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Slightly jocular title but this is no joke. This comes via a friend who’s a nurse & it’s genuine. The general drift of it echoes what my Dr friends told me about our counties situation when we went for a beer last week.
It’s outrageous and actually quite scary.
Posted anonymously by an A&E doctor:
Im writing this because I’m angry. Actually more than that, I’m fu*king livid.
I’m an A&E reg with 9+ years experience in A&E both here and overseas. This morning was the first time EVER that I cried in my car after a shift.
I was on nights over this New Years period, but New Year was not the issue, every shift is like this now.
Where 5 years ago we had 50 patients in the department on handover at night, we now have 180. It used to be around 20 patients to see with a 1-2 hour wait for clinician, it’s now 60-70 with a 10 hour wait.
People used to lose their minds if patients were coming up to 4 hour breaches. Last night 60% of the patients in A&E had been there for more than 12 hours, some for more than 40. Many I saw the night before, still in the same place when I came on.
No triage or obs after 2 hours of arrival, no bloods or ECGs or gas for 4 hours. Regularly finding people in the waiting room after 4 hours with initial gases showing hyperkalamia or severe acidosis or hypoglycaemia.
87 year olds coming in after falls sitting on chairs for 18 hours. Other elderly patients lying in their own urine for hours because there’s no staff, or even room to change them into something dry. As the reg in charge of the shift, Ive had (on multiple occasions) to help the sole nurse in the area change patients by holding a sheet around the bed because we have to do it in the middle of a corridor. People lying on the floor because there’s no chairs left, trolleys parked literally wherever we can put them.
Things have been getting even worse for the last 3 months. 5 weeks I came home raging to my wife that people are sitting in their own piss for hours and it’s so inhumane. Now we’ve got to the point where people are actually dying. People who’ve been in A&E for 2-3 days,
The media and public might blame the A&E nurses and doctors for this, but honestly what the fu*k are we meant to do with 180 people in a department built for 50. With 8 nurses rather than the MINIMUM staffing of 12. 1 or 2 nurses per area, giving meds, doing obs, trying to provide basic cares to 25-30 people, an absolute impossibility. And there’s less nurses every week, because honestly why would you put yourself through this day after day?
Resus patients are quickly assessed and stepped down to make room for the next pre-alert, going to the area with those same poor nurses, already overstretched, now inheriting an severely unwell patient.
We need to accept the truth, the NHS isn’t breaking, it’s broken. And the same bastards who broke it are doing reality TV shows and writing books about how they saved the NHS whilst refusing to increase nursing pay. We try and shovel shit with spoons whilst they pour it in with dump trucks
The NHS as we knew it is dead, and it breaks my heart, because it’s a beautiful system. It shouldn’t be like this, and those of us who have been around for longer than 5 years know it wasn’t always like this.
The public have no idea, they don’t really know how dangerous this all is. When they come in they’re horrified, but most of the population don’t know how bad it is. This could be their mum on a trolley for 17 hours, or their wife or son or daughter.
I genuinely feel it’s now our responsibility to speak out. We don’t for fear that it will make our hospital look bad or harm our careers. But it’s not a hospital problem, it’s a national problem, and it’s a problem brought about by the politics of the people in power.
We need to shine a light on what they’ve done, make the public so angry that they demand a change. Massive recruitment of nurses through a proper wage/paid uni/free parking/free Nando’s if that’s what it takes would be a start.
If anyone has any idea how we could coordinate some kind of campaign to show the state of emergency departments in the UK right now please write a response, because I can’t work in this much longer, and more importantly I’m not sure the patients can survive it.
But don’t you know, the NHS is not in crisis and it is sufficiently funded. The PM told us earlier.
They've also been getting an extra £350m a week since Brexit 🙄
My daughter is a nurse in a regional centre and she can confirm it's totally shit. The other week she was supposed to be scrub nurse for two operations at the same time, obviously she couldn't be.
