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"Inappropriate triage for someone in acute pain"

About: The Ulster Hospital / Emergency Department The Ulster Hospital / General Surgery (Ward 3D)

(as a friend),

I brought my best friend/colleague in Ulster Emergency Department (A&E) around 8:30pm due to complaints of throbbing abdominal pain. At ED a  nurse examined my best friend and finally her obs and bloods were done. Around 2am, the pain got worst so I asked the receptionist when will my friend be examined by a doctor, but I found the receptionist to be not-so-accommodating, they said that they cant do anything cause there are other patients who came before us. They even told me to buzz on door we needed pain relief.  

I felt hopeless that time, cause I couldn't do much. My best friend took all sorts of pain relief, from Paracetamol, to ibuprofen to Co-codamol but it did not make any difference, the throbbing pain is still on-going. As a nurse myself, I believe I know the type of pain my colleague was experiencing cause she used to have a high pain threshold. I approached one of the nurses in ED cause I was a bit worried and they told me that their system is usually like this and my best-friend has to wait cause her flimsy note was placed almost at the bottom of the listing. ( I wonder how my best friend was assessed for triage?).

I have seen doctors in that area assessing other patients who were very mobile, not acutely-ill and most of them ended up discharged to home. New shift came around 7:30am, new receptionist was assigned. Then I asked when is the estimated time that my best friend will be seen, they said that there were at least 3 people before her. 9am came, my friend was still in agony, and asked me to just go home so she can sleep. I insisted to stay cause I knew something was not right about her condition.  

We waited and waited until past 10am. My best friend's name was called. On examination, the doctor suspected something suspicious in my friend's right side of tummy, they said maybe her pancreas or gallbladder is affected. So, the doctor requested for USS Abdomen and they also said that my best friend has to be admitted (finally).

As her Next of Kin, I was emotional and worried since we are just foreign here and away from our families. We have then waited for a bed while not having breakfast nor lunch cause she has to fast for USS. Around past 4pm my best friend was eventually sent to the ward, admitted in a bay with other patients. The USS was rescheduled to the next day. My best friend did not get a good sleep on the first night due to fever and painful tummy. Also, another patient on the same bay was in pain hence there was no peaceful night.

The next day came and my best friend had her USS done. They found out that her gallbladder was very swollen (cholecystitis). Luckily, the staff of the Surgical Ward were very helpful and managed to transfer my best friend in a side room. I really felt sorry for my best friend for all the experiences she had.  I am hoping that the delay of assessment and poor triage in ED did not make her condition worst. 

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Responses

Response from Jennifer Nicholson, Lead Nurse - Emergency Care, Emergency Medicine - A&E, South Eastern Health and Social Care Trust 4 months ago
Jennifer Nicholson
Lead Nurse - Emergency Care, Emergency Medicine - A&E,
South Eastern Health and Social Care Trust
Submitted on 28/12/2023 at 11:31
Published on Care Opinion at 11:31


Hi purple sky

Thank you for providing feedback about you and your friends experience while attending the Emergency Department. Triage follows a regionally recognised framework to categorise all patients depending on information given at the time and clinical information from the observations completed such as blood pressure and pulse. This will assign the patient an appropriate category.

There are a number of streams within ED, paediatrics, minors, majors and depending on numbers in each stream some may be seen quicker than others. Although mobility is not a sign of how unwell a patient may be.

As you indicated you are not from Northern Ireland you may not be aware of the well-publicised significant challenges our entire healthcare system within Northern Ireland is currently facing. As an organisation, the South Eastern Trust is experiencing severe pressure on our hospital services, this is particularly felt overnight as our medical staffing drops down to minimal levels and with unprecedented pressures due to high attendance levels and overcrowding within ED, resulting in a high volume of patients waiting for prolonged periods of time in ED for placement in a ward bed. Overcrowding is a cause of great concern, not only to patients and their families but also to the staff working in affected units.

I do hope your friend is making a full recovery and pass on our best wishes.

Kind Regards

Jenny

ED Lead Nurse

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