Should self inflicted wounded people use our A&E departments?

Widdershins

Obvious Desperate Breakfasts wrote: »

Yes, that A&E sounds awful. I unfortunately have been through A&E in a few different hospitals and I was rushed through everything time I needed to be. I do find it hard to believe that I wouldn’t have been brought straight through with the condition I was in with the abscess at the hospital you describe but maybe. I would have gone unconscious if there had been any kind of wait though so that would have got them moving.

I probably wouldn't believe it if it hadn't happened to me/people I know and believe. There'd be no such thing as medical negligence cases if it never happened.
I went a bit spaced-out but didn't lose consciousness that I know of so it's not guaranteed. In a way, I wshed I had.

Andy From Sligo

few years back my wife ate a piece of kiwi fruit in a salad - she never had kiwi fruit ever before that she could recall - within minutes her face was going rashy and her tongue was swelling up (please dont say it was self inflicted and that she was not forced to eat the salad) went to A&E, waiting room was absolutely chocked full signed her in and on the LED scrolling noard read "there is currently a 4 hour wait" sat down after signing her in (whats your doctors name, address religion, next of kin blah blah blah..) didnt even get to seeing the triage nurse ... she went to go to the toilet , came back from the toilet and dropped to the floor like someone had pulled the legs away from her - next minute load of nurses came out of no-where lifted her into cubicle - and told me to wait in family and relatives room .. I was shyting meself praying she would be OK. about what seemed for ages but i think it were around 20 mins they said you can see your wife now .. she were sitting up right as rain and swelling had gone down , they gave her adrenaline or epi-pen or something , nurse said any longer and her tongue would have swelled so much it would have choked her - god that was a frightening time

Obvious Desperate Breakfasts

Widdershins wrote: »

I probably wouldn't believe it if it hadn't happened to me/people I know and believe. There'd be no such thing as medical negligence cases if it never happened.
I went a bit spaced-out but didn't lose consciousness that I know of so it's not guaranteed. In a way, I wshed I had.

I don’t believe I would have been left waiting in the hospital you describe. I would have gone unconscious, no maybe about it. That can’t be ignored and I doubt staff would have just shrugged their shoulders at someone collapsed on the floor.

Tommy Halpin Kelly

What about suicide victims?

Tommy Halpin Kelly

Tommy Halpin Kelly wrote: »

What about suicide victims?

nice bait :rolleyes:

the_syco

Tommy Halpin Kelly wrote: »

What about suicide victims?

It's not their fault they they happened to be near Mr Snackbar when he pulled the rip cord.

El_Duderino 09

Andy From Sligo wrote: »

(please dont say it was self inflicted and that she was not forced to eat the salad)

Nurse said any longer and her tongue would have swelled so much it would have choked her - god that was a frightening time

Just to clarify, we shouldn’t use your own logic to point out that she caused her own emergency. Ok

And if the hospital had faffed around to figure out whether her condition was self inflicted and sent her to private hospital, she could well have died in the meantime. Sounds like a terrible idea really, doesn’t it?

Are you proposing the hospital should only send people to private hospital for self inflicted problems if it’s not AFS’s wife?

El_Duderino 09

Double post

Andy From Sligo

El_Duderino 09 wrote: »

Just to clarify, we shouldn’t use your own logic to point out that she caused her own emergency. Ok

And if the hospital had faffed around to figure out whether her condition was self inflicted and sent her to private hospital, she could well have died in the meantime. Sounds like a terrible idea really, doesn’t it?

Are you proposing the hospital should only send people to private hospital for self inflicted problems if it’s not AFS’s wife?

If you cannot realise what group of people of self inflicted injuries should not be waiting to be seen in a HSE accident and emergency department then I am not going to go through explaining it again . and once people have made their minds up that its a stupid idea its not worth trying to explain to them otherwise or change their minds

SusieBlue

Andy From Sligo wrote: »

few years back my wife ate a piece of kiwi fruit in a salad - she never had kiwi fruit ever before that she could recall - within minutes her face was going rashy and her tongue was swelling up (please dont say it was self inflicted and that she was not forced to eat the salad) went to A&E, waiting room was absolutely chocked full signed her in and on the LED scrolling noard read "there is currently a 4 hour wait" sat down after signing her in (whats your doctors name, address religion, next of kin blah blah blah..) didnt even get to seeing the triage nurse ... she went to go to the toilet , came back from the toilet and dropped to the floor like someone had pulled the legs away from her - next minute load of nurses came out of no-where lifted her into cubicle - and told me to wait in family and relatives room .. I was shyting meself praying she would be OK. about what seemed for ages but i think it were around 20 mins they said you can see your wife now .. she were sitting up right as rain and swelling had gone down , they gave her adrenaline or epi-pen or something , nurse said any longer and her tongue would have swelled so much it would have choked her - god that was a frightening time

Yet a few posts ago you were suggesting children, people with disabilities & the elderly should get seen to first, just because, even if their issue isn't urgent or life threatening.

