This is the 2nd part of the story of my hospital admission in January 2017 and details the actual admission itself, my time in A & E and the problems encountered. If you haven’t already read about the days leading upto to my admission you can do so here:
The decision is made that I need to go to the hospital, my breathing has become shallower, my chest much tighter, I am coughing virtually non stop and the back to back nebs that had previously eased my problems were helping less and less.
My local hospital is only about 5 minutes drive away but during previous admissions we have always been advised to ring for an ambulance rather than be driven there, this is probably because they have seen my wife’s driving but they claim that the real reason is so that the ambulance crew / paramedic can radio ahead and so the hospital can prepare for my arrival. However I felt that on this occasion I didn’t need an ambulance as in my opinion this wasn’t a medical emergency, I just needed additional treatment and care that I was unable to provide for myself. My wife wasn’t in agreement with me but rather than argue with me she decided to drive me there.
I had packed my bag the previous day as I knew that a hospital admission was becoming more and more likely. I managed to dress myself and struggle down the stairs. My wife took my bag to the car before returning to the house and helping me to the car. As soon as I got into the car I regretted not phoning for an ambulance. The bitterly cold January air hit my chest like a ten ton truck, despite this and my breathing becoming worse I wasn’t going to admit my mistake to the wife. Once sat in the car and with the heater on I set up my portable nebuliser in the hope that it would provide some temporary relief, it didn’t!
By now the time had reached something like 6.30 and the roads were pretty quiet, we reached the hospital pretty quickly.
The wife abandoned the car in the drop off area outside A & E and virtually dragged through the doors. By this time I was struggling to string words together and I slumped onto a chair in the waiting room. Things become a little blurry as to exactly what happened next but from my own memories and with the help of my wife I have pieced the following together.
My wife booked me in at reception and explained what my problems were. She was then told that she would have to move her car. She came to check on me before gong to move the car and telling me that she would be straight back.
I vaguely recall been taken through to see a young male nurse who did the usual, checked my blood oxygen levels and my blood pressure. My blood pressure was through the roof and though my oxygen levels were lower than usual they were not a major concern (or not at least to the nurse). My chest was listened to and I was told that it was clear, I tried to object but was struggling to piece together any sentences. I then passed him my medication cards which details my medication, peak flow, symptoms, usual treatment and other medical issues. These cards are always with me and I am told by many medical professionals that these are superb and provide vital information. This nurse seemed less impressed as he took one look and threw them back at me.
The next few comments will remain with me for a long time. I was told that I needed a chest X-ray but there were no porters available to take me to the X-ray department. I was asked if I knew where the X-ray department was and told to walk there, if I wasn’t able to, I would have to return to the waiting room and wait for a porter but they were short staffed and would have a long wait. I was told that my sats suggested that I was well enough to walk and it wasn’t that far away! I was stunned and angry, usually the portable X-ray machine would be brought to me or at worst a porter, carer or nurse would take me to the X-ray department on a trolley. In my dazed and by this stage confused state and with still no sign of my wife I tried to walk to the X-ray department. Halfway there I remember slumping up against the corridor wall wondering what the hell I was doing. After a few minutes a total stranger came up and asked if I was ok, I managed to croak “X-ray” and they helped me to the the X-ray department. I don’t know who this person was but I am eternally grateful for their assistance. I somehow managed to have my X-ray and found my way back to A & E where I was told to waiting in the waiting room where I was reunited with my wife. The walk around the hospital had taken its toll on me and by now I was not really aware of what was going on. My wife tells me that after a few minutes I was taken back through but not to A & E but through to the adjacent paediatrics department and placed in a cubicle. I belief that the A & E depart was full and so they were using this area is an overspill area.
Nobody came to see me in this cubicle and nobody even passed for over 30 minutes, by now I had been in hospital for almost 2 hours, I had not seen a doctor and not given anything, no nebulisers, nothing! My wife was becoming more concerned as I appeared to be struggling more and more. She decided to walk round to the A & E department and ask for some assistance. A doctor quickly arrived and after reading my medical card and listening to my chest decided that I had no or little air movement at all. He prescribed back to back nebs, oxygen and arranged for my blood gasses to be checked, surprise, surprise!
The nebs and oxygen helped slightly, the blood gasses confirmed that I was having problems and it was decided to move me into the actual A & E ward where I could be monitored more closely. I was taken on a trolley as I was not considered well enough to walk!
My breathing was not getting any better but at least it was not getting any worse. Numerous doctors and nurses came and went and another couple of hours passed by, still on back to back nebs I was now becoming dehydrated and was shaking badly. I was given IV fluids and finally 5 hours after requesting them I was given IV magnesium. Mind you that neatly didn’t happen as there were no drip stands available. The nurse decided on a makeshift stand by fastening the bag to the curtain rail with a bandage!
The magnesium started to help and I slowly began to feel slightly better, just a shame that it took so long to give me some. I was told that I was going to be admitted, no shock there, but was told that the waiting time for a bed was in excess of 24 hours! By now we had been in for something like 7 or 8 hours and was now sharing a cubicle with another patient due to the shortage of space. My wife went for a coffee and on her return told me that it was like a war zone outside, people were receiving treatment on chairs and trollies in the corridors and in the waiting room.
The registrar from the intensive care unit came to see me, he would return a couple of times before it was decided that I had stabilised enough to not need ICU. That was a relief and probably helped speed up my eventual transfer to the ward. By now we gaff beenin hospital for over 13 hours and I was now borderline HDU (high dependency) or AAU (acute admissions). The doctor came to see me again and I told him that I felt well enough to not need HDU (purely on the strength that I new I would get a bed quicker on AAU). The doctor who had reservations agreed. Within 20 minutes the nurse came and we were on our way to AAU. Not too bad compared to some people who were waiting much longer than me, I had a bed within 14 hours.
As it turned out, going to AAU was probably the wrong decision as I was to end up in HDU anyway but at the time I was just desperate to get out A & E and onto a ward. The biggest joke though was that a couple of bays were closed on AAU due to cut backs, yet people were waiting in excess of 24 hours for a bed and in the meantime receiving treatment on chairs in corridors!
I will write about my experiences of this latest hospital admission over the coming days but this day on A & E was not a pleasant experience for a number of reasons, some my own fault, some beyond my control.
I’m sure had I rang for an ambulance I would’ve received quicker care but as I was a walk up, my condition was not considered serious.
The fact that I was forced to walk for an X-ray was a disgrace, as was the way I was treated by the nurse who first saw me and ignored everything that I said.
The fact that it took so long to be given nebulisers and oxygen was potentially becoming serious, had my wife not complained I would probably be sat waiting now!
To leave somebody with breathing difficulties on an empty paediatric ward without checking on them or at least providing an emergency buzzer is worrying.
The delay in taking blood gases and giving me magnesium is disappointing.
With the exception of the poor attitude of the nurse who I first saw, virtually everybody else were first class, they were over stretched and over worked. The problems resulted from not enough beds, not enough staff (doctors, nurses, carers or porters) and not enough equipment (drip stands) . Ultimately it appears to be all about money and planning !!!
I know that I am not alone in my concerns about A & E departments, if you have any comments or experiences yourself (good or bad) please leave a comment or get in touch on twitter.