As Jedi Master Yoda would have remarked “Reassured, I not was!”

A tale of two medical visits (acknowledgement to Dickens). Two Saturdays ago, I had to go urgently to our local University Hospital North Durham (UHND): a day ago, I had to convoy my wife in a Patient Transport Service (PTS) Ambulance for a chest X-ray at the same hospital. Two different medical visits, two very differing outcomes.

As to my urgent trip to the A&E department, I copy the email sent to the Patient Experience Department, (their title, not mine):-

I was working in my back-garden on Saturday 4th August afternoon, hacking away at some overgrown bush, when I was stung on the eyelid by a bee. My eyelid swelled up and closed my eye completely, which prevented my driving, so I had to beg for a lift to the hospital from my neighbour. I was literally in agony, but despite asking at least twice for speedy access to medical help, was forced to wait in the laughingly-named Accident and Emergency queue for well over an hour/two hours before I was ushered into the ‘Triage’ room where three uniformed staff members performed their duties. I stated that I had been stung by a bee on my eyelid, and I was in great pain, but the remorseless note-taking, questions on such vital statistics such as how much alcohol did I drink were relentlessly pursued. After what seemed like another hour, but was actually around ten minutes: I was gravely handed a green plastic card, and told that I should have gone to the ‘Urgent Care’ facility, based at the end of the main corridor.

I arrived at the ‘Urgent Care’ sector, where I found two elderly staff people seated behind a desk, where I was informed, “just take a seat in the adult waiting room, and someone will attend.” There were about six or seven other people in this quaintly-named ‘Urgent Care’ facility, and upon enquiring, found no-one had come near, or been attended to for quite a while. After a very short while, I was in danger of losing my temper, so decided to ascertain who was supposed to be doing what, as besides my own immediate pain: I was intensely concerned about my wife, whom I was forced to leave alone in our house, as she has been ill for decades, and is unable to even move without my help. I asked, somewhat forcefully, to speak with someone in authority as to the progress of attending not only to my problems, but also everyone else’s who seemed to have been forgotten.

I was spoken to by an man of asian appearance, dressed in a purple/red uniform, and was told that all would be well, and please have patience. I replied that my patience had run out some time back, and all I was concerned with was being relieved from the bee-sting pain, and being able to return as quickly as possible to my wife.

After a further five minutes, I was ushered in to a room where I was treated by a nurse-practitioner (I think,), again dressed in purple/red-scrubs uniform. Once again, instead of being relieved from the severe pain I was experiencing, I was sat down and, once again, asked lots of questions by this young woman, whilst she tapped away at her keyboard. Eventually, I was told to lie down on the day-bed, and the young woman checked that I had indeed got a bee-sting, and the sting was still embedded in my eyelid. I was then amazed to see this young uniformed woman search through various desk drawers and then through her HANDBAG  for a pair of fine tweezers. She failed to find anything, and so approached my eye and plucked the sting out with her FINGERNAILS, complete, I believe, with nail-varnish, although I cannot confirm the last observation.

A young female doctor then entered the treatment room, gazed learnedly at a) my eyelid and then b) at the sting which had been extracted from my eyelid, and gravely stated “Yes, you have been stung by a bee, my father keeps bees and he gets stung all the time”; then disappeared as speedily as she had appeared. The young nurse-practitioner ( as I believe she was), then proceeded to print off an eye reading test, and holding it up asked me to read the letters; before pronouncing herself satisfied with my eyesight and reading skills. She then gave me a small pack of antihistamine pills, and packed me off.

I was very annoyed at the cavalier manner in which I was treated, being made to wait for what seemed like an age before being ‘interviewed’ by the Triage Trio, and then casually told that I should have gone straight to the Urgent Care facility (the name itself being a genuine source of sardonic amusement to those unfortunate enough to have to use it), but decided to leave things be but: after spotting a newspaper article about the effects of a single bee-sting, decided to write and complain in the strongest possible terms.  I was trained in engineering disciplines, I understand matters mechanical, civil and electrical; but leave health-related matters to those who have been trained in such things, and therefore was unaware that death can and does occur with a SINGLE BEE STING due to the onset of anaphylactic shock.

