Waterford A&E - The Care

Sully

Hey,

For the first time in a very long time, I had to rush a friend into A&E on the advise of the local ambulance and Care Doc. He had been messing about in a skate park (without a board) - and fell, hitting his head. He was unresponsive for 10mins - so I got called down, along with a friend who works in the local Ambulance. At first we were not aware of how serious, until I arrived and found him dased and confused. Seemed to be OK other then that, but couldnt remember what happened. We were advised to bring him straight in, but since I had the car I decided to drive him in as it would be quicker (by the time Ambulance / Care Doc arrived). On the way in he started to forget things that just happened, and couldnt remember where he was etc.

Arrived in A&E, quiet enough, and explained the situation. Didnt say much, just to sit him down and was given an ice pack. Shortly he was seen to, looked at briefly and put into a corner in the A&E Ward. Despite our concerns, and a gash on his head, they didnt rush to attend to him. His memory was getting worse and he was getting upset. The only time he was seen properly was when his parents arrived and made a scene. They claimed they were "busy" and he was not "top priority".

Docs looked at him, and are concerned he may have damaged his skull. They want to do a CT Scan and keep him in overnight. He couldnt remember anything from today or yesterday. Not even getting colleg exam results!

Iv never been to A&E, but I was shocked at the lack of care. They just seemed so relaxed and un-concerned about the whole thing. Maybe it wasnt as serious as we thought, but id imagine someone loosing there memory who had a bad fall - would be serious!!

Is this normal? Is this what our Health Service has turned into?

c - 13

Sounds about normal for A&E alright longest i've been waiting in A&E was nearly 8 hours, after I broke fingers in a car crash. The place is a bloody joke, I understand that there are certain cases that will (and rightfully should) take priority but it just seems to be a raffle in there as to who is seen and who is not.

Add to that there were three drunks in there the last time I was in (GF f*cked up her knee at work) all shouting and bellowing as to why they were being left so long, one of them fell badly while drunk it would seem. THe nurses kept telling them they wouldnt be seen until they were sober and yet one of them wanted to go across to Tesco and sneak in a naggin for the "patient". Ridiculous ! They should get a drying out room for these kind of people.

Fajitas!

A&E's always seem careless, but usually there's a hell of a lot going on that you don't see. And people do become desensitised to cases coming in, I'm sure after any bit of experience in an A&E, staff have seen everything and anything before.

Tbh though, as I found out through personal experience, if someone really needs to go to the hospital, don't go driving them yourself, get an ambulance, at least you're getting seen to straight away.

kensutz

I was admitted to A&E 7 weeks ago with chest pains. The triage nurse called me in and decided to do an ECG to kick things off. After 4 failed attempts to get it working she decided it wasn't necessary to do one, after all it's just a chest complaint. She then decided to measure my pulse rate and O2 count. After 2 attempts to get that working, she ended up getting no reading.

She then found out that she had a child size clip on my finger and not the adults. That was then put on my finger and she reset the machine and told me to keep an eye on the readings while she was out of the room and let her know what it was. I sat there for about 5 minutes while it took a pulse but no oxygen count. She came back and asked me what came up, I told her nothing and that I'm no professional. She checked the wires again to see that the adult clip wasn't plugged in to measure the count.

I wonder why I always refuse to go near WRH if I can. :rolleyes:

Sully

Fajitas! wrote:

Tbh though, as I found out through personal experience, if someone really needs to go to the hospital, don't go driving them yourself, get an ambulance, at least you're getting seen to straight away.

Apparently that's not the case, according to someone I know who works in the Ambulance. They claim its the exact same story - waiting and waiting.

Most people I saw either had broken a bone in there body or had stomach pains. Nothing critical.

sonners

I've been rushed to WRH on three occasions in the last 12 months each time with a very serious allergic reaction. I've never sat in the waiting for more than 3 minutes. All of the doctors and nurses I've been in contact with have been professional, caring and quick. I always get a bit emotional when it happens coz its a pretty scary thing and they pump alot of drugs into you for it but they have the patience of a saint.

I know not everyone has the quick responses and treatment I've received but I do feel that some (not all) people arrive in with minor injuries and expect to be home within the hour. All of our hopsitals are majorly under staffed and under equiped. The Doctors and Nurses are doing the best they can with what they have, and I've found that if you speak to them they are just as frustrated (if not more so) with the system as we are.

