"This has affected my confidence in the A&E dept"

Recently around 2am I was admitted via ambulance to A&E at Hairmyres hospital, I have several concerns around the level of care I received and the way I was treated there.

Back Story.

I had been suffering severe dental pain for a few days which I was able to self manage until I re-registered with a dentist as I had just moved to the Lanarkshire area. However, the day before I went to A&E the pain got progressively worse to the stage I couldn't eat or sleep and was effecting my daily life work etc. The worst pain occurred around 7pm at night so I decided to dial 111 and use the NHS24 service for advice, after speaking with a dental nurse over the phone the decision was made that I should be booked in to the Dental Hospital for Greater Glasgow & Clyde located on Sauchiehall street. My appointment was made for that evening at at 8:30pm. The dentist who treated me decided the cause of pain was a root of a baby tooth that was imbedded in my gum next to a tooth in my opinion was causing the pain- she removed the piece of root. I explained my concerns that I believed that it was the back right molar that was causing the pain (as a part of my filling had fell out two days ago)  after she removed the root I still was feeling a lot of pain.  She proceeded to tell me my gum was infected due to the root and I should see a dentist in the morning who would re-fill the tooth and give me a course of anti-biotics.

After my emergency dental treatment I returned home that evening took some pain killers and decided to try and sleep ( for two nights I hadn't slept and I was exhausted). I was awoke with severe, chronic pain in my mouth worse than before, I was in so much pain I was screaming into a pillow as I simply could not cope with that level of pain.  I began vomiting, felt feverish, shivering and was walking around in a daze due to the constant pain, at this point I was very concerned due to the infection in my mouth and the level of pain I was suffering. I called my dad who is a paramedic for advice and he called NHS24 on my behalf due to his concern. I then spent an hour on the phone to call handler, dental nurse and then a general nurse. The nurse decided that due to the level of pain I was suffering and my symptoms of vomiting, fever etc that an ambulance was needed- she arranged the ambulance. 

The ambulance arrived around 12am. When they arrived the pain was getting worse & I was vomiting and feeling extremely dizzy. They took my blood sugar which was showing very low and gave me a glucose gel to ingest to increase my blood sugar. The paramedic put a cannula in my arm to administer a drug that would stop me vomiting. He took my heart rate & blood pressure which was high- he told me this was because of the level of pain that was causing me extreme stress. He then decided to give me a dose of morphine which would hopefully control the level of pain I was going through ( I explained I had never had morphine before but was happy to take it to decrease the pain I was suffering). He explained they were going to take me to hospital where although they can't act directly on the source of my dental pain but would monitor me due to my symptoms and help manage my pain. I was very thankful I was going to hospital as I could not function to due my fever symptoms and level of pain I was suffering. 

Around 1am I arrived at the A&E department.  Even after 3 x doses of morphine I was still suffering an extreme amount of pain which I made clear to the paramedic who wheeled me in. The charge nurse told the paramedic to sit me on a chair located between reception and the nurses/doctors station in A&E- at this point I was drowsy due to the morphine and in a lot of pain. I found it difficult to stay upright on the chair. I was left sitting on the chair unsure what was happening I felt that I was ignored. I over heard nurses chatting at the station saying things like ' is this a dental hospital now' ' not a real emergency' etc. This made me feel extremely uncomfortable and uneasy at the level of care I was about to receive, I felt that they didn't care about the pain I was in and the level of fever symptoms I was experiencing, I found it extremely unprofessional and insulting . After about an hour of sitting, I could not stand the pain & forced myself up to approach the nurses station asking how long I was going to wait, one of the staff responded with ' we are waiting for a bed' and no point was I asked if my symptoms were worse. I contacted  my mum at this point who is a also works in the health service, she was very concerned at how I was left sitting without being approached by a nurse as this was my first time I had ever taken morphine and I should be monitored. 

