Rather die than go back to hospital - British Heart Fou...

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Rather die than go back to hospital

DeepFriedMarsBar profile image
60 Replies

After a recent trip to hospital (3 days, 2 nights) for a non cardio related issue, I have to say, I'd rather die peacfully at home than be subjected to the incompetencies, unnecessary delays and egotism that I experienced.

I don't want to write a big rant but it boils down to this: One department does not communicate properly with others, resulting in treatment plans being scrapped and everything starting again every time you move from one department to another. When I asked about this I was told in no uncertain terms that the ward doctor did not trust or believe anything that came from AAU. (Acute Assesment Unit). This added hours and hours of unneccessary delay, addittion suffering and worsening health. It also tied up a hospital bed for far longer than was necessary.

Secondly there was no understanding of mental health whatsoever. When I asked for my mental health conditions to be taking into consideration I actually got told that Clinical health was more important, and some staff actually switched off, and stared at the wall and even rolled their eyes whenever mental health was brought up. Staff - especially senior staff like Doctors and Consultants, had visible disdain and contempt for mental health and would rather deal with "real" conditions.

This has had such a terrible effect on me that I would rather die at home than go back to that hospital.

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DeepFriedMarsBar
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60 Replies
Happyrosie profile image
Happyrosie

I’m so sorry this happens (happened to a friend of mine the other day too, you are not alone).

Such a waste of resources that should be spent on patient care. My friend was in A &E and then Acute Assessment for almost three days, repeating tests and questions. With no result.

Grrrrrrrr

BeKind28- profile image
BeKind28-

Hello :-)

I am so sorry you feel this way but I can relate very much how your experience went

I have had similar several times and when you are already so anxious like me and afraid of Hospitals it really does make you feel this way and when you come away you say I am never putting myself through that again but I hope if you need to you will like me

As for Mental Health and I have put so many complaints into my local Hospital every point they say sorry and admit I have been let down and they are going to make changes but they never do

I am Autistic so when at the Hospital even though I have a passport which they should follow and read but never do I feel I do not belong anywhere as the Mental Health say I do not belong with them and learning disabilities say the same as I have no learning disabilities and there is no one at all to help anyone that is Autistic that is struggling so I know how it feels when you have extra difficulties and they are not taken into account

It has left me feeling the same but please I know this has been a bad experience but if you ever need to attend again stay strong and go and also I would put a complaint into Pals at your Hospital changes need to be made and without speaking up and letting them know that will not happen so if you have the strength let them know how your experience has affected you

Someone is always on here to listen to you so please when you need to come and talk with us :-) x

LaceyLady profile image
LaceyLady in reply toBeKind28-

I’m afraid PALS is a waste of time, been there

BeKind28- profile image
BeKind28- in reply toLaceyLady

Hello :-)

They are not brilliant I agree but I escalated my last complaint and got a reply admitting they made mistakes however if that changes anything I doubt very much :-)

Hope you are keeping well :-) x

LaceyLady profile image
LaceyLady in reply toBeKind28-

still having challenges 🙄 but ‘I’m still standing’ as it gos 😜

BeKind28- profile image
BeKind28- in reply toLaceyLady

Hello :-)

Sorry you are still having challenges but glad you are still standing :-) x

LaceyLady profile image
LaceyLady in reply toBeKind28-

Thanks. Had to go for a check on a mouth issue, alls ok so thats good 💗

BeKind28- profile image
BeKind28- in reply toLaceyLady

Hello :-)

For me I feel dealing with heart issues is not even what I can cope with and I had to go with my ear as well as a lump under my scar but thank goodness all was good

I am pleased though that you were checked out and all was good must have been a relief for you :-) x

meadfoot profile image
meadfoot

I had a similar experience in my large local teaching hospital a and e in January. The place was filthy, overflowing bins in toilets, blood soaked tissues left in sinks, filthy toilet, no hand wash or paper towels. Rude staff, lost me in the system three times in ten hours. I was literally crawling on my hands and knees on the corridor as I was almost passing out if I stood. Still no care.

Another lady with a collapsed lung was sent home almost being carried by her partner as “it would be easier if she went to her own local hospital’. Easier for who I wonder, certainly not the patient.

All the vending machines were either empty or broken and no sandwiches available. My daughter went out and spent thirty pounds of her own money on sandwiches from a local tesco and shared them with people waiting.

