By an anonymous A&E doctor
I’m writing this because I’m angry. Actually more than that, I’m fu*king livid.
I’m an A&E registrar with over nine years’ experience in A&E, both here and overseas. This morning was the first time EVER that I cried in my car after a shift.
I was on nights over this New Year period, but New Year was not the issue, every shift is like this now.
Where five years ago we had fifty patients in the department on handover at night, we now have 180. It used to be around 20 patients to see with a 1-2 hour wait for clinician, it’s now 60-70 with a 10-hour wait.
People used to lose their minds if patients were coming up to 4 hour breaches. Last night, 60% of the patients in A&E had been there for more than 12 hours, some for more than 40. Many I saw the night before, still in the same place when I came on.
No triage or obs after 2 hours of arrival, no bloods or ECGs or gas for 4 hours. Regularly finding people in the waiting room after 4 hours with initial gases showing hyperkalamia or severe acidosis or hypoglycaemia.
87 year olds coming in after falls, sitting on chairs for 18 hours. Other elderly patients lying in their own urine for hours, because there’s no staff, or even room to change them into something dry. As the reg in charge of the shift, I’ve had (on multiple occasions) to help the sole nurse in the area change patients by holding a sheet around the bed because we have to do it in the middle of a corridor. People lying on the floor because there’s no chairs left, trolleys parked literally wherever we can put them.
Things have been getting even worse for the last 3 months. Five weeks ago I came home raging to my wife that people are sitting in their own piss for hours and it’s so inhumane. Now we’ve got to the point where people are actually dying. People who’ve been in A&E for 2-3 days.
The media and public might blame the A&E nurses and doctors for this, but honestly what the fu*k are we meant to do with 180 people in a department built for 50? With eight nurses, rather than the MINIMUM staffing of 12. 1 or 2 nurses per area, giving meds, doing obs, trying to provide basic cares to 25-30 people, an absolute impossibility. And there’s less nurses every week, because honestly why would you put yourself through this day after day?
We try to shovel shit with spoons, while they pour it in with dump trucks
Resus patients are quickly assessed and stepped down to make room for the next pre-alert, going to the area with those same poor nurses, already overstretched, now inheriting a severely unwell patient.
We need to accept the truth, the NHS isn’t breaking, it’s broken. And the same bastards who broke it are doing reality TV shows and writing books about how they saved the NHS, whilst refusing to increase nursing pay. We try and shovel shit with spoons whilst they pour it in with dump trucks
The NHS as we knew it is dead, and it breaks my heart, because it’s a beautiful system. It shouldn’t be like this, and those of us who have been around for longer than 5 years know it wasn’t always like this.
The public have no idea, they don’t really know how dangerous this all is. When they come in, they’re horrified, but most of the population don’t know how bad it is. This could be their mum on a trolley for 17 hours, or their wife or son or daughter.
I genuinely feel it’s now our responsibility to speak out. We don’t for fear that it will make our hospital look bad or harm our careers. But it’s not a hospital problem, it’s a national problem, and it’s a problem brought about by the politics of the people in power.
We need to shine a light on what they’ve done, make the public so angry that they demand a change. Massive recruitment of nurses through a proper wage/paid uni/free parking/free Nando’s if that’s what it takes would be a start.
If anyone has any idea how we could coordinate some kind of campaign to show the state of emergency departments in the UK right now please write a response, because I can’t work in this much longer, and more importantly I’m not sure the patients can survive it.
Pictured Steve Barclay, Secretary of State for Health and Social Care
This is taken from a Facebook post, the original here.
