Should self inflicted wounded people use our A&E departments?

Andy From Sligo · 02-11-2018 10:41pm

AndrewJRenko wrote: »

And do those people who advise you have any experience or qualifications in the matters they are advising you on?

yep, no experience and qualifications on the matters they are advising me on how to do my job or improve my business , just general members of public - whats the problem? - i am prepared to listen to everyones idea about anything whether they are experienced / qualified or whatever .. then I use my expertise to decide whether I act on their advice ... normally/sometimes

AndrewJRenko · 02-11-2018 11:06pm

Andy From Sligo wrote: »

yep, no experience and qualifications on the matters they are advising me on how to do my job or improve my business , just general members of public - whats the problem? - i am prepared to listen to everyones idea about anything whether they are experienced / qualified or whatever .. then I use my expertise to decide whether I act on their advice ... normally/sometimes

Remind me never to hire you.

Andy From Sligo · 02-11-2018 11:08pm

AndrewJRenko wrote: »

Remind me never to hire you.

good - the chances of that I dare say will be slim to zero anyway

AndrewJRenko · 03-11-2018 1:24am

Andy From Sligo wrote: »

good - the chances of that I dare say will be slim to zero anyway

Good to see that we can agree on something

Conor84 · 03-11-2018 2:40am

Andy From Sligo wrote: »

I really really dont know what a solution could be .. but i still really hate the thought of drunks, druggies, prisoners, abusive people sharing the same HSE A&E dept as other people .. am sure there has got to be a better solution out there so they can still get care/medical help if they need it but as I say , when they have to share with others ... and i am still not happy the way even still these days an awful lot of people are choosing to go to A&E which could have been sorted with their GP / local medical centre for one reason or another . and other patients who might be waiting for an MRI scan / CT scan but instead of wating for it want to fast track having one so present themselves to A&E - Then if there was good proper 24hour support of mental health system in Ireland then the people who need help could get it from mental health services and not have to seek it from the A&E (I heard of one instance of a lad who tried to take his life and the GP said if you try to get through to the mental health services and get no answer or any help and still feel suicidal go straight to A&E ?!?)

it all needs sorting out and categorising somehow better than it is now , and then I do believe waiting times could be reduced.

i spent a good bit of time in ED waiting rooms mainly with relatives and would have pretty much agreed with you. The thinks you said I would have thought the same about when you are with a sick relative and see these "undesirables" there taking up time and causing problems for staff and other patients and relatives and thinking its not fair.

Vut it must be hard on the staff. Imagine what would be said if they turned away a drunk who later died because he was refused treatment or somebody who came in threatening to harm themselves and wasnt treated when nothing else was open or available.

Haye to say it but I was one of those "undesirables" a few years back. I was arrested for assault one night and the Guards were going yo be interview me . When I was getting arrested I got a hit on the head and had a headache. The doctor saw me in the cell and said I should go to hospital to have it checked out. I spent a few hours there getting it checked ot and got brought back to the station
.
Maybe I brought it on myself but if had been something serious and they didnt bring me to hospital and I was brought back but if they hadnt and I was found collapsed in the cell it would have been more serious for everybody.

While I was in the ED waiting I could see people staring ay me sitting there handcuffed with 2 Gardai in uniform, It was horrible sitting there like that and feeling people were talking about me. And some drunks and junkies coming up to us alike they knew you and asking what were we in for!There was also another "real" prisoner there with prison officers so am sure people were giving out about us taking up hospital time. I dont think we got seen quicker because of it but dont know.

Should say got treated well by the staff in the hospital

Big Bag of Chips · 03-11-2018 9:20am

Andy From Sligo wrote: »

I can hardly be blamed myself for the failing because this country hasnt got an accessible mental health service available 24hrs all year round.

It has. It's called "hospital". Wouldn't it be great if every suicidal person could be talked around with a cup of tea and a biscuit. Wouldn't it be great if all was needed was someone to talk to. Very sick people need hospital treatment. I don't understand why you find that so difficult to understand.

Your entire thread has been how to get genuinely sick people out of A&E, for what? To make A&E "work properly" and clear the way for those who are not particularly sick but who don't want to wait? Those people you mentioned who decided not to go to A&E because they'd be waiting hours?

By the way you can't just show up in A&E and get an MRI or other scan. The doctors who have years of training and experience will decide whether or not a person needs a scan when they present to A&E. And yes, someone who is on a waiting list for a specific scan might end up very ill in A&E and be scanned. But they won't have "jumped the queue". Their condition will have deteriorated and emergency investigations are deemed necessary.

