My nose started to bleed yesterday, first from one nostril, then from the other. It wouldn't stop in spite of pressure for ten minutes, then twenty, then thirty.
I'm in my seventies and on two blood thinning pills because of a complex blood disorder which makes me liable to get blood clots. I normally test my blood to check the dose I'm taking is right but my machine was broken. I was worried the problem might not be my nose but my bleeding had got out of control and I might be at risk of intestinal bleeding (which has happened before) or a stroke (which hasn't).
So my wife and daughter took me to A&E at the Whittington Hospital. At first we were shocked by how crowded it was (possibly 50 people waiting at 11am and more arriving all the time). The triage nurses had almost no space to work in. The waiting room was cramped and the automatic doors to the outside were broken so the reception area and receptionists were freezing. We were told I might need to wait for several hours. I work in the NHS myself so I realise how short of resources it is now and how much pressure everyone is under.
In spite of this, triage nurse we saw (Kate) responded incredibly well. When I explained what had happened she understood straight away and arranged within minutes for me to go through to the urgent care centre and have some blood tests. A nurse called Mirella saw me and was cheerful and kind and very skilled. She told me she was several hours into a twelve hour shift. She took my blood and put a cannula into my hand.
Then she took me round to a cubicle to wait for medical assessment. From there we watched doctors and nurses at the staff station as they came and went seeing other patients. They were all obviously being calm and efficient and above all good-humoured with patients and each other. After another hour or so my nosebleeds stopped (four hours after starting). They asked if we could go back to the waiting room as they needed the cubicle for someone more urgent.
We had to spend nearly another four hours in the waiting room, which was more crowded than ever. But here's what really impressed me. I watched the receptionists and triage nurses deal with new patients as they arrived, and with patients who had waiting a long time who were frustrated or cross or (in one case) rude. They all remained fantastically calm and helpful.
I inquired two or three times if they knew when I would be called back into the urgent care centre for my medical assessment or if my blood test results were back. They checked each time on their computers each time. Eventually my results did come back and they told me so I knew I wasn't in danger.
At 5pm (six hours after our arrival) I was called through to see an advanced care practitioner (ACP) nurse called Harriet. She couldn't have been more thorough or kind. (I told her I work for the NHS organisation that provides training for ACPs but I promise you she was lovely even before then!). She gave me lots of useful advice and told me I didn't need any further treatment.
Here's the conclusion. If you had told me the previous day I would have a health scare and would spend six hours in a casualty department, I would have expected it would be a horrendous experience. Well it could have been, but it wasn't because (a) the triage was done so quickly and expertly so I knew at once I was in a safe place (b) all the staff I saw were so obviously well trained, efficient, kind and working incredibly hard (c) they handled all my questions and my anxiety patiently and respectfully and I could see they did this with everybody.
Incidentally, I teach interactional skills to health professionals for a living (and write books and articles for health care journals about this). I have also worked in organisational consultancy in the NHS and often done observation exercises of people and teams working there. I know a good department when I see one, even (or especially) in very hard pressed times like these with a government that thinks it's more important to give handouts to billionaires than to pay nurses and admin staff decently. I think the Whittington should be really really proud of their A&E team. Thank you everybody.
PS. It was freezing the whole day and I spent most of it standing near the entrance, but I came home to find our back garden covered in snow with foxes romping around it. Happy Christmas and festive season to all.