The current hospital / A&E crisis

kevthegaff · 06-01-2023 12:07am

Look how well covid vaccinations were rolled out in GP and health centres, where did all the extra staff come from? Where there's a will there's a way, maybe there should be like a covid testing centre except a mobile a and e centre where they can send minor problems straight to pharmacies while treating some patients for dehydration etc and moving important cases to the hospitals.

Dav010 · 06-01-2023 8:14am

https://www.boards.ie/discussion/comment/120071798#Comment_120071798

The main reason many GP clinics refused to provide vaccinations was/is that it interferes with the Clinics ability to see patients. Also, retired staff, both Drs and nurses temporarily helped out as vaccinators. It is also worth bearing in mind, giving a vaccination is simple, and quick, diagnosis and treatment are not, so it is hard to see how vaccination roll out, which was often done on a sessional basis (afternoons/mornings) during the week could be compared to general GP practice.

odyssey06 · 06-01-2023 9:32am

Flu is being blamed, as much if not more so than covid, for current surge.

Does anyone know how extensive the testing for flu is? Is it just being used as a catch all term for "respiratory virus not covid"?

I know there are sampling \ surveillence reports on flu to detect if it is circulating and what strains, but not sure if that is able to say that X people in hospital have it.

And does anyone know if the flu vaccine is well matched to those strains?

mumo3 · 06-01-2023 12:06pm

I feel a way to relive some of this pressure is to make some antibiotics available over the counter!! I know this is probably going to ruffle a few feather here but I think it could be done. I'm sure there are plenty of people on here, who have had a time when they've been unwell and could tell that they where going to need and antibiotic to get over it, and other times we've all had illnesses where we've know we'd have to just wait it out.

I'm lucky to have a pharmacist that is extremely helpful and competent, I have often visited them before making an appointment with a GP and have only made that appointment on their recommendation as they are usually good at giving you an over the counter treatment.

I aware this would not doubt be abused, like everything else is, but if they can restrict the purchase of painkillers, I'm sure they could put some sort of system in place.

06-01-2023 1:15pm

https://www.boards.ie/discussion/comment/120072249#Comment_120072249

My own lovely GP and myself rocked up together at a vaccination centre for influenza right at same time. Vaccinations are indeed best done in settings outside of regular GP practice.

06-01-2023 1:19pm

https://www.boards.ie/discussion/comment/120073021#Comment_120073021

My pharmacist, Sheena, was on the radio recently (Claire Byrne I think) with this very message. She has the skills and know-how to prescribe certain items, especially to regular patients whom she knows. Eg, she knows my full medical history, my GP contact details, what other medications I’m on and would be in a very good position to make a judgement on selecting the correct antibiotic or indeed refusing it where she thought it was inappropriate.

MEGA BRO WOLF 5000 · 06-01-2023 1:19pm

https://www.boards.ie/discussion/comment/120071284#Comment_120071284

Rumours. HIQA didn't show up. They hid the patients for the fire martials. Up corridors and into corners they went. It's amazing what management can do when they put their mind to it. They were well aware they were coming.... Not that it matters, one time they came unannounced and they didn't even look into the zones where patients were piled into, they were more concerned with a broken trolley up some random corridor.

Cluedo Monopoly · 06-01-2023 1:20pm

https://www.boards.ie/discussion/comment/120073021#Comment_120073021

The purchase of painkillers....

Customer: 24 Nurofen please

Pharmacy staff: Are you addicted to painkillers?

Customer: No

Pharmacy staff: Grand, here you go.

06-01-2023 1:29pm

https://www.boards.ie/discussion/comment/120072359#Comment_120072359

The current quadrivalent vaccine is very effective. Trouble is a lot of people who should have got it simply didn’t. It had been well flagged in southern hemisphere that a major flu season was on the way. I had zero problem getting it, simply booked at a pharmacy and got it free. Of course, like any vaccine, people with already compromised immunity may not have developed a good enough response to the vaccine. My own cousin, who has Rheumatoid Arthritis, goes off her self-injected Enbrel ahead of getting vaccines so as to develop a response. With RA she can afford to do that, but with many conditions which require immune suppression you just cannot stop the medication like that without potentially very serious consequences.

