Accidents at home and are Surgery's helping the NHS?
Friday 11 March 2005 | Written by Richard Brunton | Life | Comments (9)
I've cut my thumb. Not a little slice, or a nick, but a swathing, deep gash. Indeed the whole distance again and I'd have lost the top of my thumb from the nail up. Yes, it was that bad.
I was busy slicing away some vegetables on Monday night ready for tea, and was slightly distracted while cutting - I shall pause afterwards for your laughs - a leek.
Yes, a leek. Happy now? Stopped? Then I shall continue the tale.
I cut into the thumb really deeply, and if I can get a photo I shall add it for all to see. At the time it was amazing the amount of blood that just started spurting forth, and I was shocked by the huge flap of skin that had lifted away from my thumb
No, not flap. Chunk. That's a much better word to describe it. The sharpened chefs knife had dug right into the tip and had threatened to decapitate the poor digit.
It was only quick thinking that seems to have saved me too much discomfort, although not from me. I shouted. My girlfriend kept watching TV. I swore. Swore again. Then repeated a line of swear words. Only then did she shout through asking what was wrong.
Once quickly explained she shot off, managed to get a couple of plasters and shot back to find the blood flowing out of the open V. With a quick application of pressure and a sheet of recycled kitchen roll, I pressed the lump back in place, closing the gap. The first plaster fell to the wayside, it's sticking area soaked in blood.
At this point I feel the need to step in and say I really am not joking. It was this bad.
One plaster went over quickly, pulling the edges of the gap together, then another went around the thumb, and it was pretty secure and very tight. A tiny gap was left above the nail where blood was quickly drying. This was a good sign.
For most of the evening I sat with my hand above my head, but still somehow managed to post to the MovieBlog - what a martyr! I even managed to sleep on my back all night with my hand on my chest, thumb above the heart. I awoke a few times but I think that was because I was about to move. Boy was my back uncomfortable in the morning
The morning was also the decision of whether to go to the Doctor or A&E. There was no more blood, and so we decided against it, not really remembering how deep it was.
That day I exploited the messy plasters to great affect, telling all the ladies around my desk about the near death experience and my heroic save. They either grimaced or laughed. Strangely none of them fell at my feet with offers of lurid acts.
My girlfriend went to the pharmacist that day and bought strip stitches, basically thin breathable 3M tape strips. So that evening I sat with my thumb in a bowl of water and watched it turn slowly brown, peeling off the plasters bit by bit. Uncomfortable, but by no means painful. I was very brave.
After a quick swab with an antisceptic wipe the strips were pulled tight across the wound and sealed the skin together, very effective indeed. We were surprised at the level of healing, the wound was not bleeding, seeping yes, but not bleeding and it had started to knit together already.
Later that day I started touching the top half of my thumb to see if there was any pain, and I discovered a patch where there's no feeling at all. Bit of concern at that point, and yesterday I decided to call the Doctor Surgery and see if I could get it checked quickly.
I know that there is an open surgery from 13:30, but once I'm in town for work it's difficult to get back out, so I thought I could nip in the morning, get the Nurse to look at it and give me her thoughts. After all, the Pharmacist at the Chemist offered to do just that if I popped in.
Now this is the bit that floored me. I asked about seeing the Doctor or the Nurse, the receptionist directed me to the open surgery straight away, so I pointed out it was difficult for me to get back out once I was in town working. I again asked about seeing the Nurse first thing in the morning, and she enquired as to the problem. I explained about the cut and the loss of feeling in a small portion and she put me on hold, obviously to talk to the Nurse.
You should go to A&E and they will take you through to the nurology department as well.Surgery Receptionist
So that was without seeing anyone at the Surgery, just talking to the Receptionist relaying the words of the Nurse. I pointed out that I didn't want to go in and waste their time, and she restated that I should go to A&E.
In the news every week we are told that the NHS is failing, they are struggling for beds and the Hospitals are overcrowded, understaffed and struggling. I've been in an A&E before a few times, and the most recent was a long drawn out process with most of the time sitting waiting for a Nurse, Doctor or transfer to another area.
So without being seen by my local Doctor or Nurse, they had referred me directly to A&E with a cut finger and loss of feeling in a small area. Not only that, I was going to tie up some specialist in the field of Nurology. I couldn't believe it. I thought the first line of defense for the NHS would be the Nurse, then the Doctor, then the specialist, and only if it was an Accident or an Emergency, hence the name, should I go directly to the Hospital. It would take a few minutes for them to look at it and tell me what they think.
