NATIONAL HELL SERVICE
The Government is intent on introducing Polyclinics Hospitals where all manner of services will be on offer for the public.
Have you visited your A & E department recently. You know doubt found that waiting for hours to be seen was a usual occurrence. The low staffing levels at the sharp end are to blame but also the systems in place at the present time for dealing with all manner of injuries.
What we have noticed recently is that even if the waiting area for treatment has but few customers the problem seems to be back stairs were staff shortages mean that though a doctor looks at the injury promptly there is a delay for the wound to be dressed and the appropriate treatment given. This means that a cubicle is occupied by a patient which could have been available for another patient.
It appears that even if the waiting area is empty and all cubicles occupied they cannot complete the treatment recommended by the doctor because there are insufficient nurses to follow up the doctors diagnosis and therefore the patient has to wait until a nurse is available. Surely the number of nurses on duty should be sufficient to ensure that
EVERY PATIENT IS ATTENDED TO BY A NURSE AFTER THE DOCTOR HAS SEEN A PATIENT.
Otherwise the patient might as well be still in the waiting room instead of having to wait for the treatment to be completed.
The patient a 79year- old frail lady with a severe cut to the lower leg was seen promptly by the doctor but had to wait a time to have the wound attended to and dressed and an injection given. The reason given for the delay in treating an elderly patient distressed and fainting on occasions was that the staff were treating those patients coming in by ambulance.
If this is so, then it is a dangerous system, because what is the use of having patients in the cubicles if the treatment cannot be given in a reasonable time to enable the cubicle to be occupied by another who may have been in the waiting for 3 hours which was the time that the nurse quoted.
The injury in the case mentioned above was a severe gash on the lower leg which because of its location could not be stitched in the usual manner and therefore required the skin being brought together and held by tape. the amount of blood at the scene of the accident was more than one would imagine but no doubt the age of the patient was a considering factor.
What we were unable to understand was that any patient particularly an elderly person of 79-years-of age could have been treated in the manner mentioned above. We were led to believe that the elderly were not to be discriminated against but on the contrary to receive the same treatment as a young child that had a similar injury.
The Staff Nurse who was approached to ask on two occasions when it would be possible for a nurse to attend to complete the treatment was unable to obtain the services of the nurse because she was too busy elsewhere but she herself decided to complete the necessary treatment and her expertise and sensitive manner were of the highest standard.
The husband attending his wife had witnessed the accident and was himself feeling unwell because of the suddenness of the accident and the amount of blood at the scene so was in no mood to see his wife not receiving what he considered appropriate treatment.
We instanced a case a few years ago of a 75-year-old man who was in a car when rammed by another coming from a side road only a few hundred yards from his doctors surgery. The accident occurred at approximately 9am and the pensioner was so traumatised that he had to be assisted from his vehicle by the occupants of the other vehicle.
Later that Friday afternoon at 3pm he walked the few yards to his doctors surgery and after being told to sit down for a few minutes for a doctor to see him he was a few minutes later told that he could not be seen and that he should go to the local A & E for treatment. Well! as many have possibly experienced that could be a 3/4 hour wait. Obviously the last thing the patient wanted to do was to get in any vehicle after such a severely traumatic experience. It is possible that the practice mentioned is one which will have to close when the local Polyclinic opens.
We are against the very idea of such large Hospitals -whatever the designation. Far better to be treated by your local surgery were you are NOT A NUMBER as you will be in a mammoth organisation which would have such a large staffing level constantly being replaced that it is disturbing to the elderly and disabled and no doubt the majority of patents who prefer their local doctor.
But whether it is the local practice or the polyclinic in the end it comes down to the service offered.
On Thursday July 3 at approximately 10.30 pm the 79-year-old grand mother was suffering such acute pain from the injured leg that she asked her husband to take her down to A & E a few miles away.
The husband was greatly alarmed because over their 45 year marriage his wife was always the last person to complain about her health even though she had had a number of operations on her shoulder and leg and for other reasons .She was always stoic about illness. So to hear his wife ask for to be taken down to A&E was certainly a first and he realised that something was very wrong with the leg so he took her to the hospital. On arriving at approximately 10.30pm his wife spoke to the person in the reception area and explained that the leg which had been seen and dressed by their staff a few days ago and had been seen by the local practice nurse ,was giving great pain and the leg was badly swollen.