I have truly not seen such chaos and lack of care, more like a third world country than a UK hospital. When I eventually came home being told to contact my london professor as they didn't know what to do with my symptoms, I had picked up covid while there along with my accompanying husband and daughter too. All round a dreadful unsafe environment. I vowed next time I needed a and e care I would go elsewhere.

I am currently away from home and had an accident where a rusty nail rammed through my finger on Sunday. That's what I get for painting a broken fence. The local hospital I attended was clean, efficient, busy but effective. Worlds apart from my so called top notch home teaching hospital up north.

I so empathise with you. Look after yourself. Best wishes.

in reply tomeadfoot

I totally sympathize but if you were expected to work in those kind of conditions everyday how would you honestly feel. I agree it's unacceptable but it's due to the government running this not the NHS Staff. Underfunded, hospitals falling apart etc. Your daughter was very kind buying sandwiches but that was her choice. I'm sure you will think I'm not being sympathetic but I see the NHS as a very precious place. I'm here because of there care, my husband is here because of the treatment he is receiving. Like you said you/we have a choice to go somewhere else. Lucky I Thinks. I wish you well.

Greenthorn profile image
Greenthorn in reply to

Well said. I'm a volunteer at University College London Hospital and the standards of care and cleaning are excellent. Sure, there is a shortage of staff, and sure, many weeks might pass before they work out what might be wrong with a patient, with so many tests and procedures carried out in an elimination process. I'm proud to be a volunteer at UCLH.

in reply toGreenthorn

I am proud of our nhs and volunteers like yourself. I do wonder if these ungrateful people or family ever had a real emergency, like a heart attack, cancer, in a motor accident, and they are treated and saved by the people they are criticising would they then still moan. 🤔 Probably because it's the same old people. I'm not sure this site is for them?? It's for the people who are looking for answers. They have concerns. Maybe they should try Facebook. Have a lovely day and carry on the good work.❤

Greenthorn profile image
Greenthorn in reply to

Thanks for the thumbs up. Have a good rest of the week! Positives will always outweigh negatives.

DeepFriedMarsBar profile image
DeepFriedMarsBar in reply to

The same hospital I complained about abve almost killed me a number of years ago when I had a ruptured appendix and peritonitis. The same thing happend in that case - A&E correctly diagnosed th situation, booked an operating theatre and surgeon and started the process of getting me ready for theatre. At the same time a bed became available on the ward and the ward doctor took over. He cancelled the OR and surgery and declared that since I was diagnosed by himself that everything that had gone before was void. He then disappeared for several hours. When he came back I was critically ill and all hell broke out - I was rushed into emregency OR and told later that I only just made it.

It is vital that the negative aspects get air time too.

Of course I'm grateful for the care I did receive, all I am saying is that it could easily be better if mental health was taken seriously, and communications improved, and egotism expelled to the past.

in reply toDeepFriedMarsBar

Good to hear all got resolved and you received the care you needed. Thank goodness for the NHS. Just saying.

wischo profile image
wischo in reply to

To be fair the NHS is in place to help people with heart attacks, cancer etc as well as lots of other tests and illnesses that are all too reguarly ignored and put on the long finger. I would prefer to have a timely scan and catch heart disease or cancer early than present with a life threatning heart attack or stage 4 cancer. Most other countries have a proper contribution scheme for a better health service like the scandanavian countries, Germany, Holland, Australia to name a few but the contributions come down to the population having to pay more if they want this. The NHS was the envy of the world in its day but all that has changed with the economy and has been getting worse for the last 20 or so years annually. Consultants, Doctors, nurses etc are expecting decent pay levels and who can blame them. And yes I do think you are being unsympathetic to the post and yes mental health is a major cause of major illnesses and is as important as any other ailment.

in reply towischo

Hi wischo, thank you for your post. Of couse all medical illnesses deserve the same attention. And I agree if we want a better nhs we need to contribute more, for all the reasons you state plus our expanding population. We expect our older generation to pay for there care if they have to go into a care home. I wonder though how many people would agree? Unfortunately we now seem to have a culture of as long as I'm alright no one else's feelings matter. A very sad situation.

DeepFriedMarsBar profile image
DeepFriedMarsBar in reply toGreenthorn

I'm really pleased to hear that. It give me hope that improvements can be made. No is ever going to improve if we never air our negative experiences.