Anyone on a routine waiting list for anything in any hospital are told if their symptoms get worse to go back to their GP to send in a new letter and they might be moved to the urgent waiting list. Or if their symptoms get very bad to come to A&E.

Andy From Sligo · 03-11-2018 3:22pm

I know what you are saying - but i still maintain that a stretched service such as A&E / ED department is stretched further. I am still pretty sure when the health service was devised years ago and A&E departments were introduced the original premise was not to be set up a department as a one fits all service and to accommodate drunks and drug users every weekend that have been intoxicated for their own recreational delights or people with an alcohol problem(s) and other things but more like public that have fallen off ladders, hammered a nail into their fingers, been in a car crash, have suffered a stroke or heart attack and the list goes on - again I am not saying that everyone who turns up to A&E / ED should be turned away with no treatment ... I am saying that sometimes they maybe should not even be brought to HSE ED department even in the first place and if/ when picked up by ambulance be transferred to other emergency places and if that means its a private hospital or some other place where they can get treated then that might be a solution and if needed be pay through the nose for their treatment if it is proved beyond doubt that their injuries are self afflicted and could have been avoided .... although most probably even them places dont even want their departments over-run with drunks and druggies and rowdy people either.

Big Bag of Chips · 03-11-2018 4:26pm

But ED works. It treats emergencies such as you've described above, and non emergencies are treated once the emergencies have been dealt with. People waiting on trolleys are not waiting to be seen by ED. At that point the over stretched ED have done their job and are waiting to move the patient out of ED into an inpatient bed. That is why people are on trolleys, to free up ED cubicles to treat the next emergency that comes in.

Your suggestion of charging "self inflicted injuries" through the nose in an alternative location... What happens if a person can't afford it?

Andy From Sligo · 03-11-2018 7:06pm

Big Bag of Chips wrote: »

...

Your suggestion of charging "self inflicted injuries" through the nose in an alternative location... What happens if a person can't afford it?

you dont solve a problem by causing another problem - there are vay'z of paying ....

ohnonotgmail · 03-11-2018 7:09pm

Andy From Sligo wrote: »

you dont solve a problem by causing another problem - there are vay'z of paying ....

But that is exactly what you are doing. You are trying to solve the problem in EDs by moving some patients elsewhere.

Andy From Sligo · 03-11-2018 7:20pm

Big Bag of Chips wrote: »

But ED works. It treats emergencies such as you've described above, and non emergencies are treated once the emergencies have been dealt with. People waiting on trolleys are not waiting to be seen by ED. At that point the over stretched ED have done their job and are waiting to move the patient out of ED into an inpatient bed. That is why people are on trolleys, to free up ED cubicles to treat the next emergency that comes in.
..

have a look at the bigger picture though - 2 things / issues that spring to my mind and I am sure there are more issues when an ED gets overloaded on a busy night

you have children , they are not feeling well or they have swallowed something or broken their arm or something and you find yourself waiting in ED ... it could be a friday or saturday night and the drunks walk in or are being brought in by ambulance and for a certain amount of time you are sitting their with your child waiting and something kicks off , a load of shouting , swearing , punching , staff being abused and shouted at, drunks puking up on the floor and eventually they might be man-handled out by hospital /ED security or the Gardai called - can you imagine how frightening this could be for children in the waiting room and seeing and hearing things they do not need to hear or see - yes I understand you cannot wrap your children up in cotton wall but come on ...

secondly if someone did go into ED /A&E with depression / suicidal / autism /phsycosis /aspergers whatever - presumably they will still have to do a bit of waiting to see someone until they are free presumably .. what a bloody depressing/frightening environment to be in and just make them agitated more than what they are already

If people are in the ED in excruciating pain (which a lot of the time) the most thing you want to do especially if your not numbed by the drink is just sit there in peace and quiet and wait for your turn

AndrewJRenko · 03-11-2018 9:02pm

Andy From Sligo wrote: »

you have children , they are not feeling well or they have swallowed something or broken their arm or something and you find yourself waiting in ED ... it could be a friday or saturday night and the drunks walk in or are being brought in by ambulance and for a certain amount of time you are sitting their with your child waiting and something kicks off , a load of shouting , swearing , punching , staff being abused and shouted at, drunks puking up on the floor and eventually they might be man-handled out by hospital /ED security or the Gardai called - can you imagine how frightening this could be for children in the waiting room and seeing and hearing things they do not need to hear or see - yes I understand you cannot wrap your children up in cotton wall but come on ...

EDs for children are generally separate to EDs for adults. Why are you scratching around looking for problems that don't exist?