I'm already considering changing Surgery, and in the meantime I'm going to see the local Pharmacist for their advice. This I will receive over the counter in a matter of a minute or two. Perhaps this should be how I deal with more problems and bypass the NHS totally until I am in need of critical care.
The thumb? Well it's healing well, although even this morning the wound opens up when the stitches are off, but it is closing more and more each day. The scar is going to be huge. It extends from the top of my short nail, about 30mm from the tip, right round to the pad of the thumb and slicing into the thumb about 50mm.
At the moment it's a great no dishwashing excuse!
Comments
11-03-2005
02:08
I would just like to point out that obviously, due to the level of blood loss and immminent shock which was setting in - Richard is inanccurate in his recollection of my precise activities at the time of the incident. I was, in fact, in the process of getting changed and attended to the emergency situation in a topless state! As Richard may recall, he did actually go and get me a tee shirt whilst I continued preparing the aforementioned Leek once the bleding had subsided.
11-03-2005
03:17
So, having phoned your GP and described how you nearly sliced the tip of your thumb off and are complaining about loss of feeling you are shocked that the GP staff had the cheek to advise a trip to A&E?
I think they did exactly the right thing. Either your thumb will heal on its own or needs stitches and possibly surgery to restore the feeling. In either case your GP wouldn't be able to help.
Sounds to me like you were loath to sit in A&E for a couple of hours only to be told its fine and were looking to save some time...
11-03-2005
05:06
Actually no, I wouldn't be surprised at all if that's what I had told the receptionist.
What I actually said to them was that I had cut into my finger a few days ago, it was healing but that in a tiny bit I'd lost feeling. I'm not one to overplay illness in real life.
I was loathed to go and sit in A&E and take up the valuable resources that I am continually being told by this Government that I am wasting. That was especially the feeling after I had talked to the receptionist.
How were they to know which way I was playing it, either under or over egging the story? I can only see the fact that the receptionist turned to the Nurse to talk to her for a few seconds and told me to go to A&E, at no point did they suggest, as I had asked for, that I come by the Surgery first thing for the Nurse to see and let me know what I should do without a telephone diagnosis through the Receptionist.
However, I can easily get this service from the Pharmacist in Boots Chemist, so why would I want to go and see a Nurse anymore?
I had thought the Doctors and Nurses of your Surgery were the personal and front line for Health care, but more and more they are diverting cases to the Hospitals and specialists without giving any opinion.
I guess I'm more heavily clouded by the experiences of my Mother and her attempts to get some decent health care. Her surgery have failed her totally and offer her no solution to her ongoing problems. The Hospital have helped, but tests show nothing more. Private health care has gone even further to help her. However in the end Internet research has shown possibilities and her suggestions to the Doctors have resulted in the course of action she found on the Internet being prescribed.
I'm ranting now! Breath.
11-03-2005
10:26
Sorry, still not convincing me.
From the NHS website:
Minor Injuries Units are for patients with less serious injuries, such as sprains, cuts and grazes. The waiting times are usually much shorter than those in A&E, as staff must give priority to serious and life-threatening conditions. You do not need an appointment to visit a Minor Injuries Unit. Minor Injuries Units are led by highly qualified nurse practioners with more experience and expertise than many a doctor in this kind of treatment.
Minor Injuries Units can treat a wide variety of problems including:
Cuts/grazes and lacerations
Sprains and strains
Broken bones (fractures)
Bites and stings (including human/animal bites)
Infected wounds
Minor head injuries
Minor eye infections, foreign bodies & scratches
If you are not sure whether your injury is minor and can be treated in a Minor Injuries Unit, telephone NHS Direct on 0845 4647, who can advise you and direct you to the most appropriate place for your care.
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11-03-2005
11:54
Wow. Now that is such a good way of giving the health care staff in the A & E the history of your present condition.
Before I go on let me just say I can not stop laughing reading your side remarks on this but also that your girlfriend is a funny person after sharing her "version" of the events. I wish I know you two personally I think we will all have a blast, oh yes, this is not about me, but your thumb.
