. A whole day waiting? I don't call waiting for 24 hrs very efficient! I'm sure they're all very pleasant, but the workload is mostly filled with people who shouldn't be there. If they'd got rid of all the cry-babies when you went in, you probably would only have had to wait 23 hrs 30 mins.

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    2. Perhaps get some Army medics, fresh out of Afghanistan and armed with freedom of liability chits, in to do the triage...

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    3. Hippo has summed the dilemma up perfectly. 'Sadly, in the blame culture we have today, medical staff are unwilling to accept responsibility for turning anyone away. The media will just as happily run a headline, 'Man turned away dies in ditch' and demand the resignation of the Health Trust Manager as 'A&E collapsing'. Lovely to hear from Hippo again. Jan B.

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  8. I agree totally. I fell down on my way to work last September (making sure Twiglet avoided a car that had parked on the pavement, prat). Anyhow, I went A over T and my glasses broke and made a huge hole in my temple, blood everywhere, crying Twiglet. Thankfully hubby hadn't set off for work yet, so after phoning doctors surgery, who told me to go to A & E in case I needed stitches, we popped off to hospital. I reported to the receptionist and within 10 minutes, I had seen a very lovely an efficient nurse, who cleaned me up and stuck my head back together - still have a lovely scar!!
    I was amazed how quiet it was and how quick the process was. However, this was 8.30am on a Friday morning, sure it's another story on a weekend.
    I think if it's a drug or alcohol related admission or a time waster, people should be billed.
    Twiggy

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    1. Many peoples first line of thought is A & E. Rather than phone their GP, they head straight for the hospital.

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  9. I saw on our local news the other day that one hospital has erected a tent in the car park to deal with the overspill.

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    1. I bet it wasn't for the drunks either!

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  10. The last time we were in A&E DD had climbed a railing and got impaled (scared me half to death) the place was full of drunks, 4pm in the afternoon. Although my DD was not seriously injured we had to wait 5 hours because they were too busy chasing the drunks around and trying to sort them out. Maybe they should be charged for wasting time, may sober them up!!

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    1. Unfortunately this is all too common nowadays.

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  11. Here we have after hour clinics where you can go with your sniffles and sneezes etc but people still tend to sit in the emerg waiting room for hours waiting to be told they have a cold. Ridiculous. Maybe it should be a rule that the emergency ward is for those brought in by ambulance or police car.

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  12. This is the price of having a free service at point of contact! But I do not think it would be inappropriate to 'fine' people for wasting time at A and E. I wonder how many people who really need the service don't go because they are too ill to face the long waits and unpleasantness of boisterous obnoxious drunks. A wonderful health care service is being abused and it's time to stop wringing our hands and do something about it...

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    1. I can hear the applause from here!

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  13. Small emergency buildings are popping up all around here for people to go to for non-life threatening injuries or illnesses. We refer to them as "doc in a box' and they definitely relieve the burden on the hospital ER where more seriously ill patients are treated.

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    1. We call those 'prisons', but the authorities are reluctant to use them.

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  14. You want horror stories? Here the partial bill for a compound lower leg fracture resulting from an ATV roll-over in the southwest Texas desert.
    http://thefieldlab.blogspot.com/2015/01/affordable.html
    The statement does not show the actual surgeon's charge which will likely be an additional 20 or 30K $. Nor the 46K $ helicopter extraction for which he also had insurance. Page back for more details and gruesome photos.

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    1. Four months in a multi-starred hotel would have been cheaper. No wonder the medics are all so bloody rich.

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    2. Its not the medics or doctors, it's the hospital admin that gets it from those that have insurance to pay for those that wont. And now this new gimmick called obamacare officially institutionalizes the ponzy scheme.

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  15. To finish this off, I've just been listening to a Radio Presenter called 'Cristo' on LBC talking about his experience last Monday. He confirmed that the place was full of drunks and tramps, and also said that the walls were plastered with posters asking people for 'feedback'. He even received a text message asking if he'd recommend them to friends and family. Amazing.

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  16. I saw the saddest thing yesterday. A twenty something man without a coat and two mismatched socks (no shoes) and carrying a purse stand outside the doors at a large store. He was obviously in a drugged state or seriously crazy, manic and pulling on his hair. It was freezing out and he was very thin. He needed to be taken to a hospital and checked out.

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