Andy From Sligo · 03-11-2018 9:36pm

AndrewJRenko wrote: »

EDs for children are generally separate to EDs for adults. Why are you scratching around looking for problems that don't exist?

i dunno about the ED's where you are - but not the ED's i have been to - everyone shares the same waiting room from all walks of life

Obvious Desperate Breakfasts · 03-11-2018 9:42pm

Andy From Sligo wrote: »

i dunno about the ED's where you are - but not the ED's i have been to - everyone shares the same waiting room from all walks of life

It’s already been pointed out in the thread that there are pediatric EDs. I’ve been unfortunate enough to have spent a lot of time in EDs and I’ve seen teenagers waiting but never children.

henryforde80 · 03-11-2018 9:43pm

OP Lets all wrap ourselves in cotton wool, not drive a car, play sports, do any pastimes we like, don't get drunk, don't get up on a ladder at work, walk down the stairs, don't drive motorbikes, don't use sharp knives to cook dinner, don't go swimming, don't use the gym.

Comparing someone climbing a mountain and falling is the same as someone up on a ladder at work.

Do you have a brain?

Andy From Sligo · 03-11-2018 9:44pm

Obvious Desperate Breakfasts wrote: »

It’s already been pointed out in the thread that there are pediatric EDs. I’ve been unfortunate enough to have spent a lot of time in EDs and I’ve seen teenagers waiting but never children.

sorry i have missed something .. where? - where in the country?

whelan2 · 03-11-2018 9:50pm

Andy From Sligo wrote: »

sorry i have missed something .. where? - where in the country?

Olol in drogheda has a paediatric a and e. Great job. Was in there Monday night with one of my kids. Had to walk through adult casualty to get there-there were drunks, indeed when I was swapping over care of our child with my husband at 6am I met 3 lads with beer cans walking into casualty. Great to have kids out of that environment

Lucyfur · 03-11-2018 9:57pm

Andy From Sligo wrote: »

i dunno about the ED's where you are - but not the ED's i have been to - everyone shares the same waiting room from all walks of life

Sligo's ED has a separate paediatric waiting area. And if at all possible, suidcidal patients are brought to a private family room.

Andy From Sligo · 03-11-2018 9:59pm

henryforde80 wrote: »

OP Lets all wrap ourselves in cotton wool, not drive a car, play sports, do any pastimes we like, don't get drunk, don't get up on a ladder at work, walk down the stairs, don't drive motorbikes, don't use sharp knives to cook dinner, don't go swimming, don't use the gym.

Comparing someone climbing a mountain and falling is the same as someone up on a ladder at work.

Do you have a brain?

well done resulting to insults ....

Big Bag of Chips · 03-11-2018 10:07pm

Most ED's will do as much as possible to get children out of there quick as they can. Most children once triaged will be sent to the paeds ward to be treated there if it is appropriate.

Do you know much about hospitals, or EDs, Andy? You seem to be basing a lot of your opinion on what you've heard on the news or on what you've heard others have said. Hospitals and EDs generally work very efficiently with what they're presented with.

henryforde80 · 03-11-2018 10:12pm

Andy From Sligo wrote: »

well done resulting to insults ....

I just don't understand your arguments. It's very difficult to comprehend.

I'll refrain from using sharping knives to cook my dinner as could cut myself and require stitches which would take up valuable A and E time. Everyone knows sharp knives are dangerous.

Also people who like mountain climbing shouldn't be treated in A and E along with soccer, rugby players, boxers etc.

Andy From Sligo · 03-11-2018 10:13pm

Big Bag of Chips wrote: »

Most ED's will do as much as possible to get children out of there quick as they can. Most children once triaged will be sent to the paeds ward to be treated there if it is appropriate.

Do you know much about hospitals, or EDs, Andy? You seem to be basing a lot of your opinion on what you've heard on the news or on what you've heard others have said. Hospitals and EDs generally work very efficiently with what they're presented with.

yeah, true it is a lot of a lot of it has to do with what I have have heard others say and their experiences and hearing people on the news seeing as I tend to not got anywhere ED departments to see for myself but it sounds horrendous especially at weekends - why is it allowed to just carry on like that and everyone to find it acceptable?

03-11-2018 10:16pm

Andy From Sligo wrote: »

i dunno about the ED's where you are - but not the ED's i have been to - everyone shares the same waiting room from all walks of life

Children go to paediatric.. they are seen by a different department.. in every ED.

Andy From Sligo · 03-11-2018 10:23pm

Sonny Faint GrocerMGS wrote: »

Children go to paediatric.. they are seen by a different department.. in every ED.

glad to hear it - I know that wasnt the case when my son went into A&E when he was little and fell over onto a fireplace he didnt go to pediatric and had to wait in the waiting room for hours with all and sundry like everyone else

Should self inflicted wounded people use our A&E departments?

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