All I knew was that I was in great pain, the source of relief was the hospital, and I managed to get to the UHND as fast as I could. The lady who tapped out and filled in my details at the A&E counter was obviously a civilian, and thus unknowing of the necessity for speedy action to prevent the possible onset of shock such as experienced by the unfortunate man who was bitten with a single sting, but the red-uniformed person, seated behind the same A&E counter whom I spoke to TWICE was such a person, trained with some medical knowledge, even though she was obviously not a doctor.  I was casually informed that there was a queue, the A&E department was busy, and I should be seated, and be patient, and await my turn at ‘Triage’.

It is my view that the UHND ought to urgently review its whole ethos around A&E, as well as the “Urgent Care” facility, and inform the people who work there that they are there to do one job, to serve the public, and not to arrange things so that they are the ones not pressurised, not to live their lives at NHS speeds, which is about two-thirds to one-half of the speed which everyone else works at!

I was contacted this morning by a member of the ‘Experience team’, and taken thought the parts of my complaint which needed to be reviewed. Which was fine, but even this person didn’t understand my frustration, and not only mine, but everyone else’s who sat in that dusty, slightly grubby A&E waiting room, that there was absolutely no idea, no sense of ‘Emergency or Urgency’, no signs of anyone hurrying to engage with the people who were queuing to be attended to by our ‘World-Leading NHS’. She stated that my complaint would be reviewed, and I would be advised of the outcome. She also casually stated that I had no need to worry about the possible onset of anaphylactic shock from this bee-sting. I asked why I should not have worried, and she replied that if such shock occurred, it would have been instantaneous, I would have been unable to breathe; and I would be dead!

As Jedi Master Yoda would have remarked “ Reassured, I not was!”

The second appointment was enabled with the help of the PTS to transport my wheelchair-bound wife to the UHND main X-ray department for a chest X-ray. We were picked up by the PTS ambulance team at 10.45, delivered to the hospital after one detour to pick up another wheelchair-using patient, moved to the main X-ray room where my wife was wheeled in after a wait of five minutes, X-rayed and moved back almost immediately. The reception staffer called the PTS team, and we had to wait literally ten minutes before our transport team arrived to take my wife back to the ambulance and then home: a total time for the trip there and back, plus the X-ray; of 1.75 hrs. To the PTS, and to the Main X-ray guys at UHND, a ‘well-done’ from my wife and I!

13 comments for “As Jedi Master Yoda would have remarked “Reassured, I not was!”

  1. Errol
    August 16, 2018 at 4:21 pm

    I think you mean ‘Reassured not, was I.’

    And yes, the NHS is inefficient. It’s full of foreigners and people who know that not going to A&E will mean many months of waiting to be seen.

  2. auralay
    August 16, 2018 at 6:13 pm

    My feeling is that the root malaise of the NHS is due to a bloated bureaucracy.
    This causes two problems.
    a) A plethora of overpaid (and over-pensioned) middle managers are soaking up scarce resources needed by front line staff and other essential workers.
    b) Far, far worse is the fact that these parasites feel the need to justify their existence. They are forever concocting performance criteria and targets. They then devise endless forms to complete at each stage of treatment and demand explanations for any deviation from procedure.
    This leads to staff, as you observed, spending far more time ticking boxes than actually treating patients, while being terrified of being disciplined for showing any initiative.
    Many good nurses and doctors are very frustrated at all this red tape, but many others, of course, are happy to sit in front of a computer all day, rather than doing any work.
    Which type will flourish in the modern “Envy Of The World”?

    PS. I bet you feel lucky that the nurse-practitioner had the leisure to grow such nice, strong fingernails.

    • August 17, 2018 at 4:13 am

      Point a – yes.

      • auralay
        August 17, 2018 at 7:57 am

        Not point b), James?
        My experiences in our local hospital, both A&E and paediatrics, have been pretty positive. Even so I reckon the staff spend 2/3 time on forms and questionnaires and well under 1/3 directly with patients.

        Halve the red tape to 1/3 of time and you effectively double the front line staff!

        Sack half the grey hordes and you could afford more support staff from pharmacists to cleaners.

        • August 17, 2018 at 10:04 am

          That too, of course.

