"Pain relief in A&E"

Unfortunately, my experience was the worst I have ever experienced. I am in my thirties and  have a chronic and severe skin condition. I developed an infected abscess in my armpit earlier this week and was prescribed medication by my GP. However by Friday evening the abscess had become more swollen and infected and I was advised by NHS24 to attend DGRI A&E.

I arrived at A&E on Friday evening with what I believed to be a seriously infected armpit. This was due to an abscess the size of a golf ball growing inwards due to scar tissue blocking any sinus tract development. This armpit has already been heavily operated on several times in the past. At around 7:40pm I was greeted by one of the A&E doctors who escorted me to a minors room with a bed with no pillow or blanket (cubicle 4G). I showed the doctor what my issue was. It was very painful to move and lift my arm.

The doctor examined me and I was offered two paracetamol. I explained to the A&E doctor that I had already taken painkillers  just prior to my arrival (about an hour and half ago). The doctor explained that they would like to start me on IV antibiotics and have the surgical team assess my armpit. They cannulated me and then left the cubicle.

I tried to get comfortable on the bed but unfortunately couldn't not achieve this. A really nice Auxiliary Nurse came in and took my clinical observations. It was found I was pyrexic and had tachycardia. I was wailing loudly in agony with my armpit pain. It felt like a hot knife stabbing me constantly and I was feeling delirious, nausea, freezing cold whilst radiating heat. I was offered paracetamol which I took however I asked for something stronger in addition as the pain was 10 on the pain score chart. I was given pain relief but this did not reduce my pain.

My wife arrived around 9:30pm and saw that I was in severe pain. She asked nursing staff in A&E what the plan was as I had not received any antibiotics yet and my pain was not under control. An Auxiliary Nurse came in and offered me paracetamol again however I declined this as I had just taken some from the Nurse.

The Auxiliary nurse took my clinical observations again however I can't remember what these showed as I was in pain, cold and shivering. The Auxiliary said that there was a bed available in ward D9 at 11:00 pm. Unfortunately, I did not see any doctor again whilst I was in A&E and was not started on IV antibiotics until I was in ward D9.I did not see another Doctor until I was transferred to ward D9.

Overall I was in DGRI A&E department, which didn't seem overly busy, for up to 4 hours with no support offered for positioning for comfort, no step wise approach to pain management.  I was left with the door closed in significant pain.

I was transferred to D9 where the surgical team and nurses team took over my care, immediately noticing I was very unwell. I was given IV medication to good effect. The new doctor in the morning on D9 came to visit and advised I was to take pain relief on the hour which I tried. Unfortunately, this did not help with my pain and I was still significantly hindered by pain.

I kept buzzing the nurses to ask for something stronger but was told the doctor only wants me on the prescribed medication. I asked to speak with the doctor at their earliest convenience. This took over 2 hours. During this time my pain had significantly worsened.

I left my room to find help. I saw what I believed were two gynaecology doctors on D9. I was nearly doubled over in pain. I asked these two doctors for help. One doctor asked if I had chest pain as I was clutching my arm, I replied no my arm is in agony it is badly infected and please help me. The other doctor just stared at me and did not speak and they both went back to typing. I was flabbergasted. I turned around and put my shoes on and stated I was leaving as nobody is helping me. The doctors continued to stare and shrug.

A nurse approached me and explained I was very unwell, and need treatment and that my surgery will be soon. I was supported back to bed feeling delirious again. Another hour had past with no more pain relief when the Doctor arrived to see me. I argued that not enough has been done. I asked why I was being left in such significant pain. I explained I can't stop yelping from the pain. The doctor said yes we can hear you. The doctor in D9 was adamant I remain on the hourly pain relief even though I said again, they were  not working. The Doctor finally gave in and allowed me to have IV medication .

During the day before my surgery I was left alone in my room across from the Doctors top station. Unfortunately yet again wailing in my room severely in pain and delirious as the pain relief had worn off. I was offered a further 2 paracetamol.