"Treatment in A&E"

The patient is a 75 yr old gentleman with dementia, fragile health due to multiple co-morbidities. He was attending A& E as his main carer had been ill and in 3 weeks he had deteriorated rapidly, wasn't eating, become a more extreme falls risk, couldn't get out of flat where he lives alone, hadn't had food to eat, had lost a great deal of weight. Although SS had been alerted that was ill an unable to look after him - they merely asked who would be looking after him - I told them there was no-one. No care plan was provided.

In the three weeks he had developed intermittent pyrexia that appeared to correspond to a return of cellulitis in his left elbow for which six weeks prior he had been hospitaised for 1 week and given intensive antibiotic intravenous treatment. His elbow is extremely painful, limited in movement, red, swollen, skin mottled and patchy above and below the elbow joint. I was concerned that he might be developing sepsis and took him despite recuperating from my own illness and feeling very unwell myself, in his wheelchair to A& E at 7pm on Saturday.

We were triaged promptly by a disaffected nurse who barely listened to our concerns and who did not even examine the injured arm. We were told to go and wait in the waiting room again which we did. The patient was feeling increasingly unwell. Apparently there was a major incident at some stage and we saw armed police enter Waiting area. We waited and waited - we saw and heard other patients being called in the usual NHS way of first name last name. We did not hear his name called in that manner at all. At one stage a very sloppy unprofessional looking 'nurse' stood at the door and said a first name the same as the patient's. We wondered if that his 'call' but decided they must have been talking to a colleague as we expected a professional call we did not think it was for him - apparently, as we found out much later that was his 'call'! ! ! After 2 hrs I checked with reception to be told he was not on the list as he had been called three times and had not responded. They said they had put out a tannoy  call - neither of us heard his name on a tannoy.

I asked to see the Manager and was told they were involved in the major incident. I asked to see who was next in line and was told there was no-one. I was extremely angry and the patient was becoming very agitated, frightened and very unwell, begging me to take him back to his flat. We were told he had to be triaged again and we would have to wait 2hrs again if we wanted to see a doctor.

He was finally triaged again by a nurse who insisted he had been called three times and who was not prepared to try at all to resolve the confusion and distress we were experiencing. They were passively hostile to us, and made no attempt to assist me with the wheelchair although I was obviously struggling due my own poor health. They DID actually manage to examine his infected arm and told us to wait again. I parked his wheelchair directly opposite the door to Cubicles. Someone came to the door and said his full name, and took him for bloods.

The initial 'sloppy' nurse who had said a first name came into the cubicle. They went to his infected arm and tapped for a vein. I advised that as that arm was infected blood should be drawn from the other arm, whereupon they took his sound arm and drew blood from this non affected arm. We were sent back to wait - for another 2 hours. On several occasions he nearly fell out of his chair as fever exacerbated- he needed to lie down so I tried to make him a bed of our coats on empty chairs in the waiting room. He was cold and frightened.

I had just got him settled when he was called in a professional manner that we both had no trouble hearing and he was at last allowed to lie down and saw a competent doctor at 11. 00 pm (4 hours after our arrival in A& E)- the nurse who looked after him was highly professional and caring. I heard other nurses referring to him as "Mr......" I experienced this as sarcastic and demeaning. The whole 4 hour experience up to that point was grossly unprofessional, anxiety provoking and in no manner treated the patient no myself the Carer with basic dignity nor respect. The staff at A& E have a duty of Care to all patients and are paid to manage all incidents 'minor' AND 'Serious'. This patient has been kept in Hospital. It is thanks only to chance not medical 'care' that he did not develop sepsis and die in the waiting room at A& E due to gross negligence of the staff. Basic training and skills in professional behaviour are, in our experience, once again slipping VERY badly at TGH. It was as bad last night as when it was in special measures.