If I'm rushed to ardkeen or a family member is and we're left waiting, part of me is relieved because if you go in and they rush you inside and have a bit of a panic - well thats not normally good news. At the end of the day if they make you wait its because they can afford to do so and some poor soul is in there in a much worse condition than you are-just thank god thats not you.

Sully

kensutz wrote:

I was admitted to A&E 7 weeks ago with chest pains. The triage nurse called me in and decided to do an ECG to kick things off. After 4 failed attempts to get it working she decided it wasn't necessary to do one, after all it's just a chest complaint. She then decided to measure my pulse rate and O2 count. After 2 attempts to get that working, she ended up getting no reading.

She then found out that she had a child size clip on my finger and not the adults. That was then put on my finger and she reset the machine and told me to keep an eye on the readings while she was out of the room and let her know what it was. I sat there for about 5 minutes while it took a pulse but no oxygen count. She came back and asked me what came up, I told her nothing and that I'm no professional. She checked the wires again to see that the adult clip wasn't plugged in to measure the count.

I wonder why I always refuse to go near WRH if I can. :rolleyes:

Jaysus thats bad. Talk about in experienced!

merlante

In that situation you have to make a song and dance about the incident like his parents did. A lot of people come in with a sore head and they often just keep them around until a doctor can conveniently see them -- at least they're in the A&E in case they get worse.

But in your friend's case, it sounds like he could have died at any moment. That being the case, you have to convey this urgency to them in any way that you can.

I think the staff do care, but for them it is a job, and they are probably overworked, often demoralised by the environment, and probably get a fair amount of abuse. Usually when you see them one on one they are very nice.

Newaglish

merlante wrote:

But in your friend's case, it sounds like he could have died at any moment. That being the case, you have to convey this urgency to them in any way that you can.

Seriously, I think the doctors are experienced to know whether or not someone could "die at any moment". Or do you think you are more qualified than the average ER doctor?

Making a "song and dance" about things is utterly rude and ignorant. it would be different if his status suddenly changed while in the waiting room but if he's already been assessed, I think the doctors know what they're doing.

timmywex

should have defo called an ambulance, you dont know if there were any other problems with him (neck,spine etc)

also, an ambulance wouldnt take that much longer to get him to hospital, they have lights and a siren...... you dont, you had to sit in traffic im sure

when you got to the hospital, your friend would be brought straight into recuss and seen by at least one doctor within a minute id say, your friend that works with ambulance should have known this!!


any time anything mildy serious such as this happens, call an ambulance staright away....even if it turns out the person is ok by the time the ambulance arrives, they will have no problem responding and this happening, but wouldnt be too happy to turn up and the person nearly passing away or critical..



oh, and btw, the ambulance tell their control if they are coming in with anything serious and control contact the recieving a+e who have a team ready to recieve and a space in recus, anyone in an ambulance is given priority and looked over by a doctor, they may then be told to wait.....after a doctor looks at them.soon, the ambulance will be able to email patient conditions to the a+e on route in also i think, the computer system is there anyhu

run_Forrest_run

yes our health system is a joke...and who did we vote back into Government? :mad:

Sully

merlante wrote:

In that situation you have to make a song and dance about the incident like his parents did. A lot of people come in with a sore head and they often just keep them around until a doctor can conveniently see them -- at least they're in the A&E in case they get worse.

But in your friend's case, it sounds like he could have died at any moment. That being the case, you have to convey this urgency to them in any way that you can.

I think the staff do care, but for them it is a job, and they are probably overworked, often demoralised by the environment, and probably get a fair amount of abuse. Usually when you see them one on one they are very nice.

In fairness, I told the receptionist and staff that Care Doc advised me to bring him in and that his memory has got worse since arrival. Didnt seem to give a crap.

Sully

timmywex wrote:

should have defo called an ambulance, you dont know if there were any other problems with him (neck,spine etc)

Perhaps I would have taken that approach if I was there at the start, but when I arrived he was up and walking about seemingly normal giving out that I was fussing.

also, an ambulance wouldnt take that much longer to get him to hospital, they have lights and a siren...... you dont, you had to sit in traffic im sure

There was little traffic, it was 11PM and I took the right routes to avoid any possible traffic. I only met traffic at the ring road where even an Ambulance couldnt get them to move (nowhere for them to go and id doubt they will speed up)

when you got to the hospital, your friend would be brought straight into recuss and seen by at least one doctor within a minute id say, your friend that works with ambulance should have known this!!

