"Lengthy wait in the Emergency Department"

I was referred to the ED at FVRH by my GP at the end of February. I presented to my GP with a 6 week history of saddle numbness, bilateral leg weakness & intermittent loss of power to both legs (legs had collapsed under me on a number of occasion in the preceding 3-4 weeks). My GP contacted the on call orthopaedic doctor (ortho) who advised I present at ED and advise I was an 'ortho expect case'.

I presented at ED at approx 10:15hrs. I was triaged as normal to await the ortho review. I was taken to a bay in the treatment  area at approx 11:45, where a detailed history and examination was undertaken. This included blood screen, bladder scan and referral for MRI. I was taken for my MRI and returned to the ED at 14:00hrs to await the result/diagnosis from the MRI.

After a further 3hr wait, at 17:00 the same ortho doctor came to tell me that they were waiting to hear back from neurosurgery in Edinburgh re the treatment/management plan. They proceeded to tell me that the MRI revealed an abnormality which would need to be reviewed by neurosurgery. I was advised that I may need to be transferred as an urgent through to Edinburgh or alternatively they may opt to see me as an outpatient. I was advised that I should hear within the hour what was happening.

After a further 2hrs waiting until now 19:00 I asked for an update. There was still no news from neurosurgery. I waited another hour before again requesting an update, there was still no feedback. At this point I urged the nurse to pursue this for me as I had now been in the department for over 9 hours. Aside from my growing frustration I was aware I was occupying a bed for all of this time.

Eventually after 10hrs 30mins since I presented at ED, at  20:45 another ortho doc (due to shift change) came to give me some feedback. They proceeded to tell me that I could go home and that I was being referred to physio. You can understand my confusion and dismay at having being retained in ED for all of this time to be given this advice. I had a mix of concern and confusion based on the original advice and apparent concern by the doctor to the effect that I may require urgent transfer to neurosurgery or at least be reviewed by neuro as an outpatient. Least of all the dismay at having to wait ten and a half hours for this final decision to imparted.

My frustration, anger, disappointment , disgust and lack of faith was further fuelled by the additional advice I was given by the new ortho doctor. They proceeded to tell me to take analgesia for my back pain or for my sciatica, neither of which I have. Clearly this doctor had made no effort to acquaint themselves with my presentation history. I eventually said that I had been here for over 10hrs to be told I need physio.  Their response was that at least I had had an MRI.  I appreciate having had the MRI scan so quickly but I found their tone to be sarcastic and not they way to emphasise this!

Equally I am glad that I am not someone who is of nervous/anxious disposition as this experience would have been particularly stressful / distressing to such an individual and makes one realise why people/patients verbalise their anger and frustration.

This experience has made me question and doubt the processes within ED whereby patients are subjected to what I would consider unacceptable lengthy waiting times. There must surely be scope for improvement within and across such processes that would facilitate improved patient journey, more effective and efficient coordination and use of resources.

I would just like to add that as a health care professional myself I am aware that there can be numerous issues which may cause delay and complexity within the ED care provision however, I consider there are lessons to be learned from my experience from the perspective of the Emergency Department. I would also like to take the opportunity to say that the nursing staff were sympathetic and empathetic about the waiting time I had been subjected to and did their best to mitigate the situation.