MoretonCross profile image
MoretonCross in reply to

You are correct, I think you're not being sympathetic at all.

in reply toMoretonCross

As a wise man said "the positives will always out way the negatives. Keep well.

not_today profile image
not_today in reply to

I'm from the US and it's like third world country with horrible undertrained staff that laughs at patients at all 4 hospitals here in Rochester NY but I went to Buffalo and it was like a whole different planet. And the biggest one UofR Strong Memorial is getting 50 million dollars from the government to expand the ED. More room for more filth, no staff & the ones they do have are inept and are more concerned with their phones and flirting with their colleagues than helping patients. I lost consciousness the last time I was there and they kept saying it was my anxiety and discharged me and I went to a different hospital and my HR was 16 and BP was 70/50 and swung up into the 200s... I was literally dying from uncontrolled dysautonomia which the resident had never even heard of. This is happening in pockets and I don't understand why people don't name these doctors and share with each other because it's a competitive field and we shouldn't be giving bad doctors and hospitals our business. Oh and our hospitals' patient relations haven't answered the phone or been seen in the office in almost a decade. We have no one to complain to... Wishing everyone well from NY.

in reply tonot_today

And I wish you well. When you read experiences like yours you highlight how lucky we are.❤

LaceyLady profile image
LaceyLady in reply to

No excuse for rude dismissive attitude to the patients, they’re supposed to be professionals.

in reply toLaceyLady

Quite agree, it's a two way street, no excuse for rude dismissive attitude to our hard working, over stretched NHS staff. In fact there is no excuse for anybody to behave like that to someone else.

DeepFriedMarsBar profile image
DeepFriedMarsBar

Thank you everyone for your replies.

I'm encouraged to know its not just me!

It seems to me that the patient experience, and waiting times, could be massively improved with just a few simple steps towards efficiency and trust.

I think if I need to be admitted again I'll ask to go to a different hospital. It's further away, but I don't like the prospect of going through the same things again. Maybe they have to make the experience a bad one to discourage 'frequent flyers'. I certainly am not a frequent visitor, I need to be dragged there!

LaceyLady profile image
LaceyLady in reply toDeepFriedMarsBar

I had appalling insensitive rude unbelievable treatment on ward in 2021 before and after a femoral hernia operation. They also let my heart meds run out without a care, could have had a heart episode which might have kept me in!! My daughter came and got me out, had to virtually break into the ward as no one was answering the door bell AND no one supplied a discharge form and I left without a nurse or dr anywhere to be seen. Yes I wrote and complained, got a lot of whitewash. I never want to be in out county hospital again as I’d probably come out in a body bag

Yumz199725 profile image
Yumz199725

Oh that's awful 😔 I'm sorry to hear, unfortunately communication in hospitals is an absolute joke Ive had awful experiences aswell but fancy just ignoring you 😔 that's so rude!

Displacedheart profile image
Displacedheart

The nhs has made me feel like this too, but after realising I am victim of cover up culture.. I will stand up and fight not just for me but for everybody. Including you. I am so sorry that you've had such a bad experience it's starting to sound like the norm - but hopefully this can be changed.... be assertive and keep pushing - stay strong 💪 so sorry to hear of your experience

Sharpglo profile image
Sharpglo

Hello there, feeling such compassion for you. I know how you are feeling. When I experienced something similar , complete frustration after waiting 6 hours in A&E which wasn’t busy, I thought ‘who can I complain to’ ‘the police’ came to mind. Where do you live? Always keep hope, turn a page on it, don’t think of it again. See what you can do positively for yourself. Write a complaint to your local MP and the hospital.

andrew290171 profile image
andrew290171

Sorry you had such a bad time. think that's pretty much par for the course these days. I went back with chest pain last year after being instructed to go to a and e by my GP. Similar story. Made me feel like I was wasting their time and I was making it all up. That was after 16 hours sat in a chair in a and e before I got put on a trolley

Cavalierrubie profile image
Cavalierrubie

l have had a similar experience. An AE doctor was very rude and kept telling me that l shouldn’t have gone to AE and three times during the hurried conversation he told me l could go home. The staff in the room just stood and stared at me. I have AF and other problems. I reported the doctor to the hospital in April and have not heard a thing except a letter telling me they have received my complaint. Don’t expect to hear anymore. It is very degrading and humiliating and l was very upset. It won’t stop me going again and hopefully l never meet that horried doctor again. We have to keep strong and stand up for our rights.