She wasnt with us, I was asking her advise over the phone. She gave out we didnt call for an Ambulance, but she didnt realise the full story as the others had told her he was "Grand". It was to late by the time I got all the facts to ask her what next, as I was on the phone to Care Doc and they said "Drive him straight in and if you have any problems call us and we will assist".

any time anything mildy serious such as this happens, call an ambulance staright away....even if it turns out the person is ok by the time the ambulance arrives, they will have no problem responding and this happening, but wouldnt be too happy to turn up and the person nearly passing away or critical..

I suppose, I just acted on the advise of Care Doc tho.

oh, and btw, the ambulance tell their control if they are coming in with anything serious and control contact the recieving a+e who have a team ready to recieve and a space in recus, anyone in an ambulance is given priority and looked over by a doctor, they may then be told to wait.....after a doctor looks at them.soon, the ambulance will be able to email patient conditions to the a+e on route in also i think, the computer system is there anyhu

Not sure how the Order of Malta do it - the Health Board ambulance is at least 20mins away. Plus, only the other day it was called out to a house down here (via 999) and they never responded to the call after 20mins. When asked why, "nobody was available" - but they never said this (ie called back).

Sully

run_Forrest_run wrote:

yes our health system is a joke...and who did we vote back into Government? :mad:

FF (who admited that they think that the "Health Service is not in crisis") and the greens (I wonder what there solution to fix our Health Service would be)

c - 13

Sully wrote:

(I wonder what there solution to fix our Health Service would be)

Herbal Salve and some voodoo like chanting methinks.

merlante

Newaglish wrote:

Seriously, I think the doctors are experienced to know whether or not someone could "die at any moment". Or do you think you are more qualified than the average ER doctor?

Making a "song and dance" about things is utterly rude and ignorant. it would be different if his status suddenly changed while in the waiting room but if he's already been assessed, I think the doctors know what they're doing.

The problem in A&E is getting to see a bloody doctor in the first place! There are always people in A&E with suspected concussion, but if you think that someone is very bad then you have to make them aware of it.

The doctor/nurse is not going to know how bad someone is until they are examined properly. If you have reason to believe that someone is very bad, based on the fact that you have spent more time with them than they have during the doctor/nurse's 30 second 'assessment', then you have to make it very clear to them. The assessment is only a filtering process to see if someone needs to be seen right away or whether they can wait. It is not a proper medical examination.

Hospitals are run by a bureaucracy at the end of the day, as they have to be to cope with the numbers coming in in an efficient manner. (In addition, the WRH is possibly the busiest hospital in the state, and is therefore under a lot of pressure.) The fact is that no bureaucracy or system is perfect, and it is often the case in reality that people have to make a song and dance in order to get the appropriate care.

For example I have heard from a few sources that if you are really bad, an ambulance should be called so you are seen straight away. If you are driven to the A&E by a friend or family member, even though it might be faster than waiting for an ambulance, you may or may not be seen straight away. This is a failing of the system because the same patient might receive different care depending on how they arrived at the hospital. I'm sure there are a whole host of similar things that I don't know about.

Paddy@CIRL

Spent three hours in A&E before with a collapsed lung ....

Then got a wheelchair to X-ray that only had one tire ....

But in fairness as been pointed out, if your 'that' bad you'll be looked after, I know we all hear the horror stories but sure that can happen even if they were paying full care and attention, the body doesnt run like machine, its not predictable ...

Sully

Paddy@CIRL wrote:

Spent three hours in A&E before with a collapsed lung ....

Then got a wheelchair to X-ray that only had one tire ....

But in fairness as been pointed out, if your 'that' bad you'll be looked after, I know we all hear the horror stories but sure that can happen even if they were paying full care and attention, the body doesnt run like machine, its not predictable ...

I was rushed to hospital with a collapsed lung twice.. first time my Da brought me in and I was seen to straight away. Put straight into a room with a bed, checked and sent for x-rays.

Second time via ambulance - same story.

Tho, my collapsed lung was pretty bad - I couldnt breath pretty much but the Oxygen helped. Order of Malta took care of me the second time, glad of there help.

Fajitas!

Sully wrote:

(I wonder what there solution to fix our Health Service would be)

No three story hospitals, and better train routes.