The receptionist said she would ask the nurse if she could have the wound looked at. On returning to her post she said that it was not possible for the leg to be examined but that she could wait for 2/3 hours or call back later when the queue had reduced its size. The 79-year-old grand mother knew she could not sit for such a time with such a painful and swollen leg so she ask her husband to take her home.
We are astounded that a hospital that had already been responsible for dressing the wound in the first place should when the patient returns in such circumstances not be concerned that they may have overlooked the severity of the wound and its likely hidden dangers. The leg was not X-Rayed though the wound was in the area of the shin bone. One would also have thought that a 79-year-old-grandmother in such intense pain deserved better treatment than to be treated in this offhand manner.
In a matter of hours the grandmother will be taken by car the short distance to the local doctor. Her husband is obviously greatly worried that there might be something very wrong with his wife's leg considering the increased swelling and intense pain. He and his wife will know the result in a matter of hours but he is unable to sleep with such a great worry on his mind.
At approximately 3am she awoke in so much pain but after taking further pain relief tablets finally got off to sleep.
At 11 am on Friday 4th July she has an appointment but her husband asked her to agree to go round to the surgery when it opened at 8.30 because it was important that there was no delay in the doctor seeing the leg in order to decide on future medication.
Looking from the outside of the supposed system within A&E in its dealings with the injured we ask where has COMMON SENSE gone when a vulnerable 79-year-old in such pain is treated in such a cavalier way by the nurse on duty who should at least have looked at the swollen leg considering that it was their hospital that had originally been responsible for dressing the wound and giving the appropriate treatment. There were no x-ray or antibiotics given possibly for a good reason but time will tell about that decision.
The husband awaits with much in trepidation that the injury has not become more serious because of the off-hand manner in which the 79-year-old grandmother had been treated.
WE WERE RIGHT!
FRIDAY JULY 4-2008
When the 79-year-old grandmother who was refused immediate medical examination of her swollen and painful leg at the A&E at 10.30 last night went to the local surgery for a previously arranged appointment and after being seen by the nurse who was concerned at the condition of the leg the doctor was called and he immediately prescribed antibiotics. (we hope not too late.)
So the elderly patient had to wait 12 hours before her condition was properly assessed and the essential possible life-saving medication given.
The NURSE at the reception area who refused to see the 79-year-old grandmother last night at 10.30 pm should be ashamed of herself. The elderly patient was in great pain throughout the night and only an increase in pain relief medication eased her pain to allow her to have a few hours sleep
It is to be remembered that the hospital A&E had treated the wound in the first place and one would have thought that they had an obligation to see promptly someone who subsequently suffered great pain and swelling of the leg and foot which made it impossible to get her foot into her usual footwear.
For everyone's sake we hope that the belated necessary live-saving medication does it's job?
September 5th -2008
Well it is as we feared as after 10 weeks of changing dressings three times a week and a STOP and GO spell of antibiotics which were not given by the A&E when the pensioner was seen by the doctor with the terrible ripped and torn leg and even the patient's practice treated the injury of no consequence until a week after the injury and it was many weeks later they took the first swab which reminds us that last Friday after having her leg dressed by a nurse she asked if the doctor would look at the wound because of its condition and was told that it was not necessary. But the 79 year old was so concerned about the condition of her leg and the growing pain after 10 weeks of OFF and ON treatment -being taken off antibiotics and a few weeks later put back on again that on leaving the nurse she saw the doctor and asked her if she would look at the leg and was told that she could not do so because it would make her schedule longer and cause a delay to her seeing her patients on time. Well the pensioner has often found that she had to wait a half hour or longer on occasions as no doubt many other patients so that comment was callous in the extreme when one considers that the nurse had taken yet another swab last Friday in order to identify the infection.
When the 79 year old mentions the deteriorating condition of her leg she is told to keep her leg up and rest it -which she has done. But the fact that another swab was necessary points to the seriousness of the condition. After ten weeks of OFF and ON treatment and a callous attitude by the doctor. WE would say inhuman disregard for a frail 79 year-old who has now been informed that she has been booked in for the District Nurse to look at the serious condition of the wound.