06-01-2023 1:32pm

https://www.boards.ie/discussion/comment/120073392#Comment_120073392

One way of preventing multiple dispensing of codeine containing medicines would be to require a “medicines record card” that you had to show pharmacist, and which would show when codeine had last been purchased in any pharmacy in the country. I know that won’t happen any time soon and is a while other discussion.

mohawk · 06-01-2023 2:23pm

https://www.boards.ie/discussion/comment/120073021#Comment_120073021

Antibiotic resistance is a real threat to human health/lives. The solution can’t be to create more superbugs. They are also terrible for your gut health and should only be taken when strictly necessary.

Even now when it’s been flagged multiple times many people still don’t get that antibiotics don’t work against viruses. Many expect antibiotics for every sore throat and cough they get.

You might need an antibiotic following a viral infection because the virus has created a great breeding ground for the bacteria and you have developed a secondary infection.

mumo3 · 06-01-2023 2:39pm

https://www.boards.ie/discussion/comment/120073705#Comment_120073705

I completely agree with you on the point, however, like a GP the pharmacist can also refrain from giving you an antibiotic, if they feel it is not needed.

I had that sh!tty flu the week running up to Christmas, and my doctor prescribed me an antibiotic in case the infection took hold in my chest over Christmas, when the doctor would be unavailable. I didn't take it, because luckily I didn't feel the need to take it. But If I got an ear infection and I know I have an ear infection, its crippling to have to wait for 3-4 days to get an appointment with my GP, so he can confirm it and I can then go to the pharmacy with my bog standard amoxicillin prescription to eventually start a treatment that should have been started days previous, but in the mean time I'm eating codeine tablets to try and get some respite.... Where is the sense in that.

Northernlily · 06-01-2023 2:55pm

What's the **** point in giving management a heads up for inspection.

Shambolic but not surprising. Incompetent Managers all looking after each other.

Think Robert Watt and think the culture that exists in the HSE.

mohawk · 06-01-2023 3:01pm

https://www.boards.ie/discussion/comment/120073783#Comment_120073783

The wait to see a GP and some people having no GP is definitely a contributing factor to where we are now. It’s about a 3-4 day wait here for our GP too, but they do their best to squeeze you in if it’s for a small baby which I appreciate. Friends of mine are being told 1-2 weeks for an appointment with their GP which is crazy.

Being seen in a timely manner in the community is vital to fix this mess long term. There needs to be enough staff for this though as just because your a GP doesn’t mean you shouldn’t have some level of work/life balance.

Strumms · 06-01-2023 3:05pm

Figures from the Department of Health show that 649 non-EU students enrolled in medicine courses around the country in 2021, approximately 46% of all enrolments in both undergraduate and graduate entry medical courses.

A 2017 a study found that 94% of Irish medical graduates remained in Ireland compared with 41% of those from other countries…

So 59% of people who come here to study medicine say… “ thanks for the opportunities, I’m qualified, bye “

Yet we have a shortage of doctors and two fast a growing population, both temporary and permanent, that it is impacting emergency care.

redlough · 06-01-2023 3:10pm

https://www.boards.ie/discussion/comment/120073960#Comment_120073960

So what do you suggest we do?

Block people from overseas coming to study in Ireland?

Jizique · 06-01-2023 3:16pm

https://www.boards.ie/discussion/comment/120074006#Comment_120074006

It is definitely feasible to block non-EU students, might be an issue with EU students due to freedom of movement; not saying it is the right action but it can be done, even if the fees are very attractive to RCSI

Strumms · 06-01-2023 3:16pm

https://www.boards.ie/discussion/comment/120074006#Comment_120074006

not block, further limit. Especially for healthcare courses…..medicine, physiotherapy, psychology ( shortage has been termed a crisis )

We need more beds more doctors…. We have the universities just not got enough graduates staying… numbers above are evidence.

mohawk · 06-01-2023 3:19pm

https://www.boards.ie/discussion/comment/120073960#Comment_120073960

There are places reserved for non EU students and in many cases those fees are being paid for by foreign governments. If the students don’t go back after they qualify they have to pay their government back. Others like Americans are paying for themselves so can stay or go back. Other thing is that Irish universities aren’t training those non EU doctors out of the kindness of their hearts. They do it for the money.

