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"Patient experience of the emergency department"

About: Craigavon Area Hospital / Emergency Department Craigavon Area Hospital / Radiography services

(as a service user),

I attended CAH ED a few weeks ago. On arrival the reception staff having received communication from my GP automatically prioritised my care. This was excellent and reassuring. During my 9 hour stay I had numerous investigations and interacted with different staff and departments. The following are some of the things I wish to share to support improvement of patient experience and safety and are not meant as a complaint. 

- I was cannulated and bloods taken twice in the blue area corridor in full view of others and whilst sitting elbow to elbow with other patients despite the plaster room being free. Two or three other rooms had Do Not Use signs up. 

- cannulation tray was set on the floor and items lifted from floor level. On reflection this could not possibly meet infection control measures?

- I was told I needed an x-ray. I was already seating outside x-ray door. Approx 30 mins later a nurse asked me if x-ray knew I was waiting. I replied I hope so. Nurse went into the room and on return said, they do now.  I was taken straight away. Approx 5 staff were in the x-ray room. Should the x-ray staff not be alert to patients needing to be seen? 

- I had to wait on a porter to take me to the CT Scanner. I was able to walk but the porter said if I didn't go in the porter chair I would have to stand as there were no chairs in the scanner dept. This was a waste of staff time and resources and delayed me attending 

- in the blue area the nurse shouted up the corridor (common practice) and pointed "you". All seated patients asked if the nurse meant them. Nurse continued to point and reply until everyone else had replied, and I realised it was me they were speaking to.

- staff mainly stayed in the notes room, only stepping out to shout up the corridor instructions e.g. CT scanner porter is on there way. Everyone knew everyone else's care. No confidentiality was maintained 

- Prior to discharge a Doctor told me I was being red flagged for Ultrasound Scan and the reason why. This was told to me sitting elbow to elbow with other patients. I was extremely annoyed at this behaviour which was appalling especially given again the plaster room was free. More bloods were taken but I did not know why. My care was not explained and I left the unit not knowing what was wrong with me. The upset of being spoken to in front of others  I appreciate was a further contributing factor to my confusion. I had to phone my GP the next day to unravel my diagnosis and plan of care. My GP was excellent, patient and reassuring, and communicated clearly to me. 

- In ED there was no oversight of care or anyone coordinating stages of care, moving treatment/patients along hence managing attendance levels and patient experience and safety.

- Most staff did not introduce themselves. Staff in various coloured bought scrubs, pink, green, blue etc. One person in jeans, one in track bottoms. Causes confusion as to who is who (regardless of professionalism and infection control) Staff with long painted nails. 

- appreciate it is an aging building but very poor ventilation 

- the unit was noisy because of staff calling out names and instructions that everyone could hear. Could buzzers not be purchased and staff walk to the patient to converse? 

-I was not allowed to leave the unit but yet no food or fluids were available/offered. Appreciate some people may need to fast but again this could be managed and a water station at least put in place. I'm sure there is plenty of research on dehydration and health outcomes yet within a few hours of being in the hospital patients are on the wrong path. One man asked for coffee and was told to buy it. He had no money and was advised not to leave the unit. Was told if he spoke nicely to someone they might make him a cup.

I do not believe anyone intentionally sets out to cause harm or upset. I appreciate CAH ED is a busy unit but staff did not appear to be rushing about manically providing care. Yes there are long waits but there always has been in ED. Is the ambulatory unit always staffed to ease the pressures in the main ED area?  Yes room is limited but there was free spaces. 

My fear is staff have accepted a lower standard of care as the norm and therefore it is now acceptable to treat and give diagnosis in corridors. Please do not use the excuse space is limited. This behaviour is never acceptable, and as stated rooms were free. My grave concern is staff have become desensitised. I hope that there is actions from care opinion stories and not just the sharing of a story with no meaningful actions and monitoring. 

Do you have a similar story to tell? Tell your story & make a difference ››

Responses

Response from Ann Tate, Lead, Radiography services, Southern Health and Social Care Trust 2 weeks ago
We have made a change
Ann Tate
Lead, Radiography services,
Southern Health and Social Care Trust
Submitted on 07/05/2024 at 09:27
Published on Care Opinion at 09:27


Thank you for highlighting your experience in ED

We strive to provide timely and efficient care to all our patients.

We are reviewing how referrals are sent to us and identifying any potential delays.

Signs had been removed due to renovations and these have now been replaced. These instruct patients to alert a staff member if they have not been called within 20 mins.

We are a teaching department and consequently have students on a daily basis and new staff being trained in relation to equipment. Unfortunately during the time of your visit the second X-Ray room was being serviced.

It is always important to have patient feedback to improve our services

Thank you again

Ann Tate

Principal Led Radiographer

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Response from Paul Smyth, Interim Head of Service Emergency Departments, Acute & Emergency Medicine, Southern Health and Social Care Trust 2 weeks ago
We have made a change
Paul Smyth
Interim Head of Service Emergency Departments, Acute & Emergency Medicine,
Southern Health and Social Care Trust
Submitted on 07/05/2024 at 11:03
Published on Care Opinion at 11:03


Thankyou for you feedback which is always welcome and we appreciate the detail you have provided. I will say at the outset that the "blue corridor" is an inappropriate clinical environment. It is a corridor and offers no privacy for users of our service.

Unfortunately, during your time in the emergency department there were no vacant cubicles. The nursing staff have to regularly free up cubicles to allow ambulance staff to handover their patients and to create capacity in the resuscitation room. Once the emergency department becomes overcrowded there is simply not enough space. The cause of the overcrowding is that each day there is a significant number of patients delayed in the emergency department waiting on admission beds. As a last resort the ED staff have to move people out of cubicles onto chairs on the Blue Corridor.

The other rooms with signs saying "Do not Use" are out of commission as a refurbishment is ongoing encompassing those rooms. This refurbishment is to improve the ventilation in the ED. The plaster room was free and could have been used to explain your management plan, red flag scan and diagnosis. The staff do have procedure trolleys that they should have used to bring the cannulation equipment. We have shared your feedback with the ED sister. She will remind staff of the principles of good communication with service users and the importance of trying to maintain confidentiality particularly on a corridor. She will also remind staff to introduce themselves. All the ED nursing staff wear uniforms. The medical staff wear their own scrubs. We are not sure who the staff member wearing jeans was.The Trust has recently re-issued its Uniform Guidance and directed managers to improve compliance.

Each shift has a sister in charge 24 hours a day. They provide the oversight which can be challenging due to the numbers of patients in ED. We also have meals served 4 times a day. Outside of mealtimes staff can ask the support service staff to make tea and toast. We apologize your experience was well below our accepted standard. The sister is using your feedback in her safety briefs as we will improve.

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