Imagine how much longer your wife would have been waiting if that were the case??

El_Duderino 09

Andy From Sligo wrote: »

If you cannot realise what group of people of self inflicted injuries should not be waiting to be seen in a HSE accident and emergency department then I am not going to go through explaining it again . and once people have made their minds up that its a stupid idea its not worth trying to explain to them otherwise or change their minds

I get that you don’t want to discuss it when it’s your wife. She should just get the treatment she needs. Your proposal is only for other people.

It takes years to finally figure out whose actually at fault in accidents. Gathering all the data and expert testimony takes time. Any you’re proposing the hospital should figure that stuff out on the spot and decide whether or not to treat.

Your wife could have innocently eaten a kiwi by complete accident. Or she could have been intentionally self harming. The doctors first job is the same in any case - treat the patient.

If time was of the essence in your wife’s case, then how thorough would you like the investigation into your wife’s case to have been? How should they have gathered all the facts and ruled out self inflicted harm?

Wouldn’t it just be simpler to let hospitals triage patients in order of urgency and leave it at that?

Andy From Sligo

SusieBlue wrote: »

Yet a few posts ago you were suggesting children, people with disabilities & the elderly should get seen to first, just because, even if their issue isn't urgent or life threatening.

Imagine how much longer your wife would have been waiting if that were the case??

You only choose to read what you want to read or choose a way to pick my posts to pieces to a way where you come back and score some points . I am pretty sure I said that it couldn't be put into practice all the time. I was citing if you have a department full of non emergency cases and people are waiting for hours to be seen there needs to be a system like that maybe , if I didn't put that and you don't realise that a life or death situation takes precedence then I am not going to spell it out and waste any more time explaining things.

Its pointless now anyway. I get it , I get on here that a lot of people think its a stupid idea. I asked what people thought in the original post, I have my answer that its a stupid idea, I have an answer that people think I am stupid person and an ebarrasement so that's the end of it, now all I seem to be doing is answering people like you who are determined to try and slip me up on what I put previously and 'catch me out' for what reason I don't know , maybe just for kicks?

SusieBlue

Andy From Sligo wrote: »

You only choose to read what you want to read or choose a way to pick my posts to pieces to a way where you come back and score some points . I am pretty sure I said that it couldn't be put into practice all the time. I was citing if you have a department full of non emergency cases and people are waiting for hours to be seen there needs to be a system like that maybe , if I didn't put that and you don't realise that a life or death situation takes precedence then I am not going to spell it out and waste any more time explaining things.

Its pointless now anyway. I get it , I get on here that a lot of people think its a stupid idea. I asked what people thought in the original post, I have my answer that its a stupid idea, I have an answer that people think I am stupid person and an ebarrasement so that's the end of it, now all I seem to be doing is answering people like you who are determined to try and slip me up on what I put previously and 'catch me out' for what reason I don't know , maybe just for kicks?

We have such a system already, its called triage.
A nurse assesses the patient and determines the urgency and severity of their issue, and then places them in a queue to see the doctor based on her findings.

As for your second paragraph, I never called you a stupid person or an embarrassment, or any of the rest of that.
You sound a bit hysterical.

this thread has gone downhill

and I didn’t think that was even possible

Mint Sauce

The problem with our A&E/ED departments is, is that some can be treated by GPs, or its a friday/saturday night, and people are in for drink related incidents, both of which can cause delays, or give an unpleasent experience.

I am sure its much the same in the UK and and NHS, where the service is free to all. How ever there were suggestions or propasals of a small charge there, applied to all, of say £10 or £25. If your admission was deemed nessesary of A&E/ED treatment, then this charge would be wavied or refunded. What if something similar was suggested here, €10 applied to medical card holders, considering the none card holders are already charged €100. Now if they were sent by their GP, then it would be a nessesary case, and therefore not applied, or if they were a walk in, and it was a nessesary case, it would be also be waived/refunded.

It might certainly reduce the number of unessary walk ins, and drunkards at weekends, and reduce the stress on staff, and patients alike.

AndrewJRenko

SusieBlue wrote: »

We have such a system already, its called triage.
A nurse assesses the patient and determines the urgency and severity of their issue, and then places them in a queue to see the doctor based on her findings.

Isn't it amazing how some people manage to convince themselves that they are experts in everything, when in reality, they know little about anything?

Andy From Sligo

SusieBlue wrote: »

We have such a system already, its called triage.
A nurse assesses the patient and determines the urgency and severity of their issue, and then places them in a queue to see the doctor based on her findings.