Eventually, a nurse showed me to a room helped me on a bed & hooked me up to be monitored. I asked  why I was mocked and that I overheard the whole conversation about me while sitting waiting & that I felt I wasn't being treated with respect. The nurse responded with ' it wasn't directly at you' and then proceeded to ask what score my pain out of1- 4 was & I told him 4 that I was in extreme pain and felt sea sick. The nurse took notes and then left me in the room. They returned and told me I was to be given more morphine to help with the pain but seemed totally uninterested in me as a patient. An hour later, I was still in pain and the nurse popped in to say a doctor was going to see me to administer an anaesthetic as a block to the pain and that I was next on the list and shouldn't be waiting too long. At this point I was feeling very unwell ( I hadn't eaten or drank anything in 48 hours). 

After two hours the nurse hadn't come in to see me and the doctor was no where to be seen, I began to worry that I was forgotten about, the morphine had worn off and the pain was very severe. A nursing assistant came in and asked if anyone had seen me I explained that the nurse told me two hours ago that a doctor was going to administer a pain block & I was next on the list. The nursing assistant apologised to me and said they couldn't believe no one had been in to see me yet.  The nursing assistant told me that she was going to raise this with the charge nurse & get a doctor to give me some pain relief as she could see the level of distress I was in. Shortly after this a another nurse came in to ask how I was I explained I'm in a lot of pain and a nursing assistant was going to get a doctor to help block the pain. I felt that this nurse's attitude towards me was shocking.  They stated "listen it's a dentist you should be seeing", that they deal with emergency situations and the doctors have more priorities to deal with. I then stated it was the level of pain I was suffering was the reason that I was brought via Ambulance to A&E and I had already followed the correct procedures of seeing a dentist at the dental hospital earlier that evening and I had severe pain & fever symptoms after my visit, I explained I had been here for 3 and a half hours and that if a doctor didn't see me I was going to go home but I would be complaining about the level of care , in a huffy manner the nurse left me in my room. 

The nursing assistant returned half an hour late with the first nurse that seen to me. They explained that there were two emergency situations where both doctors on shift couldn't leave their side. I accepted this as obviously life or death situations move me to the bottom of the priority list. However, if it wasn't for the care of the nursing assistant I would of been left for hours without any pain relief or explanation as to why I wasn't being seen to.  The nurse then administered more morphine and explained the doctor would be in to see me. 

An hour later the doctor and a paramedic came in to see me.  The doctor was very abrupt telling me they had emergency situations to deal with.  The doctor explained they did not have dental facilities. I explained I was aware but I was brought to A&E due to the pain explaining my pain score was 4 and I couldn't sleep or function due to it & the paramedic who brought me in agreed this should be managed in hospital. The doctor then administered the anaesthetic into my mouth and monitored me for 15 mins to make sure I did not have a reaction. The pain extremely decreased and I was so thankful for this injection, I felt I could function again.  She explained my mum had called 'about 3 times' I  explained due to the length of time I had been here my battery ran out and that I asked if anyone had a charger no one responded. She prescribed me anti-biotics & painkillers. I phoned a taxi from reception to take me home as I had been up the whole night and was exhausted.

In conclusion, I was a patient in extreme pain showing fever symptoms from a gum infection following an emergency dental procedure during a time of night where no dental services were available. I was admitted to A&E via ambulance where the paramedic agreed I should be admitted to hospital as it was clear I could not self manage the chronic pain and this was causing me to be in stress. I was spoken about in a disrespectful manner in ear shot, ignored & my pain levels were diminished by the medical staff within the A&E department. I had followed the correct procedure for extreme dental pain, NHS24, Dental Hospital, NHS24, Ambulance, A&E. I felt because the source of the pain was dental that they washed their hands of me.

I spent five hours in A&E feeling ignored and belittled. I feel if it wasn't for the excellent care of a nursing assistant I would of been there for another 5 hours left in a bed without anything to help manage the pain and distress I was under. I am head of a customer services department and if a member of my staff spoke to a customer the way I was spoken to/about that would be gross misconduct.  I believe the duty of care to a patient experiencing high volumes of pain was not adhered to. This has effected my confidence in the A& E department at Hairmyres hospital and if I am unfortunate enough to be in an emergency situation in the future I will be refusing to receive treatment from that department.