  3. Bemused
    August 16, 2018 at 8:18 pm

    A couple of anecdotes:

    My late mother collapsed in a shop and was taken to hospital by ambulance, I made my way there from work. My mother was confused and frightened, she lay in A&E for 3 hours before being transferred to a ward where she was interrogated about her smoking habits and drinking habits, I bit my tongue for as long as I could before erupting and demanding medical attention. My mother was having a severe diabetes attack and needed fluid and sugar. It was nearly 5 hours before treatment commenced.

    During a routine tooth extraction it was discovered that the tooth was badly compacted and despite the best efforts of 2 dentists and 3 anaesthetics they had to install a temporary covering and refer me to hospital. As per the Scottish targets I got my appointment 11 weeks later, 1 week less than the targets. I attended the appointment only for the consultant to wave the dentists letter, look at my X-ray for 2 seconds and grandly announce that I would need to be admitted for surgery and to go to reception for an appointment. I was in with the consultant less than a minute. The appointment for surgery? 10 months later. 1 week short of a year from the original dental appointment! But I did “see a consult” within the target dates. Box ticked move on. The icing on the cake was I left hospital and developed an infection, it was so bad my dentist reopened my gum, scraped out the gunge and made me rinse out with something or other. This was done without anaesthetic and what a relief it was.

    The NHS killed my Father-in-law and missed my own fathers cancer 4 times, by the time they did find it it was too late.

    The NHS needs reform.

    • Pcar
      August 16, 2018 at 10:06 pm

      @Bemused

      Rinse probably chlorine bleach, may have been chlorhexidine.

  4. Pcar
    August 16, 2018 at 9:31 pm

    @Mike

    Well said & done.

    NHS A&E – note Emergency – is a disgrace. Your wife’s experience was abnormally good, but more importantly it was rule/procedure based.

    A&E by definition is not, yet bureaucracy driven NHS insists it must be. Nothing will change until NHS is broken up and privatised.

    btw: I tend to do DIY rather than endure 6 hours plus at A&E.

  5. Pcar
    August 16, 2018 at 9:32 pm

    @James – bin

  6. Edward Spalton
    August 17, 2018 at 2:02 am

    Well, I have to say that my experiences at Derby Royal Hospital for several minor procedures and a
    painful fracture of two small bones in my right foot were entirely different. If I had been a private patient and received the same treatment, I would have been well pleased with an excellent bargain.

    But over the county boundary in Staffordshire things have been very different. I attended a church there for many years and the experiences which people told me were appalling. One of the less gruesome was a lady visiting her husband and not finding him. She eventually found a nurse, busy on the computer. After waiting a long time to get her attention, she asked where he was. ” He’s in Bay 5″ said the nurse.
    ” That’s not him” she replied. ” O YES, IT IS” said the nurse crossly. ” Look dear, I’ve been married to hike for forty two years and that’s not him”. So the nurse stirred herself and they went looking, eventually finding the man and reuniting him with both his wife and correct medical records. This was at a hospital where there had earlier been estimated to have been something like 1,200 probably premature deaths due to neglect and short staffing – all of which occurred whilst the hospital was ticking all the right boxes to obtain “foundation status”. I was initially sympathetic to the staff who must have been in terror of management to put up with this. But then I heard that the lady who had finally blown the whistle and got people to notice had been compelled to move home because the trade unionists resented the news becoming public about ” our hospital”. She later received a minor honour for her courage in speaking up. Some nursing staff were disciplined but the responsible managers mostly moved on smoothly to promoted posts in different hospitals. So, I think the NHS is probably like the curate’s egg. ” Parts of it are excellent”.
    If I were taken ill in Staffordshire, I would try very hard to get someone to take me to Derby.

    • August 21, 2018 at 7:37 am

      It’s a national service. There should be no difference in counties. But there is.

  7. August 17, 2018 at 10:05 am

    I’ve linked at my place.

  8. Voice of Reason
    August 18, 2018 at 3:42 pm

    It’s no better here in the states. Go to the ED, and you can wait for hours with severe problems while they treat drunks and junkies around you, or families who use it as their family doctor, since they have no insurance.

    The frustration at being asked the same questions again and again is a common one. My wife, a nurse practitioner, explains that people often suddenly mention that they took some pills a few hours ago, or similar revelations. The repeated questions are an attempt to avoid killing people, plus trying to establish a human contact, rather than just reading a chart.

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