scentedgardener profile image
scentedgardener

I have to say my experiences have been fairly negative, apart from the first time, although I have never been made to feel that they thought I was wasting their time. The worst thing I experienced was when the person came to take the initial bloods I asked if they would be testing calcium. (I asked because I have a condition where calcium can be high, and I had been prescribed a medication that raised it.) The answer I got, through gritted teeth was "We'll do what's necessary!" with much emphasis on necessary.And it comes to something when paramedics who are taking you to A&E ask where your snacks and drinks are, so they can collect some to take with you as you can't even get a drink of water without bothering staff.

nilmonisikdar40 profile image
nilmonisikdar40

I concur what you have said. It happened to me quite often. Recently I was in ITU ( Intensive treatment unit) for 3 weeks which could have been avoided . It was lack of communication between acute medical unit and psychiatry because there was more emphasis on mental health than physical health.

Having worked in MH for many years I can confirm that there is a general ignorance about MH issues in hospitals treating physical problems and a prejudice against people who have MH needs. I have two suggestions, the first obviously too late for now but good to bear in mind if/when you encounter a similar problem.

Every general hospital has a MH liaison team. If you feel your psych' needs are not being acknowledged or addressed insist onseeing a member of that team. If that's not facilitated (I've experienced that) then ring the switchboard and ask to be put through to them yourself. They will be well used to communicating and dealing with the general nurses & medic's prejudices, (which are often borne of their fears & lack of understanding.)

Secondly, follow up your experience with the local PALS service so that the managers on the units are made aware of the problems. (You could also asked the psych' liason to follow up too.)

I've also experienced lack of communication between teams, though not as badly as you. Being your own advocate in today's unstaffed, overstressed NHS is often the only way of overcoming such obstacles. Obviously when you're unwell that's very difficult. Do you have a relative/friend who could advocate for you?

Curryandchips profile image
Curryandchips

My husband had exactly the same experience as yourself.

The total incompetence of our NHS trust has led me to start a complaint

Not only with the hospital but also his GP practice who put barriers in the way when he needed to go to hospital.

Please make a formal complaint, as nothing will change if we do not make a noise about this.

DeepFriedMarsBar profile image
DeepFriedMarsBar in reply toCurryandchips

Thank you.

One irony is that everywhere you go in the hospital there are posters up with a big QR code begging for feedback on how they can improve. I have given feedback, and I was kind and polite in doing so in order not to get ignored, but at the same time I believe I got my point across. I doubt anything will change though.

Personally I think the nursing staff would be sympathetic but are scared of speaking out.

PaintingthePavement profile image
PaintingthePavement in reply toDeepFriedMarsBar

It used to be that the nursing staff (think, Matron!) were responsible for everything other than the medical side. Now it's the 'Business Managers' who run everything and set the priorities - profit over patient care. It's all about throughput and cost-cutting.

Ardbeg28 profile image
Ardbeg28

Ah, you're named after the infamous DeepFriedMarsBar—a culinary creation that's either a joke or a guilty pleasure, depending on who you ask! 😂 Indeed, it seems the Scots have quite the sense of humour when it comes to inventing such unhealthy delights. But hey, you've got to give them credit for creativity! Just try to avoid eating this heart-stopping treat lest you find yourself back in the hospital where you don't want to be. (P.S. I'm a Scot BTW!) And I'm truly so sorry you had such an awful time in hospital. It is so true one department doesn't communicate with the other so you have to repeat everything and you feel awful and personally I usually forget things. Keep well.

DeepFriedMarsBar profile image
DeepFriedMarsBar in reply toArdbeg28

LOL, yes my nickname on here is supposed to ironic - and at the same time give a hint to where in the UK I am ;-)

I wouldn't dare eat such a thing! I'm not really a fan of deep-fried-anything ;-)

Thanks for all your support.

