"Frightened about the quality of care available in A&E"

I was sent to the Royal Devon and Exeter Hospital by an ambulance called by the duty doctor via my G.P. practice.

I had total hip replacement surgery at the Nightingale Hospital in Exeter on 3 days previous. I developed a high temperature and low SATs and the duty doctor considered I needed to be in hospital to check for possible post operative infection or potential pulmonary embolism.

The ambulance arrived within an hour and the crew members were kind and professional. I was given oxygen in the ambulance. On arrival at the hospital the crew explained we would need to wait in an overflow carpark as we were one of 16 ambulances waiting outside A and E.

As I was only 3 days post op, I was experiencing considerable pain from my wound, especially since I was lying on a narrow, hard ambulance trolley. One of the crew, went in search of an inflatable mattress topper, which made the wait much more bearable.

After about three hours, I was taken into the A and E department and transferred to a wider trolley bed. I was then taken back out of the department by another ambulance crew and back onto an ambulance! It transpired that my first crew had finished their shift.

The wait continued for another couple of hours, until I was transferred back inside into a corridor queue. The second crew were as kind and professional as the first and both did regular basic observations, I had some pain relief and the oxygen continued.

In the early hours of the morning, my bed was moved into a bay in A and E and I was handed over to A and E staff. A doctor arrived to take a brief background history.

It is at this point that I feel my care became so bad as to require reporting. A nurse arrived with an observation trolley and attached a blood pressure cuff , SATs monitor, and ECG electrodes. I believe they took my temperature. They said they had to ask me some questions. The bay was open and no curtains were drawn. They asked, in quite a loud voice, whether I had ever had one or more traumatic abortions. They then asked a few general questions around smoking and allergies. Then they asked me if I was safe at home. I was hesitant and they asked loudly if I was worried about abuse? I replied I wasn't and they then asked me what kind of sandwiches I would like. At that point I didn't even have any water!

They fetched equipment for putting in a cannula and taking blood. They began this process without any explanation or warning. Their first attempt was in the back of my left hand. They struggled to insert it for several minutes and a great deal of blood began to run down my arm. Then I felt a very intense pain in my hand, and when I looked down, the cannula had gone into my hand and back out again just above my wrist!

I told the nurse it wasn't right and very painful and they turned round and called out to several colleagues, none of whom responded. They then told me they didn't usually work on A and E and was unfamiliar with that type of cannula. They pulled it out and then came back with a different type which they tried, and failed to put into my left hand. The nurse then left. By this point the blood pressure cuff had fallen off onto the floor and the monitoring equipment was emitting a constant loud beeping, which was ignored by all staff. As was I. 

I felt shocked and frightened. I knew that I had been sent as an emergency with a temperature and SATs that were suspected of being potentially very serious post operative complications.

By that time it was seven hours since the ambulance first arrived at my home. I felt complete confidence in the ambulance crews, just sorry that the system was letting them and me down. But once in A and E care seemed chaotic and disturbing.

Eventually I shouted out to a passing nurse and explained what had happened. They seemed unaware that my blood tests had been abandoned, and told me my experience was typical of today's NHS. But from then on my care became more reassuring - I had regular observations and a doctor arrived and fitted a Venflon, which was later used for I.V. antibiotics.

I remained in hospital for three days and was eventually diagnosed with pneumonia, having had a CT scan to rule out PE.

However, although the care on the Acute Surgical ward and subsequently on Lowman ward was acceptable, no thought was given to the fact that I was a post op surgical patient. My wound was not inspected at any stage, except during one visit by my orthopaedic consultant. I kept asking for crutches so that I could go to the toilet by myself, but was only given some on the day of my discharge. I ended up sharing a walker with the patient in the bed opposite! My bed had a broken electronic adjustment system so I found it really hard to get in and out. I only saw a physio on my last day and they weren't an orthopaedic specialist so couldn't answer some of my questions definitively.

I have had many experiences, poor, adequate , good and excellent with NHS care during my lifetime, but this was the first time I have ever felt really frightened about the quality of care available