h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

There's been a lot of debate over recent years about a target culture within public services affecting the end user, whether as a patient in the NHS, or in Schools etc.
The scenario I am relating below is one concerning Health.
At 7pm last night my oldest brother phones me from the doctors surgery. He, like me, has an ongoing heart problem and he was seeing his gp having experienced severe chest pain and breathlessness. They carried out an ecg and other checks and decided he should be in hospital. To this end the surgery phoned the local Hospital to inform them accordingly. Fine so far. Then my brother was called back in to the gp who handed him a letter to give to the hospital doctor. Now things start to go a little bit awry. He's told he has to make his own way to hospital. I get a phone call, could I take him as my other brother has broken his ankle and can't drive. No probs. I'll take him. He decides the best way is for him to get home, pack a bag and I pick him up from there, that way his car won't be left in the surgery car park. (be the last of my worries frankly but there we go)
I pick him up at 7.40 and we go to the hospital.We arrive at close to 8.15pm. Now I assumed we would go through the A+E dept. being this late but apparently we don't. We're directed straight through to a unit called the AMU. This apparently is the acute medical assessment unit. We sit in a waiting area for a further 40minutes then we're called through.A nurse takes all the relevant details and starts to set up monitoring equipment.
Dotted about this unit are lots of expensive looking machines,heart monitors and the like. The nurse went through 3 of these before she found one that actually worked.
At 11pm still no sign of a doctor. We ask the nurse who says my brother is third on the list to be seen. I ask for a rough estimate timewise when this would happen as I really need to be at home doing my own meds as well as the fact my brother is here with a serious heart problem. At midnight still no sign of a doctor so it's arranged that I would return home but be on stand by in the event they decide not to keep him in. This means I can only take 2 of the last of my 3 meds I normally take at night as one actually helps with sleep. Not a good idea if I have to drive back to pick him up. At 1am my brother phones, still no doctor but they've taken some blood tests. 2am, still no doctor. I'm starting to feel somewhat 'grotty' myself by now. We really need to know whats going on. At 3.15am I get a call, the doctor has at last put in an appearance, taken one look at the ecg, blood tests and said my brother stays overnight and will be moved to the cardiac care unit sometime today for a cardiologist to see him. I can finally take last of my meds and go to bed. It's now 4am.

In total it took 7 and a 1/2 hours for him to be seen. A+E was bypassed, why? because you have to be seen within 4hrs. There is NO target as such to be seen in the AMU so therefore the hospital haven't breached the terms of the target.
The AMU has 15 beds, 7 of which were in use. There were just 2 SEN nurses, 2 trainee nurses and a cleaner on duty. There was a doctor that was seeing a patient in the next bay to my brother.

Both me and my brother looked at each other, shocked at what we heard.
""Doc to Nurse...put her on an antibiotic drip and monitor vitals every hour. I'm 10 minutes late for a meeting so the next shift doc. will take over shortly.""
With that he, along with 2 other doctors, (no idea where they'd appeared from) disappeared through a door and vanished. 1/2 an hour later the one re-appeared, meeting obviously over, then proceeded to put on his jacket, bid the nurses good night and was off.

Why, to start with, did the GP surgery not arrange an ambulance if they were so concerned that my brother was about to have a heart attack?
It seems, apart from the 4 hour rule in A+E which would have applied if taken in by ambulance, the surgery has exceeded its budget for use of ambulances except in extreme emergencies.
There were other issues I witnessed during the time I was in the AMU which I found troubling. Laptops unattended on the nurses station, displaying patient information. One went onto screensave mode but when the nurse touched the mouse pad it opened to the page, no password was required. Hardly a secure way of having and using data.
10s of 1000s pounds worth of equipment lying around yet according to one nurse at least half were waiting for repairs and/or replacement.
There is no Doctor permanently available/on duty for the AMU, apparently the Doctor in the A+E dept. has responsibility for the AMU as well so if A+E are busy then those in the AMU have to wait, (as my brother did, for over 7hrs).

It begs the question, with all the billions spent on the health service over the last 10yrs, why haven't they got the basics right?

The latest on my brother is he's stable and waiting to see the cardiologist.

As for me, I'm shattered, out of synch with my own meds, so I'll pop out to cast my vote then I'll try for some kip for a few hours while waiting to hear from the hospital as to what happens next.

That's horrible, ST. Hope both you and your brother will recover soon.

This is terrible - but thank goodness your brother seems to have had a lucky escape. I hope he gets good attention from now on and improves some more.

I seem to have been taking elderly relations back and forth to hospital in the UK myself recently ( including one to A&E ) but never found anything like this - all seemed to be very good standard of care.


My friend ( who is a bit snobbish and who has a rich husband ) refused to go to the local Spanish A&E recently, and so went to the private hospital. Because there were so many forms to fill, regarding who was going to pay for the care, it took her literally hours before she saw a doctor, got into a bed. She needed oxygen - she was having severe breathing problems - but the private hospital was only interested in whose credit card they were going to be using. . .

I've just spoken to BMT on the phone, and while we chatted the mobile rang - his brother is being discharged this afternoon, so he's gone back to collect him...

BMT is shattered!


lil x

This is not good....

But in many cases here in the States, I am sure that such a scenario plays out over and over again,esp. for the financially disadvantaged.

I hope that you and family will get the treatment that you need..

I think as is usual too many chiefs and not enough indians. I hope you'll both be fine.

I'm not saying owt, I'll get yiked

Lil, thanks for the update.

BMT, I am sure you will not be online tonight but I wanted to wish you all the best for yourself, and for your brother. It sounds something of a nightmare, and not what you either of you need right now.

Take care,

Websailor

Oh dear. Get some sleep as soon as you can!

to you and your brother

Gordon's (RIP) target culture is deadly. It ruins patient care, as you so vividly showed, and it also destroys education, which has been replaced by training in test taking, and also uses up hours and hours which caould be spent actually teaching and - whisper it - learning. No doubt it interferes across the board (pun not intended) in areas I'm not so familiar with.

Spelling: could - sorry, typo, not modren educashun.

Any news anyone

Websailor

Hi all. I'm fine again now. It took a few days for things to stabilise and get back into the 'meds' routine and sleep pattern again.
One thing it has demonstrated for me is that the medics are right when they keep telling me that things I did prior to the heart issues, that I took for granted, I wouldn't be able to do now. I guess this latest escapade involving long hours just goes to prove that very point especially when it puts me out of 'synch' with medication.
As for my brother, he's now due to see a new cardilogist at a different hospital, there is little that can be done surgically to rectify his problem also and as such he's had his HGV licence revoked and is basically in the same boat as me. There is a slim possibility a pacemaker may make things more comfortable for him but thats about all, it'll be a case of control with meds again really.
That's 2 out of 5 brothers now struck down. My other 3 brothers have been called in for 'monitoring' now, we're all over 40.

Now to prepare for the Hull meet and have some relaxation with some special people over the coming w/e.

Have a good, relaxing time BMT! Glad you feel better.


Jabs

Hi, BMT, so glad you are feeling much better. Have a good weekend. The forecast is for the weather to improve a bit which always helps.

Websailor