Was talking to a paramedic friend of mine the other day and she said they dread taking patients to A&E because it's pretty much guaranteed to be end of shift for them. Unable to discharge the patient into A&E as there isn't space, unable to attend any other incident, no idea of when they'll finally get home.
She said her longest wait to date was 6hrs before they could release the patient and drive back to their home base where they were 2.5hrs late. She said others have seen worse.
But yeah, it's been at the back of my mind on rides...
A couple of weeks ago local to me, an elderly lady fell on the ice and broke her hip. Residents helped her out, supplied duvets, hot water bottles etc, kept her company and kept the rain off but it was nearly 2hrs before the ambulance got there. Took 3 phone calls to 999 to escalate it. Even then it was "only" a rapid response vehicle, not something capable of conveying the woman to hospital. That took another 30 mins to get there.
I know a nurse on A&E who openly admits people have died due to the situation as it is now, the eare deaths that would not have occurred a couple of years ago
It is truly broken. 🙄
The ward situation is just as knackered also. Boarded Bays is the new one.
Bays designed for four patients now has a fifth bed slapped in the middle (must be mobile apperantly) with no access to an Oxygen point or a Nurse call bell.
If the worst comes to worst and crash trolley has to come in, fifth bed has to wheeled out to corridor!
People know exactly how bad it is and they aren't blaming the A&E staff.
Whether they actually understand what it really means, or how awful it is for the staff.
My parents are in their 80s and have caught the awful cold - trying to make sure they don't get worse, needing hospital may kill them
We know this, we knew this 4 years ago ) and earlier) yet somehow when it comes to a person on a booth alone, with a pencil and a ballot paper, it isn't what they think our care about. Htf is that?! Gawd help us.
It’s shocking and sad to hear.
I think there is a massive branding issue behind the strikes and situation. It’s like the unions or whoever is managing it need a decent PR co.
Public perception is that it is about pay rather than the situation being described here.
Even what is described here doesn’t get to the core of the problem.
You can increase pay by 50% and increase hiring but nothing is going to outpace the increase in use by a rapid aging population. Even without incompetence that alone breaks the system.
How can that be solved without increasing hospital count for n the UK by x%. At guess from sounds of it we will need 50% increase within the next 10 years. Anyone got any ideas?
At the large city centre NHS hospital my wife works at they now have a marquee in the car park as a triage/waiting area. A *ing tent. In 21st Century Britain, which is supposedly a first world country.
She's also just received a parking fine from the city council after they doubled the parking fee from £4 a day to £8 a day with no notification or signage or anything. She gets her ticket from a coin operated machine in the dark. She only has to do this because she was lied to in her job interview to return to this hospital after a few years in a community hospital whilst our kids were young. I.e. she would have a staff parking permit.
It is *ing bollocks. The ****s we call a government need running out of Downing Street at the sharp end of a pitchfork. That smug prick Sunak with his £750m in the bank and his gold-plated future telling people there is no crisis can **** right off. It is an outrage.
Well, no-one has said it yet, so I suppose I should.
**** the Tories, and **** you if you vote for them.
APF
For balance:
I parked for free at my local hospital today - as all staff and patients can.
I was seen on time (TBF, I was first of the day), by a friendly and professional nurse, who sorted my treatment and emailed the consultant while I was there.
I walked around to the pharmacy and picked up mrs_oab's drugs (worth as much as our car, picked up every quarter).
I bumped into an elderly neighbour at the main entrance, who I helped over the ice to thier daughters car. He had been in A&E at 7.30am, and was leaving the hospital at 9.30 am, with follow up clinic booked for tomorrow.
APF +1000!
I understand the chronic underfunding and funds not going to the right areas, but it's the huge increases in people using A&E that is a real shocker for me, i just don't understand why people are still running to A&E for things that a minor injuries could sort, or 111 or a pharmacist, it just seems to be straight to A&E which comes with the added annoyance that a lot of people who should be going to A&E are leaving it due to the press just now giving these horror stories.