As for your second paragraph, I never called you a stupid person or an embarrassment, or any of the rest of that.
You sound a bit hysterical.

when i was in A&E - there was another problem , the amount of time it took to actually seeing the Triage nurse - if that hasnt improved we also have to see how that can all be sped up like from the actual time you enter A&E and the time then to 'sign in' - then the amount of time to sit in the waiting room waiting to be seen by the triage nurse ... I dunno maybe it is quicker these days the amount of time waiting to even get to see the triage nurse.

I did not particularly say you called me a stupid person (i dont think so) - you were the straw that broke the camel's back with your post though so i think i said 'some people on here calling me stupid' so , very sorry if i just cited you only as calling me stupid - you just got the brunt of it.

You were doing so well until the end bit until you said I sounded a bit hysterical - because see you have judged already, and got it wrong - you havent met me , you cannot tell the tone in what i was saying in my reply to you, never saw any body language and you you assumed that I sounded hysterical to you.

Andy From Sligo

AndrewJRenko wrote: »

Isn't it amazing how some people manage to convince themselves that they are experts in everything, when in reality, they know little about anything?

indeed - if what you are saying that triage nurses are expert in everyone who walks into A&E and can determine who needs treatment in what order that's quite a big ask of them and their expertise .

I know the triage nurse is human at the end of the day but I have read many horror stories of triage nurses in A&E departments only to tell people to go home and take a couple of paracetamol ... only for the person to go home, get progressively worse and die!

I know not a very common occurrence but it happens/has happened. - so now they could be wary of that now and on side of caution not send anyone home until they have been seen in a cubicle by a proper doctor/consultant .. and then hence busy waiting rooms and longer waiting hours.

I would liken triage nurses sometimes to those secretaries on 'reception' in drs surgeries whereby you ask to see a doctor and they they start diagnosing you on the spot, forgetting that they are not a doctor but a receptionist.

AndrewJRenko

Andy From Sligo wrote: »

indeed - if what you are saying that triage nurses are expert in everyone who walks into A&E and can determine who needs treatment in what order that's quite a big ask of them and their expertise .

I know the triage nurse is human at the end of the day but I have read many horror stories of triage nurses in A&E departments only to tell people to go home and take a couple of paracetamol ... only for the person to go home, get progressively worse and die!

I know not a very common occurrence but it happens/has happened. - so now they could be wary of that now and on side of caution not send anyone home until they have been seen in a cubicle by a proper doctor/consultant .. and then hence busy waiting rooms and longer waiting hours.

I would liken triage nurses sometimes to those secretaries on 'reception' in drs surgeries whereby you ask to see a doctor and they they start diagnosing you on the spot, forgetting that they are not a doctor but a receptionist.

Andy, rather than getting into the detail - can I ask why or how you think you know more about running A&E departments than the people who actually run them? You know, the consultants who've trained for 20+ years to get to their level, the nurses who've trained for 5 years and practiced for many more years, even the administrators who spent 1/3 of their adult lives in A&E dealing with people coming in and out.


What makes you think you know more than them?

Widdershins

Mint Sauce wrote: »

The problem with our A&E/ED departments is, is that some can be treated by GPs, or its a friday/saturday night, and people are in for drink related incidents, both of which can cause delays, or give an unpleasent experience.

I am sure its much the same in the UK and and NHS, where the service is free to all. How ever there were suggestions or propasals of a small charge there, applied to all, of say £10 or £25. If your admission was deemed nessesary of A&E/ED treatment, then this charge would be wavied or refunded. What if something similar was suggested here, €10 applied to medical card holders, considering the none card holders are already charged €100. Now if they were sent by their GP, then it would be a nessesary case, and therefore not applied, or if they were a walk in, and it was a nessesary case, it would be also be waived/refunded.

It might certainly reduce the number of unessary walk ins, and drunkards at weekends, and reduce the stress on staff, and patients alike.

I'm a medical card holder due to long term serious illness. As far as I remember there already is a fee for A&E visits without a GP's letter. I'm not 100% sure.

Given the fact that medical card patients wait much longer for tests and consequently, longer for treatments, I think self referrals are understandable if someone ends up in dire straights while in waiting list limbo. I haven't done this myself but a few friends present in A&E several times a year out of desperation and pain from their illness. (I know you said necessary walk-ins fee would also be waived )

But I would be i favour of a fee for anyone who could be proven to be a deliberate time waster.

Widdershins

AndrewJRenko wrote: »

Andy, rather than getting into the detail - can I ask why or how you think you know more about running A&E departments than the people who actually run them? You know, the consultants who've trained for 20+ years to get to their level, the nurses who've trained for 5 years and practiced for many more years, even the administrators who spent 1/3 of their adult lives in A&E dealing with people coming in and out.


What makes you think you know more than them?