Looking back if the pensioner had received the correct treatment -antibiotics and a swab taken at the time she had her ragged and torn leg dressed in A & E ten weeks ago, and when she saw the nurse at the practice days later and her injury brought to the attention of the doctor and antibiotics given instead the wound was re-dressed and she was told to return for further dressings to be changed. The doctor was not informed.
If she could have been seen by the duty doctor and antibiotics and a swab taken instead she was told by the nurse on duty that she would have to wait 2.5 hours in A&E for treatment . This was an impossible condition as the pensioner had left her bed because of the pain she was experiencing and had asked to be taken down to the hospital . The 79 year old who had just left her bed did not feel well enough to sit there when she needed sleep and to return to her bed and take painkillers.
This terrible ordeal looks even bleaker as there appears after ten weeks no real effort by the practice to be concerned about the pensioner's condition but simply to say that for them to spend a few seconds to see the seriousness of the wound the patient was told we must keep to our schedule, knowing as they must that their responsibility is first to those patients who they already need treatment and a caring attitude and not hide behind the rigidity of a callous routine.
The husband of the 79-year old had feared from the beginning over ten weeks ago that matters would most likely not improve and he has been tragically proved right. This is a classic case of the uncaring regulation and target culture NHS which leads to mistakes being made and the patient treated as an unnecessary gog in the wheel.
He is now even more most apprehensive of what the future holds should this injustice continue?
5th September, 2008
On Wednesday the 9th of September the 79 year-old grandmother went to the surgery to have her leg dressed as usual by the nurse who on seeing the worsening condition of the leg asked the doctor if antibiotics should be given and after some prevarication he agreed.
The leg is giving the patient much pain at times necessitating taking pain-killers. The original wound has healed but there has appeared two abscess's on the leg below the wound close to her foot which is as mentioned above to be looked at by the District Nurse on the coming Thursday.
We believe the system is at fault because it is now left to the nurse to decide whether to ask the doctor to look at the wound and give the antibiotics or other medication required. In the first place someone is treated at A&E and needs the local nurse to dress the wound the patient should FIRST be seen by the doctor THAT TIME and not referred to the doctor over a week later by the nurse. The doctor when seeing the wound asked the patient whether she had been given antibiotics which the answer was NO.
With the doctor delegating more work to nurses who now must make the LIFE or DEATH decisions before any further treatment can be given it is more important that if the wound has not healed by a certain time that the doctor should HERSELF or HIMSELF make provision for the patient to be monitored FIRST by the doctor and then referred to the nurse for the dressing etc. At the present time you have the attitude of one doctor who implied there rote system was more important than giving priority to patients who are still being treated by the practice after they had the original wound treated at A & E.
Tomorrow on Thursday the 11th September the patient is to see the District Nurse and also to obtain a scan of the leg-this after over ten weeks after the visit to A & E when the severity of the wound was ignored and NO antibiotics given and later as explained above on the occasion of the 79-year-old having to leave her bed in order to be taken down to the same A & E and to be told that she would have to wait over 2.5 hours. Obviously this was out of the question because the patient needed to get home to obtain more pain-killers and get back to rest when the medication had taken effect.
FURTHER PROGRESS REPORT.
NATIONAL HELL SERVICE
LATEST! OCTOBER 18-2008
After weekly visits to the local surgery to have the wound redressed since early July 2008 the 79-year-old who was not given the appropriate treatment when her leg was cut on a jagged stone brick wall - not given antibiotics at the time and the refusal of the Doctor on A&E to look at the wound when she had to leave her bed in order to be taken down to the hospital because of the intense pain and was told to wait 2/3 hours to be seen.
Since the accident the patient has not been referred to a specialist to find out WHY it is taking almost 5 months for the leg to heal. Possibly it is as we read in the Daily Mail on October 18th that Doctors are paid a bonus if they DO NOT refer a patient to a SPECIALIST. We have heard so many crack-pot decisions from New Labour over the past 11 years that this must be top of the list for madness and even the BMA have pointed out that their crazy scheme will mean that patients will have illnesses that will become more serious and more costly in the end. Most importantly, moreover, many more patients will have their lives shortened in order supposedly so that the Government can save resources-something they have failed to do themselves since 1997 because of the extravagant mistakes for which we are all paying the price in October ,2008.
[Further progress report to follow]