Still can't see this government doing anything good in the time they have, they like to use the issues caused by Russia/Ukraine/Covid/etc, but when looking for excuses to not fund the NHS or pay those striking more they ignore the actual issues and go back to inflation, or the lack of unemployment as the basis to why it's prudent not to pay people more in these hard times.
Timely.... My wife's just rushed in to say her 92yo grandpa is in a side room in A&E with SATs of 40% as there are no beds available. ****
How can that be solved without increasing hospital count for n the UK by x%. At guess from sounds of it we will need 50% increase within the next 10 years. Anyone got any ideas?
the key issue is "bed blocking" by those needing support at home which cannot be arranged. Thats what creates the logjam. Home care is paid at below national minimum wage and is as a result of generally poor quality. Home care workers have either to work unpaid overime or leave needs unfufilled. Home care providers cannot recruit an councils cannot increase funding
Sort the home care situation out then folk can get moved out of A&E into the main hospital. Patients not entering thru A&E will not have appointments / operations cancelled for lack of beds. Reducing waiting lists takes the pressure of GPs as they are not having to look after such sick peiople at home and will not have to continually re refer
So the key is sort out social care
What has caused the huge increase in a&e demand? I'm not sure I've seen an explanation. Ageing population? Missed GP appointments? People avoiding care homes? All of the above perhaps.
Even with the Tories in government I never thought I'd see the NHS in the catastrophic state it's now in.
I'm terrified that if I needed to call an ambulance for my old mum now that going into hospital would be the end of her for sure.
I absolutely f*****g hate what the Tories have done to the NHS. They are vermin.
Well, no-one has said it yet, so I suppose I should.
* the Tories, and * you if you vote for them.
I totally agree. I've had some experience as a member of the public as a user of A&E and taking my nan to A&E, in the last few years.
All i'll say is anyone who votes tory should be strung up to the nearest lampost.
Strikes and pay rises won't make any difference.
You can't tell me it hurts less when someone dies in an ambulance queue for a&e admission any less if you earn £14ph or £12ph. It will still rip a piece of your heart out.
I dont think most of the staff who work on the front end do so for the pay and benefits. They do it to help people when they need it the most.
Its to keep raising awareness that the system needs billions, that cant be allowed to be siphoned off by tories, adding to the pot.
So they can help more people, safely and efficiently.
Where we are now with covid , kamikaze budget and putin means finding the billions is not going to happen, the tories will privatise as soon as they can get all their ducks in a row to benefit themselves, and blame everyone else and we all will pay. Again.
That said, the number of chancers calling 999 and turning up at A&E's is also a joke.
I know you can't judge a book by its cover but i'm fairly confident at least 60% of people presenting themselves in A&E are not emergencies.
What has caused the huge increase in a&e demand?
Part of it is down to the lack of GP appointments which in at least part is caused by the logjam meaning GPs spend more time with very sick people who need hospitals but cannot get a bed so have less appointments for others
Part of it is down to the lack of GP appointments which in at least part is caused by the logjam meaning GPs spend more time with very sick people who need hospitals but cannot get a bed so have less appointments for others
Also this.
The whole system has systematicaly run into the ground by the conservatives.
The NHS as we knew it is dead, and it breaks my heart, because it’s a beautiful system. It shouldn’t be like this, and those of us who have been around for longer than 5 years know it wasn’t always like this.
In June 2016 a pal of mine was 50/50 on leaving the EU, I patiently explained why I thought that leaving wasn't a good idea plus the kind of folk who were behind leaving weren't the kind of folk you'd want been involved in running the country. "What's the worse that could happen though" he said.
He was commenting on the state of the NHS today on FB, I reminded him of his words...
i just don’t understand why people are still running to A&E for things that a minor injuries could sort, or 111 or a pharmacist, it just seems to be straight to A&E
Because out of hours provision is also ****ed. We used to see a GP if there was a minor problem but since the GP contract change if someone needs a hands on assessment it's ring 111 who tell you to go to A&E. QED
For further balance. I’ve worked through out Christmas and midweek last week. It’s dire, not just in our area across the UK. I can see data for lots of areas when on duty and they all the same. I attended an incident at the weekend where they had waited hours for something they should never had. I couldn’t apologies enough to the family. I got back to my car, angry upset and disappointed in what has happened. Then had to get on with the next incident.
