The Problem with A&E 2.0

You can read my original article “The Problem with A&E” here

A&E: the initials stand for “accident and emergency”.  It is the place people go when they are injured, ill and need treatment quickly.

Yesterday I was admitted to my local A&E department because my pain had rocketed to levels that I had never felt before.  I was at work and got myself in a pickle, but was lucky that one of the nurses was there to help and care for me.  My husband came and got me and on the advice of the people I work with, took me to A&E. 

Now, I’ll be honest and say that my husband is not that keen on taking me to A&E.  Not because he doesn’t love me and wants me to get help, because he gets worried about how I will be treated.  Based on past experiences, we haven’t been treated that well at all, and my husband can care for me a lot better than some of the healthcare professionals I have come across. 

This time round we went to a different hospital, one that was closer to where we live and I had undergone surgery before.  To my surprise, I got taken straight through – my hobbling, ice pack stuck to my pelvis and appearance must have shown them how serious it was.  

But that’s when it started going down hill.

The triage nurse left me and my husband in an open bay, where he was continually interrupted whilst taking my history.  The nurse did not appear to have English as their first language, so was using Google in front of us to spell some of my health conditions and find out what they are.  And then, the highlight of my day was being told that it would be “easier to get pain relief if I had a face like this (they demonstrate a face of someone in pain) compared to this (they demonstrated a face of a happy person)”.  I was shocked, but not surprised – this is what those of us with invisible illnesses are faced with everyday, the fact that what we suffer is mainly not seen with the naked eye.  

Although I was given pain relief there and then, I was then dragged around to another area of A&E.  Now, most A&Es are structured with a “majors” and “minors” department – one for basically life-threatening problems and one for serious problems that don’t put a persons life at risk.  I was taken round to the “minors” department, and despite my triage nurse being told by the various people who interrupted us that there was a space for us, we got there only to be told “we’re full”.  Full.  My promised bed had been taken within the space of seconds – and yes that demonstrates how busy and quick A&Es are, but it also demonstrates how there is no communication whatsoever

So we were taken to sit in some chairs at the back of the department, where I was so sure I would be forgotten that I was in tears – a combination of pain, frustrated and nerves.  As I looked around I could see that the individual bays were far from welcoming or caring – they consisted of either a plastic chair or one of those padded recliners, and each was full.   When I eventually got one (a comfy recliner!) a nurse assessed me and I got further pain relief, but that was that.  No idea about what would happen next.  No clue as to what was wrong with me.  My husband and I together, me in agony, unable to get comfortable on a broken seat.  

The thing is, you are very much a lost cause in A&E unless you are on the brink of dying.  It’s sad but it’s true.  We sat and watched as they misplaced my notes, waited for the nurse to talk to the doctor for almost an hour about anti-sickness whilst I was giving it all not to throw up, and when I came back from investigations, I was supposed to have further pain relief but no one came to see me at all – not even when I went home.  I noticed how the nurses were doing everything for everyone else – they had their own patients to look after but were dipping in and out of other peoples, causing delays in care, medication and sorting out tests.  Things didn’t seem to get done, as something else would take their mind from it and then they’d come back to it when it was almost too late.  People would come up and handover information to them mid-treatment, the phone would be answered in the midst of a consultation – it was a complete mess.

There didn’t seem to be any consultants or experienced doctors anywhere – it appeared that junior doctors were running the department, and that was who I saw.  The junior doctor who was just months out of doing their exams (I overheard them talking about their upcoming graduation ceremony to a nurse) and appeared to know very little about Endometriosis.  The doctor told me “Endometriosis only causes pain cyclically” (e.g. when you’re bleeding), and that they didn’t think that was the pain that bought me to A&E.  It didn’t matter that I told them my extensive history and they had my medical notes that detailed everything about what I was going through.  

By the evening my husband and I were ready to go home.  It didn’t matter that this is where I had been 4 weeks ago when I was admitted and underwent emergency surgery.  It didn’t seem to be as important to this hospital as it did to the other one.  I was just another number, another person to send home.  And that is what happened.  The junior doctor discharged me, told me I didn’t need to go home with any medication as I had morphine at home.  They told me how they couldn’t do any more for me, as I had pain relief at home.  They told me that I could come back if things didn’t improve or got worse, but honestly – what’s the point?

I was made to feel like an inconvenience, like I was making it up and like I was just seeking pain relief.  It was like as soon as they realised I had chronic pain, they already had no hope for me.   

You know I left that hospital with no discharge summary, no information or advice and nothing to help.  I was in the same position as I was before I went in; that hunched over 25-year-old in too much pain to walk.   What was it that I was expected to do now?

Unfortunately, I am now a firm believer that A&E is not the place for us, and by us I mean those of us who suffer with chronic pain, chronic conditions and invisible illnesses.  Unless we are on our hands and knees, crying our eyes out and visibly unwell, I don’t think we get anywhere – I think we just get repeatedly turned away.  And do you know what?  One day they will turn us away when something is seriously wrong. 

A&E doctors, nurses and healthcare professionals are celebrated for saving lives, treating people in critical situations, but they cannot be celebrated for how they treated me or others I know have been in a similar situation.  

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