/ NHS as told by Mr Pie
> From what I gather on the radio, triage nurses are massively overworked and can’t turn people away. Surely that’s got to be one of the first things to address.
How do you know if what you turn up with isn't life threatening without triage?
By following the advice they publically state. The first port of call shouldn't be a&e.
Can I self medicated; painkiller, day in bed, box set of usa trash....
Visit the pharmacy
Book with local nurse or doctor
Easier said than done though in many cases, my daughter broke her foot the other week, I was all for leaving it (which would have been the case in my day to see what developed), obviously we didn't know it was broken before going to hospital. My wife insisted we go to A&E, and so we found out she needs a splint and crutches.
As for the other suggestions, it's very difficult to get to see a doctor. What do you do when it's out of hours?
While I agree there are many cases of people not using their heads, there are many people not bothering and ending up with more serious ailment because of it.
Girl in Scotland has just died, probably because she didn't get to hospital early enough.
It’s more of a question of not having enough effective triage nurses during peak periods and not being able to give people A&E ‘appointments’.
”Yes, your foot is probably broken. We are very busy at the moment, here is an appointment for 6 hours time. You can go home and come back later.”
That way the waiting rooms aren’t stuffed full of people with semi-serious ailments and no one ends up sitting on floors.
The real problem at the moment is people that are quite unwell arriving by ambulance, without the capacity in the department. These "majors" aren't going to be able to be triaged to come back, and it is a problem with bed space and staffing rather than triage. This is likely to get much worse over the next few weeks as flu is likely to reach epidemic levels - something that hasn't happened since 2010/11.
In a busy emergency department, the waiting time for "minors" such as small broken bones in the foot often goes up to several hours anyway, and the sitting around waiting acts a filter for more trivial ailments - people give up and go home. I'm not sure that giving appointments to come back would help, as you'd remove the filter and feed demand.
That’s a fair point and kind of what I meant by sending minors home. Although thinking about it I’d surprised if the Triage nurses don’t have the power to tell people to go home as it’s not an emergency.
When I had a mallet finger they wanted me to see a doctor immediately, whilst not life threatening, it needed immediate remedial bandaging to make sure it repaired properly. I’m guessing it’s a tough call.
> It’s more of a question of not having enough effective triage nurses during peak periods and not being able to give people A&E ‘appointments’.
But that was my point you have to go to hospital to find out it's broken, thereby adding to the chaos. It's pretty difficult to diagnose a broken bone without an X-ray, unless of course it's sticking out of somewhere. You still need the xray. As it happens we did get sent home and had to go to the fracture clinic the next day.
What do you do if a doctor tells you to go to A&E?
Not so long back I stuck a Stanley knife half way through my finger, I went to the doctor on site and he advised going to hospital, he'd cleaned it up and put steri-strips on it. The strips we holding and I didn't bother with the hospital. Had this been my daughter or son there'd have been no thoughts of not going to hospital.
> The real problem at the moment is people that are quite unwell arriving by ambulance, without the capacity in the department. These "majors" aren't going to be able to be triaged to come back,
Many people, who can arrange alternative transport, think that travelling by ambulance gets them to the front of the que on arrival. Such people would rather wait for an ambulance than make their way to hospital under their own steam. They would probably get to hospital quicker, in the current busy period, and be triaged quicker as a result.
We could also discuss the "111 Phone Service" and how effective it is, or not, on those added pressures and demands.
A few years ago I was assaulted and received an injured toe. At the time I was told that it was a soft tissue injury. It was just a toe and it would get better. A week later and after doing four shifts at work the pain became intolerable. An x-ray confirmed things were a bit more severe than a soft tissue injury.
I suspect A&E are trying to do two jobs. Accidents and emergencies. Possibly they need two systems. An accident system and an urgent minor injuries clinic.
There is also the paramedic motorcycle service. I took my son to hospital for a gash in his head. Unknown to me someone had called 999. The paramedic arrived shortly after I had left. We were seen straightaway at the hospital, wound cleaned, glued and dressed. The doctor told me I should have waited for the paramedic who could have done all that and saved me a trip.
So maybe that’s one solution.
You got to hospital under your own steam and you were seen promptly.
I have yet to see a single paramedic who will glue a head wound and leave a patient at home.
> The doctor told me I should have waited for the paramedic who could have done all that and saved me a trip.
> So maybe that’s one solution.
Again how were you to know this?
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