Your A & E experiences, good and bad

I've worked in ED (A&E) before as a doctor. I've also worked as a junior doctor in Ireland. I once worked 42 hours with 2 hours sleep somewhere in the middle, and towards the end of the 42 hours I was helping out in an operation. I started at 7am one morning, worked that day, that night, got those 2 hours (not altogether of course) and worked the next day. At 6pm that next I was asked to help out in theatre. The operation started at 7pm and lasted till 1am. I then drove home, to be back in work 6 hours later.

The above is fairly common in a lot of country hospitals by the way.

The problems as I've seen them:

Not enough beds on the wards. People are admitted to hospital when a surgical or medical registrar sees them and decideds they need to stay in. Emergency staff don't typically admit people to hospital (unless there's an obervation unit). There's a couple of reasons why people wait so long for beds.

First is that there aren't enough full stop, but it's not as simple as just putting more beds in a room - you need staff to care for these people and that costs money.

Second reason is that people don't go home as quickly as they should. Loads of reasons for that. Not enough people like physios/occupational therapists to see patients on the wards to assess whether they're safe to go home, and whether they need extra support/home modifications at home. I worked in a large Dublin hospital where it would sometimes takes 10 days for the patient to be seen by OT. I now work in Australia where patients are seen on the same day. Then there's not enough social workers to work out extra home supports for patients when they're discharged. Not enough money in general to fund home help. Not enough people to help out in discharge planning. So patients end up staying longer.

Third reason is that when patients come in, but can't go home for various reasons (not safe, need full time nursing care), there's nowhere for them to go! Family, despite their best efforts, can't afford a nursing home, so they're put on the public waiting list. That waiting list in a Dublin teaching hospital was 9 months - and that was short compared to other places. So you have an elderly (and sometimes young person) in an acute hospital bed when clearly a rehabilitation bed, or nursing home, would be a lot more appropriate.

Fourth reason is more of a general one, but in a lot of hospitals there's just not enough resources! You'd be waiting a week for a CT scan to stage people's newly diagnosed cancers! It was outrageous, but not because staff were lazy - there were genuinely scans that were more urgent. If you want people out earlier, get their scans done earlier, reported on earlier and get them out of hospital.

Fifth (and I'm tired now, this is my longest post ever I'd say) reason why the public in general are waiting so long in ED is that there are not enough people to see and assess them. And I'm talking about more doctors. Fairly simple solution!

For all those people who had positive experiences in ED - I'm glad the service worked well for you. Believe me when I say that there are plenty of doctors within the health service that wish it was the same for everyone.

Best

Had an accident and fractured 3 vertebrae was rushed in by ambulance. Had an x-ray within 10 minutes, CT within 30 and admitted within 90 minutes.

Then waited 4 days to see a physio (happened on a friday morning of a bank holiday weekend, physio's were off for the weekend and none were available to see me on the Friday.

Got seen on the Tuesday, fitted for a brace, 20 minutes of physio and discharged.

Worst.

I suffer from an oddball allergic reaction. Every now and again (4 times in 20 years) I break out. it starts with hives on the face, then moves around my body. After some time (anything from 6 to 12 hours) the hives die down by my face starts to swell, probably 30 minutes later my tongue starts to swell and then my throat. Never been any further before I get treated with an injection of cortisone which clears it all up within 10 to 15 minutes.

First time it happened I was about 13 and it frightened the hell out of me when my tongue started to swell. Lucky for me my dad was a nurse and got me straight to A&E.

Second time I was 25 or 6 but remembered the previous occasion, knew I had loads of time and went straight to hospital, explained my history and got the injection, was watched for 30 minutes and sent home.

Third time similar situation.

Last time I was in the middle of doing a job on my grandmothers fuse-board. I knew I had plenty of time (my first mistake) and rather then leave her with no power I finished up (took 30 minutes) I was in a different county and decided rather then go in to that their hospital I would go to my own where they had dealt with this before and it was all on file. (took about 2 hours but again I knew I had loads of time before it got serious)

Again explained my history (and as I said its all on file anyway). Got into triage and again explained my history. At this stage the hives were on my back but in the process of dieing down there and I could feel them coming on my legs. Nurse had a look (I openly admit they didn't look like much at this stage) hmmmmd and sent be back to the waiting room. I explained there was another 3 hours or so before things potentially got serious and went out.

5 hours later I could feel the hives dieing away and knew what was coming so went back to the window and explained my case to the girl in reception. She went to triage and told me I would be called in a few minutes.

An hour later and my tongue is starting to swell and I'm getting worried. Back to the window (at this stage I was finding it very difficult to speak and even more difficult to be understood) and tried to explain my situation. Again I was told to wait. 45 minutes later throat was starting to swell and I was getting really worried so went back up to the window. At this stage the other two people in the waiting room were looking at me in horror (my face had swelled so much I looked like the elephant man) and the lady in reception ran to get a doctor. I was brought in and explained the situation to the doctor. He gave my the injection, told a nurse to watch me and then went away. 20 mins later I was fine and was discharged.

I can honestly say I was terrified...

If it ever happens again I will go straight to the nearest hospital.

Vorsprung wrote: »

The problems as I've seen them:

Not enough beds on the wards.

Second reason is that people don't go home as quickly as they should.

Third reason is that when patients come in, but can't go home for various reasons (not safe, need full time nursing care), there's nowhere for them to go!

Fourth reason is more of a general one, but in a lot of hospitals there's just not enough resources!

Fifth (and I'm tired now, this is my longest post ever I'd say) reason why the public in general are waiting so long in ED is that there are not enough people to see and assess them. And I'm talking about more doctors.

Many thanks Vorsprung.

Many UNthanks to our seriously disturbed health policies, Mary Harney. :mad:

Had glandular fever and quinsy, was waiting 11 hours in A&E, having not eaten or slept for two days, i couldn't swallow. Was able to take water but very little because i couldn't swallow it, had to allow it to trickle back my throat. Needless to say i was in great pain. Couldn't speak either.

Had nurses passing every 2 hours or so, asking how i felt, even though i couldn't answer, i was 16 and had tears streaming down my face it was agony. In the end i was only seen because the quinsy was more serious than anyone thought, low down in the neck the was a second abcess causing some type of blockage on my airway. I couldn't breath, collapsed on to the floor and only then was i see by a doctor.