PaintingthePavement profile image
PaintingthePavement in reply toDeepFriedMarsBar

John Betjeman: 'come friendly bombs and fall on ...😜

Ardbeg28 profile image
Ardbeg28 in reply toDeepFriedMarsBar

To my ane kith and kin, very pleased to hear that. I decided it was just a tongue and cheek Scots humour nickname!

serenfach profile image
serenfach

I worked for the NHS in the '70s, when Matron used to come round and everyone was scared of her, including the top doctors. Everything was clean, everyone was cared for. When my kidney went south a few years ago, I found myself on the Urology ward, the only female, sharing a 4 bedder with 3 men. Obviously they were there for penile problems and did not dress their lower half, so a parade of jewels passed my bed day in, day out.

The ward was filthy - stains on the furniture, stains on the curtains, a dressing under my bed was there the whole time I was in. My security was never considered. The man opposite me was handcuffed to the bed, so had to use a bed pan in full view. No one came in with an air spray...

I had an op to remove the kidney which went badly wrong, but that is another story. While in ICU there are no bells for the patients, but monitors on the staff desk for each patient. My morphine drip stopped working and I was in a lot of pain, but could not cry out as intubated. The nurse finally noticed my vitals on the monitor, came over and complained that she wanted to finish her jigsaw and I would have to wait. I was deeply scared.

When I was able, I wrote a five page report of all the shortcomings, sent it to the hospital management and each board member, and my MP. Apparently changes were made.

On two further occasions, they tried to give me drugs to which I was allergic - they had not read the notes, and were cross with me for refusing the drugs!

My chances of surviving are higher outside the hospital!

PaintingthePavement profile image
PaintingthePavement in reply toserenfach

You mention the Matrons who were feared by all. The problem with cleanliness in hospitals became many times worse when they gave the cleaning contracts to external companies. Up until that point the cleaners were employed by the hospitals and directly responsible to to the clinical ward managers who could take immediate action if cleaning wasn't up to scratch. Then suddenly the clinical staff had to contact the cleaning company representative who then had to act. Everything was done for minimum prices with the private companies making a profit on top. Demotivating for the cleaning staff, frustrating for the clinical staff, and terrible for the health of the patients.

survivorsguilt profile image
survivorsguilt

Sorry Deep Fried Mars but a negative posts will help neither you nor anyone else. Look for complaint process on -line or call your local PALS and get their advice. I found the following in a mili second. quote; You can make a complaint about hospital treatment in writing, by phone, by email, in person, or using an online complaints form. You can address your complaint to the complaints manager, the Chief Executive of the hospital. It's hard I know because I've recently had a bad experience.

MaggieSylvie profile image
MaggieSylvie in reply tosurvivorsguilt

Negative complaints are indeed helpful. My partner has been detained in hospital for nearly four months, and that was after a short time at home. Being detained because he "couldn't climb the stairs" caused him to deteriorate both physically and mentally. He has just gone into a care home because they don't feel they can send him home. This is because the community nurses have said we were not at home when they called. There is such a small window when we can go anywhere and each time, we were at is pre-booked hospital appointments. His issues have not changed and his mental health is becoming more and more worrying. So for me, it's not a stay of a week, but a stay of most of this year so far. Now he's in a home and I have no idea what's going on and yet after less than 24 hours, I have been accused of being "unco-operative", when I've been given no guidelines, other than visiting can be at any time. Four months is a long time to be in hospital but to my mind it's a short time for an intelligent man to become what sometimes seems like a village idiot. I'm feeling as distressed as he is.

So yes, it's helpful to see that there are hospitals run less well than our own and to read the experiences of others, that are different but equally shocking. We are all desparate together, I'm afraid. I am afraid.

serenfach profile image
serenfach in reply toMaggieSylvie

Ask for his full medical notes. Check the blood tests for over low or high results, Check the drugs for interactions. Check the original notes to see if they were treating him correctly. My notes were a shambles - I even changed sex at one point. If they know you are checking, they are more careful.

Be unco-operative - it means you care, and are fighting for him. I am so sorry you are going through this. Hug.

MaggieSylvie profile image
MaggieSylvie in reply toserenfach

Full medical notes! I wonder. It took several attempts for me to get a copy of his discharge notes from the last time. I suppose his GP would have been given access, but they should be long and detailed and have notes from two hospitals, as he was shunted backwards and forwards. Bloods should have been checked multiple times a day for glucose but they weren't because at one stage recently he was "found unresponsive". No responibility accepted there then. Drugs are ok, I think as he's not taking many.