Its also deliberate tory policy to create crisis in the NHS so they can say privatisation and insurance based services are the only cure. Make no mistake - its deliberate
sillysilly
Full Member
It’s shocking and sad to hear.I think there is a massive branding issue behind the strikes and situation. It’s like the unions or whoever is managing it need a decent PR co.
Its not bad PR... it's a right wind press all too keen to blame all the failings on the NHS rather than government and then paint nurses etc as overpaid moaners! 😡
APF for PM.
Unfortunately there are too many people (about 2% too many according to the most recent poll) who regard rubber dinghies containing a handful of migrants as a greater threat to our way of life than a crooked government that embezzled billions during the most acute part of the pandemic. A government that is headed by an unelected billionaire who regards anyone with less money than him as a deserving lover.
Unfortunately the current state of things is also, partly, a reflection of the lumped stupidity of the electorate - who swallow any old crap so long as it says it is all someone else's fault.
Aaaaaargh.
111 also has its triage issues.. if there's any doubt about the health of a person it's basically a recommendation to call 999.
There's no easy way around that, a person on the end of the phone, who is not a doctor, or even a qualified nurse, can't realisticaly triage over the phone, so the script will lead to... call an ambulance.
Well, no-one has said it yet, so I suppose I should.
* the Tories, and * you if you vote for them.
I don't think I've ever felt more in agreement with anything said, ever.
Have had horror stories from friends in the NHS for years but they really have become scarier over the last few weeks. One friend said they turned up for their shift on their ward and they were the only person available to look after 17 patients, it's meant to be a minimum of 4 patients to each nurse. They're really struggling with staffing levels especially as it's an expensive part of the country to live in (Cornwall) and that lots of their European colleagues have left.
I'm actively avoiding any undue risks right now as I don't want to be a burden on the system unnecessarily.
That said, the number of chancers calling 999 and turning up at A&E’s is also a joke.
I know you can’t judge a book by its cover but i’m fairly confident at least 60% of people presenting themselves in A&E are not emergencies.
It isn't unknown for people to feign an injury so that they get an ambulance (usually on a Friday night after drinking a lot), get taken to hospital then leg it. Voila, free taxi home. One of my friends even had one patient in the back of his ambulance tell him to go to one hospital rathe than the one they were going to as it's easier for them to get home afterwards.
One of my cousins is a serial visitor, he's a drug addict and dealer so is there 3-4 times a week with issues or for being beaten up. There's a group of locals that essentially clog up the system as the local drug rehabilitation clinic was closed down and the next nearest help available is 20 miles away. The whole system is being ground down politically and financially despite the absolute efforts of the front line staff.
And in case anyone forgot to mention it:
**** the Tories and if you vote for them **** you too.
Its also deliberate tory policy to create crisis in the NHS so they can say privatisation and insurance based services are the only cure. Make no mistake – its deliberate
For sure, this is a diliberate and concerted effort by the Conservatives. They don't mind killing a bunch of people, as long as thier retirement funds and investment portfolios are looking good.
Steer clear of the really thick chains as they are very heavy and inflexible to thread through bikes without causing damage or inconvenience
Godda say I'm surprised it took to post 23 fir someone to point this out. I was thinking of starting a post about this very thing the other day.
As Tij says, it's completely deliberate. They're painting us into a corner. They know we're pretty much ****ed. They've ****ed the economy and they've ****ed the NHS. There is no way Labour can rescue this shitshow in one term. The scum party will be back in 6 years and be able to lay the blame on someone else. The peasants will believe them and they'll come to the rescue with the only available option, which is to sell-off great swathes of the NHS to the Merkans.