There is nothing stopping the government from increasing the number of places if they want too, but then you get into question of whether there is enough senior doctors to train the medical students and junior doctors.

BagofWeed · 06-01-2023 3:20pm

https://www.boards.ie/discussion/comment/120071217#Comment_120071217

Never asked you to believe it. My condition that night was exactly what A&E exists for. Had an emergency treatment the next morning and was out by 3pm that day. Gold star treatment IMO I couldn't fault them for anything. They know what's serious and what ain't.

In saying that both my mum and son were waiting days after attending a different A&E for different conditions during the summer.

redlough · 06-01-2023 3:20pm

https://www.boards.ie/discussion/comment/120074065#Comment_120074065

https://www.boards.ie/discussion/comment/120074066#Comment_120074066

But blocking student who work in the hospitals during university will just make the issue worse would it not?

I know for nurses and I guess the same for doctors they spend a significant amount of time in hospitals working while in Uni

If you start to block/limit you are just reducing the numbers even further?

mumo3 · 06-01-2023 3:22pm

https://www.boards.ie/discussion/comment/120073938#Comment_120073938

And I put that down to being courteous to the receptionist. The amount of people giving out about them being too nosey is shocking. These people are the gate keepers for the GP's if you can't be nice to the gate keeper, you aren't getting through the gate.

When I had the Flu that time, I overslept and my appointment was in ten minutes, was never going to make it called and explained the situation, the receptionist said to me "you sound like sh!t, are you ok with taking a phone consultation" 😂 Doctor called me with the next hour in-between appointments, now still charged me, but if it wasn't for the receptionist I wouldn't have been sorted.

BagofWeed · 06-01-2023 3:26pm

https://www.boards.ie/discussion/comment/120071515#Comment_120071515

Cardiac is gonna propel the patient to the top of the list and into an observation unit. An ECG and xray will do the decision making.

Strumms · 06-01-2023 3:26pm

https://www.boards.ie/discussion/comment/120074092#Comment_120074092

yes, not about money though , it’s about us having enough qualified medical staff… professors etc…

government have no way of ‘making’ anyone pay money back.

increasing places ? Are there enough qualified doctors and professors though ? do we have the facilities for bigger / more classes ?

thomas 123 · 06-01-2023 3:32pm

Not fact checked by me but awful if true.

06-01-2023 3:39pm

https://www.boards.ie/discussion/comment/120074147#Comment_120074147

I mean with so few staff and so many patients and such chaos, anything can and does get missed. Became a cardiac case myself, but if you are behind pulled curtains like I was post surgery, with no staff in attendance for a king time, unless you can call out and advocate for yourself you literally could slip away unnoticed.

06-01-2023 3:44pm

https://www.boards.ie/discussion/comment/120074121#Comment_120074121

You wouldn’t be allowed through my GP door with infection on you, phone consult only.

mohawk · 06-01-2023 3:47pm

https://www.boards.ie/discussion/comment/120074189#Comment_120074189

Along with there being slightly less beds. I would love to know if number of places to train nurses, doctors, radiographers, physios etc. changed over that time period.

If there is one thing successive Irish governments are woeful at it is long term strategic planning.

mumo3 · 06-01-2023 3:55pm

edit

06-01-2023 3:55pm

I heard a doctor being interviewed this morning on Radio 1, he said there was a significant cohort of young people turning up to A&E with influenza type symptoms when they shouldn’t be near the place, and that younger people especially need to be educated that the likes of flu can be unpleasant in the extreme, but rarely warrants any medical intervention in a normally healthy young individual and folk should expect to just weather it out in bed at home. He said that such folk don’t seem to realise the degree of sickness that is experienced during a bout of real influenza, he believes that public education needs to be improved. A hospital can offer no treatment to speed through the course of flu. I didn’t hear what percentage of attenders he believes this to be, but they are filling the pre-triage waiting area and contributing to the spread of infection.

The current hospital / A&E crisis

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