I've seen the way they cannot keep to the correct gender somewhere, and I suspect it is a lack of language skills (communication is 90% of problems on the wards). When you correct their wrong assumptions, the notes do not change. The notes, probably correctly describe the patient as they observe him when he is received onto the ward but nowhere is there any description of how he was before he became so ill, and this is how the patient becomes institutionalised. There is no expectation that he will ever return to his old life; now he is in a care home, and what motivation do the staff have to make sure this is possible? £1500 per week after the initial NHS-funded 28 days.

I don't want to be unco-operative; I don't want to be bullied either. If he comes to any harm at all I will blow the whistle. Thank you for your hug. I feel it🤗

survivorsguilt profile image
survivorsguilt in reply toMaggieSylvie

My point was that we are powerless to help you even though many of us have had bad experiences in the hospital, I certainly have. We can speak words of comfort but unless you complain through the correct channels nothing will be done and we can't do it for you. I suggested the correct procedures. Have you contacted PALS or the hospital complaints department? That will help because they are legally bound to investigate your complaint. call

MaggieSylvie profile image
MaggieSylvie in reply tosurvivorsguilt

I'm sure PALS knows me well by now, but no, I haven't complained about his treatment - only his clothes and white stick that have just disappeared into thin air. On the last day he got his denture back! Certainly there are enough anomalies on the discharge notes to give me cause to complain.

Thanks for giving me a shove. I would have replied sooner but I have been having trouble opening links. I could use my messages here as a basis for my complaints.

Dunandjam profile image
Dunandjam

I agree with you. I had to be hospitalised for a week to receive chemo due to having angina! On the 4th day had an angina attack first thing in the morning and the pump was taken out. I was t released until Saturday and I was probably the fittest on the Ward! I kept asking to go home ( only live less than a mile away)! You’d think they’d want to get me out but there was a shortage of doctors!

MaggieSylvie profile image
MaggieSylvie in reply toDunandjam

That's it. No-one to formally discharge you!

Marymara profile image
Marymara

You must not only complain to the hospital,but write to your MP, sounds outrageous, understaffed hospital is no excuse for incompetence, we have let too many people in this country to deal with.

Natali999 profile image
Natali999

Unfortunately I've met many patients that have said they would rather die at home after a negative experience at hospital. Which includes delays, poor communication orundestanding patient wellbeing alongside the clinical. You should aways be involved in your care and yes there are some clinical staff that have a very boring detached approach to medicine and patients. Epistemic injustice springs to mind.

Submit a complaint.

Bluelobby profile image
Bluelobby

Said it many times .....BROKEN BRITAIN

Snoogs profile image
Snoogs

”Gubmint” run healthcare … what could go wrong ? Pathetic

Adlon57 profile image
Adlon57

Yes same here, rather die at home than be tied up with wires and tubes, I'm terminal but rather go at home than stuck in a hospital ward! I remember waiting outside a woman's toilet in the hospital for seven hours, suspected broken neck, fallen down stairs.

Vrouse profile image
Vrouse

Maybe if we had less people abusing the NHS service, the treatment and care of patients would be improved. We recently have spent 10 hours in A&E. I was amazed, shocked and disgusted at the number of people that don't seem to understand the meaning of "Accident" or "Emergency". So many people decided to leave to go to a walk in centre the following day, hardly emergencies if they could wait until the next day! Some came in with injuries over a week old, why not seek treatment before for your "bruised toe"! The staff are run ragged and doing their best and don't deserve the rudeness and attitude from so many. It is a fraught place to be if you are in genuine need of attention, my partner was very poorly and was admitted with sepsis but so many time wasters are adding to an already overrun service.

Adlon57 profile image
Adlon57 in reply toVrouse

Its the NHS 'system' which does not work, underpaid staff, you HAVE to have patience, it is the categorisation of patients that causes the most trouble, a bit of common sense, might help, THINK, is your injury/condition really that bad, how long have you had 'it', these are for EMERGENCIES, are you REALLY an emergency, there are A LOT who are not, the "sticky plaster brigade" and 95% of the medical staff are underpaid and overworked ALWAYS REMEMBER that!

Vrouse profile image
Vrouse in reply toAdlon57

The problem is the NHS has to be over cautious because of the fear of being sued these days....

Adlon57 profile image
Adlon57 in reply toVrouse

Good point! Life [or death] is never simple...

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