TBF you don't have to be an expert to see there's something wrong with those things happening. I have a lot of respect for the good staff in AandE but those cases do worry me and I haven't always had a good experience there myself. Cases like that usually glaringly wrong and the people had symptoms that would be described as urgent according to any medical advice you could find anywhere.

Widdershins

Widdershins wrote: »

But I would be i favour of a fee for anyone who could be proven to be a deliberate time waster.

And you’d make them pay it how? I don’t think any hospital is in the business of demanding money from patients because they don’t feel like they were worth the time. I’ve encountered many an A&E doctor who was so careless and useless that by their own shoddy behaviour I could’ve been charged that fee despite the fact it was the doctor who was wrong in that situation.

Widdershins

Sonny Faint GrocerMGS wrote: »

And you’d make them pay it how? I don’t think any hospital is in the business of demanding money from patients because they don’t feel like they were worth the time. I’ve encountered many an A&E doctor who was so careless and useless that by their own shoddy behaviour I could’ve been charged that fee despite the fact it was the doctor who was wrong in that situation.

Fair enough. Sorry to hear that, and I can relate! I thought their system for invoicing could be used. I guess they'd better look at the triage system again as time wasters are getting in while genuine ones are sent home to take paracetamol.

Widdershins

Widdershins wrote: »

Fair enough. Sorry to hear that, and I can relate! I thought their system for invoicing could be used. I guess they'd better look at the triage system again as time wasters are getting in while genuine ones are sent home to take paracetamol.

You’d be surprised actually, the timewaster drunks are the ones more often sent off home above anyone else. Was talking to an orderly who pointed out a drunk woman making a scene “That’s why you’re waiting so long, by the way”.

Andy From Sligo

AndrewJRenko wrote: »

Andy, rather than getting into the detail - can I ask why or how you think you know more about running A&E departments than the people who actually run them? You know, the consultants who've trained for 20+ years to get to their level, the nurses who've trained for 5 years and practiced for many more years, even the administrators who spent 1/3 of their adult lives in A&E dealing with people coming in and out.


What makes you think you know more than them?

ah I see - i picked you up wrong , I thought you was saying that the triage nurses get things wrong - whereas you didnt , you think I have written somewhere that I know more than the 'experts' and was telling them how to run a A&E department

... well I wasnt , I have offered up a suggestion to discuss in maybe some way the waiting times in A&E departments could possibly be cut down

taken the wrong way again - it must be the way I explain stuff , I know i am not the best at getting a point across .. many people is seems get upset or offended by it

pekitivey

Three words. "Duty of care" Its a two tiered health system for sure here in Ireland. That means everyone has the option to go private, if a private option is there. But, forcing people into private health care based on the nature of their injuries and making them pay for it is ludicrous. I think you may have been born in the wrong era, and country. Because your ideas seem a little bit..... off putting tbh.

Andy From Sligo

Sonny Faint GrocerMGS wrote: »

And you’d make them pay it how?.....

you can pass these onto third party debt collection agencies who can either take them on in full or they can recover the outstanding debts on behalf of the health service...

El_Duderino 09

Andy From Sligo wrote: »

ah I see - i picked you up wrong , I thought you was saying that the triage nurses get things wrong - whereas you didnt , you think I have written somewhere that I know more than the 'experts' and was telling them how to run a A&E department

Of course triage nurses get things wrong occasionally because medicine is a tricky business. You’re proposing introducing an entirely new layer of triage based on whether the patient is at fault or not.

If nurses are already stretched to make medical decisions, how in the name of jaysus is adding liability into the mix going to make things better?

Andy From Sligo

Sonny Faint GrocerMGS wrote: »

You’d be surprised actually, the timewaster drunks are the ones more often sent off home above anyone else. Was talking to an orderly who pointed out a drunk woman making a scene “That’s why you’re waiting so long, by the way”.

waiting for the day the court case comes when a drunk is sent home from a A&E dept ..... then something bad happens and they sue the health service for hundreds of thousands .. or they die

as i said before , maybe they should be passed onto somewhere else like a private facility to get treated if they need it , and then sent an appropriate bill for being treated - whether medical card holder or otherwise

Skarlett Black

I fell and broke my back putting a picture up in the sittingroom. - Sure I didnt need a picture in the sittingroom really did I?
I dropped a television on my foot and broke a bone. - I suppose I didn't really need to move the telly. Do we really need televisions anyway?
I burnt myself badly with the kettle making a cup of tea. - Did I really need to be making tea?
I dislocated my knee playing soccer. - Did I really need to be playing sports?
I went hillwalking and fell down the hill and cracked my skull. - Did I really need to be out walking and enjoying a day out?
I was cycling to work and got a belt of a car. - Did I really need to be going to work though?


Come on like.