You both did well acting on the emergency on your own. As a nurse working for the NHS, my advice will be that in future should any more accidents like these happen, I will advise that you do go straight to A & E Richard, especially now that Trusts are expected to reach the 4 hours minimum waiting time for patients to be seen. I am quite sure that you will be attended to promptly especially after havung done a thorough assessment of your injury. I can not say so much about the GP system but in A&E are doctors of both medical and surgical speciality so you can expect a quicker service unlike the Surgery that will be by an appointment basis.
As a nurse specialising on Infection Control, I suggest that you clean the wound site with saline solution and change the dressing not as often but only when it gets soiled so as to prevent any build up of microorganisms that can go to the wound. I hope that you can type with a speed like Clark Kent's soon Richard! *winks*
12-03-2005
12:58
Not trying to convince anyone Andy, it's my site I can think and write what I want, and I know I'm right!
Actually I'm guessing you have some connection with the health industry, especially from where I think you came from. Simone, you're a nursein A&E as well, so you both have one up on me.
I am, what they call, a patient. A lowly member of the public. All I know is that my hospital is struggling to stay afloat, much like the rest of the NHS, and people are being kept waiting for major operations and investigations just because of lack of resources and money.
I'm told to go to my Doctor first, I have been all my life, and I would think it's quite recently (in the length of my life that is) that I've even considered going to the nurse at the surgery before my Doctor.
So what have I been told differently to the above? What you've just told me. You see you guys know because the Government and the health service have made sure you know...me? I'm a lowly patient, tax payer and private individual. I have no idea where the boundaries between NHS Direct, my Doctor and the Hospital, and the only message I am getting from the Government is the Hospital is too busy for me.
I'm not blaming the NHS, or the professionals there (apart from my surgery's receptionist and nurse for not giving me the proper advice). I, as a patient, don't have this information. What I did is what I believed I was supposed to know.
Actually thinking of NHS Direct (now I've checked the site) and the fact that the Hospital will cover such minor things (I have yet to check if my Hospital has a Minor Injuries Unit, why do I need a Doctor? - My Mother's case definitely backs that up.
Thanks for the information though. Next time I slice through my appendages, I shall follow this advice! It's on the site now!
12-03-2005
01:26
Sorry Richard, but you've assumed wrong. I've got nothing to do with the health service. I've been a CG artist for 20 odd years so rank as another lowly member of the public.
As for why you need a GP, the best description I can think of is for aches and pains, sniffles and bugs, that sort of thing. When bits of your body are hanging off, bending the wrong way, or maybe outside when they should be a visit to A&E is in order.
12-03-2005
01:23
Ooops, no offence I hope Andy! CG artists can be just as important.
Understood. I think it's what I'm told by the Government and my Health industry is the contradiction.
However, finger is healing well!
14-03-2005
02:56
ooooh, touchy this one. I have a large number of doctor-type(their description not mine) friends ranging from GP to demertology to cardio to orthopedic, blah blah and being the sports freak that i am, my body usually has something wrong with it(self-induced of course). I normally ring one of my friends, after a self-diagnosis, to see what i should do and besides the "why were you doing that in the first place" and "I told you that would happen". I normally get pretty good 20sec advice(which i think is what Richard was after?) a general direction for my problem please.
Most GP surgeries are overbooked and GPs are expected to see patients in very short10-15min slots. Remembering that most people go to the GP for re-assurance, sometimes the diagnosis is really just someone to talk to and requires more counselling than medication.
What exactly is my point? Well! everytime i have injured myself and its minor ligament, twisting or tweaking, my physio friend will strap my thumb(etc) or recommend exercises after an examination. Any time there is blood on show they will suggest AnE. However the numerous experiences i have had of AnE, lots of junior doctors forced to work long hours on low pay, usually means a long waiting time followed by a "sometimes" hesitant, and i am sooooooooooo generalising, doctor. And before i am slagged, my best friends mum(senior nurse) and dad(surgeon) started a hospital in Australia and know how hard a job it is. Ok, i was trying to make a point then wasn't I?
1. Hurt myself slightly, ring a friend.
2. twist a limb of sorts, ring a physio. get strapping.
3. two week plus bug that won't shift lotsof sleep and fluids, go to a GP.
4. bleeding of concern, AnE.
5. Bleeding of real concern, wave my arms around and scream like a girl(while dialing the emergency services).
Oh, and richard, next time i am around at yours i am sooooo cutting my finger. I liked the initial result, however due to my girls-blouse-ness i will probably faint(from the sight of blood, not from the topless girlfriend.... :)