Newaglish

I really don't understand the problem here - OP quotes two times he's been seen and treated straight away, and his original post was about a similar case where his friend was seen straight away.

Just because you have to wait for treatment doesn't mean the doctors don't care.

Sully

Newaglish wrote:

I really don't understand the problem here - OP quotes two times he's been seen and treated straight away, and his original post was about a similar case where his friend was seen straight away.

Just because you have to wait for treatment doesn't mean the doctors don't care.

Eh, im reffering mainly to last night. We got talking then about other times, where I was rushed in not being able to breath, having a severe pain and couldnt keep my eyes open. They didnt have a choice - I had to be seen.

My original point was when I brought my friend in who had fallen, hit his head, became unconscious, was brought straight into Ardkeen A&E and failed to be seen by a doctor until his Mother came in and made a fuss. Until then, our requests for him to be seen, our explanations regarding his fall etc were pretty much ignored.

To us, a chap who had a head injury and was unconscious - and was starting to loose his memory fairly bad -- is pretty serious and nothing to "Ah sure, he can sweat it out".

Either your pro-Fina Fail (most FF supporters wouldnt like something which reflects bad on their party to be discussed) or you have some sort of connection with Ardkeen Hospital and are doing your best to support them. Fact is, our Hospital Service in Ireland is atrocious. No getting away from that fact!

Newaglish

Sully wrote:

Arrived in A&E, quiet enough, and explained the situation. Didnt say much, just to sit him down and was given an ice pack. Shortly he was seen to, looked at briefly and put into a corner in the A&E Ward.

You said he was seen to shortly? I'm fairly sure the doctor is more qualified than you and was able to assess whether or not the case was an emergency. You've quoted yourself times where in emergencies you get seen and treated immediately.

Either your pro-Fina Fail (most FF supporters wouldnt like something which reflects bad on their party to be discussed) or you have some sort of connection with Ardkeen Hospital and are doing your best to support them. Fact is, our Hospital Service in Ireland is atrocious. No getting away from that fact!

I'm not pro-Fianna Fáil. I voted Fine Gael if that makes you any happier.

The Health Service Executive is one of the most badly run organisations I have ever come across (having had to work alongside them in the past).

There's a big difference between a very poorly run bureaucratic organisation and a lack of care from the medical staff. You can run into some terrible doctors in the best run Health Services in the world. It's a bit unfair to start criticising the doctors/nurses when in reality, I don't see what your problem was. Did you want to be in and out in 30 minutes with a cup of tea and a few ham sandwiches?

Sully

Newaglish wrote:

You said he was seen to shortly? I'm fairly sure the doctor is more qualified than you and was able to assess whether or not the case was an emergency. You've quoted yourself times where in emergencies you get seen and treated immediately.

I explained that already. In addition, he was NOT seen by a doctor until at LEAST an hour of being brought in.

It's a bit unfair to start criticising the doctors/nurses when in reality, I don't see what your problem was. Did you want to be in and out in 30 minutes with a cup of tea and a few ham sandwiches?

Problem? You dont see one? A chap is brought in after falling and being unconscious for some time. We has a bad gash / bruise in addition to a splitting headache. He cant remember anything that happened that day, nor the day before. He is getting upset and panicking while people just stroll past without a care in the world. Trying to explain what happened and the fact Care Doc told us to bring him in immediately - seemed to go in one ear and out the other. So, we are left confused and annoyed that he has not been properly seen to. A "quick examination" is not sufficant. Its nothing to do with the length of time being present - its to do with the time taken to be seen to by a professional.

It took his parents, on arrival, to get them to listen and get a doctor. On doing so, the doctor was concerned and sent him straight for XRays and CT Scans. He is still present in Hospital to this day, and there is no ETA for his departure. His memory is still poor.

Im sorry, but this was not a simple broken bone or a stomach pain which a lot of people come in with - it was a lot more serious then that and I believe that A&E should have approached the matter better.

Newaglish

Sully wrote:

I explained that already. In addition, he was NOT seen by a doctor until at LEAST an hour of being brought in.

Sully wrote:

Shortly he was seen to, looked at briefly and put into a corner in the A&E Ward.

I think this is what I don't entirely understand? Who was he seen by exactly?

I also think you might be confusing the severity of his condition with the urgency of it. So what if he's still in hospital? You could go into A&E with cancer, you'd be in hospital a long time but it's not a medical emergency so to speak.