God I loathe the electorate.
Strikes and pay rises won’t make any difference.
You can’t tell me it hurts less when someone dies in an ambulance queue for a&e admission any less if you earn £14ph or £12ph. It will still rip a piece of your heart out.
I dont think most of the staff who work on the front end do so for the pay and benefits. They do it to help people when they need it the most.
The strikes are about conditions, work overload, lack of recruitment, cutbacks not just pay.
It’s also deliberate tory policy to create crisis in the NHS so they can say privatisation and insurance based services are the only cure. Make no mistake – its deliberate
This. Unfortunately. And now they know they will likely lose the next election they give even less of a shit about anything other than furthering their own interests.
Spent 12 hours (7pm-7am) in A&E a couple of Mondays before Christmas with chest pains.
Was an interesting cross section of walk-ins.
More than a few who simply couldn't get GP appointments.
I couldn't even get past the GP gatekeeper with chest pains, was offered a phone appointment.
The staff were great, one even came round got everyone hot drinks as the tea machine was broken.
It was a 4 hour wait between each time I was called in. 30mins before triage iirc.
Well, no-one has said it yet, so I suppose I should.
* the Tories, and * you if you vote for them.
First time I’ve ever agreed which a palace fan. Well said Alex (you’re still shit though) 😉
For additional balance, my orthopaedic surgeon friend had several operating lists cancelled over the last few weeks because management had commandeered all his recovery beds for A&E. Sure that’s only elective hip operations getting bumped but Apparently the managers were so desperate they had also tried to cancel some cancer related operating lists. In this instance they were shut down but it illustrates how bad things are.
Pay rises are part the answer. The nhs is haemorrhaging staff, losing far more than thy can recruit. A pay rise would help staff retention. Knowing that the government values you at the same level as Lidl values it’s shelf stacking staff doesn’t help you cope with the longer hours, the stress, the knock on effects on home and social life etc...
What I will praise is the people.. the off duty fireman who attended my nan as first responder, and the paramedics who turned up not long after.
These are the people who are propping up the whole health system, and I can't praise them enough, 100% professional and on the ball despite the circumstances.
These are the people in society we need to look after more, not less.
Politicians are either clueless (cannot think out of the box) or do not have the determination or lack the will.
May I suggest the followings: (yes, someone will come along to say that's unfair because we want that too etc, go work in NHS then)
1. Reduce drastically or abolish income tax for those working or pay by the NHS (can work out the details later if the earn beyond certain level), or a combination of pay rise and reduce income tax. Personally, I favour No income tax if they earn below say £45K as nurses, if they earn more you can decide or work out the rate etc.
2. Govt should create a rule that all those paid by NHS should receive low mortgage interest rate (if they intend to climb the property ladder) or very minimum mortgage interest rate, tell that to the financial institutions. If financial institutions do not like it then they can go.
3. Same goes to all public transports (trains and buses). NHS workers get massive discounts while travelling on them or even free etc.
My overall view is that there must be an incentive to attract people to join NHS. This can be done in many ways but as I say if there is a will there is a way.
Not sure if my suggestions make sense but as usually someone might disagree if they are working for Inland Revenue.
It’s always worth restating that this is not accident or incompetence, this is deliberate, planned Tory policy.
They’ve always hated the nhs, hated that a hugely successful and popular public service exists. It proves that the ‘only private industry works’ mantra is a lie. The Tories want peoples health expenses to go to private companies, as in USA, not because it’s a good system but because they and their friends will get fat on it.
i just don’t understand why people are still running to A&E for things that a minor injuries could sort,
Tried that recently?
I know you can’t judge a book by its cover but i’m fairly confident at least 60% of people presenting themselves in A&E are not emergencies.
You can't get GP appointments, so if you have something potentially serious - a nasty rash, recurring chest pains, a headache that won't go away etc etc you've got nowhere else to go. It's now called a 'walk-in centre' but it's still just the same A&E, here in Cardiff at least.