Sully

Im not to sure what she was. She just looked in his eyes, gave him an ice pack, and told him the doctor would see him in a while.

Then the wait went on, and he was getting worse and the staff didnt seem to care until his mother came in and made a fuss.

My comment about being in the length of time was to show that it was not a simple "your in your out" A&E case. I had no issues with him being kept in longer, actually im glad - it shows they care. (Not A&E anymore tho)

PetraMac

Newaglish wrote:

Making a "song and dance" about things is utterly rude and ignorant.

Sorry to disagree Newaglish, but normal standards of politeness simply don't apply when you're in a health-related crisis. My family has had all too much experience of the health system in recent years, and the one thing we've learned is that you often _have to_ make a song and dance and stand up for yourself if you want to get seen with any degree of speed and listened to.
There was one occasion (not in WRH I must point out) when my husband was waiting for an x-ray in excruciating pain, could barely sit up. The x-ray staff were totally unconcerned, chatting about who was going on lunch next, really making a mockery of their whole service. It was up to me to go and point out the situation with my husband and not shut up until they finally took him in to be x-rayed. It's against my nature to be "rude" but in that kind of situation you have no choice.
In our experience, unfortunately, it's the people who are polite and don't make a fuss who are often kept waiting and get sub-standard service.

PoleStar

Having read all the posts I think it would be interesting for people to give them the real story from one who is on the inside! Im a doctor working in hospitals around Ireland for the last 7 years.

1. Regarding initial assessments when you arrive in hospital: Patients are often dismayed that when they arrive with something serious, they are seen by a nurse, often very quickly and then sent out to the waiting room to wait. Sometimes a nurse will call a doctor to see the patient quickly (again this might take 1 minute). The patient then has to sometimes wait a long time. This process is called triage, where patients are divided into 1 of 5 categories in order of urgency. This can be done very quickly by any experienced nurse or doctor and the purpose is to identify those who need to be seen first. People are often dissappointed that they are only seen by a nurse/doc for like, a minute and then sent back to wait for hours. ITs not that the nurse or doc doesnt care, but when you have limited resources thats the only way it can work.

2. Ambulances: patients who arrive in ambulances are assessed the same way as patients coming in the door themselves. I.e. they are triaged as I explained above. You will not be seen first just because you came in an ambulance. I ahve come across many patients who phoned an ambulance because they had no car, couldnt get a taxi, or thought that they would be seen first, however, they are treated as any other. I guess however, really sick patients often have to come in an ambulance, and they have to be seen first anyway and thats perhaps why you get the impression than ambulance patients are seen first. Please note I am not suggesting that anyone should ever hesitate calling an ambulance if they think they should. If you are worried, call one, thats what the paramedics are there for. If it turns out you are not seriously ill, then thats great but always better to be safe than sorry I say.

3. Drunks in A/E: people often say that drunks should be put in a drying out room. Unfortunatley while no one likes having a drunk in A/E, they must be seen and treated like any other patient. What people often forget that a lot of drunk people in A/E end up there because they fall when drunk and hit their heads or perhaps were in a fight. While we might say, "it serves you right" to ourselves, we cannot look at it like that and they need treatment for their head injury or broken ribs just the same as any other patient that is there. As for what you might call the "down and out alcoholic", we should have pity on them as they too need help and unfortunately in Ireland, there is often no where else for them to go except the local A/E.

4. As for those who shout and make a song and dance about their condition. The only reason people like this are seen first is because they are making a nuisance for all the other patients in the department and no other reason. For some reason, people think that its ok to shout and curse at a nurse or doctor in casualty. This not only makes the job more stressful and often slows the whole A/E department down by delayin things, but it also makes it very stressful for other patients. When I visit my bank manager, I dont shout at him and curse at him if things arent the way I want them but for some reason this is ok to do in a hospital. Patients like this are often seen first just to get rid of them and make the department an easier place to be in both for patients and staff and the only effect they often have is to jump the queue and skip ahead of other patients who also need to be seen too. Please note I am not suggesting that people should just say nothing in casualty, if you are waiting a long time and are seriously concerned, if you approach a member of staff and address your concerns to them, they will listen.

I hope this has provided some useful inside information to people here.

timmywex

just so ye know, waterford a+e is the busiest in the country. Sometimes its second with cork beating it but most of thetime, they have the biggest turnover of patients. average for may: 185 patients oer day